Abstract:AIM: To study the different epidemiological features of patients with contact lens-related microbial keratitis(CLRMK)in Tanta University Hospital in Egypt in order to assess different aspects of that problem, improve patients' awareness and in a trial to find practical solutions.

METHODS: All cases with keratitis attending the Outpatient Clinic of Ophthalmology Department at Tanta University Hospital during a period of 5y starting from the first of January 2009 to the end of December 2013 were selected and carefully examined and cases with CLRMK were further examined and investigated.

RESULTS: Out of total 108 496 attendants during this period with different complaints, there were 1463(1.3%)cases suffering from different forms of keratitis and 151(0.1%)with CLRMK. Results revealed that CLRMK is common in age group <30y, more in students(49%), families with large number and large crowding index, rural than urban residence, patients with outdoor water sources and insanitary sewage disposal. From history taking, it was found that CLRMK was more common with overnight use, insanitary storage cases or solutions and unsafe sources like shops of cosmetics and hair dressers. Cultural results were positive in 92% and negative in 8% of cases. The positive culture results were mixed infection(bacterial and fungal)in most of cases(53, 35.1%), bacterial only(43, 28.5%), fungal only(31, 20.5%)and acathamebic in 12(8%)of cases.

CONCLUSION: CLRMK is more frequent in students, rural areas, in outdoor water supply, insanitary sewage disposal. Overnight use, insanitary storage cases or solutions and unsafe sources were associated with increased incidence of CLRMK.

Abstract:AIM: To evaluate the safety and efficacy of intracameral moxifloxacin in preventing endophthalmitis after cataract surgery.

METHODS:Sixty-five eyes of 65 patients underwent cataract surgery between January and June 2012. Some patients received intracameral moxifloxacin at the end of surgery, while others did not(controls). Pre- and postperative logarithm of the minimum angle of resolution(logMAR)best corrected visual acuity(BCVA), intraocular pressure(IOP), corneal edema, and anterior chamber(AC)status were examined.

RESULTS: Thirty-three patients(19 males, 14 females); average age, 64.81±11.61y(range: 41-82y)received moxifloxacin and 32 patients(15 males, 17 females); average age, 65.43±11.10y(range: 42-81y)did not. The differences in patient age(P=0.827)and sex(P=0.396)were insignificant. Preoperative BCVA was approximately 20/130 in both groups. After surgery, moxifloxacin and control patients had a BCVA of 20/25 and 20/23, respectively(P=0.160). Preoperative IOP was 14.93±2.77mmHg(range: 11-21mmHg)in moxifloxacin patients and 15.06±2.42mm Hg(range: 12-21mmHg)in controls(P=0.850). After surgery, IOP was not statistically different between two groups(moxifloxacin: 14.06±2.31(range: 10-19mmHg), controls: 14.03±2.36mmHg(range: 10-19mmHg), P=0.960). Slight differences in corneal edema(P=0.623)and anterior chamber cell(P=0.726)incidences between two groups were not statistically significant.

CONCLUSION: Intracameral moxifloxacin is safe and effective in preventing endophtalmitis after cataract surgery.

Abstract:AIM: To investigate the effect of intraocular pressure(IOP)fluctuations on the visual performance in steroid responders after laser in situ keratomileusis(LASIK).

METHODS: Fifteen post-LASIK patients who underwent steroid-induced IOP fluctuations were enrolled as study group. And all received effective therapy when identified. Another 15 matched post-LASIK patients who used topical steroids for the same duration without developing hypertension were selected as control group. During the follow-up visits, uncorrected distant visual acuity(UDVA), photopic contrast sensitivity, wavefront aberrations, and corneal topography, were measured. These aimed at comparing the differences in postoperative changes between the groups.

RESULTS: In study group, comparison of preoperative and postoperative IOP, the amplitude of abnormal IOP fluctuations reached 10.6±4.4mmHg(ranged from 21.3 to 32.9mmHg). Compared with postoperative ocular hypertension, statistics demonstrated significant changes such as UDVA, photopic contrast sensitivity, and wavefront aberrations, and corneal topography under the condition of normal tension. 1)UDVA: a significant difference was seen in UDVA between ocular hypertension and normal tension(P<0.001); 2)Contrast sensitivity: results showed significant differences in 3, 6, 12, and 18 cycles/degree of photopic contrast sensitivity(all P<0.05); 3)Wavefront aberrations: statistics indicated significant differences in higher order aberrations(HOA), trefoil and spherical aberration(P<0.05 for all); 4)Corneal topography parameters such as Q-value, difference value(Diff-value)between the posterior corneal surface and the best fit sphere in the central region(Φ=6mm), and central corneal thickness(CCT)showed significant differences(P<0.01 for all). However, in control group, except for the increased CCT with time, no other significant changes were observed during the follow-up visits.

CONCLUSION:Transient abnormal IOP fluctuations might induce remarkable optical and visual changes, and limiting the IOP fluctuations might improve the visual performance in steroid responders after LASIK.

Abstract:AIM:To investigate the effect of histone deacetylase inhibitor(HDACi)trichostatin A(TSA)on synthesis of collagenⅠand proliferation of human Tenon fibroblasts(HTFs)induced by transforming growth factor-β₁(TGF-β₁).

METHODS: Firstly, the effect of TSA at different concentrations(200, 400, 600 and 800nmol/L)on HTFs viability after 24h was detected using MTT proliferation assays. Then, the effect of TSA at 400nmol/L and 600nmol/L mixed with 5ng/mL TGF-β₁ on HTFs viability after 24h were investigated using MTT proliferation assays. Furthermore, the mRNA and protein expression of collagen Ⅰ in HTFs after treatment with TSA at different concentrations(400, 600nmol/L)mixed with 5ng/mL TGF-β₁ as well as 600nmol/L TSA were detected by RT-PCR and Western-blot.

RESULTS: Compared with control group, the results of MTT showed that HTFs viability decreased significantly after treated with TSA at 400, 600 and 800nmol/L(P<0.05). The HTFs proliferation induced by TGF-β₁ could be attenuated by TSA at 400 and 600nmol/L(P<0.05). The results of RT-PCR and Western-blot confirmed that TSA at 400 and 600nmol/L had reversal effect on up-regulated gene transcription and protein expression levels of collagen Ⅰ induced TGF-β₁.

CONCLUSION:TSA can inhibit the HTFs proliferation induced by TGF-β₁ and attenuate gene transcription and protein expression of collagen Ⅰ.

Abstract:AIM:To investigate the role of adiponectin(APN)in C57BL/6J mice model of oxygen-induced retinopathy(OIR).

METHODS: Neonatal C57BL/6J mice were divided randomly into three groups: normoxic control group, physiological saline injection of OIR group and adiponectin injection of OIR group. The mice of the latter two groups were exposed to 75%±2% oxygen from 7d(P7)～P12 to induced OIR. Recombinant APN(rAPN)was injected intraperitoneally(i.p., 3.0μg/g)in a mice model of OIR from P7～P15. Another set of mice model of OIR were received a similar treatment with physiological saline. All eyes were collected at P17. The right eyes were whole mounted and stained with Lectin to observe central retinal avascular area and the growth of pathological neovascularization; The left eyes were performed histopathological cross sections stained with HE to analyzed the histopathological changes in the retina. The eyes were enucleated to assess the levels of reactive oxygen species(ROS)and NO. The protein expression of iNOS, nNOS, eNOS were detected by Western-blot.

RESULTS: The central retinal avascular area, neovascular area were markedly decreased after the APN injection compared with physiological saline injection of OIR group(t=7.304, P<0.01; t=2.654, P<0.01). Compared with physiological saline injection of OIR group, the levels of ROS were lower(t=13.349, P<0.01), the levels of NO were higher(t=3.023, P<0.01), the expression of iNOS were decreased(t=5.112, P<0.01), the expression of eNOS were decreased(t=7.421, P<0.01). nNOS expression had no significant difference(t=1.074, P>0.01).

