Abstract:AIM: To evaluate the long-term results and complications of Ahmed glaucoma valve (AGV) implantation in refractory glaucoma. METHODS: A retrospective review of 13 patients (13 eyes) with refractory glaucoma who underwent AGV implantation and had a minimum follow-up of 18 months was performed. All patients underwent a complete ophthalmologic examination and intraocular pressure(IOP) measurement before surgery and at 1 month, 3 months, 6 months, 1 year after surgery and yearly afterwards. Complications and the number of antiglaucoma medications needed were recorded. RESULTS: Mean age was 27.3±16.0 years. All eyes (100%) had at least one prior incisional surgery. Mean follow-up was 61.3±30.8 months. IOP was reduced from a mean of 35.0±7.0mmHg to 18.2±7.9mmHg at 12 months and to 17.0±4.1mmHg at 96 months (P<0.05) with a lower number of medications from baseline, 76.9% patients required additional procedures to achieve the success criteria set by previously published series. The most common complications were encapculated cyst formation in eight eyes (61.5%) and tube exposure in four eyes (30.8%). CONCLUSION: Encapsulated cyst formation was the most common complication which hindered succesful IOP control after AGV implant insertion for refractory glaucoma. Despite cyst excision with anti-fibrotic agents, successful IOP reduction was not achieved in 76.9% of the patients without antiglaucoma medication.

Abstract:AIM: To study the distribution of ocular higher-order aberrations(HOAs) and mesopic pupil size in individuals screened for refractive surgery. METHODS: Ocular HOAs and mesopic pupil size were studied in 2458 eyes of 1240 patients with myopia, myopic astigmatism and compound myopic astigmatism and 215 eyes of 110 patients with hyperopia, hyperopic astigmatism and compound hyperopic astigmatism using the Zywave aberrometer (Busch& Lomb). All patients had correctable refractive errors without a history of refractive surgery or underlying diseases. Root-mean-square values of HOAs, total spherical aberration, total coma and mesopic pupil size were analyzed. Ocular HOAs were measured across a ≥6.0mm pupil, and pupil size measurements were performed under the mesopic condition. RESULTS: The mean values of HOAs, total spherical aberration and total coma in the myopic group were 0369±0.233μm, 0.133±0.112μm and 0.330±0.188μm, respectively. In the hyperopic group the mean values of HOAs, total spherical aberration and total coma were 0418±0.214μm, 0.202±0.209μm and 0.343±0.201μm, respectively. Hyperopes showed greater total HOAs (P<001) and total spherical aberration (P<0.01) compared to myopes. In age-matched analysis, only the amount of total spherical aberration was higher in the hyperopic group (P=0.05). Mesopic pupil size in the myopic group was larger (P≤0.05). CONCLUSION: The results suggested that significant levels of HOAs were found in both groups which are important for planning refractive surgeries on Iranians. There were significantly higher levels of total spherical aberration in hyperopes compared to myopes. Mesopic pupil size was larger in myopic group.

Abstract:AIM: To report the effectiveness and safety of primary 23-Gauge (G) vitreoretinal surgery for rhegmatogenous retinal detachment (RRD). METHODS: In this retrospective study, 49 eyes of 49 consecutive patients who underwent primary 23-G transconjunctival sutureless vitrectomy (TSV) for RRD between January 2007 and July 2009 at our institution were evaluated. RESULTS: Mean follow-up time was 8.9±7.7 months. Retinal reattachment was achieved with a single operation in 47(95.9%) of 49 eyes. In two eyes (4.1%), retinal redetachment due to new breaks was successfully treated with reoperation using the 23-G TSV system. Mean logMAR visual acuity was 2.01±0.47 preoperatively and 13±0.5 postoperatively (P<0.001, Paired t-test). Mean preoperative intraocular pressure (IOP) was 14.1±2.8mmHg. Mean postoperative IOP was 12.3±3.6mmHg at 1 day, 131±2.1mmHg at 1 week, 14.3±2.2mmHg at 1 month. Iatrogenic peripheral retinal break was observed in 1 eye (2.0%) intraoperatively. No sutures were required to close the scleral or conjunctival openings, and no eyes required convertion of surgery to 20-G vitrectomy. CONCLUSION: Primary 23-G TSV system was observed to be effective and safe in the treatment of RRD.

Abstract:AIM: To investigate the inhibitory effect of Lithium chloride on human Tenons capsule fibroblasts(HTFs) and explore its mechanism. METHODS: The SRB and BrdU methods were used to observe the activity of HTFs after treated with Lithium chloride in vitro, apoptosis percentage and cell cycle were analyzed by flow cytometry (FCM)．Morphological changes in apoptotic cells were observed by Hoechst 33258 fluorescence staining． RESULTS: The cultured HTFs were significantly inhibited by Lithium chloride in concentration of 40, 80, 160mmol/L compared with the control group and it was dose-dependent and time-dependent．It was demonstrated that Lithium chloride could evoke G₂/M cell cycle arrest and induce apoptosis,especially in the high concentration groups. CONCLUSION: Lithium chloride could restrain growth of HTFs by evoke G₂/M cell cycle arrest and induce apoptosis.

Abstract:AIM：To study the expression of β-arrestin1 in the spleen cells of experimental autoimmune uveitis (EAU). METHODS: The mice were injected into the foot with IRBP R16. On day 3, the spleen was extracted and the single celI suspension was made. Immunohistochemistry and RT-PCR were done on these spleen cells. RESULTS: The expression of β-arrestin1 on the spleen cells of EAU groups was much higher than that in the normal groups. CONCLUSION: β-arrestin1 might play an important role on the EAU.

Abstract:AIM: To investigate the effects of ginkgo biloba extract(GBE) with different concentration on the proliferation of human pterygium fibroblasts cells(HPFs)． METHODS: The HPFs were incubated with GBE at concentration of 12.5mg/L, 25.0mg/L, 50.0mg/L, 1000mg/L for 24-72 hours, the effects of GBE on the proliferation of HPFs were evaluated by MTT assay. Flow cytometry (FCM) was used to examine the cell cycle distribution and apoptosis of HPFs exposed to different concentrations of GBE for 48 hours. RESULTS: The proliferation of HPFs was not significantly inhibited incubated with 12.5mg/L GBE for 24 hours through MTT assay (P>0.05). Other groups could significantly inhibit HPFs proliferation in a dose- and time-dependent manner, and there were significant differences between each of the two groups (P<0.05). Flow cytometry examination suggested the cell percentage in the G₀/G₁ phase increased while that of the S phase decreased exposed to different concentrations of GBE for 48 hours, the rate of apoptosis of HPFs respectively reached 4.37%, 8.14%, 11.09%, 15.18%, and there were significant differences between the two groups (P<0.05). CONCLUSION: GBE can significantly inhibit HPFs proliferation and induce its apoptosis with dose- and time-dependent manner.

Abstract:AIM: To detect the protection effect of taurine on photic injury in retinal pigment epithelial (RPE) cells of rabbits with single-cell gel electrophoresis assay (SCGE). METHODS: The 2-4 passage RPE cells of rabbits were adopted to establish visible high damage model.The cultured RPE cells were pretreated with taurine of 40mmol/L, 80mmol/L for 24 hours, whereas control group was pretreated without taurine. The cells DNA damage of various groups was detected with SCGE. RESULTS: The DNA damage on RPE cells of rabbits was reduced, 80mmol/L group had obvious effect than the other groups. There was significant difference with control group in tail DNA% and tail length(P<0.01). CONCLUSION: Taurine can protect RPE cells in rabbits against photic injury. Its effect is does-dependent.

Abstract:AIM: To investigate the distribution of adeno-associated-virus induced angiostatin Kringles5-GFP gene in ratsocular tissues after injected in vitreous cavity and to provide experiment basis to retinopathy treatment. METHODS: After injected rAAV-Kringle5-GFP with the titer 2.5×10¹² vg/mL 10μL in vitreous cavity, the SD rats were sacrificed at day 1, 5, 10, 20, 40, 60 and 90. The distribution and expression of GFP in ocular tissues such as vitreous, retina, chloridum, iris and so on were observed under green microscopy. The expression degrees were recorded as -, +, ++, +++ and ++++. RESULTS: Kringle5 expressed in vitreous at the day 1 after injection and increased with the time. After 5 days, it expressed in retina, ranged from optic disc to peripheral retinal tissues. In iris and choroid, Kringle5 showed a strong expression. It could also be found in corneal endothelium and crystalline lens. CONCLUSION: The adeno-associated-virus induced angiostatin Kringles5-GFP gene can strongly express not only in retina but also in other ocular tissues. Thus, adeno-associated virus is the best vector for gene in curing retina disease.

