Abstract:AIM: To study the prevalence of complications of cataract surgery and any association between the occurrence of complications and experience of surgeon, type of surgery, type of anaesthesia and visual outcome.

METHODS: This was a retrospective study of patients who underwent cataract surgery over a period of two years in a district hospital in Malaysia. The demographic details of patients, type of surgery done, as well as type of anaesthesia used and experience of the surgeon were noted. The types of intraoperative and postoperative complications were recorded. The final best corrected visual outcome was recorded.

RESULTS: Complications occurred in 11.1% of the total 1007 patients operated. Posterior capsule rupture(3.6%)was the most common complication. The experience of the surgeon and the type of anaesthesia used did not affect complications during surgery. Intracapsular cataract extraction(ICCE)and phacoemulsification converted to extracapsular cataract extraction(ECCE)were significantly associated with more complications(P<0.001). The visual outcome was significantly poor in patients with complications(P<0.001).

CONCLUSION: The occurrence of complications during cataract surgery significantly affected the visual outcome. The type of surgery done was associated by the occurrence of complications. However, the experience of the surgeon and the type of anaesthesia used did not affect the occurrence of complications. We recommend that particular attention be given to ICCE and phacoemulsification converted to ECCE to minimise the complications and thereby reducing the chances of poor vision postoperatively.

Abstract:AIM:To survey the eyesight status of students in the Zhejiang Province of China and its influencing factors, thereby providing a recommendation for eyesight protection of pupils.

METHODS: Totally, 6600 school students aged from 7 to 17 in Zhejiang Province were included while their eyesight status in correlation with relevant factors such as physical activity attitude and duration spent with computer and TV were investigated. Visual inspection was performed by using standard logarithmic vision acuity charts.

RESULTS: The prevalence of poor vision among high, middle and primary school students in China's Zhejiang Province has reached 71.1%, exceeding its level of 2005 and also the national average level in the same period. The rate of poor vision among 7-17 years old students increased with age, being fastest in children aged 9 years old and the rate of poor vision in girls is higher than in boys. The eyesight of primary and junior school students was not significant different between urban and rural areas, while the eyesight of urban was better than that of rural high school students. The students' attitude toward sports and time spending with sports in addition to other factors had a positive effect, whereas time spent in front of TV and computer did not significantly affected their eyesights.

CONCLUSION: Age, sex and urbanization influence the development of students' eyesight and it is worth to pay close attention to the positive effects of physical activity.

Abstract:AIM: To discuss Daidzein intravitreal injection whether has protective and recovery effects on acute nerve damages.

METHODS:After the crush models of acute optic nerve were set up, 72 males SD rats were divided into 4 groups randomly as common group without surgery, FBS negative control group, Daidzein treatment group(10μmol/L, 100μmol/L, 1000μmol/L)and positive control group using rats nerve growth factor(mNGF, 100ng/mL). Three days after interference, all experimental animals were executed. HE staining was used to evaluate morphologic change of the retina, immunohisochemical staining and western-blot tests for identifying and quantifying the distinct expression of Caspase-3 and GAP-43 among the groups.

RESULTS:Compared with the normal group and negative control group, retinal morphology of different concentrations of each Daidzein treatment group and positive control group was more complete, the expression of Caspase-3 protein was relatively lower, the expression of GAP-43 protein was relatively higher, the differences have statistically significance(P<0.05).

CONCLUSION: Daizein injection in the vitreous cavity has the capacity of protection and restoration in rat's acute nerve damages.

Abstract:AIM:To study p42/p44 mitogen-activated protein kinases(MAPK)signal transduction pathway effect on vascular endothelial growth factor(VEGF)expression induced by elevated glucose concentration in cultured human retinal pigment epithelium(hRPE).

METHODS:hRPE cells were cultured and divided into four groups: normal glucose group(NG)(5.6mmol/L), high glucose group(HG1:15mmol/L D-glucose,HG2:20mmol/L D-glucose,HG3:30mmol/L D-glucose), PD98059 group: hRPE cells were treated by an efficient and selective inhibitor PD98059(20μmol/L)of p42/p44MAPK signal transduction pathway and solvent dimethyl sulfoxide group(DMSO group). The expression of VEGF and pigment epithelium derived factor(PEDF)mRNA was detected by RT-PCR. VEGF protein expression in cultured hRPE supernatants was detected by enzyme-linked immumosorbent assay(ELISA).

RUSULTS:VEGF mRNA and protein expression induced by elevated glucose concentration increased significantly. VEGF mRNA and protein expression were restrained in PD98059 group. Ratio of(VEGF/β-actine)/(PEDF/β-actine)in PD98059 group decreased significantly compare with that in high glucose group.

CONCLUSION:p42/p44MAPK signal transduction pathway might play a part in VEGF expression induced by elevated glucose concentration in cultured hRPE cells.

Abstract:AIM:To compare the synthesis efficiency of n3 and n6 very long chain polyunsaturated fatty acid(VLC-PUFA)by overexpressing ELOVL4 protein, providing guidance for treating Stargardt-like macular dystrophy(STGD3).

METHODS:To establish recombinant adenovirus with the ELOVL4 protein and green fluorescent protein, transferred into cultured PC12 cells. The cells were divided into 3 groups: PC12, PC12+Ad-GFP and PC12+Ad- ELOVL4, former two groups serve as controls. ELOVL4 gene expression was quantified by qRT-PCRs. ELOVL4 protein was analyzed by Western-Blot(WB). The transduced cells were treated with both EPA and AA(1:1). After 48h of incubation, cells were collected, total lipids extracted and fatty acid methyl esters prepared and analyzed by gas chromatography-mass spectrometry(GC-MS).

RESULTS: When supplemented together, 20:5n3(EPA)and 20:4n6(AA)were efficiently taken up at almost the same amounts in the PC12 cells regardless of ELOVL4 expression. The ELOVL4-expressing cells elongated both EPA and AA to a series of n3 and n6 VLC-PUFAs. From 20:5n3/EPA, 34:5n3 and 36:5n3 account for 0.71% and 1.6%, respectively. From 20:4n6/DHA, 34:4n6 and 36:4n6 were only 0.46% and 0.61%, respectively. The total relative mol% of n3 VLC-PUFAs synthesized from EPA was almost two times that of n6 VLC-PUFAs synthesized from AA.

CONCLUSION: ELOVL4 protein preferentially elongates n3 PUFA to VLC-PUFAs over n6 PUFA. Dietary supplementation of appropriate n3/n6 PUFAs may provide STGD3 patients with some therapeutic benefits.

Abstract:AIM: To study the expressions and clinical significance of PDCD4 and B7-H4 in optic gliomas in children.

METHODS: We used immunohistochemistry to evaluate the expressions of PDCD4 and B7-H4 in specimens from 52 optic gliomas in children cases, and analyzed the correlation of PDCD4 and B7-H4 expression with clinicopathological factors children optic gliomas.

RESULTS: PDCD4 expression reduced in optic glioma tissue: PDCD4 expression rate in 52 cases of optic glioma tissues decreasing was correlated with tumor malignancy increase(P<0.01); B7-H4 positive expression increased in optic glioma tissue: B7-H4 expression rate in 52 cases of optic glioma tissues increasing was correlated with tumor malignancy increase(P<0.01); PDCD4 expression was negatively correlated with B7-H4 expression in optic gliomas(P<0.01).

CONCLUSION: Expressions of PDCD4 and B7-H4 may be clinically relevant to tumor malignancy of optic gliomas in children and prevention of metastasis and prediction of prognosis.

Abstract:AIM: To investigate the effect of low intensity white light irradiation on the retinas of mice.

METHODS: Thirty C57BL/6J mice were randomly divided into two groups. The number of the mice in each group was 15. The mice in experimental group received dark adaptation from 5:00p.m. to 6:00p.m.,and then exposed to LED white light from 6:00p.m. to 7:00p.m. everyday for a month. At 1, 3, 7, 14 and 30d after the beginning, we examed the histology of mice retinas, calculated the thickness of outer nuclear layer(ONL),inner nuclear layer(INL)and analyzed electrophysiology of mice.

RESULTS:One month after experiment, compared to the control group, the latency of Rod-R a wave of the mice in experimental group significantly prolonged, the amplitude of Cone-R b wave of the mice in experimental group significantly decreased and the latency of b wave of the mice in experimental group significantly prolonged(P<0.05).There are no significant difference in the histology of retina, ONL and INL thicknesses.

CONCLUSION: 100lux low intensity white light could give rise to the impairment of the retinal functions in dark-adapted mice.

Abstract:AIM:To investigate the efficacy of intravitreal ranibizumab combined with laser therapy in the treatment of macular edema caused by branch retinal vein occlusion(BRVO).

