Abstract:AIM: To evaluate the visual and anatomic outcomes of intravitreal ranibizumab injections for myopic choroidal neovascularization(mCNV)in Chinese patients.

METHODS: This study is a retrospective case. Thirty-five patients treated for mCNV were included in this study. Their eyes were treated with a single intravitreal injection of 0.5 mg ranibizumab following a pro re nata(PRN)regimen indicated by persistent or recurrent CNV. Best corrected visual acuity(BCVA), CNV findings on fundus fluorescent angiography(FFA), central retinal thickness(CRT)on optical coherence tomography(OCT), total number of treatments, and complications were evaluated.

RESULTS:The mean follow-up duration was 20mo(range 16-24mo). Twenty-eight patients(80%)were followed up for more 22mo. The mean baseline BCVA was 0.74 logarithm of the minimum angle of resolution(logMAR)\〖standard deviation(SD)0.23\〗 and improved significantly to 0.49 logMAR(SD 0.31)(P<0.001, Wilcoxon signed-rank test)after treatment. At the final months of follow-up, 21 of the 35 eyes(60%)showed an improvement of 2 lines or more in BCVA, 13 eyes(37%)remained unchanged, and 1 eye(3%)had a deterioration of 2 lines or more. Mean CRT decreased from 297 μm(SD, 72)at baseline to 228 μm(SD, 61)at the final follow-up(P<0.001, paired t-test). During follow-up, the mean number of repeat injections was 3.2(SD, 0.94; range, 1-7 injections). No drug-related complications were observed after treatment.

CONCLUSION:The long-term outcomes observed in this study suggest that intravitreal ranibizumab is safe and effective for treating mCNV.

Abstract:AIM: To evaluate the impact of postnatal dexamethasone therapy(PNS)on incidence and severity of retinopathy of prematurity(ROP)in premature infants. ROP is one of the most important causes of visual impairment in infants which can lead to blindness. The increased survival of extremely low birth weight and low birth weight(LBW)infants in recent years due to advances in neonatal care has produced a population of infants at very high risk of developing ROP. Not only there are controversies around the effect of antenatal and postnatal steroids(PNS)on the incidence of ROP in premature infants, the association of this agent and severity of ROP has not yet been assessed.

METHODS: A total of 115 neonates with birth weight less than 1500g and gestational age less than 29wk were selected from Children Hospital between April 2012 and June 2013 who met the criteria for entering this double blind control study. Patients were divided randomly into case and control groups and intravenous dexamethasone 0.25mg/kg/12h was administered from day 8 to day 14 of age for case group and the control group received no dexamethasone. Ophthalmologic examinations were started at 6^th week and followed until resolution.

RESULTS: Of the neonates with ≤1500g birth weight admitted to neonatal intensive care unit, 69%(80/115)survived. Neonates of lower gestational age(≤25wk and 26-28wk)had an increased incidence of ROP. The incidence of ROP(stage II or higher)was 8.6% among all 58 infants enrolling this study. Severe retinopathy of prematurity was detected in 2(7.4%)of 28 neonates received PNS and 3(9.7%)of 30 neonates who did not received PNS. No significant difference was observed for ROP incidence between postnatal dexamethasone receiving versus control group infants(P=0.35). Beyond that the incidence of severe ROP(stage>II)did not have significant difference between cases(7.4%)and control(9.7%)group too(P=0.36).

CONCLUSION: Our study demonstrated that there is no marked difference between neonates received post natal dexamethasone and no receiving neonates on incidence and severity of retinopathy of prematurity. Therefore, dexamethasone which was useful in treatment of chronic lung disease in preterm infants seems be safely administered without concern about increasing risk of ROP.

Abstract:AIM: To explore adult perceptions of vision screening for children in Chennai, India and the role that poverty may play in this.

METHODS:This was a four-week cross-sectional study, conducted on randomly selected individuals who attended outreach camps in low socio-economic areas in and around Chennai, India in December 2012. Individuals were approached after they had received their free vision screenings and asked to complete a short face to face semi-structured interview. Every third individual was approached and was initially asked if any children lived in their place of residence. If they responded yes, they were then asked to take part in the study.

RESULTS: A total of 120 individuals participated in the study. Of these, 38%(95%CI: 30, 47)of the participants indicated that at least one child in their residence had previously had an eye examination(group 1)and 62%(95%CI: 53, 70)of the participants responded that no child in their residence had ever had an eye examination(group 2). The median standardized poverty score, using the Simple Poverty Scorecard for India, was 61(range 19-80)and 60(range 21-93)in groups 1 and 2 respectively. There was no statistically significant difference between the poverty scores in the two groups.

CONCLUSION:We found that less than half of the participants recalled that their children had previously had an eye examination. There was no statistically significant difference in the poverty scores between participants who identified the presence of a previous eye exam and those who did not. Compared to those participants whose children had never had an eye examination, those participants whose children had, were more likely to have a favourable attitude towards a check-up eye examination for their children. This study suggests that adult perceptions of the importance of eye examinations for children do not appear to be influenced by poverty levels. Improving adult perceptions of childhood eye examinations will likely require interventions other than poverty alleviation.

Abstract:

Abstract:AIM:To investigate changes and significance of CD4⁺CD25⁺T cells and expression of FOXP3 mRNA in peripheral blood mononuclear cell(PBMC)from patients with proliferative diabetic retinopathy(PDR)and observe its clinical significance on pathogenesis of PDR.

METHODS: Flow cytometry was used to analyze the proportion of CD4⁺ CD25⁺ T cells in PBMC with PDR and normal control, the expression of FOXP3, IL-17, CTLA-4 mRNA in patients with PDR, diabetes and normal control were detected by Q-PCR. The clinical data of glycosylated hemoglobin(HbA1c), age, blood lipid, renal function and the degree of their relevance were analysed by Wilcoxon rank and inspection, Linear correlation analysis.

RESULTS:CD4⁺ T cells decreased, CD4⁺CD25⁺T with no significant difference, FOXP3 and CLAT-4 decreased in PDR, IL-17 increased in PDR patients. CD4⁺T cells associated with age, the level of CD4⁺CD25⁺T was positive correlation with the patient's serum creatinine(Cr), but had no significant with age, HbA1c, blood lipid, Cr and urea nitrogen(BUN). HbA1c, triglyceride(TG), cholesterol, low density lipoprotein(LDL)were higher than normal value in PDR patients.

CONCLUSION: CD4⁺ CD25⁺ T cells may be involved in the pathogenesis of PDR. In addition, abnormal blood lipid indicate that PDR may be associate with blood lipid level.

Abstract:AIM:To explore the expression and significance of CC chemokine receptor7(CCR7)and vascular endothelial growth factor(VEGF)in retinal endothelial cell(REC)under hypoxia.

METHODS:Rhesus choroid-retinal vascular endothelial cells(RF/6A)were cultured under normoxic and hypoxic conditions in vitro and divided into the normoxia group, the hypoxia control group(transiently transfected with the vector plasmid)and the treated group(transiently transfected with the CCR7siRNA recombinant plasmid). Plasmids were transiently transfected in RF/6A cells using Lipofectamine^TM2000(LF2000). RF/6A cells proliferation and apoptosis detected by CCK8 and flow cytometry and the protein and mRNA expression of CCR7 and VEGF were measured by Western blot and RT-PCR.

RESULTS:The cell growth rate became slower and apoptosis rate became increased in the hypoxia group than that in the normoxia group, and in the treated group than that in the normoxia and hypoxia control groups(all P<0.05). Compared with the normoxia group, there were high protein and mRNA expression of CCR7 and VEGF in the hypoxia control group, the differences had statistical significance(t_CCR7protein=3.38, t_VEGFprotein=4.75, t_CCR7mRNA=4.27, t_VEGFmRNA=5.34, all P<0.05). And there was an obvious positive correlation between the expression of CCR7 and VEGF(r_protein=0.71, r_mRNA=0.83, all P<0.05). The protein and mRNA expression of CCR7 and VEGF were obviously decreased in the treated group compared with the normoxia and hypoxia control groups(all P<0.05).

CONCLUSION: CCR7 can upregulate the expression of VEGF in REC under hypoxia. CCR7- VEGF signaling pathway may have potential function in the retinal neovascularization(RNV), and CCR7siRNA may provide an effective method for RNV.