CONCLUSION:The realtus demonstrate that APN can promote physiological NO by acting endogenous eNOS, while suppress ROS/RNS generation and play a protective role in retinal vessels in OIR process.

Abstract:AIM: To evaluate the inhibitory effect of hypoxia inducible factor-1α(HIF-1α)small interfering RNA(siRNA)on the expression of vascular endothelial growth factor(VEGF)protein and explore the feasibility of potential therapeutic approach for diabetic neovascular disease.

METHODS: Using pSilencer2.1-U6neo for plasmid vector, HIF-1α siRNA recombinant plasmid was constructed. There was totally 54 healthy Sprague Dawley rats in which 15 rats were chosen as normal group and 39 rats were constructed for diabetic retinopathy model by streptozotocin(STZ)which was divided into three subgroups randomly including control model group(DR group, 15 rats), vector group(12 rats)and gene therapy group(HIF-1α siRNA group, 12 rats). Nothing was transfected into DR group and normal group. The vector plasmid and HIF-1α siRNA were injected into the vitreous in vector group and HiF-1α siRNA group respectively. The retinal morphology was observed by hematoxylin-eosin(HE)staining and the expression of VEGF protein was measured by immunohistochemical staining. The inhibition efficiency of VEGF was calculated at 24, 48, 72h and 1wk after injected. Significant differences between groups were evaluated by one-way analysis of variance, followed by LSD-t analysis.

RESULTS: HIF-1α siRNA recombinant plasmid was confirmed by enzyme digestion and sequence analysis. HE staining showed that the retinal cells at each layers in normal control group were arranged regularly, and cell's morphology was roughly normal. The retinal cells at each layers arranged in disorder in diabetic rat And the inner limiting membrane was not complete with neovascular buds and neovascularization cluster growing out of the inner limiting membrane vertically. Immunohistochemical staining showed that the positive expression of VEGF was brown yellow granules, which was mainly located in ganglion cell layer. It also revealed the expression of VEGF protein was weakly positive in normal control group, while the DR group and empty vector group were significantly increased. Compared with DR group and the empty vector group, gene therapy group was significantly decreased, the difference was statistically significant(P<0.05). VEGF protein level was reduced by 27.4%, 40.6%, 47.5%, 64.5% at 24, 48, 72h and 1wk.

CONCLUSION: Intravitreal injection with HIF-1α siRNA can efficiently inhibite VEGF protein in retina of diabetic rats, which may be a new method for the treatment of diabetic neovascular disease.

Abstract:AIM:To observe the effect of different concentrations of sodium hyaluronate on ocular surface change of dry eye.

METHODS: New Zealand rabbits with dry eye was prepared and treated with 0.1% and 0.3% sodium hyaluronate drops fluid respectively, which were regarded as low concentration treatment group(group B)and high concentration treatment group(group C)respectively. However, the rabbits treated with saline were regarded as control group(group A). And then, corneal fluorescein staining, Schirmer test, conjunctival goblet cells, mucin expression and histological changes were observed.

RESULTS: On D7 and D14 after treatment, corneal fluorescein staining scores were lower in group B and group C than that in group A(P<0.05). However, Schirmer test, goblet cell density and mucin content were higher in group B and group C than those in A group(P <0.05). Tear secretion and goblet cell density were higher in Group C than those in group B(P<0.05). Compared with group B and group C, the thicknesses of corneal and conjunctival epithelial cell layer were thinner in group A. There were not obvious abnormalities in corneal and conjunctival stroma in each group.

CONCLUSION: The sodium hyaluronate can improve ocular surface damage of dry eye in New Zealand rabbits. The high concentration of sodium hyaluronate has better effect than low concentration.

Abstract:AIM: To observe the changes of corneal endothelial cell density and morphology after femtosecond laser small incision lenticule extraction(SMILE).

METHODS: In this prospective study, 60 patients(120 eyes)with myopia or myopic astigmatism, who volunteered to receive SMILE from April 2014 to October 2014 in Shengjing Hospital of China Medical University, were divided into two groups: contact lens group(60 eyes)and non-contact lens group(60 eyes). The values of corneal endothelial cell density and the percentages of hexagonal cells, detected by NIDEK confoscan4 corneal confocal microscopy before and 1wk, 1, 6mo after surgery, were recorded and analyzed.

RESULTS: All patients were with successful surgery and there were no complications intraoperative and postoperative. No differences were noted between two groups in terms of average age, refractive error, stromal ablation depth, residual stromal bed depth, and postoperative uncorrected visual acuity(P>0.05). Using the analysis of variance of repeated measurement data, there were no statistically significant differences regarding mean endothelial cell density and percentage of hexagonal cells in pre- and 1wk, 1, 6mo post-SMILE within non-contact lens group(F=0.864, 2.488; P=0.460, 0.061). In the contact lens group, no differences were found regarding mean endothelial cell density in pre- and 1wk, 1, 6mo post-operation(F=0.135, P=0.939), but there were significant differences in the percentage of hexagonal cells(F=4.913, P=0.002). The percentage of hexagonal cells decreased significantly at 1wk post-operation(30.70±4.08)% compared with preoperative(32.23±4.15)%(P=0.045), returned to the preoperative levels at 1mo after surgery(33.05±4.28)%(P=0.364), and showed no difference(P=0.091)at 6mo after surgery(34.06±5.11)% with preoperative data. The percentages of hexagonal cells in the contact lens group were significantly lower in pre- and 1wk, 1mo post-operation than those in the non-contact lens group(t=2.051, 1.723, 2.092; P=0.037, 0.042, 0.034), however, there was no statistically significant difference between two groups at 6mo after surgery(t=0.131, P=0.986).

CONCLUSION: If the required residual stromal thickness limit was ≥300μm, SMILE to correct myopia or myopic astigmatism has no effect on the corneal endothelial cell density, only has short effect on the percentage of corneal hexagonal cells, which is slighter than wearing contact lens. SMILE to correct myopia is safe for corneal endothelium.

Abstract:AIM:To compare the curative effects between laser multi-point scanning and single-point multiple scanning for the treatment of non-proliferative diabetic retinopathy.

METHODS:Fifty patients with non-proliferative diabetic retinopathy from January 2010 to January 2014 in our hospital were selected for the study, and were divided into two groups, the control group and the observation group, using a random number table. Twenty-five patients(43 eyes)in the observation group completed panretinal photocoagulation(PRP)therapy once by 577nm laser multi-point scanning. Twenty-five patients(41 eyes)in the control group completed PRP therapy by the single-point multiple scanning. The differences of average threshold sensitivity of visual field, F-ERG a/b wave amplitude, the clinical effective rates, the laser energy, the number of laser spot and the energy density between the two groups at various time points were compared.

RESULTS:At 1d after the treatments, average threshold sensitivity of visual field was lower than those at 1d before treament, and the difference was statistically significant(t=2.421, P=0.017). The differences of average threshold sensitivity between the two groups at 1d before treatments, at 1d, 1, 2, 6, 12mo after treatments, were not statistically significant(P>0.05). The F-ERG a wave amplitude of both groups at 1d after treatments were lower than those of 1d before treatments, and the difference was statistically significant(t=2.319, P=0.025). There were no differences of the F-ERG b wave amplitude between both groups at 1d before treatments and at 1d, 1, 2, 6, 12mo after treatments(P>0.05). The F-ERG b wave amplitude of both groups at 1d after treatments were lower than those at 1d before treatments, and the difference was statistically significant(t=2.276, P=0.031). There were no differences between the two groups in terms of clinical effective rates and the number of laser spot(P>0.05). Laser energy used in the observation group was higher than that in the control group, the energy density was lower than that in the control group. The differences on the two items were statistically significant(P <0.05).