METHODS:There were 78 patients(78 eyes)who were diagnosed with macular edema caused by BRVO using fundus fluorescence angiography(FFA)and optical coherence tomography(OCT). Group A: randomly selected 26 cases(26 eyes)were given grid laser photocoagulation(GLP). Group B: randomly selected 26 cases(26 eyes)were given GLP first, and then received intravitreal ranibizumab 1wk later. Group C: randomly selected 26 cases(26 eyes)undergone intravitreal ranibizumab first, and then given GLP 1wk later. There was no significant difference in macular edema. We analyzed the changes in the best corrected visual activity(BCVA), central macular thickness(CMT)before and 1wk, 1,6mo after treatment.

RESULTS: Compared with before treatment, 1wk after treatment: mean value changes of BCVA and CMT were no significant difference in group A(P>0.05); mean value changes of BCVA was improved and mean value of CMT was decreased in groups B and C, the difference was statistically significant(P<0.05); BCVA and CMT changes between groups had statistical significance(P<0.01); After treatment 1, 6mo: compared with before treatment, mean BCVA was improved in three groups, mean CMT was lower, the differences were statistically significant(P<0.01); BCVA and CMT changes between groups were statistically significant(P<0.05); compared with 1mo after treatment, mean BCVA and CMT were no significant difference(P>0.05)between groups A and B after 6mo treatment; mean BCVA improved and CMT average value was decreased in group C, the difference was statistically significant(P<0.01); BCVA and CMT changes between groups were statistically significant(P<0.01).

CONCLUSION: Intravitreal injection ranibizumab combined laser therapy can effectively reduce BRVO induced macular edema, enhance vision acuity. Compared with GLP, combination therapy has more rapid onset of treatment, and reduce macular edema better; Intravitreal ranibizumab should be given in front of the GLP, and the treatment effect is more precise, more stability.

Abstract:AIM:To observe the clinical curative effect of different duration of retinal vein occlusion(RVO)by laser photocoagulation treatment, discuss the timing of the RVO laser photocoagulation treatment, provide the basis for clinical choice of RVO photocoagulation treatment time.

METHODS: Retrospective analysis. Line selection retinal laser photocoagulation treatment for 103 cases(103 eyes)with RVO, patients were divided into three groups according to the onset time. In group A(46 eyes), course ≤1mo, 28 eyes with branch retinal vein occlusion(BRVO), 18 eyes with central retinal vein occlusion(CRVO); 30 eyes were ischemic RVO, 16 eyes were non-ischemic RVO. In group B(38 eyes), 1moRESULTS: The best corrected visual acuity improved rate, retinal hemorrhage, macular edema, absorption, macular center concave thickness decreased of patients with different course after RVO photocoagulation treatment, the early group was better than that of the late, non-ischemic RVO was better than that of ischemic RVO, laser photocoagulation treatment effect BRVO was better than that of CRVO and the difference was statistically significant(P<0.05).

CONCLUSION: RVO laser photocoagulation in the early intervention treatment can accelerate the retinal hemorrhage, macular edema, absorption, effectively protect the patient's existing vision, improve the long-term vision, and has a certain clinical practical significance.

Abstract:AIM: To evaluate the safety, efficacy and stability of posterior chamber phakic intraocular lens(ICL)implanation and clear lens extraction for the correction of high myopia.

METHODS: The study enrolled 56 cases(100 eyes)of high myopia. Group I comprised 32 cases(58 eyes)receiving ICL implantation and Group II comprised 24 cases(42 eyes)undergoing clear lens extraction. In this study, we evaluated the two groups of subject's the visual and refractive results, intraocular pressure(IOP), endothelial cell density(ECD), anterior chamber depth(ACD), lens transparency, the surgical complications as well as visual adverse symptoms before and after surgery.

RESULTS: The postoperative subjects in group I and group II were followed, uncorrected vision acuity(UCVA)>0.5 were 69.0% in group I and 71.4% in group II after 3mo. UCVA>0.5 were 72.4% in group I and 73.8% in group II after 1a. Predictability of the manifest spherical equivalent refraction within ±1.00D was achieved in 62.1% of eyes in group I and 57.1% in group II after 1a. The central vault of the ICL(distance from posterior surface of ICL to the crystalline lens)measured with anterior segment optical coherence tomography(AS-OCT)was 0.35-0.54(0.40±0.16)mm. Twelve point one percent of eyes in group I and 7.1% of eyes in group II had transient mild increase in IOP. Here were statistically significant differences between preoperative and postoperative ECD(P<0.001). Complications of surgery: 1 eye had ICL spontaneous rotation, 2 eyes had anterior subcapsular cataract, 4 eyes noticed halos around lights at night in group I. Three eyes had posterior capsule mild opacification, 3 eyes noticed halos around lights at night, 12 eyes had difficulty in near vision in group II.

CONCLUSION: ICL implantation and clear lens extraction are effective, safe and predictable surgical option for the management of high myopia. No severe complications occurred, but its long time effect and safety still need more time to prove.

Abstract:Keratoconus is a progressive, non-inflammatory corneal thinning disorder that produces a unique spectrum of change in the surface curvature of the cornea. The suspected factors associated with the cause of keratoconus include genetic mechanisms, familial associations, allergy, atopy and so on, but environmental factors, such as abnormal rubbing, contact lens wearing and ultraviolet radiation may be easily ignored. Although it is commonly thought that keratoconus is a result of various pathological progress mediated by multiple factors, those chronic trauma could play important roles in the pathological progress. The classic definition of keratoconus is still referred as a non-inflammation disorder with malnutrition of keratectasia, more and more clinical evidences and experimental results that may refute this concept. It may be due to the long-term persistent chronic trauma resulted from eye rubbing, contact lens or ultraviolet radiation. Under this conditions, the increased release of inflammatory mediators and matrix metalloproteinases may accelerate keratocyte apoposis and enzyme metabolism disorders, with the result of matrix cell lost, tensile strength decreased and keratectasia. Here, for some papers known about the relationship between chronic cornea trauma and keratoconus were reviewed and discussed its possible causal relationship.

Abstract:High-risk corneal transplantation immunological rejection is a primary factor affecting the success or failure of the corneal transplantation. As a result, application of immunosuppressive agent in high-risk corneal transplantation rejection reaction occupies an irreplaceable position. However, many local and systemic adverse reactions appeared in the process of application. In order to improve the achievement ratio of the corneal transplantation, experts and scholars at home and abroad have obtained remarkable achievements in dosage form, route of administration and drug combination; meanwhile, a considerable progress was also made in genetic engineering. This paper is a review of prevention and treatment on high-risk corneal graft rejection reaction.

Abstract:The mammalian TOR(mTOR)pathway is a key regulator of cell growth and proliferation which is also a fundamentally important player in a large variety of human diseases. The pathway regulates many key cellular processes and is implicated in a large number of pathological conditions, including cancer, obesity, diabetes, and cardiovascular disease, age-related diseases and other proliferative disease. It integrates signals from nutrients, energy status and growth factors to regulate many processes, including autophagy, ribosome biogenesis and metabolism. Our article reviews the advancement of laboratory results on mTOR pathway in proliferative diseases in ophthalmology.

Abstract:By reshaping the cornea without the creation of a stromal flap, excimer laser corneal surface ablation eliminates flap-related complications and avoids the risk of ectasia that may occur after laser assisted in situ keratomileusis(LASIK). Post-operative pain is one of the most significant disadvantages of surface ablation and thus the management of pain and discomfort following surface ablation is of great importance. We summarize mechanism of corneal pain and current approaches to pain management after surface ablation.

Abstract:AIM:To observe the structural basis of ocular motility abnormalities in patients with congenital fibrosis of the extraocular muscles type Ⅰ(CFEOM Ⅰ)due to missense mutations in the developmental kinesin KIF21A using high-resolution magnetic resonance imaging(MRI).

METHODS: Totally 11 affected individuals reported KIF21A mutations were correlated with MRI studies demonstrating extraocular muscles(EOMs)size, location, contractility, and innervation. EOMs and the motor nerve in the orbits were imaged with T1 weighted in a triplanar scan using a dual-phased coils with 2.0mm thick. Motor nerves were imaged at the brainstem using head coils and 3D-FIESTA with 0.6-mm thick.

RESULTS: Patients with CFEOM Ⅰ exhibited different degrees of hypoplasia of oculomotor nerve, the abducens nerve and the trochlear nerve were also affected, of which 8 cases of orbital section could see the signal of abnormal nerve dominated by oculomotor nerve to lateral rectus. The both sides of six EOMS in all patients exhibited variable atrophy and abnormal bright internal signal on T1 imaging, particularly severe for the superior rectus and levator muscles.

