Abstract:AIM: To evaluate the therapeutic effect of autogenous conjunctival flap covering on deep corneal ulcer.

METHODS: The data of 14 eyes of 14 patients with deep corneal ulcer who underwent autogenous conjunctival flap covering in China Medical University Eye Center from May 2010 to October 2011 were retrospectively analyzed. There were 6 cases of viral keratitis, 7 cases of fungal keratitis, 1 case of bacterial keratitis. Patients of fungal keratitis were rinsed with fluconazole, patients of viral or bacterial were rinsed with gentamycin before conjunctival flap covering. Part or whole conjunctival flap covering were done according to the size of corneal ulcer. Antibiotics were used for 4 weeks according to different keratitis post-operation. All the patients were followed-up 10-18 months postoperation, corneal ulceration repairation, conjunctival flap survival situation, complications and visual acuity were observed.

RESULTS: Corneal ulcer in all cases cured by once surgery(100%).Autogenous conjunctival flap survived and sticked with ulcer closely 2 weeks post-operation(85.71%), except one case conjunctival flap fell off. The another 13 patients conjunctival flaps became transparent and retracted in different degree in the later following-up time. One recurred case of fungal keratitis three months post-operation was cured by dropping natamysin for 3 weeks. One case complicated with shallow anterior chamber three months post-operation. One case complicated with descemetocele ten months postoperation. One case complicated with glaucoma one year postoperation. All the patients preserved the globe, but vision improved unconspicuously.

CONCLUSION: Autogenous conjunctival flap covering is effective for deep corneal ulcer.But long-term postoperative observation has certain complications.

Abstract:AIM: To investigate the success rate and relevant factors for probing and irrigation in children with congenital nasolacrimal duct obstruction(CNDO).

METHODS: A total of 261 eyes from 235 children were treated surgically with probing due to CNDO between 2005 and 2011. Patients were classified into three groups with respect to age. Group 1(12-24 months), group 2(24-48 months)and group 3(48-120 months)consisted of 131, 82 and 48 eyes respectively. Probing was performed for upper and lower punctum under general anesthesia. Postoperative control visits were performed on 1^st day, 1^st and 2^nd weeks, 1^st and 3^rd months. Success rate and correlation with age were analyzed using Mann Whitney U and Chi-square tests.

RESULTS: The mean age for the 235 patients(122 females, 113 males)was 27.6±10.7(12-120)months. The rates of success after one probing in groups 1, 2 and 3 were 90.1%, 85.4% and 47.6% respectively and the procedure was significantly more successful in groups 1 and 2(P<0.05). Probing was repeated in 53(20.3%)patients and rates of success in groups 1, 2 and 3 were 61.5%, 58.3% and 25.0% respectively.

CONCLUSION: Probing is an effective treatment for CNDO especially in children < 2 years of age. Rate of success decreases with advancing age, but second probing and application both through upper and lower canaliculi are measures that may improve the outcome.

Abstract:AIM: To report a distinct and sporadic case of congenital fibrosis of the extraocular muscles(CFEOM).

METHODS:A case report.

RESULTS: A 3-year-old Chinese boy who presented with exotropia and ptosis was diagnosed with CFEOM. Abnormal optic nerves were depicted by fundus examination, neuroradiology and electrophysiology. Pathological study showed muscle fibers were atrophic degeneration.

CONCLUSION: Our case highlights that CFEOM may have abnormal optic nerve and nontypical eye movement. The pathological study could help to find out the muscle fibers' alterations.

Abstract:AIM:To observe the expression of discoidin domain receptor 2(DDR2)in retinal pigment epithelium(RPE)cells under hypoxia state, the expression of DDR2, hypoxia inducible factor-1α(HIF-1α)and vascular endothelial growth factor(VEGF)in RPE cells under hypoxia state with stimulation of collagenⅠ, discussing the effects of collagenⅠ and DDR2 in choroidal neovascularization(CNV).

METHODS:It was an controlled experimental study, using 200μmol/L CoCl₂ treated RPE cells to establish chemical hypoxia model. The expression of DDR2 in cells was examined after hypoxia 0, 2, 6, 12, 24 hours by immunofluorescence, reverse transcription polymerase chain reaction(RT-PCR)and Western blotting. In hypoxia state with collagenⅠ's(10μg/mL in 50 degrees incubated box )stimulation, the expression of DDR2 and HIF-1α in cells were examined after hypoxia 0, 2, 6, 12, 24 hours by RT-PCR and Western blotting, using enzyme linked immunosorbent assay(ELISA)to observe the expression of VEGF in cell culture supernatant.

RESULTS:After prolonged hypoxia, the expression of DDR2 mRNA and protein were reduced. CollagenⅠcould multiply the expression of DDR2 mRNA and protein in hypoxia as time goes on, it could active DDR2. The expression of HIF-1α mRNA, protein and VEGF protein dropped off in hypoxia state with collagenⅠ's stimulation compared with hypoxia.

CONCLUSION: The expression of DDR2 in RPE cells reduced with time under hypoxia state. CollagenⅠcan activate DDR2 as time goes on. In hypoxia state with collagenⅠ's stimulation can surpress hypoxia induced up- regulation expression of HIF-1α and VEGF in RPE cells.

Abstract:AIM:To observe the influence of drug-containing plasma on the lacrimal gland epithelial cells and the expression of Bax mRNA and Bcl-2 mRNA in Lacrimal gland epithelial cells.

METHODS:Randomly divided the lacrimal gland epithelial cells in good condition into the flavonoid treatment group without androgen cultural(hereinafter referred to as Buddleia flavonoids group), the control group with androgen cultural(hereinafter referred to as androgen group), and the blank group without androgen cultural(hereinafter referred to as the blank group). Total flavonoids with Buddleia plasma, testosterone propionate and blank plasmain were added to begin the interposal. Then, cell models of dry eye syndrome were established. Trizol reagent was used to extract the whole cell RNA. RT-PCR method was used to detect the expression of the Bax mRNA and Bcl-2 mRNA in lacrimal gland epithelial cells, and the results were contrasted.

RESULTS:The Buddleja group and the androgen group inhibited the expression of Bax mRNA in lacrimal gland epithelial cells, compared with the blank group the difference was significant(P <0.01), the expression of Bax mRNA in the Buddleia group is lower than that in the androgen group, the difference was significant(P <0.01), however, the expression of Bcl-2 mRNA in the Buddleia group and the androgen group were higher than that in the blank group, the difference was significant(P <0.01). The expression of Bcl-2 mRNA in Buddleia group is higher than the androgen group, the difference was significant(P <0.01).

CONCLUSION:Buddleja role of flavonoids in the drug- containing plasma androgen levels decrease in cell models of dry eye syndrome can inhibit the expression of Bax mRNA, decrease the amount of the expression of Bax mRNA, and promote the expression of Bcl-2 mRNA, increase the expression of Bcl-2 mRNA. It is possible that the Buddleja flavonoids drug-containing plasma achieve the inhibition of apoptosis by inhibiting the expression of the Bax mRNA and promoting that of Bcl-2 mRNA in lacrimal gland epithelial cells.

Abstract:AIM: To study the mechanism of SiPc(C₃₅H₂₇O₅)₈ mediated PDT on retinal pigment epithelial cell(RPE).

METHODS: hRPE cells were divided into blank control group, laser group, photosensitizer SiPc(C₃₅H₂₇O₅)₈ group, PDT 1J group, PDT 2J group. CCK-8, fluorescent microscopes blue excitation were applied in the experimental groups, and active oxygen level of RPE cell mitochondria and RPE cell apoptosis rate were detected by DCFH-DA.

RESULTS: Different concentration photosensitizer \〖SiPc(C₃₅H₂₇O₅)₈\〗 mediated PDT on RPE had different effects, in which 5 μg/L of concentration had the most serious damage.

CONCLUSION:New photosensitizer SiPc(C₃₅H₂₇O₅)₈ mediated PDT on RPE has certain damage effect, its possible mechanism is that the increasing RPE cell mitochondria reactive oxygen species level caused by photosensitizer \〖SiPc(C₃₅H₂₇O₅)₈\〗 mediated PDT results in cell apoptosis.

Abstract:AIM: To investigate the effect of all-trans retinoic acid(ATRA)on the bystander effect of herpes simplex virus thymidine kinase(HSV-tk)/ganciclovir(GCV)suicide gene system mediated by recombinant adeno-associated virus 2(rAAV2)in lens epithelial cells(N/N1003A)in vitro.

METHODS: The expression of TK gene in lens epithelial cells mediated by rAAV2/HSV-tk was detected by RT-PCR. MTT assay was used to observe the changed bystander effects of HSV-tk/GCV system in N/N1003A cells after ATRA therapy. The effects of ATRA therapy on the apoptotic rates of HSV-tk/GCV system in N/N1003A cells were investigated by flow cytometry.

RESULTS: HSV-tk gene mediated by rAAV2 was transfected successfully into N/N1003A cells and expressed stably. The bystander effect of HSV-tk/GCV system on N/N1003A cells in ATRA treatment group was significantly improved when compared with control group(P<0.01), and the apoptotic rates of the study group were notably increased(P<0.01).

CONCLUSION: ATRA can significantly enhance the bystander effect of HSV-tk/GCV suicide gene system mediated by rAAV2 in rabbit lens epithelial cells in vitro.