Abstract:AIM: To evaluate the vision related quality of life (VRQOL) and anxiety and depression symptoms and investigate its changes in primary angle-closure glaucoma (PACG) by trabeculectomy interventions. METHODS: The present study included 42 PACG patients.A healthy control group(n=42)sociodemografically matched to the group was established. The VRQOL and anxiety and depression symptoms were evaluated and analyzed on the pre-operative and post-operative month 1 by using two instruments. Instruments applied included the NEI-VFQ-25 and Hospital Anxiety and Depression Scale (HADS). RESULTS: The incidence of anxiety, depression, anxiety combined depression in comitant constant esotropia patients was 23.8%, 23.8%, 16.7%, respectively. Compared with control subjects, PACG patients showed significantly impaired disease-specific VRQOL in 10 out of 12 subscales, including ‘General Health’, ‘General Vision’ , ‘Ophthalmological pain’, ‘Social Functioning’, ‘Distance vision’, ‘Mental Problems’ , ‘Peripheral Vision’, ‘Near vision’ , ‘ Social role’ and ‘Dependency’ (P<0.05)．Compared with pre-operative values, significant improvements were noted after surgery in NEI-VFQ summary score, anxiety and depression scores (P<0.05). The VRQOL of PACG patients improved at 1 month after second surgery compared with those of pre- surgery：MD=41.6(General Health), 34.5(Ophthalmological pain), 32.6(Society Functioning), 21.2(Mental Problems), 24.8 (Social Activities), 21.8(Dependency) \[F=10.4(General Health), 6.4 (Ophthalmological pain), 10.6 (Society Functioning), 8.3 (Mental Problems), 7.3 (Social Activities), 6.9(Dependency)；P<0.05\]. CONCLUSION: PACG patients were affected in mentation and VRQOL while surgery interventions can improve VRQOL, anxiety and depression in strabismus patients.

Abstract:AIM: To observe the anterior segment difference between primary angle-closure glaucoma(PACG) and normal eyes. METHODS:With the use of anterior segment optical coherence tomography(AS-OCT), we observed 116 PACG patients and 336 normal people for the anterior segment structures, including lens thickness(LT), anterior chamber depth(ACD) and angle opening distance(AOD). RESULTS:Compared with normal eyes, PACG eyes had shallower ACD, thicker LT and shorter AOD(P<0.05). CONCLUSION:PACG is charactered with shallower ACD, thicker LT and shorter AOD. AOD could be a diagnosing character for the early stage of PACG. AS-OCT is a useful tool for the early diagnosis of PACG.

Abstract:AIM: To compare therapeutic effect in surgical removal of idiopathic epimacular membrane(IEM) with transconjuctival sutureless 23-gauge(23G) vitrectomy and conventional 20-gauge(20G) vitrectomy. METHODS: Fifty-six cases 56 eyes with IEM underwent either 23- or 20-gauge vitrectomy from March 2008 to June 2011. Main outcome measures included visual acuity(VA), intraocular pressure(IOP), operative complications and surgical time．Postoperative mean follow up was 16 months. RESULTS: The VA increased three months after surgery in 23G group. The logMAR at day 1, week 1 and month 3 was 1.78±0.94, 1.51±0.88, 1.48±0.91, respectively. The differences between the three time points and preoperative baseline was significant (t=3.3917, P=0003；t=11.1779, P=0.0000; t=4.3424, P=0.0000). The VA of the three points was logMAR=2.11±1.00, 1.93±102, 164±1.00 respectively in 20G group. The differences between postoperative week 1, month 3 and preoperative baseline was significant(t=2.3578, P=0.033; t=3.5552, P=0.003). The intergroup differences at the three time point was not significant(t=0.9582, P=0.34；t=1.2761, P=0211; t=0.4897, P=0.628). The mean IOP at day 1, week 1 and month 3 in 23G group was 11.62±9.7, 15.86±6.6, 16.84±5.6mmHg while in 20G group was 18.56±7.71, 1533±5.21, 14.72±3.56mmHg, respectively. The differences of IOP at day 1 was significant(P<0.001). The mean surgical time of 23G group 41.20±7.47 minutes was significantly less than that of 20G group(52.28±7.11 minutes, P<0.001). No endophthalmitis or retinal detachment was found in both 23G and 20G group. Postoperative discomfort and intraocular inflammation were significantly reduced in the 23-gauge group. CONCLUSION: The 23G TSV system is a safe and efficient surgical technique for IEM surgery. Operating time is significantly reduced, minimizing surgery-induced trauma, and reducing the patients discomfort.

Abstract:AIM: To observe the characteristics of visual electrophysiological activity in normal young rhesus monkeys in anesthesia state, so as to provide more effective checking methods and clinical reference for the establishment of various diseases rhesus animal model. METHODS: Totally 16 healthy rhesus monkeys (32 eyes), 36 to 48-month-old, were selected. Under general anesthesia achieved by intramuscular injection of ketamine, visual electrophysiology instrument(ROLAND CONSULT Co., Ltd) was applied for the detection of flash electroretinogram(f-ERG), and measured values were recorded under different stimulus intensity; The values of f-ERG in normal human adolescents were gained by the same method, then the data were compared and statistically analyzed. RESULTS: The result of f-ERG showed that, compared with the same age of human, the incubation period of ERG in rhesus monkey was shortened and the amplitude was also reduced under different stimulation intensity and stimulation method in dark adaptation state, while in light adaptation the amplitude of b-wave had no significant difference compared with that of human. CONCLUSION: This study provides the optimal stimulation conditions and normal reference range of f-ERG in normal rhesus monkeys. Comprehensive analysis shows that the ERG responses of rhesus monkeys was weaker than normal humans in dark adaptation state, while it has no significant difference in light adaptation state. It reminds us that when we examine the various ophthalmological diseases of rhesus animal model, we should be more careful about the normal reference value scope of ERG.

Abstract:AIM:To quantitatively detect the diseased corneal epithelial cells, conjunctival cells before and after aqueous tear deficiency dry eye treatment by using corneal confocal microscope and conjunctival impression cytology, so as to further accurately evaluate the dry eye treatment outcome and prognosis. METHODS:There were 21 cases (41 eyes) which were clinically diagnosed as aqueous tear deficiency dry eye based on their history, symptoms, corneal and conjunctival signs and relevant examinations. All patients with dry eye were treated by polyethylene glycol eye drops combined with Carbopol gel. Based on conjunctival impression cytoscopy, squamous metaplasia and goblet cells number of conjunctival cells in dry eye patients were graded and the impression cells classification before and after treatment was statistically compared. Morphological change of nerve fibers under corneal epithelial before and after dry eye treatment was observed by using Heidelberg laser confocal microscopy. The changes of corneal epithelium cell density before and after treatment under peer conjunctival cells dryness were quantitatively evaluated. RESULTS:Impression cytoscopy: before treatment ≤ grade Ⅱ in 6 eyes, grade Ⅲ in 25 eyes, ≥grade Ⅳ in 10 eyes; 6 months after treatment ≤ grade Ⅱ in 19 eyes(463%), grade Ⅲ in 17 eyes(41.5%), ≥grade Ⅳ in 5 eyes（12.2%）. The proportion of patients with different levels of impression cells before and after treatment was significantly changed. Morphological changes under confocal microscopy: cell density decreased in cell necrosis exfoliated area of corneal epithelial before treatment; corneal subcutaneous nerve fibers appeared branch unorganized, abnormal strike line, no subcutaneous nerve fibers in 5 eyes. Regional cell density increased 6 months after treatment. All patients can seen subcutaneous nerve fibers, a small number of cases still appeared branch unorganized, abnormal strike line. Confocal microscopy showed under the conjunctival impression cytology degree at the same level, the corneal epithelial cell density before and after treatment were compared, there was statistically significant difference (P<0.05). The cell density was significantly increased after treatment. CONCLUSION: The aqueous tear deficiency dry eye treatment outcomes were quantitatively observed by using corneal confocal microscopy and conjunctival impression cytology in order to determine the significant value of above two methods in dry eye treatment evaluation.