Abstract:AIM: To study the effect of bone mesenchymal stem cells(BMSCs)and chondroitinaseABC(ChABC)on photoreceptor apoptosis in the retina of sodium iodate-induced rats.

METHODS: Forty Sprague Dawley rats(SD rats)were intraperitoneally injected with NaIO₃ (30g/L, 100mg/kg)to establish the retinal degeneration models(postnatal 28d). These rats were devided into 4 groups. Group A was not injected, group B was injected with BMSCs, group C was injected with BMSCs and ChABC, and group D was injected with phosphate buffer saline(PBS). After 28d, subretinal injection were applied. Hematoxyln-eosinstaining(HE), tunel and immunohistochemistry were performed at 21d after subretinal injection.

RESULTS: Photoreceptor number and photoreceptor apoptosis rate of B and C groups were more than those of A and D groups, and there was significant difference statistically(P<0.05). Photoreceptor number and photoreceptor apoptosis rate of group B were compared with those of group C, and there was no statistical significance between B and C groups(P>0.05). Glial fibrillary acidic protein(GFAP)was expressed by BMSCs after intraocular injection.

CONCLUSION: BMSCs and ChABC injected into subretinal space may alleviate photoreceptor apoptosis so as to protect retinal photoreceptor cells in degenerated rats.

Abstract:AIM:To study the MRG15(death factor related gene)in age-related cataract(ARC), differential expression of normal lens epithelial cells.

METHODS: Forty mature healthy female SD rats were randomly divided into study group and control group, 20 rats in each group, the study group were ovariectomized, low concentration of naphthalene long interval of administration, the establishment of perimenopausal ARC model, the control group of conventional farming. In the subtractive hybridization cloning by MRG15, and make the probe of the cDNA fragment using digoxigenin labeled. Access to the two groups of rats anterior lens capsule after slicing, and then through the differential expression in situ hybridization clear lens epithelial cells.

RESULTS: The cloned MRG15 through BamH1, EcoR1 enzyme digestion and agarose gel electrophoresis, available for 639bp long cDNA fragment. GeneBank display contrast, their homology was 99.0%. In situ hybridization, ARC patients and normal lens epithelial cells were observed in the expression of MRG15. Study group the percentage of positive cells compared with control group, showed a significant difference(P<0.05). Integral index study group and the control group compared with, was significantly difference(P<0.05).

CONCLUSION: ARC, MRG15 in normal lens epithelial cells expressed ARC, and compared with the normal expression of lens epithelial cells, which may produce inhibitory effects are associated with MRG15 transcription in human lens epithelial cells in the part of key genes, by reducing the lens epithelial cell function, make its appear aging, and the formation of cataract, clinical response to this should further study.

Abstract:AIM: To study the relationship between vasculogenic mimicry and human pterygium and to evaluate the clinical significance.

METHODS: Twenty samples of normal conjunctiva and the aggressive and quiescent period of pterygium of both 50 cases were studied under the light microscope by HE stain, Periodic acid-Schiff stain(PAS), immunohistochemistry staining with CD34, VEGF and immunohistochemistry combined with PAS stain.

RESULTS: The expression of CD34 and VEGF in pterygium was significantly higher than those of normal conjunctiva specimens(All P<0.05). The expression of CD34 and VEGF in aggressive cases was apparently higher than that in quiescent cases(All P<0.05). Vasculogenic mimicry was identified in 38 of 50 aggressivcases and 11 of 50 quiescent cases by PAS stain, with a statistically significant difference(P<0.05). Bivariate analysis showed that vasculogenic mimicry were positively correlated with aggressive cases(Spearman's correlation coefficient r=0.540>0.5, P=0.000).

CONCLIUSION: Neovascularization exists in pterygium and vascular mimicry is one of the blood supply pathways of the pterygium and play an very important role in the development of pterygium.

Abstract:AIM: To investigate pathogeny and effects of surgery on paralytic strabismus.

METHODS: A retrospective study was done in 46 patients with paralytic strabismus who underwent squint correction in our hospital from June 2010 to June 2013. Among 26 horizontal strabismus, the cases of extra rectus palsy was 16, internal rectus palsy was 10. Among all20 vertical strabismus, the cases of superior oblique palsy, superior rectus palsy, inferior rectus palsy, double elevator palsy counted for 7, 8, 2 and 3, respectively. Pathogenesis: trauma was 19 cases, followed by 10 cases that the causes could not be identified. Nine was congenital paralytic strabismus, 8 occurred after nose or brain surgery. The surgery methods included rectus muscle recession, rectus muscle resection, partial rectus muscle transposition, Jensen procedure, inferior oblique myectomy and anterior transposition of inferior oblique. Statistical software SPSS10.0 was used in chi-square test between two groups, while the situation of paralysis eye movements improved by two methods in the horizontal strabismus group was compared with t test.

RESULTS: Among all horizontal strabismus the rate of cure, improvement and inefficiency was 20(77%), 5(19%)and 1(4%), respectively. Among vertical strabismus the ratio of cure, improvement and inefficiency was 15(75%), 3(15%)and 2(10%). There was no significantly difference between the two groups(P>0.05). The movements of paralytic eyes were improved. Two procedures used in horizontal strabismus, can improve paralysis eye movements were 3.76±0.91, 3.72±0.84mm, with no significant difference(P=0.93)statistically.

CONCLUSION: Paralytic strabismus in adults had complicated conditions. Choosing different operation methods in treating paralytic strabismus according to the degree of paralysis can result in satisfactory cosmetically alignment of the eyes and modify head position and diplopia.

Abstract:AIM:To evaluate clinical effects of the apodized diffractive multifocal intraocular lens(MIOL)implantation.

METHODS: Seventy-two patients(72 eyes)with age-related cataract were divided into two groups by randomized controlled clinical trials, 32 eyes of 32 cases received the apodized diffractive MIOL, 40 eyes of 40 cases received monofocal intraocular lens(MoIOL). Three months after surgery, uncorrected distance visual acuity(UCDVA), intermediate visual acuity(IVA), near vision, correct near and far vision were observed. Visual function and quality of life questionnaire was measured.

RESULTS:Three months after surgery, the uncorrected near visual acuity(UCNVA)and IVA(40, 60, 80cm)in MIOL group were significantly higher than that in MoIOL group(P<0.05). The UCDVA, best corrected distant visual acuity(BCDVA), best corrected near visual acuity(BCNVA)and distant corrected visual acuity(DCNVA)had no statistically significant difference between two groups(P>0.05). Contrast sensitivity values had no statistically significant difference between two groups at 3mo postoperatively(P>0.05). The spectacle independence in MIOL group was significantly higher than that in MoIOL group(P<0.05)and near vision satisfaction in MIOL group was higher than that in MoIOL group(P<0.05). Compared with those adverse visual symptoms and distant vision satisfaction, there were no statistically significant difference between two groups(P>0.05).

CONCLUSION: The apodized diffractive MIOL can provide excellent full range of vision and visual quality, effectively decrease the dependence of glasses and improve the life quality after sugery.

Abstract:AIM: To detect the effects of topical antiglaucoma medication on the ocular surface structures in glaucoma patients.

METHODS: Forty-nine eyes from 35 patients treated with topical antiglaucoma medication over 3mo and 45 eyes from 45 normal subjects were collected. The antiglaucoma medication group was divided to subgroup A(single antiglaucoma medication treated group)and subgroup B(combined antiglaucoma medication treated group). The ocular surface structures were performed in all subjects, including Schirmer I test(S I t), tear film break-up time(BUT), fluorescein staining(FL), rose bengal staining(RB), conjunctival impression cytology(CIC), goblet cells density(GCD), content of tear MUC5AC.