Abstract:AIM: To investigate the dynamic changes of T cells in different stage of experimental autoimmune uveoretinitis(EAU)and supply technical guide for optimal treatment protocols and curative effect evaluation of uveoretinitis.

METHODS: EAU was induced in C57BL/6 mice by subcutaneous immunization of CFA+PTX+IRBP in hind limb and empennage. Peripheral blood flowcytometry was performed at 3, 7, 14, 21 and 28 days after immunization, respectively.

RESULTS: After immunization with specific antigen IRBP, clinical assessment showed EAU occurred at 14 days and became severe at 21 days, but gradually relieved at 28 days. Accompanying with intraocular inflammation of EAU, both CD4⁺CD25⁺ T regular cells and CD4⁺CD3⁺ helper T cells increased. Especially,CD4⁺CD25⁺ T regular cells increased more obviously at 21 days. The number of CD4⁺CD25⁺Foxp3⁺ T regular cells had a great raising and gradually reduction after 28 days. The ratio of CD4⁺CD25⁺Foxp3⁺/CD4⁺CD25^-Foxp3⁺ had a piecemeal increase after 3 days and reached the peak at 21 days then reduced at 28 days.

CONCLUSION: The groups of CD4⁺CD25^+/- Foxp3⁺ T regular cells have a close relationship with the development and turnover of EAU. The groups of CD4⁺CD25^+/-Foxp3⁺ T regular cells provide a new thread for clarity remission mechanism of EAU, prevention and treatment of EAU.

Abstract:AIM: To investigate the effects of different forms of light on the expression of TGF-β₂ of guinea pig retinal pigment epithelial(RPE)cells.

METHODS: Ten two weeks old healthy guinea pigs, RPE cells were cultured conventionally and divided into four groups: focused light group, defocused light group, parallel light group and the control group. The first three groups were exposed to the focused light, defocused light(passed though lens from parallel light)and the parallel light, the control group was untreated. The level of the expression of TGF-β₂ protein and TGF-β₂mRNA was measured by immunocytochemistry and real-time fluorescence quantitative chain reaction 24 hours after light exposure and the pattern-effect relations were explored. The data were analyzed by means of analysis of variance(ANOVA).

RESULTS: The level of both TGF-β₂ protein and TGF-β₂ mRNA were significantly increased in the focused light exposed group compared with the other groups, followed with the defocused group(P<0.05).

CONCLUSION: It was suggested that different forms of light can affect the expression of TGF-β₂ in guinea pig RPE cells, and was most obvious in the focused light exposed group.

Abstract:AIM: To observe the ultrastructural changes of the lens in the human age-related cataract.

METHODS: The normal lens(3 cases), the lens epithelial cells(LECs)and nuclear of age-related cataract(5 cases)were observed by Philips-208 type transmission electron microscopy(TEM)and JSM-6380LV type scanning electron microscopy(SEM).

RESULTS: TEM: Compared with the normal lens, in 5 cases of age-related cataract, LECs of anterior capsular had a large number of irregular shape nuclear, chromatin condensation, mitochondria and other organelles in cytoplasm swelled. In some fiber cells of the cataract lens, the cell boundary was not so obvious with dissolution and necrosis. SEM: Cataract cortex lost the smoothness, fiber cells of the nucleus surface were deformation and compression, connection between the fiber cell changes.

CONCLUSION: The pathologic ultrastructural changes of the epithelial cells and fiber cells of the cortex and nucleus in lens may play a critical role in the pathogenesis of age-related cataract.

Abstract:AIM: To observe the clinical effects of trabeculectomy with incision of “W” form and adjustment suture for primary angle-closure glaucoma(PACG).

METHODS: In a prospective randomized sample controlled clinical study, 48 patients(48 eyes)were randomly divided into two groups:(group A)trabeculectomy with incision of “W” form and adjustment suture;(group B)traditional compound trabeculectomy surgery. The vision, intraocular pressure, astigmatism, ocular surface disease index(OSDI), tear film function, filtering bleb, success rate of operation and postoperative complications were performed at 1 week, 3 months and 6 months postoperatively.

RESULTS:There were no significant difference for corneal astigmatism, OSDI and tear film function between two groups preoperatively( t_astigmatism=0.764,t_OSDI=0.652,t_{break up time} =-1.837, t_{tear river altitude} =-1.535, t_ST=-1.821, t_FL=1.916,P>0.05). There were no statistically significance for OSDI, break up time(BUT), Schirmer test(ST), tear river altitude and fluorescein staining(FL)at 1 week post-operation in group A compared with the fellow eyes(t_AOSDI =1.052, t_ABUT=0.974, t_{Atear river altitude} =0.998, t_AST =-1.225, t_AFL =0.784, P>0.05), whereas statistically significance at 1 week post-operation in group B compared with the fellow eyes(t_BOSDI =14.538,t_BBUT=5.241, t_{Btear river altitude} =2.694, t_BST =-3.189, t_BFL =-1.355,P<0.05). There were no statistically significance for symptom eyes, OSDI, BUT and FL at 2 weeks post-operation in both groups compared with the fellow eyes(t_AOSDI =0.828,t_ABUT=0.537, t_{Atear river altitude} =0.662, t_AST = -0.691, t_AFL =0.046; t_BOSDI =0.774,t_BBUT=1.082, t_{B tear river altitude}=0.629, t_BST =-0.558, t_BFL =-0.719, P>0.05). There were statistically significance for surgically induced astigmatism, filtering bleb in both groups(t _astigmatism=9.964, χ² _{filtering bleb}=9.662,P<0.05), whereas no statistically significance on vision, intraocular pressure, cumulative survival rate of functional filter blebs and success rate of operation in both groups(P>0.05).

CONCLUSIONS: Trabeculectomy with incision of “W” form and adjustment suture is a more favorable solution for primary angle-closure glaucoma patients, which can stabilize the tear film,mitigate the symptom of ocular surface and corneal astigmatism, and therefore improve the visual quality.

Abstract:AIM: To investigate the differences in central corneal thickness(CCT)measurements using pachymetries of ultrasound and Schempflug system.

METHODS: The CCT of 150 healthy corneal eyes(from 86 cases)were measured with non-contact tonometry/pachymetry NT-530P, Pentacam and ultrasonic pachymetry. The consistency of the measurements was statistically analyzed by one-way ANOVA and Bland-Altman plot. The differences were analyzed by Pearson correlation coefficients.

RESULTS: The CCT values measured with non-contact tonometry/pachymetry NT-530P, Pentacam and ultrasonic pachymetry were(541.19±32.47)μm,(542.76±32.40)μm and(539.88±31.98)μm, respectively. No statistically significance differences were found among the three instruments(F=0.290, P=0.748), and there were high correlations among them(r₁=0.954, r₂=0.973, r₃=0.948). The sample(150 eyes)was divided into 3 groups according to the CCT measurements obtained with ultrasonic pachymetry for further analysis: CCT≤520μm,520μm 570μm. The 3 groups have high relation and good consistency(P>0.05).

CONCLUSION: There are no statistically significant differences among the three instruments, and the correlations of them are high.

Abstract:AIM: To evaluate the application effect of iris hook combined with capsular tension ring(CTR)in traumatic cataract lens dislocation operation.

METHODS: Twenty-three patients(23 eyes)of traumatic cataract with lens subluxation underwent cataract operation, and they were divided into 2 groups. Observation group: 14 eyes, iris hooks were positioned to fix capsular bag, CTR was implanted, and then the patients underwent phacoemulsification and were implanted foldable intraocular lenses in the lens capsule. Control group: 9 eyes underwent conventional cataract ultrasonic emulsification operation mode.

RESULTS: Comparison between two groups, in the observation group, the postoperative visual acuity was improved, the difference was significant(P<0.01); the observation group was lower than the control group in complication rate, and the difference was significant(P<0.01).

CONCLUSION: The application of iris hook combined with CTR in the treatment of cataract with lens dislocation can improve the operability and safety, reduce operation complication, postoperative intraocular lens can be safe and stable in the capsular bag, visual recovery is good.

Abstract:AIM: To investigate the relationship between nocturnal blood-pressure declining(dip)and retinal nerve injury of patients with open angle glaucoma and normal tension glaucoma.

METHODS: The procedure included vision field examination, OCT checking of the average retinal nerve fiber layer thickness, 24-hour monitoring of intraocular pressure, 24-hour ambulatory blood pressure monitoring on 51 ophthalmic clinic's test subjects(51 eyes)with open angle glaucoma and normal-tension glaucoma, then the differences between three DIP groups were compared.

RESULTS:The patients were classified into three groups according to dip, and there were significant variance in the value of mean defect(MD)(P=0.032), intraocular pressure peak value(P=0.003), and visual field defect score deviation(P=0.041)among the three groups. There was significant dip differences(P=0.028)among the visual field defect progressing group, visual field defect invariant group and visual field defect improving group: The visual field defect progressing incidence rate in overdipper group(50%)was higher than that in non-overdipper group(7%). The RNFL correlated factors were the nocturnal minimum mean arterial-pressure and dip(P=0.011, P=0.032,R²=0.081); MD correlated factor was intraocular pressure fluctuations(P=0.026,R²=0.115); pattern standard deviation's correlated factors were intraocular pressure fluctuations and dip(P=0.020, P=0.044, R²=0.141).