CONCLUSION:There is no significant difference on clinical efficacy between laser multi-point scanning and single-point multiple scanning of PRP therapy. But the energy density of multi-point scanning mode is lower, and the damage made by this mode is less.

Abstract:AIM: To investigate the level changes of serum Chemerin in patients with diabetic retinopathy(DR)and explore its role in the development of DR.

METHODS: A total of 90 diabetes patients from January 2012 to December 2013 were enrolled, including non-diabetic retinopathy(NDR,n=30), simple diabetic retinopathy(SDR, n=30), proliferative diabetic retinopathy(PDR, n=30). Thirty healthy persons were included as normal control(NC). Chemerin level, tumor necrosis factor-α(TNF-α), adiponectin were assessed by enzyme-linked immunosorbent assay.Clinical characters including BMI, underlying diseases, blood lipids ect. were collected.

RESULTS: The serum levels of Chemerin in NC, NDR, SDR, and PDR group were 12.35±3.56, 26.50±5.34, 34.67±7.72, 40.97±8.97μg/L respectively. The serum levels of Chemerin in SDR and PDR group were significantly higher than those in NC and NDR group(P<0.01). Serum levels of Chemerin positively correlated with TNF-α(r=0.8746, P<0.01)and negatively correlated with adiponectin(r=-0.7418,P<0.01). The results of Logistic regression analysis showed that Chemerin was an independent risk factor for DR(OR=8.458, 95%CI: 1.611～44.410, P=0.012).

CONCLUSION: The results show that serum Chemerin level is significantly elevated in DR patients, and Chemerin may be involved in the development of DR.

Abstract:AIM:To evaluate the clinical efficacy of mouse nerve growth factor combined with compound anisodine on the treatment of nonarteritic anterior ischemic optic neuropathy(NAION).

METHODS: Clinical case series study was applied. One hundred and twenty-two patients with monocular onset NAION were randomly divided into three groups. Routine treatment was given to all of patients. Control group A(40 patients with 40 eyes)were undergone subcutaneous injection of compound anisodine besides superficial temporal artery, 2mL each time, twice per day; control group B(41 patients with 41 eyes)were given intramuscular injection of mouse nerve growth factor, 30μg each time, once per day; and the combined group(41 patients with 41 eyes)received compound anisodine and mouse nerve growth factor for four consecutive weeks. Visual acuity and fundus were observed every day during the treatment period. When the treatment finished, the best corrected visual acuity(BCVA), visual field and OCT were checked and recorded. The results were analyzed.

RESULTS: The recovery of visual acuity and visual field in the combined group was better than those of two control groups(P<0.05). Optic nerve fiber layer became thinner in the combined group which was still thicker than that in the control groups after the treatment, and there was significantly statistical difference(P<0.05). Visual acuity, visual field and retinal nerve fiber layer had no statistical differences between control group A and control group B(P>0.05). The effective rates of the three groups were respectively 70%(control group A), 65.9%(control group B), 92.7%(the combined group). The overall effective rate of patients in the combined group was significantly higher than that of two control groups(P<0.05), while the clinical efficacy of two control groups had no statistical difference(P>0.05).

CONCLUSION: Mouse nerve growth factor combined with compound anisodine has a remarkable effect on the treatment of NAION.

Abstract:Heat shock protein(HSP)is a kind of heat stress protein that widely exists in organism. Its expression will be significantly increased if the cells are under stress conditions(such as heat shock, pathogen infection, tissue injury, physiological stress, etc.). HSP60 is one of the families of HSPs, which can be induced by various stimuli, and may be released by stress or necrotic cells. HSP60 could play an important role in anti-infection, autoimmune, aging and apoptosis. The latest researches showed that HSP60 involved in the pathogenesis of a variety of eye diseases. Therefore, the effect and of HSP60 on the eyes and its molecular mechanism in related disease processes were reviewed in this study.

Abstract:Protein unwinding includes advanced structure changes, the formation and fracture of disulfide bond and so on. Protein unwinding is widely involved in the physiological and pathological processes in vivo, of which advanced structure changes have important influences on the occurrence and development of conformational diseases. In order to seek for the common pathological mechanism and corresponding intervention approach, this review summarizes the current information about conformational diseases, especially about cataract and Alzheimer's disease.

Abstract:Cataract extraction and the intraocular lens(IOL)implantation are the first choice to cure children cataract both domestic and overseas so far. However, IOL implantation in the eyes of children, especially in infant, has always been cared by ophthalmologists. Timely implanting IOL after the cataract extraction has played a significant role in terms of the refractive correction, the establishment of visual function, the prevention of amblyopia and the reconstruction of binocular vision. However, on the issue of IOL implantation after cataract extraction, there is always controversy on cataract treatment programs for children, and the focus of the controversy is when the IOL should be implanted. Theoretically, the principle of pediatric cataract surgery is the sooner the better, aiming to remove deprivation factor, open the visual pathway, implant IOL timely, and promote the visual development. How to find both “early” and safe IOL implantation time point is undoubtedly helpful for the rehabilitation of visual function of these children. The issues on the IOL implantation after children cataract extraction both at home and abroad are summarized below.

Abstract:With the rapid development over the past two decades,femtosecond(10^-15s)lasers(FS)has become a new application in ophthalmic surgery. As laser power is defined as energy delivered per unit time, decreasing the pulse duration to femtosecond level(100fs)not only increases the power delivered but also decreases the fluence threshold for laser induced optical breakdown. In ablating tissue, FS has an edge over nanosecond lasers as there is minimal collateral damage from shock waves and heat conduction during surgical ablation. Thus, application of FS has been widely spread, from flap creation for laser-assisted in situ keratomileusis(LASIK)surgery, cutting of donor and recipient corneas in keratoplasty, creation of pockets for intracorneal ring implantation. FS applied in keratoplasty is mainly used in making graft and recipient bed, and can exactly cut different tissue of keratopathy. FS can also cut partial tissue of cornea, even if it is under the moderate corneal macula and corneal edema condition.

Abstract:As the progress of modern techniques for cataract extraction surgery and various needs of intraocular lens(IOL)implantation, continuous curvilinear capsulorhexis(CCC)is still in absolute dominance among different ways of incision of anterior capsular lens in clinical practices, due to its advantages such as smoothness of capsulor opening, strong anti-tearing ability, integrity of supporting capsular bag, and strength at maintaining IOL stability. This article describes in general the historical development of CCC and complementary methods adapted to raise success rate when it is used in special cases of cataract extraction surgery. Meanwhile, the article also discusses briefly and envisions the prospects of femotsecond laser applied in CCC technique for cataract extraction.

Abstract:Retinopathy of prematurity(ROP)is an important cause of infant blindness and visual impairment in the world, of which main clinical characteristics are peripheral retinal vascular abnormalities, including large non-perfusion area and abnormal neovascularization. Numerous researches have demonstrated that ROP affects the differentiation and maturity of retinal photoreceptor cells, with more significantly effect on rods than cones, and later mostly caused ametropia, strabismus, amblyopia and a series of abnormal visual functions, the specific mechanism remains unclear. After treatments, even the retinal vascular proliferation lesions disappear itself, but the abnormal development of photoreceptor cells and the resulting visual dysfunction will persist. Currently the best evaluation mean of clinical assessment about retinal function is mainly visual electrophysiology, especially flash electroretinogram(f-ERG), which can reflect the whole retinal functional status before ganglion cells, has a unique significance for the evaluation of retinal photoreceptor cells function. In this review, we aims at the development of neural retina(mainly photoreceptor cells)and its related mechanisms, also the visual function changes appeared in the late period about ROP and its mechanisms, guiding us to pursuit better methods for treatment.

Abstract:Collagen protein has special biological characteristics and physical properties, including quaternary structure, low immunogenicity, biocompatibility, biodegradability and hemostatic properties and so on, which are the foundation of collagen protein being widely used and it has important relationship with the occurrence and development of some eye diseases, such as keratoconus, conjunctivochalasis, high myopia, etc. This paper reviews the recent progress of collagen protein in eye diseases.

