Abstract:AIM: To evaluate the visual quality of cataract patients of high myopia with posterior staphyloma after phacoemulsification and intraocular lens(IOL) implantation, and analyze the reasons. METHODS:This study comprised cataract patients of high myopia with posterior staphyloma(Group A) and cataract patients of high myopia without posterior staphyloma(Group B)and cataract patients of emmetropia(Group C) .Postoperative visual function, including uncorrected distance visual acuity (UCDVA) and best-corrected distance visual acuity(BCDVA) were evaluated 3 days and 6 months postoperatively. Contrast sensitivity, fundoscopy and patients self satisfaction in the 3 groups were also compared. The relationship of vision and the axial length was also evaluated in Group A. RESULTS: Of the 545 eyes, 91 eyes were in the Group A and 227 eyes were both in Group B and C. The Group B and C had statistically significant better UCDVA and BCDVA than Group A from 3 days postoperatively to the final follow-up (both P<0.05). Group C had statistically significant better UCDVA and BCDVA than Group B at 3 days postoperatively (P<0.05). There were no statistically significant differences in UCDVA or BCDVA between Group B and C at 6 months postoperatively. The Group C had statistically significantly better contrast sensitivity than Group A and B; Group B had statistically significantly better contrast sensitivity than Group A (all P<0.05). After statistical test, it was testified that there was negative correlation between axis length of eye and postoperative vision in cataract patients of high myopia with posterior staphyloma. Patients in Group A and B reported being more satisfied than those in Group C(both P<0.05), but there were no significant differences between Group A and B. CONCLUSION: The visual quality of cataract patients of high myopia with posterior staphyloma after phacoemulsification and IOL implantation is worse than that of high myopia without posterior staphyloma and emmetropia. It is directly related to the posterior segment pathological changes in high myopia.

Abstract:AIM: To determine the efficacy of combined pars plana vitrectomy (PPV) with primary scleral fixated intraocular lens (IOL) in patients with ocular trauma. METHODS: A retrospective case series descriptive study. A consecutive 8 patients of ocular trauma which underwent combined PPV with primary scleral fixated IOL at the University Malaya Medical Centre were reviewed. One patient had bilateral injury making it 9 eyes for analysis. The presenting visual acuity, technique of surgery, complications and outcomes were analyzed. RESULTS: Vision improved in 8 out of the 9 eyes (89%). The major postoperative complication noted was an elevated intraocular pressure while suture breakage was not noted in our series. CONCLUSION: Combined PPV and sutured IOL has a good outcome in eyes with history of trauma.

Abstract:AIM: To find out if presbyacusis is a predictive clinical parameter for early diagnosis of pseudoexfoliation syndrome (PES). METHODS: This is a prospective, case-control study. 30 patients with PES in one or both eyes constituted the study group and the other 30 presbyacusis patients were in control group. Pure-tone hearing threshold levels (HTLs) were measured at 0.5, 1, 2, and 4 kHz. Tympanometric peak values and transient evoked otoacoustic emissions (TEOAE) testing results were also recorded. All subjects underwent a detailed ophthalmic examination. RESULTS：Distribution of the hearing levels was different between the study group and control group. Mild hearing loss (21-40 dB) was higher in control group than that in study group. Mean hearing thresholds at each of the examined frequencies were compared directly between the two groups. Clinically significant differences were found when we compared mean pure-tone HTLs between the 2 ears of the two groups. However, there was not a statistically and clinically significant difference between the 2 ears mean pure-tone HTLs at high frequency (4 kHz). CONCLUSION：We concluded that patients who are diagnosed with presbyacusis in ear, nose, and throat should not be performed any ophthalmic examinations, which would save time and money in daily clinical practice.

Abstract:AIM: To report a case of bilateral ocular ischemic syndrome(OIS) with bilateral common carotid artery complete occlusion in a patient after long-term radiotherapy for nasopharyngeal carcinoma. METHODS: Interventional case report. A 57-year-old man presented with a 6-month history of amaurosis fugax in his left eye and ocular and periorbital pain, diagnosed with bilateral OIS. Bilateral panretinal photocoagulation (PRP),cataract surgery, carotid endarterectomy and an Ahmed valve implant were performed consecutively. RESULTS: After PRP and uneventful cataract phacoe- mulsification administrated, the conditions of bilateral eyes were stabilized. However after bilateral carotid endarterectomy, the intraocular pressure(IOP) was increased，accompanied by the visual acuity reduced to counting fingers at six inches. CONCLUSION: The management of bilateral OIS with bilateral common carotid arteries complete occlusion after long-term radiotherapy for nasopharyngeal carcinoma is frustrating and the prognosis for vision is poor.

Abstract:AIM: To induce a rat model of retinal vein occlusion (RVO) by photosensitizer erythrosin B and to observe temporal changes in retinal physiology and histology in the laser-induced model. METHODS: Ophthalmoscopy, fundus photography, and fluorescein angiography (FA) were performed following laser-induced central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) immediately after laser treatment and at 1 hour and 3 hours and 1 day,2, 4, 7, 14 and 21 days. Retinal histology was examined at 7, 14 and 21 days. RESULTS: For CRVO and BRVO, reperfusion of occluded branch veins was observed 7 days after treatment. Retinal edema and hemorrhages peaked on day 4, and by day 14, treated retinas appeared pale and yellow precipitate was observed by day 21 for CRVO upon ophthalmoscopy. In BRVO rats, retinal hemorrhages were limited to the vein-occluded region, although edema was more widespread and, to a limited extent, involved the untreated hemi-retina. Significant ganglion cell layer (GCL) cell loss was observed in both CRVO and BRVO groups after day 14. CONCLUSION: Laser-induced RVO in rats resulted in targeted vascular occlusion that persisted for 7 days. Significant GCL cell loss was seen within whole retina of both CRVO and BRVO model. This reproducible model provides a valuable tool for the study of the molecular events associated with retinal ischemia and cell death.

Abstract:AIM: To research tissue and ultrastructure in retinal pigment epithelium（RPE） of apolipoprotein E-deficient(ApoE-/-) mice effected by dyslipidemia in using jianpiquyu method,and to explore the effects on the VEGF/VEGFR2 pathway. METHODS: Thirty-six 2-month-old ApoE-/-mice were randomly divided into three groups:the group of normal chow(group A);the group of high fat chow(group B)，the group of treatment(group C),twelve mice in each group.Animals were killed after five months feeding and animal bodymass,blood lipid and hemorheology levels were detected．RPE was observed by light microscopy,transmission electron microscopy and immunohistochemistry． And the VEGF were analysed by Western blot. RESULTS: The animal bodymass,lipid and hemorheology levels in group B were significantly higher than those of group A and group C(P＜0.05).The thickness of RPE in group A was statistically higher than that of group B and group C(P＜0.05)，but there was not statistically signigicant difference between group B and group C（P>0.05）.VEGF and VEGFR2 dyeing area and intergral optical density in group B were higher than those of group A and group C(P＜0.05).Protein expression in retina in group B was higher than that of group A and group C(P＜0.05). CONCLUSION: It plays a positive role in ameliorating biochemical indicators such as lipid and hemorheology levels in dyslipidemia ApoE-/-mice by using jianpiquyu method.It also plays a regulatory function in the VEGF/VEGFR2 pathway in this age-related macular degeneration (AMD) animal model.

Abstract:AIM: To evaluate the pharmacokinetics of cyclosporine A(CyA)-loaded chitosan(CS) nanoparticles in rabbits after intravitreal injection. METHODS: Experimental study on pharmacokinetics of sustained release drug in vitreous. Twenty rabbits were intravitreally injected CyA-loaded CS nanoparticles. Liquid vitreous was aspirated at the time of 1 day, 2,3,5,7,9,11,14,21,28 days postoperatively for determination of CyA concentration by high-performance liquid chromatography. RESULTS: 81％ of CyA was released in vitro from CyA-loaded CS nanoparticles after 14 days. The level of CyA ranged from 448.5ng/mL to 1237.7ng/mL during 28 days in vitreous cavities. CONCLUSION: Intravitreal injection of CyA-loaded CS nanoparticles leads to a sustained release of CyA with a high bioavailability. CS nanoparticles is a potentially promising delivery system for the posterior segment diseases.