Abstract:AIM: To observe the effect and security of applying mitomycin C (MMC) in Epi-LASEK surgery of middle or high myopia. METHODS: The 406 eyes underwent Epi-LASIK surgery were randomly divided into MMC group (203 eyes) and control group (203 eyes). Automatic rotational Epi-LASIK, which had features of a blunt oscillating blade, was used to make epithelium flap. Visx star S4 excimer laser was used for myopia. 0.2g/L MMC solution was covered on the corneal stroma bed after the laser ablation in MMC group. Refractive diopter determined keeping time. The eyes in control group received the same thing as MMC group except MMC. The other operate were identical. The postoperative symptom, epithelial flap, incorrect visual acuity, dioptersand, haze formation were recorded. RESULTS: All of surgery had been finished successfully. The period of follow-up ranged from 6 months to 2 years. Stimulate formation were light in two groups. It often happened in the first day and got better in the second day. On the third day of postoperative, 15 eyes had I-II level stimulate formation in MMC group and 13 eyes in control group. There was no statistically significant difference between two groups (P>0.05). The corneal epithelia healed up within 3-5 days in all patients, with no significant difference between two groups (3.78±0.75 vs 3.55±0.89, t=1.522, P>0.05). Epithelial flaps of 191 eyes (94.1%) in MMC group were well healed when took off the lens for 3-5 days and 198 eyes (97.5%) in control group. Six month after surgery, 195 eyes (93.6%) in MMC group acquired satisfactory visual and 172 eyes (847%) in control group. There were statistically difference in two groups (P<0.05). Refractive regressions quantity of 11 eyes (5.4%) in MMC group was up to -0.50D in 6 month after surgery and 23 eyes (11.3%) in control group. 167 eyes(82.3%) in MMC group suffered 0 level haze while 125 eyes (61.6%) in control group. There were statistically difference (P<0.05). CONCLUSION: The application of 0.2g/L MMC during Epi-LASIK is proved to be a safe and effective method for middle or high myopia. It can reduce the formation of haze and prevent UCVA falling.

Abstract:AIM: To evaluate digital multimedia visual training as treatment for amblyopia in children. METHODS: Seventy-six juvenile patients(117 eyes) with amblyopia were chosen and treated with digital multimedia visual training and classic combined therapy. Each amblyopia type were used in this study for two groups, experinmental and control. The therapeutic effect and treatment time of two groups were compared and the binocular function was observed. RESULTS: When compared with control group, the treatment time was significantly shorter(P<0.05), and it would took much longer for the correct visual acuity increasing 1 LogMAR line in control group, while experimental group got better efficacy in binocular vision(P<0.05). CONCLUSION: The multimedia visual training can promote binocular function and shorten the treatment cycle of vision dysfunction. The new treatment can achieve the best treatment effectiveness in a short time and provide a new feasible way for amblyopia clinical therapy.

Abstract:Bullous keratopathy(BK) has become a common corneal disease which can lead to blind. BK is the last phase condition of endothelial decompensation. Because of corneal endothelial damage, the corneal edema developed, associated with bubbles in the epithelium. It is increasingly observed accompanied with other eye diseases, such as some intraocular surgeries, ocular trauma and endophthalmitis, so that it is difficult to treat. In recent years, many surgical methods have been developed along with clinical medications and traditional operation methods. Clinical research of exploiting intralamellar surgery of cornea, expanding amniotic membrane transplantation(AMT) and AMT with other operation methods have been realized successfully. There are corneal endothelial transplantation and culturing the corneal endothelium which offer considerable theoretical advantages over penetrating keratoplasty(PKP) in treatment of endothelial dysfunction and are being practiced and evaluated clinically. Available literature related to BK, clinical treatments and research advances are reviewed in this article.

Abstract:Through literature research, recurrent herpes simplex keratitis(HSK)has been a heated subject in ophthalmology research, the pathogenesis and treating drugs of HSK has become a focus. With the development of medical research we have a new understanding of HSK. However it is not consistent on specific pathogenesis and therapy of HSK, and further study is needed.

Abstract:Diabetic retinopathy(DR) and diabetic nephropathy(DN) are two most common complications of diabetes microvascular illness . Because both belong to diabetes microvascular complications, the pathogenesis and clinical characteristics also have similarities between the two. Understanding the mutual relationship and common influencing factors can predict the others occurrence, development, and provide practical guide for clinical treatments .

Abstract:Diabetic retinopathy(DR) is a retina manifestation of systemic capillary circulatory disorder caused by glycometabolism disorder. Damage to the retina was mainly the result of hyperglycemia, thickening and increased permeability of vascular walls. It is also accompanied with microvessel disorders of brain and kidney. DR is one of the most common microvessel complications of diabetes, which may cause vision loss severely. Its occurrence and development is depended on the degree of metabolic disorders and also related with age, course of the disease, genetic factor and management of diabetes. As the disease progresses, DR enters a proliferative stage, which is the main reason for blindness. The incidence of DR is 25% after 5 years of diabetes, 60% after 10 years and 75%-80% 15 years later, of which 25% are proliferative diabetic retinopathy. DR seriously threaten life quality of human. This paper reviews the prevention and treatment of DR.

Abstract:Choroidal melanoma(CM) is the most common intraocular tumor in adults. It is a major ocular problem that could threaten the patients life and requires early diagnosis and treatment. During the past decade, there has been a trend in the management of CM from enucleation to conservative nonenucleation treatments such as thermotherapy, plaque radiotherapy, charged-particle radiotherapy, and local resection. Recent researches have shown that combined modality therapy has been more and more popular now. We reviewed the current literature for trials and case reports on choroidal melanoma and discusses its diagnosis and current treatment.

Abstract:Neonatal dacryocystitis is a common disease in the childrens eye clinic, the main treatment methods include massage, lacrimal duct intubation, laser and balloon dilatation of the lacrimal. This article made a review on the treatment effect, the timing and advantages and disadvantages of these methods.

Abstract:Anisometropic amblyopia is a decrease in the best-corrected visual acuity in one eye, resulting from significantly different refractive errors in the patients two eyes. Early intervention in the critical period of vision development is important for the treatment. The orthodox treatment was occlusion of the dominant eye, however, it was influenced by age and the compliance. It is reported that amblyopia was difficult to be cured after the critical period. With the development of clinic research, there has been hope in the treatment of adult and adolescent anisometropic amblyopia. Orthodox occlusion, reflection surgery, and perceptual learning have played roles in the treatment. This article made a review for treatment in adult and adolescent anisometropic amblyopia.

Abstract:Alpha-crystallin consists of two subunits: αA- and αB- crystalline, and is a major protein component of the mammalian eye lens. Being a member of the small heat-shock protein family, alpha-crystallin possesses chaperone-like function. It prevents aggregation of partially denatured proteins and the inactivation of enzymes. Mutations in alpha-crystallin genes can cause cataract and myopathy. This review focused on some of the expression, structure, function and genetics of alpha-crystallin.

Abstract:Eyes growth is an active process relies on the visual guidance. The retina,choroid and sclera are all involved in this process. There are a variety of signaling molecules that play an important role in regulating the eyes growth. Insulin-like growth factor-1 (IGF-1) is a powerful growth-promoting factor, and its role in the maintenance and controlling of cells growth, proliferation, differentiation, maturation and regeneration has been well recognized. There is also a wide range of expression of IGF-1 in eyes, which participate as a contributor in the occurrence and development of eye diseases. In recent years, its role of regulating the eyes growth has been widespread concerned. IGF-1s recognized role in regulating the eyes growth is reviewed in this paper.

