Abstract:AIM: To present the efficacy of Endoscopic trans-ethmosphenoid optic canal decompression(ETOCD)combined with steroid and nerve growth factor(NGF)therapy in patients with short-time traumatic optic neuropathy(TON).

METHODS: A retrospective analysis of 151 TON patients(151 eyes)were performed. Their first treatment were all initiated within 5 days of injury. All patients were treated with methylprednisolone for 3 days. There were 117 patients did not improve with methylprednisolone treatment were offered ETOCD. Local and systemic administration of steroid and NGF were given to them after surgery. According to the visual acuity(VA)preoperatively, all patients who underwent surgery were divided into Group A \〖no light perception(NLP)\〗 and Group B(with residual vision).

RESULTS:VA was improved in 70 of 117 patients after surgery, with a total efficacy of 59.8%. The effective rate of Group A and B were 44.8% and 80.0% respectively. Group B had significantly higher effectiveness rate than Group A(χ²=14.781, P<0.05).

CONCLUSION: ETOCD combined with steroid and NGF may be an useful way to improve VA in short-time TON patients. Patients with preoperative residual vision had better prognosis in VA postoperatively. However, NLP patients may benefit from surgery as well.

Abstract:AIM: To evaluate the demographics, characteristics and visual outcomes of open globe injuries in children of amblyogenic age in Hong Kong.

METHODS: All medical records of children aged between 0 to 8y old who sustained open globe injuries between Jan. 1^st, 2005 and Jan. 1^st, 2015 were reviewed retrospectively. The demographics, clinical features(laterality, etiology and zone of injury, other associated ocular injuries), type of primary and secondary operations performed, preoperative and postoperative best spectacle corrected visual acuity(BSCVA)complications were collected and analysed.

RESULTS: A total of 7 cases, 2 males and 5 females were identified. The median age of presentation was 5 years old. All suffered from penetrating injuries(100%). Four cases(57%)had improvement of visual acuity compared with preoperative visual acuity. Final visual acuity was hand movement in one(14%)patient, 20/200-20/50 in four(57%)patients, and 20/40 or better in two(29%)patients.

CONCLUSION: There is a relative low rate of open globe injuries in young children in Hong Kong. Good visual outcomes may be obtained depending on the location and severity of the open globe injury together with prompt surgical management to restore the integrity of the globe and aggressive management of amblyopia.

Abstract:AIM: To determine the effect of lowered target oxygen saturation levels on and identify risk factors of retinopathy of prematurity(ROP)in neonatal respiratory distress syndrome(RDS).

METHODS: Medical records of consecutive preterm infants(N=252)diagnosed with RDS between Jan. 2009 and Dec. 2012 were retrospectively reviewed. The patients were divided into higher-saturation(90-97%; n=116)and lower-saturation(85-93%; n=136)groups according to their target oxygen saturation ranges. ROP severity was assessed and relevant systemic parameters were evaluated.

RESULTS: Incidence of ROP, need for laser ablation, and proportion of aggressive posterior ROP were not significantly different between the groups, but the lower-saturation group had a better survival rate(P=0.005). Patients who spent an additional day in incubator care had a 1.041 times greater chance of developing ROP(odds ratio=1.041; 95% CI=1.003-2.275; P=0.002), whereas a one-point increase in the 5min Apgar score reduced the possibility by 24.7%(odds ratio=0.753; 95% CI=0.152-0.965; P=0.033).

CONCLUSION: Target oxygen saturation levels of 85% to 93% may improve survival without affecting ROP development in infants with RDS. The relevant risk factors are duration of incubator care and 5-min Apgar score.

Abstract:AIM: To evaluate changes in pulsatile ocular blood flow in normal tension glaucoma(NTG)patients.

METHODS: In this prospective case control study color Doppler imaging(CDI)was used to determine ocular blood flow parameters - peak systolic velocity(V_max), end diastolic velocity(V_d), time average mean of maximum velocity(TA_max), pulsatility index(PI), resistive index(RI)and systolic/diastolic ratio(S/D)in ophthalmic artery(OA), central retinal artery(CRA)and short posterior ciliary artery(SPCA)in NTG patients and a comparision was made with the normal subjects. Unpaired Student's t-test was used to compare the two groups and P≤0.05 was considered significant.

RESULTS: V_max in OA, CRA and SPCA in the NTG group was decreased when compared to normals with P values 0.605, 0.254 and 0.348 respectively. V_d in the NTG group was also decreased in all the three vessels when compared to the normal subjects with P values 0.000, 0.014 and 0.138 in OA, CRA, and SPCA respectively. The PI and RI were increased in all the vessels in the NTG group with P values 0.000 and 0.045 for the OA, 0.000 and 0.006 for the CRA and 0.002 and 0.024 for the SPCA. S/D ratio was increased in the NTG group as compared to normals with P values 0.047, 0.041 and 0.189 in OA, CRA and SPCA respectively.

CONCLUSION: This study concludes that CDI may provide an effective way of measuring part of the vascular component of glaucoma. We found decreased blood flow velocity and increased resistive indices in the ocular vasculature in the NTG group as compared to normal subjects.

Abstract:AIM: To evaluate the outcomes of Orbiflex K^®(SwissLens SA, Prilly, Switzerland)contact lenses in the visual rehabilitation of patients with keratoconus at different disease stages.

METHODS: This study included 80 eyes of 52 patients who were admitted to the eye clinic of Dr. Lütfi K?rdar Kartal Training and Research Hospital between Nov. 2012 and Dec. 2013 with a diagnosis of keratoconus. All patients received a rigid contact lens prescription and were followed up for 12 months. The mean age of the patients was 26.1±6.9y(range:15-43y). The patients were grouped according to the Amsler-Krumeich classification and staging using their keratometric values. Uncorrected visual acuity(UCVA), best-corrected visual acuity(BCVA), subjective refraction, corneal topography, keratometry, central corneal thickness measurements, and biomicroscopic examination were performed for all eyes before and after contact lens application.

RESULTS: The mean value of the flat meridian(K1)was 50.25±4.17 diopters(D), whereas the mean value of the vertical meridian(K2)was 53.82±4.81D. The mean K value was 52.03±4.42D. The mean UCVA was 1.31±0.21 logMAR(Snellen 0.05±0.04), and the mean BCVA while wearing spectacles and the contact lens were 0.79±0.33 logMAR(Snellen 0.21±0.17)and 0.05±0.08 logMAR(Snellen 0.91±0.13), respectively. Visual acuities were compared before and after contact lens application, and the differences were statistically significant(P<0.001). The mean line increases for stages 1, 2, 3, and 4 keratoconus groups were 5.18±1.38(range: 2-8), 5.86±1.79(range: 2-8), 6.32±2.16(range: 3-9), and 6.92±2.35(range: 3-9)lines, respectively.

CONCLUSION: Orbiflex K^&#xAE; lens provide significant visual improvement in patients with keratoconus at all stages of the disease.

Abstract:AIM: To study the role of nitric oxide(NO)and γ-aminobutyric acid(GABA)in the formation of amblyopia by establishing 2 different types of amblyopic models.

METHODS:A total of 18 aged 3-week kittens were randomly divided into monocular deprivation, strabismus and normal groups. All types of amblyopia were developed in the experimental eyes that were detected by P-VEP 12wk later. The cats were killed and the immunocytochemistry staining method were applied to observe under the light microscope the changes of distribution and positive cells areas of NO and GABA across the amblyopic retinal, compared to that from the normal cats of identical age.

RESULTS: The P-VEP showed that the amplitude of wave P1 was lower(P<0.05)and the P1 latent time was longer(P<0.05)in two types of amblyopic cats than those in the normal cats. Compared to the normal cats, the NO and GABA positive cells areas were obviously reduced(P<0.05)across the retina in the amblyopic cats. But no significant difference was found between two kinds of amblyopic cats.

CONCLUSION:The NO and GABA play an important role in the formation of amblyopia in the level of retinal.

Abstract:AIM: To discuss the protective effects and possible mechanisms of quercetin in oxidative damage of human retina pigment epithelium(RPE)cells induced by H₂O₂.

METHODS: RPE cells were subculture, and they were divided into negative control group: cultured with normal culture medium; oxidative injury group: 100 μmol/L H₂O₂ treated for 12h; quercetin low dose group: 100 μmol/L quercetin incubated for 24h then treated with 100 μmol/L H₂O₂ for 12h; and quercetin high dose group: 100 μmol/L quercetin incubated for 24h then treated with 100 μmol/L H₂O₂ for 12h. Cell viability were tested by MTT colorimetric detection, apoptosis rate was detected by flow cytometry, apoptotic cell morphology was observed by Hochest33258 staining, expression of catalase(CAT), superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)were tested by colorimetric detection.

RESULTS: Quercetin inhibited H₂O₂-induced cell viability decreased in RPE cells, after treated with different concentrations of quercetin, RPE cells activity increased to(79.67±4.98)% and(83.00±3.60)%, which had statistical significance difference compared with oxidative damage group(48.93±3.39)%(P<0.05). After treated with different concentrations of quercetin, the apoptosis rate of RPE cells decreased to(23.23±3.29)% and(16.23±1.94)%, respectively, which had statistical significance difference compared with oxidative damage group(38.03±4.76)%(P<0.05). In addition, quercetin also increased the expression of CAT、SOD、GSH-Px in RPE cells, which had statistical significance difference compared with oxidative damage group.

