Abstract:AIM: To observe the effect of traditional Chinese medicine(TCM)of bushenhuoxue on primary visual cortex(PVC)brain-derived neurotrophic factor(BDNF)in rat model of chronic elevated intraocular pressure(EIOP), and explore the mechanism of it initially.

METHODS: The rat model of chronic EIOP was established by unilaterally cauterizing 3 episcleral veins, then 30 rats were divided into 3 groups randomly: control group, model group, and treatment group. After given drugs or normal saline for 8 weeks, the rats were put to death. The effect of intraocular pressure(IOP), expression of BDNF and ultrastructure of neuron cell in the PVC was observed.

RESULTS: Unilaterally cauterizing episcleral veins increased IOP of the rat model obviously, there was significant difference compared with pre-operation(P<0.01). Semi-quantitative pathological analysis on PVC showed that BDNF of total area in the model group was(82438±2597.39)S/μm²,mean optical density was(1155.9±123.14), integrated optical density was(12915±673.28), compared with the control group {total area was(132370±7588.47)S/μm², mean optical density was(5365±379.65), integrated optical density was(35102±2648.5)}, there were statistical differences(all P<0.05),there was statistical difference in BDNF of total area between model group and treatment group{(108980±9126.77)S/μm², P<0.05}, significant difference in mean optical density between the model group and treatment group(3220.4±413.67, P<0.05), statistical difference in integrated optical density between the model group and treatment group(23821±3431.68, P<0.05).

CONCLUSION: TCM of bushenhuoxue can repair the PVC damage in the rat model of chronic EIOP by enhancing expression of BDNF, improving ultrastructure of neuron cell.

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

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

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

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

Abstract:AIM:To elucidate the relation between tissue factor pathway inhibitor-2(TFPI-2)expression and the expression of matrix metalloproteinases(MMPs)in keratocytes.

METHODS: Primary culture and subculture of rabbit keratocytes were established in vitro. Plasmid vector pBos-Cite-neo/TFPI-2 was transfected into keratocytes with Lipofectamine 2000. After being selected by G418, three groups of cells including TFPI-2 gene transfected cells K-TFPI-2, empty vector transfected cells K-V and non-transfected cells K-P were screened for TFPI-2 mRNA and protein by reverse transcription-polymerase chain reaction and Western blot analysis, respectively. The activity of MMPs in the three groups of cells was detected by substrate zymography and compared by ANOVA.

RESULTS: Expression of mRNA and protein of TFPI-2 was more in the cells of K-TFPI-2 than in the other cells of K-P and K-V with a significant difference(mRNA:0.79±0.02 vs 0.51±0.03 and 0.48±0.02, P=0.000 and P=0.000; Protein:24.5±0.8 vs 15.5±0.5 and 14.9±0.9,P=0.000 and P=0.000). Compared with the two groups of K-P and K-V, the cells of K-TFPI-2 had a significant decreased activity of MMP1(12.3±0.7 vs 16.7±1.2 and 15.9±0.7, P=0.001 and P=0.003)and MMP2(15.4±1.3 vs 18.2±1.1 and 17.8±1.1, P=0.027 and P=0.046).

CONCLUSION: It is suggested that the expression of TFPI-2 may strongly inhibit the activity of MMPs in keratocytes in vitro, which provides an experimental basis for curing CNV with gene therapy.

Abstract:AIM:To observe the expression of syndecan-1 on epiretinal membranes obtained from patients with proliferative diabetic retinopathy and retina of diabetic rats.

METHODS:SD rats were given intraperitoneal injection of streptozotocin to induce diabetes. Ink perfusion and stretched retina were used to observe the retinal blood vessels. Immunohistochemistry staining was used to detect syndecan-1 protein in the rat retina and epiretinal membranes of proliferative diabetic retinopathy.

RESULTS:In the diabetic rats of 9-week, peripheral retinal blood vessels shaped tortuously, capillary network was significantly reduced, and parts of the capillary perfusion was bad. In the control group, strong positive staining of syndecan-1 was detected in the nerve fiber layer and ganglion cells, moderate positive staining was observed in the inner plexiform layer and outer segments of photoreceptor, and weak positive staining was detected in the outer plexiform layer. In the retina of diabetic rats, syndecan-1 decreased. Moderate positive staining of syndecan-1 was observed in the nerve fiber layer, ganglion cells and outer segments of photoreceptor, weak positive staining was detected in the inner plexiform layer and outer plexiform layer. Among 13 specimens of epiretinal membranes, weak positive staining of syndecan-1 was detected in 8 cases(61.5%)and negative staining was observed in 5 cases(38.5%).

CONCLUSION:Syndecan-1 is down-regulated in the retina of diabetic rats and epiretinal membranes of proliferative diabetic retinopathy.

Abstract:AIM: To investigate if insulin can promote retinal pigment epithelial(RPE)cell proliferation and the secretion of transforming growth factor β₂(TGF-β₂).

METHODS: Human RPE cells were exposed to different concentrations insulin at different times(0 to 48 hours). We used the MTS method to test the proliferation of RPE cells. And we used the ELISA method to text the secretion of TGF-β₂ of RPE cells in various cases, and the Real-time PCR method to test the expressions of TGF-β₂ mRNA.

RESULTS: The MTS results showed that after 12 hours exposure of insulin RPE cells proliferated significantly(P<0.05). ELISA results showed that insulin can significantly promote the secretion of TGF-β₂ of RPE cells, and this process was independent of time and dose. And Real-time PCR results showed that 24 hours after the stimulation of insulin, TGF-β₂ mRNA increased significantly(P<0.01), and 10×10³U/mL insulin group, TGF-β₂ mRNA expression were significantly higher than the 0.1× 10³U/mL insulin group(P<0.01).

CONCLUSION: RPE cells are important intraocular sources of TGF-β₂, and insulin can promote the proliferation of RPE cells and the secretion of TGF-β₂ to promote myopia.

Abstract:AIM: To investigate the ultrastructure of the basal vitreo- retina interface in enucleated pig eyes after vitreous injection of enzymes.

METHODS:Totally 130 eyes were obtained from freshly slaughter pigs and divided into 5 groups. Each group was sub-divided into the 15 minutes group and the 30 minutes group, with 13 eyes in each group. The control group were performed middle vitreous injection of 0.1mL PBS, 200U/mL and 800U/mL hyaluronidase(HA)were injected in groups A and B, 10U/mL and 50U/mL chondroitinase(CA)in groups C and D. After incubation for 15 minutes and 30 minutes, the eye balls were fixed with 4% glutaraldehyde and retina fixative solution. Pathological examination, eosin-hematoxylin staining, scan electron microscopy were taken to evaluate the remaining vitreous on vitreous base, transmission electron microscopy to evaluate retina toxicity.

RESULTS:Both of gross appearance and hematoxylin+eosine slice all revealed basal vitreous partially liquefied and degradation. Remarkably decrease was found in basal vitreous than the control group both in the HA 800U/mL group and the CA 50U/mL group when using electron microscopy scanning. Transmission electron microscopy in group B, C and D revealed the remaining vitreous were less than the control group.

CONCLUSION: Both CA and HA can cause basal vitreoretinal detachment in enucleated pig eyes. But the HA may cause less damage to the retina.

Abstract:AIM:To assess the neuroprotective effects of traditional Chinese medicine in the treatment of glaucoma.

METHODS:The electronic bibliographic databases were searched,including Medline(1966-01/2011-03), EMbase(1996-2010), Cochrane library, Wanfang database,VIP(1999-2011), CNKI, the radomized controlled trials of TCM treatment compares with Western medicine treatment of the glaucoma were assembled Data were extracted and evaluated by two reciewers independently with a designed extraction formation by Meta-analysis based on the Cochrane net suggestion.

RESULTS:A total of 8 theses written in Chinese were retrieved,including 719 patients.The results of Meta-analysis showed the combination therapy of TCM and western therapy significant improves the effect of neuroprotection(P<0.01). In order to boost and qualify the curative effects of the aucupuncture, more precise samples should be designed and a multi-research central need to be bulit. however, according to the existing cases, the evidences of the effectiveness are weak due to the limited numbers of samples and the methodological defect.

CONCLUSION: The existing evidence supports the combination therapy of TCM and western medicine stronger than the only used of western medicine(P<0.01). But owing to the limited studies and few number of TCM treatment for glaucoma's neuroprotection, the large sample andmulticenter random ized controlled trial is still needed to verify the superiority of TCM for neuroproctive effect of glaucoma's teatment.

Abstract:AIM:To study normal value of corneal thickness in healthy subjects in different age groups with Fourier-domain optical coherence tomography(FD-OCT).

METHODS:Total 420 eyes of 210 healthy volunteers were analyzed. These were divided into three groups: young group(YG, n=70, 140 eyes, 18 to 40 years old), medium group(MG, n=70, 140 eyes, 41 to 60 years old), old group(OG, n=70, 140 eyes, more 61 years old). Corneal thickness in central zone and inner-ring and outer-ring zones were measured by using FD-OCT.