RESULTS:The results of S I t was 11.54±5.47mm, and BUT was 11.86±3.13s, and FL and RB score was0.42±0.61 and 0.37±0.98 in normal control group, which was 8.11±4.30mm and 7.49±2.62s, and 1.15±0.87, 1.28±1.08 respectively in antiglaucoma medication group. The differences were significant between normal group and antiglaucoma medication group(t=3.395, P=0.001; t=7.363, P=0.001, t=-4.266, P=0.001; t=7.363, P=0.000); The results of S I t was 9.51±4.76mm, BUT was 8.46±1.24s, and FL and RB score was 0.91±1.03 and 0.85±1.07 in subgroup A, which was 6.34±4.05mm and 6.38±1.25s, and FL and RB score was 1.84±1.14 and 1.56±1.31 in subgroup B. The differences were significant between subgroup A and subgroup B(t=2.514, P=0.012; t=5.844, P=0.000; t=-2.992, P=0.003; t=-2.072, P=0.043). Compared with normal control group, conjunctival epithelium cells damage was observed in antiglaucoma medication group that cell volume enlarged, and cytoplasm/nucleus decreased. The score of CIC of antiglaucoma medication group was significantly increased compared with normal control group(u=6.354, P=0.000), while there was no difference between subgroup A and subgroup B(u=0.69, P=0.48). GCD of normal group and antiglaucoma medication group was(68.37±12.82)/mm² and(32.83±10.68)/mm² respectively. The difference was dramatically(t=14.610, P=0.000); GCD of subgroup A and subgroup B was(39.12±9.35)/mm² and(27.58±8.47)/mm², which was statistically different(t=4.530, P=0.001). The content of tear MUC5AC was significantly decreased in antiglaucoma medication group(13.84±6.72ng/mL)compared with normal control group(32.61±8.65ng/mL)(t=11.804, P=0.000), while the content of tear MUC5AC was also significantly decreased in subgroup B(10.67±4.58ng/mL)compared with subgroup A(20.17±5.84ng/mL)(t=6.349, P=0.000).

CONCLUSION: Topical antiglaucoma medication can decrease tear secretionand tear film stability and damage ocular surface. Combined antiglaucoma medication caused severe damage on ocular surface structures.

Abstract:AIM: To compare the corneal biomechanical changes at early stage after femtosecond laser assisted in situ keratomi(LASIK)and microkeratome LASIK according to different residual corneal stroma thickness/cornea thickness(RCST/CT).

METHODS: Ninety-four patients(187 eyes)with femtosecond LASIK(FS-IK)and 96 patients(192 eyes)with microkeratome LASIK(M-IK)were included in this study. LASIK group was divided into three groups according to the ratio of RCST/CT, which were IK-I group(RCST/CT<55%), IK-Ⅱ group(55%≤RCST/CT<60%)and IK-Ⅲ group(RCST/CT≥60%). Corneal hysteresis(CH)and corneal resistance factor(CRF)were measured by reichert ocular response analyzer(ORA)at pre-operation, postoperative 1and 3mo.

RESULTS: Compared with FS-IK and M-IK,there were no statistical difference in CH and CRF(F=0.44, F=2.56, P=0.51, P=0.11). Based on different RCST/CT, there were statistical differences in CH and CRF between group Ⅰ and group Ⅱ(F=103.03, 128.48,P<0.05), group Ⅱ and group Ⅲ(P<0.05), group Ⅰ and group Ⅲ(P<0.05). There were statistical differences in CH and CRF between pre-operation and different postoperative times(F=576.99, 1162.06, P<0.05). CH and CRF of postoperative 1mo and 3mo were significantly smaller than pre-operation(P<0.05), but there was no statistical difference between postoperative 1and 3mo(P>0.05).

CONCLUSION: The biomechanical parameters decreased at early stage after femtosecond LASIK and microkeratome LASIK, but there is no statistical difference between femtosecond LASIK and microkeratome LASIK. The less the ratio of RCST/CT, the more effect on biomechanics.

Abstract:AIM: To investigate the changes of early anterior chamber parameters after femtosecond laser in-situ keratomileusis(FS-LASIK).

METHODS:A total of 90 patients(90 eyes)in routine operation indications received FS-LASIK operation from January to June 2014 in our hospital were collected, including 47 males(47 eyes), 43 females(43 eyes), aged 18-33 years old(mean age 22.38±3.96 years). According to the diopter, the patients were divided into three groups: 30 cases(30 eyes)were in mild myopia group(group A)with diopter ≤3D; 30 cases(30 eyes)were in moderate myopia group(group B)with diopter >3D and ≤6D; 30 cases(30 eyes)were in high myopia group(group C)with diopter >6D. Pentacam measurements were used to measure the anterior chamber parameters including the changes of anterior chamber depth(ACD), anterior chamber volume(ACV), anterior chamber angle(ACA)before surgery and at 1, 3mo after surgery respectively.

RESULTS:All surgical procedures were performed successfully without complications. Compared with the value of ACD and ACV at pre-operation and 1, 3mo post-operation among groups A, B, C, there was statistically significant difference(P<0.05). In group A, there was statistically significant difference between the values of ACD, ACV at 1, 3mo post-operation(P<0.05), while in groups B, C, there was no statistically significant difference(P>0.05). However, in groups A, B and C, the value of ACA had no statistically significant difference(P>0.05). Diopter had no obvious relevance with the changes of ACD, ACV, ACA values.

CONCLUSION:The early changes of anterior chamber parameters after FS-LASIK, including that ACD become shallow, ACV become smaller, but there was no obvious effect on the peripheral anterior chamber angle. There will be a further instruction for those people who want to perform intraocular surgery after ocular refractive surgery.

Abstract:AIM:To investigate the retinal thickness change of high myopia amblyopic children, so as to discuss the relationships between the retinal thickness of central fovea of macula and the factors of axis oculi and age.

METHODS:Thirty-nine children(65 eyes)with the average age of(9.91±3.41)years were recruited. All eyes were ruled out the pathological changes of fundus diseases and front section. After atropine optometry, they were divided into three groups: high myopia amblyopic group(24 eyes), high myopia group(19 eyes)and normal group(22 eyes). Retinal scans were obtained for all eyes using Heidelberg optical coherence tomography(OCT). Subfoveal macular thickness, retinal thickness at 0.5mm, 1.0mm, 1.5mm, 2.0mm, 2.5mm, 3.0mm superior(S, 12:00 position), temporal(T, 9:00 position), inferior(I, 6:00 position)and nasal(N, 3:00 position)from the fovea were measured and axial length was also surveyed by A-ultrasound. Statistical analyses were performed to evaluate retinal thickness at each location and to correlate subfoveal macular thickness with axial length and age.

RESULTS:The average subfoveal macular thinkness of the high myopia amblyopic group was thinner than high myopia group but thicker than normal group. There was no statistical difference between three groups(P>0.05). Retinal thickness inferior to the fovea at 0.5mm temporal and superior to the fovea in the high myopia amblyopic group at 1.0mm temporal were both thinner than normal group which had statistically significant(P<0.05). Retinal thickness on nasal, superior, temporal, and inferior at 1.5mm, 2.0mm, 2.5mm, 3.0mm from the fovea were measured, high myopia amblyopic group were the thinnest in the three groups, and there was statistically significant between three groups(P<0.05). There was no correlation between the average subfoveal macular thickness and axial length, age in high myopia amblyopic group.

CONCLUSION:There are significant abnormalities of macula retinal structure in high myopia amblyopic children.

Abstract:To improve the effect of glaucoma filtration operation in reducing intraocular pressure(IOP), it's important to prevent and inhibit fibrotic scar formation during and after operation. This paper focuses on the current and future possible means for modulation of wound healing after glaucoma filtration surgery, mainly including series of medications(antimetabolites, anti-inflammation drugs, antigrowth factor drugs, drugs acting on cell signal pathways, etc.), new drug delivery system and other technologies. This article also discusses the future orientation in this field.

Abstract:Corneal neovascularization(CNV)is one of the most important causes that affecting corneal transparency, and it is a high risk factor of allogeneic corneal graft rejection. It has become a research focus for the regulation of CNV. microRNAs are a class of endogenous non-protein-coding micromolecule RNAs which play a critical role in regulating a series of life process. Researches in recent years show a close correlation between microRNA and CNV. In this article we reviewed the recent advances in these researches.

Abstract:α-crystallin is the predominant structural protein in the lens. It is a member of small heat shock proteins(sHSPs)which has the common functions of HSPs. It also has anti-apoptotic activity etc. Recently, it has been proved to combine with the cellular membrane of retinal ganglion cells(RGCs)to enhance the survival of RGCs and the regeneration of axons, thereby partly restore visual function. But we haven't come to a unified conclusion of the mechanism. This review is focused on structure and functions of α-crystallin, the protection function and mechanism of α-crystallin towards RGCs after the optic nerve injury.