CONCLUSION: High-resolution MRI can directly demonstrate pathology of motor nerves,affected EOMs, and ‘Pulley' hypoplasia caused by CFEOM Ⅰ due to mutations in KIF21A,and these findings suggest that the neuronal hypoplasia is the etiological factor of CFEOM.

Abstract:AIM:To observe the application efficiency of 5g/L indocyanine green(ICG)staining technique for continuous circular capsulorhexis(CCC)during phacoemulsification in white cataract.

METHODS:Ninety-eight patients(98 eyes)with white cataract were randomly divided into staining group(50 cases, 50 eyes)and control group(48 cases, 48 eyes). The control group didn't do anterior capsule staining. The staining group was injected to fill the anterior chamber, 5g/L ICG 0.1mL was applied on the central surface of the anterior capsule, using a 27G blunt needle through the side-port after 30s, and the redundant ICG was replaced by BSS, and continuous curvilinear capsulorhexis was accomplished using capsulorhexis forceps.

RESULTS: In staining group: after ICG staining, the capsule, which presented uniform light green and visualization of the anterior capsule was significantly improved. There are 48 eyes capsulorhexis success. The rate of success was 96%. Meanwhile, in control group, there was 29 eyes capsulorhexis success. The rate of success was 60%. The difference was statistically significant(P<0.05). During follow-up, no dye particle and the complications of iritis or high intraocular pressure were found in the eyes of staining group. Anterior chamber inflammation, corneal opacity compared with control group, the difference was not statistically significant.

CONCLUSION:Indocyanine green staining increases the visibility of anterior capsule in over mature cataract, and it should be an effective and helpful method which can increase the success rate of capsulorehxis. At the same time, it can reduce the incidence of intraoperative complications. This will help beginners quickly grasp continuous curvilinear capsulorhexis, and shorten the learning curve.

Abstract:AIM:To compare the operation effect of 2.2mm micro incision and 3.0mm incision coaxial phacoemulsification.

METHODS: Patients with age-related cataract(90 cases, 90 eyes)were enrolled in the study from January 2012 to June 2013 in our hospital, and they were randomly divided into 2 groups: 2.2mm incision group(45 eyes of 45 cases), 3.0mm incision group(45 eyes of 45 cases). Corneal tunnel incision coaxial phacoemulsification was performed. At 1d, 1wk, 1, 3mo after operation, the visual acuity, corneal endothelial cell count, central corneal thickness, operation astigmatism were recorded.

RESULTS: One day after operation, the visual acuity of 2.2mm incision group were significantly improved, the difference was statistically significant(P<0.05), there were no differences in two groups at 1wk, 1, 3mo after operation. No significant differences between the two groups of corneal endothelial cell counting, central corneal thickness at 1wk, 1, 3mo after operation were observed(P>0.05). Operation source astigmatism had statistically significant difference at 1d, 1wk, 1, 3mo after operation(P<0.05), it decreased significantly in the 2.2mm incision group.

CONCLUSION: The 2.2mm small incision coaxial phacoemulsification with postoperative visual acuity improved more significantly, can significantly reduce the operation astigmatism.

Abstract:AIM:To investigate how to design personalized cataract surgery programs to achieve surgical correction of preoperative corneal astigmatism with surgical astigmatism under the guidance of corneal topography, improve postoperative visual quality and reduce the cost of treatment.

METHODS: Totally 202 cases(226 eyes)cataract patients were divided into randomized treatment group and individualized treatment group. According to the method and location of the incision, randomized treatment group were divided into 8 groups. Surgical astigmatism after different incision were calculated with the use of preoperative and postoperative corneal astigmatism through vector analysis method. Individualized treatment groups were designed personably for surgical method with reference of every surgically induced astigmatism, the surgical method chooses the type of surgical incision based on close link between preoperative corneal astigmatism and surgically induced astigmatism, and the incision was located in the steep meridian. The postoperative corneal astigmatism of individualized treatment group was observed.

RESULTS: Postoperative corneal astigmatism of individualized treatment group were lower than that of 3.0mm clear corneal tunnel incision in the randomized treatment group, there were statistically significance difference, while with 3.0mm sclera tunnel incision group there were no statistically significance difference. After 55.8% of patients with the use of individualized surgical plan could undergo the operation of extracapsular cataract extraction with relatively low cost and rigid intraocular lens implantation, the per capita cost of treatment could be reduced.

CONCLUSION: Personalized cataract surgery programs are designed to achieve surgical correction of preoperative corneal astigmatism under the use of corneal topography, improve postoperative visual quality and reduce the cost of treatment.

Abstract:AIM: To investigate the differences among Lenstar 900, A-scan ultrasound and keratometer in measurement of axial length(AL), anterior chamber depth(ACD)and corneal curvature(K₁, K₂, Km), and evaluate the consistency of the instruments, with the purpose providing references for the clinical application of Lenstar 900.

METHODS: In this study we picked up 36 patients(50 eyes)underwent cataract surgery, and lens nucleus hardness were under level IV. Before the operation, AL, ACD and K₁ , K₂, Km were measured by Lenstar 900, A-scan ultrasound and keratometer respectively. The differences between the results were compared by the paired t-test. The correlation of the results was analyzed by Pearson correlation analysis, and the consistency was measured by Bland-Ahamn method.

RESULTS: The mean AL and ACD values measured by Lenstar 900 and A-scan ultrasound had no significantly statistic differences(P>0.05). The K₁ , K₂, Km measured by Lenstar 900 and keratometer were not significantly statistical different(P>0.05). The results measured by these three instruments had close linearity correlation(r>0.9, P<0.01). The consistency of the results was well in Bland-Ahamn analysis.

CONCLUSION:The preoperatively biometric result of Lenstar 900, A-scan ultrasound and keratometer in patients with cataract are all reliable, and they can be substituted by each other. However, Lenstar 900 can not only measure AL, ACD and corneal curvature at the same time, but also cornal thickness, lens thickness, white to white, pupil size, optical axis eccentricity, retinal thickness and so on. It has a number of advantages such as non-touching, convenient and efficient, and can be recommended to use widely.

Abstract:AIM: To investigate the effect of lowering intraocular pressure(IOP)and side effect of travoprost(TA)on phacoemulsification and intraoclular lens(IOL)implantation in primary open-angle glaucoma(POAG).

METHODS: Patients with POAG already received surgery of phacoemulsification and IOL implantation were selected by randomized, single-blind, parallel group trial. TA was applied once a day in 43 patients(43 eyes)of treatment group and brinzolamide was used twice in 43 patients(43 eyes)of control group. All patients were observed for 12wk. IOP, ocular symptom and adverse reaction etc. were observed.

RESULTS: The daily average IOP(mean±standard deviation)in the treatment group decreased from(24.20±3.01)mmHg(1mmHg=0.133kPa)to(16.77±2.89)mmHg and that in the control group was from(23.87±3.47)mmHg to(18.81±3.07)mmHg. IOP pre- and pro-treatment within two groups had significant difference(P<0.01), IOP between the groups at each time point had statistical difference(P<0.05). Conjunetival congestion increased and itching in treatment group was obviously more serious than that in the control group, but the treatment could continue. No other ocular and systemic adverse events related to the drugs were found.

CONCLUSION: It is demonstrated that travoprost is highly effective and safe in reducing IOP in POAG already received surgery of phacoemulsification and IOL implantation.

Abstract:AIM: To observe the effect of Ahmed glaucoma valve implantation intravitreal bevacizumab in the treatment of neovascular glaucoma(NVG).

METHODS: Twenty-two cases(22 eyes)who presented with NVG were first treated with intravitreal bevacizumab 0.1mL(2.5mg), then with Ahmed glaucoma valve implantation after regression of iris neovessels. Cases were followed-up for 6-36(mean 24)mo with observation on visual acuity, IOP control, regression of iris neovessels, and complications during or after surgery.

RESULTS: Iris neovessels was regressed in different degree after injection within 1wk in 22 eyes. At final follow-up, the IOP of 18 eyes were all less than 21mmHg without any drugs and of 3 eyes with 1-3 kinds of anti-glaucoma drugs after combined Ahmed glaucoma valve implantation. The IOP of one eye was controlled after cryotherapy. The mean IOP dropped from 45.36±8.13mmHg preoperatively to 15.59±3.21mmHg postoperatively. IOP reduction was statistically significance between preoperative and postoperative(P<0.05)at final follow-up. Visual acuity was improved in 9 eyes(41%)and was no changed in 13 eyes. No serious complications were observed during or after intravitreous bevacizumab injection and Ahmed glaucoma valve implantation.

CONCLUSION: Ahmed glaucoma valve implantation and intravitreal bevacizumab in the treatment of NVG is useful and safe. It improves the success rate of surgery and preserves visual function, furthermore its complications are less.