RESULTS:The thinnest zone was 527.19±1.72μm in central cornea zone, and the thickest zone was 582.42±2.50μm in superior in outer zone. Differences of corneal thickness were not significant in different measured zones(P>0.05). Average values of corneal thickness made by FD-OCT was better consistent and highly correlated for three groups(right eye: YG-MG: r=0.949, MG-OG: r=0.924,YG-OG: r=0.981. left eye: YG-MG: r=0.996, MG-OG: r=0.901, YG-OG: r=0.876).

CONCLUSION: Measurement of cornea thickness by FD-OCT is more reproducible, reliable and convenient, and may better represent actual cornea thickness.

Abstract:AIM: To investigate diabetic choroidal hemodynamics in order to provide valuable theories for preventing and treating diabetic retinopathy(DR)and make compensation for the ocular disease of diabetes mellitus(DM).

METHODS: Color Doppler flow imaging(CDFI)was used to quantitate peak systolic velocity(PSV), end diastolic velocity(EDV)and resistence index(RI)of the ophthalmic artery(OA), the temporal posterior ciliary artery(PCA₁), and nasal posterior ciliary artery(PCA₂), in the control group(15 patients)and 45 DM patients. Statistic software was used to analysis the hemodynamic parameters.

RESULTS: Relative to the control, the EDV, PSV and RI have changed in non-diabetic retinopathy(NDR), non- proliferative diabetic retinopathy(NPDR)and proliferative diabetic retinopathy(PDR), and the differences are more evident according to the severity of DR.

CONCLUSION: We conserved the choroidal circulatory properties of DM. CDFI is very valuable to evaluate the hemodynamic changes in diabetic eyes, and has important significance in the early impression of diabetic choroidopathy.

Abstract:AIM: To study the changes of corneal curvature after the operation of pterygium excision with transplantation and pterygium excision with limbal stem cell transplantation.

METHODS:Patients with pterygium were selected. They were divided into 2 groups in random: simple pterygium excision was performed in group A; pterygium excision with limbal stem cell transplantation was performed in group B. The results of visual acuity, astigmatism, corneal curvature and central anterior chamber depth were tested between pre-surgery, post-surgery 15 day and post-surgery 1 month.

RESULTS:Visual acuity seemed to be mostly unaffected up to a height of 2.5mm. Naked visual acuity of post-surgery was better than that of pre-surgery. Corneal horizontal curvature on post-surgery was statistically and significantly improved. Corneal vertical curvature: group A, the corneal vertical curvature of post-surgery was higher than that of pre-surgery(P<0.05); 15 days postoperatively, the vertical curvature of group B had no statistical difference with that of pre-surgery(P>0.05), and 1 month postoperatively, the vertical curvature was higher than that of pre-surgery and post-surgery 15 days(P<0.05). Corneal mean curvature on post-surgery was statistically and significantly better than that of pre-surgery.

CONCLUSION: The patient's naked eye visual acuity is improved after pterygium surgery; the horizontal diameter line curvature of the cornea is ascended, but the vertical diameter line curvature of the cornea did not change significantly.

Abstract:AIM: To investigate the visual quality after phacoemulsification combined with customized implantation of refractive multifocal intraocular lens(Rezoom NXG1 MIOL)and diffractive multifocal intraocular lens(ReSTOR SA60D3 MIOL).

METHODS: A prospective, nonrandomized, unmasked clinical trial was performed. Patients with age-related cataract who were to undergo phacoemulsification were divided into two groups: multifocal intraocular lens(MIOL)vs monofocal intraocular lens(SIOL). 10 patients were included in each group. In the group of MIOL, patients got implantation of ReZoom NXGl MIOL in the dominant eye and ReSTOR SA60D3 MIOL in the fellow eye while patients in the group of SIOL got implantation of Sensar AR40e IOL bilaterally. One month postoperatively, distance, mid-range and near visual acuity, contrast sensitivity, focal depth were measured. Satisfaction of visual quality was investigated by questionnaire.

RESULTS: One month postoperatively, the patients in the MIOL group were satisfied with distance visual acuity, meanwhile they achieved better mid-range and near visual acuity compared with patients in the SIOL group. Under mesopia condition, SIOL implantation gave better contrast sensitivity in spatial frequency at 3 cpd, and no difference was observed in other spatial frequency, while under photopia condition, no significant difference was observed among all the five types of spatial frequency. The focal depth of MIOL was 5.30D, which was significantly higher than 2.85D of the SIOL. Satisfaction of visual quality of near and mid-range was significantly higher in the MIOL group.

CONCLUSION: Customized implantation of intraocular lens after phacoemulsification provides better visual acuity and visual quality postoperatively.

Abstract:PAX6 gene plays an important role on the embryological development through regulating cell proliferation, migration, differentiation and adhesion. This is supported by the fact that expression of PAX6 is dysregulated in several congenital diseases, especially in eye, nose, nerve system, pancreatic gland and endocrinologic system. In this review a general background of the PAX6 gene was summarized, and we also give a brief introduction of roles on genes up and down stream from PAX6 gene and its genetic mutation within eye development.

Abstract:In recent years, the small-incision cataract extirpation andintraocular lens implantation has become more and more mature, which has satisfactorily improved the cataract patients' postoperative vision, but because of the artificial lens is lack of accommodation, patients still need to wear glasses for postoperative near or far visual. Multifocal intraocular lens has provided a full-distance visual for cataract patients, but the visual quality problems appear. With the elevation of demands for life, the research and development of accommodating intraocular lens also goes deeper. This paper will review the research progress of accommodating intraocular lens in clinical application.

Abstract:Dislocation of intraocular lens(IOL)is one complication of cataract extraction and posterior chamber IOL implantation. The reasons for IOL dislocation include incompletion of lens capsule cut, unevenness of capsulorhexis, break of zonules and/or posterior capsule, remain of lens cortex, capsule contraction, drag of exudate and organize strap, after cataract, trauma, etc. And the treatments for IOL dislocation include simple IOL reposition, capsular tension ring(CTR)implantation, anterior chamber IOL implantation, suspensory IOL implantation, IOL dislodgment, vitrectomy, etc.

Abstract:Choroidal hemangioma(CH)is a benign vascular tumor that occurred in the fundus posterior pole. Although it is a benign tumor, exudation from the lesion can lead to retinal detachment and other complications that make visual loss for patients. CH can occur as a circumscribed choroidal hemangioma(CCH), generally without systemic associations, or as a diffuse choroidal hemangioma(DCH)that is often associated variations of Sturge-weber syndrome(SWS). The management of CH has included laser photocoagulation, radiation therapy, transpupillary thermotherapy(TTT), photodynamic therapy(PDT). This article aims to introduce the current situation and the latest progress of the various therapies, to explore the most safe and effective method for the treatment of CH.

Abstract:Review of the literature published in studying the relevant tear physiological function, tear discharge and blink, and as we combined with our clinical practice experiences in the lacrimal apparatus disease, we clearly put forward the theory that blink is the power of the basal tear secretion and discharger. The relationship between physiological function of the discharge basal tear and blink was studied; we also put forward the theory that there has no independent neural reflex arc, which has shared with the blink basal tear secretion. In this paper, we put forward the hypothesis that the blink is the power of the front tear film refreshment, formation and discharged. We make clear the concept of blink, classification, and basic neural reflex arc.

Abstract:AIM:To evaluate the clinical effects of scleral buckling for the early retinal detachment eyes with silicone oil tamponaded.

METHODS: This retrospective observation included 26 cases(26 eyes)who had the signs of early retinal detachment after the silicone oil tamponaded under 15 days. All the cases received scleral buckling and were observed with the change of retinal reattachment, visual acuity and intraocular pressure(IOP)for 6-18 months.

RESULTS: All 26 cases(26 eyes)had the retinal detachment at the inferior side. The retina of 22 cases(22 eyes)was anatomical attached(92%)after the operation and 4 cases(4 eyes)accepted another time of silicone oil tamponaded. The visual acuity improved in 22 cases(22 eyes), 3 cases(3 eyes)had no change and 1 case(1 eye)decreased. The IOP increased at early period after the operation and became normal after 3 months.

CONCLUSION: Scleral buckling is effective for the early retinal detachment eyes with silicone oil tamponaded.

Abstract:AIM: To evaluate the clinical values of oral ganciclovir on the treatment of corneal endotheliitis.

METHODS:The data of 14 eyes of 14 patients with corneal endotheliitis diagnosed in China Medical University Eye Center from October 2011 to October 2012 were retrospectively analyzed. Oral ganciclovir was orally administered 1.0g 3 times per day for 2-4 weeks, and then by 0.5g 3 times per day for 4 weeks; 1.5g/L ganciclovir ophthalmic gel and 10g/L prednisolone acetate eye drops were adopted in eyes. The symptoms and signs, together with effective rate and cure rate were evaluated before and after the therapy 1 ^st week, 2^nd week,4^th week and 8^th week respectively. The recurrence was followed up. The score before and after the treatment by Rank-sum test was compared.