Abstract:Application of capsular tension ring(CTR)in phacoemulsification has become a common method to increase the stability of the capsular bag. CTR can effectively reduce the posterior capsular opacification(PCO), prevent intraocular lens(IOL)decentration and tilt, not cause IOL degree deviation and aberration increase. In this review, we summarized the development overview of CTR in phacoemulsification.

Abstract:Vascular endothelial growth factor is indispensable inducing factor in retinalangiogenesis. After the retinal neovascularization of proliferative diabetic retinopathy(PDR)patients, it can cause fibrovascular membrane formation, epiretinal membrane fibrosis increased, resulting in traction retinal detachment with further aggravate the condition. The recent research suggests that cytokines promote fibroblast proliferation, movement, adhesion, and secretion of extracellular matrix functions in the diabetic state of the environment changes to profibrogenic state, resulting in the accumulation and fibrosis of extracellular matrix. This paper reviewed the status quo of the correlation between vascular endothelial growth factor and fibrosis-related cytokine.

Abstract:As a member of the stem cells family,mesenchymal stem cells(MSCs)have been proved to be effective on the repair of tissue injury. Although the specific mechanism is still unclear, MSCs do have a promising future in retinal disease therapy. The results of the current research are diverse. We still have an urgent and long way to explore the details of MSCs. So it's significant for further understanding of MSCs to analyze the possible mechanism and influencing factors.

Abstract:Mesenchymal stem cells(MSCs)are a population of multipotent stem cells with various neurotrophins from bone marrow which are widely used in tissue, cell repair and alternative research. Recently, some researches have shown that MSCs could enhance the viability of neurons under a pathological circumstance by secreting some neurotrophins. So the neuroprotection of MSCs can provide a new method of the treatment on retinopathy that it possible to promote cells survial and functional recovery. Here we make a brief review on the secretory function of neurotrophin and neuroprotective effects of MSCs on retinal cells and its application in the treatment of retinal disease.

Abstract:Electroretinogram(ERG)is an objective examination in evaluating retinal function, which is also suitable to evaluate retinal function of multiple ophthalmic diseases. In recent years, studies have found that ERG can find functional changes prior to morphological changes of fundus examination in early diabetics, which provides a new way for researches of pathological mechanism, early diagnosis and prognosis evaluation for diabetic retinopathy, and then also provides a new therapy for diabetic retinopathy. In this paper, using ERG in the diagnosis of early diabetic retinopathy was reviewed.

Abstract:Obstructive sleep apnea hypopnea syndrome(OSAHS)is a disorder characterized by repeated episodes of collapse of the upper airway during sleep,and ultimately lead to the repeated cycle of night intermittent hypoxemia. Recently,an association of OSAHS and diabetic retinopathy(DR)has been reported. This paper reviewed the correlation between OSAHS and DR from clinical relationship, the relevant examinations and its possible mechanism of action.

Abstract:AIM:To evaluate the effect and safety of intrachamberal triamcinolone acetonide(TA)injection during cataract surgery on controlling postoperative inflammation and macular edema on diabetic patients.

METHODS: Three hundred patients(300 eyes)with type 2 diabetes who scheduled for cataract surgery were randomly divided into three groups: group A: 0.3% tobramycin/0.1% dexamethasone eye drops and pranoprofen eye drops treatment for 1mo postoperatively; group B: intrachamberal injection of TA 1mg after cataract surgery, and 0.5% levofloxacin eye drops treatment for one month postoperatively; group C: intrachamberal injection of TA 2mg after cataract surgery, and 0.5% levofloxacin eye drops treatment for one month postoperatively. The main measurements included visual acuity, intraocular pressure(IOP), corneal endothelial cell density, anterior chamber inflammation and the thickness of macula of the three groups.

RESULTS: All cataract surgeries were done successfully by a single surgeon. The best corrected vision of group B and C was better than that of group A 1d, 1wk and 1mo postoperatively(P<0.05). The inflammation of anterior chamber of group B and C was milder than that of group A 1d and 1wk postoperatively(P<0.05). The average IOP of group C 1d postoperatively was higher than that of group A(P<0.05). There was no significant difference between group B and group C on the best corrected vision, anterior chamber inflammation and IOP at any time point. No significant change in the macular thickness was found in patients of group B and C before and after cataract surgery, while there was thicker macula in patients of group A 3wk and 1mo postoperatively when comparing with that of the baseline(P<0.05). There was no significant difference among three groups on corneal endothelial cell density at any time point.

CONCLUSION: Intrachamberal TA injection during phacoemulsification can effectively control postoperative inflammation, reduce the macular edema and accelerate the recovery of visual acuity. Intrachamberal TA 1mg has good effect and safety.

Abstract:AIM: To observe the characteristic of choroidal circulation in diabetics and investigate its changes as well as the relationship between it and the development and progression of diabetic retinopathy(DR).

METHODS: All 45 diabetics were divided into 3 groups: no diabetic retinopathy(NDR), nonproliferative diabetic retinopathy(NPDR), proliferative diabetic retinopathy(PDR); and 20 health people were selected to be control group. All subjects were examined by FFA and indocyaine green angiography(ICGA)(Heidelberg retina tomography, Germany)at the same time. The characteristics of angiograph results were comparatively observed and the feature of diabetic choroidapathy were analyzed.

RESULTS:(1)There were no significant differences between DR groups and control group in the central retinal artery(CRA)filling time. There were significant decreases of the choroidal artery filling time in DR groups, compared to the control group(P<0.05).(2)In all DR groups, the more serious DR, the bigger proportion of reverse filling.(3)With more serious DR, the ratio increased gradually in early phase of choroidal filling deficiency angiograph and in the late phase of spot hyperfluorescence.

CONCLUSION: ICGA may be a useful adjunct to FFA in the evaluation of choroidal vascular changes in DR. The research provides that the diabetic choroidal circulation was abnormal before the occurrence of DR, which fully proved the presence of diabetic choroidopathy.

Abstract:AIM:To analyze the association between the macular thickness and emmetropic, low myopic, moderate myopic and highly myopic eyes.

METHODS: The 276 teenagers(276 eyes)between 18～28 years treated in our hospital from January, 2013 to May, 2014 were selected, whose corrective visual acuity was ≥1.0 and intraocular preasure was ≤21mmHg and who were willing to participate in this research. Forty-nine emmetropic, 72 low myopic, 104 moderate myopic and 51 highly myopic eyes were measured by optical coherence tomography(OCT)to detect the central subfield thickness, bitamporal, superior, lateral and inferior region thickness of inner and outer region, average thickness of retinal macula, foveal thickness and retinal volume. The thickness of different parts of macula lutea was measured and statistically compared among emmetropic, low myopic, moderate myopic and highly myopic eyes.

RESULTS: The central subfield thickness of emmetropic, low myopic, moderate myopic and highly myopic eyes were(225.38±20.97),(230.97±19.15),(227.01±16.92),(231.91±18.97)μm. The average thickness of retinal macula,of emmetropic, low myopic, moderate myopic and highly myopic eyes were(280.92±12.71),(278.15±11.90),(270.05±12.07),(267.93±11.08)μm. There were no significant differences of center thickness(F=1.253, P=0.291)and central subfield thickness(F=1.034, P=0.378)between emmetropic, low myopic, moderate myopic and highly myopic eyes. The macular thickness of inner and outer region in moderate myopic eyes was significantly less than that in emmetropic eyes, and there was significant difference(P<0.05). Comparison between low myopic, moderate myopic and highly myopic eyes was carried out and macular thickness of all regions of inner and outer region in moderate myopic group was significantly increased, and there was significant difference(P<0.05). There was no significant difference when compared with the macular thickness of inner and outer region of the highly myopic group(P>0.05).

CONCLUSION: In low myopic eyes of teenagers, the center macular thickness do not become thinner. However, the macular thickness of inner and outer region is thinner than that of emmetropic eyes. Furthermore, with the increase of the degree of the myopia, the amount of macular thinner gradually decreases from outer region to inner region.