CONCLUSION:Quercetin effectively inhibited H₂O₂-induced RPE cells damage by improving cell antioxidant enzyme activity, which provide reliable experimental basis for the treatment of injuries in RPE cells.

Abstract:AIM: To be one of the primary cause injury to multiple sites of ocular of glaucoma which affects over 70 million people worldwide. We applied data mining techniques, linear and the matrix operations, efficiently calculated the network and estimated the possible function of the “node” genes of the retina and optic of glaucoma, in order to provide new thought and method on the pathogenesis of glaucoma.

METHODS: The data in this study is from Gene Expression Omnibus(GEO)which belong to Nation Center for Biotechnology Information(NCBI), the quality of the raw data CEL files was processed and analyzed by the Expression software which belong to Affymetrix Inc., Santa Clare, CA, USA. Significant analysis method(SAM)which base on the T test was used to identified the significant genes. Based on GRNInfer and Gvedit soft we set up gene networks of optic and retina of mice and further more enriched analysis which based on DAVID and MAS3.0 online software were processed.

RESULTS: The analysis between the group of the optic nerve heads and retinas in different stage of glaucoma showed that the amount of significant different expressed genes in the optic never head group increased significantly comparing with the group of retina in the early stage of glaucoma, the analysis of the genes network construction show that: the node genes of optic nerve heads included Unc13c、Kif5a、TRPM1、PANX; and the node genes of retina include POU4F1, NEFL, BC03870, CALB2. Metabolic pathways enrichment analysis which based on MAS3.0 online platform show that there was mainly the amyotrophic lateral sclerosis, tyrosine metabolism, melanogenesis, Nitrogen metabolism, Gap junction, Leukocyte transendothelial migration metabolism pathway enriched out in optic nerve head; and there was mainly amyotrophic lateral sclerosis, neurodegenerative disorders, prostate cancer, leukocyte transendothelial migration metabolism pathway enriched out in retina.

CONCLUSION: By understanding bioinformatics result, it seems optic were more sensitive than the retina to high intraocular pressure, and weather high expression of TYrp1 gene can be as a sensitive diagnostic item require more evidence back up. Functional enrich analysis of node gene showed that cytoskeleton reconstructed,molecular motor and nutrients transport function improve in optic; and in retina, the most prominent finding in retina was enrichment function modules were focus on regeneration, repairing and differentiation of cells, which remind that we should reinforce research on reparation of retina of primary glaucoma. Metabolic pathways enrichment analysis show that inflammatory response plays prominent place in optic and retina of primary glaucoma, because of the optic narrow and crowed anatomic shape, nutrient metabolism and substances transfer enrichment modules play an important role in optics of primary glaucoma.

Abstract:AIM: To study and compare the outcomes of coaxial 2.2 mm phacoemulsiflcation with conventional coaxial 3 mm small-incision cataract surgery.

METHODS:A randomized prospective study was conducted on 100 patients with age-related cataract: coaxial 2.2 mm micro-incision cataract surgery was performed in 50 cases(50 eyes), and coaxial 3 mm small incision cataract surgery was performed in 50 cases(50 eyes). Statistical analysis was takenwith the data of the two groups. Visual acuity, VF and QOL were compared at intervals of 1wk and 3mo after surgery. In addition, surgically induced astigmatism(SIA)was analyzed. Statistic analysis was taken by Student's t-test and Chi-square test.

RESULTS: There was no significant difference on BCVA(t=-1.366, -1.688; P=0.148, 0.107)between these two groups. One week and 3mo after the surgery, SIA was(0.46±0.29)D,(0.43±0.26)D in the 2.2 group; and(1.55±0.59)D,(0.89±0.28)D, in 3.0 group. The differences between these two groups were statistically significant(t=-7.348, -3.788; P=0.000, 0.000)There were no statistically significant differences on VF scores between two group, while it's got a better score in 2.2 groups on vision adaptation.(t=-3.348, P<0.05).

CONCLUSION:Coaxial 2.2mm micro-incision cataract surgery could significantly reduce SIA and obtain morestable status of VF and QOL. This suggests that the coaxial 2.2 phacoemulsification surgery implanted AkreosMI60 intraocular lens could get earliervisual rehabilitation postoperation.

Abstract:AIM: To explore the clinical effect of capsule membrane phacoemulsification and capsular bag in phacoemulsification in treatment of hard nuclear cataract with high myopia.

METHODS: A total of 297 patients(322 eyes)with hard nucleus cataract(Ⅳ-Ⅴ grade nucleus)and high myopia were selected from Mar.2014 to Mar.2016 in our hospital. They were randomly divided into the observation group with 149 cases(162 eyes)and the control group with 148 cases(160 eyes). The observation group received capsule membrane phacoemulsification and the control group received capsular bag in phacoemulsification. The therapeutic effect and safety of patients in two groups were compared. The comparison of phacoemulsification time, energy parameters and corneal endothelial cell density used t-test, post-operative visual acuity and the occurrence of complications were tested by Chi-square test.

RESULTS: The harder the nucleus was, the longer the phacoemulsification time and higher the average phacoemulsification energy was, and the differences were statistically significant(P<0.05). The phacoemulsification time and energy parameters of the observation group were significantly lower than that of the control group(P<0.05). One month after operation, the postoperative visual acuity in two groups was significantly higher than the visual acuity at 1d after operation(P<0.05). But there was no statistical significance on the visual acuity at 1mo after operation between two groups(P>0.05). After operation, the density of corneal endothelial cell in two groups was significantly lower than the density before operation(P<0.05). But there was no statistical significance on the density of corneal endothelial cell after operation between two groups(P>0.05). The intraoperative complication rate of observation group was significantly lower than that of the control group(P<0.05), but there was no statistical significance on postoperative complication rate between two groups(P>0.05).

CONCLUSION: For the treatment of hard nuclear cataract with high myopia, capsule membrane phacoemulsification and capsular bag in phacoemulsification have similar effect, but capsule membrane phacoemulsification has better safety.

Abstract:AIM: To evaluate the efficacy and stability by comparing acuity and diopter of small incision lenticule extraction(SMILE), femtosecond laser in situ keratomileusis(FS-LASIK)and laser in situ keratomileusis(LASIK)in treating myopia with a follow-up of 6mo.

METHODS: A retrospective study, 42 cases(84 eyes)received SMILE, 37 cases(74 eyes)received FS-LASIK and 31cases(62 eyes)undergone LASIK in our hospital during Apr.2014 to Jun.2014 were involved. The follow-up data of 6mo was analyzed. The preoperative spherical equivalent was -5.91±1.83D, -5.89±1.96D, -5.88±1.68D in SMILE, FS-LASIK and LASIK group, respectively. The differences of preoperative best corrected visual acuity(BCVA), pupil diameter(PD)and central corneal thickness(CCT)had no statistically significant between three groups. The postoperative uncorrected visual acuity(UCVA), BCVA and diopter were comparative analyzed at 1wk, 1, 3 and 6m after surgery.

RESULTS:1)No patients lost to follow-up of 1wk and 1mo. A total of 10 eyes(5 cases), 10 eyes(5 cases)and 8 eyes(4 cases)lost to follow-up of 3m in SMILE、FS-LASIK and LASIK group, respectively, and raised to 18 eyes(9 cases), 12 eyes(6 cases)and 14 eyes(7 cases)in follow-up of 6m. 2)At 1wk follow-up, the differences of UCVA between SMILE group, FS-LASIK group vs LASIK group was statistically significant respectively(t=4.098, P=0.000; t=2.493, P=0.004). 3)In LASIK group, the differences of UCVA between 1wk vs 3, 6m follow-up was statistically significant respectively(t=3.410, P=0.001; t=3.771, P=0.000), the differences of UCVA between 1m and 6m follow-up was statistically significant(t=2.283, P=0.026). 4)The differences of diopter were not statistically significant among three groups at 1wk, 1, 3 and 6mo follow-up respectively(χ²=0.119, P=0.942; χ²=1.504, P=0.471; χ²=0.949, P=0.622; χ²=0.277, P=0.871). 5)the differences of eyes with UCVA≥5.0 was statistically significant between SMILE group vs FS-LASIK group, LASIK group at 1wk follow-up(χ²=9.249, P=0.002<0.05/3; χ²=12.906, P=0.000<0.05/3), there was no significant statistical difference between FS-LASIK group and LASIK group(χ²=0.500, P=0.604). 6)there was no significant statistical difference of eyes with SE(±0.50D)at any time post operation among three groups(χ²=0.809, P=0.697; χ²=1.176, P=0.634; χ²=0.871, P=0.736; χ²=0.683, P=0.770).

CONCLUSION: All of SMILE, FS-LASIK and LASIK are effective and stable on treating myopia according to follow-up of 6mo. However, in this study, SMILE group shows more effective than FS-LASIK and LASIK at 1wk, which could enhance postoperative UCVA more rapidly.