RESULTS: One week after therapy of oral ganciclovir, the symptoms and signs bettered, the score changed from 19.14±4.57 to 11.43±3.86, then 6.93±2.59 for 2^nd week, and 0.29±0.87 for 4^th week. Till 8^th week, the symptoms and signs of all the patients disappeared completely. The effective rate was 71%, 100%, 100%, 100% after the therapy 1^st week, 2^nd week, 4^th week and 8^th week respectively. Compared with the vision of before, 10 cases fully recovered, 3 cases declined mildly, and 1 case significantly reduced. None of the cases recurred during the follow-up time.

CONCLUSION: Treating corneal endotheliitis by oral ganciclovir combined with eye drops is effective. Oral ganciclovir could prevent recurrence.

Abstract:AIM: To study the influence of phacoemulsification on five sites of corneal endothelium of senile cataract in patients after anti-glaucoma surgery.

METHODS: Patients with cataract after anti-glaucoma surgery were selected, and the surgery of phacoemulsification was performed by a same skilled surgeon, The superior, inferior, central, nasal, temporal endothelium cells were observed with a non-contact endothelium scope on pre-operation and seventh day, first month, third month and sixth month of post-operation.

RESULTS: After operation, there were obvious differences of corneal endothelium of every sites between two groups(P<0.01).

CONCLUSION: Endothelium cells of senile cataract in patients after anti-glaucoma surgery are easier to be damaged in the phacoemulsification, so preoperative evaluation, surgery manner and postoperative treatment are very important.

Abstract:AIM: To study the effect of vitamin A palmitate eye gel on ocular surface reconstruction after laser in situ keratomileusis(LASIK), and to evaluate the efficacy and safety.

METHODS: One hundred and twenty patients(240 eyes)performing LASIK were enrolled in this study. The right and left eyes were randomly divided into experimental group and control group. The experimental group were treated with vitamin A palmitate eye gel for 1 month, four times a day after LASIK, and the same as control group in other treatments. The SchirmerⅠ test, break-up time(BUT)and corneal sensation were detect at preoperation and the postoperative 1^st day, 1^st month, 3^rd month in two groups.

RESULTS: There were significant difference in BUT and tear secretion quantity between the experimental group and the control group at the postoperative 1^st month and 3^rd month(P<0.05), which provided evidence that the postoperative BUT and tear secretion quantity of experimental group recover faster than that of the control group. Comparing with control group, the experimental group had no significant difference in corneal sensation at the postoperative 1^st day,1^st month and 3^rd month(P>0.05), which revealed that vitamin A palmitate eye gel had no obvious effect on recovery of corneal sensation after LASIK. During the treatment, there was no adverse drug event occurred.

CONCLUSION: Early use of vitamin A palmitate eye gel postoperatively is applicable for ocular surface reconstruction, but has no obvious effect on the regeneration of corneal sensation.

Abstract:AIM: To analyze the causes and disposal of posterior capsule rupture of the lens in phacoemulsification for cataract.

METHODS: A total of 326 cases(377 eyes)with cataract were selected and underwent phacoemulsification and intraocular lens implantation. The causes of 23 cases(23 eyes)who suffered posterior capsule rupture were analyzed.

RESULTS: Posterior capsule rupture occurred in 23 eyes(6.1%)during the operation; 17 cases with visual acuity≥0.3(73.9%).

CONCLUSION: It is necessary to know the dangerous factors of posterior capsule rupture and avoid the incidence. If noticed early, the complications can be reduced and the visual acuity can be improved as well.

Abstract:AIM:To explore safety and effectiveness of stratified emulsion splitting technology in highly hard nuclear cataract ultrasonic emulsification.

METHODS: Totally 43 cases(47 eyes)of highly hard nuclear cataract was performed cataract extraction combined IOL implantation with stratified emulsion splitting cataract ultrasonic emulsification technology.

RESULTS:Postoperative visual acuity 1 day, 1 week and 1 month best-corrected visual acuity ≥0.5 was accounted for 70.21%, 87.23% and 89.36%. Intraoperative capsule rupture was found in 2 eyes. Corneal mild edema was found in 7 eyes(14.89%)after the first l day post-operation.

CONCLUSION:Stratified emulsion splitting technique has a practical application with little tissue damage, low capsular rupture rate and few complications for highly hard nuclear cataract patients and can bring a desirable outcome.

Abstract:AIM: To investigate the advantage of burst mode of phacoemulsification for rural hard nucleus cataract.

METHODS: Totally 162 eyes(162 cases)were randomly divided into small incision cataract extraction(SICE)group and burst group. Actual phaco-emulsification(Phaco)power, Phaco time, visual acuity, corneal edema and other complications were recorded.

RESULTS: Visual acuity was significant improved in both two groups postoperatively. But the difference between the two groups was statistically significant(P <0.05)and visual acuity recovery was faster in burst group than in SICE group. In comparison of the astigmatism between the burst group and SICE group, the difference was significant(P <0.05)in early stage. The actual Phaco power in burst group was(16.2±5.4)% and Phaco time was(42.8±6.1)s econds. Serious corneal edema occurred more frequently in SICE group(69 eyes)than that in the burst mode group(12 eyes), 6 eyes suffered posterior capsular rupture in SICE group.

CONCLUSION: Burst Phaco mode reduced Phaco time and actual Phaco power consumed during phacoemulsification and reduced corneal edema and surgery complications in hard nucleus cataract surgery. It is an effective measure for hard nucleus cataract for better postoperative visual acuity and shorten recovery time.

Abstract:AIM: To observe the clinical effect of 2.5 mm-long hooker using improved pre-chop phacoemulsification method with ozil technique and to discuss the clinic characteristics of this improved surgery method.

METHODS: Retrospectively analyzed 247 patients(320 eyes)with ozil phacoemulsification and intraocular lens implantation surgery. The 247 patients were randomly divided into two groups. The two groups were given different chop method during the surgery: improved pre-chop and traditional stop and chop. The improved pre-chop group were canceled water separation steps, the ultra-long chopper were entered into the capsular bag under the rim of continuous circular capsulorhexis, by passed the intraocular lens equator then reversed the hooker upward against the posterior pole of lens and cracked the nuclear into half with the phacoemulsification hand pieces extruding the nuclear from above downward without using energy, then rotated the nuclear and repeated the chop step. The control group used the traditional stop and chop technique. Pre-surgery recording included the best-corrected visual acuity(BCVA)and corneal endothelial cell counting. Average power(AP), real ultrasound phacoemulsification time(U/Time), accumulated energy complex parameter(AECP), BSS perfusion amount and complications were recorded. And the corneal edema and corneal endothelial cell counting were observed at one week post the surgery.

RESULTS: Compared the sub-group of two groups with the same hardness of nuclear, the AP, U/Time, AECP and the BSS perfusion amount of the improved pre-phaco group were lower than the stop and chop group(P<0.05)with significant difference. Also the lose rate of corneal endothelial cell of the improved pre-phaco group was lower than the stop and chop group(P<0.05).

CONCLUSION: Using the improved pre-phaco method in the ozil phacoemulsification cataract surgery could raise the energy utilization efficiency, decrease the BBS perfusion amount during the surgery and further lower the injury to the corneal endothelial cell brought by the phacoemulsification surgery.

Abstract:AIM: To research the refraction of eyes after phacoemulsification of cataract and diffractive aspheric multifocal intraocular lens(IOL)implantation under the guidance of IOL master.

METHODS: Totally 68 patients(84 eyes)with age-related cataract were selected. Routine preoperative examinations were completed, and IOLs were determined under the guidance of IOL master. All the patients underwent phacoemulsification of cataract and multifocal IOL(Tecnis AMO00)implantation. 3 months later, postoperative visual acuity and the refraction(according to the integrated refractometer)of patients were observed.

RESULTS: The refraction types of these 84 eyes included 36 myopia and 48 hyperopia, with spherical and cylindrical diopter between -0.5D to +0.5D. No significant refractive error was detected. There were 64 eyes(76%)with postoperative uncorrected distance visual acuity ≥0.8, 77 eyes(92%)with best-corrected distance visual acuity ≥0.8, 58 eyes(69%)with uncorrected near visual acuity ≥0.8, 74 eyes(88%)with best-corrected near visual acuity ≥0.8, 58 eyes(69%)with intermediate visual acuity ≥0.8.

CONCLUSION: Diffractive aspheric multifocal IOL provides a high level of full vision, and will be more accurately selected under the guidance of IOL master. No significant refractive error was detected after surgery, and patients were much satisfied.

Abstract:AIM:To evaluate the quality of life and influence factors in glaucoma patients after trabeculectomy.

METHODS:The quality of life of 123 cases of glaucoma after trabeculectomy patients were evaluated with a scale of life quality for diseases with visual impairment.

RESULTS:The quality of life scores of glaucoma patients after trabeculectomy were low. The Visual status was the significant factor to the patient's quality of life; The analysis of multiple stepwise linear regression indicated the visual status(β=-10.139, P=0.000), health education(β=2.576, P=0.000), number of operations(β=-3.598, P=0.002)and gender(β=3.807, P=0.013)are the main influencing factors.