Abstract:AIM：To explore regulative effect of recombinant human erthropoietin(rhEPO) on the expressin of Bcl-2 and Bax protein on retina following eye contusion, and to clear the protective mechanism of rhEPO for traumaic retina. METHODS: Of 45 two-month old male SD rats, 5 rats were obtained at random for normal control group.The left eye contusions were made by modified Allens falling strike for the rest 40 rats.Successful model rats were randomly divided into model group and rhEPO group. Each group is subdivided into 4 groups according to the different time point (12，24 hours，3，7 days), 5 rats per group.The rhEPO group animals were injected with rhEPO intraperitoneally,once a day. The model group animals were injected with physiological saline.The retina specimen were gotten after stopping giving rhEPO and physiological saline. Paraffin retinas sections were made and the expressions of Bcl-2 and Bax protein in the rat retinas were tested with immunohistochemistry staining. RESULTS: The expressions of Bcl-2 and Bax protein were modest in normal groups. With prolonging of time, The expression of Bcl-2 protein decreased gradually, and reached minimum at 3 days after ocular trauma in normal groups. Except for 12 hours, the expression of Bcl-2 protein was lower in model groups than that in normal groups at each time point, while the expression of Bax protein gradually increased and reached peak at 3 days after ocular trauma in model group. Except for 12 hours, the expression of Bax protein was higher in model groups than that in normal groups. The expression of Bcl-2 protein was obviously higher in rhEPO groups than that in model groups, while the expression of Bax protein was obviously higher in rhEPO groups than that in model groups at 24 hours, 3 days and 7 days. CONCLUSION:Bcl-2 and Bax take part in pathologic process of ocular trauma; rhEPO upregulates the expression of Bcl-2 and downregulates the exprssion of Bax on retina cells following ocular trauma, which maybe inhibits the apoptosis of retina cells.

Abstract:AIM:To observe the expression of Nogo-A and NgR in rat retinal ischemia-reperfusion(RIR) acute injury and to investigate their significance and correlation. METHODS: Ninety adult SD rats were randomly divided into normal group(6 rats), experimental group(RIR group,42 rats) and sham group(42 rats).The experimental group and sham group were subdivided into 0 hour,6,12,24,48,72 and 168 hours subgroups according to different time after RIR injury.Six rats were bring into every subgroup.Ligating the ratssingle common carotid artery was used to establish animal models of rat retinal ischemia. Pathomorphology was detected by hematoxylin and eosin stain and the expression of Nogo-A and NgR was measured by immunohistochemistry. RESULTS: Compared with normal group, the expression of Nogo-A and NgR in sham group had no statistically significant difference (P>0.05). Compared with sham group ,experimental group had the expression of Nogo-A gradually increased in 12 hours after RIR(P<0.05), peaked in 48 hours(P<0.01),decreased in 72 hours(P<0.05) and reached in normal leavel in 168 hours(P>0.05); the expression of NgR increased in 6 hours after RIR(P<0.05), peaked in 48 hours(P<0.01),decreased in 72 hours(P<0.05) and reached in normal leavel in 168 hours(P>0.05). The expression of Nogo-A and NgR in experimental group showed a positive correlation(P<0.01). CONCLUSION: Nogo-A and NgR expressed at each time point after RIR as a parabola.NgR expressed prior to Nogo-A.They were all peaked at 48 hours after RIR.The expression of Nogo-A and NgR closely related to RIR injury, with a collaborative relationship between the two.

Abstract:AIM: To investigate the protective effects of exogenous estrogen and effects on expression of Bcl-2 and Bax protein against retinal ischemia-reperfusion injury(RIRI)． METHODS:Seventy-two SD rats were randomly divided into normal control(N,n=8),simple ischemia-reperfusion model group(IR, n=32),estradiol benzoate treatment group (E₂+IR,n=32).In the latter two groups,each sub-group was determined by the time after ischemia-reperfusion: 6, 24, 48 and 72 hours. By improving the anterior chamber intraocular pression to set up ischemia-reperfusion model in big rats.The morphology change of retina tissue was detected by light microscope.The changes of Bcl-2, Bax protein were measured by immunohistochemistry in retinal tissue . RESULTS:.In the E₂+IR group, the damage of the retina was significantly reduced than IR group.In IR group,the expression of Bax protein began to add at 6 hours after reperfusion,24 hours reached the peak,48 hours began to reduce,and 72 hours had weak expression. In IR group the expression of Bcl-2 reached the peak at 6 hours,with time going,the expression of Bax began to reduce;but in E2+IR group were increased significantly than IR group in all the time points(P<0.01). CONCLUSION:The retina organization was injured by ischemia-reperfusion injury.Bcl-2 and Bax protein had taken part in the RIRI. Estradiol benzoate could increase the expression of Bcl-2 and cut the expression of Bax protein, and protect the retina tissue.

Abstract:AIM: To detect the expression of TLR4 in rats corneal epithelium with pretreatment of Aspergillus. METHODS: Healthy Wistar rats were randomly divided into four groups of A, B, C and D. Group A was the blank control group. Rats corneal epithelium was stimulated by Aspergillus for 4 hours in group B,C and D. Rats corneal epithelium was scraped immediately in the completion of the stimulation in group B. The epithelium was scraped after 96 hours in group C. The epithelium was stimulated again by Aspergillus after 96 hours in group D, and was scraped immediately. Real-time PCR was used to assay the mRNA expression of TLR4 receptor in the epithelial tissue. RESULTS: The expression of TLR4 was significantly increased by the stimulation of Aspergillus, and it became normal after 96 hours. The expression of TLR4 was no significant difference after twice stimulations. CONCLUSION: The expression of TLR4 can be increased by the stimulation of Aspergillus, but the basic expression level has no significant change.

Abstract:AIM： To preliminarily discuss the mechanisms of cycloslporinc(CsA) on the IL-17⁺ cells in uveitis. METHODS: Fifteen HLA-B27 uveitis patients with active uveitis were involved in this study. Blood samples were taken from these patients for analysis of IL-17. The levels of IL-17 in the supernatants of PBMCs from patients before treatment cultured without or with CsA at different concentrations were detected by enzyme-linked immunosorbent assay (ELISA). Intracellular staining with flow cytometry was used to evaluate the expression of CD69 on the IL-17-producing cells in different groups. RESULTS: The results showed that CsA inhibited the secretion of IL-17,but it did not influence the expression of CD69. CONCLUSION: Our findings showed that one of the mechanisms of CsA on the treatment of HLA-B27 uveitis is the inhibition of the secretion of IL-17.

Abstract:AIM: To compare corneal flap thickness created with Ziemer LDV femtosecond laser and Moria M2 mechanical microkeratome. METHODS: A retrospective analysis of 100 cases (200 eyes) were performed with myopia and astigmatism (sphere -2.00- -12.00 diopters\[D\];cylinder 0.00- -3.50 diopters\[D\]). Fifty cases (100 eyes) were treated with Ziemer LDV femtosecond laser (Intended flap thickness was 110μm) and fifty cases (100 eyes) were treated with Moria M2 mechanical microkeratome using the 110μm head. Corneal flaps parameters were measured at center and 1mm,2mm,3mm from center located in meridian 0°,45°,90°,135°section, each section including seven points evaluated by RTVue FD-OCT one week after procedure. All measurement points were analyzed. RESULTS: The mean flap thickness at center was 108.69±11.75μm in Ziemer group and 130.75±13.36μm in Moria M2 group. There was a statistical difference in relative points between the two groups (t=24.791,P<0.01). The mean value of each section by subtraction a target flap thickness of 110μm was 9.70±6.84μm in Ziemer group and 21.63±11.79μm in Moria M2 group at center. Ziemer group was significantly less than Moria M2 group (t=17.493,P＜0.01). Flap thickness of seven points in the same section were significantly different in both Ziemer group and Moria M2 group（P<0.01）. CONCLUSION:Flap creation with Ziemer LDV femtosecond laser was superior to Moria M2 mechanical microkeratome in precision and predictability. The flap thickness of different point in the same section was not equal in two groups.

Abstract:AIM:To evaluate the severity of different stages of diabetic retinopathy (DR)with optical coherence tomography (OCT) for the determination of retinal morphological changes of non-diabetic retinopathy (NDR) and non-proliferative diabetic retinopathy (NPDR) and with multifocal electroretinogram (mfERG) for the determination of changes in retinal electrical activity. METHODS：Totally 30 elderly people of 50-70 years (30 eyes) were taken as normal group,50 patients(50 eyes) with confirmed type 2 diabetes as experimental group. They were conducted OCT and mfERG examination in standard state, and the results were statistically analyzed. RESULTS:For patients with NPDR, retinal morphological changes showed that most of the neural epithelium of the macular area thickened, indicating that the retinal function was in continuous decline as for the risk factors of diabetes. Neural epithelium of the macular area didnt change obviously at NDR stage but obviously thickened at NPDR stage, indicating that the morphological changes of the macular area were not large in the early diabete, and with the exacerbations of diabetes, the morphology had great changes. Electrophysiological changes showed that the response density of mfERG P1 wave gradually decreased as the disease worsened, which significantly reduced at NDR stage, while at NPDR stage, declined more obviously, indicating that the electrical activity at the macular area had been weakened before retina morphological changes, which declined more obviously after morphological changes. CONCLUSION：Determinating the morphological and electrical activity changes of the macular area with OCT joint mfERG, both means had a high application value in the early observation, follow-up and further treatment options of the disease.