CONCLUSION: Normal tension glaucoma demonstrated a higher incidence rate of excessive declining of nocturnal blood pressure than open angle glaucoma. Overdipper group has a higher incidence rate of visual field defect progressing than non-overdipper group. This result supports that there is obvious vision damage progress in the nocturnal blood-pressure excessive declining group. The nocturnal blood pressure value of declining in the visual field defect progressing group is higher than the other two groups. The data confirms that both the excessive declining of nocturnal blood pressure and the excessive fluctuations of diurnal intraocular pressure are high risk influential factors in glaucoma retinal nerve injury progressing.

Abstract:AIM: To analyze the wavefront after computer assisted corneal topography guide optimized refractive keratectomy(ORK-CAT)excimer laser in situ keratomileusis(LASIK).

METHODS: Forty patients(80 eyes)from the myopia laser treatment center of our hospital were measured and divided into two groups, in which 20 cases( 40 eyes)received routine LASIK(convention group), 20 cases(40 eyes)received ORK-CAT personality LASIK(ORK-CAT group). The visual acuity, refractions and the higher order aberrations of the patients were examined 1 month, 3 and 6 months after operation.

RESULTS: There was a significant difference in refractive diopter between the two group post-operation(P<0.05). Refractive diopter between the two group had no significant difference 3 and 6 months post-operation(P>0.05). Both of the group regressed slightly after the surgery and the ORK-CAT group was less than the convention group. The higher order aberration was increased after LASIK operation(P<0.05). The higher order aberration of convention group was higher than that of ORK-CAT group 1 month, 3 and 6 months after operation(P<0.05).

CONCLUSION: Patients received ORK-CAT personality LASIK treatment have better quality of vision after surgery than those received convention LASIK treatment.

Abstract:AIM: To evaluate the safety and clinical effect of protein- free calf blood extract after epipolis laser in situ keratomileusis(Epi-LASIK)surgery.

METHODS: Totally 112 eyes with Epi-LASIK were randomly divided into Group A(protein-free calf blood extract eye gels)and Group B(recombinant human epidermal growth factor, rhEGF): Group A with 29 patients 58 eyes were treated by protein-free calf blood extract eye gels and Group B with 27 patients 54 eyes were treated by rhEGF eye drops. In each group after Epi-LASIK, the drug was used immediately. Postoperative irritation, growth of epithelial flap, postoperative visual acuity, time to achieve the preoperative best-corrected visual acuity, haze development etc were observed for 6-12 months.

RESULTS: The growth of epithelial flap in the Group A was better than the Group B and there was statistically significant difference(P<0.05). One month after surgery, 45 eyes(77.6%)in the Group A and 32 eyes(59.3%)in the Group B achieved the preoperative best-corrected visual acuity which was statistically significant(P<0.05). The time to achieve the preoperative best-corrected visual acuity in most Group A patients was shorter than 1 week while in the Group B it was longer than 2 weeks, which was statistically significant(P<0.05). There was no significant difference in haze development between 2 groups(P>0.05).

CONCLUSION: Application of protein-free calf blood extract after Epi-LASIK can relieve epithelial flap edema, shorten time of visual acuity rehabilitation and alleviate the sensation of dry eye. It is a safe, effective method and presents a captivating prospect.

Abstract:AIM: To compare visual function of patients with cataract and high myopia after implantations of aspherical and spherical intraocular lens(IOL).

METHODS: Forty-two eyes of cataract patients with high myopia were retrospectively analyzed. 22 eyes were implanted aspherical IOL and 20 eyes were implanted spherical IOL. All the patients uncorrected distance visual acuity(UCDVA)were >0.2. Vision, accommodative amplitude, contrast sensitivity(CS)were examined at 6 months after operation.

RESULTS: There were no significant differences in best-corrected distance visual acuity(BCDVA), best-corrected near visual acuity(BCNVA), accommodative amplitude between aspherical and spherical IOL(P>0.05). After 6 months, CS and glare contrast sensitivity(GCS)of the low and medium space frequency in implanted aspherical IOL were better than implanted spherical IOL(P<0.05), but there were no significant differences in CS and GCS of the high space frequency(P>0.05).

CONCLUSION: Cataract patients with high myopia, CS and GCS in implanted aspherical IOL are better than that of implanted spherical IOL.

Abstract:AIM: To evaluate the clinical efficacy of the treatment for patients with presbyopia by Shotfile software.

METHODS: Seventy-seven eyes of 44 patients with complete information received the operation by the TOSCA surgery and the Shotfile software for the correction of presbyopia. The distance and near vision(dominant eye, non-dominant eye, binocular), refraction, higher order aberration, contrast sensitivity and stereo vision were compared between the preoperative and postoperative. The degree of the postoperative satisfaction was investigated.

RESULTS: The average distance vision of dominant eyes 6 months after operation were 1.00±0.16; and non-dominant eyes were 1.00±0.23. The average near vision of dominant 6 months after operation were 1.07±0.29; and non-dominant eyes were 1.09±0.33. The average spherical equivalent 6 months after operation were -0.41±0.56D. The postoperative mean spherical equivalent was lower than the preoperative, which was statically different(P<0.05). With the 6mm pupil diameter, the preoperative total higher order aberrations, horizontal coma, vertical coma and spherical aberration were: 0.573±0.308, -0.025±0.173, -0.025±0.110, 0.174±0.133; the total higher order aberrations, horizontal coma, vertical coma, spherical aberration 6 months after operation were 0.594±0.247, -0.090±0.212, -0.272±0.195 and 0.297±0.146. There was statistically difference in the vertical coma and spherical aberration between the preoperative and the postoperative 6 months(P<0.05). The low, medium and high frequency contrast sensitivity were decreased after 10 days and 1 month and it returned to the preoperative level 3 months after operation. There was no significant difference between the preoperative and postoperative stereo vision(P>0.05). 38 patients(86.4%)were satisfied with the effect of surgery; 4 patients(9.1%)relatively were satisfied with the effect of surgery; 2 patients(4.5%)were not satisfied with the near vision after operation. There were no operative or postoperative serious complications.

CONCLUSION: We found that the Shotfile software was a well-tolerated and effective procedure for treating patients with prisbyopia, and it can effectively improve the near vision without loss of distance vision in early period. The increasing spherical aberration can compensate for the depression of lens regulation ability in patients with presbyopia. While the increase of horizontal coma and vertical coma, it may lead to a decline of visual quality. There was no difference between the preoperative and postoperative stereo vision.

Abstract:The occurrence of the after-cataract and the patient's age of undergoing surgery; the size of the capsular bag; continuity of capsule mouth; blood aqueous humor barrier damages released inflammation medium; residual lens epithelial cell migration differentiation and the amount of lens cortex; other factors of the artificial lens implantation, such as material. The after-cataract is the most common complication of cataract surgery and is the main reason of the visual acuity decline after surgery. In present study, we summarized the prevention method of after-cataract.

Abstract:As an importantmetal ion chelator, ethylenediamin- etetraacetic acid(EDTA)has been widely used in many fields of industrial, medical and biological engineering and so on. There were reports about EDTA being used to treat band keratopathy and some other ophthalmic diseases as early as the mid-20^th century. And in the subsequent studies, researchers had discovered that the EDTA is a good penetration enhancer which can release the tight junctions between the corneal epithelial cells, and indirectly increase the transshipment of drugs to the cornea. Recently, the chelating function of EDTA has also been widely used for separating or extracting of corneal cells in biological engineering. The purpose of this paper is to review the applications of EDTA's chelation in the treatment of corneal diseases, the penetration of ophthalmic agents to cornea and the corneal biological engineering.

Abstract:With the rapid advances in laser technology and surgical techniques, complicationsbecome less frequent. Patients are satisfied with visual outcomes. But a growing number of scholars have found that corneal refractive surgery greatly alters the structure of the corneal and corneal biomechanical properties. Even serious complications such as iatrogenic keratectasia may happen. That remains one of the refractive surgeon's greatest concerns. In this review, we describe the cornea material properties, summarize changes of corneal biomechanical properties after LASIK and review factors that may be related to vatiations in characterization of the biomechanical response of the cornea.

Abstract:Multifocal electrophysiology can be used to record many focal electroretinogram responses across the test field in a relatively short period of time, providing insights into the mechanisms of retinal diseases. It can be used in the early diagnosis and prognosis of some retinal diseases, and can be used to objectively and sensitively observe the curative effect of medicine or surgery. Now we made a overview of the research progress of multifocal electroretinogram in clinical ophthalmology.

Abstract:Retinalischemia-reperfusion model is thought to be a critical step in investigating its mechanism, prevention and treatment. A number of animal models and analytical techniques have been used to study retinal ischemia, but there is little quantitative investigation. This article assesses the various establishment methods of experimental retinal ischemia-reperfusion models and compares the different features of the models.

Abstract:The ultrasound microbubble contrast agent to carry the drug and gene targeting therapy system is a new hot research field. In recent years,it is widely used in targeted therapy of cardiovascular diseases, liver cancer and other illnesses while still a beginning in basic study and clinical disease treatment of ophthalmology. This review summarizes the current research of ultrasound microbubble contrast agent with drug and gene targeting therapy in basic study and clinical treatment of ophthalmology.

Abstract:As the main operation for the complex retinal detachment, the silicone oil tamponade is adopted widely at present. Silicone oil can cause lens opacity due to its property, there is a clinical significance to understand the causes and treatment for complicated cataract.