CONCLUSION: The scores of quality of life of glaucoma patients after trabeculectomy were low. Therefore, doctors should not only pay attention to the clinical treatment of patients with glaucoma, but also take care of the quality of life according to the patient's occupation, economic status when protecting visual function. It is necessary to give some health education and psychological treatment to improve their quality of life.

Abstract:AIM: To investigate the clinical efficacy of trabeculectomy combined with phacoemulsification and intraocular lens implantation for the treatment of primary chronic angle-closure glaucoma.

METHODS: A retrospective analysis was performed on 65 patients(70 eyes)with chronic angle-closure glaucoma and varying degrees of lens opacity admitted to our hospital ophthalmology from February 2011 to February 2012. Patients underwent trabeculectomy combined phacoemulsification and intraocular lens implantation. And after that patients were followed-up for at least 6 months. Postoperative visual acuity, intraocular pressure(IOP), and bleb complications were compared and analyzed.

RESULTS: According to the international standard eye chart check, after 3 months follow-up, visual acuity improved 1 line accounted for 80%(56/70); After 6 months follow-up, after vision correction the vision acuity that improved 1 line accounted for 93%(65/70); after 6 months of follow-up, IOP<21mmHg, accounted for 89%(62/70); functional blebs accounted for 89%(62/70), fewer postoperative complications.

CONCLUSION:Trabeculectomy combined with phacoemulsification and intraocular lens implantation in the treatment of primary chronic angle-closure glaucoma is a safe and effective surgery method and it has a good visual recovery, IOP decrease, and fewer complications.

Abstract:AIM: To investigate the effect of anterior chamber puncture combined trabeculectomy in the treatment of high intraocular pressure continued state of acute angle-closure glaucoma.

METHODS: Totally 80 cases with angle-closure glaucoma from March 2011 to June 2012 in our hospital were retrospectively analyzed, and 40 cases were given trabeculectomy after anterior chamber decompression(observation group)while 40 cases were received trabeculectomy after drugs decompression(control group). The clinical efficacy was compared between the two groups.

RESULTS: The postoperative vision recovery, anterior chamber angle and pupil improvement were better than the control group, and the incidence of complications were less than the control group, the difference was statistically significant(P<0.05).

CONCLUSION: The efficacy of anterior chamber paracentesis combined with trabeculectomy in the treatment of high intraocular pressure continued state of acute angle-closure glaucoma is effective, and it is a simple surgery with fewer complications, which is worth to actively promote in clinic.

Abstract:AIM: To investigate the clinical effects of phacoemulsification combined with goniosynechialysis in the management of chronic primary angle-closure glaucoma(CPACG).

METHODS:Totally 57 cases(57 eyes)with CPACG and cataract were treated with phacoemulsification combined with goniosynechialysis. Intraocular pressure(IOP), anterior chamber angle, best-corrected visual acuity and central anterior chamber depth were monitored during follow-up for 8-15 months in these eyes.

RESULTS: The IOPs of 52 eyes were normal without any medications. The IOPs of 4 eyes were normal with a single antiglaucomatous eye drops. The IOP of 1 eye was normal with two kinds of antiglaucomatous eye drops. The anterior chamber angles became wider and the synechial angle closure were reopened after surgery in all eyes. The best-corrected visual acuity were improved except 1eye with optic atrophy. The postoperative central anterior chamber depth became deep.

CONCLUSION: Phacoemulsification combined with goniosynechialysis is able to safely effectively control IOP and also improve the visual acuity of CPACG.

Abstract:AIM: To observe the efficacy of the argon laser photocoagulation treatment of central serous chorioretinopathy(CSC).

METHODS: The treatment groups: 18 patients(18 eyes), argon laser photocoagulation and oral jolethin, vitamin B1, inosine and venoruton tablets. Control group: 18 patients(18 eyes), oral lecithin complex iodine, vitamin B1, inosine, venoruton tablets. Foveal thickness and neuroepithelial layer detachment range were measured by optical coherence tomography(OCT)before treatment, after 1 month and 3 months post-operation to compare the decline in value of foveal thickness and neuroepithelial layer detachment range of the two groups.

RESULTS: After 1 month of treatment, the decline in value of the center foveal thickness: the value of treatment group was 256±72μm; the value of the control group was 82±57μm, and the difference of the two groups, P <0.05; the decline in value of neuroepithelial layer detachment range: the value of the treatment group was 3 548±168μm, the value of the control group was 1 520±143μm, And the difference of the two groups, P<0.05. After three months of treatment, the decline in value of the center foveal thickness: the value of treatment group was 383±75μm, the value of the control group was 312±67 μm, and the difference of the two groups, P<0.05; decline in value of neuroepithelial layer detachment range: the value of the treatment group was 4 908±172μm, the value of the control group was 4 211±153μm, and the difference of the two groups, P <0.05. The differences were statistically significant between the treatment and the control groups(two independent samples t-test).

CONCLUSION:Argon laser photocoagulation treatment of CSC is an effective treatment method and can significantly shorten the course.

Abstract:AIM: To dynamically observe the subtle structure changes in the acute central serous chorioretinopathy(ACSC)by optical coherence tomography(OCT).Compare the efficacy of laser, drug and the combined treatment.

METHODS: Totally 96 cases(98 eyes)of ACSC were confirmed by FFA and OCT, the differences of subretinal fluid absorption and visual acuity by drug, laser and laser combined with drug therapy were compared. Follow-up time was 2 weeks, 4 weeks and 8 weeks.

RESULTS: Between the groups were no statistically significant in the range of retinal detachment before treatment. After 2, 4 and 8 weeks treatment, the range of retinal detachment and cure rates were not statistically significant between the laser group and drug group. Compared to aforementioned two groups, a smaller range of retinal detachment and higher cure rate was found in combined treatment group, the differences were statistically significant.

CONCLUSION: The combined treatment of drug and laser can shorten the course of ACSC, improve the cure rate; OCT is noninvasive, simple, intuitive, can sensitively track the healing process of ACSC.

Abstract:AIM: To observe the choroidal thickness in the macular area in affected and unaffected fellow eyes with central serous chorio retinopathy(CSC)and in healthy controls.

METHODS: Twenty-six cases with unilateral CSC and controls were recruited in this study. All eyes were divided into three groups: 26 eyes in Group A(affected eyes with CSC), 26 eyes in group B(unaffected fellow eyes)and 26 eyes in group C(right eyes of age and sex matched control). Enhanced depth imaging was obtained by using spectral-domain optical coherence tomography. Subfoveal choroidal thickness and choroidal thickness at 1mm/3mm nasal, temporal, superior and inferior to the fovea were measured.

RESULTS: Choroidal thickness was significantly increased in affected eyes with CSC than unaffected fellow eyes(t=5.57, P<0.01).The mean subfoveal choroidal thickness(SFCT)was 528.31±91.24μm in group A, 413.71±79.35μm in group B, and 301.31±52.46 in group C. The subfoveal choroid was significantly thicker in group A than Group C(P<0.01). SFCT in unaffected fellow eyes were thicker than the controls(P<0.01).

CONCLUSION:Choroidal thickness is thicker in affected eyes with CSC and also in fellow unaffected eyes, indicating that the choroid blood vessels are high and perfusion state, may be one of the factors of the disease CSC.

Abstract:AIM:To explore cataract surgery complication of the anterior chamber injection 0.1mL dexamethasone for uveitis complicated cataract patients.

METHODS: The experimental group was injected 0.1mL dexamethasone to anterior chamber at the end of phacoemulsification(Phaco)+intraocular lens(IOL)implantation, while the control group did not. And the different postoperative inflammation between them was observed.

RESULTS: The differences of visual acuity between the two groups on the first two days after operation were statistically significant(P<0.05). The postoperative corneal edema and anterior chamber flare between the two groups in the first day were different(P<0.05). And the percentage of the experimental group postoperative visual acuity improved was higher than that of the control group.

CONCLUSION: It can reduce short-term postoperative inflammation, improve visual acuity earlier and do not impact the short-term postoperative intraocular pressure that uveitis complicated cataract was injected 0.1mL dexamethasone to anterior chamber at the end of Phaco+IOL.

Abstract:AIM: To observe the clinical curative effect of scleral buckling surgery for the treatment of old retinal detachment.

METHODS: We selected 134 cases old retinal detachment patients as the objects in our hospital in recent years, all the patients was monocular retinal detachment. 66 cases of them were less than six months, 68 cases of them were more than six months, they were given scleral buckling surgery and the vision rehabilitation was compared after surgery.

RESULTS: Totally 61 cases(45.5%)of the patients' postoperative visual acuity was above 0.1, it was significantly higher than before the surgery; for the patients with retinal detachment less than half a year, 90.9% visual acuity was increased, 86.4% of the surgeries was success, they were significantly higher than the patients with retinal detachment more than six months. These differences were statistically significant(P<0.05).

CONCLUSION: Scleral buckling is a simple and effective method for the treatment of old retinal detachment. It can achieve higher cure rates and given the treatment earlier, the curative effect would be better.

Abstract:AIM: To study the cause of high-risk neonatal retinal hemorrhage risk and analyze its related factors.

METHODS: After the first 72 hours of the birth, the newborns in the pediatrics were examined for fundus used the wide area digital fundus imaging system(RetCam Ⅱ).