Abstract:AlM：To evaluate the efficacy and safety of photodynamic therapy (PDT) and intravitreal Avastin for choroidal neovascularization (CNV) due to pathologic myopia(PM). METHODS: Seventeen patients(17 eyes) with subfoveal CNV caused by pathologic myopia received PDT followed by an intravitreal injection of 1.5mg Avastin three days later. Verteporfin PDT was performed using the recommended standard. All patients were followed clinically and with fundus flourescein angiography(FFA) and optical coherence tomography(OCT) at baseline and 1 month, 3, 6, 12 months after treatment. The best-corrected visual acuity (BCVA) was measured and the OCT findings were examined before and 1 month, 3, 6, 12 months after treatment. Follow-up time varied from 6 months to 16 months (mean, 10.3 months). The BCVA levels were converted to logMAR equivalents and datas were analyzed using the paired t-test (SPSS 14.0), and P<0.05 was considered statistically significant. RESULTS: At the last visit,the mean BCVA（logMAR）was 1.007±0.103 before treatment and 0.873±0.100 at the last visit (P<0.01). The BCVA improved more than two lines in 4 eyes (23.53%), improved one line in 5 eyes (29.41%) and stabilized (no change) in 8 eyes (47.06%) and none decreased. FFA showed CNV complete closure in 10 eyes (58.82%) , partial closure in 7 eyes (41.18%).The central macular thickness (CMT) on OCT images decreased from 194.67±12.74μm at baseline to 132.07±8.32μm after treatment(P<0.01). No complication occurred. CONCLUSlON: PDT and intravitreal Avastin for CNV caused by PM was effecetive with an significantly improvement in BCVA, FFA and OCT. But visual prognosis was found to be influenced by age at treatment.

Abstract:AIM:To estimate the influence of pterygium excision with autologous conjunctiva-flap transplantation upon tear film function in patients with pterygium. METHODS: All patients undergoing pterygium excision with autologous conjunctiva-flap transplantation received the tear film break-up time (BUT), Schirmer I test and tear fern test (TFT) at preoperative 1 day and postoperative 3,7,30 days,conjunctival impression cytology (CIC) of tear film mucous layer was tested at 1 day before surgery and 30 days after surgery to evaluate the function of tear film. RESULTS: A total of 87 cases (87 eyes) enrolling in the current study, 45 cases were male, 42 cases were female. Patientsage ranged from 45 to 81 years with an average age of 64.1±8.8 years. Mean BUT at 30 days of follow-up was longer than that before surgery, they were 11.47±323 seconds and 9.43±3.25 seconds, respectively (P<0.05). The proportion of cases with normal results of TFT (graded as TypeⅠandⅡ)was 90% which was significant higher than that tested before surgery (P<0.05). Goblet cell density after surgery (39.73±18.46/10 high power microscopic) was higher than preoperative results (48.85±18.80/10 high power microscopic) with a significant difference(P<0.05). Improvement of Schirmer I test was found between first test and early tests after surgery (P<0.05), whereas it wasnt observed between the first and the last test (P>0.05). CONCLUSION:Pterygium excision with autologous conjunctiva-flap transplantation can improve the function of tear film.

Abstract:AIM: To evaluate the efficacy of non-steroidal anti-inflammatory drugs to relieve the symptoms of dry eye after laser-assisted in situ keratomileusis (LASIK). METHODS: Sixty-six patients (132 eyes) were involved and made a self-controlled study in Shandong Eye Institute from November to October 2010. Based on conventional treatment, only artificial tears drops was used for the left eye, and 1g/L Pranoprofen drops was added for the right eye. According to the frequency of the drops, they were divided into two groups, including group A (4 times/day)and group B (6 times/day). Subjective symptoms, Schirmer test(SⅠt), tear break-up time(BUT), fluorescein staining(FL), rose bengal staining, index of surface variance(ISV) and vertical asymmetry(IVA) were recorded and made a statistical analysis respectively before and 10 days, 1 month after surgery. RESULTS: Compared with the control eyes ,there was a statistically significant difference in all the indicators except ISV and IVA of 10 days after the surgery, and except FL, ISV and IVA of 1 month after the surgery in both group A and group B.There was a statistically significant difference in BUT and rose bengal staining of ten days after the surgery between group A and group B(P<0.05). There was no statistically significant difference in indicators 1 month after the surgery. CONCLUSION:The tendency of ISV and IVA from topography shows a great leap but less specificity to evaluation of dry eye after LASIK. Add with 1g/L Pranoprofen drops after LASIK surgery could relief the symptoms of the dry eye effectively though reduce the inflammation and prolong the tear BUT. Increasing the frequency of the non-steroidal anti-inflammatory drugs could not significantly raise the efficiency of the drugs.

Abstract:AIM:To study its controlling effect of ocular development and correlation of controlling effect to the degree of myopia by observing concentration of insulin like growth factor 1(IGF1) and insulin like growth factor binding protein-3(IGFBP-3) in children with myopia and emmetropia. METHODS: Sixty children 120 eyes with myopia and 60 children 120 eyes with emmetropia were collected at random. All subjects with myopia were examined and separated into three groups according to visual acuity: mild myopia worse than -3.00D, moderate myopia(-3.00 --6.00D), high myopia(better than -6.00D). IGF1 and IGFBP-3 of all subjects were measured with enzyme linked immunosorbent assay (ELISA). The data were analyzed by SPSS 13.0 statistics software. RESULTS:There was no statistical difference between two groups in age, gender, height, weight, corneal refractive power and corneal thickness. The ocular axial length of myopia group was longer than control group. IGF1 and IGFBP-3 concentration of myopia group were higher than control group. The more degree of myopia,the higher IGF1 and IGFBP-3 concentration . There were positive correlations between IGF1 or IGFBP-3 and the degree of myopia, ocular length, refraction. There were no correlations between IGF1 or IGFBP-3 and height, weight, corneal refractive power, corneal thickness. CONCLUSION: Experiments further confirm controlling effect of IGF1 and IGFBP-3 concentration on ocular development. There exist the correlations between the controlling effect and the generation and development of myopia. Biological activity of IGF1 is controlled by IGFBP-3.

Abstract:GlycoproteinB,D（gB， gD） are essential components for infection by herpes simplex virus-1 (HSV-1)，possess important epitope, participate in viral transmembrane process, mediate virus spreading between the cells, and play an important role in the process of host immune and viral infection.The study of their molecular and functional properties has important significance for research of herpes simplex keratitis(HSK) mechanism of action and preventation. In recent years, the research in HSVgB, HSVgD has certain progress, already developed vaccine specific to HSVgB, HSVgD epitope. Here,we reviewed the research progress in HSK related gB, gD and vaccine.

Abstract:Artemisinin is extracted from herbal medicine,Artemisia annua L,which can be made into many derivatives after chemical alteration.With further research into the pharmacological effects of artemisinin and its derivatives,immunosuppression effect was discovered.Considering the clinical application of artemisinin and its derivatives,the prospect of immunosuppression effect in uveitis control is very promising.

Abstract:Corneal collagen cross-linking(CXL) is a new treatment for keratoconus. Based on the topical administration of riboflavin and irradiation with ultraviolet A (UVA) light of 370nm, this procedure can lead to photosensitive reaction and thus to induce cross-linking between and within collagen fibrils in order to increase rigidity and biomechanical stability of the cornea. This new approach has been also shown to be an effective treatment for some kinds of other corneal diseases. However, recently, adverse effects and complications related to epithelial removal have been reported. For this reason, researchers proposed the transepithelial corneal collagen cross-linking. The purpose of this paper is to review the basic principle, procedure, effect of epithelial removal and the laboratory and clinical researches about transepithelial corneal collagen cross-linking with Riboflavin/UVA.

Abstract:As the visual quality requirements of the cataract surgery increase, the application of multifocal intraocular lens has been a hot research subject recently. So far, the multifocal intraocular lens has been divided into refractive multifocal intraocular lens, diffractive multifocal intraocular lens and hybrid multifocal intraocular lens. This article summarizes the progress of clinical application of three types of multifocal intraocular lens and their design principles.

Abstract:There are a number of anti-cicatricial drugs for glaucoma filtration surgery, for example, 5-Fluorouracil(5-FU), mitomycin C(MMC) and so on, but these medicines also have certain complications and side effects. The ophthalmologists are looking for more safe, effective and permanent drugs. In this summary, the author will make the conclusion of these articles published in PubMed from 2009 to 2012 concerning secreted protein acidic and rich in cysteine(SPARC), small interfering RNA(siRNA), Pirfenidone, Sirolimus sustained delivery film, and so on.

Abstract:At present, there are many fundamental approaches to study label retinal ganglion cells(RGCs). Retrograde labeling is the common method of label RGCs, but there are many deficiencies. In the present studies, people have found that many kinds of proteins were specific expressed by RGCs, and tried to use immunolabeling method to label RGCs. This review focuses on recent advance in research on labeling RGCs.

Abstract:In recent years, with the significant progress in modern educational technology，there has been obvious improvement in ophthalmological teaching reform in China. In this article, we discussed how to realize teaching and studying in ophthalmology education，improve the quality of education and train the high-quality talents. Evidence-based medicine (EBM) has been used in teaching. Teachers emphasize creative thinking and quality education. Teaching mode has been transferred from the traditional lecture based learning mode to the problem based learning mode. Many modern teaching techniques have been applied in ophthalmology education, including computer assisted instruction (CAI), database system, virtual reality, slit-lamp microscope teaching system and experiment of anatomy. This article summarizes current status and prospects of ophthalmological teaching reform in China.