Abstract:With the report on successful application of amniotic membrane transplantation in clinical ophthalmology, especially in the treatment of ocular surface diseases, the basic research on the application of amniotic membrane in ophthalmology field also gained more attention. In this paper, the histological, immunological, and biological characteristics of amniotic membrane in the field of ophthalmology clinical application were reviewed.

Abstract:Ultrasonic biomicroscope(UBM)can clearly show the structure of the anterior segment of eyes, and can be used for the quantitative measurement, because it isn't affected by the refractive media and pupil size, and it has the advantages of non-interference, non-invasion, non-contact, real-time, and can be used for the study of the physiology and pathology, pathogenesis, diagnosis, treatment of the disease of anterior segment of eyes.

Abstract:In recent years, the endoscope technology and related treatments have gradually been enriched and improved: endoscope was gradually spread and applied in lacrimal passage surgery, glaucoma surgery, lens implantation, posterior segement surgery, orbit surgery and eye plastic surgery, initiating a new era of minimally invasive eye surgery. It has the advantage of fewer traumas, less complications, under direct vision operation, safe and effective have been widely approved by ophthalmologist. This paper summarized the development process and application status of ophthalmic endoscope in eye surgery and its future development.

Abstract:AIM:To invest the clinical effect of He-Ne laser on the therapeutic program of the herpes zoster keratitis(HZK).

METHODS: We have set the He-Ne laser and medicine combination therapy as observation while the medicine therapy as contrast according to clinic case-control method. We have calculated the quantity data from both ocular and whole body aspects.

RESULTS:The skin crusts generating rate was better in the observation group at 10^th day of therapeutic program. The pain relief rate was better in the observation at 5^th day of program(χ²=4.03, P<0.05). The difference of the patients' keratitis between both groups was significant(t=4.227, 8.208; P<0.01), the general results of observation group were better( χ²=4.49, P<0.05). We did not found any serious complications during the whole program.

CONCLUSION:The He-Ne laser improves the treatment efficiency of medicine to the HZK.

Abstract:AIM:To investigate and compare the therapeutic effects of phacoemulsification and small-incision cataract surgery on senile cataract.

METHODS: Totally 355 cases(393 eyes)of senile cataract patients were divided into group A and group B by treatment modality. Group A with 180 cases(193 eyes)was treated with cataract surgery through a small-incision, and group B with 175 cases(200 eyes)was treated withphacoemulsification. Postoperative visual acuity, corneal astigmatism and the density of corneal endothelium were compared respectively.

RESULTS: One day postoperatively, the visual acuity inphacoemulsification group was much better than that in small-incision cataract surgery group, but there were no statistically significant differences at 7 and 30 days. The corneal astigmatism in patients with small-incision cataract surgery was higher than that of with phacoemulsification 7 days postoperatively, but there was no significant difference at 30 days. For those patients with Ⅳ-Ⅴ degree of nuclear hardness, the density of corneal endothelium in phacoemulsification group was less than that in small-incision cataract surgery group.

CONCLUSION: Suitable operative mode should be chosen according to the nuclear hardness of senile cataract patients.

Abstract:AIM: To compare the effectiveness of incision suture and no suture in small incision non-phacoemulsification cataract surgery.

METHODS: Totally 420 patients 477 eyes with cataract underwent small incision non-phacoemulsification cataract surgery through sclera tunnel incision(6-7mm)and implanted rigidly artificial crystal(The diameter was 5.5 mm), the incisions of 205 patients 230 eyes(group A)with cataract were symmetrically sutured two needles, the incisions of 215 patients 247 eyes(group B)with cataract were not sutured. Bare eye vision and corneal astigmatism were observed at postoperative 2 days and 3 months.

RESULTS: At postoperative 2 days, bare eye sight or the best-corrected visual acuity(BCVA)through spherical mirrors ≥0.5 was in193 eyes(83.9%)in group A and in 190 eyes(76.9%)in group B, at postoperative 3 months, bare eye sight or BCVA by spherical mirrors ≥0.5 was in 205 eyes(89.1%)in group A and in 198 eyes(80.2%)in group B, there was statistical difference in vision changes at postoperative 2 days and 3 months between two groups(P < 0.05); At postoperative 2 days, mean corneal astigmatism was 1.53±0.59D in group A and 1.85±0.97D in group B, at postoperative 3 months, mean corneal astigmatism was 1.05±0.43D in group A and 1.31±0.65D in group B, there was statistical difference in mean corneal astigmatism at postoperative 2 days and 3 months between two groups(P < 0.01); In group A there were no postoperative complications such as incision leakage, shallow anterior chamber, iris encephaloceles or iris embedded in sclera incision, etc; but in group B there were 3 eyes(1.21%)with incision leakage and shallow anterior chamber after operation and 4 eyes(1.62%)with iris encephaloceles and iris embedded in sclera incision at postoperative one day.

CONCLUSION: Incision suture in small incision non-phacoemulsification cataract surgery has better visual recovery, less corneal astigmatism and more safe than that no suture.

Abstract:AIM: To investigate the safety and efficacy of phacoemulsification in the treatment of special types of cataract.

METHODS:Clinical data were retrospective analyzed, and the surgery essentials of phacoemulsification and intraocular lens implantation in the treatment of special type of cataract, such as cataract after glaucoma surgery, small pupil cataract, uveitis complicated cataract, and post-traumatic cataractwere researched.

RESULTS:Of the 73 cases(84 eyes)for the treatment of special types of cataract, simple phacoemulsification in 27 cases 28 eyes; posterior chamber intraocular lens implantation in 52 eyes; anterior chamber intraocular lens implantation in 4 eyes; average intraocular pressure at postoperative 1 month was 12.72±2.63mmHg, the off-blind rate was 99%, off-disability rate was 96%; complication rate was 4%.

CONCLUSION: The surgery for special type of cataract is difficulty, small incision phacoemulsification and retained posterior capsule combined intraocular lens implantation is the ideal surgical removal for special type of cataract.

Abstract:AIM: To study the therapeutic effects of small incision inside the tunnel sub-nuclear techniques.

METHODS: Totally 400 cases with age-related cataract were randomly divided into experimental group(200 cases)and control group(200 cases). Small incision inside the tunnel sub-nuclear techniques was performed on the experimental group, and the control group using small incision inside the anterior chamber nuclear techniques division.

RESULTS: There were no significant differences between two groups in the postoperative visual acuityone day and one week after surgery; the incidence of complications in the experimental group was lower than that in the control group.

CONCLUSION: Small incision cataract extraction inside the tunnel sub-nuclear techniques is a safe and effective operation method, especially suitable in basic-level hospital.

Abstract:AIM: To observe the efficacy of phacoemulsification and intraocular lens(IOL)implantation for diabetic cataract.

METHODS: Totally 38 cases(41 eyes)with diabetic cataract(observation group)and 117 cases(127 eyes)with non-diabetic simple senile cataract(control group)in the same period all received phacoemulsification and IOL implantation and the efficacy and postoperative complications were observed and compared.

RESULTS: There were 32 eyes(78.0%)in the observation group and 110 eyes(86.6%)in the control group getting postoperative best-corrected visual acuity>0.4 respectively, the difference between two groups was not significant(P>0.05). The incidence rate of corneal edema and fibrin exudation in the observation group were 31.7% and 19.5% respectively which were significantly higher than the control group, the differences between groups were statistically significant(P<0.05); the incidence rate of posterior capsular opacification was 14.6% in the observation group and 11.0% in the control group, the difference between groups was not significant(P>0.05).

CONCLUSION: The treatment of phacoemulsification and IOL implantation for diabetic cataract is safe and feasible and has the same efficacy with the simple senile cataract.

Abstract:AIM: To investigate the methods, effect and complication of treating different types of after cataract withNd:YAG laser.

METHODS: A total of 360 patients 382 eyes with different types of after cataract were treated by Nd:YAG laser. The complication and visual acuity were observed. Laser parameters in three groups of one-level, two-lever, three-level membrane were recorded. Laser parameters in four groups of senile cataract, congenital cataract, complicated cataract and traumatic cataract were statistically analyzed.

RESULTS: The best-corrected visual acuity had significant difference after laser treatment(P<0.05). The average total laser energy and pulse had significant difference comparing with senile and traumatic group(P<0.05). The complications included high intraocular pressure in 7 eyes(1.8%)and the damage of lens in 26 eyes(7.7%).

CONCLUSION:Nd:YAG laser is a safe and effective method for after cataract. Three-level membrane in traumatic cataract is in majority. Single dose energy, total pulse and total laser energy are all big. Different therapic laser parameter according to different patients and timely treatment of complication can improve effect and safety.

Abstract:AIM: To investigate the effect and skill of posterior chamber intraocular lens implantation withoutsuture for posterior capsule rupture of cataract.

METHODS: Totally 31 cases(31 eyes)of cataract patients underwent continuous curvilinear capsulorhexis(CCC). When finding the posterior capsule rupture in small incision cataract surgery, the surgeon prevented expansion of posterior capsule rupture. After vitrectomy, the surgeon implanted posterior chamber intraocular lens by residual posterior capsule or anterior capsule.

RESULTS: After 1 week, corrected visionin 80.6% eyes were more than 0.5. After 3 months follow-up, corrected vision in 83.9% eyes were more than 0.5. 31 eyes had no serious complication.

CONCLUSION: Posterior chamber intraocular lens implantation withoutsuture is effective and convenient in the treatment of posterior capsule rupture.