Abstract:AIM: To compare the efficacy and safety of bevacizumab with mitomycin(MMC)in augmenting trabeculectomy for glaucoma.

METHODS: Databases including PubMed, CBM, CNKI, VIP and WanFang Data were electronically searched for all randomized controlled trials(RCTs)about comparing the efficacy and safety between bevacizumab and MMC in augmenting trabeculectomy for glaucoma before the date of Jun.2016. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, and evaluated the included studies. Then, Meta-analysis was performed.

RESULTS: A total 4 RCT involving 286 eyes(143 for bevacizumab group, 143 for MMC group)were included. The results of Meta-analysis showed that there was no significant difference between bevacizumab and MMC in the last follow-up after surgery in IOP(WMD=2.21, 95%CI: -0.17 to 4.58, P=0.07), complete success rate(OR=0.69, 95%CI: 0.26 to 1.81, P=0.45)and the numbers of anti-glaucoma medicine(OR=0.12, 95%CI: -0.15 to 0.39,P=0.39). And there was no significant difference between bevacizumab and MMC in postoperative complications:hypotony(OR=0.7, 95%CI: 0.12 to 4.05,P=0.69), bleb leak(OR=1, 95%CI: 0.21 to 4.74,P=1), encapsulated bleb(OR=1.15, 95%CI: 0.38 to 3.44, P=0.81), choroidal detachment(OR=1.22, 95%CI: 0.29 to 5.22, P=0.78)and cataract(OR=1.15, 95%CI: 0.38 to 3.44, P=0.81).

CONCLUSION: Bevacizumab and MMC in augmenting trabeculectomy for glaucoma have similar efficacy and safety. Bevacizumab can't result in better outcome in term of IOP reduction. Clinicians should choose suitable solution according to disease characteristics.

Abstract:The optic nerve disease is a kind of diseases that seriously affect the visual function. In recent years, magnetic resonance diffusion tensor imaging(DTI)technology has been widely applied in the field of optic nerve diseases. Compared with the ophthalmic testing, such as optical coherence tomography imaging, visual evoked potential, field of vision, this method has obvious advantages. It not only can directly show the morphology changes of the optic nerve, visual pathway and visual cortex, but also can quantitatively analyze the morphological and pathological changes of the optic nerve, visual pathway and the visual cortex. This article reviews the imaging principle of diffusion tensor imaging, the progress and development prospect of diffusion tensor imaging in the study of the optic nerve diseases.

Abstract:Glaucoma is a group of irreversible blind eye diseases with specific optic nerve damage and visual field defect.Early diagnosis and treatment of glaucoma is vital for prognosis, but difficult in clinical practice.Macular ganglion cell complex thickness(mGCC)consists of the inner three layers of retina:retinal nerve fiber, ganglion cell and inner plexiform layers, which is glaucoma target tissue so to be measured the thickness of the mGCC as better indicator for early diagnosis in glaucoma.Optical coherence tomography(OCT)is a non-contact, good repeatability technique to obtain fast high-resolution images from the anterior and posterior segments of the eye, and it has been widely used in ophthalmology.Spectral-domain(SD)OCT allows a higher image resolution and can measure the thickness of mGCC thickness, providing new parameters for the early diagnosis of glaucoma.

Abstract:Glaucoma is a group of diseases which can threaten and damage the optic nerve and its visual pathway, leading to visual impairment as a result. Glaucomatous optic neuropathy is a chronic disease accompanied by apoptosis of retinal ganglion cells(RGCs), visual field defect and cupping of optic nerve head. The gold standard in functional glaucoma evaluation is standard automated perimetry(SAP), but it is often limited to the subjective feelings of the patients. Still, visual electrophysiological techniques cannot replace the conventional inspection, but with its rapid development, it has provided a new strategy for the early diagnosis of glaucoma as a supplement because it can show changes in amplitude and latency before visual field defect. Here we review three special electroretinograms and multifocal focal visually evoked potentials in the early diagnosis of glaucoma.

Abstract:Choroidal neovascularization(CNV)is a common severe complication of ocular fundus diseases, with great potentiality to cause blindness. The treatments of CNV include photodynamic therapy(PDT)and anti-vascular endothelial growth factor(VEGF)therapy. However, PDT produces little visual benefits, and may result in ischemia, inflammatory responses, even the secondary expressions of VEGF. Anti-VEGF therapy sustained visual efficiency by repeated injections, causing economic burden and adverse effects related to injection. Recently, PDT combined with anti-VEGF therapy has progressed in laboratory and clinical research. Therefore, the combined modality therapy became one of the treatment options for CNV. In order to reduce the side effects of mono-therapy, further study is required to determine appropriate combinations and dosage.

Abstract:Neovascularization is the main cause of blindness, such as diabetic retinopathy, retinopathy of prematurity and age-related macular degeneration. Vascular endothelial growth factor(VEGF)plays an important role in the formation of angiogenesis, and is considered to be the most potent angiogenic growth factor. Placental Growth Factor(PlGF)is one of the VEGF family, which play a crucial role in endothelial cell proliferation and migration, angiogenesis, and immune-mediated inflammation. Meanwhile, PlGF is specifically expressed in pathological angiogenesis, but not in normal blood vessels. In recent years, there has been increasing attention to PlGF, therefore this article reviews the role of PlGF in neovascular ocular diseases.

Abstract:Central serous chorioretinopathy(CSC)is an important cause for central vision loss. It mostly occurs in young and middle-aged men. It is a condition characterized by a serous detachment of neurosensory retina at the posterior pole and leakage from the retinal pigment epithelium(RPE). Most patients with acute CSC will resolve spontaneously. However, in cases of chronic CSC with persistent serous retinal detachment, patients might develop progressive vision loss. This article was made a brief review of the current treatment methods, including laser, photodynamic therapy(PDT), intravitreal anti-vascular endothelial growth factor therapy and the mineralocorticoid receptor antagonists.

Abstract:AIM: To compare the clinical efficacy of three combined surgical treatments for cataract induced by silicone oil -filled eye.

METHODS: The data of 75 eyes of 75 patients with cataract induced by silicone oil-filled eye were reviewed. Those patients were divided into group A, B, C. The patients in group A were treated by phacoemulsification combined with silicone oil removal through pupil and IOL implantation, the patients in group B were treated by phacoemulsification combined with silicone oil removal through 23G vitrectomy system and IOL implantation, the patients in group C were treated by phacoemulsification combined with silicone oil removal through 20G vitrectomy system and IOL implantation. The operation time, intraocular pressure, best corrected visual acuity(BCVA), discomfort days and complications before and after the surgery were compared.

RESULTS: The differences of the intraocular pressure were not statistically significant between the three groups after the surgery. The BCVA of the three groups were all improved, but the differences were not statistically significant between three groups. The differences in postoperative complications showed no statistically significant. Otherwise, group A and B cost less operation time. The discomfort days of group A were less than other groups.

CONCLUSION: Three different surgical methods were safe and effective, appropriate surgical approach could be chosen according to the patients' clinical manifestations. For patients with cataract induced by silicone oil-filled eye whose retina recovered well, phacoemulsification combined with silicone oil removal through pupil and IOL implantation is a time-saving, safe and effective method.

Abstract:AIM: To explore and compare effect of coaxial micro-incision phacoemulsification and standard coaxial phacoemulsification in the treatment of cataract.

METHODS: A total of 88 patients(88 eyes)with senile cataract who underwent selective cataract ultrasonic emulsification resorption combined with intraocular lens implantation in the hospital from Aug. 2013 and Aug. 2015 were selected, they were divided randomly into the control group(44 cases, 38 cases completed, 6 cases dropped out)and the observation group(44 cases, 40 cases completed, 4 cases dropped out). The control group received standard coaxial 3.0mm small incision phacoemulsification, the observation group received coaxial 1.8mm micro-incision phacoemulsification. All patients were combined with intraocular lens implantation. Intraoperative effective ultrasonic time, cumulative release energy, best corrected visual acuity before and after surgery in the two groups were recorded, corneal endothelium cell population, incision corneal thickness, percentage of cornea hexagon cell, corneal astigmatism changes before the operation, 1d, 7d, 30d after the operation were compared.

RESULTS: There was no significant difference in intraoperative effective ultrasonic time, cumulative release energy in the two groups(P>0.05). There was no significant difference in postoperative best corrected visual acuity between the two groups(P>0.05). Corneal endothelium cell population, percentage of cornea hexagon cell 1d, 7d, 30d after the operation in the two groups were significantly decreased compared with those before the treatment(P<0.05), but there was no significant difference in the two groups(P>0.05). Incision corneal thickness 30d after the operation in the observation group was significantly lower than the control group(P<0.05). Degree of corneal astigmatism in the observation group 1d, 7d, and 30d after the operation were significantly lower than the control group(P<0.05).

CONCLUSION: Coaxial micro-incision phacoemulsification and standard coaxial phacoemulsification can improve visual acuity of cataract patients, but the former can reduce degree of corneal astigmatism.

Abstract:AIM:To observe and analyze visual quality changes of the patients with posterior capsule opacification(PCO)Nd:YAG laser posterior capsular dissection, including the change of the best corrected vision acuity(BCVA), total high-order aberration(tHOA), and the modulation transfer function(MTF).