Abstract:AIM:To investigate VEGF expression at various stages of diabetic rats eye disease through Meta analysis and then provide effective reference for clinical treatment.

METHODS:The randomized controlled experiment which studied the VEGF expression in the course of diabetic eye disease and used diabetic rat model was screened by searching database including pubmed, EMBASE, Medline, CNKI, Wanfang, VIP. Jadad scale(5 points as the full marks)was used to assess the quality of the included literatures. Data synthesis was carried out by the fixed effect model after heterogeneity test. Subgroups were divided according to different experiment stages.

RESULTS:Eight high quality literatures were included, two literatures were excluded after heterogeneity test. Data synthesis showed that VEGF expression in intraocular tissue of diabetic rats increased by 1.62%\〖95%CI(1.20～2.03),P<0.01\〗.

CONCLUSION:VEGF expression in intraocular tissue of diabetic rats is increased in each stage and gradually decreases monthly from two to six months.

Abstract:AIM: To evaluate the effects of intracameral cefuroxime injection on the prophylaxis of postoperative endophthalmitis after cataract surgeries, and compare endophthalmitis conditions between intracameral cefuroxime injection group and no intervention control group, using Meta analysis to search literatures at home and abroad.

METHODS:By searching through Pubmed, the Cochrane Library, EMBASE, QVIP, CNKI, Wanfang, the literatures published from January 1^st 2006 to January 31^rd 2015 were collected. The data in five literatures about the effects of intracameral cefuroxime injection on the prophylaxis of endophthalmitis after cataract surgeries were analyzed. By extracting data, incidence of endophthalmitis after cataract surgeries with taking the preventive measures or not taking was compared by Review Manager 5.2. Adopting fixed effect model, values of odds ratio(OR)and 95% Confidence Interval(95%CI)were recorded and compared, analyzed sensitivity analysis, excluded heterogeneity and calculated outcomes.

RESULTS: After comparing the incidence of endophthalmitis from intracameral cefuroxime injection group and control group, the result was statistically significant \〖OR=0.11(P<0.01); 95% CI: 0.07～0.18\〗.

CONCLUSION:Intracameral cefuroxime injection can effectively decrease the occurrence of endophthalmitis after cataract surgeries.

Abstract:AIM:To investigate the relationships of pain assessment with time perception and satisfaction for cataract surgeries in patients under topical anesthesia.

METHODS:Ninety patients with 90 eyes received cataract surgeries were included. Pain in surgery was assessed by using Visual Analogue Scales(VAS). According to VAS results, the patients were classified into three groups: Level-I pain group(VAS:0 score), level-Ⅱ pain group(VAS:1～3 scores), level-Ⅲ pain group(VAS:>3 scores). The differences of the three groups on age, sex, laterality, objective duration of the operations, subjective duration and satisfaction for the surgeries were analyzed.

RESULTS:No statistically significant differences between every two groups on age, sex and laterality were detected(P>0.05). The actual operation time and subjective duration was relatively long in the surgery examples with higher pain scores(P<0.05). The patients in Level-I and level-Ⅱ pain group can accurately perceive the duration of their surgery, while those in level-Ⅲ pain group can not accurately perceive. The higher pain scores the patients had, the lower proportion of successful operation was(P<0.05).

CONCLUSION:The accuracy of time perception and satisfaction for surgeries decreased with the aggravation of intraoperative pain in patients under topical anesthesia. So it is an important part of preoperative education and visits to let the patients understand that the feeling of pain cannot be used as a judgment whether the cataract surgery is successful.

Abstract:AIM:To observe the long-term effect and influence factors of trabeculotomy in primary infantile glaucoma.

METHODS: The clinical data of 172 infants(257 eyes)with primary glaucoma was analyzed. After the follow-up visits, the change of postoperative intraocular pressure was observed. Upon the rising intraocular pressure, the operation was considered to be failure as long as 1 or 2 kinds of drugs were taken to ineffectively reduce the pressure. Based on the multivariate Logistic regression analysis, the risk factors for the failure of trabeculotomy were analyzed. Through Cox regression analysis, the influence factor of successful operation and the curve for success rate of operation at each time point was drawn.

RESULTS: The median time of follow-up visits was 30.7(8.4～57.9)mo and follow-up rate was 89.02%. Through the multivariate Logistic regression analysis, the preoperative intraocular pressure and corneal transparency were the high risk factors for the failure of trabeculotomy(P<0.05); through Cox regression analysis, the corneal transparency was the influence factor for the successful time of trabeculotomy(P<0.05).

CONCLUSION: Compared with preoperative intraocular pressure, the corneal transparency can reflect the severity of primary infantile glaucoma in a securer way. The scores of preoperative corneal transparency and detection of intraocular pressure can predict the control effect of postoperative intraocular pressure.

Abstract:AIM: To explore the improvement of visual function and the adverse reactions of retinal laser photocoagulation combined with ranibizumab for the treatment of neovascular glaucoma(NVG), to provide the basis for clinical treatment.

METHODS: One hundred patients with 129 eyes in our hospital from January 2012 to June 2014 were selected. They were randomly divided into the observation group and the control group, 50 cases in each one. Patients in the control group(67 eyes)were treated with retinal laser photocoagulation, and those in the observation group(62 eyes)were given retinal laser photocoagulation combined with ranibizumab treatment. After the treatment, the degeneration of iris neovascularization, visual acuity, intraocular pressure, ocular fundus and the adverse reactions were evaluated. Optical coherence tomography(OCT)was used to detect retinal nerve fiber layer(RNFL)thickness and visual field defect.

RESULTS: The degeneration rate of the iris neovascularization in the observation group was 95.2%(59/62), higher than that of the control group 83.6%(56/67)(P<0.05). The visual acuity of the observation group 4.3～4.7 was 62.9%(39/62), higher than that of the control group 49.3%(33/67); the visual acuity of the observation group ≤4.3 was 25.8%(16/62), lower than that of the control group 43.3%(29/67)(P<0.05). The retinal vein circulation time and intraocular pressure of the observation group after treatments were respectively 8.20±0.41s and 18.50±0.48mmHg, lower than those of the control group 9.42±0.30s and 23.94±0.52mmHg(P<0.05). The degeneration time of the iris neovascularization of the observation group was 6.19±0.27d, which was lower than that of the control group 8.37±0.31d(P<0.05). RNFL thickness of the observation group after treatments was 91.12±2.05μm, higher than that of the control group 85.06±2.19μm; the vision field defect of the observation group after treatments was 13.44±0.59dB, lower than that of the control group 15.92±0.56dB(P<0.05). The difference of adverse reactions between two groups was not statistically significant(P>0.05).

CONCLUSION: The treatment of NVG with laser photocoagulation combined with ranibizumab has good clinical efficacy, and can significantly improve the vision and retinal structure and function of the patients, and is safer.

Abstract:AIM: To observe the clinical effects of intravitreal injection of bevacizumab combined with complex trabeculectomy for neovascular glaucoma(NVG).

METHODS: Totally 46 patients with advanced NVG from February 2011 to September 2013 in our hospital were selected and divided into observation group(group A)and control group(group B), 23 cases in each group. Patients in group A were treated with intravitreal injection of bevacizumab combined with complex trabeculectomy. Patients in group B were treated with cyclocryotherapy. The visual acuity, intraocular pressure(IOP), degeneration of iris neovascularization and postoperative complications of the two groups were observed. All the patients were followed up for 12mo.

RESULTS: The postoperative IOP was decreased significantly compared with preoperative in the two groups, and the IOP level of group A was lower than that of group B, the difference was statistically significant(P<0.05). Nineteen cases(83%)were treated successfully in group A, and 12 cases(52%)in group B, the difference was statistically significant(χ²=4.847, P=0.028).