Abstract:AIM: To analyze the effect of phacoemulsification combined goniosychialysis for cataract extraction in the treatment of angle-closure glaucoma(ACG).

METHODS: Totally 46 cases(56 eyes)of ACG which had cataract and closed range of anterior chamber angle less than or equal 180° received phacoemulsification surgery with intraocular lens(IOL)implantation combined goniosychialysis. The intraocular pressure(IOP), vision, depth of anterior chamber, width of anterior chamber angle of preoperative and postoperative were observed.

RESULTS: The IOP of 56 eyes was all under the control of 21mmHg(1mmHg=0.133kPa)after operation and the anterior chamber angles became wilder than preoperative. Best-corrected visual acuity was improved. There was no serious operation complication. The preoperative and postoperative IOP, best-corrected visual acuity and anterior chamber depth had statistically significant differences.

CONCLUSION:We can receive satisfactory clinical effect of phacoemulsification surgery combined goniosychialysis for the proper patient who suffering from ACG and cataract.

Abstract:AIM: To study the etiology of high intraocular pressure(IOP)after trabeculectomy.

METHODS:Clinical data of 30 patients 34 eyes including the first time preoperative, intraoperative and postoperative situation were recorded, and when high IOP occurred, ophthalmic specialized examination(intraocular pressure, vision, angle of anterior chamber, etc)and UBM was perfoemed to analyze the cause of high IOP after trabeculectomy from September, 2009 to December, 2010.

RESULTS:The cause of high IOP after trabeculectomy included: filtering bleb flat scarring in 12 cases 15 eyes; malignant glaucoma tendency in 5 cases 6 eyes; postoperative bleeding anterior chamber 3 cases 3 eyes; sclera disc incision unobstructed 2 cases 2 eyes; Preoperative high IOP lasted for a long time in 2 cases 2 eyes; encapsulated filtering bleb in 2 cases 2 eyes; Other reasons such as preoperative uveitis in 1 case 1 eye; postoperative intumescent cataract in 1 case 1 eye; poor operation in 1 case 1 eye and surgery way not chosen wisely in 1 case 1 eye.

CONCLUSION: The main reason for high intraocular pressure after trabeculectomy is the postoperative filtering bleb flat scarring.

Abstract:AIM: To observe the efficacy of citicoline sodium on glaucoma visual field damage.

METHODS: Glaucoma patients with visual field defects and intraocular pressure(IOP)< 18mmHg were chosen, totally 29 patients 48 eyes were selected, of which 16 cases were male, 27 eyes, 13 cases were female, 21 eyes; in which 25 eyes were with primary open-angle glaucoma; 19 eyes with angle-closed glaucoma, and 4 eyes with normal IOP glaucoma. Citicoline sodium tablets were used orally, each 0.2g 3 times daily, continuously for three months. The visual field mean defect(MD), mean sensitivity(MS)and loss variance(LV), and other indicators were detected before and 1 month, 3 months after treatment.

RESULTS: One month after treatment, the MS of 48 eyes was significantly higher than that before treatment, the difference was statistically significant(P<0.01); MD value was significantly lower than that before treatment, the difference was statistically significant(P<0.05). Three months after treatment, the MS of patients was significantly higher than that before treatment, the difference was statistically significant(P<0.01); MD and LV value decreased, the difference was statistically significant(P<0.01).

CONCLUSION: Citicoline sodium has protective effect on visual function of primary glaucoma to some extent.

Abstract:AIM:To research the correlation between the physiological blind spot visual field variation and optic disc parameters detected by microperimetry-1(MP-1), short-wavelength automated perimtry/blue-on-yellow perimetry(SWAP/B-YP), standard white-on-white perimetry(W-WP)in the modern clinical comprehensive detection of glaucoma patients.

METHODS:The optic area visual field detection in 39 cases of 78 normal physical examinees(all soldiers), 59 cases 118 eyes with early stage of glaucoma, 25 cases 50 eyes with middle stage of glaucoma was detected using HUMPHREY Ⅱ-750 automated full field perimetry, SWAP/B-YP, MP-1, and precisely positioned by 45° non-mydriatic fundus camera and superimposed. The data obtained by the three perimeters were analyzed. Key indicators included cup/disc(C/D)ratio and mean deviation(MD).

RESULTS: There was obvious difference in the MP-1 and SWAP/B-YP. Compared with the normal physical examinees, C/D, MD enlarged in patients with early stage of glaucoma, and physiological blind spot was slightly enlarged, and there were obvious variations in blind spot, MS, MD observed in patients with middle stage glaucoma by the three perimeters. When glaucoma was detected by MP-1 combined SWAP/B-YP, with the guidance of Logistic regression analysis, the specificity, sensitivity, accuracy rate of MD was 92.0%,95.0%,93.9%, respectively, and after the comprehensive analysis of C/D, the rate could surpass 99%.

CONCLUSION: The sensitivity of MP-1 and SWAP/B-Y was higher in detection of early stage of glaucoma than standard W-WP, and they had good correlation, but for the advanced glaucoma, W-WP was fast, accurate, and time-saving, The above three perimeters can fully reflect that 45° non-mydriatic fundus camera combined with the visual field function comprehensive analysis, which combines morphology and fuctionial study to get the precise and quantitative materials of visual function, can improve the clinical diagnosis effect of glaucoma.

Abstract:AIM: To find the risk factors for recurrent retinal detachment after silicone oil removal.

METHODS: We retrospectively reviewed all silicone oil removed surgeries performed between January 2008 and October 2011 in our vitreous-retinal group. All eyes had pars plana vitrectomy and silicone oil tamponade before in our center caused by retinal detachment. Binary logistic regression was used to find out the risk factors associated with recurrent retinal detachment. Factors analyzed included gender, age, primary diagnosis, lens state before silicone oil removal, duration of silicone oil, times of posterior segment surgeries, whether circling buckle was used, whether 20-gauge or 23-gauge vitrectomy was used, if combined with anterior segment surgeries during silicone oil removal, if combined with anterior segment or retinal operations during silicone oil removal.

RESULTS: Altogether, 128 eyes were collected, and 23 eyes(18.0%)had recurrent retinal detachment. Times of posterior segment surgeries before silicone oil removal and primary diagnosis were the independent risk factors associated with recurrent retinal detachment. The duration of silicone oil had a positive correlation with intraocular pressure elevation(IOP≥25mmHg).

CONCLUSION: Recurrent retinal detachment is a relatively frequent complication after silicone oil removal, especially for eyes with serious ocular trauma and multiple posterior segment surgeries.

Abstract:AIM: To investigate the efficacy and safety of the mouse nerve growth factor(M-NGF)in treating diabetic optic neuropathy(DON).

METHODS: All 67 cases(115 eyes)with DON were randomly divided into two groups according to the need of photocoagulation or not, and each group was randomly divided into normal treatment group and M-NGF treatment group. Patients in normal treatment group were treated by conventional way and those in M-NGF treatment group were treated with M-NGF plus conventional treatment for 3 weeks. Two months later, the vision and visual field of different groups were inspected and the safety was evaluated.

RESULTS: The effective rate was 71.4% in normal treatment group and 94.7% in M-NGF treatment group(P<0.05)in non-photocoagulation group, and 73.0% in normal treatment group and 93.3% in M-NGF treatment group(P<0.05)in photocoagulation group. The general effective rate of later was higher than the former(P<0.05), while the treatment effect had no significant statistical difference(P>0.05). Apart from local injection pain and swelling scleroma in several patients, other side effects were not found.

CONCLUSION: M-NGF is an effective and safe way to treat DON, which is worth widely applying in clinical practice.

Abstract:AIM: To investigate the clinical effects of vitrectomy combined with intravitreal phacoemulsification to treat dislocated lens into the vitreous cavity.

METHODS:Retrospective study of 23 cases patient's data, whose lens were dislocated into the vitreous cavity were treated by vitrectomy combined high-energy(80%-100%), high negative pressure(200-500mmHg)intravitreal phacoemulsification. We observed the best-corrected visual acuity preoperative and postoperative and complications.

RESULTS:Twenty-three cases of dislocated lens into the vitreous were removed successfully by this method, with no surgery-related complications. The mean follow-up period was 18 months. Preoperative best-corrected visual acuity ranged from 3.3 to 4.2, and postoperative best-corrected visual acuity ranged from 3.7 to 4.9. There was a significant difference(t=-11.244, P=0.000).

CONCLUSION:Pars plana vitrectomy combined with intravitreal phacoemulsification to treat dislocated lens into the vitreous cavity is an effective and safe method.

Abstract:AIM: To discuss the function of rigid gas permeable(RGP)oncone corneal refraction.

METHODS: Forty-six patients 73 eyes were diagnosed with early conical cornea. In statistical analyses, the vision correction of patients with spectacles framework are compared to that of other patients with RGP.

RESULTS: Vision correctionof patients with RGP is statistically different from that of patients who wear framework glasses(P<0.05). The difference values between the patients' two-times of optometry examination results on the condition of wearing RGP were statistically different from the difference values of examination results on condition that patients wear no glasses(P<0.05). In the condition of wearing RGP, vision correction among male patients was statistically better than that among female patients(P<0.05). Vision correction of the patients below 25 was not statistically different from that of the patients above 25(P>0.05). The patients' cornea were 490μm thick, which was statistically different from normal corneal thickness(P<0.05).