METHODS:In this prospective observational study, 100 cases of patients(100 eyes)with posterior cataract underwent Nd:YAG laser posterior capsular dissection(posterior capsular diameter dissected was 5mm or higher). The mean age was 65.52±7.01 years old. The change of the BCVA was collected. The tHOA and MTF under the 3mm and 5mm pupil diameter were assessed by iTrace respectively before and after Nd:YAG laser posterior capsular dissection.

RESULTS:All the surgery went well without obvious intraoperative and postoperative complications happened. The preoperative BCVA was 0.451±0.023 while the postoperative BCVA was 0.763±0.025. The difference of BCVA before and after Nd:YAG laser surgery was statistically significant(P<0.01). At 3mm pupil diameter, the tHOA preoperative was 0.551±0.031 while the postoperative tHOA was 0.214±0.011, the differences were significance(P<0.05). At 3mm pupil diameter while the spatial frequencies(5cpd, 10cpd, 15cpd, 20cpd, 25cpd, 30cpd)respectively, the MTF tHOA value postoperative(0.644±0.023, 0.49±0.011, 0.311±0.015, 0.202±0.018, 0.056±0.027, 0.041±0.011)were significantly higher than that preoperative(0.401±0.021, 0.261±0.026, 0.179±0.012, 0.108±0.014, 0.031±0.016, 0.022±0.021), and the difference has statistical significance(P<0.05). At 5mm pupil diameter, the tHOA preoperative was 0.752±0.028 while the postoperative tHOA was 0.361±0.014, the differences were significance(P<0.01). At 5mm pupil diameter while the spatial frequencies(5cpd, 10cpd, 15cpd, 20cpd, 25cpd, 30cpd)respectively the MTF tHOA value postoperative(0.426±0.027, 0.209±0.018, 0.172±0.013, 0.116±0.015, 0.049±0.010, 0.034±0.014)were significantly higher than that preoperative(0.234±0.021, 0.102±0.019, 0.088±0.016, 0.058±0.022, 0.021±0.014, 0.016±0.011), and the difference had statistical significance(P<0.05).

CONCLUSION:Patients with posterior capsule opacification(PCO)Nd:YAG laser posterior capsular dissection can help improve BCVA, reduce tHOA, increase MTF tHOA values, and significantly improve visual quality of patients.

Abstract:AIM:To study the changes of tear film and ocular surface after the coaxial micro incision 2.2mm and 2.8mm in the phacoemulsification.

METHODS:Eighty-six patients(One hundred and six eyes)from 2014/06 to 2016/01 in our hospital were enrolled. The patients were randomly divided into two groups. Forty-four patients(Fifty-three eyes)in group A: coaxial 2.2mm micro-incision phacoemulsification cataract extraction and intraocular lens(IOL)implantation; Forty-two patients(Fifty-three eyes)in group B: the conventional coaxial 2.8mm small incision phacoemulsification cataract extraction and IOL implantation. The break up time(BUT), dry eye symptom(DES)score, Schirmer's I test(SⅠt)and lid-wiper epitheliopathy(LWE)score were assessed preoperatively and postoperatively.

RESULTS: At 1wk, 1 and 2mo postoperatively, the BUT in two groups decreased after operations, and the BUT of group B was significantly lower than those of group A, the differences were statistically significant(t=3.098, 4.512, 4.329; all P<0.05). The DES score in two groups increased, the DES score of group B was significantly higher than those of group A and the differences were statistically significant(t=-9.449, -10.029, -7.141; all P<0.05). The SⅠt in two groups increased after operations, the SⅠt of group B was significantly higher than those of group A and the differences were statistically significant(t=-6.293, -4.009, -3.283; all P<0.05). The LWE score in two groups increased after operations, the LWE score of group B was significantly higher than those of group A and the differences were statistically significant(t=-6.542, -5.125, -3.632; all P<0.05). At 6mo postoperatively, compared with the preoperative data, the BUT, DES score, SⅠt and LWE score in group A showed no statistically significant differences(t=0.659, 1.276, 0.548, 0.169; P>0.05). The BUT, DES score, SⅠt and LWE score in group B showed statistically significant differences(t=-4.063, 7.306, 3.621, 4.208; all P<0.05).

CONCLUSION: Ocular surface has less damage and tear film has little influence at early stage after the coaxial 2.2mm microincision phacoemulsification, compared with the conventional coaxial 2.8mm incision phacoemulsification surgery.

Abstract:AIM: To investigate the efficiency of intravitreal ranibizumab therapy(IVR)for polypoidal choroidal vasculopathy(PCV)in single or multiple polyps.

METHODS: A total 63 patients diagnosed with PCV in Shaoxing City People's Hospital from May 2013 to May 2015 were enrolled and divided into single polyp group and multiple polyps group. All patients received intravitreal ranibizumab 3 monthly and were followed up for 12mo. Observe the changes of best corrected visual acuity(BCVA)and central retinal thickness(CRT)at different time points.

RESULTS: The single polyps group exhibited a better BCVA, shorter greatest linear dimension, and lower prevalence of fibro-vascular pigment epithelial detachment compared with the multiple polyp group before treatment(P<0.05). Significant difference of BCVA were observed at 3, 6 and 12mo between the two groups(P<0.05). BCVA at 3, 6, 12mo was significantly better than that at baseline in single polyps group. The single polyp group exhibited a significantly thinner CRT at 6 and 12mo compared with multiple polyps group(P<0.05). The single polyp group showed improvement in CRT over the followed up period(P<0.05). The CRT in multiple polyps group at 3 and 6mo significantly decreased compared with preoperative(P<0.05).

CONCLUSION: IVR meet better result in PCV patients with multiple polyp and polyp numbers may be valuable to prognosis.

Abstract:AIM: To investigate the effects of external counterpulsation combined with laser photocoagulation for treatment of non-proliferative diabetic retinopathy.

METHODS: A prospective study method were used from Aug.2013 to Feb.2016. A total of 104 cases in our hospital for treatment of non-proliferative stage of diabetic retinopathy patients were selected as the research object, and all the patients were equally divided into observation group and control group, 52 cases in each group according to the order of admission. Patients in control group were treated with panretinal laser photocoagulation treatment. The observation group were given external counterpulsation combined with laser photocoagulation for treatment, observed the prognosis in the two groups.

RESULTS: The total efficiency in the observation group and the control group were 98.1% and 84.6%, the observation group was significantly higher than the control group(P<0.05). The eye artery EDV and PSV values in the observation group and the control group after treatment were significantly higher than those before treatment(P<0.05), while the observation group after treatment of eye artery EDV and PSV value were significantly higher than those in control group(P<0.05). The CMT values in the observation group before and after treatment were 198.13±45.32μm and 200.46±31.94μm, while the control group were 203.14±51.94μm and 202.90±42.95μm that compared between the two groups were not statistically significant(P>0.05).

CONCLUSION: External counterpulsation combined with laser photocoagulation treatment has good safety in the treatment of non-proliferative diabetic retinopathy, it can promote eye artery blood flow speed, thereby improve the therapeutic effect.

Abstract:AIM: To observe the efficacy of intravitreal injection with ranibizumab combined with laser photocoagulation for macular edema(ME)secondary to macular branch retinal vein occlusion(MBRVO).

METHODS: A retrospective analysis included 33 patients(33 eyes)with ME secondary to MBRVO were taken. All patients received intravitreal injection of 0.5mg ranibizumab(0.05ml)at first visit. The continue PRN treatment and laser photocoagulation were based on the visual acuity changes and optical coherence tomography findings. The changes of best corrected visual acuity(BCVA), central macular thickness(CMT), and amplitude density and latency of P1 wave in mfERG were observed before treatment and 6mo after treatment.

RESULTS: Before the treatment, logMAR was 0.68±0.35, 6mo after treatment was 0.34±0.23, BCVA was improved obviously(P<0.01), BCVA in 21 patients(63.64%)were improved in two rows among all the patients. CMT before treatment was(487.30±63.58)μm, after treatment was(238.84±52.66)μm(P<0.01). The amplitude densities of P1 wave in ring 1, ring 2 and ring 3 after treatment were significantly increased(all P<0.01), and the latencies were decrease(all P<0.05). The conjunctival hemorrhage was observed in 2 eyes after treatment.

CONCLUSION: Intravitreal injection with ranibizumab combined with laser photocoagulation for ME secondary to MBRVO can reduce the CMT and improve visual function.

Abstract:AIM: To observe the efficacy and safety of intravitreal injection of Conbercept for the treatment of wet age-related macular degeneration(AMD).

METHODS: Retrospective analysis. A total of 20 patients involving 22 eyes were diagnosed of wet AMD and confirmed by routine ophthalmic examination, fundus fluorescein angiography(FFA)and optical coherence tomography. All these affected eyes received intravitreal injection of 10 mg/ml of 0.5mg Conbercept, once monthly, for 3 successive times during the initial treatment. The need for repeated treatment was determined according to patients' disease conditions. The patients were followed up once monthly for ≥6mo. The changes in best corrected visual acuity(BCVA), central retinal thickness(CRT)and choroidal neovascularization(CNV)lesion leakage of the affected eyes before and after treatment were compared and analyzed.