Abstract:AIM:To analyze the outcome and complication of the norvancomycin integrity treatment in bacterial endophthalmitis. METHODS: Twenty-seven patients 27 eyes were observed from July, 2009 to August, 2011. All the patients underwent corpus vitreum bacterial culture and suspecptibility. The vitreous injections of norvancomycin were performed. The treatment also included intravenous injection of norvancomycin and levofloxacin. The patients without improvement underwent vitrectomy with norvancomycin perfusion fluid after two to four days. The best-correct visual acuity, intraocular pressure, anterior chamber and vitreum changes were observed before and after operation. The data were evaluated by statistical analysis. RESULTS:Twenty-seven patients were healing well with increase of visual acuity. 56% specimens were found positive by 67% for gram-positive bacteria. Most gram-positive bacteria were susceptible to norvancomycin while the gram-negative to levofloxacin. 8 patients healed by vitreous injections and 18 patients by vitrectomy. The best correct visual acuity and symptoms were increased. CONCLUSION: The bacterial culture of vitreous could guide the clinical treatment. The norvancomycin integrated treatment is effective for bacterial endophthalmitis.

Abstract:AIM: To compare the Pseudophakic accommodation of three monofocal intraocular lens implantation eye after phacoemulsification. METHODS: A total of 78 eyes from 78 patients under going phacoemulsification received intraocular lens based on the principle of voluntary. Twenty-three eyes from 23 patients who had implantation of AcrySof Natural intraocular lens were randomized into groupⅠ. Twenty-four eyes from 24 patients who had implantation of Canon staa intraocular lens were randomized into groupⅡ. Thirty-one eyes from 31 patients who had implantation of Canon staa intraocular lens were randomized into group Ⅲ. Main outcome measures included best-corrected distance visual acuity, distance corrected near vision, and the Pseudophakic accommodation amplitude. All the clinical data were obtained at 3 months postoperatively. RESULTS:At 3 months postoperatively, best-corrected distance visual acuity were similar among the 3 groups(F=0.317, P=0.729). Near vision on the basis of best corrected distance vision were statistically significant (F=3.377, P=0.039), added value on the basis of best-corrected near and the accommodation amplitude were statistically significant (F=10.094, P=0.000; F=16.806, P=0000) the among three groups. CONCLUSION: Three monofocal intraocular lens after cataract surgery implanted all could gain better distance visual acuity, near vision of the Acrysof Natural and the Canon staa intraocular lens implantation were more satisfactory, Acrysof Natural intraocular lens eyes had a better Pseudophakic accommodation.

Abstract:AIM:To observe the clinical effect of the ReSTOR+3D multifocal intraocular lens (MIOL). METHODS:Fouty cases (80 eyes) with age-related cataract were divided into two groups with the same standard. 20 cases were bilaterally implanted with the Alcon ReSTOR+3D MIOL and another 20 cases with Alcon Nature blue-filter monofocal intraocular lens(SIOL) in different time. Both groups were performed clear corneal incision phacoemulsification combined with intraocular lens(IOL) implantation. Distance visual acuity and near visual acuity were observed at postoperatively l day. At postoperative 30 days, distance/near visual acuity, corrected distance/near visual acuity, best-corrected near visual acuity and contrast sensitivity(CS) were also observed. Visual quality, postoperative satisfactory and spectacle independence rate of each visual functional area were evaluated by questionaires. RESULTS:Allcases had good distance visual acuity postoperatively. The MIOL group was better than the SIOL group in uncorrected near and middle visual acuity. CS in the MIOL group was lower than that in the SIOL group, but there was no functional significance. In the MIOL group, 85% of the cases achieved total spectacle independence. CONCLUSION:The ReSTOR+3D multifocal IOL provides a satisfactory full range of vision, which is safe, effective and has high satisfactory.

Abstract:AIM:To evaluate the visual and refractive outcomes after higher power toric intraocular lens(IOL) implantation in patients with high amounts of corneal astigmatism. METHODS:This study comprised 21 cases 24 eyes with cataract and more than 2.5 diopters (D) of corneal astigmatism who had toric AcrySof SN60T6, SN60T7, SN60T8 or SN60T9 IOL implantation. The preoperative and postoperative 3 months uncorrected distance visual acuity (UCDVA) and best-corrected distance visual acuity (BCDVA), preoperative corneal astigmatism, residual refractive cylinder and IOL axis and position in postoperative 1 week and 3 months were evaluated. RESULTS:Three months postoperatively, 75％ of eyes showed the 0.5 or better in UCDVA. The preoperative corneal astigmatism was 3.45±0.63D. The postoperative 3 months residual refractive cylinder was 0.72±0.23D(P＜001). The anticipated correction was 3.12±0.54D. The achieved correction was 3.05±0.66D (P＞0.05). The mean Toric IOL misalignment was 3.2°±2.1°. CONCLUSION:Implantation of higher power toric IOL during cataract surgery is a safe, effective and predictable method in correcting high amounts of corneal astigmatism.

Abstract:AIM:To evaluate the therapeutic efficacy and safety of trabeculectomy for primary acute angle-closure glaucoma(PACG) with high intraocular pressure (IOP)． METHODS:Fourty-eight cases (50 eyes) of PACG were retrospectively analyzed，which underwent trabeculectomy. These cases were divided into 2 groups by the preoperative IOP： the operation group (12 eyes，IOP≥40mmHg)，and the control group (38 eyes，IOP＜40mmHg)．The IOP，visual acuity，complications and surgery outcome of both groups were compared． RESULTS: No severe complications such as choroidal hemorrhage，malignant glaucoma were observed in both groups during surgery and postoperation．The success rate of operation in the control group was much higher than that in the operation group shortly after the operation with significant difference (P=0.0332）．But the success rate of both groups had no significant difference（P＞0.05）in return visit． CONCLUSION:Trabeculectomy for PACG with persistent high IOP should be performed actively to avoid further damage to the visual function．

Abstract:AIM:To evaluate the clinical curative effect of intravitreal Avastin injection for the treatment of neovascular glaucoma. METHODS:There were 23 neovascular glaucoma patients(23 eyes) whose visual acuity was higher than counting fingers treated in our hospital from January 2007 to October 2011. After intravitreal Avastin injection, the change of iris neovessels was observed. When the neovessels subsided in 3-7 days, the anti-glaucoma operation was performed. The intraocular pressure, visual acuity, change of neovessels, inflammatory reaction, complications were observed and followed up 12-24months. RESULTS:In the 23 eyes, there were 21 eyes that iris neovessels subsided in 3-5 days after injection, the effective rate was 91.30%. There were 2 eyes that iris neovessels thinned in 5 days, atrophied in 7 days, and subsided in 2 weeks. The difference of intraocular pressure was less than 2mmHg before and after the Avastin injection. There were no complications and adverse reaction after Avastin injected in 23 eyes, then performed compound trabeculectomy. In the following up days of 12-24 months, there were 18 eyes intraocular pressure in normal range without anti-glaucoma medicine; there were 3 eyes intraocular pressure below 21mmHg adding 2 kinds of anti-glaucoma medicine and 2 eyes intraocular pressure below 21mmHg adding 3 kinds of anti-glaucoma medicine. CONCLUSION:Intravitreal Avastin injection can subside or atrophy the neovessels of neovascular glaucoma, then filtered operation were performed on patients, which avoids intra- or postoperative hemorrhage, destructive operation and preserves better visual acuity and controls intraocular pressure. The complications were treated postoperatively and visual function was protected.

Abstract:AIM:To analyze the outcome of clinical pathways for patients with primary acute angle-closure glaucoma in our hospital for two years and evaluate the value of this way. METHODS:Eighty-three eyes of 82 patients who suffered primary acute angle-closure glaucoma from January 2010 to December 2011 were cured with filtering operation (trabeculectomy or composite trabeculectomy) by managing with clinical path, they are divided path group. The control group was another 67 patients from January 2008 to December 2009, who suffered the same disease and cured with the same operation not by managing with clinical path. The working days before surgery, days in hospital, cost for cure, curative effect, and degree of satisfaction of patients were all recorded for analysis. RESULTS:The path group had an average of 2.6 working days before surgery, 7.0 days in hospital, cost of 2158 yuan for cure, degree of satisfaction of patients(974%). The control group had an average of 4.2 working days before surgery, 11.2 days in hospital, cost of 2630 yuan for cure, degree of satisfaction of patients(90.2%). They were all statistically different(P＜0.05), but there was no difference in curative effect(P>0.05). CONCLUSION: The clinical path for patients with primary acute angle-closure glaucoma can not only shorten working days before surgery and days in hospital, but also save cost for cure and improve the degree of satisfaction of patients.