Abstract:AIM: To measure the retinal function in retinal vein occlusion(RVO)combined with macular edemain patients treated with ranibizumab by using multifocal ERG(mfERG), and to analyze and evaluate the effects of ranibizumab treatment on macular edema.

METHODS:A retrospective, self-control method was used. Fifteen eyes of 15 patients who were clinically diagnosed as RVO with macular edema were included in this study. All patients were routinely corrected visual acuity, slit lamp microscopes, intraocular pressure, color fundus photography, FFA and OCT, the central 10° vision field, mfERG examination, corrected visual acuity using ETDRS visual acuity table. All patients were treated with intravitreal injection of ranibizumab 0.05mL/0.5mg and follow-up 3～12mo, including the monthly review once. The best corrected visual acuity, intraocular pressure, fundus, central macular thickness, central 10° vision field, the change of mfERG of these patients were observed. According to the referral, the repeated injection treatment was decided. The end of the follow-up was the time point to determine the efficacy, and the changes of vision field and mfERG in patients were recorded and analyzed.

RESULTS: The central visual field mean defect(MD)was significantly decreased at last follow-up(t=4.01, P<0.01). The 1^st and 2^nd ring N1 wave latency and the former P1 wave latency were significantly reduced(t=13.65, 16.31, P<0.01). The density values of P1 wave from treatment response in 1^st ring were significantly increased(t=7.78, P<0.01).

CONCLUSION: Intravitreal injection of ranibizumab treatment of macular edema secondary to venous occlusion can give a better prognosis and improve the sensitivity of patients' macular. The method of mfERG can accurately and objectively reflect the retinal function changes in patients with macular edema and could be potentially used in clinical.

Abstract:AIM: To investigate the correlation of retinal vein occlusion(RVO)with blood lipids and carotid artery changes.

METHODS: Forty cases(40 eyes)with RVO who presented to Eye Hospital of Xinxiang Medical University between May 2013 and April 2014 were selected as the research objects. Proceeded blood lipids and color doppler ultrasonography examination, including total cholesterol(TC), triglycerides(TG), high-density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), common carotid artery intima-media thickness, carotid plaques, internal carotid artery blood flow mechanics parameters were detected. Thirty eyes(30 cases)were enrolled as control underwent above examinations.

RESULTS: TC, TG, LDL-C of RVO group was obviously higher than those of the control group(P<0.05), while HDL-C level was obviously lower than that of the control group(P<0.05). Incidence of carotid artery plaque formation in RVO group was obviously higher than that in the control group. Intima-media thickness(IMT)of common carotid artery was obviously increased in RVO group(P<0.05). Both peak systolic velocity(PSV)and end diastolic velocity(EDV)of internal carotid artery reduced(P<0.05), and Resistance index(RI)increased(P<0.05). The eyes of the sick side and the contralateral carotid artery measured value had no statistical difference(P>0.05). There were also no statistical difference between ipsilateral and contralateral carotid artery measured value of control group(P>0.05).There were no differences in age, sex between RVO group and control group(P>0.05).

CONCLUSION: Lipid metabolism disorder, carotid artery changes is closely related to the pathogenesis of RVO.

Abstract:AIM:To explore the correlation of center retinal thickness and axial length in non-proliferative diabetic retinopathy(DR).

METHODS:A total of 80 cases(155 eyes)of non-proliferative DR patients were divided into three groups according to the axial length, 22～24mm of 27 cases(51 eyes)were normal group, 24～26mm of 28 cases(55 eyes)were long axis group, > 26mm of 25 cases(49 eyes)were super long axis group. The center retinal thickness and ocular axial length of three groups were measured and the correlation of center retinal thickness and axial length were analyzed.

RESULTS:Among the inner ring and outer ring, the center retinal thickness of upper and lower, bitamporal and nasal side of super long axis group was thicker than that in normal group, with statistically significant difference(P<0.05); Among the inner ring and outer ring, the center retinal thickness of upper and lower, bitamporal and nasal side of super long axis group was thicker than that in long axis group, with statistically significant difference(P<0.05); The DR central macular of retinal thickness was no correlation of the axial length(P>0.05), but retinal thickness get thinning with increased of axial length on the inner ring and outer ring area, showed a negative correlation(r_{inner ring} =-0.63,r_{outer ring}=-0.67, P<0.05).

CONCLUSION:Center retinal thickness and ocular axial length in non-proliferative DR patients, and center retinal thickness of super long axis patients are thinning obviously.

Abstract:AIM: To study the effect of Qi Ming granule intervention on retinal function in the patients with simplex diabetic retinopathy.

METHODS: Eighty cases of simple diabetic retinopathy patients in our hospital from May, 2012 to May, 2014 were randomly divided into two groups, and each group had 40 cases. The control group was received conventional treatment combined with compound Xueshuantong capsule. The observation group was given conventional treatment combined with Qi Ming granule treatment.

RESULTS: The total efficiency(95%)of the observation group was higher than that(80%)of the control group, and there was statistically significant difference(P<0.05). After treatment, visual field mean sensitivity of the observation group was higher than that of the control group, and there was statistically significant difference(P<0.01). After treatment, patients with O₁ and O₃ latency, the observation group was compared with the control group, and there was statistically significant difference(P<0.05). After treatment, patients with O₁, O₃, and O₄ amplitude, the observation group was compared with the control group, and there was statistically significant difference(P<0.01). After treatment, fibrinogen and blood viscosity of low shear, plasma viscosity, and whole blood viscosity of the observation group were lower than those in the control group, and there were statistically significant differences(P<0.01). After treatment, total cholesterol and low density lipoprotein cholesterol of the observation group was less than those in the control group, and there were statistically significant differences(P<0.05). After treatment, the patients in the observation group serum insulin-like growth factor-1 and vascular endothelial growth factor serum insulin levels were lower than those of the control group of patients, and there were statistically significant differences(P<0.01).

CONCLUSION: Qi Ming granule can delay the progress of the simplex diabetic retinopathy, and it has a good effect on the treatment of early diabetic retinopathy and can improve the function of retina.

Abstract:AIM: To compare the accuracy of SRK-T, SRK-Ⅱ, Haigis and LSW1 used for intraocular lens(IOL)power calculations in patients with high axial myopia undergoing cataract surgery.

METHODS: A retrospective comparative study was carried out on 97 eyes of 72 patients with axial length(AL)>26mm, who were underwent phacoemulsification with IOL implantation. Preoperative AL was measured by the IOL master, postoperative refractive errors 1mo after surgery were measured by automatic refracto-keratometry(Nidek). IOL power was calculated by SKR-II, SRK-T, Haigis and a new formula developed by the author: LSW1 formula, Power(P)= P₁+P₀, P₁=(2xP_SRK-T+P_SRK-II)÷ 3; when 101≤ 15D, P₀=0.5D; when 51≤10D, P₀=1.0D; when 01≤5D, P₀=1.5D; when P₁≤0D, P₀=3D. According to the results of postoperative refraction calculated the theoretical IOL degree(IOL theory)that could achieve emmetropia. The difference between the IOL formula from four formulas and IOL theory was IOL predictive error(PE). Then IOL PE was converted into refractive PE and absolute prediction error(AE)of each formula. The AE and PE were also analyzed by SPSS 11.0 software.

RESULTS:(1)Among all the patients selected in this study, the average age was 63.25±9.65 years(41～82 years). Average K₁=43.97±1.75, average K₂=45.14±1.98, the average central anterior chamber depth(ACD)3.59±0.38mm, average AL measured by IOL master was 28.67±2.00(26.07～33.98)mm. The average IOL diopter was 8.06±4.33(-3～-14.5)D, the chosen IOL diopter was between the results measured by SRK-T and SRK-Ⅱ formulas.(2)Refractive PE values may be reacted refractive predictable trends. The average PE of LSW1 formula, SRK-T, SRK-Ⅱ, and Haigis were -0.60±0.66D, 0.82±0.92D, -0.52±0.84D, 0.55±0.74D, and the AE of these four formulas were 0.74±0.5D, 0.94±0.79D, 0.81±0.55D, 0.73±0.55D, respectively. The proportion of hyperopia in these four formulas were LSW1 14.4%(14/97), SRK-T 82.5%(80/97), SRK-Ⅱ 20.6%(20/97), Haigis 79.4%(77/97).