RESULTS:Within 1, 3 and 6mo after treatment, the mean BCVA(logMAR)of the affected eyes increased when compared with before treatment; the difference was statistically significant(P<0.01). In 1, 3 and 6mo after treatment, the mean CRT of the affected eyes decreased when compared with before treatment; the difference was statistically significant(P<0.01). During the last follow-up, FFA showed that macular CNV lesion leakage disappeared in 20 eyes(90%)while leakage mitigated in 2 eyes(9%). During the follow-up, there were no treatment-related serious ocular complications and systemic serious adverse reactions.

CONCLUSION:Clinically, intravitreal injection of Conbercept for the treatment of wet AMD can increase visual acuity of the affected eyes. It also can decrease CRT of the affected eyes, and inhibit neovascular leakage. There are no treatment-related adverse reactions.

Abstract:AIM: To evaluate the clinical outcomes of combined wavefront-guided and aspheric laser in situ keratomileusis(LASIK)to correct myopia and myopic astigmatism.

METHODS: Prospective study. Forty-five patients(62 eyes)with myopia and myopic astigmatism were randomly dividied into two groups: the wavefront-guided and aspheric LASIK group and the wavefront-guided LASIK group. Safety, efficacy, predictability, ocular higher order aberrations(HOAs), and contrast sensitivity under mesopic condition were compared at 6mo postoperatively.

RESULTS: Both platforms had equal safety, efficacy and predictability. At 6mo after operation, total HOAs, spherical aberration and coma increased in both groups(P<0.01). The changes of total HOAs and spherical aberration in wavefront-guided and aspheric group were significantly less than those in wavefront-guided group(P<0.05), while the change of coma between two groups was not statistically significant(P=0.657).Contrast sensitivity in the wavefront-guided and aspheric group recovered to preoperative levels under mesopic conditions at all spatial frequencies(P>0.05), while contrast sensitivity in the wavefront-guided group recovered to preoperative levels at all spatial frequencies(P>0.05).

CONCLUSION: Wavefront-guided and aspheric LASIK induced less HOAs and associated with better mesopic contrast sensitivity compared with wavefront-guided LASIK.

Abstract:AIM: To compare the change of visual quality of femtosecond-laser in situ keratomileusis(FS-LASIK)and laser in situ keratomileusis(LASIK)for myopia.

METHODS: A retrospective case series. A total of 89 cases 178 eyes were chosen from Jan.2014 to Dec.2015. There were 46 cases(92 eyes)in FS-LASIK and 43 cases 86 eyes in LASIK. The visual acuity, refraction state, subjective visual quality score, high order aberration were measured at 6mo after surgery.

RESULTS: All patients underwent operation smoothly, and no complication was observed during and after surgery; there was no statistically significant difference between two groups at visual acuity(P>0.05). Postoperative diopter compared with preoperative expectations diopter difference is statistically significant between two groups(P<0.05). Subjective visual quality score was compared statistically significant postoperative 6mo in two groups(P<0.05). Six months after surgery in the two groups of patients with corneal aberration RMS values, spherical aberration and coma compared with preoperative increases, more than the expansion of the size of the FS-LASIK group low mechanical plate layer knife group, the difference was statistically significant(P<0.05).

CONCLUSION: Femtosecond laser corneal flap is more accurate and reliable and the discrete degree is smaller. It can make more thin corneal flap. Femtosecond laser disc of LASIK surgery compare with traditional mechanical plate layer knife following LASIK has better visual quality.

Abstract:AIM:To evaluate the effect of rigid gas permeable(RGP)lens on the tear film and the visual quality in adolescents with a double-pass system.

METHODS:This was a prospective study comprised 23 myopia patients(39 eyes)wearing rigid gas permeable contact lens(RGP)between Jun.2015 and Aug.2015 in the Department of Ophthalmology of Jinling Hospital. Uncorrected visual acuity(UCVA), sphere refractive, cylinder refractive, Schirmer I test, tear film break-up time(BUT), the visual quality and the tear film quality with OQAS II were obtained before and 1wk, 1, 3, 6mo after wearing. The data was analyzed using t-test and One-way.

RESULTS:The UCVA in before and after 1wk, 1, 3, 6mo were 0.23±0.10, 0.81±0.23, 0.99±0.11, 1.01±0.09, 0.95±0.14, the difference was statistically significant(F=723.36, P<0.01). The sphere in before and after 1wk, 1, 3, 6mo were(-2.83±1.34)D,(-0.63±0.82)D,(-0.12±0.20)D,(-0.03±0.10)D,(-0.10±0.30)D respectively, the difference was statistically significant(F=107.01, P<0.01). The refractive cylinder in before and after 1wk, 1, 3, 6mo were(-0.12±0.21)D,(-0.13±0.22)D,(-0.12±0.21)D,(-0.14±0.26)D,(-0.21±0.27)D respectively, there was no significant difference before and after wearing RGP(F=2.58, P>0.05). Schirmer I test showed no statistically significant difference before and after wearing RGP(F=4.88, P>0.05). The stability of tear film was reduced after wearing RGP, and the difference was statistically significant(F=135.11, P<0.01). The modulate transfer function(MTF)cut-off frequency was reduced after wearing RGP, the object scatter index(OSI)was increased after wearing RGP, and the difference was statistically significant, the tear film quality OSI was increased after wearing RGP, and the difference was statistically significant(F=6.16, 19.23, 10.62, P<0.01).

CONCLUSION:The UCVA is significantly increased after wearing RGP. However, there was no significant change in the base-line of tear secretion, but BUT is significantly reduced after wearing RGP. The stability of the tear film is reduced, which can lead to a decline in visual quality.

Abstract:AIM:To study the visual acuity and refractive status of students pupils and middle school students in Shenzhen, and to provide a scientific basis for the prevention and control of myopia.

METHODS:A cluster sampling method was used to select five primary school students(6 737)and three junior middle school students(1 925)from Shenzhen. The visual acuity,anterior segment, fundus, eye position, and refractive status were measured. Information on associated factors for poor vision were also obtained using a questionaire. The risk factors of poor vision and the rate of myopia between grade or gender were analysed by Chi-square test.

RESULTS:The rate of poor vision was 67.0%. Female, family history of high myopia, long time of continuous look near, short time of outdoor activities were the main risk factors. The rate of emmetropia, hyperopia, astigmatism and myopia were 15.1%, 11.3%, 11.0% and 62.6% respectively. Emmetropia, hyperopia and astigmatism incidenece rate decreased with age growing, but myopia incidence rate was increased. There were significant differences between adjacent two grades in myopia(χ²=7.338-45.018, P<0.05)except the primary grade six and the junior grade one. There were significant differences between boys(61.0%)and girls(65.5%)in myopia(χ²=17.180, P<0.05).

CONCLUSION:The rate of poor vison is pretty high in students of Shenzhen aged between 5 to 16 years old, and myopia is the main reason. The development rate of myopia is increased with age. Early management of myopia may play an important role in controlling poor vision in students.

Abstract:AIM: To evaluate the case-based learning(CBL)in ophthalmology teaching practice.

METHODS: A total of 88 students were taught by the combination of lecture-based teaching with CBL form of sensory organs in Jinzhou Medical Teaching Classes. After class, the questionnaire was filled by each student to evaluate the CBL teaching mode.

RESULTS: The description of the data was analyzed as a percentage of each option. All the students were taught by CBL at the end of the class, most of the students could accept the teaching mode, it was helpful for students to understand the principle of clinical treatment, increased the interest in the process of teaching. And it was conducive to review the knowledge and exercise clinical case analysis ability. And it could recognize the ophthalmic diseases and special auxiliary examination. CBL teaching mode could stimulate students' interest in learning ophthalmology, it was beneficial to the cultivation of theory combined with practice and clinical thinking.

CONCLUSION: CBL teaching mode can be used as an auxiliary teaching lecture-based learning teaching.

Abstract:According to the clinical teaching for ophthalmology professional degree graduate students, we changed the mode of "all pouring", "echoing what the books say", to the "point to point" mode, giving effective teaching, and strengthening the cultivation of the new postgraduates. The "point to point" mode refers to the teaching content of "point to point", the teaching mode of "point to point", the teaching guidance of "point to point", the teaching assessment of "point to point".The content is to be refined, the teaching content is no longer entirely devoted, scripted, but choosing the classic, the key and difficult points. The mode is not limited to teaching, but to training, teaching modes include not only lecture, but also multimedia presentations, on-site teaching, guiding surgery teaching, laboratory, thesis writing training, papers report, clinical thinking and operation basic skill, medical record writing training. The guidance is not limited to time, but to having effect, the teaching guidance is not limited to the tutor, physicians at all levels having the teaching tasks, with different guarantee effect. The assessment is not just scoring, but to practice, the teaching assessment is not a piece of test paper, but the clinical skills practice, medical record writing practice, operation basic skill practice, the clinical process practice, experiment skills practice and thesis writing practice. For the professional degree graduate students, through the "point to point" teaching mode, it will lay the foundation for the clinical practice better to develop a good habit of continuous learning, self learning, lifelong learning, for their future knowledge update, for their future career life.