CONCLUSION: Intravitreal injection of bevacizumab combined with complex trabeculectomy for neovascular glaucoma can effectively control IOP, and has higher successful rate.

Abstract:AIM:To study the effect of vitrectomy with intravitreal injection of triamcinolone acetonide for the treatment of proliferative diabetic retinopathy.

METHODS: Vitrectomy with intravitreal injection of triamcinolone acetonide 2mg was performed on 47 eyes of 45 patients. The intraoperative and postoperative complications, postoperative visual acuity, intraocular pressure and the changes of macula central fovea thickness were observed.

RESULTS: Intraoperative complications: 7 eyes(15%)happened Iatrogenic tear hole, 13 eyes(28%)happened retinal hemorrhage; Postoperative complications: 13 eyes(28%)found triamcinolone acetonide entered anterior chamber, 9 eyes(19%)found hyphema, 6 eyes(13%)presented fundus hemorrhage. Visual acuity was improved in 35 eyes(74%)after 3mo and 27 eyes(57%)after 6mo, with statistical difference with preoperative(P<0.05). the intraocular pressure of postoperative were 23.47±5.21, 26.58±6.35, 19.12±5.76 and 17.43±4.91mmHg at 7d, 1, 3 and 6mo respectively. Compared with preoperative(16.32±4.64mmHg), the differences had statistically significant at 7d and 1mo(P<0.05). Macula central fovea thickness were 404.05±89.71, 277.14±41.25, 254.82±33.64 and 226.49±28.57μm at7d, 1, 3 and 6mo respectively. The differences had statistically significant at 1, 3 and 6mo compared with preoperative 433.51±101.02μm(P<0.05).

CONCLUSION: Vitrectomy combined with intravitreal injection of triamcinolone acetonide 2mg can reduce macular edema and improve visual acuity. It is an effective and safe procedure for proliferative diabetic retinopathy.

Abstract:AIM:To compare clinical effects of intravitreal injection of anti-vascular endothelial growth factor(VEGF)medicine for proliferative diabetic retinopathy(PDR).

METHODS: Eighty-four patients with PDR(84 eyes)in our hospital in January 2010 to January 2015 were selected, and were randomly divided into three groups(A, B, C, 28 eyes of 28 cases ). The patients in group A underwent vitrectomy, those in group B received intravitreal injection of ranibizumab before vitrectomy; and those in group C got intravitreal injection of conbercept before vitrectomy. Operative time, complications, and postoperative best-corrected visual acuity at 6mo of the three groups were compared.

RESULTS: After treatment, the incidence of intraoperative and postoperative complications and the operation time of group B and group C were lower than those of group A. Compared best corrected visual acuity at preoperative and postoperative 6mo, and among three groups, there were no statistically significance difference(P<0.05). There were no statistical differences compared visual acuity improvement among three groups(P>0.05).

CONCLUSION: Intravitreal injection of ranibizumab and conbercept before vitrectomy can decrease the operation time and intraoperative bleeding, reduce the incidence of intraoperative and postoperative complications and improve BCVA of patients in the treatment of PDR.

Abstract:AIM: To observe the clinical efficacy of internal limiting membrane(ILM)peeling combined silicone oil removal and filled with C₃F₈ on silicone oil-filled eye with submacular fluid.

METHODS: Thirty-one patients(31 eyes)with persistent submacular fluid after pars plana vitrectomy combined with silicone oil filled in our hospital from January 2007 to December 2013. According to operation mode, those patients were divided into group A(silicone oil removal)and group B(ILM peeling combined silicone oil removal and C₃F₈ filled).Follow-up time after surgery was 6～12(mean 8.33±1.45)mo. The LogMAR best-corrected visual acuity(BCVA)and the neuroepithelial thickness of macular fovea was observed at postoperative 3, 6mo.

RESULTS: Postoperative 3mo LogMAR BCVA was improved in each group compared to preoperative LogMAR BCVA, the difference was significant(t=2.326, 2.577, P<0.05). the difference on LogMAR BCVA improvement rate of group A and B had statistical significance(χ²=5.473, P<0.05). Postoperative 6mo LogMAR BCVA was improved in each group compared to preoperative LogMAR BCVA, the difference was significant(t=4.216, 3.801; P<0.05). The difference on LogMAR BCVA improvement rate of group A and B had significance(χ²=4.210, P<0.05). Postoperative the neuroepithelial thickness of macular fovea was decreased in each group compared to that of preoperative

CONCLUSION: ILM peeling combined silicone oil removal and C₃F₈ filled is an effective method in treatment of silicone oil-filled eye with persistent submacular fluid.

Abstract:AIM:To observe the efficacy and safety of intravitreal injection of Ranibizumab in the treatment of macular edema secondary to central retinal vein occlusion(CRVO).

METHODS: According to the standard, 24 patients with macular edema secondary to CRVO were double-blind randomized to group Ⅰ and group Ⅱ. They were aged 30～70 years old, average(51.58±10.32)years. Patients of group Ⅰ were treated with intravitreal injection of 0.5mg ranibizumab monthly for the first three months and given compound thrombosis capsule. Compared with group Ⅰ, patients of group Ⅱ were only given compound thrombosis capsule. Subjects of two groups use PRN(Pro re nata)therapy with ranibizumab from the third month. No significant difference was found between the two groups in the best-corrected visual acuity(BCVA)and central retinal thickness(CRT)before the treatment(P>0.05). BCVA, CRT, laboratory results and ocular and systemic adverse reactions of the two groups during treatment were conducted and statistically analyzed.

RESULTS: BCVA of group Ⅰ was 52.67±1.78 before treatment, and BCVA were respectively 63.67±1.61, 66.25±1.60, 69.58±1.68, 70.75±5.22, 65.58±4.34, 68.92±3.4, 70.17±3.7 at 1wk, 1, 2, 3, 4, 6, and 12mo after treatment with significant difference compared with before injections(P<0.05). CRT of group Ⅰ was 539.00±10.94μm before the treatment, and that were respectively 326.67±20.83, 264.58±17.11, 232.00±13.04, 231.25±78.68, 316.00±172.48, 218.00±105.25, 220.58±33.43μm at 1wk, 1, 2, 3, 4, 6, and 12mo after treatment with significant difference compared with before injections(P<0.05). BCVA of group Ⅱ was 52.25±2.83 and CRT was 539.92±12.21μm, BCVA of group Ⅱ was 57.08±3.12μm 3mo after treatment and significant difference was found compared with group Ⅰ 3mo after treatment(P<0.05). CRT of group Ⅱ was 497.92±11.91μm 3mo after treatment and significant difference was found compared with group Ⅰ 3mo after treatment(P<0.05). Ocular and systemic obviously adverse reactions were not found during treatment.

CONCLUSION: Intravitreal injection of ranibizumab contributes to relieving macular edema, improving visual acuity and reducing fluorescence leakage of macular area in short-term. But patients need repeated injection. Ranibizumab is effectiveness and safety in the treatment of macular secondary to CRVO.

Abstract:AIM:To compare and research visual function(VF)and the quality of life(QOL)after Q value guided aspheric profile laser in situ keratomileusis(LASIK)by visual quality questionnaire.

METHODS: One hundred and twenty-three patients(245 eyes)were performed LASIK with Q value guided aspheric profile ablation as the intervention group, and 152 patients(304 eyes)were performed conventional LASIK as the control group. Uncorrected and best corrected visual acuity(UCVA and BCVA), refractions, corneal Q-value of the patients in the two groups were measured at postoperative 1 and 3 mo respectively, and the differences of these examinations between the two groups were analyzed. Every patient was interviewed with a questionnaire concerning VF and QOL at 3mo postoperatively, the grades were measured and analyzed between two groups.