CONCLUSION: The PE of Haigis formula is the smallest among all the four formulas, followed by LSW1 formula, and SRK-Ⅱ formula, and SRK-T formula. LSW1 formula and SRK-Ⅱ formula indicate a slight tendency for myopia shift; while Haigis formula and SRK-T formula indicate a tendency for hyperopic shift. SRK-T formula has a larger tendency for hyperopic shift, and cannot provide accurate IOL power calculations in cataract patients with high AL. LSW1 formula has the smallest variability and is the most suitable formula for cataract patients with high AL.

Abstract:AIM: To investigate the thicknesses change of macula central fovea(MFT)and retinal nerve fiber layer(RNFL)in children with ametropic amblyopia and normal children.

METHODS: The medical records of 56 children with ametropic amblyopia and 56 normal children in our hospital during the same period were retrospectively analyzed. Optical coherence tomography(OCT)was used to measure the MFT and RNFL. The MFT and RNFL change in two groups were statistically evaluated.

RESULTS: The sex, age and axial length were no significant difference between amblyopia group and control group(P>0.05). The MFT in amblyopia group and control group were 135.15±15.15μm, 136.14±14.26μm respectively(P>0.05). The RNFL in amblyopia group and control group were 117.02±8.97μm, 110.43±7.94μm respectively, and there was significant difference(P<0.05). There was negative correlation between RNFL and axial length in control group(r=-0.36, P<0.05), but there was no significant correlation in amblyopiagroup(r=0.11, P>0.05).

CONCLUSION: There are no significant changes in MFT between children with ametropic amblyopia and normal children, but RNFL is thicker in amblyopia group than that in control group, and there is no correlation with axial length.

Abstract:AIM: To observe the clinical effect of houttuynia cordata eyedrops combined with basic fibroblast growth factor(bFGF)eyedrops in treating dry eye after keratorefractive surgery.

METHODS: Respectively, 117 patients(204 eyes)were randomly assigned to treatment group(61 patients, 113 eyes)andthe control group(56 patients, 91 eyes). In control group, the eyes were used bFGF eyedrops four times a day, one drop at a time, and the treatment group was used bFGF eyedrops and houttuynia cordata eyedrops. After 2wk and 4wk of treatment, clinic symptom, Shirmer Ⅰ test(SⅠt), break-up time of tear film(BUT)and fluorescence staining were recorded respectively.

RESULTS: After 2wk and 4wk of observation, the clinic symptom of two groups was both improved. SⅠt, BUT and fluorescence staining scores in the treatment group were significantly better than those in control group(P<0.05). After 4wk, the total effective rate of treatment group was 98%, while that in the control group was 90%, there was significant difference between the two groups(P=0.011).

CONCLUSION: Houttuynia cordata eyedrops can improve the effect of bFGF eyedrops in treating dry eye after keratorefractive surgery.

Abstract:AIM: To investigate the effects of a cold patch on postoperative pain and other relevant reactions to transepithelial photorefractive keratectomy.

METHODS: In this prospective, randomized controlled study, forty patients(80 eyes)scheduled to undergo transepithelial photorefractive keratectomy for myopia or myopic astigmatism were randomly and equally divided to be treated with iced balanced salt solution during the surgery(washing group, 20 cases, 40 eyes)or to wear a postoperative cold compress for 24h(cold compress group, 20 cases, 40 eyes). The main outcomes were visual analogue pain score 8, 16, 24h after surgery, postoperative eyelid edema, conjunctival hyperemia, epithelial healing time, Haze, and postoperative best-corrected visual acuity.

RESULTS: Demographic data and the pain scores during surgery were similar between the two groups. The mean postoperative pain scores of patients in the cold compress group at 8, 16, and 24h were significantly lower than that of the washing group. Scores for postoperative eyelid edema and conjunctival hyperemia in the cold compress group were also lower than in the washing group. Patients in the cold compress group applied fewer painkillers. The epithelium healing time, Haze, and early recovery of visual acuity were similar between the two groups.

CONCLUSION: Wearing a cold eye shield after transepithelial photorefractive keratectomy can effectively relieve pain and inflammation and reduce the consumption of painkillers.

Abstract:AIM:To provide the basis for the scientifically establishment of the health management model and the specifically therapy through investigation and analysis of the correlation between life quality and health in patients with low vision in Shayibake, Urumqi city.

METHODS: Bilateral low vision patients were recruited in 3 400 persons in twelve communities of Shayibake with the investigation of low vision and life quality by random sampling method. Then they were investigated with the questionnaire and eye examination.

RESULTS: The actual subjects were 3 091 cases, the diagnosis of low vision population wee 220 patients in which 200 cases completed the questionnaire(accounting for 6.47%). The main leading causes were cataract(92 patients, accounting for 46%), ocular fundus disease(37 patients, accounting for 18.5%), and glaucoma(28 patients, accounting for 14%). As the general health: the incidence of health patients(98 patients)was 49%, patients with hypertension(37 patients)was 18.5%, patients with diabetes(28 patients)was 14%, patients with cardiovascular and cerebrovascular diseases(25 patients)was 12.5%. In this study, there were statistical significance between the health group, hypertension group, diabetes group, cardiovascular and cerebrovascular diseases group and the other groups with variance analysis(F=4.15, P=0.003). But there were no statistical significance among the other groups. Furthermore it was shown that the value of QOL of patients with low vision were age(F=9.81, P=0.000)and degree of education(F=28.43, P=0.000)with statistical significance. But nation(t=0.12, P=0.901)and gender(t=1.64, P=0.102)with no statistical significance.

CONCLUSION:The value of QOL of patients with low vision is declined significantly with the effect of age and and degree of education. While there are no significant difference among the health group and hypertension group, diabetes group, cardiovascular and cerebrovascular diseases group.

Abstract:Currently, refresher doctors' training is an important form of continuing medical education in our country, effectively promoting and improving the clinical ability and the service level of practitioners in basic-level medical organization. We combine ophthalmic professional features with refresher doctors' training in practice to explore ophthalmic continuing clinical training specifications. Training on the current status and new changes has been analyzed in order to further improve the training quality. The competent administrative departments and clinical teaching hospital should make full use of its advantages to institutionalize, specialize and standardize the training. We suggest linking the continuing clinical training with job promotion; strengthen core clinical ability and being strict with appraisal system so that after the training the trainees can spread standardized guidelines and technology, alleviating the current medical demand and the difficulties in the reform.

Abstract:AIM:To discuss mathematic relationship with academic degree of intraocular lens in aphakia.

METHODS: Based on geometrical optics method, Gullstrand exact model eye(No.1)and standard intraocular lens model eye, academic degree of intraocular lens by the mathematic relationship with corneal anterior curvature radius(r₁)were deduced, and corneal posterior curvature radius(r₂), corneal thickness(T), ocular visual axis(L)and effective lens position(ELP)in aphakia were analyzed.

RESULTS: The theoretical value of intraocular lens(IOL)was calculated by individual corneal data of numeration that academic degree of intraocular lens in aphakia.

CONCLUSION: Implanted correct IOL in aphakia, all kinds of which with refractive error can be rectified and come to correlation emmetropia.

Abstract:AIM: To investigate clinical therapeutic effect and safety of small incision extracapsular cataract extraction combined with intraocular lens implantation in blindness prevention and treatment.

METHODS: Clinical data of 425 patients with cataract(425 eyes)were analyzed retrospectively, who received small incision extracapsular cataract extraction combined with intraocular lens implantation in the No.413 Hospital of Chinese PLA, with the help from “handicapped rehabilitation engineering in Dinghai District of Zhoushan City” from September 2013 to August 2014. Visual acuity before and after operation, average corneal curvature, corneal astigmatism and intraoperative and postoperative complications were compared statistically and analyzed emphatically.