CONCLUSION: Corrected visual acuity of patients wearing RGP is better than that of patients with framework glasses. The optometry examination result of patients with RGP is more accurate. Corrected visual acuity of men is better than that of women, on the condition of wearing RGP. Vision correction extent has no difference among patients of different ages, when they wear RGP. The cornea of cone corneal patients is commonly thinner than that of normal persons.

Abstract:AIM: To observe and analyze the clinical effect of minimal occlusion + Haidinger brush + flicker red light + distance visual function training of red E standard logarithm visual acuity chart in treating children with myopic amblyopia.

METHODS: Totally 97 children(186 eyes)with myopic amblyopia were treated, 47 children(89 eyes)in group A aged 4-12(5.79±1.98)years old were treated by covering + flicker red light + near visual function training and 50 children(97 eyes)in group B aged 3-10(5.92±1.72)years old were treated by minimal covering + Haidinger brush + flicker red light + distance visual function training of red E standard logarithm visual acuity chart. The patients with mild myopia, moderate myopia and high myopia were 16, 52 and 21 eyes in group A and 18, 55 and 24 eyes in group B(χ²=0.004, P>0.05). The patients with low amblyopia, medium amblyopia and severe amblyopia were 23, 49 and 17 eyes in group A and 26, 55 and 16 eyes in group B(χ²=0.136, P>0.05). All patients were followed up for 24 months to comparatively analyze the efficacy of two different combined therapies.

RESULTS: The recovery rate, effective rate and inefficacy rate was 35.96%, 40.45% and 23.60%, respectively in group A, and 56.70%, 26.80% and 16.49%, respectively in group B(χ²=6.022, P<0.05). The patients whose myopic degree developed ≤1.0D, 1.0D-3.0D and ≥3.0D were 3, 49 and 37 eyes in group A and 4, 69 and 24 eyes in group B after therapy(χ²=5.074, P<0.05).

CONCLUSION:The efficacy is better of minimal covering+ Haidinger brush + flicker red light + distance visual function training by red E standard logarithm visual acuity chart for treating children with myopic amblyopia and the develop of myopic degree were mild after therapy.

Abstract:AIM: To observe the effect of Esculin and Digitalisglycosides Eye drops on the accommodation function of juvenile myopia.

METHODS: Totally 158 cases of myopia with an average age of 15.22±0.96 years old were selected between June 2011 and July 2011, including 66 males and 92 females, with mean refractive diopter -4.46±1.31D. Based on pupil dilation and medical optometry, the patients wore corrective glasses, and then they were divided into experimental group 72 patients, and control group 86 patients. The experimental group was used Esculin and Digitalisglycosides Eye drops 3 times a day for both eyes, 30 days a course, and reviewed every two weeks to evaluate the amplitude of accommodation, accommodative lag, accommodative sensitivity, positive and negative relative accommodation, and the data obtained were analyzed using ANOVA.

RESULTS: Theaccommodative sensitivity in the experimental group was obviously improved compared with that in control group, and the difference was statistically significant(left eye:F=6.342,P<0.05; right eye: F=7.966, P<0.05; both eyes: F=6.922,P<0.05). The negative relative accommodation in the experimental group was obviously improved compared with that in control group, and the difference was statistically significant(F=6.102,P<0.05). There was no significant difference in refractive diopter between the two groups(F=2.361,P>0.05).

CONCLUSION: Esculin and Digitalisglycosides Eye drops can effectively improve the accommodation function of juvenile myopia.

Abstract:AIM: To evaluate the efficacy ofphotorefractive keratectomy(PRK)in correcting mild-to-moderate myopia with the low dose(0.02g/L)mitomycin C(LMMC)in eyes for 30 seconds.

METHODS: Fifty-seven eyes of 30 patients with mild-to-moderate myopia were treated with PRK, and theLMMC was administered topically for 30 seconds. Seventy-seven eyes of 39 patients with mild-to-moderate myopia were treated with LASIK. The follow-up was evaluated 6 months later. Independent samples t test, Chi-square test were used for statistical analysis. Significance level was set P<0.05.

RESULTS: In the PRK+LMMC group 6 months later, mean spherical equivalent refraction was 0.210±0.72D, spherical equivalent refraction within ±0.50D was obtained in 71.9% of eyes, uncorrected visual acuity≥1.0 was obtained in 77.2% of eyes, and mean best spectacle-corrected visual acuity was 1.19±0.18, and they were-0.017±0.81D, 70.1%, 72.7% and 1.16±0.19, respectively, in the LASIK group 6 months later. The differences between two groups were not statistically significant(t=1.76; χ²=0.051; χ²=0.805; t=0.984, all P>0.05). No eye presented more than grade 1 haze in PRK+LMMC group. 1 eye occurred epithelial ingrowth in LASIK group.

CONCLUSION:PRK correcting mild-to-moderate myopia with LMMC administered topically for 30 seconds intraoperatively is equally effective with LASIK, and avoids LASIK flaps complications. PRK is an effective alternative to LASIK.

Abstract:AIM:To investigate the clinical features of ocular syphilis.

METHODS:The clinical data of 13 patients with active ocular syphilis were retrospectively reviewed. The diagnosis was made first in eye clinic. Twelve patients received systemic penicillin therapy and 1 patient was treated with ceftriaxone due to penicillin allergy.

RESULTS:The major ocular manifestations included chorioretinitis(9 cases, 17 eyes), neuroretinitis(2 cases, 3 eyes), optic neuritis(1 case, 1 eye), exudative retinal detachment(1 case, 2 eyes). The mean follow-up visual acuity was 0.56±0.23, and follow-up of(rapid plasma reagin)RPR titer was 1:16.6.

CONCLUSION:Ocular syphilis has different manifestations, which is easy to misdiagnosis and missed diagnosis. Oculist should be vigilant to detect and treat early.

Abstract:AIM: To compare the effect of primary pterygium excision using several surgeries.

METHODS: A total of 206 eyes of primary pterygium were selected and all underwent pterygium excision. They were divided into 4 groups. Group A with 50 eyes using simple pterygium excision. Group B with 47 eyes using simple pterygium excision and mitomycin C(MMC). Group C with 52 eyes using simple pterygium excision and amniotic membrane transplantation combined with MMC. Group D with 57 eyes using autologous corneal limbus stem cells transplantation. Postoperative follow-up was 2 years.

RESULTS: The recurrence rate was remarkably different between group A and the other three groups.The recurrence rate in group B was lower than that in group A, but higher than the other groups. The recurrence rates among the last two groups had no significant difference. Average surgery time was 13 minutes in the group A, which was greatly shorter than other groups. Average surgery time of the last two groups was a little longer. Most recurrences occurred within 12 months.

CONCLUSION: MMC can reduce the recurrence rate of simple pterygium excision. Pterygium surgeries including free autologous conjunctival grafting and amniotic membrane transplantation are associated with fewer recurrences.

Abstract:AIM: To investigate the proportion of different types, ages, distribution of genders, different ranks, treatments as well as visual function in military inpatients with glaucoma in recent 7 years.

METHODS: All military inpatients with glaucoma in our hospital from January 2004 to December 2010 were studied.

RESULTS: In all 69 cases 125 eyes, 110 eyes with primary glaucoma and 15 eyes with secondary glaucoma accounted for 88.0% and 12.0% respectively. 56 eyes with primary angle-closure glaucoma(PACG)accounted for 44.8% and 54 eyes with primary open angle glaucoma(POAG)accounted for 43.2%. It's most common in ages from 61-70. The male accounted for 92.8%. The army division-level cadre patients accounted for 40.6% and the solider patients only accounted for 17.4%. 60 eyes with surgical treatment accounted for 48.0%. The binocular and monocular blindness rate was 11.6% and 16.0% respectively.

CONCLUSION: The military inpatients with POAG were close to inpatients with PACG. Most of the inpatients were the middle-aged and elderly patients. The treatment was individual and it had a high blindness rate. It may relate to military cultural conditions.

Abstract:AIM: To investigate the status of eyesight dysfunction among primary and secondary school students in the city of Xi'an, so as to provide scientific evidence for vision protection.

METHODS: Eyesight test was performed among 3 869 students(7 738 eyes)which were selected by multistage sampling. According to the diagnosis criterion of eyesight dysfunction, the students were classified as normal, slight, moderate, and severe group. The data were inputted into a database set up by EpiData 3.1 and analyzed by SPSS 18.0.

RESULTS: The rate of eyesight dysfunction among primary and secondary school students in the city of Xi'an was 54.9%,and most students were with severe eyesight dysfunction. The rate increased with the age and grade, the rate of girls was significantly higher than that of boys(χ²=63.19, P<0.01). The rate of students of urban was significantly higher than that of rural(χ²=547.53, P<0.01).

CONCLUSION: The prevalence of eyesight dysfunction is still apparent in primary and secondary school students in the city of Xi'an. Effective measures should be implemented to prevent and reduce the incidence of eyesight dysfunction.

Abstract:AIM:To investigate the efficacy of interferon alpha-2b(IFN-α-2b)combined ganciclovir on corneal endotheliitis.

METHODS: The 15 cases identified with corneal endotheliitis were treated with periocular injection of IFN-α-2b combined ganciclovir 0.25g one time a day given by intravenous infusion and in conjunction with aciclovir eyedrops every two hours and tobramycin & dexamethasone eyedrops 4 times a day, and continuously treated for 1 week.