RESULTS: At postoperative 3mo, UCVA was improved in 238 eyes(97.1%)in the intervention group and 291 eyes(95.7%)in the control group and there was no statistical difference between the two groups(χ²=0.78, P=0.38). Meanwhile, there was no significant difference in term of postoperative refractions between the two groups(0.15±0.58D vs 0.11±0.59D; t=0.75,P=0.45). All patients' corneal central Q values increased postoperatively, but the Q value of 0.28±0.10 in the intervention group was obviously lower than that of 0.67±0.13 in the control group(t=-38.71,P=0.00). The integrated VF was 50.50±5.60 in the intervention group and 48.36±6.15 in the control group, there was statistical significance between the two groups(t=3.01,P=0.00). The scores in the terms of night vision, dark visual field, fine discrimination, contrastive discrimination, glaring and asthenopia in the intervention group were higher than those in the control group, and the differences were statistically significant(all P<0.05).

CONCLUSION:Q value guided aspheric profile and conventional LASIK are safe and efficient for the correction of myopia and astigmatism. Moreover, Q guided aspheric profile LASIK can better maintain the aspheric character of the corneal surface and obtain better VF and QOL than conventional LASIK.

Abstract:AIM: To study the safety and effectiveness of transepithelial photorefractive keratectomy(Trans-PRK)preferentially performed on the patients with retinopathy(except retinal detachment)in the preoperative examination.

METHODS: Forty-six patients(65 eyes)with retinopathy(except retinal detachment)in the preoperative examination underwent Trans-PRK using VISX STAR S4 IR laser platform, Of which 25 cases(32 eyes)in the study group were treated by Trans-PRK before retinal photocoagulation, whereas 21 cases(33 eyes)in the control group underwent retinal photocoagulation prior to Trans-PRK. Clinical outcomes of retinopathy, uncorrected visual acuity, corrected visual acuity, refraction and intraocular pressure were observed and analyzed.

RESULTS:After two weeks of Trans-PRK and one month of retinal photocoagulation, the examination results in the study group showed that the retinal holes were not found enlarged, and no retinal detachment occurred, the retinal pathological changes were stable and retinal degeneration area did not expanded. After one month ofretinal photocoagulation and one month of Trans-PRK, retinal degeneration areas and holes were stable, did not expand and deepen in control group.

CONCLUSION:Preferentially performed Trans-PRK or retinal photocoagulation on the patients with retinopathy has no impact on retinopathy. The results show that it is safe and effective to preferentially perform Trans-PRK on patients with retinopathy, and gains time for the patients to recover uncorrected visual acuity as soon as possible and participate in physical examination.

Abstract:AIM: To study the related factors of comprehensive treatment effect on anisometropic amblyopia children, and to provide a theoretical basis for clinical intervention.

METHODS: Totally 100 cases of anisometropic amblyopia children in our hospital from October 2013 to October 2014 were selected and were divided into groups A, B and C according to curative effect after 6～18mo's treatment. Fifty-four cases of group A were judged to be cured, 34 cases of group B were judged to be improved, and 12 cases of group C was invalid. The age, compliance, anisometropia degree, anisometropia type, amblyopia degree and fixation behavior were analyzed.

RESULTS: Anisometropia type among the three groups of patients showed no significant difference(P>0.05). While the age, compliance, anisometropia degree, amblyopia degree and fixation behavior among three groups of patients had statistically significant differences(P<0.05). By regression equation analysis, the influence level of various factors on comprehensive treatment effect was in sequence of amblyopia degree, anisometropia degree, fixation behavior, age, compliance.

CONCLUSION: There are closed relationship between comprehensive treatment effect and age, compliance, anisometropia degree, amblyopia degree, fixation behavior, but there is no significant correlation between anisometropia type and comprehensive treatment effect.

Abstract:AIM: To reform the traditional teaching modes of strabismus by using digital induction to enhance logic in teaching process.

METHODS: The study was performed in the group of 20 eight-year program clinical undergraduates from the class of 2009 and 198 five-year program clinical undergraduates from the class of 2010. These students were divided into two groups receiving traditional and digital induction teaching over the same period respectively. After classes, questionnaire survey and classroom test were carried out.

RESULTS: The digital induction method was demonstrated to be superior to the traditional teaching method.

CONCLUSION: The digital induction method can improve teaching effects and academic records significantly.

Abstract:AIM: To evaluate the clinical effect of vitrectomy combined with cyclodialysis repair on primary stage for complicated ocular trauma with cyclodialysis.

METHODS: The 13 consecutive cases(13 eyes)of complicated ocular trauma with cyclodialysis from January 1, 2011 to October 31, 2014, were treated and studied, including 2 contusions, 7 penetrating injuries and 4 rupture injuries. The concomitant symptoms were corneal laceration, limbus laceration, scleral laceration, hyphema, iridodialysis, mydriasis, traumatic cataract or lens dislocation, vitreous hemorrhage, retinal contusion, retinal detachment, choroid contusion, suprachoroidal hemorrhage, intraocular foreign body, etc. The preoperative visual acuity(VA)ranged from light perception(LP)to hand movement(HM)or before eye(BE).The cyclodialysis was determined by ultrasound bio-microscopy(UBM), three-mirror contact lens or was found in operation. The limits of cyclodialysis were about 2:00～6:00 o'clock. Intraocular pressures(IOP)of contusion eyes before surgeries were 5.4mmHg and 10.2mmHg. The operation opportunity was 6h～3d after injuries and the main operation stages included closing wound in cornea and sclera, vitrectomy, lensectomy, and/or removal of intraocular blood, retinal reattachment, cyclodialysis repair by suturing. The external scleral puncture and draining were carried out in suprachoroidal hemorrhage. Inert gas or silicon oil was tamponaded.

RESULTS: The ciliary body reattached in all cases determined by UBM and three-mirror contact lens. The BCVA was improved to HM/BE～4.7 and the IOP was 9.8～24.5mmHg at 1mo after surgeries, except that one eye was corneal edema after corneal laceration sutura. Retinal reattachment was determined by ultrasound or ophthalmoscope examination.

CONCLUSION: For complicated ocular trauma with cyclodialysis, the vitrectomy with cyclodialysis repair on primary stage is effective to recover the anatomic structure and preserve the available visual function.

Abstract:AIM: To investigate the effect of ganciclovir ophthalmic gel on viral keratitis.

METHODS: Eighty-six cases(101 eyes)with viral keratitis in our hospital from May 2013 to October 2014 were randomly selected as the research subjects and were divided into the ganciclovir group and the control group, the patients in ganciclovir group were given ganciclovir ophthalmic gel and those in control group were given aciclovir eye drops. The curative effect were observed after 2wk.

RESULTS: After treatment, the symptoms of viral keratitis(photophobia, tears, pain, foreign body sensation)and the signs(ciliary congestion, corneal epithelial defect, corneal stromal edema, corneal fluorescein staining)scores of the two groups were significantly improved than before treatment, those of ganciclovir group were improved more obviously(P<0.05). The efficiency of the ganciclovir group(92.9%)was significantly higher than that of the control group(59.5%)with statistical significance(P<0.05). There was no statistical difference between the two groups of patients with adverse reactions(P>0.05). The recurrence rate of ganciclovir group was significantly lower than that of the control group(P<0.05)

CONCLUSION: Ganciclovir ophthalmic gel is a safe and effective antiviral eye drops, has exact effect on viral keratitis, and is worth of clinical application.

Abstract:AIM: To find special staining methods which is fast, accurate and easy to operate for fungal keratitis tissue section.

METHODS:Thirty-eight cases with fungal keratitis were diagnosed by positive fungal culture. Corneal specimens of these cases were conventionally fixed, dehydrated and dipped in wax for 4μm paraffin sections, then subject to conventional dewaxing to water. The results of fluorescein isothiocyanate(FITC)and periodic acid-Schiff(PAS)staining were compared.