RESULTS: In all of the 425 patients with cataract(425 eyes), the preoperative best corrected visual acuity of 99 patients were less than 0.05, and the other 326 patients were 0.05 to 0.3. Classification of lens nucleus hardness: level Ⅲ, 63 cases; level Ⅳ, 257 cases; and level Ⅴ, 105 cases. The preoperative average corneal curvature and corneal astigmatism of all patients were 44.6±1.52D and 1.35±0.96D. All the 425 patients underwent small incision extracapsular cataract extraction combined with intraocular lens implantation. Postoperative follow-up of 3mo results: the best corrected visual acuity: 5 cases were less than 0.05(blindness-free rate 98.8%); 8 cases were 0.05 to <0.3(handicap-overcome rate 96.9%); 42 cases were between 0.3 to <0.5; 127 cases between 0.5 to 0.8 and 243 cases were ≥0.8. Postoperative average corneal curvature and cornea astigmatism were 44.5±1.42D and 1.47±1.00D respectively. There were no statistically significant difference compared with preoperative condition. No severe complications such as infectious endophthalmitis or retinal detachment occurred, except 4 patients(0.9%)with posterior capsular rupture and 3 patients(0.7%)with Descemet's membrane detachment during operation; and 18 patients(4.2%)with transient corneal edema and 4 patients(0.9%)with hyphema after operation.

CONCLUSION: It is effective and safe to apply small incisionextracapsular cataract extraction combined with intraocular lens implantation in blindness prevention and treatment, and it gives excellent visual rehabilitation to cataract patients. Especially in those areas and hospitals having no condition of phacoemulsification, it's a safe and effective alternative when carrying out the program of blindness prevention and treatment.

Abstract:ATM: To analyze bacterial spectrum and drug sensitivity in conjunctival sac of cataract patients of Kazak.

METHODS:A total of 538 cases of conjunctival sac secretion in cataract patients of Kazak were collected. The samples were cultured and their sensibilities to antibiotics were tested.

RESULTS: The bacterial culture was positive in 214 cases. The positive rate was 39.8%. The variety of pathogenic bacteria were mainly made up of gram positive cocci(88.3%), and most of them were Staphylococcus epidermidis(66.4%), followed by Micrococcus(9.8%). Sex had no effect on conjunctival bacteria rate in the cataract patients of Kazak, while age, place of residence had an effect on camier rate. The camier rate of conjunctival bacteria was significantly higher in people over 60 years old than that in people with age between 40 to 59 years old. And the people from city had a significant lower bacteria positive rate than those from countryside and pastoral. Most of grams were sensitive to Vancomycin, Teicoplanin, Rifampicin, Duly cloth mildew mutual and Amikacin, the tolerance was less than 20%, and they usually had higher tolerance to Penicillin, Erythromycin, Tetracycline and Chloramphenicol(>70%).

CONCLUSION: Gram positivecocci is the most common bacteria in conjunctival sac in cataract patients of Kazak. Staphylococcus epidermidis was most common, followed by Micrococcus. The germ-carrying rate of conjunctival SAC in Kazakh population is associated with the patient's age and area of residence. The clinical use of antibacterial drugs should be strictly grasp the indications, to reduce the incidence of bacterial resistance.

Abstract:AIM: To investigate the distribution and related factors of corneal spherical aberration in the age-related cataract patients, and to provide a scientific basis for the application of aspheric intraocular lens(IOL)in cataract surgery patients.

METHODS: Retrospective study of 509 age-related cataract patients of 610 eyes in our hospital. Corneal spherical aberration, corneal curvature, corneal astigmatism and corneal Q-value were examined by iTrace visual function analysis. Statistical software SPSS16.0 was used to analyze statistically.

RESULTS: The range of corneal spherical aberration was 0～1.800μm. The mean coefficient of corneal spherical aberration was 0.266±0.010μm. Corneal spherical aberration was no significantly correlation with age, corneal curvature, corneal astigmatism(r=0.71, 0.56, 0.93, P>0.05). There was positive correlation between corneal spherical aberration and Q-value(r=0.086, P=0.03).

CONCLUSION: Corneal spherical aberration varied greatly among age-related cataract patients. The choice of asphericity intraocular lens should be a matter of personal choice.

Abstract:AIM: To compared the efficacy and complications of the Ex-PRESS glaucoma filtration device and trabeculectomy in neovascular glaucoma(NVG).

METHODS: This prospective study comprised 34 eyes of 34 patients who suffered from NVG, excluding patients with shallow anterior chamber. All patients were assigned to groups A and B according the different therapy. Group A(15 eyes)was treated with Ex-PRESS glaucoma filtration device implantation. Group B(19 eyes)underwent a trabeculectomy combined with mitomycin C. All the patients were followed up to 1a. The results of best-corrected visual acuity(BCVA), intraocular pressure(IOP), the combination of IOP lowering medications, complications were recorded statistically analyzed preoperative and 1d, 1, 4wk, 6 and 12mo after operation.

RESULTS: Mean IOP decreased significantly frompreoperative values in both groups(P=0.01). The both group had similar IOP values changes after 1, 4wk, 6, 12mo, and there were no significant difference in statistics(P=0.451). There was no significant difference in BCVA changes after operation in both groups(P=0.832). Success rate was 66.7% and 63.1% at 1a after Ex-PRESS glaucoma filtration device and trabeculectomy, respectively. Anterior chamber bleeding occurred to 8 cases after trabeculectomy in group B and to 3 cases with Ex-PRESS glaucoma filtration device implantation in group A. Choroidal detachment occurred to 3 cases in group A and 6 cases in group B. No other ocular or systemic adverse events were found during the follow-up duration.

CONCLUSION: In the short-term, Ex-PRESS glaucoma filtration device implantation has the advantages of simpleness, safety, minimally invasive, short learning curve for neovascular glaucoma, which provides us an available strategy to conquer NVG by simply operation and less suffering.

Abstract:AIM: To investigate the safety and effectiveness of semiconductor laser transscleral cyclophotocoagulation(Tscpc)on refractory glaucomatous.

METHODS: A retrospective review of 33 patients(33 eyes)whose eyes were diagnosed as refractory glaucomatous from March 2012 to March 2013 were treated with Tscpc(energy 1 000～3 000mW, time 2 000～3 000ms, range 270°～360°, count 20～40). Ocular symptoms, visual acuity, and intraocular pressure(IOP), ocular protomerite and complications were observed after Tscpc. Patients were followed up 6mo.

RESULTS: The pain sense of 32 patients(97%)disappeared or remarkably relieved at the final follow up. Mean pre-operative IOP was 50.26±9.37mmHg, which was significantly different from the final follow-up 6mo mean IOP 18.38±8.73mmHg(P<0.05). At three month postoperative, IOP of 2 cases(6%)was rise, and those patients were retreated with Tscpc. Complications included inflammation in anterior chamber reaction in 9 cases(27%), hyphema 5 cases(15%), conjunctival hemorrhage 2 cases(6%). Bulbar conjunctival congestion and edema 12 cases(36%), and atrophy of eyeball 1 case(3%).

CONCLUSION: Semiconductor laser transscleral cyclophotocoagulation is a simple, safe and effective method in the treatment of refractory glaucoma.

Abstract:AIM: To study the clinical effect and influence of using mitomycin C for the treatment of normal tension glaucoma in deep sclerectomy.

METHODS: Sixty cases(60 eyes)in our treated patients with normal-tension glaucoma from December, 2011 to December, 2012 were refered to all ineffective medication or refusing drug treatment. All patients were randomly divided into two groups. Each group had 30 cases(30 eyes). Thirty cases of patients with deep sclerectomy were treated as control group, and another 30 patients were used mitomycin C treatment as the observation group on the basis of the above.

RESULTS: The average visual acuity of the patients of observation group after operation was significantly improved better than that of the control group(P<0.05). Functional filtering bleb formation and anterior chamber formation proportion of the patients of the observation group were higher than those of control group(P<0.05). After 3mo, postoperative vision field was narrowed in 1 eye(3%)of observation group and 4 eyes(17%)in control group, with statistical significance(P<0.05). After 3mo, 3 eyes' vision field of observation group(10%)became narrow, and 8 eyes(27%)in the control group(P<0.05). The postoperative Long-term recurrence rate of observation group was 7%, obviously lower than that of control group(17%)(P<0.05). The postoperative recurrence rate of the observation group after follow-up of 1a was only 3% and significantly lower than 13% of the control group(P<0.05).

CONCLUSION: Patients with normal tension glaucoma are given deep sclerectomy, combined with mitomycin C for treatment, and the effect is obvious, high safety, low incidence of postoperative complications, low recurrence rate, worthy of clinical application and promotion.