RESULTS: All 15 cases were cured and visual acuity improved after 1 week of the above treatment, the cure rate was 100%. In 4-12 months follow-up, there was no recurrent case.

CONCLUSION: IFN-α-2b combined ganciclovir on corneal endotheliitis can get higher cure rate, lower recurrent rate and the treating course is short.

Abstract:AIM:To observe the safety and clinical effects of small-incision extracapsular cataract extraction(SIECCE)and intraocular lens(IOL)implantation for cataract patients on sight-regaining program.

METHODS:A total of 1 274 cases(1 274 eyes)of cataract patients of poverty received SIECCE and IOL implantation. Complications and postoperative visual acuity were recorded.

RESULTS:All patients received uneventful surgery. During surgery, 30 eyes(2.35%)had posterior capsule rupture, 240 eyes(18.84%)had corneal edema. Postoperative visual acuity >0.5 reached 85% in 1 week, the number reached 90% in 3 months.

CONCLUSION:SIECCE is effective and safe in sight-regaining program, which should be promoted.

Abstract:AIM: To observe the treatment effect of phacoemulsification and intraocular lens(IOL)implantation in the treatment of diabetes complicated with cataract and the key factors during the operation.

METHODS: From December 2009 to December 2010, 32 cases of diabetic cataract patients 46 eyes in our department underwent phacoemulsification and IOL implantation, preoperative conventional slit-lamp, intraocular pressure measurement, B-ultrasound was performed, and besides, computer optometry, if necessary, FFA inspection, and glucose was detected. Surgery was performed using Alcon Legacy phacoemulsification instrument, Germany Zeiss VlSu150 surgical microscope. Clear corneal incision was made, which was about 2.8mm long, and the postoperative follow-up was 1-3 months.

RESULTS: Three months postoperatively, 12 eyes were with best-corrected visual acuity>0.3, 23 eyes were≥0.5. Of the 15 eyes with diabetic retinopathy, 12 eyes were with corrected visual acuity≥0.5, the rest 3 eyes had no visual iprovement, the diabetic retinopathy was in Ⅲ-Ⅳ grade. Postoperative complications included corneal edema in 10 eyes. delayed uveitis in 6 eyes, postoperative hypertension in 4 eyes. after cataract in 3 eyes and posterior capsular rupture in 1 eye.

CONCLUSION: Phacoemulsification and IOL implantation is an ideal method for treating diabetes complicated with cataract.

Abstract:AIM: To observe the effect of depth of the rigid scleral incision on intraocular lens in astigmatism after cataract surgery.

METHODS: Corneal astigmatism in 46 cases(46 eyes)was measured based on preoperative corneal topography, then they underwent horizontal limbal incision 3mm from the sclera edge, after the operation, they were divided into 2 groups by visante oct: group A of incision depth of 1/2 the depth of the sclera(23 eyes); B group incision depth of 1/3 the depth of the sclera(23 eyes); respectively, after l week, 1 month, 3 months, corneal astigmatism was observed and statistically analyzed.

RESULTS: Postoperatively, uncorrected visual acuity in groups A, B was significantly improved, while according to the test results of corneal topography, astigmatism of postoperative 1 month, 3 months was decreased compared with astigmatism of postoperative 1 week group A had statistical significance.

CONCLUSION: 1/2 scleral incision has less effect on astigmatism for rigid intraocular lens after cataract phacoemulsification.

Abstract:AIM: To study the methods and effect of aphakia eye secondary posterior chamber intraocular lens(IOL)implantation with suture fixation under anterior chamber irrigation after vitrectomy.

METHODS: Thirty aphakia eyes underwent secondary posterior chamber IOL implantation with suture fixation under anterior chamber irrigation after vitrectomy. All the cases were followed up for 1.5 years.

RESULTS: Thrity cases(30 eyes)underwent posterior chamber IOL implantation successfully. The complications included hemorrhage of the ciliary body(1 case)in the operation and vitreous hemorrhage(1 case)and choroid detachment(2 cases)after the operation. The visual acuity of all cases was more improved than before, 24 cases(80%)had obtained post-operative visual acuity ≥0.3, of these, 8 cases(27%)≥0.5; 6 cases(20%)<0.3, of these, 2 cases(7%)<0.1.

CONCLUSION: The method of anterior chamber irrigation is safe and successful which can obtain stableintraocular pressure during and after the operation and lower complications. The operation is an effective method for improving the visual acuity after vitrectomy.

Abstract:AIM: To investigate the efficacy of mini-incision cataract extraction with intraocular lens(IOL)and goniosynechialysis for angle-closure glaucoma.

METHODS: Clinical data of 63 cases(72 eyes)withangle-closure glaucoma were analyzed retrospectively. All of them accepted the surgery of mini-incision cataract extraction with IOL and goniosynechialysis. Regular visual acuity(VA), slit-lamp, intraocular pressure(IOP)and gonioscope examination were performed before and after surgery. They were followed up for 1-6 months.

RESULTS: VA improved significantlypostoperation in 70 eyes. At the time of 3 and 6 months follow-up, IOP was significantly lower than that before operation in 65 eyes(P<0.05)and few complications occurred.

CONCLUSION: The efficacy ofmini-incision cataract extraction with IOL and goniosynechialysis for angle-closure glaucoma was definite and no severe complications occurred. This surgery should be widely applied in the primary hospitals without phacoemulsification equipment since it is economic, safe and easy to perform.

Abstract:AIM:To evaluate the effect of compound anisodine on the postoperative visual acuity and visual field change after acute angle closure glaucoma.

METHODS:Fifty-seven cases 83 eyes acute angle-closure glaucoma with postoperative intraocular pressure in the normal range, anterior chamber depth normal were randomly divided into single operation and postoperative observation of compound anisodine treated group, visual acuity, visual field improvement situation of two groups were compared.

RESULTS:The difference between preoperative and postoperative intraocular pressure of the two groups was statistically significant(P<0.01); visual acuity, visual field changes between the two groups had significant difference(P<0.05).

CONCLUSION:Application of compound anisodine on acute angle-closure glaucoma can obviously improve the postoperative visual acuity, visual field.

Abstract:AIM:To assess the therapeutic effects of krypton yellow laser for the prevention of diabetic macular edema in proliferative diabetic retinopathy(PDR).

METHODS:A total of 108 eyes of 58 patients with PDR were grouped into 3 groups. PDR without macular edema(macular treated by krypton yellow laser); PDR without macular edema(macular without treat); PDR with macular edema(macular treated by krypton yellow laser); all patients were treated by pan retinal photocoagulation(PRP); the postoperative vision, fundus fluorescein angiography and macular OCT were compared.

RESULTS:The group of PDR without macular edema(macular treated by krypton yellow laser)was better in vision than other groups.

CONCLUSION: Macular treated by krypton yellow laser before PRP can prevent macular edema.

Abstract:AIM: Toobserve the clinical effect of compound anisodine combined with xueshuantong and puerarin on central retinal artery occlusion(CRAO).

METHODS: Twenty-five cases 25 eyes with CRAO underwent the drugtreatment of compound anisodine combined with xueshuantong and puerarin; the postoperative visual acuity recovery, visual field defect, and retinal blood circulation were observed.

RESULTS: After the drug therapy, out of the 25 eyes with CRAO, 2 eyes were cured, 8 eyes with obvious effect, 13 eyes with effect, 2 eyes with no effect, the total effective rate was 92%.

CONCLUSION: Drug therapy of compound anisodine combined with xueshuantong and puerarin has obvious effect on CRAO.

Abstract:AIM: To observe the effect of nasalendoscopic dacryocystorhinostomy on chronic dacryocystitis.

METHODS: Case history, operative methods and prognosis of 17 patients(24 eyes)with chronic dacryocystitis treated by nasal endoscopic dacryocystorhinostomy in our hospital from 2010 to 2011 were retrospectively analyzed.

RESULTS: There were 17 patients recovered, one patient recurred. The case again treated with endoscopic operation and recovered. The follow up time was 6-18 months after operation.

CONCLUSION: This operative method of chronic dacryocystitis treated with nasal endoscopic dacryocysyorhinostomy might have excellent effect, less injury, low recurrence rate, high curative rate and does not affect beauty.

Abstract:AIM: To evaluate the clinical efficacy of surgical excision combined with limbal stem cell transplantation, amniotic membrane transplantation for the treatment of pterygium.

METHODS:Ninety pterygium patients from March 2007 to March 2010 were randomly divided into corneal transplantation group and amniotic membrane transplantation group, with 45 cases in each group. Corneal transplantation group were treated with surgical excision plus limbal stem cell transplantation, amniotic membrane transplantation group were treated with surgical excision plus amniotic membrane transplantation, the treatment effects of two groups were observed.

RESULTS: All the patients in two groups had been followed up for about 2 years; wound healing time of corneal transplantation group was shorter than that of amniotic membrane transplantation group, with the statistically significant difference(P<0.05); 42 cases in corneal transplantation group were cured, and recurrence in 3 cases; 39 cases in amniotic membrane transplantation group were cured, and recurrence in 6 cases; and the difference of recurrence rate of two groups was statistically significant(P<0.05).

CONCLUSION: Surgical excision combined withlimbal stem cell transplantation can treat pterygium, with low recurrence rate, fewer complications, and short healing time.

Abstract:AIM: To evaluate the postoperative effect of corneal limbal stem cell transplantation in the treatment of recurrent pterygium.