Abstract:AIM: To explore the clinical efficacy of the Ahmed glaucoma valve implantation for refractory glaucoma. METHODS: The clinic outcomes of 21 cases (21 eyes) with refractory glaucoma were reviewed,all patients underwent the placement of Ahmed glaucoma valve implant. RESULTS:The mean preoperative intraocular pressure(IOP) was 44.6±7.2mmHg. Postoperative 6 months at the last follow-up mean IOP was 15.4±5.3mmHg; Comparing than the preoperative visual acuity, 4 eyes increased, 14 eyes had no changes and 3 eyes decreased. The main postoperative complications included postoperative shallow anterior chamber (2 eyes), retained high IOP (1 eye), tube blockage (1 eye), corneal decompensation (1 eye) and fiber wrap of drainage tray (3 eyes). The procedural success rate at 6 months was 86%. CONCLUSION: Ahmed glaucoma valve implantation may be an effective procedure for refractory glaucoma.

Abstract:AIM: To study the early changes of choriodal neovascularization(CNV) one week after photodynamic therapy(PDT). Compare the differences between standard PDT and fast infusion reduced light dose PDT. METHODS: Sixteen cases（19 eyes） with subfoval CNV suffered PDT with visudyne. Of the 19 eyes included, 13 eyes suffered standard PDT (6mg/m² visudyne, injection speed is 3mL/min, the interval time between the injection and exposure to the light is 15 minutes, the wave length of light is 689nm, fluency of the light is 600mW/cm², duration of the light is 83 seconds, dose of light is 50J/cm²), 6 eyes suffered fast infusion reduced light dose PDT (6mg/m² visudyne, injection speed is 6ml/min, the interval time between the injection and exposure to the light is 15 minutes, the wave length of light is 689nm, fluency of the light is 600mW/cm², duration of the light is 42 seconds, dose of light is 25J/cm²).The changes of best-corrected visual acuity (BCVA), letters of early treatment for diabetic retinopathy study (ETDRS). Optical coherence tomography(OCT) before and one week after PDT were compared. Using the software of OCT, the bilaminar foveal thickness (Tf), neuroretinal foveal thickness (Nf), outer high reflectivity band thickness (T) and subretinal fluid thickness (SF) were measured. Compare the changes of every observation indexes pre- and postoperatively as well as their differeces. RESULTS: No significant changes had found in OCT images or visual acuity one week after PDT(P>0.05). All the indexes had no significant differences after PDT or between the groups（P>0.05）. CONCLUSION: There were no changes before and one week after PDT.Compared to standard PDT, fast infusion reduced light dose PDT had no differences.

Abstract:AIM:To investigate the operation timing of vitrectomy for proliferative diabetic retinopathy(PDR) with macular hemorrhage. METHODS:In this retrospective analysis study, 62 PDR patients (62 eyes) with macular hemorrhage were enrolled from March 2009 to December 2010. 38 cases (38 eyes) were treated with panretinal photocoagulation firstly, then underwent vitrectomy after 2 months. 24 cases (24 eyes) were treated with vitrectomy directly, and retinal photocoagulation was made at the same time. The patient were treated with BSS or silicone oil tamponade in vitrectomy surgery according to whether the merger of rubeosis iridis, optic disc neovascularization and lens intraocular, so the retina get a good reset. RESULTS:There were 16 (67%) eyes with course of disease <2 months and postoperative visual acuity ≥ 01. There were 9 (24%) eyes with course of disease≥ 2 months and postoperative visual acuity ≥ 0.1. The two groups difference was statistically significant (χ²=11293,P=0.001). The difference of filler material was statistically significant (χ² =14.078,P＜0.05), comparing the course of disease <2 months group and ≥ 2 months group. CONCLUSION: PDR with macular hemorrhage patients should use silicone oil limiting hemorrhage to those whose course of disease ≥ 2 months, the retinal was reseted good. The patients who were treated in two months after the changes can get a good visual function.

Abstract:AIM:To discuss the fundus angiography of central serous chorioretinopathy (CSC), including fundus fluorescein angiography (FFA),indocyanine green angiography(ICGA),and synchronous spectral domain optical coherence tomography(SDOCT) in order to investigate the pathogenesis of CSC. METHODS: Fifty-four cases with CSC in our hospital during June 2009 to October 2011 were checked by using Spectralis HRA-OCT. PatientsFFA,ICGA and synchronous SDOCT were analyzed and explained. RESULTS:FFA of 54 cases with CSC appeared retinal pigment epithelial(RPE)fluorescein leakage,ICGA appeared choroidal vascular abnormal in lesions and SDOCT appeared neuroepithelial serous detachment. Comparing FFA with SDOCT of 38 cases（70.4%）, FFA appeared fluorescein leakage where ICGA was small pieces RPE detachment. CONCLUSION:CSC patients disorder location can be diagnosed accurately by checking FFA,ICGA and synchronous SDOCT, which provides clinical data for CSC pathogenesis in order to better guide clinical treatment.

Abstract:AIM:To compare the difference of intraocular pressure of non-contact tonometry and Schiotz tonometer in different corneal thickness. METHODS:Totally 314 cases (627 eyes) were recruited. Corneal thickness was measured by corneal pachymeter and intraocular pressure was measured by non-contact tonometry and Schiotz tonometer. Eyes were divided into 3 groups based on corneal thickness: thin group: corneal thickness＜530μm, normal group: 530μm＜corneal thickness ≤570μm and thick group: corneal thickness＞570μm. The statistical significance of differences was evaluated by paired t-test and the agreement was assessed by Bland-Altman analysis. RESULTS:The eyes of thin, normal and thick group were: 170, 301 and 156 eyes, respectively.The intraocular pressure of non-contact tonometry and Schiotz tonometer in 3 groups were 12.82±2.67 mmHg，12.84±2.37mmHg；1367±2.66mmHg，13.58±2.41mmHg；15.45±2.91mmHg，14.76±2.39mmHg, respectively. There was significant difference in thick group and no significant difference in other groups. CONCLUSION: It is suggested that either non-contact tonometry or Schiotz tonometer could measure intraocular pressure in eyes with corneal thickness≤570μm, and consult the intraocular pressure of the two measurements in eyes with corneal thickness ＞570μm.

Abstract:AIM: To observe the clinical efficacy ofvitrectomy on different causes of vitreous hemorrhage, and the effect of correlative factor on vitrectomy. METHODS: Clinical data of different types offundus disease in 76 cases 76 eyes with vitrectomy were analyzed retrospectively. The multiple factors related with clinical efficacy of vitrectomy including the causes, age and the time were analyzed. RESULTS: In cause groups, diabetic retinopathy(proliferative) was in 31 cases (41%), rhegmatogenous retinal detachment 24 cases (32%), branch retinal vein occlusion 10 cases (13%), central retinal vein occlusion 3 cases (4%), retinal vasculitis 2 cases (3%), blunt trauma 2 cases (3%), simple vitreous hemorrhage 2 cases (3%), proliferative vitreoretinopathy 1 case (1%), polypoidal choroidal vasculopathy 1 case (1%). In age groups, there was statistical difference between each group(χ²=21.89, P<0.01); in youth group(<45), there were 26 cases, rhegmatogenous retinal detachment was in 11 cases (42%); in middle-aged group (45-59), there were 19 cases, rhegmatogenous retinal detachment was in 9 cases (47%); in old group(>60), there were 31 cases, diabetic retinopathy was in 24 cases(77%). In time groups, there was statistical difference between each group(χ²=20.37, P<0.01); in one month group, there were 26 cases, the postoperative vision of 13 cases (50%) increased over 03; in two month group, there were 24 cases, the postoperative vision of 10 cases (42%) increased over 0.1 but below 0.3, in three month group, there were 11 cases, the postoperative vision of 5 cases (45%) increased over 0.01 but below 0.09; in over three month group, there were 15 cases, the postoperative vision of 6 cases(40%) increased over 0.01 but below 0.09 and 6 cases (40%) increased over 0.1 but below 0.3. CONCLUSION: The diabetic retinopathy(ptoliferative), rhegmatogenous retinal detachment and branch retinal vein occlusion are the main causes of the vitreous hemorrhage. Vitrectomy used to treat different causes of vitreous hemorrhage is obviously effective (especially caused by rhegmatogenous retinal detachment), which can improve visual function. The vitrectomy has better clinical efficacy on vitreous hemorrhage in one to two months.