Abstract:AIM: To measure the macular thickness of normal young people by 3D 1000 optical coherence tomography(OCT)and study the repeatability of measuring results and the relationship between the thicknesses of macular and gender. At the same time, to compare our result with the data of other types of OCT, and to understand the consistency of the measuring results of macular thickness of different types of OCT.

METHODS: Totally 222 eyes in 111 young people were detected using 3D scan mode of Topcon 3D OCT 1 000(ver 2.4). Twelve cases(24 eyes)underwent repeatability check. We took transverse comparison between our measured results with other research's results.

RESULTS:There were 111 cases of young people, whose age were from 18-27 years old, all uncorrected and corrected visual acuity were ≥1.0, all intraocular pressure were <21mmHg. The average thickness of all macular region was 273.32±17.08μm. Retinal volume of macular area was 7.73±0.37mm³. Center thickness was 161-264μm, and the average thickness was 200.13±18.81μm. Central macular thickness were 188-273μm, and the average thickness was 229.00±18.20μm. The central macular thickness in men was significantly greater than that in women, and there was statistical difference. The results of repeated check of 12 cases(24 eyes)in the macular area were no statistical difference except the outer ring of nasal quadrant, and the repeatability of average thickness in central macular thickness was better than in center thickness.

CONCLUSION:The repeatability of macular examination is good. The central macular thickness can be better repeated than the center thickness. The central macular thickness is 229.00±18.20μm in young people, according to the 3D 1000 OCT measurements. There are statistical difference of central macular thickness between different genders.

Abstract:AIM:To compare the efficacy and safety of intravitreal ranibizumab to those of triamcinolone acetonide(TA)injection for the treatment of macular edema secondary to central retinal vein occlusion(CRVO).

METHODS:This retrospective study included 40 eyes of 40 patients with macular edema associated with CRVO. Twenty patients 20 eyes were treated with intravitreal injection of triamcinolone acetonide(1mg, 0.1mL), the other 20 patients 20 eyes accepted intravitreal ranibizumab(0.5mg, 0.05mL). The change of best corrected visual acuity(BCVA), central macular thickness(CMT), and intraocular pressure(IOP)before treatment and at 1, 2wk, 1, 2,3,6mo post-injection in the two groups were observed.

RESULTS:BCVA was improved at 1, 2wk, 1, 2,3,6mo post-injection in the TA group(P<0.05)and ranibizumab group(P<0.05). No significant difference was found between the two groups(P>0.05). CMT decreased significantly within each group(P<0.05), and no significant difference between groups was found(P>0.05). In the TA group, the IOP was significantly higher at 2wk and 4wk than before treatment(P<0.05). In the ranibizumab group, no elevated IOP was observed at 1, 2wk, 1, 2,3,6mo(P>0.05). However, the IOP at 1mo was significantly higher in the TA group than that in the ranibizumb group(P<0.05).

CONCLUSION:Intravitreal ranibizumab is an effective and safe treatment method for macular edema secondary to CRVO. It can effectively improve BCVA and reduce CMT without ocular and systemic complications compared with intravitreal TA.

Abstract:AIM: To assess changes of tear film function in patients after pterygium excision combined with amniotic membrane transplantation.

METHODS:Totally 126 patients with pterygium excision with amniotic membrane transplantation from January 2011 to November 2013 were entered in the study. The tear breakup time(BUT), the Schirmer I test(SⅠt)and tear ferning test(TFT)were elevated in the patients before and after pterygium excision combined with amniotic membrane transplantation. The examnation times were 1d before surgey, 1wk, 1, 2mo after surgery. Operation eyes were studied group, while opposite healthy eyes as control group.

RESULTS: Compared with the control group, BUT and TFT were significantly different in the eyes with pterygium(P<0.05); However, no obvious difference was detected in the results of SⅠt(P>0.05). The results of BUT and TFT at 1mo after surgery in study group were significantly better than 1wk(P<0.05), while no significant difference compared with 2mo(P>0.05); The tear film stability in the study group at 1wk after surgery was still inferior to the control group(P<0.05)and there was no significant difference at 1, 2mo after surgery(P all>0.05). SⅠt results did not differ between the different examination times(P>0.05).

CONCLUSION:Tear film stability was broken in the eyes with pterygium. Pterygium excision combined with amniotic membrane transplantation can obviously restore the tear film function into normal state, and the tear film function could reach steady-state 1mo after surgery.

Abstract:AIM: To observe the changes of tear film on the patients after laser in situ keratomileusis(LASIK)with corneal flap created by femtosecond laser with the different gender.

METHODS: The 120 myopic patients(240 eyes)who underwent femtosecond laser surgery LASIK from August to September 2013 were collected, and these patients were followed up for 3mo. The patients were divided into two groups according to the gender, group A was male(110 eyes of 55 patients); group B was female(130 eyes of 65 patients). Dry eye symptom score, tear break-up time(BUT), Schirmer Ⅰ test, corneal fluorescein staining were recorded preoperatively and postoperatively in 1wk,1,2,3mo.

RESULTS: Dry eye symptom score: it was statistically significant between two groups after operation in the 1wk,1, 2mo(P=0.000,0.023, 0.030). It had no statistical significance between the two groups in 3mo(P=0.283). BUT: it was statistical significance between two groups after operation in the 1wk,1, 2, 3mo(P=0.000,0.017, 0.026, 0.032). SchirmerⅠ test: it was statistically significant between two groups after operation in the 1wk, 1, 2mo(P=0.012,0.024, 0.018). It had no statistical significance between the two groups in 3mo(P=0.206)Corneal fluorescein staining: it was statistically significant between two groups after operation in the 1wk, 1, 2, 3mo(P=0.022,0.015, 0.036, 0.041).

CONCLUSION: The influence of tear film after femtosecond laser surgery for men less than that for women.

Abstract:AIM: To observe the tear film changes after phacoemulsification combined with intraocular lens implantation in age-related cataract patients and to compare the therapeutic effect of hydroxyl-glucoside and sodium hyaluronate on the postoperative dry eye.

METHODS: A total of 49 patients(70 eyes)with age-related cataract suffering from dry eye after phacoemulsification combined with IOL implantation were divided into treatment group 1(group A, 23 eyes with conventional therapy and hydroxyl-glucoside at 7d postoperatively), treatment group 2(group B, 22 eyes with conventional therapy and sodium hyaluronate at 7d postoperatively)and control group(group C, 25 eyes with conventional therapy only). Questionnaire score of dry eye symptoms, SchirmerⅠtest(SⅠt), tearfilm break up time(BUT)and corneal fluoresce in staining(CFS)were measured at 2d preoperatively and 7, 14, 30, 90d postoperatively.

RESULTS: No statistical differences existed among the three groups of preoperative 2d(P>0.05). At 2d preoperatively and 90d postoperatively, the results of questionnaire score of dry eye symptoms, SⅠt, BUT, and CFS displayed no statistical differences in the patients of three groups(P>0.05). While there was statistical significance among preoperatively and 7, 14, 30d postoperatively of the three groups(P<0.05). At 14, 30d postoperatively, the questionnaire score of dry eye symptoms, SⅠt, BUT, CFS in group A and B were better than in group C, which displayed statistical differences(P<0.05). At 30d postoperatively the questionnaire score of dry eye symptoms, SⅠt, BUT in group B were better than in group A, which displayed statistical differences(P<0.05).

CONCLUSION: At the early stage after phacoemulsification combined with IOL implantation, the tear film stability is decreased, which may promote eyesymptoms. Management with hydroxyl-glucoside or sodium hyaluronate plays a role in relief of the structure and stability of the tear film and improves dry eye symptoms, while sodium hyaluronate eye drops is more effective.

Abstract:AIM: To investigate the effect of vitrectomy in treatment of metal intraocular foreign bodies and the factors affecting visual prognosis.

METHODS:Fourty seven cases(48 eyes)with foreign bodies from January 2010 to June 2013 in our hospital underwent vitrectomy combined with intraocular foreign body removal were retrospectively analyzed. The changes of visual acuity, the size of foreign body, the complications of preoperative, and the relationship between treatment time and visual acuity were recorded.

RESULTS: Totally 46 eyes were successfully removed the complete foreign body, 2 eyes of orbital foreign bodies had not been removed. After 6mo of followed-up, the best corrected visual acuity were all improved in varying degrees(P<0.05), intraocular foreign body size combined with retinal detachment was the risk factor for visual impact(P<0.05).

CONCLUSION:Vitrectomy has obvious advantages in the treatment of metal intraocular foreign bodies. Timely and appropriate vitrectomy is very important to the recovery of visual function.

Abstract:AIM: To evaluate the relationship between axial length(AL), corneal and lens refractive power, and the refractive error in children.