METHODS: All 124 eyes of 112 patients affected by recurrent pterygium and referred to our ophthalmologic department were considered. Each patient underwent autograft transplantation of corneal limbal stem cells.

RESULTS: Totally 115 eyes of 103 patients were cured, the rate of operation success was 92.7%, while 9 eyes of 8 patients were with recurrence, the recurrent rate was 7.3%.

CONCLUSION: There are good curative effect and low recurrence rate of corneal limbal stem cell transplantation in the treatment of recurrent pterygium.

Abstract:AIM:To analyze the clinical effect of biological amnion membrane transplantation with mitomycin C in treatment of pterygium.

METHODS: The clinical efficacy of 201 cases(242 eyes), which were performed biological amnion membrane transplantation combined with mitomycin C in the treatment of pterygium in Nongsanshi Hospital from September 2008 to September 2011 were retrospectively investigated.

RESULTS: The postoperative follow-up period was 6 to 24 months. 197 cases(238 eyes)were cured(98.3%), 4 cases(4 eyes)recurred(1.7%).

CONCLUSION: Biological amnion membrane transplantation withmitomycin C in treatment of pterygium is simple, practical, safe, and efficient and can reduce the recurrence rate significantly. It is a valuable therapeutic method for the treatment of pterygium.

Abstract:AIM: To observe the curative effects of pterygium conjunctiva reverse transplantation combined with amniotic membrane transplantation for treatment of recurrent pterygium.

METHODS: A retrospective case series study. Twenty-six eyes of 26 cases with recurrent pterygium in our hospital from January 2009 to January 2012 underwent pterygium excision combined with autologous limbal stem cell transplantation and recurred more than one year. In this study, when the pterygium tissue was excised, the conjunctiva was cut and preserved after it was fully free, then the preserved conjunctiva was put reversely to cover the amniotic membrane and sutured after amniotic membrane covering the bare conjunctiva. The conjunctival graft healing condition, amniotic membrane dissolution, corneal wound repair, corneal neovascularization and pterygium recurrence rate 1 week, 2 weeks, 1 month, and 3 months after operation were observed. The follow-up period was 12 months.

RESULTS: Conjunctival graft healing time was 6.03±2.76 days, amniotic membrane dissolved absorption time was 14.26±3.64 days, corneal wound repair time was 5.42±1.58 days. In postoperative 3 months, new conjunctiva in bare sclera surface and conjunctival graft healed well, no obvious pterygium postoperative complications. In postoperative 1 year, 2 cases with recurrent pterygium recurred, pterygium recurrence rate was 8%, cure rate was 92%.

CONCLUSION: For recurrent pterygium, due to the traditional autologous corneal limbal stem cell transplantation has injured partial limbal and conjunctival scar, the postoperative pterygium recurrence rate is very high after single conjunctival transplantation or amniotic membrane transplantation. This method takes the pterygium conjunctiva reverse transplantation and avoids large area wound of ocular surface, obtains surgery materials easily and controls the postoperative recurrence of pterygium well, which is a good choice for treating recurrent pterygium.

Abstract:AIM: To evaluate the efficacy of two kinds of hydroxyapatite(HA)implantation surgeries.

METHODS: In this retrospective case series from April 2009 to January 2012, 60 patients 60 eyes were included and allocated for primary enucleation and either homologous sclera-wrapped HA orbital implant or autologous sclera-wrapped HA orbital implant under local anesthesia, in order to compare conveniently, the same number cases in either series was selected. The main outcome measures included socket examination, HA implant exposure.

RESULTS: Six eyes in the homologous group had the splits in conjunctiva; 1 eye had HA exposure. 7 eyes in the autologous group had the splits in conjunctiva; 5 eyes had HA exposure and 2 of them had HA out of the orbit finally.

CONCLUSION: Homologous sclera wrapping HA is a good way to perform orbital implant surgery.

Abstract:AIM: To observe the clinical effects ofautologous sclera covering in preventing the exposure of hydroxyapatite(HA)orbital implants.

METHODS: Primary HA orbital implants were performed in 69 cases 69 eyes with double sclera or withrectus lamellar scleral for covering.

RESULTS: Thetime of follow-up was 4 to 24 months. All patients had no exposure of HA.

CONCLUSION: Primary HA orbital implants with double sclera or withrectus lamellar scleral for covering can prevent the exposure of HA effectively.

Abstract:AIM: To compare the anesthetic effect of singleketmine and low-dose ketamine combined with proprofol in pediatric ocular trauma surgery.

METHODS: Sixty children with traumatic ocular disease were randomly divided into low-dose ketamine- propofol group(group A, n=30)and ketamine group(group B, n=30). The change of vital signs, effect and adverse reaction to anesthesia, intraocular pressure, the time of operation, duration of reviving and leaving operation room, ketamine mean consumption were all recorded in the preoperation, intraoperation and postoperation period.

RESULTS: There was no significant difference in thehemodynamic and respiratory function among 2 groups(P>0.05). The incidence of adverse reaction and hyper intraocular pressure was less than that of group B(P<0.05). Ketamine consumption in group B was significantly more than that in group A, recovery time were also longer in group B than those in group A(P<0.05).

CONCLUSION: The low-doseketamine combined with proprofol is a safe, efficacy anesthesia with stable hemodynamic function and intraocular pressure, quicker recovery and less adverse effect in pediatric ocular trauma surgery.

Abstract:AIM: To analysis the mechanism, clinical peculiarity, and treatment for pediatric orbital blowout fracture.

METHODS: The retrospective analysis included 12 pediatric patients suffered from orbital blowout fracture from 2008-2010.

RESULTS: Of the 12 pediatric patients, most of the orbital blowout fractures were located in orbital floor when the patients fell over. Diplopia occurred and embedded musculi were observed by CT. Early interventions were taken. Diplopia improved in all of the 12 pediatric patients. One week after surgery, eye movements in 6 patients became normal gradually; 4 patients' muscle recuperated in 3 months; 2 patients couldn't move their eyes normally within 6 months and traction tests were positive.

CONCLUSION: The pediatric orbital blowout fracture more often happen in floor orbital and cranny blowout is their configuration. Restricted movement and diplopia are main signs. Enophthalmos occurs rarely. Trauma and operation both can cause muscle's hurt. Early intervention usually led to better improvement and more complete resolution of ocular motility limitation and diplopia than late repairs.

Abstract:AIM: To study the characteristics and curative effects of excimer laser in situ keratomileusis(LASIK)with monovision correction for myopia in older patients.

METHODS: Totally 104 myopic patients(186 eyes)with the age of 40 years or older were treated with LASIK. Monovision correction was chosen for all these patients. The preoperative refraction, refractive diopter supposed to be corrected, and the curative effects were analyzed.

RESULTS: The postoperative uncorrected visual acuity(UCVA)were improved significantly than of the preoperative in all 186 eyes after 1 month of operation(P<0.01). The postoperative UCVA ≥1.0 in 83.7% cases of nondominant eye(87/104)and 91.5% cases of dominant eye(75/82). The postoperative UCVA were better than preoperative best-corrected visual acuity(BCVA in most cases of dominant eye(P<0.01), and kept the same level in most cases of nondominant eye(P>0.05). The postoperative refraction of nondominant eyes was -0.70±0.12D, which share the same change with preoperative design -0.78±0.11D(P>0.05), but was higher than that of dominant eyes -0.04±0.28D(P<0.01). All the patients were satisfied with the postoperative far vision and 82.7% of the patients were satisfied with the postoperative near vision.

CONCLUSION: Most of 40 years of age or older patients treated with LASIK are high myopic or high myopic anisometropia patients; LASIK with monovision correction is safe and effective for older myopic patients. Actual corrective diopter may be reduced because of age-related presbyopia, and the far vision and near vision would be satisfactory postoperatively.

Abstract:AIM: To understand the progress inanesthesia for cataract surgery researches between 2001 and 2011 through a bibliometric analysis.

METHODS:Web of Science was used for statistical sources, diabetic retinopathy literatures during 2001 and 2011 were retrieved, "the number of published articles per year, authors, source publications, subject category, literature type, literature language, institution, country/region" were analyzed by bibliometric statistical methods. Research trends, literature distribution, and any others were discussed.

RESULTS: Statistics about anesthesia for Cataract surgery researches changed from year to year a wavy trend within the Web of Science literature database. Article was the major publication form, The Johns Hopkins University was the major research institutions, and Ophthalmology was the main academic program category, "J Cataract Refr Surg" was the main source of literatures.

CONCLUSION: With the popularization of cataract surgery, anesthesia researches have become increasingly important. Exploring a safe and effective anesthesia has important clinical significance in future.

Abstract:AIM: To identify the mutation within the TGFBI gene in a Chinese family with epithelial basement membrane dystrophy(EBMD).

METHODS: A detailed family history was collected and after full clinical examination, genomic DNA of three affected and four unaffected family members was extracted from peripheral leukocytes. All exons of TGFBI gene were amplified by PCR methods and direct sequencing was carried out for mutation analysis.

RESULTS: A missense mutation c.417C>T in exon 4 of TGFBI led to an amino acid substitution R124C which was responsible for the familial disorder. This change co-segregated with all affected members of the family, but was not detected either in the non-carrier relative or control individuals.

CONCLUSION: This is the first report of the R124C mutation within the TGFBI gene in EBMD. The results broaden the relationship between genotype and phenotype of corneal dystrophy, and establish the foundation for the further molecular genetics studies.