Abstract:AIM: To discuss the effect and necessity of pars plana vitrectomy(PPV) for the treatment of vitreous hemorrhage complicated retinal hole or detachment. METHODS: Totally 28 cases(28 eyes) with vitreous hemorrhage complicated retinal hole or detachment were treated by PPV. The change of visual acuity was observed pre- and postoperatively and the relationship between vitreous hemorrhage and detachment was analyzed. RESULTS: In 28 cases with vitreous hemorrhage caused by various reasons, 7 cases occurred no retinal detachment from preoperative B ultrasound, 3 cases found retinal hole in intraoperation, 4 cases accompanied peri-hole shallow detachment. Postoperative visual acuity of 28 cases (including postoperative follow-up best-corrected visual acuity) improved in various degree, better than counting finger or before eye in 27 cases(96%),≥0.05 in 20 cases(71%),≥0.3 in 5 cases(18%).There was statistical significant difference between pre- and postoperation(P＜0.05). CONCLUSION: It is safe and effective for vitreous hemorrhage complicated retinal hole or detachment treated by PPV, and can find retinal hole and shallow detachment as soon as possible so as to avoid further enlargement of retinal detachment.

Abstract:AIM:To observe the etiological factor and clinical efficacy of comprehensive treatment for orbital cellulitis, and to improve its diagnostic method and provide its theoretical basis. METHODS:Totally 63 patients with orbital cellulitis form January 2009 to January 2012 in our hospital were analyzed. RESULTS:All patients were successfully healed within 2 weeks to 1 month without severe complication. CONCLUSION: The comprehensive treatment for orbital cellulitis with the advantages of definite effect is worth of promotion.

Abstract:AIM:To evaluate the clinic value and the curative effects of silicone reverse-intubation in treating chronic dacryocystitis and nasolacrimal duct obstruction. METHODS:Totally 67 cases were studied retrospectively about postoperative curative effect from 3 months to 12 months, including 35 cases on silicone reverse-intubation and 32 cases on dacryocystorhinostomy. RESULTS：The cure rate of the group of the silicone reverse-intubation was 94%, of the dacryocystorhinostomy was 94%. The difference of two groups was not significant(P>0.05)，while the operative time of silicone reverse-intubation was significantly less than that of dacryocystorhinostomy(P<0.001). And there were no severe complications in silicone reverse-intubation group. CONCLUSION：The silicone reverse-intubation is a simple, convenient, economical and effective surgery which is suitable to popularize for treating chronic dacryocystitis and nasolacrimal duct obstruction.

Abstract:AIM：To evaluate the efficacy, safety, and predictability of the implantation of Verisyse phakic iris-fixated intraocular lens(IOL) for the correction of severe myopia. METHODS：In this prospective study, 10 cases (13 eyes) with myopia at -15.00～-24.50 dioperts (D) were implanted with Verisyse phakic iris-fixated intraocular lens. Visual acuity, refraction, intraocular pressure, the Verisyse IOL position, contrast sensitivity, glare sensitivity, operative complications and poor visual symptoms were observed. RESULTS: The postoperative uncorrected visual acuity and best-corrected visual acuity(BCVA) significantly improved. The BCVA≥ 0.5 or better was presented in 100% eyes and ≥ 0.8 accounted for 85% at 3 months after surgery. There was no significant increase in mean intraocular pressure at each time point in one year after surgery. The Verisyse IOL appeared to be correctly positioned in the anterior chamber in all eyes. Contrast sensitivity and glare sensitivity in all eyes increased at 3 months postoperatively as compared with those of preoperative values (best spectacle corrected). Postoperative complications included as light inflammatory deposits on the PAC IOL surface at 3 months in 2 eyes; oval pupil in 1 eye. CONCLUSION：Verisyse IOL implantation for the correction of severe myopia is effective, safe and predictable. It can be a supplement for corneal refractive surgery, but follow up is still required for the evaluation of long term results.

Abstract:AIM：To explore the relationship between the corneal curvature, axial length, height, weight, bone age and the degree of myopia in students aged 6-14. METHODS：The height, weight, visual acuity were examined in children aged 6-14 in Baoshan district of Shanghai. There were 621 poor vision students were enrolled refractive examination, including the optometry after cycloplegia, corneal curvature and axial length.They were also taken the imaging examination of carpal bone to define their bone age. The relationship of examination results was analyzed. RESULTS: Statistics showed that the spherical equivalent had negative correlation with axial length and had no correlation with corneal curvature. The spherical equivalent had negative correlation with age, the axial length, height, weight, bone age had positive correlation with age, while the corneal curvature and the difference of axial length between measurement and emmetropia had no correlation with age. The height, weight, age, bone age and bone age difference had negative correlation with spherical equivalent, had positive correlation with axial length, had no correlation with corneal curvature. The height, weight, age, bone age had no correlation with the difference of axial length, and the bone age difference had weak positive correlation with the difference of axial length. CONCLUSION: The myopia of adolescent has some relationship with the rhythm of body growth and development.

Abstract:AIM:To evaluate the effect of different cover methods in treatment of amblyopia with pattern visual evoked potential (P-VEP). METHODS:A prospective study was conducted with 136 monocularamblyopia children, aged 3-6 years old, selected from children optometry specialist out-patient. They were divided into covered group(69 cases) and partially covered group(67 cases), respectively. On the basis of accurate refractive correction, the healthy eye from each group was covered for 10, 5 hours per day, and at the same time, the same amount of fine eyesight training was conducted, respectively. P-VEP (P100 amplitude and potential) test results and visual acuity improvement were analyzed. RESULTS:One month after treatment, compared with before treatment, P100 amplitude increased and latency was shortened in full cover group, and the difference was statistically significant (P<0.05), while those differences in the partially covered group were not statistically significant (P>0.05), while the difference between the two groups was statistically significant; 6 months after treatment, the visual acuity increment: cure rate, progress rate and total efficiency rate between the two groups was statistically significant(P<0.05), the difference of the P100 amplitude, latency shortening in covered group was statistically significant compared with before treatment (P <0.05), and the differences between the two groups were not statistically significant(P >0.05); the visual acuity increment: cure rate, progress rate and total efficiency rate between the two groups was not statistically significant(P >0.05). CONCLUSION:The P100 amplitude and latency were improved in cover group after amblyopia treatment in early period, partially covered group had no obvious changes than before treatment, there were significant changes in visual acuity increment in the two groups, indicating that cover group has better efficacy than the partially covered group. In the long term, no significant difference was found between the P100 amplitude, latency and visual acuity, which further indicate that the long-term efficacy of the two methods is the same and regular PVEP test can evaluate the therapeutic effect and provide guide for further treatment.

Abstract:AIM:To evaluate the effect of digital multimedia visual training in stereoacuity rebuilding of the postoperative intermittent exotropia. METHODS:Eighty-three patients with intermittent exotropia were randomly divided into 2 groups including treatment group and control group. In the treatment group, 41 patients were trained with digital multimedia system including antisuppression and fusion function training. In the control group, 42 patients received no any training. The differences of binocular visual and fusion range and final deviation were compared between the two groups before and after treatment. RESULTS:When compared with control group, the stereoscopic vision had significantly rebuilded (P<0.05), the fusion function was greatly enhanced (P<0.05), treatment group got better efficacy in final deviation (P<0.05). CONCLUSION:The digital multimedia visual training can promote binocular function and increase the final orthotropia ratio .The new treatment provides a new feasible way for intermittent exotropia clinical therapy.