Abstract:AIM: To explore the effect of comprehensive therapy in the treatment of fungal corneal ulcer and clinical outcome.

METHODS: A total of 159 cases 159 eyes fungal corneal ulcer patients took comprehensive therapy of 10 measures, followed up more than 3mo to observe the treatment effect and the final visual acuity in our hospital for treatment.

RESULTS: The average hospitalization time of fungal corneal ulcer was(12.11±5.13)d. A total of 148 cases of 148 eyes were cured, and the cure rate was 93.1%; improvement in 8 cases, accounted for 5.0%; 3 cases were ineffective, accounted for 1.9%. The final visual acuity of 89 eyes ≥0.3, accounted for 56.0%(89/159). The final visual acuity of 136 eyes ≥0.1, accounting for 85.5%(136/159), and accounting for 91.9% in 148 cured patients.

CONCLUSION: The comprehensive therapy in the treatment of fungal corneal ulcer has higher cure rate and visual acuity.

Abstract:AIM: To investigate effect of autogenous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer.

METHODS: A total of 83 cases(83 eyes)with severe fungal corneal ulcer treated in our hospital from Jan.2013 to Jan.2016 were selected. Among them, 36 cases(36 eyes)were treated with drug therapy, and 47 patients(47 eyes)were treated with autogenous conjunctival flap transplantation, two group did fungal culture and identification, observed the two groups treatment effect.

RESULTS: The effective rate of surgical treatment group was 89%, significantly higher than that of drug treatment group, the difference was statistically significant(P<0.05); The effective rate of surgical treatment of filamentous bacteria was 92%, which was significantly higher than that of drug treatment, the difference was statistically significant(P<0.05). The effective rates of surgical treatment and drug treatment of yeast were 80% and 78%, the difference was not statistically significant(P<0.05).

CONCLUSION: Autologous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer has good curative effect. The operation is simple, worthy of recommendation method. Filamentous bacterial corneal ulcer without good drug therapy effect, surgical treatment should be performed in a timely manner to improve the curative effect.

Abstract:AIM:To observe the clinical characteristics of palm video keratitis and analyze the pathogeny. And to explore methods to cure and prevent it.

METHODS:A total of 591 patients were randomly selected. Firstly, the frequency of staring at palm video equipment were investigated and break-up time of tear film with slit-lamp were observed. Then the data were calculated and the clinical characteristics were described. Finally, the correlation between incidence rate and the two factors were analyzed by SPSS13.0 respectively.

RESULTS:The incidence rate of palm video keratitis increased along with the frequency of staring at palm video equipment and decreased along with break-up time. There was significant relationship between incidence rate and the two factors respectively.

CONCLUSION:It is the most important pathogeny that staring at palm video equipment ahead and down for a long time which cause the change of tear film. That can reduce the frequency of using palm equipment and drop artificial tears to prevent and cure the disease.

Abstract:AIM: To summarize clinical characteristics and pathogenesis of iridocorneal endothelial syndrome(ICE)and investigate the treatment and prognosis.

METHODS: The clinical data of 12 cases(12 eyes)who received treatment in southwest hospital during Jun. 2007 to Feb. 2015 were analyzed retrospectively. The essential progressive atrophy of iris included 7 eyes, Chandler syndrome included 3 eyes, Congan-Reese syndrome included 2 eyes.

RESULTS: A total of 8 eyes were carried out once or multiple filtration surgery; 4 eyes were treated with glaucoma valve implantation. Postoperative follow-up time ranged from 15mo to 5y with the average of 30mo. Three months to 16mo after the surgery, the intraocular pressure of 4 patients were elevated again. Postoperative intraocular pressure was poorly controlled.

CONCLUSION:ICE syndrome is a group of clinically rare and serious eye disease. The excessive proliferation of ICE cells causes the existence of the corneal endothelial cells adhesion to the chamber angle and iris surface, which cause iris atrophy, secondary glaucoma, corneal endothelial decompensation. Currently, glaucoma filtration surgery and glaucoma valve implantation can only control intraocular pressure for several months, but the long-term prognosis is poor.

Abstract:AIM: To analyze the associated factors of poor vision after phacoemulsification operation.

METHODS: Clinical data of cases with poor vision after cataract phacoemulsification combined with IOL implantation from 341 patients(418 eyes)during Jan.2015 to Jan.2016 in our hospital were collected and logistic correlation analyzed.

RESULTS: The incidences of postoperative low vision were 10.3% for one month after operation. Forty-three eyes were reported low vision, and 41 of 43 the patients with postoperative low vision had fundus oculi disease before operation, which included 20 eyes(48.8%)with age-related macular degeneration, 16 eyes(39.0%)with diabetic retinopathy, 3 eyes(7.3%)with glaucomatous optic neuropathy, 1 eye(2.4%)with pathologic myopia of retinopathy and 1 eye(2.4%)with branch retinal vein occlusion.

CONCLUSION: The associated factors of poor vision after phacoemulsification operation are preoperative eye diseases and the nuclear hardness, and preoperative eye diseases may be the main causes of postoperative low vision. Comprehensive examination should be attached importance to, and be careful in the operation to decrease the harm for visual performance.

Abstract:AIM: The reasons of explicit and occult Descemet's membrane detachment(DMD)after phacoemulsification were analyzed and the therapeutic measures were further provided.

METHODS:A total of 31 cases diagnosed as explicit and occult DMD between Jan. 2013 and Apr. 2016 received the injection of sterile air into anterior chamber by 1-3 times, and were followed up for 3mo to observe the recoveries of cornea.

RESULTS: A total of 30 cases recovered with no visual impairment and other related complications.One case which refused being treated resulted in bullous keratitis.

CONCLUSION:Both the internal and external factors can influence the operation effect of explicit and occult DMD after phacoemulsification. Early detection and timely treatment play important roles in improving patients' visual acuity. Early examination of anterior segment OCT or UBM for intractable corneal edema is helpful to find the occult DMD with different degree and work out the targeted therapies.

Abstract:AIM: To evaluate the safety and efficacy of one transscleral sutured fixation intraocular lens implanted in the capsular treating traumatic lens dislocation.

METHODS: Twelve eyes with lens subluxation from 12 patients during Mar. 2013 to Mar. 2015 were reviewed. The stopping and chopping method combined with manual nuclear extraction was performed in extent of lens subluxation less than 1/2 quadrant and transscleral sutured fixation intraocular lens implanted in the capsular. Visual acuity, best-corrected visual acuity, intraocular pressure, corneal endothelial cell count and the position of IOL were observed and recorded.

RESULTS: All the surgeries were performed successfully. Patients were followed up for 6-12mo. During the follow-up period, the number of eyes for BCVA ≥0.8, 0.4-0.6 and ≤0.3 was 2, 7 and 3, respectively. It meant 66.67% of the eyes showed BCVA in 0.5-0.6. Intraocular pressure and the position of all intraocular lens were normal. Effects of operation on corneal endothelial cells were slight. No complications took place in and after surgery.

CONCLUSION: Without implanting capsular tension ring(CTR), we successfully use the intraocular lens(IOL)single loop suture fixation in the capsular bag for the treatment of the patient with traumatic lens dislocation. It indicates that the pressure and place shift from the use of IOL avoided by this method without implantation of CTR. This method is safe and effective for the treatment of eyes with traumatic lens dislocation.

Abstract:AIM: To find out the mean corneal spherical aberration and its changes with age in Kaifeng population.

METHODS: A total of 466 eyes of 427 Kaifeng subjects with cataract, whose age ranged from 52 to 75 years old, were divided into three groups according to the age. All the subjects were included in measuring K-readings of cornea, the corneal anterior and posterior surfaces of the spherical aberration and the total corneal spherical aberration using Pentacam(Oculus, Germany)at the 6-mm optical zone.

RESULTS:The mean corneal spherical aberration(CSA)of the whole groups was 0.339±0.153μm. Patients from 50 to 60 years old had CSA of 0.322±0.137μm, 0.326±0.157μm was the CSA of the patients from 60 to 70 years old, while those from 70 to 80 years old have a CSA of 0.401±0.182μm. The corneal K-readings had no correlation with the total corneal spherical aberration(r=0.034, P>0.05), anterior surfaces CSA, posterior surfaces and total CSA were positively correlated with age(r=0.253, 0.327, 0.233, all P<0.01).

CONCLUSION: CSA is varied among the population and CSA of elderly in Kaifeng area are slightly higher than white people, and positively correlated with age.

Abstract:AIM:To analyze effect of the inside incision positions of clear corneal incisions of cataract on astigmatism after surgery was analysis using anterior segment optical coherence tomography.

METHODS: A total of 40 patients of 43 eyes of age-related cataract were chosen. All of them were done 2.8mm clear corneal incision and phacoemulsification with foldable intraocular lens implantation. Preoperative and postoperative 1wk, 1 and 3mo, the corrected visual acuity were examined. Postoperative 1wk, 1 and 3mo, the positions and lengths of the incisions were measured. Depending on the location of the incisions, the patients were divided into two groups. Group 1: the inside mouth of the incisions(22 patients of 23 eyes)were far from the corneal vertex central line> 3mm.Group 2: the inside mouth of the incisions(20 patients of 20 eyes)were far from the corneal vertex central line ≤3mm.