RESULTS: Among 123 newborns, 19 neonates had retinal hemorrhage, and the incidence of retinal hemorrhage in newborns was 12.2%. Among 49 newborns who were came through spontaneous delivery, 18(29.6%)neonates had retinal hemorrhage, while 1(0.7%)neonate from 74 who were born by caesarean section suffered from retinal hemorrhage. The difference was statistically significant.(χ²=34.763 P=0.000). Logistic regression equation analysis tip: The risk factors of retinal hemorrhage were eutocia, premature delivery and intracranial hemorrhage.

CONCLUSION: The important relevant factors of high-risk neonatal retinal hemorrhage are eutocia and associated with intracranial hemorrhage.

Abstract:AIM: To know the change of the retina and optic nerve for proliferative diabetic retinopathy(PDR)patients after silicone oil influxing, who have been performed with silicone oil influxing following vitrectomy, recover the functions of their retina and optic nerve, and to gain an insight into the safety of such operation.

METHODS: Totally 30 patients, who were confirmed as PDR and performed with vitrectomy operation and silicone oil influxing during June 2010 to December 2011, were chosen as treat group; and 30 cases, who were performed with vitrectomy and C₃F₈ influxing due to suffering from PDR, were chosen as control group. The patients in the two groups were observed for their intraocular pressure(IOP), best-corrected visual acuity(BCVA), after surgery colored fundus photography, perimetry, etc. to examine and evaluate the retinal functions.

RESULTS: Among the 30 cases in observation group, 15 eyes were found pale optic nerve, 9 eyes were found with faint colored optic nerve, and 15 eyes were found with local blood vessel occlusion in the retina. Among the 30 cases in the control group, the gas was entirely absorbed after three months postoperation, 3 eyes were found with faint colored optic nerve, and no one was found with paint optic nerve and local blood vessel occlusion in the retina. Visual acuity: By comparing the visual acuity of the patients preoperation and postoperation in the latest follow-up visit, the visual acuity of the patient postoperation in the silicone oil influxing group is improved by 23 eyes than that preoperation, reduced by 8 eyes than that preoperation, while the visual acuity of 10 eyes keeps unchanged. postoperation in the C₃F₈ group, the visual acuity is improved by 33 eyes, reduced by 3 eyes(8.33%, P<0.05), which is of statistical significance. Using Goldmann tenometer to compare the average of the cases seven days postoperation and in the follow-up visit, the pressure in the silicone oil influxing group was 15.07±0.85mmHg, and that in the C₃F₈ group was 17.84±1.86 mmHg. The change postoperation was of significance difference(P<0.05). The pressure in one week's following visit was of no statistical significance. Visual field: among the 60 cases who were performed with vitrectomy due to suffering from PDR, the visual field examination of 26 cases three months after the operation was made. It was found that, their visual field was tubular change.

CONCLUSION:Diabetic patients with silicone oil filling 3 months after surgery to remove the silicone oil found in some patients, color fades or pale optic local vascular occlusion of the retina, the white sheath, proliferating like change, As a result, the visual acuity and visual field of the patients showed impairment to different extent. Therefore, after they are operated with vitrectomy due to suffering from PDR, the silicone oil should be released as early as possible, depending on retinal restore so as to avoid impairment of optic nerve and retina.

Abstract:AIM: To analyze the clinical effect of perioperative intervention in proliferative diabetic retinopathy(PDR)patients.

METHODS: Totally 52 cases of eye diabetic retinopathy with medical records and follow-up materials were retrospectively analyzed from May 2009 to December 2011, male 15 cases, female 25 cases, age 31 - 78 years old, all patients underwent preoperative visual acuity, intraocular pressure, slit lamp microscope, slit lamp microscope eye fundus examination, B ultrasonic, corneal endothelial mirror etc. After 1 week, 2 weeks, 1 month, 2, 3, 6 months follow-up, the patients were observed the vision, intraocular pressure, artificial crystal, fundus, perioperative observation of patients with blood glucose, blood pressure, systemic, adverse events, and so on. Implementation of all patients perioperative interventions. According to the patients with diabetes related systemic complications diagnosis rating, each complication was recorded as 1 point, no complication 0. Operation method for vitrectomy + full retinal photocoagulation, merger macular edema and macular front wall line macular inside boundary film stripping, who do the same period with cataract phacoemulsification, stage I or implant implantation of artificial crystal, according to the intraoperative situation intraocular filling long-term gas/oil/song amine Ned; During the operation, the conventional for ecg monitoring, appear obvious blood pressure fluctuation in anesthesia physician care descending controlled decompression.

RESULTS: Forty cases of 52 eyes of diabetic retinopathy in patients with type I 5 cases, eyes surgery of 12 patients(30%), each eye around 14 cases(35%), PDR stage IV 15 eyes(28.8%), V stage 16 eyes(30.7%), VI period 21 eyes(40.3%). Preoperative sight is lower than 0.02 and eyes(73.1%), 0.02 - 0.1 7(13.5%)eye, 0.1 - 0.3 5 eyes(9.6%), more than 0.3 2 eyes(3.8%). In the follow-up of sight is lower than 0.02 17 eyes(32.7%), 0.02 - 0.1 9 eyes(32.7%), 0.1 - 0.3 14 eyes(32.7%), 0.3 above 12 eyes(23.1%). One surgery cured 47 eyes(90.4%), reoperation five eyes(9.6%), early postoperative mild vitreous hemorrhage again five eyes(9.6%), late again vitreous hemorrhage along with neovascular glaucoma 1 eyes(1.9%), infectious endophthalmitis 1 eye(1.9%). The material in our hospital medicine diagnosed with complications of patients for 17 cases(42.5%), no complications of 23 cases(57.5%), the score of 0 points 23 cases, 1 points, nine cases(22.5%), 2 points, four(10%), 3 points in 3 patients(7.5%), 4 points 1 cases(2.5%). During the operation, the implementation of controlled decompression five eyes(9.6%). All patients perioperative blood glucose, blood pressure and body were stable, no adverse events.

CONCLUSION: The perioperative intervention can significantly reduce the diabetes patients with systemic complications and adverse events, but the cost of patient care increased; Stable blood sugar, blood pressure and appropriate drug therapy can reduce the incidence of early vitreous hemorrhage again. Vitreous surgery or joint operation treatment is an effective means of PDR, surgical indications and timely grasp the surgical treatment of the patients with visual function is the key to save the residual of visual function.

Abstract:AIM: To discuss the advantages and disadvantages of combined surgery, which consists of posterior segment diseases and anterior segment diseases(cataract, glaucoma, keratonosus), and analyze the hazards that may affect surgery.

METHODS: Group A: proliferative diabetic retinopathy(PDR), group B: complicated retinal detachment(RD). For comparison, group A was divided to group A₁: vitrectomy; group A₂: vitrectomy + cataract extraction; group A₃: vitrectomy + cataract extraction + intraocular lens implantation. Group B was divided to group B₁: vitrectomy; group B₂: vitrectomy + cataract extraction; group B₃: vitrectomy + cataract extraction+ intraocular lens implantation.

RESULTS: Surgery complications were the main outcome measures: neovascularity secondary glaucoma in group A and surgery recurrence or proliferative vitroretinopathy in group B. The incidence of complication: group A₃>A₂>A₁, A₃ was significantly higher than A₂ and A₁, and it was statistically significant, A₂>A₁, but it was not statistically significant. The results of group B were the same as group A.

CONCLUSION: Combined surgery will not be chosen if it is possible, and intraocular lens should not be implanted at once if the operation was influenced.

Abstract:AIM: To evaluate effect of polyethylene glycol eye drops combined with basic fiberoblast growth factor(bFGF)eye drops on dry eye.

METHODS: Fifty-one patients(102 eyes)with dry eye were divided into treating group and control group randomly. Both eyes of one were compared by each other. The eyes of treating group were treated by polyethylene glycol eye drops combined with bFGF eye drops 4 times each day for 1 month. The 2 drops were dropped 5 to 10 minutes apart each time. The eyes of control group were treated by polyethylene glycol eye drops 4 times each day for 1month. Schirmer Ⅰ test, break-up time(BUT), corneal fluorescein staining and improvement of symptoms were observed before treatment and after treatment in the two groups.

RESULTS: There was significant difference intear film break-up time(BUT), corneal fluorescein staining and symptoms between before and after the treatment of both groups(P<0.05). There was also significant difference in BUT, corneal fluorescein staining and symptoms between the two groups after the treatment(P<0.05). There was no significant difference in Schirmer Ⅰ test between all time-point of the two groups(P>0.05).

CONCLUSION: Polyethylene glycol eye drops combined with bFGF has obviously effect on dry eye.

Abstract:AIM: To evaluate the effect of variety factors on the patient's adaptability and subjective evaluation after wearing Menicon-Z rigid gas permeable contact lens(RGPCL).

METHODS: Totally 39 patients were recruited in this study. The clinic data including age, gender, spherical, astigmatism, corneal thickness, corneal curvature, basic tear and living areas were analyzed for their impact. Patients evaluated comfort and visual stability after wearing Menicon-Z RGPCL for a month.