Abstract:AIM: To explore an effective way of establishing a cataract barrier-free region by the establishment of community service network. METHODS:A primary care center and three neighborhood committees under its jurisdiction were chosen. The questionnaire was designed with reference of the questionnaire of a ravid ophthalmology hospital in India. The survey included two stages: (1) Investigation on the cognition of community residents to cataract; (2) Investigation on the willingness of accepting operation. RESULTS: There were about 1500 elder people aged over 60, and the cases who correspond actively accounted for 80.0%. In all the questionnaires resumed, the ones who had self consciousness accounted for 92.0%, and visited actively ones accounted for 54.5% while 96.5% of the investigated man needed health propaganda and education. The cognitive questionnaires were fed back to the neighborhood committees by the hospitals of communities. After ophthalmologic examination, 16.7% of them needed operation. The willingness of accepting operation was affected by the following factors: economic conditions(34.0%), psychologic situation(40.0%) and operated before(10.0%). CONCLUSION: In the downtown of Beijing even the center of the city, health propaganda and education of knowledge of cataractis essential. The cognition of cataract had nothing to do with the educational level. Participating of the hospitals with surgical technique of cataract and primary care center with the help of government was an effective way to establish a cataract-free region.

Abstract:How to improve the ophthalmology teaching quality in the limited teaching hours has been a research project for ophthalmology teachers. In this paper, we proposed several experiences for mobilizing the students interest in learning, curriculum revision in due course, the implementation of collective classes, updating multimedia courseware, training of highly qualified teachers and improving teaching ophthalmology rules and regulations and so on.

Abstract:AIM:To discover a microsurgery training pattern for ophthalmologists to make them grasp the basic skill and learn feature about the microsurgery during the requirement of clinical ophthalmology. METHODS: Set up a microsurgery of ophthalmology training system about the principles and operant skill for ophthalmologists of our hospital, refresher ophthalmologists and practice graduates. RESULTS: All of the 46 doctors skillfully grasped the basic skills of microsurgery. They could make some surgery such as resection of pterygium, extracapsular cataract extraction combined with intraocular lens implantation and trabeculectomy with operating microscope under the teachers guidance. CONCLUSION: Using the training system of ophthalmology microsurgery with practical operation，the doctors will grasp the microsurgery skill.

Abstract:AIM:To increase the cataract surgery patients understanding extent to disease related knowledge, reduce preoperative anxiety emotions, increase patients cooperating ability during surgery;strengthen the autonomy of patients who undergo bad behavior and improve the self-conscious ability after operation. METHODS:Divided the 912 cataract patients(912 eyes) who have taken phacoemulsification combined with intraocular lens implantation(PEA+IOL) into control group 424 cases and experimental group 488 cases according to the different wards. The control group undertook traditional health education, while the experimental group used the slides, together with the nurses interpretation, explained the disease related knowledge vividly, such as how to use eye drops correctly, the operating rooms layout, operation process and procedure, the key points of postoperative nursing and matters that should pay attention, etc. RESULTS:Among these two groups of patients with cataract disease, the understanding extent to cataract related knowledge, preoperative anxiety level and sleeping quality, compliance extent to medical treatment and the self-consciousness extent of avoiding bad behaviors are statistically significant (P<0.01). CONCLUSION:The application of multimedia to cataract surgery patients for health education can greatly improve the patients understanding and mastering extent to disease related knowledge, thereby reducing preoperative anxiety and noticeably improve preoperative sleep quality. As the patients got enough understanding to this disease, they could voluntarily comply with the doctors prescription, consciously avoid unhealthy behavior; actively correct unhealthy habits, so that improve the satisfaction to the nursing services.

Abstract:AIM: To discuss the clinical effect of using thefresh amniotic membrane and continuous ring lock shaped suture for the treatment of fungal corneal ulcer. METHODS:Twenty-one cases (21 eyes) with fungal corneal ulcer were treated by fresh amniotic membrane transplantation and continuous ring lock shaped suture, combined with lesion debridement and antifungal agents. RESULTS: Followed up for 3 months, among which 16 cases (16 eyes) were cured, 3 cases(3 eyes) improved, 2 cases(2 eyes) failed. CONCLUSION: Fresh amniotic membrane and continuous ring lock shaped suture for the treatment of fungal corneal ulcer is an effective therapy.

Abstract:AIM:To observe the clinical effect of phacoemulsification combined silicone oil removal in eyes with silicone oil temponade complicated cataractin diabetic retinopathy. METHODS:Twenty-two cases(22 eyes) with diabetic retinopathy after silicone oil temponade complicated cataract were performed phacoemulsification and intraocular lens implantation combined silicone oil removal. All eyes were transplanted soft intraocular lenses smoothly by corneal transparent incision. RESULTS:Visual acuity of 19 eyes improved after phacoemulsification, 13 cases were better than 0.1, 3 cases were similar with that before. Posterior capsule remained complete intraoperatively, and all eyes smoothly transplanted soft intraocular lenses. Corneal edema occurred in 5 cases, then regressed in postoperative 3-7 days. 22 cases were removed silicone oil smoothly. 3 cases occurred vitreous hemorrhage in postoperative 1 month, among which 2 cases spontaneously absorbed in 4 weeks, 1 case was performed vitrectomy combined with intraocular laser coagulation. 22 cases did not occur retinal re-detachment. CONCLUSION:Phacoemulsification combined silicone oil removal for the treatment of eyes with silicone oil temponade complicated cataractin diabetic retinopathy is not only effective, but also reduces pain caused by repeated operations.

Abstract:AIM:To investigate the small incision extracapsular cataract extraction and posterior chamber intraocular lens capsular bag implantation combined with presetting trabecular incision trabeculectomy for treatment of glaucoma complicated with cataract clinical curative effect. METHODS:Twenty-one cases with coexisting cataract and glaucoma were performed cataract extracapsular extraction and posterior chamber intraocular lens capsular bag implantation combined with presetting trabecular incision trabeculectomy. Postoperative visual acuity, intraocular pressure and complications were observed. RESULTS:All patients postoperative intraocular pressure decreased to normal range. Postoperative visual acuity improved to different degrees. After surgery in 1 eye occurred early anterior membrane of intraocular lens, 2 eyes appeared transient corneal edema. CONCLUSION: Presetting trabecular incision in small incision extracapsular cataract extraction and posterior chamber intraocular lens implantation combined with trabeculectomy is safe, effective and economical, which is worthy of promoting.

Abstract:AIM:To evaluate the clinical effect of nonperforating trabecular surgery (NPTS) combined with amniotic membrane implantation processed with mitomycin for the treatment of primary open angle glaucoma(POAG). METHODS:Fourty cases (58 eyes) with POAG executed NPTS with amniotic membrane implantation processed with mitomycin. Visual acuity, intraocular pressure and the type of blebs were recorded. RESULTS:The intraocular pressure is good after the surgery, there was no statistically significant difference in the visual acuity. The preoperative intraocular pressure was 35.3±6.8mmHg, but postoperative was 17.6±45mmHg, the difference was significant （t=16.531，P<005）. During the visit, 27 eyes （46.55%） had functional blebs, 5 eyes treated with medicine. 9 eyes（15.52%） had blebs with etiolation and presented anemia. CONCLUSION: NPTS with amniotic membrane implantation processed with mitomycin is good for the treatment of POAG.

Abstract:AIM:To observe the short-term changes of pupil and intraocular pressure（IOP） after compound anisodine injection. METHODS:In 74 cases (148 eyes), the pupil diameter and IOP were measured by classical pupil diameter ruler and non-contact tonometer immediately before and 15, 30, 60, 120 minutes after compound anisodine injection. Statistical analysis was performed using the SPSS 18.0 program and paired t-test was used in our study. RESULTS：IOP was decreased after compound anisodine injection at least in a short time(within 120 minutes),and the decrease is statistically significant(P＜0.01).The pupil was bigger at 15^th minute after compound anisodine injection than before the therapy(P＜0.01),which is last until 60^th minute. Then the pupil became smaller. CONCLUSION:Compound anisodine superficial temporal subcutaneous injection has little effect on IOP fluctuation and IOP of most patients was decreased. Mydriasis effect of the drug is minor and short-acting, which can not induce ocular hypertension. "

Abstract:AIM:To observe the efficacy transscleral diode laser cyclophotocoagulation for eyes with congenital microphthalmia(CM) complicated with glaucoma persistent high intraocular pressure. METHODS:Retrospective self-controlled study. This study enrolled 5 cases (7 eyes) with CM complicated with glaucoma persistent high intraocular pressure performed transscleral diode laser cyclophotocoagulation from January 2009 to January 2011 in Xingtai eye hospital. Pre- and postoperative visual acuity, intraocular pressure and complications were observed and analyzed statistically. RESULTS:During the follow-up all patients eye pain symptoms released. The mean preoperative intraocular pressure (IOP) was 52.56±7.31mmHg. The mean IOP of postoperative 1 month was 17.8±4.7mmHg. At the follow-up of postoperative 6 months, the mean IOP was 14.18±453mmHg. There was significant statistical difference between preoperative IOP and that of postoperative 1 month and 6 months.Compared with the preoperation (00334±0.0322), the postoperative mean visual acuity (0.127±0.165) increased, there was significant statistical difference (P<0.01). There were 5 eyes(71.4%) postoperative visual acuity increased, 2 eyes (28.6%) had not changed after laser cyclophotocoagulation. All the anterior chamber had inflammation, and all disappeared after medical treatment. CONCLUSION:Transscleral diode laser cyclophotocoagulation is a safe and effective therapeutic method to CM complicated with glaucoma persistent high intraocular pressure.