METHODS:Totally 44 children 88 eyes with refractive error who underwent retinoscopy with cycloplegia, to be measured spherical equivalent refractive error. Axial length was measured by a noncontact optical biometry(ZEISS IOL-Master), and corneal K and anterior chamber depth(ACD)were also measured by the same machine. The refractive power of the lens was calculated by using the SRK formula. The patients were divided into 3 groups, myopia(SE<0), hyperopia(SE>+0.50D)and emmetropia(0 to +0.50D). Linear Correlation and Regression were used to evaluate the correlation among the optical parameters.

RESULTS:Totally 44 subjects, 88 eyes, average 9.04±2.39 years, spherical equivalent(SE)-3.50D to +8.75D. Hyperopic AL was shorter than the other two groups(P<0.05), same trend in lens power. No significant differences among the 3 groups in corneal K and ACD. There was a negative correlation between age and SE, SE and AL, SE and lens refractive power, and there was a positive correlation between age and AL, age and lens power.

CONCLUSION:As the children's growing up, SE trends to myopia, and AL becomes longer, and lens power is stronger.

Abstract:ATM: To investigate the relationship between the oculus dominans and the eye with higher diopter among myopes, and to study the difference between the Worth 4 dot test and hole-in-the-card test.

METHODS: Totally 125 cases were divided into two groups as physiogenic anisometropic group and pathological anisomitropic group according to the degree of binoculus anisometropy. Worth 4 dot test and hole-in-the-card test were used to distinguish oculus dominans respectively based on medical optometry.

RESULTS: In physiogenic anisometropic group, the oculus dominans and the eye with higher diopter among myopes had significant relationship by hole-in-the-card test(Z = -4.057, P<0.01)and Worth 4 dot test(Z=-3.558, P<0.01). However, in pathological group, No statistical significance was between two tests(P>0.05); distinguish the oculus dominans had no statistically significant difference between the Worth 4 dot test and hole-in-the-card test(n=125, P>0.05).

CONCLUSION:The oculus dominans is determined by gene or formed during juvenile period, then myopia anisometropic may affect the choice of that. The Worth 4 dot test has some reference significance for observing oculus dominans.

Abstract:AIM: To explore the long-term efficacy of Q-factor guided laser epithelial keratomleusis(LASEK )for myopia and astigmatism with positive Q-factor.

METHODS: There were 158 eyes which were myopia and astigmatism with positive Q-factor taken in two groups randomly: 86 eyes accepted Q-factor guided LASEK as observation group and 72 eyes accepted routine LASEK as control group. The difference between the two groups about all data was similar. The uncorrected visual acuity(UCVA)and the best corrected visual acuity(BCVA)as well as diopter, ocular tension, corneal topography, Keratometry value K, aspherical factor Q, Higher-order aberrations(HOA), corneal thickness by ultrasound and, contrast sensitivity(CS), Haze were examined and compared before and after surgery. All the cased were followed up for 14d, 1, 3, 6, 12mo. And there were no statistical difference among the data before surgery.

RESULTS: After 12mo there were no statistical difference between the two groups about UCVA and BCVA. But the safety index of observation group was 1.10, that of control group was 1.07. The validity index of observation group was 1.06, that of control group was 0.99. The HOA of observation group was 0.45±0.17μm, and that of control group was 0.72±0.25μm, there was statistically significant difference(t=-8.193,P=0.000). Q factor of observation group was 0.41±0.17, that of control group was 0.77±0.22, there was significant difference(t=11.377,P = 0.028). The contrast sensitivity of 3mo post surgery of patients in the observation group returned to the level of before surgery. But in the control group the contrast sensitivity of the patients did not returned until 6mo.

CONCLUSION: Q-factor guided LASEK for myopia and astigmatism with positive Q-factor is stable, safe and effective. The operation allow for reducing the high order aberrations, maintaining the most asphericity of cornea, saving more in corneal tissue, which cause faster recovery of contrast sensitivity, less haze and better visual quality.

Abstract:AIM: To evaluate the clinical effect and the rotational stability of AcrySof Toric intraocular lens(IOL)implantation to correct preexisting corneal astigmatism in cataract surgery.

METHODS: Twenty-three patients(28 eyes)were enrolled from the department of ophthalmology in the first Affiliated Hospital of Nanjing Medical University. All patients underwent similar phacoemulsification procedure combined with AcrySof Toric IOL implantation from June 2012 to December 2013. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), anticipated residual astigmatism, postoperative residual astigmatism, and Toric IOL axis were detected and measured.

RESULTS: Three months after operation, the UCVA of all eyes were 0.75±0.16 and the BCVA were 0.84±0.15, there was no significant difference between UCVA and BCVA(t=1.036, P>0.05). The anticipated residual astigmatism was(0.28±0.12)D. The actual residual astigmatism after 3mo of the operation was(0.42±0.17)D. There was no significant difference between anticipated and actual residual astigmatism(t=1.259, P>0.05). The mean axis rotation of Toric IOL was 3.02°±1.56°(0°-7°)after 1d of operation and 3.28°±1.85°(0°-7°)after 3mo. Among all the eyes, 25 eyes(89%)rotated <5°, in 3 eyes(11%)rotated 5°-7°.

CONCLUSION:The AcrySof Toric IOL implantation shows good effectiveness, predictability and stability in correcting pre-existing astigmatism in cataract patients.

Abstract:AIM: To analyze the recovery of visual cortex activation range of color vision in anisometropia amblyopia children after treatment by using blood oxygen level dependence-functional magnetic resonance imaging(BOLD-fMRI)and SPM8 software.

METHODS: Self-control study. This fMRI study directly compared activity in visual cortex produced by color monocular stimulation in 13 monocular anisometropia amblyopia children. The project of study was blocked design. The data of functions and anatomical MRI was stimulated by three-primary colors and was preprocessed and analyzed by SPM8 that based on MATLAB software. According to the data, we compared the change of the central area of color vision when first visit and 1, 2,4wk after treatment.

RESULTS: The BA17, BA18, BA19 and BA37 of amblyopia children were different activated after they accepted the three-primary colors stimulation(P<0.01). After 4wk treatment, amblyopia children accepted red stimulation, the visual cortex activation range without expanding; after accepting green stimulus, on the left side of the visual cortex BA37, BA19, BA20, the average t value were 3.5210, 3.2716, 3.1534(P<0.01); after accepting blue stimulation, the scope of the right side of visual cortex at BA19, BA18 were expanded to different extent, the average t value were 3.7345, 3.2701(P<0.01).

CONCLUSION: After 4wk treatment, visual cortex activation of color vision of anisometropia amblyopic children is expanded, but with low extent, after the short-term treatment of amblyopia, visual cortex activation of color vision has a certain degree of recovery but not obvious.

Abstract:AIM: To evaluate the efficacy of combined therapy for amblyopia in children by making use of pattern visual evoked potential(P-VEP)game.

METHODS: This was a prospective case control study. These asthenopic children were divided into two groups. The control group(66 eyes of 49 patients): occlusive therapy with glasses, cover, precision work, red light treatment and so on, later the stereo vision training was added. The experimental group(72 eyes of 52 patients): conventional methods mentioned above with P-VEP games.

RESULTS: The total effective rate and cure rate of experimental group in 6mo were higher than those of control group. The overall effective rate was 94.4% in the experimental group and 83.3% in the control group. There was a statistically significant difference between them(P<0.05).

CONCLUSION: The comprehensive therapy by making use of P-VEP game is an individualized effective new way in treating amblyopia.

Abstract:AIM: To investigate the status of myopia in students from different kinds of schools in Shantou city, China.

METHODS: In this cross-sectional study, 2 418 students from 4 middle and high schools in Shantou were surveyed through randomized cluster sampling. Ophthalmic examination and auto-refraction were performed for all subjects.

RESULTS: Among all 2 394 students examined. The myopia rates for students from middle and high school were 48.07% and 68.28%. In normal middle school, students from rural area had lower rate of myopia than students from the urban area(χ²=13.879, P<0.01). Students from key rural high schools had lower rate of myopia than students from key urban high school(χ²=175.231, P<0.01).

CONCLUSION:The prevalence of myopia in the middle school of urban area in Shantou was higher than rural area. The increasing rate of myopia in youngsters is correlated with study stress. In order to decrease the myopia rate, it is extremely important to improve study environment in students.

Abstract:To evaluate the automated segmentation algorithm for detection of intra-retinal layers to process images obtained from ultra-high resolution optical coherence tomography(OCT). Graph theory and the shortest path search based on dynamic programming were applied to automatically segment the 8 intra-retinal layers. We experimentally verified the accuracy and reliability of the algorithm. The results showed that the intra-retinal layer boundaries between automated and manual segmentations matched well. The algorithm successfully segmented the intra-retinal layers in glaucoma, high myopia, and retinitis pigmentosa patients. The proposed automatic segmentation for intra-retinal layers provides a promising tool for quantitative analysis in clinical diagnosis and treatment.