Abstract:AIM:To explore the clinical effects of phacoemulsification and intraocular lens implantation in patients of cataract with idiopathic macular epiretinal membrane. METHODS: Totally 112 patients (118 eyes) with coexisting cataract and idiopathic macular epiretinal membrane underwent phaco and intraocular lens implantation were analyzed retrospectively covering a period from 2008 to 2011.The patients were divided into three types according to their characteristics and OCT features: the early stage, the proliferative stage, and the traction stage respectively.The visual acuity, the best-corrected visual acuity (BCVA), the central macular thickness and the membrane shape were observed and analyzed before the surgery and at 1 week and 6 months after the surgery. RESULTS:The visual acuity and the BCVA of all the patients were improved more or less 6 months after the surgery . 100% and 73% of the eyes had a BCVA of ≥0.5 in the early stage and the proliferative stage respectively,with 53% of the eyes had a BCVA of ≥0.1 in the traction stage, whereas the central macular thickness had no significant difference. Vitrectomy and internal limiting membrane removal were performed in two patients in the traction group. CONCLUSION:Phacoemulsification and intraocular lens implantation is an effective and safe method for the management of cataract with idiopathic macular epiretinal membrane. The visual quality can be improved,whereas the retinopathy does not worsened.To the patients with cataract and idiopathic macular epiretinal membrane in the traction stage, combined surgery (vitrectomy, internal limiting membrane removal, phaco and intraocular lens implantation) should be performed.

Abstract:AIM:To discuss clinical therapeutic effectiveness of phacoemulsification and intraocular lens(IOL) implantation on diabetic cataract patients． METHODS:Totally 80 cases (106 eyes) of diabetic cataract patients underwent phacoemulsification and foldable IOL implantation through temporal transparent cornea incision．The postoperative complications, visual acuity and incision healing were observed. RESULTS:All operations were finished successfully with primary IOL implantation in capsule.3 months after operation the naked eyesvision≤0．1 were in 6 eyes(5.7％)，0．2-0．5 in 28 eyes (26．4％ )， 0．6-1．0 in 72 eyes (67．9％)．There was no bleeding during operation and no infection after operation. CONCLUSION: It is safe and efficient to treat diabetic cataracts with phacoemulsification combined with foldable IOL implantation．

Abstract:AIM：To investigate the clinical effect and comprehension of the small incision extracapsular enucleation combined with intraocular lens implantation for the treatment of cataract in primary level hospital. METHODS：From January 2001 to December 2011, 2713 cases (3029 eyes) underwent small incision extracapsular enucleation combined with intraocular lens implantation, and the suitability of the surgery and treatment effects were analyzed. RESULTS: Postoperative vision was improved significantly, one day after operation, 2963 eyes(97.82%)whose visual acuity was better than 0.05 could obtain bright light. 2671 eyes (88.18%) whose visual acuity was better than 0.3 could get rid of disability. Seven day after operation, 3011 eyes (99.41%) whose visual acuity was better than 0.05 could obtain bright light. 2787 eyes (92.01%) whose visual acuity was better than 0.3 could get rid of disability. 3023 eyes (99.80%) implanted intraocular lens, main postoperative complications included 180 eyes of iritis,195 eyes of corneal edema, 138 eyes of post-capsular rupture, 30 eyes of iris damage（15 eyes of iridodialysis）, 23 eyes of intraocular hypertension, 25 eyes of hyphema and 24 eyes of crystalline lens residual.All complications could be cured by active treatment. The operation was simple and had less complications. CONCLUSION: The technique of small incision possesses satisfactory result, simple operation and cheap equipment, suitable for patients with cataract from poor areas in primary level hospital.

Abstract:AIM:To compare the effects of pre- and post- silicone oil removal combined phacoemulsification in silicone oil-filled eyes. METHODS: The clinical data of 36 patients (36 eyes) were analyzed. The 36 cataracts after silicone oil tamponade with pars plana vitrectomy were randomly divided into two groups. The two groups underwent combined phacoemulsification pre- and post-silicone oil removal respectively. The intraoperative and postoperative complications and postoperative anterior chamber reaction, intraocular pressure and corneal endothelium were observed. RESULTS:All patients operations were completed smoothly with silicone oil removal and IOL implantation, complications got effectively clinical control.The corneal endothelium cells densities and ratios of hexagonal cells were differently decreased.The ratios of hexagonal cells were significant difference between two groups of one week postoperatively. The corneal endothelial cell density and proportion of hexagonal cell were significant difference between two groups of one month postoperatively (P<0.05). CONCLUSION:The complications, anterior chamber reaction, and corneal endothelial lesion were less in group of pre-silicone oil removal combined phacoemulsification.

Abstract:AIM:To evaluate the feasibility of application with HRT-Ⅱ to detect morphological alteration of optic disc in primary open angle glaucomatous patients after complex trabeculetomy. METHODS: Totally 20 eyes of 20 cases with different stages of primary open angle glaucoma （POAG）were performed with complex trabeculectomy. All patients IOP were controlled without medicines. The follow-up period was 24 months. HRT-Ⅱscanning was differently undergone in postoperation 3,6,12 and 24 months. RESULTS: There was significant difference (P<0.05) between preoperation and postoperation in cup/disk area ratio (C/D), rim area (RA), mean and superior /inferior retinal nerve fibre layer (mRNFL) in all patients with different stages. CONCLUSION:HRT-Ⅱ can be applied to detect the post-operative morphological alteration of optic disc in POAG patients with high objectivity and repeatability.

Abstract:AIM: To evaluate the effectiveness of treating ocular surface disorders using 100% autologous serum eye drops. METHODS: Totally 35 cases (35 eyes) who had persistent corneal epithelial defects or ulcer that were nonresponsive to conventional medical treatment or amniotic membrane transplantation or lamellar keratoplasty were reviewed.These patients were treated with 100% autologous serum eye drops for 2-6 weeks. Its symptoms and corneal epithelial repair were observed. RESULTS:In 35 eyes ,12 eyes (34.3%) healed within 2 weeks,14 eyes (40.0%) healed within 4weeks.But the corneal epithelium of 9 eyes (25.7%)did not recover within 4 weeks. In herpetic keratitis and neurotrophic keratopathy the cure rate and improvement rate were 47.6% respectively, 95.2% healed within 4 weeks by using 100% autologous serum eye drops.No side effects and secondary infections were detected. CONCLUSION: The use of 100% autologous serum eye drops appears to be an effective and safe medical therapy in the treatment of persistent corneal epithelial defects or ulcer especially caused by the herpetic keratitis and neurotrophic keratopathy.

Abstract:AIM:To investigate the effect of Cyclogyl and compound tropicamide on cycloplegia with objective assessment to guide their clinical work. METHODS: Totally 60 cases(120 eyes) of myopia and hyperopia(each of 50%) aged 12 to 40 years from 2010/12 to 2011/03 were randomly selected.They were conducted mydriasis with domestic compound tropicamide eye drops 4 times, and retinoscopy 45 minutes later, and measured the amount of residual accommodation with integrated refractor.They were reinspected with Cyclogyl on the second day. RESULTS: In the hyperopia group, there were significant differences in refraction results between Cyclogyl and compound tropicamide (P<0.01); there were less differences in the myopia group (P<0.05), but still statistically significant. CONCLUSION:Clinically for refraction of patients with refractive error, compound tropicamide eye drops is an effective cycloplegic, but because of its limited cycloplegia and relaxation of accommodation, especially in hyperopic patients, it should be integrated with other relaxation methods, such as Cyclogyl, to get the final glasses prescription.

Abstract:AIM:To evaluate the effects of silicone intubation combined with laser by endoscopy for lacrimal duct obstruction. METHODS: Totally 186 patients (238 eyes) with obstruction of lacrimal passage were treated with the above method from May 2008 to June 2010. Tears recovery and fluorescein excretion test were used to determine the lacrimal duct patency. RESULTS: After the mean follow-up for 5.6 months, 214 of the 238 troubled eyes(89.9%) got cured, 20 eyes (84%) turned for better,4 eyes (1.7%) showed no effect. The total effective rate was 98.3%. CONCLUSION:Combination of laser and silicone intubation by endoscopy is a useful, economical and feasible method to treat the obstruction of lacrimal passage.

Abstract:AIM:To evaluate the clinical effects of Nd:YAG laser combined with novel lacrimal duct stent implantation treatment for nasolacrimal duct obstruction． METHODS:Totally 26 cases (29 eyes)with nasolacrimal duct obstruction were implanted with lacrimal duct stents after Nd:YAG laser surgery, and irrigated lacrimal duct regularly after surgery. RESULTS:All cases were followed up for 9-12 months.22 eyes were cured， 5 eyes improved，and 2 eyes(7%) treated ineffectively．The total efficiency was 93％. CONCLUSION:The novel lacrimal duct stent and the operation procedure are safe and simple,with less tissue hurt.It is an effective method for treating lacrimal duct obstruction and chronic dacryocystitis.