Abstract:AIM:To evaluate the surgery treatment efficacy of vitrectomy combined retinal photocoagulation on vitreous hemorrhage associated with retinal arterial aneurysm. METHODS: Retrospective analysis of vitrectomy combined retinal photocoagulation for patients with vitreous hemorrhage associated with retinal arterial aneurysms,11 cases (11 eyes, 4 males, 7 females), from January 2009 to February 2011 in our hospital. The effect, visual acuity and complications were observed and analyzed. RESULTS: Followed up 6 to 24 months after surgery, all patients had no vitreous hemorrhage again, retinal blood vessels were occlusion around the arterial aneurysms, and then the arterial aneurysms shrinked and scared. The postoperative visual acuity improved from 0.05 to 0.4, all cases increase in varying degrees. The postoperative intraocular pressure of 2 cases (2 eyes) occurred a transient rise, then return to normal after given topical ocular hypotensive medication treatment. CONCLUSION: It is an effective and precise method of vitrectomy combined retinal photocoagulation for the treatment of vitreous hemorrhage with retinal arterial aneurysm.

Abstract:AIM:To evaluate the modes and effects of surgical treatment for intraocular foreign bodies(IFBs). METHODS:The clinical data of 24 cases of IFBs were analyzed retrospectively. RESULTS: The successful rate of the extraction of IFBs treated with vitrectomy or posterior route extraction was 100%. There was not difference of the postoperative visual acuity between the two surgical means without complications. The postoperative visual acuity was improved in the cases with retina detachment, which were treated with vitrectomy. CONCLUSION: The treatment principle of the extraction of IFBs can not injury the affected eyes again. When we choose the surgical treatment for IFBs, the size, the position and the complications in the affected eyes must be analyzed.

Abstract:AIM:To explore a simple and more reasonable fixation of hydroxyapatite (HA) artificial eye mount of auto sclera. METHODS:Fixation was done in 23 cases of blindness with unknown causes. Eye contents enucleation was performed without cutting off extrinsic eyeball muscles. Episclera was sheared radially into 4 parts from nasal superior, inferonasal, subtemporal and supratemporal parts. Posterior sclera was scissored about 6mm around the optic nerve head, again downward, upward, internally and externally. Posterior sclera was sheared about radially the length of 5-6mm.Tenon capsule was dilated right-angle crossed and passively. After artificial eye mount was implanted into orbital muscle cone and sclera cavity, the 4 flaps of the sclera were cross-stitched, performing a double reinforcement effect to HA artificial eye mount RESULTS:All the HA artificial eye mounts implanted into 23 cases presented solid fixations, and full of orbital formations. After artificial eye pad was fixed, by and large, eyes were symmetrical, and artificial eye mount had a good range of motion. The follow-up studies showed none of artificial eye mount occurred to shift, expose, prolapse or other complications. CONCLUSION:The modified simple fixation of artificial eye mount of auto sclera makes it more solid for artificial eye mount to be fixed in the original eye position, and remain the original state of motion, and the operation is simple. After the fixation, it presents a very lifelike effect.

Abstract:AIM:To investigate the clinical curative effects of lower eyelid retraction patients treated by porous polyethylene lower eyelid spacer (Medpor LES) and homologous sclera transplantation. METHODS:Twenty-six cases with lower eyelid retraction were implanted with a Medpor LES or homologous sclera. Follow-up lasted for 3 months. RESULTS:Three months after surgery the clinical results of both groups were similar. However, 2 cases treated with Medpor LES or homologous sclera demonstrated insufficient lower eyelid retraction correction. There were no significant complications associated with the use of Medpor LES or homologous sclera in this study including infection and rejection. CONCLUSION:This trial shows that the use of Medpor LES or homologous sclera in the lower eyelid was safe. A good or satisfactory final outcome in the majority of cases was verified by the two operation methods. The clinical curative effects of the two groups were not significantly different.

Abstract:AIM: To compare the effects of modified traditional dacryocystorhinostomy with intranasal endoscopic dacryocystorhinostomy on chronic dacryocystitis. METHODS: Totally 112 cases with complete medical records were studied retrospectively including 53 cases with modified traditional dacryocystorhinostomy(group A) and 59 cases with intranasal endoscopic dacryocystorhinostomy(group B). RESULTS: In group A, after 6-12 months follow-up, 51 of 53 (96.2%) cases had good results; while in group B, 55 of 59 (93.2%) cases had good results. There was no statistical significant difference between the two groups (P ＞0.05). CONCLUSION:The intranasal endoscopic dacryocystorhinostomy is an effective mini-invasive operation with no facial surgical scar and its operative effect can approach that of modified traditional dacryocystorhinostomy if surgical features are grasped well.

Abstract:AIM:To evaluate the safety, efficacy of retrograde lacrimal intubation for treatment of chronic dacryocystitis. METHODS:This study included 42 cases (42 eyes) with chronic dacryocystitis from December 2009 to December 2011. The procedure of retrograde intubation was performed in local anesthesia. All cases were received retrograde lacrimal intubation, and the tube was removed after placing 3-6 months. The efficacy and the complication were observed. RESULTS:All operations on patients were conducted successfully, and the tube was removed after placing 3-6 months. 40 out of 42 caess the lacrimal were unobstructed when the tube was removed. 6 months after the tube was removed, the effective rate was 88%.3 cases occurred complication. CONCLUSION: The results show that retrograde lacrimal intubation is a safe, easy and effective method on treating chronic dacryocystitis, which is suitable for clinical application.

Abstract:AIM:To discuss the curative effect of traumatic canalicular laceration treated by annular tube implantation and inferior canalicular laceration anastomosis. METHODS:Selecting 28 cases with traumatic canalicular laceration, searched for the lacrimal broken end leaded by probe under microscope and implanted the silicone tube annularly, then performed canalicular laceration anastomosis and followed up from 6 months to 2 years. RESULTS:In 28 cases with canalicular laceration restoration, all were successful through single operation. 24 cases （85.7%）were cured, 3 cases （10.7%）improved, 1 case（3.6%） had no effect. CONCLUSION:It is simple and effective of using probe under microscope searching for the lacrimal broken end and annularly implanting the silicone tube for the treatment of canalicular laceration, which can retain normal tearing, no influence on appearance, good stability, practical and convenient performing, however, the operation technique should be pay attention to.

Abstract:AIM:To investigate the clinical features and results of the operations of V-strabismus with inferior oblique hyperfunction. METHODS: Totally 69 cases V-strabismus with inferior oblique hyperfunction admitted to hospital from February 2009 to December 2010 were selected to undergo the surgery of inferior oblique weakening joint horizontal muscle, to observe the changes of eye position before and after surgery as well as the oblique. RESULTS: Postoperative eye anteroposterior in 65 cases (94.20%), the V-sign disappeared in 64 cases (92.75%), 19 cases (27.54%) with compensatory head position all improved, 15 cases (21.74%) performed postoperative machine training to restore binocular vision function. CONCLUSION:The inferior oblique hyperfunction is the main cause of V-strabismus, the surgery of inferior oblique muscle weakening is an effective approach for the treatment of V-strabismus.