Abstract:AIM: To comprehensively investigate the current status of cataract surgery in Leshan city, and find the existing problems according to the survey results as a guide to cataract prevention and treatment in future.

METHODS: We surveyed the status of cataract surgery containing equipments, surgeons and surgery conditions in 17 ophthalmology departments of general hospitals from Leshan including 6 counties, 1 county-level city and 4 districts during 2012. Cataract surgery methods, according to various surgery financial resources, surgical performances and surgical incision, were divided into phacoemulsification and intraocular lens implantation(Phaco+IOL), extracapsular cataract extraction and intraocular lens implantation(ECCE+IOL), and each method contained 2 groups. We analyzed the outcomes following preoperative examination, surgeons, surgical methods, surgical equipments, types of IOL, surgical quantity, surgical results, and intraoperative complication.

RESULTS: In whole city there were 16 operating microscopes, 43 slit lamp microscopes, 12 non-contact tonometers, 1 intraocular lens Master, 8 optical A/B type ultrasonic examination systems, 4 YAG lasers and 12 phacoemulsification instruments. There 15 doctors could complete cataract surgery independently, and 5 of them were phacoemulsification surgeons. The total number of completed cataract surgeries reached 6 211 eyes, containing 3 564 eyes for Phaco+IOL(57%)(preoperative visual acuity ≥0.3 in Phaco+IOL1 were 1 520 eyes, 24%)and 2 647 eyes for ECCE+IOL(43%)(1 533 eyes in ECCE+IOL1, 25%). In various groups, off-blindness rate was 94.80%-100%, off-disability rate was 90.41%-100%, and 94.96%-100% received intraocular lens implantation, intraoperative complication rate was 1.00%-15.10%.

CONCLUSION: The distribution of surgeons and equipments in the whole city is unbalanced, and the utilization rate of phaco equipment is low. The levels are different in various hospitals on surgical technique, surgical quantity and surgical results. Phacoemulsification and intraocular lens implantation is considered as the main therapy for cataract, and as a transition to dioptric and personalized cataract surgery. The surgical condition of the city is good, but the proportion of cataract surgery for prevention of blindness in Leshan city is low, and the surgical technique remains to be further improved.

Abstract:AIM: To study the clinical characteristics of corneal perforation(CP).

METHODS: A retrospective analysis in July 1995 to July 2010 the First Affiliated Hospital of Fujian Medical University diagnosed CP 72 patients(72 eyes), clinical characteristics of all the patients were analyzed.

RESULTS: The incidence of corneal ulcer perforation rised year by year, the morbidity of male and female was 17:7, the onset age focused on 48 years old. Of 23 industrial workers(32%)with clear history of trauma, pathogeny identification results: top two: fungal infection and Acanthamoeba keratitis. A using history of glucocorticoid was found in 10 cases.

CONCLUSION: There are plenty of primary causes of CP such as traumas, fungal infection, Acanthamoeba keratitis, eroded keratitis, etc. CP happens in middle-aged males in Fujian province, most traumas are the causes, the main pathogenic bacteria is fungal infection.

Abstract:AIM: To make a survey on people suffering trachoma in Gansu province, and to provide evidence for developing trachoma control and prevention therapy.

METHODS: We chose the zone on the basis of relative information. Provincial Office of Blindness Prevention carried out the survey in 3 counties including Tange Township of Wushan, Xiqu Township of Minqin and Hulinjia Township of Jishishan from October 14, 2013 to November 23, 2013. One hundred and fifty primary school students were selected, including 72 boys and 78 girls aging from 5a to 10a with the average age of 7.5y. The targeted students received the fast trachoma assessment by the adoption of simplified trachoma classification system which was recommended by the World Health Organization.

RESULTS: No case of active trachoma, trachomatous trichiasis and corneal disease were examined among 150 students.

CONCLUSION: The rate of trachoma is low in Gansu province. But we still cannot get the conclusion that there is no epidemic of trachoma in Gansu. And we need to further expand the survey scope to correctly assess the trachoma case and to provide reliable evidence for trachoma prevention and control.

Abstract:AIM: To investigate the clinical effects on the deep lamellar keratoplasty for herpes simplex keratitis.

METHODS: Deep lamellar keratoplasty was performed on 105 cases with herpes simplex viral keratitis. All of these patients were followed-up for 12-36mo, the corneal graft transparency, visual acuity and viral keratitis recurrence were observed.

RESULTS:Among 24 patients after stripping the corneal stroma which was close to the Descemet's membrane, Central area of 81 cases were about 6mm×6mm of to Descemet's membrane. One hundred and one cases of planting beds were transparent. Visual acuity were improved in varying degrees, best corrected visual acuity was greater than 0.5 in 67 cases, 0.3-0.5 in 35 cases, less than 0.3 in 3 cases. There was no recurrence of viral keratitis and rejection cases during the observation period.

CONCLUSION: Deep lamellar keratoplasty is an effective technique in the treatment of viral keratitis. It is therefore should be an early surgical treatment for frequent episodes of viral keratitis cases.

Abstract:AIM: To compare the effect of trabeculectomy and combined surgery of glaucoma and cataract treating primary angle-closure glaucoma(PACG)with cataract.

METHODS:It was retrospectively reviewed that 80 patients(90 eyes)with PACG and cataract were treated in our hospital from January 2012 to October 2013. They were divided into observation group(combined surgery of glaucoma and cataract group, 45 eyes)and control group(trabeculectomy group, 45 eyes). Postoperatively, all the patients were followed up for 6mo. Intraocular pressure(IOP), visual acuity and complications were observed.

RESULTS: Compared to preoperative IOP, postoperative IOP was significantly reduced in both observation group and control group, while IOP was reduced more greatly in observation group(P=0.003). Visual acuity was significantly improved in observation group, while it was not improved significantly in control group(P=0.036). Compared to control group, complications such as shallow anterior chamber with hypotony, macular edema and anterior chamber inflammation were less observed in observation group, with significant statistical difference(P=0.002, P=0.003, P=0.001).

CONCLUSION: For patients with PACG and cataract,combined surgery of glaucoma and cataract is an effective surgery that can improve visual acuity and reduce IOP with fewer complications.

Abstract:AIM:To discuss the causes and therapeutic measures of Descemet's membrane detachment during phacoemulsification(Phaco).

METHODS: A retrospective analysis of 997 patients who had operations of Phaco and intraocular lens(IOL)implantation at the eastern part of Yangzhou No.1 People's Hospital during 2007-2012. The treatment and prognosis of 21 patients who had the complication of Descemet's membrane detachment during the surgery were observed.

RESULTS: The vision acuity of all the 21 patients had improved to different extent after therapy, no one had the decompensation of corneal endothelium.

CONCLUSION: Early detection and treatment is decisive for the vision acuity of the patients who had the Descemet's membrane detachment.

Abstract:AIM: To observe the therapeutic effect of combined trabeculectomy with improved conjunctival incision at 1mm of corneoscleral limbus posterior

METHODS: A retrospective analysis of 171 cases(220 eyes)with primary glaucoma who were randomly divided into 3 groups according to the differences of conjunctival incision and the way of suture. Group A: 44 eyes of 33 cases underwent corneoscleral limbus conjunctival incision; Group B: 94 eyes of 76 cases underwent conjunctival incision at 1mm of corneoscleral limbus posterior; Group C: 82 eyes of 62 cases underwent conjunctival flap running suture based on group B. All cases were followed up for 1a. Intraocular pressure, morphology of filtering bleb, depth of anterior chamber and water leakage in conjunctival incision were observed and compared after operation among three groups.

RESULTS: The incidence of postoperative water leakage inconjunctival incision and shallow anterior chamber were group A >group B>group C and there were significant differences among the three groups(P<0.05), The success rate was 94.5%. The intraocular pressure and morphology of bleb had no significant differences among the three groups.

CONCLUSION:Conjunctival incision at 1mm of corneoscleral limbus posterior and conjunctival flap running suture can not only reduce the rate of water leakage in conjunctival incision and accelerate the speed of incision adhesion after operation, but also significantly enhance the therapeutic effect of combined trabeculectomy.

Abstract:AIM:To observe the rehabilitation effect of oral Calcium Dobesilate Tablets and Epalrestat Tablets on the proliferative diabetic retinopathy(PDR)patients after vitrectomy.

METHODS: After vitrectomy patients informed consent, they were randomly divided into intervention group and control group, and their vision and fundus were followed up and compared at 2d; 3, 6, 9, 12mo after operation.

RESULTS: The recovery and sustainment of visual acuity, and subsiding of macular edema of patients in drug intervention group were significantly better than that in control group.