RESULTS: The average adaptation period after wearing RGPCL was 6.41 ± 4.64 days. The age factor had a significant influence of the adaptation period(F=4.07, P=0.025). Patient's discomfort caused by foreign body sensation(0.62±0.71)and eye dry sense(0.64±0.63)after wearing RGPCL for a month.

CONCLUSION: Patients adapted to Menicon-Z RGPCL in about a week. The younger the more easily adapted to the RGPCL. The main impact factor of patient's adaptation period is comfort. Detailed guidance and corresponding treatment is an important means to resolve their symptoms and long-lasting wearing.

Abstract:AIM: To study the peripheral blood T-lymphocyte and natural kill(NK)cell in patients with nonarteritic anterior ischemic optic neuropathy(NAION).

METHODS: The changes of CD₃⁺,CD₄⁺,CD₈⁺,CD₄⁺/CD₈⁺, NK in 30 NAION and 31 normal controls were measured by flow cytometry monoclonal immunofluorescence.

RESULTS: CD₃⁺, CD₄⁺/CD₈⁺ ratio in NAION patients had no significant difference from normal control, CD₄⁺, CD₈⁺ decreased significantly.

CONCLUSION: Serious immunological disturbances of T lymphocyte subsets exist in NAION patients.

Abstract:AIM: To investigate the strabismus situation in Department of Ophthalmology during physical examination of cadet candidates, and to explore the factors that influence the properties of the short-term changes of strabismus.

METHODS:The exophoria and exotropia of 4 231 qualified students in China Southern Airlines were compared and analyzed with normal students vision and refractive degree distribution during 2008-2012.

RESULTS:The exophoria value, difference of binocular visual acuity and anisometropia was large, and visual fatigue easily lead to exophoria or external oblique.

CONCLUSION:During physical examination for students with the binocular visual acuity differences >0.4, exophoria anisometropia >2.00D and visual fatigue symptoms, we should check the three levels of visual function.

Abstract:AIM: To explore the correlated factors which may affect the therapeutic effect of amblyopic children.

METHODS:The therapeutic effect of 120 amblyopic children was retrospectively analyzed, then the relation between multivariate factors and the therapeutic effect with the logistic regression model was analysed.

RESULTS: The average curative time of the 120 amblyopic children were 22.15±6.20 months, 81 cases was basically cured, and 20 cases improved, after single element analysis there were 5 factors affecting the curative effect, multivariate logistic regression analysis showed that the independent risk factors were the older age of the child, parents lack of the knowledge of the amblyopia, the poor guidance of the teacher and the deficiency of the indoor illumination, OR=3.601, 3.366, 2.690, 2.563.

CONCLUSION: The independent risk factors which affect the curative effect are older age, parents lack of the knowledge of the amblyopia, the poor guidance of the teacher and the deficiency of the indoor illumination. For this we should take actions to enhance the level of the therapeutic effect.

Abstract:AIM: To investigate the prevalence and related risk factors of dry eye in Tibetan and Han pupils in Zhouqu county, Gansu Province.

METHODS: This was a cross-sectional study. In May 2 012, two schools altogether 2 548 pupils of Zhouqu county were randomly selected as survey venues. Every participant completed symptoms of dry eye questionnaire, eye routine inspection, Schirmer Ⅰ test, tear-film break-up time, and fluorescein staining of the cornea, then confirmed the diagnosis. The SPSS 17.0 software was used to analyze the data.

RESULTS: Totally 2 548 subjects took part in this study, and the inclusion ratio was 90.61%. The prevalence rate of dry eye was 11.89%. Han-Tibetan ratio was 1.99:1(1 697:851). The prevalence of dry eye had no statistically significant difference among the Tibet nationality(12.22%)and Han nationality(11.73%)(χ²=0.132, P>0.05). The male-female ratio was 1.08:1(1 324:1 224); The prevalence of dry eye in the boy(13.22%)was higher than that of the girl(10.38%)(χ²=6.202, P<0.05).

CONCLUSION: The prevalence of dry eye has no statistically significant difference among the Tibet nationality and Han nationality. The prevalence of dry eye in boy is higher than that in the girl. And the prevalence of dry eye increases along with the aging process. The most common adverse symptoms is increased secretion. Relative risk factors of dry eye are age, trichiasis conjunctivitis and refractive error.

Abstract:AIM: To find reference and inspiration for training ophthalmology residents in our country.

METHODS: This article focused on the ophthalmology residency training program in Doheny Eye Institute, combined with the experience of Wilmer Eye Institute and Jules Stein Eye Institute. The principle and purpose of continuing medical education in America was also introduced.

RESULTS: America has a scientific system for the training of clinical physicians, especially the residency training program and continuing medical education.

CONCLUSION: By learning the experience of America, we can find new ideas for improving medical care in our country.

Abstract:AIM: To observe the clinical effective of free conjunctival flap transplantation in the treatment of refractory corneal ulcers.

METHODS: From July 2011 to November 2012, eight patients(8 eyes)with serious corneal ulcer who underwent conjunctival flap transplantation were retrospectively analyzed. The ulcers were covered with full-thickness free conjunctival flaps and were interrupted sutures. The patients wore contact lens and took medical treatment after operation.

RESULTS: Postoperatively, the corneal ulcer in 8 eyes was cured after one surgery and whose conjunctiva flaps were good. The conjunctiva flaps were not desquamated after took out stitches. The ocular surface was regular. The visual acuity was improved in different degrees.

CONCLUSION: Free conjunctival flap transplantation is safe and effective in the treatment of refractory corneal ulcers.

Abstract:AIM: To study the clinical curative effect and securityof autologous front plate layer sclera edge transplantation in treatment of corneal peripheral small area severe alkali burn.

METHODS:Totally 39 cases(39 eyes)with corneal peripheral small area severe alkali burn were included, they underwent local debridement, excision of infection at the front plate layer of corneal and adjacent lamellar sclera, also part of the conjunctiva, the front plate layer sclera and conjunctival in the corresponding health eye was taken and transplanted. Patients' postoperative subjective symptoms(pain, photophobia, and tears), vision, corneal epithelium time to repair and recurrence, the healthy eye eyesight, healing and sequel were observed.

RESULTS:After postoperative follow-up of 2-12 months, all patients' corneal epithelium healed, patients subjective symptoms rapidly recovered, no vision loss occurred, no relapse. Health canthus sclera edge wound healing was good, without sequela.

CONCLUSION:Autologous front plate sclera transplantation in the treatment of corneal peripheral small area severe alkali burn, the operation is simple, which can effectively shorten the corneal alkali burn healing time, promote corneal epithelium repair, health eyes(donor eyes)good recovery, without sequelae.

Abstract:AIM: To investigate the therapeutical effect of an improved trabeculectomy on the persistent ocular hypertension of acute angle-closure glaucoma.

METHODS: Totally 105 standardized patients were divided into two groups: experimental group and control group. The patients in experimental group were operated with an improved trabeculectomy and patients in control group were operated with the routine trabeculectomy. Visual acuity, intraocular pressure and changes of anterior chamber were recorded at the preoperative and postoperative period. The data were collected to do some statistical analysis.

RESULTS: Totally 51(73.9%)patients' visual acuities were improved in experimental group; 10(14.5%)patients' visual acuities did not change; intraocular pressure of 46 eyes(66.7%)was steady and normal; the anterior chambers of 11 eyes(15.9%)became more shadow than before. In control group, there were 17 eyes(47.2%)whose visual acuities were improved; 12(33.3)patients' visual acuities did not change; intraocular pressure of 21 eyes(58.3%)was steady and normal; the intraocular pressure of 4 eyes(11.1%)cannot be controlled, and need to be operated again. The anterior chambers of 20 eyes(55.6%)became more shadow than before.

CONCLUSION:The treatment of an improved trabeculectomy on the persistent ocular hypertension of acute angle-closure glaucoma is safe and valid.

Abstract:AIM: To determine the value of 24-hour intraocular pressure(IOP)monitoring in routine clinical practice of suspects of glaucoma.

METHODS:Fifty-one suspects of glaucoma(51 eyes)were selected for 24-hour IOP monitoring without any anti-glaucoma therapy. Goldmann tonometer was used for 24-hour IOP measurement.

RESULTS: In all of 51 eyes, there were only 21(41.2%)eyes with IOP kept in normal range and IOP variation amplitude under 6mmHg, 30 eyes(58.8%)were with large diurnal fluctuations in IOP or the peak IOP up to 21mmHg. The IOP of the 7 eyes were with intraocular hypertension only at night, with highest IOP of 54mmHg, with daytime IOP relieved to normal range. The 24-hour IOP monitoring were higher than of the daytime IOP measurement(P<0.01).

CONCLUSION:Compared with the daytime IOP measurement, the 24-hour IOP monitoring could identify diurnal IOP and/or IOP spikes better.

Abstract:AIM: To observe etiology of vitreous hemorrhage caused by retinal vein occlusion and prevention analysis.