RESULTS:One day before the surgery between Group 1 and Group 2 patients, there were no statistically significant difference(P>0.05)in corrected visual acuity and corneal astigmatism. After the surgery, corrected visual acuity gradually increased, astigmatism and cut lengths gradually decreased. But, there were no statistically significant difference at 1wk, 1 and 3mo(P<0.05).

CONCLUSION:The length of the inside mouth located within radius of the central cornea 3mm was rather longer than the length of the inside mouth located without radius of the central cornea 3mm.The SIA after surgery is greater, and postoperative visual acuity gained maybe less than the latter.

Abstract:AIM:To evaluate the efficacy and safety of Sub-tenon's anesthesia for compound trabeculectomy with high intraocular pressure.

METHODS:Forty-six eyes(46 cases)of primary glaucoma received compound trabeculectomy under Sub-tenon's anesthesia, whose preoperative intraocular pressure were higher than normal after 24 to 48h of combined medication. Both efficacy and complication of the anesthesia were studied.

RESULTS: One minute after anesthetic injection, all cases were able to achieve the effect of analgesia and eye brake. During the operation, 0 level of anesthesia effect included 35 eyes(76%), 1 level of anesthesia effect included 10 eyes(22%), 2 level of anesthesia effect included 1 eye(2%). Only 1 case of these patients needed to add the surface anesthetic once, and other cases were successfully operatedunder Sub-tenon's anesthesia. The total effective rate was 98%. No anesthesia complications occurred in all cases.

CONCLUSION:Sub-Tenon's anesthesia is safe, effective, simple and quick for compound trabeculectomy with high intraocular pressure.

Abstract:AIM:To observe the effect of phacoemulsification and intraocular lens(IOL)implantation combined with goniosynechialysis on corneal endothelial cells for the treatment of primary angle closure glaucoma(PACG)combined cataract, and to analyze the relative factors.

METHODS: Ninety-five eyes of 95 patients with PACG combined cataract were documented in this study. Twenty-two patients were male, and 73 were female. The age ranged from 46 to 85y old with a mean of(66±7)y. All patients were examined for endothelial cell count(ECC), intraocular pressure(IOP)and best corrected visual acuity(BCVA)1wk, 1, 2, 3 and 6mo after operation. Meanwhile, the range of anterior chamber closure and anterior chamber depth(ACD)were recorded before operation and postoperative 6mo.

RESULTS: The mean IOP was 36.1±4.3mmHg(28-42mmHg)preoperatively and 15.8±3.5mmHg(8-28 mmHg)(1mmHg=0.133kPa)6mo after operation. There was a decreasing trend in IOP after operation(t=17.173, P<0.01). There was an increased trend in BCVA after operation(Z=-8.351, P<0.01). The mean ACD was 1.95±0.34mm preoperatively and 3.11±0.33mm 6mo after operation. There was an increased trend in ACD after operation(t=11.483, P<0.01). There were 74 eyes in the range from 90° to 180° of anterior chamber and 21 eyes less than 90° before operation. There were 12 eyes in the range from 90° to 180° of anterior chamber and 83 eyes less than 90° postoperatively. The most of anterior chamber were open(Z=-9.013, P<0.01). ECC was 2 304±135 cells/mm² before operation and 2 243±152 cells/mm², 2 135±177 cells/mm², 2 028±172 cells/mm², 2 017±181 cells/mm², 2 006±143 cells/mm² 1wk, 1, 2, 3 and 6mo after operation respectively. ECC loss rates were 2.6%, 7.3%, 12.0%, 12.5% and 13.0%. ECC had a decreased trend 2mo after operation(F=5.568, P<0.01)and then kept stable(P_3mo=0.067, P_6mo=0.073).

CONCLUSION: Phacoemulsification and IOL-implantation combined with goniosynechialysis is an effective method to treat PACG combined cataract. It can increase BCVA and decrease IOP. ECC decreases after operation, but it is in the normal range. It is a safe and effective operation mode.

Abstract:AIM: To explorethe therapeutic efficacy of treating cataract phacoemulsification remove combined with trabeculectomy early postoperative failure with open sclera flap recanalization by phacoemulsification auxiliary hook interred the anterior chamber.

METHODS:Twenty-seven cases(27 eyes)of glaucoma combined cataract surgery(3mo)in the early failure were treated with that the phacoemulsification auxiliary hook into anterior chamber under the original sclera flap, open from the inside have adhesion of the sclera flap. Postoperative follow-up 12mo, the intraocular pressure and best corrected visual acuity were observed.

RESULTS: The postoperative follow-up was 12mo. There were functional filtering bleb in 14(52%)eyes; and the IOP was below 21mmHg in 17 eyes(63%)without any anti-glaucoma drug, and in 7 eyes(26%)with 1-2 categories of lower intraocular pressure(IOP)drugs, and 3 eyes(11%), failure and the success rate was 89% after 12mo. Average intraocular pressure after 1wk, 1mo, 3mo, 6mo and 12mo were(7.1±4.3)mmHg,(10.5±5.1)mmHg,(15.1±4.8)mmHg,(16.8±5.2)mmHg,(17.3±5.1)mmHg, significantly lower than the IOP preoperatively(30.2±6.8)mmHg(P<0.01). Average visual acuity(all of the following were best corrected vision)after 1wk, 1mo, 3mo, 6mo and 12mo was(0.32±0.52),(0.52±0.42),(0.55±0.39),(0.53±0.47),(0.54±0.42). Postoperative 1wk visual acuity deeper than preoperative(0.46±0.44)(P<0.05), more than all improved compared with preoperative(P<0.05). Postoperative anterior chamber bleeding in 5(19%)eyes, all absorbed itself in 3 to 5 days; ciliochoroidal detachment in 7(26%)eyes, except one case need operate, others were conservative treatment to heal. Postoperative continuous low intraocular pressure concurrent macular edema was 1 eyes(4%), 4mo healed after treatment.

CONCLUSION: It is a safe and effective method thattreating phacoemulsification cataract remove combined with trabeculectomy early postoperative failure with open sclera flap recanalization by phacoemulsification auxiliary hook interred the anterior chamber.

Abstract:AIM: To evaluate the clinical effects of dual-incision phacoemulsification and intraocular lens implantation combined with trabeculectomy in cataract and glaucoma patients.

METHODS: To observe the visual acuity, intraocular pressure and complications for 3-12mo after surgery as a retrospective study of 65 patients(70 eyes)with cataract and glaucoma.

RESULTS: The visual acuity of 2 eyes was lower than 0.1, 6 eyes were ranged from 0.1 to 0.3, 60 eyes were from 0.4 to 0.8, 2 eyes were over 1.0. The postoperative intraocular pressure of 26 eyes were effective controlled. The postoperative shallow anterior chamber occurred in 1 eye.

CONCLUSION: It is an ideal treatment to take dual-incision phacoemulsification and intraocular lens implantation combined with trabeculectomy in cataract and glaucoma patients and it shows better effects than normal operation method.

Abstract:AIM: To retrospectively analyze selection of operation, surgery effect, complications and treatment methods of super high myopia combined with rhegmatogenous retinal detachment(RRD).

METHODS: A total of 47 cases(47 eyes)with the super high myopia patients combined with RRD who accepted scleral buckling of external pressure, vitrectomy combined silicone oil filling, or intravitreous gas injection were chosen in our hospital from Jan.1, 2011 to Jan.1, 2016. Best corrected visual acuity(BCVA), intraocular pressure, retinal reattached rate, closure rate of holes and the postoperative complications of patients in half year were analyzed.

RESULTS: Half a year postoperation, BCVA of twenty-four cases underwent vitrectomy combined silicone oil filling were improving(71%), and eight cases with scleral buckling surgery were enhanced(73%). Statistical test showed the surgical treatment could significantly improve patients' eyesight, especially PPV with silicone oil, but the BCVA of patients with scleral buckling of external pressure in this study had no obvious significance according to the rank sum test. Compare with other surgery, pars plana vitrectomy(PPV)combined silicone oil filling had more complications, such as high intraocular pressure and diplopia.

CONCLUSION: The therapy of super high myopia patients with rhegmatogenous retinal detachment need many years' clinical experience, surgical skill of clinician and according to the number, the shape and the site of the retinal holes and area of detached retina, they need to choose the right means of surgery, and timely deal with postoperative complications, in order to improve the patients' postoperative retina, reset rate and visual function.

Abstract:AIM:To analyze the 34 cases of patients with diagnosis of lacrimal duct disease, to explore the cause and clinical characteristics of lacrimal duct inflammation, and to study the common misdiagnosis to improve the diagnosis rate, to provide clinical experience for medical workers.

METHODS:A total of 34 eyes of 34 patients were selected from 2011-06 to 2015-06 to our hospital for lacrimal duct incision. Clinical data of patients including age and gender distribution, eye and lesion location, duration, canaliculitis clinical symptoms and previous misdiagnosis were collected. The operation of lacrimal duct was carried out, and the secretion of lacrimal secretion was checked.