RESULTS: Positive detection rate of FITC staining was 97.4%(37/38), positive detection rate of PAS staining was 86.8%(33/38), with statistically significant difference(P<0.001).

CONCLUSION: FITC staining method is simple, fast, accurate, andhas high positive rate. It is superior to PAS staining, and is worth of promoting.

Abstract:AIM: To observe the change of macular fovea thickness and the incidence of cystoid macular edema(CME)after cataract surgery by using bromfenac sodium eyedrops in perioperative period, to access the applying value of this kind of non-steroidal anti-inflammatory drugs(NSAIDs)on preventing postoperative CME.

METHODS: The clinical data of patients received phacomulsification and intraocular lens(IOL)implantation surgeries by the same operator were retrospective analyzed. Twenty patients(26 eyes)in trial group received the treatment of topical bromfenac sodium(twice per day for 3d preoperatively and twice per day for 2wk postoperatively)combined with tobramycin and dexamethasone(four times per day for 2wk postoperatively). Nineteen patients(26 eyes)in the control group only used tobramycin and dexamethasone eyedrops. The changes of macular fovea thickness and the incidence of CME preoperative and 1mo postoperative were analyzed.

RESULTS: The mean macular fovea thickness of two groups improved from 221.077±22.194μm and 222.769±21.562μm preoperatively to 221.692±29.685μm and 249.538±63.153μm postoperatively respectively. There was no statistical difference in the trial group between preoperative and postoperative(P>0.05), however, there were statistical differences compare that of preoperative and postoperative in the control group and postoperative between two groups(P<0.05). The incidence of CME was 0 and 3.85% in two groups with no statistical significance(P>0.05).

CONCLUSION: The topical use of bromfenac sodium eyedrops in perioperative period possibly can prevent the increase of macular fovea thickness and the occurrence of CME after cataract surgery.

Abstract:AIM: To compare the changes of tear film stability after the combined surgery of phacoemulsification and intraocular lens(IOL)implantation through two different clear corneal incisions(3.0mm and 2.2mm).

METHODS: Preoperatively, 76 age-related cataract patients(92 eyes)with diabetes were divided into two groups. Forty-eight eyes were enrolled in group A, they were treated with 3.0mm clear corneal incision. And 44 eyes in group B were treated with 2.2mm clear corneal incision. Subjective score for dryness, Schirmer I test, tear film break-up time and corneal fluorescein staining were evaluated preoperatively and 7d, 1 and 3mo postoperatively.

RESULTS: Complains of dry eye and corneal fluoreascein staining was more severe in group A and tear film break-up time of group A was lower than that of group B with statistical difference(P<0.05)at postoperative 7d and 1mo. Schirmer Ⅰ test result of group A was higher than that of group B at postoperative 1mo with statistical difference(P<0.05).

CONCLUSION: Compared with 2.2mm group(group B), the symptom of dry eye was slighter and the duration was shorter than 3.3mm group(group A)after phacoemulsification in cataract patients with diabetes.

Abstract:AIM:To determine the most optimal concentration of the safe usage of povidone-iodine(PVP-I)in the flushing to disinfect the conjunctive sac before cataract surgeries, in order to provide a scientific basis for clinical eye surgery work.

METHODS:Sixty-two patients with phacoemulsification and intraocular lens implantation in our hospital from October 2012 to October 2014 were randomly divided into 0.25g/L PVP-I group(Ⅰ)and 5g/L PVP-I group(Ⅱ). Sterilizing effect and the complications postoperative were analyzed.

RESULTS:The sterilizing effects of the two groups after flushing conjunctiva sac using different concentrations of PVP-I were both remarkable, but the difference between the two groups was not statistically significant(P>0.05). No endophthalmitis occurred in the two groups. Observing the corneal condition after rinsing, no severe conjunctival hyperemia, corneal edema and other serious complications occurred. There was slightly punctate corneal epithelial shedding in groupⅡ, and the difference was statistically significant(P<0.05)between the two groups. After rinsing, discomfort rate of group Ⅰ was 12.5%, and 40% of group Ⅱ. The difference of discomfort rate between the two groups was statistically significant(P<0.05).

CONCLUSION:Using 0.25g/L PVP-I in the conjunctiva sac rinsing before surgeries can inhibit the growth of bacteria in the conjunctival sac, reduce the impact on the corneal epithelium thereby reducing the incidence of postoperative complications and the positive rate of bacterial culture, increasing the comfort degree of patients, bringing a better area for the surgeries.

Abstract:AIM: To discuss the efficacy of senile cataract with corneal astigmatism treated with Acrysof toric intraocular lens(IOL)implantation. to observe the clinical preoperative and postoperative visual function of Acrysof toric IOL implantation.

METHODS: In this is a retrospective observational study, 34 senile(39 eyes)cataract patients with corneal astigmatism underwent phacoemulsification combined with Acrysof toric IOL implantation. The preoperative and 3mo postoperative uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), postoperative residual astigmatism, toric lens axis, and spectacle independence were detected and compared.

RESULTS: Thirty-four patients(39 eyes)underwent phacoemulsification combined with Acrysof toric IOL implantation successfully. Preoperative UCVA was 0.15±0.06, 3mo postoperative UCVA increased to 0.65±0.15(P<0.01). Preoperative BCVA was 0.37±0.13, 3mo postoperative BCVA increased to 0.85±0.19(P<0.01).Preoperative corneal astigmatism was 2.14±0.69D and the postoperative residual astigmatism was 0.73±0.36D(P<0.01), 97% IOL rotation was <5%, the mean IOL rotation was 2.6°±1.3°, 95% patients were independence with spectacle at distance at 3mo postoperative.

CONCLUSION: Implantation of Acrysof totic IOL for correcting astigmatism is effective, the IOL has good rotation stability, and provides postoperative visual function.

Abstract:AIM:To assess the clinical results of phacoemulsification with intraocular lens(IOL)implantation in the treatment of leprosy patients with cataract.

METHODS: Total 72 leprosy patients with cataract(72 eyes)from January 2010 to January 2013 were recruited from leprosy disease villages of Guangzhou. All the participants were randomized into two groups. Thirty-six patients(36 eyes)in observation group underwent phacoemulsification combined with IOL implantation, and other 36 patients(36 eyes)in control group underwent small incision cataract extraction and IOL implantation. Efficacy measures included intraoperative and postoperative complications, postoperative best corrected visual acuity(BCVA)and corneal astigmatism. The follow-up times included 1d, 1wk, 1mo, 1 and 2a after surgery.

RESULTS: At postoperative 1mo, visual acuity recovery in observation group was faster than that in control group and the BCVA in observation group was significantly higher than that in control group(all P<0.05). Corneal astigmatism in observation group was smaller than that in control group at different time-points within 1a(P<0.05). There were no significant differences in intraoperative and postoperative complications between both groups(P>0.05).

CONCLUSION: Phacoemulsification combined with IOL implantation is safe and effective in the treatment of leprosy patients with cataract, with faster recovery of visual acuity, smaller effect on corneal astigmatism. Therefore, it is a good surgical approach to deserve recommendation in the clinical work.

Abstract:AIM:To investigate the clinical value of optical coherence tomography(OCT)combined with ophthalmic B-type ultrasound in fundus examination before cataract surgeries.

METHODS:Conventional ophthalmoscope, ophthalmic B-type ultrasound and OCT were used to exam the fundus of 176 cataract patients(278 eyes). The positive rate of fundus diseases by the three methods was calculated, and then McNemar test was used to analyze the data in pairs and the values of the three methods on diagnosis of fundus diseases were investigated.

RESULTS:Thirty-two eyes were diagnosed with fundus diseases by conventional ophthalmoscope with positive rate of 11.5%, 18 eyes(6.5%)by ophthalmic B-type ultrasound, 6 eyes(2.2%)of those 18 eyes were serious lens turbidity. Fifty-one eyes(18.3%)were diagnosed with fundus diseases by OCT and 57 eyes(20.5%)by OCT combined with ophthalmic B-type ultrasound. The positive rate of fundus disease detected by OCT had significant difference at the level of α=0.05 compared with those by ophthalmic B-type ultrasound, conventional ophthalmoscope and OCT combined with ophthalmic B-type ultrasound.