Abstract:AIM:To investigate the clinical characters and causes of subconjunctival hemorrhage(SCH). METHODS: A total of 103 patients with SCH aged 0-83 years were studied. The conjunctiva was divided into 10 equal areas. The age, gender, medical history, ocular disease history and site of subconjunctival hemorrhage were determined for all subjects. RESULTS:The number of patients involved by SCH showed an age-related increase. The number of patients with SCH increased markedly in 41-50 years of age and 61-70 years of age(0-10 years:5 patients,11-20 years:5 patients,21-30 years:10 patients, 31-40 years:15 patients, 41-50 years:24 patients, 51-60 years:14 patients, 61-70 years:24 patients, 71-80 years:5 patients, and over 80 years:1patient). The number of patients with traumatic SCH was 18 patients(54.1%) in less than 40 years of age, the number of patients with SCH by hypertension was 17 patients(56.7%) after the age of 60 years. Overall SCH was significantly more common in the temporal areas than other areas (45.6%). However the temporal areas were affected more often in traumatic SCH (50.0%). Summer subconjunctival hemorrhage was in 43 patients (41.7%). CONCLUSION: SCH showed an age-related increase in extent and was predominant in the temporal areas. However traumatic SCH was usually detected as localized hemorrhage in the temporal areas. The peak season for SCH was summer in all age groups. The trauma is the main reason in the younger group(≤40 years), but hypertension was the major risk factor in the older group(＞60 years ).

Abstract:AIM：To discuss the efficacy and safety of lifting flaps for laser in situ keratomileusis (LASIK) enhancement. METHODS：Totally 25 cases (36 eyes) of post-LASIK with residual refractive error were performed enhancement using lifting flaps, then ablated corneal stroma by excimer laser procedure. Postoperative follow-up survey included visual acuity, refractive error and complications for 1 year. RESULTS：The average uncorrected visual acuity improved from preoperative 0.39±0.16 to postoperative 092±0.17, 1.01±0.16, 1.03±0.16, 1.04±0.18 at 1 month, 3, 6, 12 months. The pre-operative mean spherical equivalent changed from -1.87±0.64D to 0.21±0.43D at post-enhancement 12 months. There was significant difference between them (P<0.01). CONCLUSION： Ｌifting flaps for LASIK enhancement is safe and effective to treat LASIK postoperative undercorrection and reftactive regression treatment.

Abstract:AIM:To select suitable surgery by pars plana vitrectomy(PPV) evaluating severity of the ocular trauma and vision prognosis in eye injuries with non-light perception. METHODS: Eight cases(8 eyes)with non-light perception in complicated ocular trauma were treated with vitrectomy surgery. RESULTS:After the surgery, non-light perception was in 5 eyes, finger counting in 1 eye, hand motion in 1 eye, 0.05 in 1 eye. In the operation, the author altered the way of performing operation to evisceration and orbital implant of hydroxyapatite in 2 eyes, eyeball enucleating in 1 eye 4 months after vitrectomy surgery, silicone oil tamponade in the other 3 eyes. CONCLUSION: PPV can evaluate severity of the ocular trauma and select the suitable operation method.

Abstract:AIM:To analyze the eye position influence on far and near stereo vision of intermittent exotropia patients. METHODS:Far stereo vision was tested by Clement Clarke International synoptophore, using random-dot picture card.Near stereo vision was tested with three-dimensional map. Far and near stereo vision of 40 intermittent exotropia patients were measured preoperative and postoperative a week respectively, and the results were analyzed. RESULTS:Preoperative existence ratio of near stereo vision was higher than the rate of far stereo vision. Preoperative visual acuity distribution of near stereo vision was different from normal. Postoperative far and near stereo vision were improved in varying degrees. The difference was statistically significant. CONCLUSION:Intermittent exotropia patients have different degree far and near stereo vision. The stereo vision damage in intermittent patients shows the loss of far stereo vision and the decline of near stereoacuity.Most patients with intermittent exotropia have near stereo vision, but the stereoacuity is lower than normal. The operation of eye position correction is important for near stereoacuity improvement and far stereo vision reconstruction. Surgery timing for patients with intermittent exotropia should be referred to the distance and near stereoscopic vision test results.

Abstract:AIM:To study the factors influencing the refraction of high myopia patients with cataract after phacoemulsification and intraocular lens implantation. METHODS:Phacoemulsification and intraocular lens implantation were performed on 30 patients (38 eyes) with axial high myopia and cataract. Three months after operation, postoperation refractions were measured and compared with predictive refractions. RESULTS: The average predictive refraction of 38 eyes was -1.39±0.47D.The average postoperative refraction was -0.87±0.93D.The average refraction error was -0.67±0.74D.There was significant statistical difference (t=3.375,P=0.002). There was low correlation between absolute refraction error and k-reading (r=0.443), and there was high positive correlation between refraction error and axial length (r=0.909). The absolute refraction error increased with the axial length growth. The average refraction error in eyes with axial length of 26-29mm was 0.61±0.39D, and with axial length ≥29mm was 1.37±0.84D.The difference was statistically significant (t=2.8601,P=0.005). The absolute refraction errors in eyes with axial length of 26-29mm were all less than 2.00D, and the refraction errors of six eyes with axial length of ≥ 29mm were ≥ 2.00D, accounting for 32%. CONCLUSION: The axial length is one of the most important factors which influence the postoperative refractive error of high myopia with cataract surgery.

Abstract:AIM:To discuss the characteristics of corneal topography for keratoconus patients and provide objective and feasible basis for diagnosis of keratoconus. And to conduct strict screening on corneal refractive surgery patients using corneal topography to increase the predictability of the operation. METHODS:Eleven cases of keratoconus patients and 11 eyes of suspected keratoconus patients used the SIRIUS 3D corneal topography instrument to check. The morphology of corneal anterior and posterior surface topography, central corneal refractive power, inferior and superior central corneal difference of average refractive power (I-S) and surface asymmetric index (SAI)were obtained. RESULTS: Keratoconus corneal thinnest point was not in the central cornea,but located to the top of the cone of the third quadrant, and surrounded by the concentric circles with refractive power gradually reduced.The difference in central corneal refractive power between keratoconus and suspected keratoconus had statistical significance. Keratoconus and suspected keratoconus corneal thickness difference was statistically significant difference.The highest points on corneal anterior and posterior surface and corneal thinnest point of keratoconus and suspected keratoconus were generally identical in SIRIUS 3D corneal topography, which accorded with the trend of the development of keratoconus. Its vectogram has a certain significance in the judgement of keratoconus. CONCLUSION: The SIRIUS 3D corneal topography is an effective method of early diagnosis of keratoconus, providing a reliable basis for the patients screening before corneal refractive surgery.

Abstract:AIM:To study the choice of parameters about Moria M2 microkeratome suitable for the Central Plains people,and to produce the desired corneal flap. METHODS:Totally 300 cases (594 eyes) with myopia from November 2009 to February 2012 in Xingtai Eye Hospital excimer laser treatment of myopia department were collected,which were conducted LASIK and came from the Central Plains region. 154 cases (305 eyes) were male (51.35%); 146 cases (289 eyes) were female (48.65%). The mean preoperative corneal curvature ranged from 40D to 47D. Corneal flap were made with Moria M2 in different curvature of the cornea, suction ring and stop position ,and corneal diameter, diameter of the corneal flap and pedicle width were measured to compare. The data were analyzed with SPSS 13.0 statistical software, two-sample mean comparison t test. RESULTS: Patient’s distribution: Hebei Xingtai 101 cases（33.67%）, Hebei Handan 56 cases（18.67%）, Shandong Liaocheng 31 cases（10.33%）, Shanxi Changzhi 23 cases （7.67%）, Henan Anyang 48 cases（16.00%）, Henan Puyang 16 cases（5.33%）, Henan Hebi, 25 cases（8.33%）. Corneal diameter on average was 11.35±0.25mm,corneal flap diameter on average was 8.83±0.47mm, corneal flap pedicle width on average was 4.28±0.82mm. Pedicle width and diameter of the corneal flap showed a positive correlation. In the case of the same curvature and stop position of blade, corneal flap diameter was positively correlated with width of the pedicle, and was negatively correlated with suction ring (P <0.05). In the case of the same suction ring and stop position of blade, corneal flap diameter and pedicle width with curvature were positively correlated (P<0.05). In the case of the same curvature and the suction ring, pedicle width and stop position of blade were negatively correlated (P<0.05). CONCLUSION:The cornea diameter of Central Plains people is generally smaller than the foreigners, we could reference to data table suitable for the Central Plains people when we conduct LASIK with Moria M2 microkeratome.