CONCLUSION: PDR patients after vitrectomy actively orally take medicine to protect retina, which can improve vision and fundus rehabilitation.

Abstract:AIM: To evaluate the efficiency of vitrectomy combined with inferior scleral buckling for a special kind of retinal detachment.

METHODS: Nineteen eyes of special retinal detachment had following features: 1)the course was more than 6mo; 2)there were at least one hole located in the 5:00-7:00 of the marginal retina; 3)the detachment range of retina more than 270 degrees and retinal proliferation in retinal detachment. The 19 eyes who received vitrectomy combined with inferior scleral buckling, retinal anatomic reattachment and visual function recovery was observed.

RESULTS: Among these 19 eyes, all eyes retinal anatomic reattachment and best corrected visual acuity(BCVA)was improved in various degrees. The BCVA was 0.01-0.1 in 5 eyes, 0.12-0.3 in 9 eyes, and ≥0.4 in 5 eyes.

CONCLUSION: It is an effective method to vitrectomy combined with inferior scleral buckling for the special kind of retinal detachment which has following features: 1)the course was more than 6mo; 2)there were at least one hole located in the 5:00-7:00 of the marginal retina; 3)the detachment range of retina more than 270 degrees and retinal proliferation of cable in retinal detachment.

Abstract:AIM: To evaluate the clinical efficacy and safety of photodynamic therapy(PDT)on choroidal neovascularization(CNV)caused by age-related macular degeneration(AMD), pathological myopia(PM), and central exudative chorioretinopathy(CEC).

METHODS: A retrospective observation on the clinical data of 53 AMD patients(53 eyes)from January 2010 to December 2012, diagnosed CNV through fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA)and optic coherence tomography(OCT), treated with PDT. The changes of best corrected visual acuity(BCVA)and central macular thickness(CMT)were compared before and 1a after treatment.

RESULTS: At the last follow-up, the BCVA was improved in 35 cases, stabilized in 15 cases and decreased in 3 cases. Fundus hemorrhage and exudation reduction after PDT was observed in all patients. FFA and OCT showed complete closure of CNV in 42 cases, partial closure in 11 cases. The visual acuity and CMT changes were statistically significant. No serious adverse event related to PDT.

CONCLUSION: PDT is helpful for maintaining the visual acuity of wet-AMD within 1a and the incidence of the adverse response is low, which suggest that PDT is an effective and safe treatment for CNV in patients of AMD.

Abstract:AIM: To investigate the indications and therapeutic effect of the conservative treatment and surgical treatment for vitreous hemorrhage.

METHODS: Hemorrhage reasons, degree of illness, and treatment and final results of vitreous hemorrhage were recorded from 2008 to 2013, and curative effect of different treatments was analyzed.

RESULTS: Selected 22 cases(24 eyes)of conservative treatment, vision degree of 6 eyes(25%)had raised, 5 eyes(21%)occurred secondary retinal detachment without treatment, 3 eyes(12.5%)suffered neovascular glaucoma were underwent operation, but the vision had lost completely. In 26 cases(31 eyes)of control(operation)group, vision of 17 eyes(55%)had improved, 2 eyes(6.5%)suffered the second operation, 2 eyes(6.5%)suffered the third surgery, 3 eyes(10%)suffered eyeball atrophy. The number of ultimate vision improved with conservative treatment were significantly lower than the number of cases with surgical treatment(P<0.05).

CONCLUSION: The surgical treatment is still visible vitreous hemorrhage treatment means of positive, but there will be eyeball atrophy and other serious complications, so we should choose a different methods in according to the different treatment objects and treatment time.

Abstract:AIM: To compare the efficiency of fibrin glue to suture technique in pterygium surgery performed with limbal autograft under different methods of anesthesia.

METHODS: A prospective randomised clinical trial was carried out in 60 eyes of 55 patients operated for primary nasal pterygium, which were divided into two groups randomly: experimental group(30 eyes in 27 patients)was under surface anesthesia(oxybuprocaine)and control group(30 eyes in 28 patients)was under local anesthesia(20g/L lidocaine). Autologous limbal graft taken from the superotemporal limbus was used to cover the sclera by a fibrin tissue adhesive after pterygium excision. Patients were followed up at least for 6mo. Time of operation, matching degree of graft and VAS score were mainly observed and recorded.

RESULTS: In experimental group the average surgery time was shorter(P=0.008)and matching degree of graft(93%)was better than control group(83%), the differences had statistical significance(P<0.05).

CONCLUSION: The surface anesthesia is enough when using fibrin glue for graft fixation in pterygium surgery, which will shorten surgery time and get better matching degree of graft.

Abstract:AIM: To evaluate the use of 23G minimally invasive vitreous cutting system in the first stage of anterior segment reconstruction on severe ocular injury.

METHODS: Fifteen patients with ocular injuries including the corneal and scleral rupture associated hyphema, vitreous hernia in anterior chamber, traumatic lens rupture, lens subluxation, applied 23G minimally invasive vitreous cutting system in the first stage of anterior segment reconstruction.

RESULTS: The anterior ocular media of early postoperative became transparent quickly. No exudative lemma and no complications were found relate to puncture incisions after operations.

CONCLUSION:23G minimally invasive vitreous cutting system can be used in the first stage of anterior segment reconstruction on sever ocular injury. It can reduce iatrogenic injury, operative complications and inflammatory response, also can shorten therapeutic time and create favorable conditions.

Abstract:AIM: To evaluate the feasibility and significance of nasal endoscope combined with Neodymium-doped Yttrium Aluminium Garnet(Nd:YAG)laser in the treatment of recurrent dacryocystitis.

METHODS: Forty-eight cases(48 eyes)with recurrent dacryocystitis were treated by nasal endoscope combined with Nd:YAG laser. The tubes were kept in place for 3-6mo after operation. The follow-up time was 3-18mo.

RESULTS: Symptoms was completely resolved in 46 eyes and improved in 2 eyes, the cure rate was 100%. There were no other complications.

CONCLUSION: Nasal endoscope combined with Nd:YAG laser provides an ideal therapeutic for recurrent dacryocystitis because of its many advantages such as a few complications, simple operation, no scars on face and so on and is fit for clinical application in primary hospitals.

Abstract:AIM: To explore the surgical methods and clinical effects on young patients with congenital lower eyelid entropion.

METHODS: There were 27 patients(45 cases)who suffered congenital lower eyelid entropion accepted the modified blepharosphincterectomy. The clinical effects and complications were evaluated.

RESULTS: After followed up for 6mo, 42 eyes were fully recovered, 3 eyes were unsuccessful and the cure rate was 93%, 5 eyes suffered minor lower eyelid skin folds, none had lower eyelid retraction and ectropion.

CONCLUSION: Modified blepharosphincterectomy is an ideal cosmetic surgical treatment for young patients with congenital lower eyelid entropion. It is an effective surgical treatment with fewer complications.

Abstract:AIM: To investigate clinical effects of local resection of eyelid tumors and pathological examination or frozen section examination as well as the stage I recovery.

METHODS: For all 92 cases 92 eyes of eyelid tumor patients who underwent local resection, reconstruction in stage Ⅰ and routine pathological examination(37 cases of suspected malignant tumors using frozen section examination. If it was malignant, excision by Moths surgery). Using free palate mucosa autograft in stage I or reconstruction by Hughes surgery combined with eye flaps repaired eyelid defects.

RESULTS: The postoperative pathological diagnosis: 52 cases were benign tumors, and 40 cases malignant tumors. All cases of eye flaps and hard palate mucosa grafts were survived. Followed up for more than 6mo, no tumor were recurred. The appearance and function of eyelid were satisfactory.

CONCLUSION: In this group of cases, nearly half of eyelid tumors are malignant tumors. It should be treated and operated as early as possible. For suspected malignant tumors, we use frozen section examination to confirm its properties in order to excision cleanly in stage Ⅰ, reducing the recurrence and metastasis. According to the eyelid defect after resection, we could do repair operation in stage Ⅰ. The inner larger defect is repaired by using hard palate mucosa transplantation or Hughes surgery. The outer layer of the eyelid defect is repaired by using eye flap glide, the free flap, the kite flap, the simple suture, etc. It should be careful when using the hard palate mucosa transplantation in the upper eyelid defect.

Abstract:AIM: To observe the effects of porous polyethylene(Medpor)as a spacer graft in the reconstruction of large areas eyelid defect after the operation of malignant tumors of lower eyelids.

METHODS: Nineteen cases(19 eyes)of malignant tumors of lower eyelid underwent the eyelid reconstruction were selected. Medpor lower eyelid inserts implantation were used to replace tarsal joint sliding conjunctival flap and pedicle flap, and repaired full-thickness lower eyelid defects then underwent eyelid reconstruction.