METHODS: Totally 50 patients with retinal vein occlusion were randomly divided into treatment group(drug therapy)and combined treatment group(drugs and laser treatment), each 25 cases, the occurrence of vitreous hemorrhage, number of cases, and the restoration of vision were observed.

RESULTS: The number of cases with vitreous hemorrhage in treatment group glass volume blood was significantly higher than that in drug combined with laser photocoagulation group.

CONCLUSION: Pay attention to imaging, drug combined with laser photocoagulation in treatment of vitreous hemorrhage caused by basic-level hospital retinal vein occlusion has obvious prevention effect.

Abstract:AIM: To observe the effect ofvitreoretinal surgery for late state of proliferative diabetic retinopathy(PDR).

METHODS: Totally 38 cases(45 eyes)with PDR stageⅥ operated with standard vitreoretinal surgery were analyzed retrospectively. Preoperative and postoperative visual acuity was studied. The complications of post-operation were analyzed.

RESULTS: Forty-five eyes were followed-up in the find examination. The vision of 0.05 or better was obtained from 14/45 eyes(31.1%)to 30/45 eyes(66.7%), in which, 22/30 eyes(73.3%)were 0.1 or better. The major operative complications included highintraocular pressure, vitreous hemorrhage, retinal detachment, complicated cataract, neovascular glaucoma, optic atrophy and ocular-atrophy.

CONCLUSION:Vitreoretinal surgery is an effective and safe procedure for the late stage of PDR to master surgical indications and techniques in order to obtain better visual improvement and reduce the surgical complications.

Abstract:AIM: To study the clinical curative effect argon chlorine laser treatment in branch retinal vein occlusion(BRVO).

METHODS:The 60 BRVO patients clinically confirmed by fundus fluorescein angiography(FFA)were randomly divided into 2 groups: group A(treatment group)30 cases underwent argon chlorine laser photocoagulation; group B(control group)30 cases were for activating blood circulation and eliminating stasis drugs(compound thrombosis the capsule)). The results of visual acuity and macula edema regression in the two groups 6 months after treatment were compared.

RESULTS: Group A: obviously effective in 8 cases, effective 20 cases. Group B: obviously effective in 2 cases, effective in 14 cases, invalid in 14 cases; Group A had 14 cases combined with macular edema, and after argon chlorine retinal photocoagulation, macular edema disappeared in 12 cases, not retreat in 2 cases; Group B had 13 cases combined with macular edema, and macular edema disappeared after medical treatment in 3 cases, not disappeared in 10 cases.

CONCLUSION:The argon laser photocoagulation is an effective treatment for BRVO, promote the visual acuity, shorten the duration of symptoms.

Abstract:AIM:To investigate clinical effect of intravitreal injection of bevacizumab and triarncinolone acetonide for diabetes macular edema(DME).

METHODS: There were 105 cases suffering diabetic macular edema. They were divided into three groups randomly, bevacizumab with triarncinolone group(35 cases), triarncinolone acetonide group(35 cases), and laser group(35 cases). Bevacizumab with triarncinolone group patients were given intravitreal injection of bevacizumab and triarncinolone acetonide. Triarncinolone acetonide group patients were given intravitreal injection of triarncinolone. Laser group were given laser photocoagulation.

RESULTS: All patients were followed up for 6 months. We observed patients' visual acuity, intraocular pressure, slit lamp, FFA and OCT. Among laser group patients, excellent in 12 cases(34.3%), effective 14 cases(40.0%), ineffective 9 cases(25.7%), total effective rate was 74.3%. Among triarncinolone group patients, excellent in 15 cases(42.9%), effective 18 cases(51.4%), ineffective 2 cases(5.7%), total effective rate was 94.3%. Among bevacizumab and triarncinolone group patients, excellent in 23 cases(65.7%), effective 12 cases(34.3%), ineffective 0 case, total effective rate was 100%. We analyzed these data by statistic method. We found excellence rate of bevacizumab and triarncinolone group was higher than other two groups', and the two differences were significant(P<0.05 and P<0.01). Total effective rate of bevacizumab with triarncinolone group and triarncinolone group both were significantly higher than laser group(P<0.01 and P<0.01). There were no significant differences between the total effective rates of evacizumab with triarncinolone group and triarncinolone group.

CONCLUSION: The clinical effects of intravitreal injection of bevacizumab and triarncinolone acetonide for DME is significant, and this method is worthy of studying and application.

Abstract:AIM: To explore the clinical manifestations and diagnostic features of spontaneous carotid-cavernous sinus fistula so as to improve the recognition and avoid misdiagnosis.

METHODS: Clinical data from 14 patients with spontaneous carotid-cavernous sinus fistula including clinical symptoms and signs, imaging, treatment were analyzed retrospectively.

RESULTS: The most common ocular symptoms in all 14 patients were exophthalmos(100%)and eye redness(93%). The CT or MRI scan performed in 12 cases revealed enlargement of the superior ophthalmic veins in 9 cases and distension of the cavernous sinus in 6 cases. The ocular manifestations improved apparently in all 4 cases undergoing embolization therapy.

CONCLUSION: Due to the wide and various clinical spectrum of spontaneous carotid-cavernous fistula, having a good grasp of diagnostic ocular features and imaging findings is significant to improve the diagnostic ability. Embolization therapy is effective in improving the ocular symptoms.

Abstract:AIM:To discuss the use and application of ultrasound biomicroscopy(UBM)in the diagnosis of no-metallic foreign body in sclera.

METHODS: Retrospective study of 15 patients who were diagnosed as scleral no-metallic foreign bodies. Their symptoms were repeated red-eye and eye-pain. All of them were in no-acute period. UBM were used to diagnose suspicious sclera foreign bodies, and were confirmed as no-metallic foreign bodies by surgical operation.

RESULTS: Medical history of 10 cases confirmed definitely botanical ocular trauma. Medical history of 5 cases was unidentified. Course of disease was 1-6 months. Clinical manifestations were repeatedly red-eye and eye-pain, which could be improved by medical treatment, but appeared once again after ceased medication. All patients presented with local rise in sclera, and lightly or heavy hyperemia without cornea edema. Ultrasound imaging was high-density imaging with the later tissue no imaging. Suspicious scleral foreign bodies were diagnosed. After operation, 11 cases were planted foreign bodies, 2 cases were coal cinder, 1 case was glass bits, 1 case was small stone.

CONCLUSION: UBM could find scleral no-metallic foreign bodies without delay,decrease.

Abstract:AIM: To analyze the magnetic resonance imaging(MRI)in twenty patients with non-glaucoma visual defect and evaluate the reasons.

METHODS: It was a retrospective cases series study. Twenty patients with visual defect who first visited at ophthalmology department were analyzed. Visual acuity, slit lamp, eyeground examination and intraocular pressure were performed. Medical histories were recorded in detail, the brain and orbit MRI were performed and analyzed.

RESULTS:There were 10 cases with BCVA 0.1-0.3, 0.3-0.6 in 4 cases, 0.6-1.2 in 6 cases, Papilledema in 5 cases, while monocular in 3 cases and binocular in 2 cases. Intraocular pressures were all normal. Visual field examinations showed quadrant hemianopsia in 11 cases, macular sparing with homonymous hemianopsia of right side in 1 case, homonymous hemianopsia of left side in 2 cases, tubular visual field in 3 cases, physiological bind spot expanded in 2 cases, diffusive visual defect in 1 case. The MRI showed multiple lacunar cerebral infarction were the commonest disease which was found in 10 cases, acute cerebral infarction in 1 case, hypophysoma, meningioma and craniopharyngioma each in 2 cases, chronic cerebral hemorrhage in 1 case.

CONCLUSION: MRI can show the visual pathway lesions and other diseases responsible for visual loss. The visual field examination is the sensitive method to detect brain diseases, which should be the necessary exam for suspected neuro-ophthalmology patients.

Abstract:AIM: To explore the early diagnosis value of the visual evoked potentials(VEP)in visual function examination of children with cerebral palsy in.

METHODS: Totally 167 cases of cerebral palsy children and 210 normal children were examined by FVEP, and FVEP wave P₁₀₀ latency and amplitude of two groups was compared.

RESULTS: Outcomes of children with cerebral palsy group FVEP P₁₀₀ latency was significantly delayed, and amplitude was significantly reduced.

CONCLUSION: FVEP is useful in visual function tests forchildren with cerebral palsy in the early diagnosis value of the clinical application.

Abstract:AIM: To investigate the operation method, peculiarity and curative effect of the treatment of chronic suppurative dacryocystitis by lacrimal endoscopic laser lacrimal passage with catheterization.

METHODS: The operation method of lacrimal endoscopic laser lacrimal passage with catheterization, and the review of postoperative follow-up results that come from 49 patients.

RESULTS: Totally 49 patients, after follow-up of 3 months to 6 months, the final cure rate was 83.7%, the effective percentage was 100%.

CONCLUSION: It takes less time on the operation, the patients recovered quickly without any scars by the treatment of chronic suppurative dacryocystitis by lacrimal endoscopic laser lacrimal passage with catheterization.

Abstract:AIM: To compare the therapeutic effect of the improved flushing probing of lacrimal passage and probing flush integrated for treatment of congenital nasolacrimal duct obstruction.