Abstract:AIM:To investigate the effect of compound anisodine on fundus blood circulation after vitrectomy with face-down position.

METHODS: Sixty patients(60 eyes)with rhegmatogenous retinal detachment received vitrectomy with silicone oil tamponade operation, who were randomized divided into treatment group(30 eyes)and control group(30 eyes). The patients in the treatment group received the subcutaneously injection of compound anisodine hydrobromide by the superficial temporal artery once daily for 14d since postoperative first day. Retinal microcirculation blood flow parameters were recorded with Heidelberg retinal flowmeter postoperative 1d, 1 and 2wk, and were compared between two groups.

RESULTS: The blood flow parameters(Vol, Flw, Vel)of control group postoperative 1 and 2wk were significantly less than those postoperative 1d. Otherwise the parameters of treatment postoperative 1 and 2wk were significantly more than those postoperative 1d. The parameters between two groups were significant different(P<0.01).

CONCLUSION: Facing down after vitrectomy with silicone oil tamponade may reduce retinal blood supply, consequently lead to retinal ischemia; compound anisodine can effectively improve the retinal and choroidal microcirculation after vitrectomy with face-down posture, reduce retinal ischemia, and enhance the visual function.

Abstract:AIM: To analyze the clinical data of 54 cases misdiagnosed as optic neuritis and to explore measures to reduce misdiagnosis

METHODS:This retrospective study comprised 54 patients that had been misdiagnosed as optic neuritis from September 2000 to June 2013. The misdiagnosis features were summarized.

RESULTS:Many diseases can easily be misdiagnosed as optic neuritis, including ischemic optic neuropathy, intracranial tumors, optic nerve vasculitis, myelinated nerve fibers, and so on.

CONCLUSION: The measures to reduce misdiagnosis consisted of detailed history collection, perfect physical examination and comprehensive expertise of fundus disease.

Abstract:AIM: To evaluate the therapeutic effects of mitomycin C(MMC)subconjuctival injection with needling revision on dysfunctional filtering blebs after trabeculectomy for glaucoma.

METHODS: MMC 0.1mL(0.2mg/mL)subconjuctival injection with needling revision was performed on 39 eyes of 36 patients with dysfunctional filtering blebs 2～12wk after trabeculectomy for glaucoma. An average of 1.31±0.58 times of treatment was performed. The intraocular pressure(IOP), blebs and complications were observed and follow up was conducted for 3mo.

RESULTS: Three months after treatment, the mean IOP was 15.8±6.6mmHg, significantly lower than that of before treatment(27.4±5.7mmHg). There were 32 eyes with successful filtering blebs, with the success rate of 82.1%. Subconjuctiva hemorrhage occurred in 7 eyes, shallow anterior chamber and hypotony occurred in 1 eye, No such complications as leakage of the wound and choroidal effusion were observed during the follow up.

CONCLUSION: MMC subconjuctival injection with needling revision is a safe, simple and effective method for dysfunctional filtering blebs after trabeculectomy.

Abstract:AIM: To observe the curative effects of amnion transplantation to treat recurrent pterygium.

METHODS: Excision of recurrent pterygium and amnion transplantation to 56 cases(68 eyes)were adopted. The response of the graft and the recurrent pterygium after surgery were observed.

RESULTS: The epithelium corneas in 68 eyes in 56 patients were smooth and the healing time were 4.61±1.23d in 17(5.17±1.22)mo. Amniotic membrane transplantation were successful and there were no graft rejection, scleral ulcer, fornixes and limited eye movement.

CONCLUSION: Amninon transplantation can block angiogenesis, quickly promote epithelial healing wounds, there is no recurrence and eye infections after surgery. It is a safe and effective surgical method.

Abstract:AIM: To evaluate the clinical efficacy and safety of intralesional injection of bevacizumab on primary pterygium treatment.

METHODS: A total of 66 patients(66 eyes)from May, 2012 to April, 2013 were randomized into 2 groups. The treatment group(34 eyes)was received an intralesional injection of bevacizumab 1.25mg(100mg/4mL)each time, once a month, a total of three times. The control group(32 eyes)was received a combination of artificial tears and non-steroidal anti-inflammatory eye drops.

RESULTS: After 6mo follow-up, it was showed that there was a statistically significant reduction of injection and the elevation of pterygium was compared with the baseline in both groups(P<0.05). There was no significant difference of vision, intraocular pressure and percentage of corneal pterygium compared with the baseline in both groups(P>0.05).

CONCLUSION:Intralesional bevacizumab can control primary pterygium effectively for at least 6mo with no serious ocular or systemic adverse effects.

Abstract:AIM:To compare the therapeutic effects of different surgical methods in treating pterygium patients and to observe tear film stability.

METHODS: A total of 120 pterygium patients(120 eyes)were divided into three groups, each 40 cases(40 eyes). Data including Schirmer Ⅰ test(S Ⅰ t), tear break-up time(BUT), corneal fluorescein staining(CFS)were recorded preoperatively and postoperatively to evaluate the clinical efficacy of surgery and the effects of tear function changes.

RESULTS: There were no significant differences in BUT in group A before the operation and one month after operation. Groups B and C showed significant difference before and after operation, but differences were not statistically significant(all P<0.05); One month after operation, there was significant difference in CFS among group A, B and C(P<0.05), but the difference was not satistically significant between groups B and C; After 3mo, BUT in group A was not significant difference compared with the preoperative; but there was significant difference in groups B and C(P<0.05). When compared it between groups B and C, there showed no significant difference; Group A showed no significant difference in SⅠt compared with preoperative, SⅠt of groups B and C were significant differences compared with preoperative(P<0.05), but no significant difference between the two groups; After 3mo, CFS of preoperative group A and group B and group C had no significant difference. After 10mo follow-up, there was axsignificant difference(P<0.05)in recurrence rate in group A comparing with groups B and C, there were differences between groups B and C, but no statistically significant. Surgery is more likely to relapse in summer than in winter.

CONCLUSION: Pterygium excision combined with self-corneal limbal stem cell transplantation and Tenon capsule closed is an ideal surgical to reduce the recurrence and improve tear film function to some extent.

Abstract:AIM: To explore the treatment effect of initial lacrimal passage irrigation and probing in neonatal dacryocystitis.

METHODS: In this retrospective case series study, 224 outpatients( 256 eyes )with neonatal dacryocystitis were selected from January 2012 to December 2012 in our hospital.The patients were divided into 5 groups(1～3mo, 4～60mo, 7～9mo, 10～12mo and >12mo). Initial lacrimal passage irrigation and probing were operated, the therapeutic effect of different groups were compared.

RESULTS: In this study, 256 eyes of 224 cases, 242 eyes(94.5%)were cured and 14 eyes(5.5%)were failed. Bony nasolacrimal duct obstruction happened more obviously in children aged more than 10mo with lower cure rate. More probing was required with the children aged(Spearman rank correlation analysis, γ_s=0.746, P<0.01). All of the 226 eyes with Hasner valve obstruction were cured. Bony nasolacrimal duct obstruction was 30 eyes, 16 eyes were cured(the cure rate was 53.3%). The cure rate of two parts of the obstruct had significant difference. There were no cases of infection and false passage.

CONCLUSION: The treatment of primary lacrimal passage irrigation and probing in neonatal daryocystitisis effective and safe, the optimal timing of treatment is 1～9mo. With the growth of age, the cure rate is decreased.

Abstract:AIM: To investigate the effects on patients with chronic dacryocystitis treated with two methods: external dacryocystorhinostomy(EDCR)and intranasal endoscopic dacryocystorhinostomy(IEDCR)combined with intubation of lacrimal ducts, and to explore the best operation method.

METHODS: Totally 37 cases(37 eyes)were randomly divided into two groups, using EDCR and IEDCR respectively, postoperative follow-up lasted 6～12mo.

RESULTS: The success rate of IEDCR group and EDCR group were 94%(17 eyes)and 90%(20 eyes)respectively. There was no significant difference between EDCR group and IEDCR group(P>0.05). There were Slighter postoperative reaction, no postoperative scar, faster postoperative recovery in IEDCR group than those in EDCR group.

CONCLUSION: EDCR and IEDCR were effective methods. Especially IEDCR is minimal invasive technique and worthy of promotion and application.