RESULTS: Appearance of eyelids and functional improvements were satisfactory with no stimulation on the eyeball and no effect on the visual function. Implants is with no absorption, shift, exclusion or infection and no tumor recurrence in all cases during the follow up for 6-36mo.

CONCLUSION: Medpor lower eyelid inserts implantation can instead tarsal plate for the reconstruction of medium to large areas lower eyelid defect, which is easy performing with rare complications. It is an ideal alternatives of tarsal plate.

Abstract:AIM: To study cilncial features and significance of Vogt-Koyanagi-Harada syndrome(VKHS)by fundus fluorescein angiography(FFA).

METHODS: All 16 cases(30 eyes)of VKHS were underwent by detailed paysical examination. Then took colour photographs and examined by FFA.

RESULTS:Uveitis stage of VKHS could be classified into three kinds of fundus appearances. The vision damage was mainly associated to exudation of choroidal vessel and exsudative retinal detachment rather than edema of optic disc which could achieve a better recovery.

CONCLUSION: FFA is an important and valuable examination to diagnose the VKHS forepart.

Abstract:AIM: To investigate the clinical characteristics, surgical outcome and curative effect of congenital fibrosis of the extraocular muscles(CFEOM).

METHODS: The eye exam of members in a Chinese family with CFEOM includes visual acuity, intraocular pressure, dilated fundus exam, extraocular muscle function test, orbital CT scan, and ultrasound. We did extraocular muscle surgery or frontalis suspension procedure for affected subjects in the family.

RESULTS: The incidence of CFEOM in this family was 31%. All patients were affected bilateraly with symptom of congenital eye movement disorder, ptosis, hypotropia, perverted convergence on upgaze and chin up head position. As the age grows, the diseases worsen unobviously. No other systemic disorder was found. Surgical treatment improved the anomalous head position although the ocular movement disorder preserved.

CONCLUSION: The pattern of inheritance in our serial patients are autosomal dominant. Surgery can improve chin up head position and cosmetic appearance. However, the eye movement deficiency cannot be improved.

Abstract:AIM: To compare the effectiveness on 10g/L cyclopentolate and 10g/L atropine on cycloplegia in children before optometry.

METHODS: Eighty eyes of 40 children among 4-12 years old with refractive error were recruited in this study. 10g/L cyclopentolate eye drops were topically administered once per 5min for 3 times and optometry was performed after 45min. Three days after that, 10g/L atropine sulfate eye gel then was used 3 times per day for consecutive 3d and again the refractive diopter was obtained at the 4^thd. The differences of the results in retinoscopy refraction were compared between 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel.

RESULTS: Therefraction results of those given 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel were no statistical different in both 4-8 years group and 9-12 years group with myopia(≤-3.00D)(P=0.411, 0.924). The differences of refraction results of both the drugs were significant in 4-8 years group with low hypermetropia, medium hypermetropia and high hypermetropia(P=0.007, 0.007, 0.009). No significant difference was found in 9-12 years group with low hypermetropia(P=0.592), given 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel, but the differences of refraction results of both the ophthalmic preparations above were significant in 9-12 years group with medium and high hypermetropia(P=0.039, 0.012).

CONCLUSION: Both 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel have the cycloplegic effects, but their cycloplegic effects are significant different among hypermetropia children. Thus, the reasonable cycloplegic should be chosen according to the specific situation.

Abstract:AIM: To observe the application of Suresight handheld auto-refractometer in measuring diopter of infants in Community Health Service Center.

METHODS:Totally 836 cases(1 672 eyes)from June 2013 to December 2013 were examined diopter of infants by Suresight handheld auto-refractometer in Community Health Service Center.

RESULTS: Within 1 672 eyes of 836 infants were examined, 202 eyes were diagnosed ametropia, 38 eyes were suspicious, 240 eyes were transferred to the department of ophthalmology, the referral rate was 14.35%; 172 eyes were diagnosed ametropia, and the diagnosis rate of the referral patients was 71.67%. Among 172 eyes, 46 eyes were provided with corrected glasses, accounting for 2.75% of the number of screening, and 126 eyes were given intensive monitoring, accounting for 7.54% of the number of screening.

CONCLUSION: Application of Suresight handheld auto-refractometer in refraction screening for infants in Community Health Service Center is convenient and effective. With two-way referral between community health service center and department of ophthalmology can monitor and intervene vision development of infants much earlier.

Abstract:AIM: To observe the clinical effect of phacoemulsification and posterior chamber intraocular lens(IOL)implantation in the treatment of unilateral high myopia combined with age-related cataract.

METHODS: A retrospective clinical study was carried out in a single ophthalmology center. All patients diagnosed of unilateral high myopia with age-related cataract were performed phacoemulsification and posterior chamber IOL implantation. The axial length of operation eye was ≥27mm, and the axial length of unoperated fellow eye was≤25mm. Visual acuity and complications were followed up for 1, 7d, 1, 3mo postoperative.

RESULTS: Thirty-three patients with average age 68.8±9.26(41-87)y were enrolled in this study, 7 cases were men, 26 cases were women. The mean axial length of operation eyes was 29.44±1.80(27.1-32.71)mm and the mean axial length of unoperated fellow eyes was 23.39±0.92(21.72-24.90)mm. The average axial length difference of binocular eyes was 6.06±1.97(2.78-9.92)mm. The best corrected visual acuity(BCVA)increased from 0.02±0.02(light perception～0.12)preoperatively to 0.20±0.20(0.02-0.8)at 3mo postoperatively. There was statistically significant difference(t=-5.278, P<0.05). Among the 10 patients whose axial length difference of binocular eyes was 2.01-5.00mm, 60% of their postoperative BCVA were >0.3. Among the 13 patients with binocular axial length difference of 5.01-7.00mm,46.2% of BCVA were >0.3,46.2% achieved 0.05-0.25. Another 10 patients of binocular axial length difference between 7.01-9.99mm, 90% of BCVA were <0.3, of which 40% were <0.05. No complications occurred during operative and postoperative.

CONCLUSION:Phacoemulsification and posterior chamber IOL implantation can effectively improve the postoperative visual acuity and it is safe for unilateral high myopic patients combined with age-related cataract. The recovery of visual acuity is related with binocular axial length difference.

Abstract:AIM:To observe the effect of wearing glasses with full correction or under-correction on the development of juvenile myopia.

METHODS:This study included 132 cases(264 eyes )from January 2008 to September 2012 who were collected from our clinic.They were divided into 2 groups, full correction and under-correction. Students in group 1 wore glasses with full correction, students in group 2 wore glasses with under-correction 0.25D to 0.5D lower than normal. Reexamination was done every 6mo.After 12mo, refractions were checked, the development of myopia was compared.

RESULTS:There were no statistically significant differences between two groups after 6mo(P=0.0693); however, there were significant differences after 12mo(P=0.0013).

CONCLUSION:The development of myopia is slow if students often wear glasses with full correction.

Abstract:AIM: To compare and analyze the stereopsis of intermittent exotropia children under the different backgrounds of dynamic stimuli and static stimuli.

METHODS: We collected 56 children(male 26, female 30 with intermittent exotropia at the age from 5y to 12y and examined their stereopsis under the different backgrounds of dynamic stimuli and static stimuli using a multidimensional sense perception training software. The differences between the dynamic stereopsis and static stereopsis were compared.

RESULTS: Totally 17 cases(30%)had both dynamicstereopsis and static stereopsis, 39 cases(70%)had either dynamic or static stereopsis deficit, only 10 cases(26%)had dynamic stereopsis, 25 cases(64%)static stereopsis left and 4 cases(10%)were without any form of stereopsis. The positive rate of dynamic stereopsis was better than the positive rate of static stereopsis, with statistical significance(P<0.05).

CONCLUSION: Dynamicstereopsis is better than the static stereopsis to intermittent exotropia children.

Abstract:AIM:To immediately observe the complication of corneal flap after LASIK surgery.

METHODS:A retrospective case series were studies.Totally 2 040 cases(4 080 eyes)from January 2010 to October 2012 in our hospital were collected, the corneal flap was observed using lamp microscope after LASIK within 30min. Corneal flap dislocation, corneal flap strial and intraface debris were examined after operation, the effective treatment and controlled measure should be taken for these complications.

RESULTS: Postoperative complications were corneal flap dislocation 102 eyes(2.5%), corneal flapstriae 95 eyes(2.33%), interface debris 105 eyes(2.57%). No failure case was seen. There had no corneal flap-related complications, which seriously impact the visual quality after the surgery.

CONCLUSION: Carefully postoperative examination at the first-time is an effective way to manage some complications of post-LASIK. Thus promoting the diagnosis and treatment of post-LASIK complications.