METHODS: Totally 252 cases(273 eyes)of congenital nasolacrimal duct obstruction, admitted in our outpatient department from July 2008 to September 2012 were observed; One hundred and forty cases(156 eyes)were treated with improved flushing probing of lacrimal passage treatment, and 112 cases(117 eyes)were treated with probing flush integrated treatment; The therapeutic effects of the two methods were compared and followed-up time was 1 week to 1 month.

RESULTS:The improved flushing probing of lacrimal passage group had 152 eyes successful probing at once, 2 eyes failed during follow-up. The probing flush integrated group had 107 eyes successful probing at once, 8 eyes failed during follow-up. Difference between the two groups was statistically significant(P<0.05).

CONCLUSION:Compared the effect of treatments of congenital nasolacrimal duct obstruction,the improved flushing probing of lacrimal passage is significantly better than probing flush integrated.

Abstract:AIM: To observe the clinical effects of planting silicone lacrimal drainage tube for punctum lacrimale obstruction diseases.

METHODS: Forty-two punctum lacrimale obstruction patients(72 eyes)were involved and underwent silicone lacrimal drainage tube spherical under local anesthesia, after the surgery they all pointed antibacterial eye drops. All patients were divided into two subgroups; one were over 60 years old, the other all under 60. Irrigation of lacrimal passage was performed once a week for 4 times, then the drainage tube was removed one or three months later.

RESULTS: All the patients were successfully implanted with silicone lacrimal drainage tubes. No secretion was found by lacrimal passages irrigating during 14 months. 59 eyes(82%)were cured completely, 8 eyes(11%)were improved significantly, 5 eyes(7%)were unchanged. And the treatment success was more obvious in younger group than that in elder group.

CONCLUSION: The treatment for punctum lacrimale obstruction diseases by planting silicone lacrimal drainage tube is a perfect way. It is simple, safe, and timesaving, less bleeding without incision, scar and has high successful rate. So this method is worth being spread widely.

Abstract:AIM: To studythe timing of secondary treatment for neonatal dacryocystitis and the depth of the needle with probing.

METHODS: The treatment effect of the second lacrimal passage after the first treatment failure was analyzed and the depth of the needle was studied.

RESULTS: Due to the recovery rate of the lacrimal passage is related to age, there was no statistically significant difference in age, among the three groups(P>0.05). Divided according to timing, 10 eyes were cured by secondary treatment in less than 1 week, accounting for 91%; 12 eyes were cured in 1-2 weeks, accounting for 92%; 6 eyes were cured in more than 2 weeks, accounting for 75%. There was statistically significant difference in achievement ratio(P>0.05). The achievement ratio was the highest and the complication ratio was the lowest in 1-2 weeks.

CONCLUSION: 1-2 weeks is the best timing of secondary treatment.

Abstract:AIM: To study the result ofcosmetic surgery for recurrent senile lower lid entropion.

METHODS: The clinical data of 14 eyes(10 patients)who underwent blepharosphincterectomy by the same surgeon in our hospital were retrospectively studied from 2006 to 2011.

RESULTS: All the 10 cases were corrected, no case was recurred.

CONCLUSION: Treatment with blepharosphincterectomy for recurrent senile lower lid entropion is attended with good results.

Abstract:AIM: To evaluate the correction of inferior oblique anterior transposition(IOAT)in the treatment of bilateral superior oblique paralysis with inferior oblique overaction(IOOA).

METHODS: Totally 28 patients with bilateral IOOA underwent equal bilateral IOAT; the horizontal deviation was corrected at the same operation. The amount of vertical deviation in primary position and inferior oblique overaction pre-operation and post-operation was measured. Curative effects of surgical method were analyzed.

RESULTS: For 26 patients with vertical deviations in primary position in the range of 15^△-25^△, clinical effect of cure was observed with disappearance of head position. Vertical deviations in primary position decreased from >25^△to 7.8^△ for the patient who underwent bilateral IOAT combined with contralateral inferior rectus recession. Head position was improved and IOOA was eliminated for all patients with no eye movement restriction after surgery.

CONCLUSION:IOAT is an effective method for correcting large vertical deviation in patients of bilateral superior oblique paralysis with IOOA, especially in elimination of unequal bilateral IOOA. It has the advantage of easy to operating, low recurrence and effective.

Abstract:AIM: To evaluate the clinical effect of lengthening of allogenic levetor muscle with scleral graft in correcting lower eyelid retraction in patients with inactive thyroid ophthalmopathy.

METHODS: Totally 12 patients(16 eyelids)with inactive thyroid associated ophthalmopathy were collected. All patients had a typical manifestation of lower eyelid retraction.

RESULTS: All patients had subjective improvement in appearance and symptom. We have found eyelid edema to be a common complication of sclera grafts.

CONCLUSION: Lengthening of allogenic levetor muscle with scleral graft is effective in correcting lower eyelid retraction.

Abstract:AIM: To study the eye condition of children with spastic cerebral palsy.

METHODS: After eye routine examination of 72 children with spastic cerebral palsy, a clinical analysis of eye position, fundus, refractive status and stereopsis vision were surveyed.

RESULTS: The children with spastic cerebral palsy suffered from some eye diseases, including tropia, fundus anomaly, refractive error and streopsis anomaly.

CONCLUSION: In order to improve vision quality of children with spastic cerebral palsy, the early treatment of tropia and refractive error should be given attention.

Abstract:AIM: To investigate the method and observe effectiveness of autologous limbal stem cell transplantation combined with amniotic membrane transplantation in the treatment of recurrent pterygium.

METHODS: Medical records of all patients with recurrent pterygium treated by autologous limbal stem cell transplantation combined with amniotic membrane transplantation from January 2010 through June 2011 were retrospectively analyzed, and the recurrent rate was observed.

RESULTS: Totally 30 cases(32 eyes)were analyzed. The followed up time was 12 to 24 months, mean 16 months. In all eyes, 30 were transparent or only left a little corneal nebula, without new blood vessels, recurrence occurred in 2 eyes, and the recurrent rate was 6%.

CONCLUSION: Autologous limbal stem cell transplantation combined with amniotic membrane transplantation is a safe and effective method for recurrent pterygium.

Abstract:AIM: To observe the difference of treatment of amblyopia while children were kept in hospital or training in family.

METHODS: The amblyopia children from nursery were examined, 90 patients(114 eyes)were randomly selected for the treatment group, and 90 patients(108 eyes)were selected as control in April 2011 in Shenyang City. All of the subjects refracted with 1% atropine, then wear glasses. The dominant eye was covered if both eyes differ by more than two lines. Amblyopia patients from the hospital group were treated in hospital, while the control group in family.Visual acuity was observed and the efficacy was evaluated monthly. The follow-up lasted for 6 months.

RESULTS: After 6 months' treatment, for the hospital treatment group, invalid in 0 case, improvement in 18 cases(20%), almost recovery in 72 patients(80%). For the family treatment group at 6 months invalid 9 cases(10%)(2 cases gave up training), improvement in 22 cases(73%), almost recovery in 15 cases(17%). There was a significant difference(χ²=73.77, P<0.005).

CONCLUSION: For the treatment of amblyopia, children kept in the hospital for treatment is better than treated in family.

Abstract:AIM: To observe effect of the laser in situ keratomileusis(LASIK)combined with perception learning in treating adult amblyopia.

METHODS: Amblyopic patients 23 cases(33 eyes), included simple mild-moderate myopia 12 cases(15 eyes), simple high myopia 11 cases(18 eyes), effect of LASIK combined with perception learning were analyzed after two months.

RESULTS: The postoperative visual acuity in mild-moderate myopia and high myopia groups were 0.80±0.11, 0.91±0.08 respectively, which were all better than the best-corrected visual acuity, and the spherical equivalent after treatment were 0.16±0.39, 0.05±0.04D respectively, which were all much better than that before treatment.

CONCLUSION: LASIK surgery combined with perception learning can effectively treat the adult amblyopic patients.

Abstract:AIM:To investigate the distribution characteristics of eye diseases in the cadres in Chendu, Sichuan province.

METHODS: In 2012 we carried out a research on eye diseases for cadres in Chendu health check-up by the West China Hospital of Sichuan University and 767 cases of cadres undergoing preliminary ophthalmological checks. The checks included eye sight, slit-lamp microscope, intraocular pressure and direct ophthamloscopy check.

RESULTS:There were 565 cases confirmed with eye diseases, accounting for 73.7%, of which sufferers of cataract, ametropia, macular degeneration, glaucoma, retinopathy and pterygium constituted respectively 379 cases(49.4%), 209 cases(27.2%), 28 cases(3.7%), 10 cases( 1.3%), 7 cases(0.9%)and 5 cases(0.7%)of the population. We found 52 cases in this health check-up with cataract and 1 case with glaucoma, 5 cases with pterygium.

CONCLUSION: Detection rate of eye diseases is 73.7%, especially for cataract, refractive error and maculopathy. Through this health check-up there are 58 new-found cases of eye disease, regular medical is good for finding disease early, and referred to the specialist doctor in time.