RESULTS:Patients over the age of 40 accounted for 77% of the population, men accounted for 23.5%, women accounted for 76.5%. Left eye in 15 cases, right eye in 19 cases, and were monocular onset, 26 cases(76%)of patients with lower lacrimal duct inflammation. Clinical symptoms:increased secretion, canthal conjunctival congestion, swelling, lesion location around the lacrimal puncta swelling and tenderness, slightly raised, epiphora, foreign body sensation. The culture results Showed 34 cases of discharge inspection. A total of 20 cases were fungal growth, 6 cases of bacterial growth rate were 59%, 18%, and 8 cases were not detected, 10 cases of lacrimal duct stone were found by pathological examination. There were 3 cases of Aspergillus, 5 cases of Candida, 2 cases of actinomycetes, 4 cases found in Gram staining microscope. Misdiagnosis of canaliculitis for other eye diseases, including 12 cases of chronic dacryocystitis, 8 cases of chronic conjunctivitis, 6 cases of acute conjunctivitis, stye in 4 cases, the misdiagnosis rate reached 88%.

CONCLUSION:In the middle and old aged people, the lacrimal duct is more than that of the male. The main pathogenic bacteria causing lacrimal duct infection may be fungi, which can be treated with anti-fungal drugs. For the removal of the lacrimal duct stone, we should distinguish the types of pathogenic bacteria for the treatment of the disease. In the case of misdiagnosis, the clinical manifestations of different clinical manifestations from the lacrimal duct infection and other diseases of the eye should be carefully examined and carefully treated.

Abstract:AIM: To investigate the comparison of different types of catheter treatment of anastomotic ring canalicular effect.

METHODS: Retrospective analysis. A total of 114 cases 114 eyes were randomly selected between May 2013 to May 2015 jointly admitted to Huizhou Huizhou City People's Hospital and the Central People's Hospital of canalicular patients in accordance with the agreement of the annular catheterization divided into three groups, group A of annular nasal lacrimal duct catheterization in 36 eyes, group B for the whole nasal lacrimal annular catheterization in 33 eyes, group C between the upper annular tears point catheterization 45 eyes. Through the A, B, C three groups after 1, 3wk, 1, 3mo and 1y follow-up were analyzed to compare.

RESULTS: Group A of 31 eyes were cured, improved in 2 eyes, 3 eyes, the effective rate was 91.7%; group B, 27 cases were cured, improved in 3 eyes, 3 eyes, the effective rate was 90.9%; group C, 40 cases were cured, improved in 2 eyes, 3 eyes, the effective rate was 93.3%. A, B, C three groups efficiency pointless difference(P=0.124). Eye Effect: A, B, C meaningful difference among the three groups(F=36.578; P=0.002), Group A scored the highest score of a minimum group C, respectively(3.5±0.8)and(2.3±0.7); comparison meaningless difference between group a and group B(t=0.086, P>0.05); Group A and C and comparison of differences between group C and group B have the significance(t=15.241, t=17.472; P<0.05). Nasal influence: A, B, C meaningful difference among the three groups(F=778.581; P=0.001), the highest score in group B, group C minimum scores were(6.6±0.8)and(0.9±0.7); A, B, C three groups comparison of differences twenty-two have significance(t=17.262; t=18.247; t=16.647; P<0.05). Shape Effect: A, B, C difference among the three groups of meaningful(F=481.113; P=0.002), Group A scored the highest score of a minimum group C, respectively(5.8±0.9)and(1.2±0.6); Compare the difference between Groups B and C meaningless(t=0.087, P>0.05); comparing the differences between the Groups A and B and between Group A and C were significance(t=26.362, t=27.532; P<0.05). Unplug risk: A, B, C meaningful difference among the three groups(F=751.121; P=0.003), Group A scored the highest score of a minimum group C, respectively(6.5±0.7)and(1.5±0.7); A, B, C three groups comparison of differences twenty-two have significance(t=19.642; t=20.153; t=18.345; P<0.05). Group A had 8 patients had lower eyelid eversion, 5 cases of inferior lacrimal point expansion, 13 cases of sneezing, itchy nose, runny nose syndrome. Group B had 20 cases of varying degrees of now sneezing, itchy nose, runny nose syndrome. Group C had no serious complications.

CONCLUSION: Similar to A, B, C three groups of treatment efficacy, patient lacrimal functional recovery is safe and effective, which the group C treatment, during treatment and less material and fewer postoperative complications in patients, it is worth promotion.

Abstract:AIM: To observe the effect of perioperative detail treatment of pterygium.

METHODS:Sixty cases(100 eyes)of pterygium patients were collected from Sep.2012 to Jan.2014. All cases were performed modified pterygium excision with limbal epithelial autograft transplantion under microscope. Corneal wound healing, graft survival, and the recurrence of pterygium were observed.

RESULTS:All cases of conjunctival flap survive, corneal wound closed well. The patients were followed up for 7 to 12mo. Among them, 3 eyes recurred and the recurrence rate was 3%. There were no serious complications.

CONCLUSION:In the operation of pterygium excision with limbal epithelial autograft transplantion, standard and detail treatment can significantly improve the clinical effect.

Abstract:AIM:To evaluate the clinical effects of femto-LASIK using new Ziemer LDV Z6 femtosecond laser machine(Z6).

METHODS:Two-hundred cases(400 eyes)was randomly separated into two groups: Group A included 200 eyes which corneal flaps were made by Z6, and Group B included rest of 200 eyes which corneal flaps were examined by a traditional Ziemer LDV CrystalLine femtosecond laser machine(CrystalLine). Visual acuity, slit lamp, refraction, Sim-K average, intraocular pressure(IOP), non-invasive tear break-up time(NIAvg-BUT), operation difficulty and complications were compared between two groups preoperatively and postoperatively.

RESULTS:There was no significant differences between two groups in visual acuity, refraction, Sim-K average, IOP and NIAvg-BUT either preoperatively or 6mo postoperatively(P>0.05). Although there were significant differences in operation difficulty and complications were found between two groups(P<0.05), there was no serious complication in any group. Furthermore, a clear demarcation line could be observed in the cornea of Group A postoperatively.

CONCLUSION:More careful and strict requirements are needed when using the new Z6 femtosecond laser for corneal flaps.

Abstract:AIM: To discuss the clinical efficacy of fresh amniotic membrane(AM)during the microscopic adjustable suture surgery in children's intercommunity strabismus, in order to guide clinical treatment.

METHODS: With the clinical randomized control study(RCT), 60(112 eyes)cases of patients in childhood who received microscopic strabismus surgery in our hospital were divided them into two different groups from Jan.2010 to Oct.2015. According to the application of AM on the basis of ophthalmology outpatient number, 30 cases(58 eyes)in group A were treated with rectus muscle recession surgery combined adjustable suture combined with AM. The other 30 cases(54 eyes)in group B were treated with rectus muscle recession surgery combined adjustable suture only. All patients in two groups were followed-up over 6mo after the strabismus surgery.

RESULTS:Twenty-seven cases(48 eyes)of all the strabismus patients must be adjusted after strabismus surgery, and the eye position adjustment rate was 42.9%. At 1mo after surgery, eye position of 18 cases(29 eyes)can be adjusted in all patients, and 44.8%(16 cases, 26 eyes)in group A with the average of adjustment lengths was 2.56±0.64mm, and 5.6%(2 cases, 3 eyes)in group B, with the average of adjustment lengths was 0.52±0.28mm, the differences of the adjustment rate and the average of adjustment amount were both high statistically significant(χ²=22.477, P<0.01; t=16.502, P<0.01)between the two groups. Except of 3 cases who couldn't cooperate with eye position adjustment, they all received eye position adjustment in different degrees in one month after strabismus surgery,and after eye position adjustment, 27 cases(53 eyes)in group A got normal eye position, and the correction rate of eye position was 91.4%, and 16 cases(28 eyes)in group B got normal eye position after eye position adjustment, the correction rate was 51.9%, the differences of the correction rate were statistically significant(χ²=21.827, P<0.01)between the two groups.

CONCLUSION: The application of fresh AM in the microscopic adjustable suture strabismus surgery is exactly effective in treatment of children's intercommunity strabismus. It can significantly extend the adjustment time and increase the adjustment amount, and it also can statistically improve the controllability and achievement ratio for children's strabismus surgery.

Abstract:AIM: To explore the clinical value of combined detection of C-reactive protein(CRP), erythrocyte sedimentation rate(ESR)and white blood cell(WBC)count in patients with ocular syphilis.

METHODS: Dates of CRP, ESR, WBC, TPPA and RPR of 51 ophthalmopathy patients caused by syphilis and 50 normal control from Jan. 2012 to Dec. 2015 in eye hospital were recruited and analyzed statistically.

RESULTS: The positive rates of CRP, ESR and WBC of oculopathy patients were 16%, 18% and 39%, respectively, which were higher than those in the control group. In patients group, the positive rate of ESR was higher than CRP and WBC. There were no obvious relationships between RPR titers and positive ratios of CRP, WBC and ESR.

CONCLUSION: The blood level of CRP, WBC and ESR may have certain help in estimating and monitoring condition of patients with ocular syphilis.