Abstract:AIM:To determine the prognosis by evaluating the retinal function and hemodynamic changes pre-and postoperation in retinal detachment patients, and investigate the clinical value of the techniques. METHODS: Central retinal arteries（CRA）were studied with color Doppler imaging （CDI）in 62 cases with unilateral rhegmatogenous retinal detachment, the fellow eyes served as control. The measured parameters included peak systolic velocity (Vmax), end diastolic velocity (Vmin) and resistance index(RI).The preoperative and postoperative retinas of retinal detachment were detected with multifocal electroretinogram (mfERG). RESULTS：There were no significant differences between the sick eyes and control eyes in the CDI parameters of CRA preoperatively. RI was significantly elevated (P<0.05), Vmax and Vmin were significantly declined (P<0.05) 2 weeks postoperation. The amplitude of a wave and b wave of mfERG were both significantly elevated in the detached area after retinal detachment operation(P<0.05). Compared with preoperation, the latent period decreased (P<0.05). CONCLUSION: Retinal reattachment and CRA hemodynamics are evaluated with combined mfERG and CDI examination, to avoid impaired reattachment and scleral ischemia after local silicone sponge implant.

Abstract:AIM:To study the curative effect,complications, safety and merit of Knife 90 and 110 of Moria M2 in excimer laser in situ keratomileusis(LASIK) for myopia. METHODS:The selected 105 cases (202 eyes) of LASIK surgery patient were divided into two groups according to the stochastic tables. Knife 90 of Moria M2 was used in 51 cases (98 eyes) of LASIK patients, Knife 110 in 54 cases (104 eyes) of LASIK patients as control.After operation, optical coherence tomography (OCT) was used to detect two groups of corneal flap thickness.Two groups of techniques were observed 1 day, 1 week, 1 month, and 3 months postoperatively with uncorrected visual acuity (UCVA), corrected visual acuity(CVA) and corneal flap shape, involution situation, complications. RESULTS:Corneal flap thickness of Knife 90 group was 118.3±15.2μm, corneal flap thickness of Knife 110 group was 130.5±17.1μm, having significant difference. Knife 90 group had not discovered interlaminar punctiform metal detritus, Kinfe 110 group had interlaminar punctiform metal detritus case (12 cases), having significant difference.The two groups were similar in form of the corneal flap, involution situation, postoperative reaction and postoperative UCVA. CONCLUSION: The LASIK efficacy and complications of Knife 90 are similar with Kinfe 110, however, Knife 90 can retain a relative thicker cornea stroma, correct higher diopter, howe less interlaminar punctiform metal detritus and complications, therefore it has better safety and adaptation range．

Abstract:AIM:To evaluate the quality of life in glaucoma patients and to explore the factors that affect their quality of life. METHODS:Totally 126 patients with glaucoma were evaluated the quality of life with the National Eye Institute visual function questionnaire. RESULTS:The scores of the patients with glaucoma were generally decreased, especially in patients with the obvious change of the visual acuity and the visual field, elder patients, and people whose physical function was decline, with lower education levels, poorer compliance and no medical insurance and no stable income. There were obvious difference (P<0.05). The multiple factor stepwise linear regression analysis showed that the scores of the quality of life was closely related to the visual function, the age, the income, the compliance behavior, the mentation and the social activity (P<0.05). CONCLUSION:With the protection of visual function in patients with glaucoma, we must pay attention to their social, psychological and other factors and give the enough health education and psychological counseling to improve their quality of life.

Abstract:AIM:To investigate the relationship between the corneal astigmatism and different myopic diopters in 20-29 years-old people in Hubei Province so as to find out the change rule. METHODS:A random sample of 2254 cases of 20-29 years old youth residents in Hubei Province were chosen and the astigmatic diopter, axis and myopic diopter with corneal topography were determined to analyse the change rule. RESULTS: In the 20-29 year-old residents with myopia and astigmatism in Hubei Province, astigmatism with the rule in the three sections of high,moderate,and low myopia were 79.48%, 68.95% and 69.48%, astigmatism against the rule were 20.52%, 31.05% and 30.52% respectively for men; astigmatism with the rule in the three sections of myopia were 80.22%, 75.28%, and 66.92%, astigmatism against the rule were 19.78%, 24.72% and 30.08% respectively for women, indicating a higher proportion of astigmatism with the rule than astigmatism against the rule; the proportion of astigmatism was high in the range of 26 ° -150 °, which were approximately 74.6%, 83.0% and 82.3% respectively in the three sections of myopia for men, showing the proportion in the moderate myopia section the highest, and which were approximately 75.3%, 82.7% and 87.2% respectively in the three sections of myopia for women showing the proportion in the low myopia section the highest ;visible at the same time, the proportion of astigmatism with the rule in the mens moderate myopia section was higher than that in the women’s the same section, while that in the women’s high and low myopia sections was higher than that in the men’s same sections. CONCLUSION: In the 20-29 year-old residents with myopia and astigmatism in Hubei Province, astigmatism occurred in a high proportion within the range of 26 ° to 150 °; the proportion of astigmatism with the rule was higher than that of astigmatism against the rule; the proportion of astigmatism with the rule of women was higher than that of men in the high and low myopia sections,while the proportion of astigmatism with the rule of men was higher than that of women in the moderate myopia section. The differences were statistically significant.

Abstract:AIM:To analyze the pathogenic bacteria and drug sensitivity in cases of dacryocystitis secondary to congenital nasolacrimal duct obstruction（CNDO）. METHODS:Bacterial cultures and drug sensitivity tests were conducted for the lacrimal sac secretion from the 98 cases (110 eyes) with CNDO. RESULTS:Totally 155 bacterial strains were isolated from lacrimal sac secretion in 94 eyes, and the pathogenic bacteria positive rate was 85.5%. The bacteria positive rates of Gram positive cocci and Gram negative bacilli were 65.8% and 23.9%, respectively. 94.2% of all isolated strains were sensitive to levofloxacin. CONCLUSION: Drug sensitivity test showed that the vast majority of bacteria had high sensitivity to levofloxacin. New quinolone antibiotic eye drops are applicable to dacryocystitis secondary to CNDO.

Abstract:AIM:To evaluate the efficacy and stability of AcrySof Toric intraocular les (IOL) to correct residual astigmatism in patients after one year from phacoemulsification cataract absorption(PEA) and AcrySof Toric IOL implantation. METHODS: This study included 13 eyes of 13 consecutive cataract patients with more than 0.75 diopter (D) of preexisting corneal astigmatism.1 year after IOL implantation, the uncorrected visual acuity（UCVA）,residual refractive cylinders, corneal keratometer，and AcrySof Toric IOL axis were measured. RESULTS: UCVA :before operation presented＜0.1 in 4 eyes，0.1-0.3 in 8 eyes，0.4-0.6 in 1 eye，after operation，07-0.9 in 7 eyes，≥1.0 in 6 eyes. There was statistically significant difference between before operation and after operation（P<0.05）.The residual refractive cylinders was -1.97±0.73D（-3.5-1.25D） before operation and -0.44±0.45D(-1.25-0D) after operation.There was statistically significant difference between before operation and after operation（P<0.05）.As for rotational stability,1 year after implantation, all AcrySof Toric IOL rotated less than 10 degrees.The mean AcrySof Toric IOL axis rotation was 4.07°±3.07°(0°-10°). CONCLUSION: The AcrySof Toric IOL implantation is safe and effective to correct residual astigmatism in 1 year after cataract surgery.

Abstract:AIM:To investigate the effectiveness of phacoemulsification for cataract extraction in the treatment of angle-closure glaucoma(ACG). METHODS:Totally 16 cases(18 eyes)of acute ACG which had cataract and closed range of anterior chamber angle smaller than 180° received small incision cataract surgery with intraocular lens (IOL) implantation alone.Postoperative intraocular pressure (IOP), depth of anterior chamber,width of anterior chamber angle and visual acuity were observed with 1-12 months follow-up. RESULTS:IOP of 18 eyes was all under the control of 20mmHg(1mmHg=0.133kPa) 1 week after operation and the anterior chamber angles became wider.Best-corrected visual acuity acquired increase in 17 eyes at different degrees.1 eye had no changes. There was no serious operation complication.During the follow-up time IOP of 17 eyes had no change compared to postoperative 1 month.Eyesight of 1 eye decreased because of fundus hemorrhage.The preoperative and postoperative IOP,anterior chamber depth and sight had statistically significant differences. CONCLUSION:With the proper selection of indications,the clinic effect of phacoemulsification for cataract extraction in the treatment of ACG was satisfactory.