CONCLUSION:OCT is more valuable and more sensitive on detecting macular diseases than the other two. However, the structure of retinal layer of the patients who had serious lens turbidity cannot be observed, which can be remedied by ophthalmic B-type ultrasound. The examination of OCT combined with ophthalmic B-type ultrasound is the most valuable one on accurate and early diagnosis of fundus diseases and the prediction of the visual acuity after surgeries.

Abstract:AIM:To investigate the efficacy and safety of needle revision combined with subconjunctival injection of 5-Fluorouracil(5-FU)for the treatment of early non-functioning blebs after Ex-PRESS glaucoma drainage device implantation.

METHODS:The medical records of 18 cases(23 eyes)with non-functional blebs within postoperative 3mo treated with needle revision combined with subconjunctival injection of 5-FU after Ex-PRESS glaucoma drainage device implantation in our hospital were retrospectively analyzed. All cases were followed up for at least 6mo.The IOP, the changes of filtering blebs morphology before and after treatments and complications were analyzed.

RESULTS:The IOP before and immediately, 1, 3, 6mo after treatments were 24.13±2.94, 15.13±4.93, 14.98±5.12, 15.18±3.77 and 15.54±5.07mmHg(1mmHg=0.133kPa)respectively. The IOP at every time point after treatments was significantly decreased compared with that before treatments(all P<0.05). The formation rate of functional filter bleb and the total success rate were both 83% at 6mo after treatments. The treatment was failed in 4 eyes(18%). The most common complications were filter bleb subconjunctival hemorrhage and corneal epthelium damage. There were no other severe complications during the follow-up period.

CONCLUSION:It is safe, convenient and effective to treat early non-functional blebs after Ex-PRESS glaucoma drainage device implantation by needle revision combined with subconjunctival injection of 5-FU around the filtering bleb.

Abstract:AIM: To observe the clinical effect of half-dose verteporfin photodynamic therapy(PDT)in the treatment of chronic central serous chorioretinopathy(CSCR).

METHODS: It was a retrospective case series analysis. Nineteen eyes of 14 patients with CSCR diagnosed by best corrected visual acuity(BCVA), direct ophthalmoscope, fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were enrolled. The course of the disease was ranged 6～12mo, PDT was applied with half-dose verteporfin(3mg/m²). The patients were observed to determine the anatomic and functional outcomes during 6～12mo of the follow-up. Comparisons of pre- and post-treatment BCVA and central foveal thickness(CFT)were performed using a paired t test.

RESULTS: At the last follow-up visit, the mean BCVA was 0.57±0.08, there was statistical difference compared with that before PDT(t=2.110; P<0.01). Seventeen eyes(89.5%)had improved vision, and 2 eyes(10.5%)had stable vision. The mean CFT was reduced from 368.67±32.18μm to 228.44±56.88μm with statistical significance(t=2.110; P<0.01). The results of OCT showed that subretinal fluid completely disappeared in 17 eyes(89.5%), partly absorbed in 2 eyes(10.5%)after treatment. There was no recurrence during the follow-up.

CONCLUSION: Half-dose of verteporfin PDT is effective and safe for the treatment of chronic or recurrent CSCR.

Abstract:AIM:To observe the clinical efficacy of laser photocoagulation combined with compound xueshuantong capsule on the treatment of retinal vein occlusion.

METHODS: Sixty-four patients with retinal vein occlusion were randomly divided into laser photocoagulation treatment group(control group, n=32)and laser photocoagulation combined with compound xueshuantong capsule treatment group(observation group, n=32). The visual acuity, macular thickness and clinical effective rate of the two groups were observed and compared.

RESULTS:The total clinical effective rate and the proportion of visual improvement of the observation group were significantly higher than those of the control group, and the differences between the two groups were statistically significant(P<0.05 or P<0.01); The macular thickness at 1, 3, 6mo after the treatment of the two groups were significantly lower than those before the treatment(P<0.05), and macular thickness at 1, 3, 6mo after the treatment of the observation group were significantly lower than those of the control group at the same period(P<0.05).

CONCLUSION:Laser photocoagulation combined with compound xueshuantong capsule has a good effect in treating retinal vein occlusion, which can effectively improve visual acuity, reduce macular thickness, and deserves further study.

Abstract:AIM:To observe clinical effects of endoscopic dacryocystorhinostomy combined with adjunctive mitomycin C(MMC)on the treatment of recurrent chronic dacryocystitis after lacrimal duct intubation.

METHODS:Sixty-two eyes of 62 cases with recurrent chronic dacryocystitis after lacrimal duct intubation were randomly divided into two groups: treatment group(31 cases)and control group(31 cases). Patients in the treatment group were undergone endoscopic dacrystorhinostomy combined with MMC placed on the anastomotic bone hole.Patients in the control group only received endoscopic dacryocystorhinostomy. The follow-up period arranged from 3 to 12mo.

RESULTS: At 6mo postoperative, the cure rate and effective rate of the treatment group was 90% and 97% respectively, and those of the control group were 74% and 94% respectively. The effective rate of the treatment group was higher than that of the control group significantly(Z=14.66,P<0.05).

CONCLUSION: Endoscopic dacryocystorhinostomy combined with MMC is an effective supplemental method which can prevent postoperative anastomotic cicatricial adhesion and improve the long-term outcome.

Abstract:AIM: To investigate drug toxic corneal epithelial damage due to non-standard drug application and to propose treatment principles.

METHODS: A retrospective analysis on 58 eyes of 31 patients with drug toxic keratopathy was processed. The types, the frequencies and application periods, and the clinical manifestations of keratopathy were categorized. For those diagnosed, all drops were stopped, instead, low-cornea-toxic and preservative-free drops were used. The treatment results were followed.

RESULTS: Data indicated that drug toxic keratopathy included punctate, false dendritic, diffuse keratitis and stromal infiltration. All patients presented the history of the frequent and long-term using of multiple eye drops. For all 58 eyes, the average drops type was 3.60±0.74, the average frequency and period of drop application was 12.08±2.12 times per day, and 25.58±11.41d, and the average treatment period was 29.5d. After treatment, 54 eyes(93.10%)were recovered and 4 eyes(6.90%)improved.

CONCLUSION: Drug toxic keratopathy has close relationship with the variety drug types, frequency and period of drops application. Correct diagnoses and standardized drug treatment are essential to reduce or prevent the occurrence of drug toxic keratopathy.

Abstract:AIM: To observe the changes of eye movement parameters before and after appropriate treatment for school-age myopic children, try to investigate possible mechanism and obtain the most appropriate protocol for juvenile myopia.

METHODS: After getting the parents consent, 50 school-age children(age 7～12 years old)with visual acuity <0.8 were enrolled. All the subjects existed inappropriate treatment including measuring refraction under non-cycloplegia, wearing over- or under-corrected spectacle or inappropriate spectacle parameters ect. All the subjects were treated with appropriate treatment including measuring refraction under cyclopedia, dropping raceanisodamine eye drops 1～2 drops three times per day, adjusting spectacle parameters to appropriate range, etc. Before and 6mo after appropriate treatment, eye movement parameters including positive and negative relative accommodation, amplitude of accommodation and sensitivity of accommodation were measured with the comprehensive refractometer.

RESULTS: There are statistical significance in the amplitude of accommodation, the positive relative accommodation and the sensitivity of accommodation(P<0.01)while no statistical significance in negative relative accommodation before and after appropriate treatment(P>0.01).

CONCLUSION: Appropriate treatment can save more accommodative amplitude and will benefit myopia progression.