Abstract:AIM:To study the preventive effect of Fufang Xueshuantong capsule on macular edema after phacoemulsification in diabetic cataract patients. METHODS: Using single-center randomized controlled clinical research,180 cases (180 eyes)of diabetic cataract patients were collected. Exclusion criteria included a history of previous intraocular surgery, vitreous loss during cataract surgery, uveitis, vitreoretinal pathology, glaucoma, cornea spot, and postoperative severe corneal edema, uveitis, anterior chamber bleeding, secondary glaucoma.They were divided into research group and control group. The research group patients （90 cases）had Fufang Xueshuantong capsule 1.5g tid immediately after surgery, continuously used for 2 weeks; the control group patients （90 cases） did not. The visual acuity of two groups and the incidence of macular edema were observed 1 day, 7 days, 1 month, 3, 6 and 12 months postoperatively. RESULTS:One day,7 days, 1 month, 3,6,12 months postoperatively, the mean vision of the research group was markedly higher than that in control group (P<001). In the research group, 12 cases had macular edema. 26 cases had macular edema in the control group. The incidence of macular edema in research group was markedly lower than that in control group（P<0.01）. CONCLUSION:After uneventful phacoemulsification in diabetic cataract patients,Fufang Xueshuantong capsule can improve the ischemia and hypoxia state of optic nerve and retina,reduce macular foveal capillary leakage and prevent the occurrence of macular edema.

Abstract:AIM:To sum up the experience for more effectively carrying out pneumatic retinopexy. METHODS:The cases which had taken pneumatic retinopexy were analyzed retrospectively in Guangdong provincial peoples hospital in five years. RESULTS:A total of 32 cases had taken pneumatic retinopexy, 20 cases (62.5%) of them had a successful retinal reattachment with one time surgery. The reopening of original hole for proliferative vitreoretinopathy(PVR) or new hole and macular hole without photocoagulation accounted for the causes of failure. No retinal or lens injury were observed in operation. CONCLUSION:Pneumatic retinopexy has favorable effect for small hole which locates in above quadrant, especially for shrinking hole. The method in this paper is simple and worth trying.

Abstract:AIM:To study clinical effects of Erigeron Breviscapus injection combined with retinal laser photocoagulation in the treatment of diabetic retinopathy. METHODS: Totally 50 cases of diabetic retinopathy were treated with Erigeron Breviscapus injection and retinal laser photocoagulation, control group of 50 cases used simple hydroxybenzene sulfonic acid capsules orally. Fundus, visual acuity and blood rheology changes were observed before and after treatment. RESULTS:Erigeron Breviscapus injection and retinal laser photocoagulation therapy could significantly improve vision in patients with diabetic retinopathy, eye microcirculation in patients was markedly improved.Total effective rate was 90%,the differences were statistically significant (P<0.05). CONCLUSION:Erigeron Breviscapus injection combined with retinal laser photocoagulation in the treatment of diabetic retinopathy has good efficacy, to better improve the microcirculation status of diabetic retinopathy, and delays and improves diabetic retinopathy.

Abstract:AIM:To observe the clinical effects of pancreatic kininogenase for treatment of early diabetic retinopathy(DR). METHODS:Totally 230 cases (395 eyes) of DR (Ⅰ-Ⅲ period) patients were randomly divided into two groups. On the basis of conventional therapy, the treatment group of 120 cases (210 eyes) were treated with pancreatic kininogenase for 12 months. The control group of 110 cases (185 eyes) received conventional therapy for 12 months. The changes in fundus, fluorescence fundus angiography (FFA) and vision were observed before and after treatment. RESULTS:The fundus improvement in treatment group was significantly higher than that in control group, the visual acuity improved (P<0.05). CONCLUSION: Pancreatic kininogenase for treatment of early DR is effective, which has positive significance for early DR patients.

Abstract:AIM: To study the clinical curative effect of compound anisodine injection in treatment of optic nerve contusion. METHODS:Seventy-two cases (72 eyes) with optic nerve contusion that underwent inpatient care in Cangzhou Peoples Hospital between January 2009 and May 2011 were retrospectively analyzed. In the treatment group, 36 cases (36 eyes) were injected compound Anisodine near superficial temporal artery, 36 cases (36 eyes) using conventional drug treatment were as the control group. RESULTS:Twenty-eight days after treatment, the treatment group was significantly better than the control group in the recovery of visual acuity, fundus and visual field. CONCLUSION: Compound Anisodine injection is an effective and easy treatment of optic nerve contusion.

Abstract:AIM:To investigate the clinical effect by nasal endoscopic dacryocystorhinostomy in treating acute dacryocystitis. METHODS:The clinical data of 15 cases (15 eyes) under nasal endoscopic dacryocystorhinostomy in treating acute dacryocystitis from July 2008 to July 2010 were retrospectively analyzed. RESULTS:The efficiency was 93%, in 15 cases ( 15 eyes), 13 eyes were cured, 1 eye was improved and 1 eye was invalid. CONCLUSION: Nasal endoscopic dacryocystorhinostomy in treating acute dacryocystitis can shorten the course of disease and is practicable clinically.

Abstract:AIM:To observe the treatment efficacy of 1-6 months age infantile congenital nasolacrimal duct obstruction(CNLDO) and dacryocystitis by probing of lacrimal passage and the lacrimal secondary adhesion occurrence. And the children were divided into 1-3 months age group and 3-6 months age group, to compare the efficacy and the incidence of adhesion to determine the best opportunity of probing treatment. METHODS:Totally 288 cases of 1-6 months age with CNLDO and dacryocystitis were randomly selected from June 2007 to December 2011 in our hospital, including 150 male cases, 138 female cases,230 unilateral cases and 58 bilateral cases.The age distribution was 30-180 days, an average of 86.66±40.55 days. The children were divided into 2 groups according to age: first group of 1-3 months age,173 cases(observation group); second group of 3-6 months age, 115 cases(control group). Treatment methods of two groups were the same, with 1% tetracaine for topical anesthesia of the punctum, appropriate expansion of the inferior lacrimal punctum, routine operation of irrigation and probing of the lacrimal passage using round-head flushing probe with external diameter of 0.5mm or 0.6mm and measuring hole , but the probes included angle with the horizontal line maintained in 75°-85°after its entering into the lacrimal sac, and the probe retained for 30-60 minutes to dilate the lacrimal duct after successful probing of the lacrimal passage. The children took prone position for removal of the probes and the lacrimal residual secretion and cell debris were rinsed as completely as possible.The lacrimal adhesion was recorded in the process of probing of lacrimal passage. The lacrimal passage was rinsed again 4-6 days after operation to observe and consolidate the curative effect. Followed up for 3-6 months,the two groups were compared with curative effect and lacrimal secondary adhesions. RESULTS: The cure rate of first group was 98.1%, lacrimal secondary adhesion rate was 29.3%. The cure rate of second group was 82.6%, lacrimal secondary adhesion rate reached 70.3%. Through statistical analysis, the effect of two groups had significant difference, 1-3 months age group was significantly better than 3-6 months age group; the formers lacrimal secondary adhesion rate was lower than the latters. CONCLUSION:For CNLDO and dacryocystitis,the treatment effect of probing is very good in advance to 1-3 months age.The longer condition, the more lacrimal secondary adhesion opportunity, the lower efficacy. Previous claim was lacrimal passage probing after 6 months age.Through clinical observation, the author thinks that 1-3 months age is the optimal probing time, suitable for wide popularization and application in basic level hospital.

Abstract:AIM:To investigate the application of double-passage silicone tube in the treatment of traumatic inferior lacrimal duct laceration. METHODS:Thirty-two cases (32 eyes)of traumatic inferior canalicular laceration were treated by canaliculoplasty from October 2008 to September 2011. All cases were performed with silicone tube double-passage annular canalicular intubation.The condition of epiphora and irrigation of lacrimal passage were observed after 6 months extubation continuously. RESUITS:The 32 cases were followed up in 6 months after extubation, the treatment was effective in 29 cases (91%)，3 cases (9%) showed no effect. CONCLUSION:The effect of double-passage silicone tube in the treatment of traumatic inferior lacrimal duct laceration is satisfactory. This method can be easily accepted by patients and worthy of clinic application.

Abstract:AIM:To discuss the treatment for old lacerated canaliculi. METHODS:Eighty four cases (84 eyes) of old lacerated canaliculi were treated by incision on anterior part of eyelid. The canaliculi breakage was looked for under the microscope.After implanting of silicagel tube, the canaliculi breakage was anastomosed.The tube would be reserved for 3 months. RESULTS:All canaliculi breakage could be seen under the microscope,62 cases (73.8%) were cured,17 cases (20.2%) were utility and 5 cases (6.0%) had no effect. CONCLUSION:With incision on anterior part of eyelid, implanting of silicagel tube is a very effective method to treat old lacerated canaliculi.

Abstract:AIM:To analyze the clinical and histopathologic classification of eyelid neoplasms so as to provide an evidence for clinical diagnosis and treatment of eyelid neoplasms. METHODS: Totally 105 cases (105 eyes) of patients with eyelid tumor pathological data were analyzed retrospectively in two years, and histopathologic classification of eyelid neoplasms were studied retrospectively. RESULTS: In all 105 cases (105 eyes) of eyelid neoplasms, benign tumor were 101 cases (101 eyes), malignant tumor were 4 cases (4 eyes). Among benign eyelid tumors there were inflammatory granulation tissue 22 cases (22 eyes)，seborrheic keratosis 16 cases (16 eyes), squamous cell papilloma 13 cases(13 eyes), intradermal nevus 12 cases (12 eyes), dermoid cyst 12 cases(12 eyes). Among malignant tumors there were basal cell carcinoma 2 cases (2 eyes), sebaceous gland carcinoma 1 case (1 eye) and malignant melanoma 1 case (1 eye). CONCLUSION:Pathologic classification of eyelid neoplasms is helpful for the pathological diagnosis and treatment of these diseases.

Abstract:AIM:To investigate the outcome of combining grafting of hard palate mucosa and orbicularis musculocutaneous flap in the reconstruction of full-thickness eyelid defects caused by eyelid malignant tumor． METHODS:For all 10 cases (10 eyes) with medium to severe full-thickness eyelid defects larger than or equal to the 1/2 full length of eyelid,oral hard palate mucosa grafting plates were used to substitute tarsal plates and conjunctivas and reconstruct posterior layer eyelids；orbicularis musculocutaneous flaps were transferred to cover the hard palate mucosa and substitute the defected eyelid skin and muscle layer and reconstruct anterior layer eyelids． RESULTS: All cases were followed up for more than 6 to 12 months．Appearance of eyelids and functional improvements were satisfactory．The hard palate mucosa grafting plates and their transfer flaps survived without untoward effects of contraction, dislocation, infection or necrosis． CONCLUSION:Combining grafting of hard palate mucosa and orbicularis musculocutaneous flap can repair full-thickness eyelid defects as a one-stage operation with definite and good outcome．

Abstract:AIM:To evaluate the effect of clinical treatment for the traumatic hyphema in children. METHODS:Retrospective summary was conducted on 179 cases (185 eyes) with hyphema treatment. Drug therapy, surgery timing and methods, and prevention of complications were discussed. RESULTS:The visual acuity improved after treatment, visual acuity >0.3 was in 81 eyes, accounting for 43.8%, visual acuity <0.05 was in 25 eyes, accounting for 13.5%. The rate of blindness declined 63.8%. CONCLUSION:Ocular trauma should be actively prevented in children.Drug treatment is the first in children traumatic hyphema, complications should be actively prevented and reduced.And doctors should master the timing of surgery, and conduct effective treatment of complications.

Abstract:AIM:To discuss the value of CT diagnosis of adenoid cystic carcinoma in the lacrimal gland. METHODS:A detailed analysis of 26 cases （26 eyes） of adenoid cystic carcinoma in the lacrimal gland. RESULTS:The 26 cases consisted of 15 right eye illness and 11 left eye illness. Among all the cases, 15 of them exhibited round or oval pathological changes and distinct bound, 11 exhibited irregular sublobal changes and sawtooth bounds.The author also found an uneven dispatch of tumor and calcification. 26 pathological changes surrounded and oppressed the eyeball. In 14 cases, pathological changes grew from the outer eyepit to the inner eyepit and were confused with the eyestrings thus further affected the optic nerve. Orbital bone moth-eaten destruction was in 21 cases, osteolytic destruction in 5 cases. CONCLUSION:CT diagnosis is highly effective in determining adenoid cystic carcinoma in the lacrimal gland.

Abstract:AIM:To study the effect of pedicled conjunctival transplantation combined with mitomycin C(MMC) for the treatment of pterygium complicated with conjunctivochalasis. METHODS: Totally 122 cases (156 eyes) of pterygium complicated with conjunctivochalasis were treated with pterygium excision and pedicled inferior conjunctival transplantation with intraoperative 0.2g/L MMC. RESULTS:All the 122 cases(156 eyes) had different degree of improvement on ocular symptoms 2 months after operation. Lacrimal river was normal in 136 eyes (87.18%);tear film break time (BUT) was more than 10 seconds in 117 eyes (75.00%); the conjunctival relaxed fold was free between the eyeball and inferior eyelid margin, internal and external canthus in 147 eyes (94.23%) under slit-lamp microscope; the eyelid margin location was normal in 142 eyes (91.03%).With the postoperative observation of 6 months to 4 years, 5 eyes had pterygium recurrence, the relapse rate was 3.21%;15 eyes had conjunctivochalasis recurrence, the relapse rate was 9.62%. CONCLUSION:Pterygium excision and pedicled inferior conjunctival transplantation combined with MMC for the treatment of pterygium complicated with conjunctivochalasis is easy with operation and materials, safe and reliable, which has little damage, fewer complications and lower recurrence rate, suitable for clinical promotion.

Abstract:AIM:To evaluate the clinical features，diagnostic methods and treatment of intraorbital foreign body injuries． METHODS:In a retrospective study， the records of 16 consecutive cases with foreign bodies in the orbit were analyzed with special attention to clinical manifestations，imaging findings，treatment and follow-up results． RESULTS: Of all the cases, 13 cases underwent surgical removal of retained foreign bodies and the surrounding decomposed tissues,11 cases were successful. The wounds or incisions healed well．After follow-up for 6 months,all wounds healed normally and all patients recovered wel1．No complications were encountered． CONCLUSION: The clinical manifestations of these different foreign bodies are complex and many complications may occur if they were mishandled. CT is the preferred examination for this condition．With the combination of correct diagnosis， proper surgical skills，and complete removal of foreign bodies and surrounding decomposed tissues,foreign bodies can be treated efficiently.

Abstract:AIM:To study the effectiveness and safety of toric implantable collamer lens (TICL) for high myopic astigmatism. METHODS:TICL were implanted in 20 cases (32 eyes) with high myopic astigmatism. The range of preoperative myopia was -2.00 to -24.00D, mean -11.33±4.93D. Astigmatism range was -1.25 to 6.00D, mean -2.13±126D. All eyes were followed up for 3-12 months. Each eye that received TICL implantation did Pentacam examination and observation on intraocular pressure(IOP), the rotation of TICL et al . RESULTS:The mean absolute rotation 12 months postoperatively was 5.47±3.37 degrees,75.0% of eyes rotated less than 5 degrees. 5 eyes had increased IOP shortly after surgery. Dazzling sensation occurred in 2 cases (3 eyes). No severe complications including cataract or glaucoma occurred. CONCLUSION:The short term clinical outcome of TICL for high myopic astigmatism is effective and reliable and no complications occurred during the observation period. The long term clinical outcome needs to observe.

Abstract:AIM:To observe the effect of wearing glasses with full correction or undercorrection on the development of early true low myopia. METHODS:This retrospective study included 50 cases (100 eyes) aged 8-12 years old in school from July 2010 to August 2011. Diopter was between -1.00D and -2.00D. They were divided into 2 groups, both with cycloplegic mydriasis medical optometry. In group 1, myopic degree was -1.55±0.37D with full correction (50 eyes); in group 2,myopic was -1.50±0.48D with undercorrection (50 eyes), the development of myopia was compared with students t-test in two groups. RESULTS: Degree of myopia was increased -0.75±043D in the first group, that in the second group was -1.55±0.27D, the difference was significant (P＜0.01). CONCLUSION: The development of myopia is rapid if myopia wear glasses with undercorrection. People with more than -1.00D of myopia should wear glasses with undercorrection which can improve retinal image quality, so that the development of myopia may be decreased than that with undercorrection.

Abstract:AIM:To investigate the causes of low vision after cataract surgery. METHODS:During 2009-2011 740 eyes underwent phacoemulsification and intraocular les (IOL) implantation.The clinical data of 48 eyes of low vision after cataract surgery were retrospectively analysed. RESULTS:The reasons of low vision after cataract surgery: diabetic retinopathy involving the macula lutea accounted for 22.9% (11/48), high myopia retinopathy accounted for 20.8% (10/48), age-related macular degeneration accounted for 18.8% (9/48), optic atrophy accounted for 16.8% (8/48), and the other 20.8% (10/48). CONCLUSION:The main reasons of low vision after phacoemulsification and IOL implantation are retinopathy and optic neuropathy, but the operation itself still has important clinical significance.

Abstract:AIM:To investigate the treatment effect of compound Anisodine and physical therapy for the treatment of amblypia in over-age children. METHODS:Totally 60 eyes of amblyopic children aged from 12 to 18 were divided into two groups, one group used compound Anisodine and physical therapy (CAPT group), the other was treated with physical therapy only (PT Group) .All patients were regularly checked in the following half year. Visual acuity, pattern-visual evoked potential (P-VEP) before and after treatment were tested and analyzed. RESULTS:After treatment, the effective rate of CAPT group was 50.00% and the PT group was 23.33%, the difference between these two groups was significant on statistics（P<0．05）. The comparison of the P-VEP before and after treatment in CAPT group was significant on statistics（P<0．01）,the latency was reduced and the amplitude was increased. The latency comparison of the P-VEP before and after treatment in PT group was significant on statistics（P<0.05）,but amplitude was not （P >0．05）. Comparing two groups P-VEP after treatment, the CAPT group was significant on statistics（P <0．05）, the latency of the P-VEP was reduced and the amplitude was increased. CONCLUSION: It is a good and effective way for the amblyopia in older children to have additional compound Anisodine treatment.