Abstract:AIM: To investigate the changes of corneal biomechanical properties before and after femtosecond laser assisted LASIK(FS-LASIK)using Corneal Visualisation Scheimpflug Technology(Corvis ST)and Ocular Response Analyzer(ORA), and the correlation with other myopic parameters.

METHODS:Sixty three patients(63 eyes)who had myopic femtosecond laser assisted LASIK(FS-LASIK)were enrolled in the study. The right eye of each patient was analyzed in this study. The corneal biomechanical parameters pre-operative and 1mo post-operative was measured with the Corvis ST(Oculus, Wetzlar, Germany)and ORA(Reichert, Buffalo, New York, USA). Comparison of the biomechanical property values before and after surgery was peformed using Paired t-test or Mann-Whitney U. Pearson or Spearman correlations were used to evaluate the relationship between parameters.

RESULTS: The postoperative 1^st A-time, Vin, 2^nd A length, Vout, HC time and Radius demonstrate significant decreases comparing with preoperative values(P=0.00, P=0.00, P=0.00, P=0.00, P=0.00, P=0.00 respectively). The postoperative 2^nd A-time, DA and PD significantly increases(P=0.00, P=0.00, P=0.00), however, the 1^st A length had no significant difference after surgery. The CH and CRF were significantly lower after FS-LASIK(P=0.00, P=0.00). A statistically significant correlation coefficient was found between preoperative central corneal thickness(CCT)with postoperative-preoperative changes of 1^st A-time, 2^nd A-time, DA and Radius respectively(P=0.01, P=0.04, P=0.03, P=0.01).

CONCLUSION:There were significantly changes of corneal biomechanical properties after FS-LASIK surgery. The changes of corneal biomechanical properties after FS-LASIK can be reflected by some parameters of Corvis ST and ORA. The mainly influence of corneal biomechanical alteration was possibly correlation with corneal thickness.

Abstract:AIM:To present the outcomes of early treatment with corneal collagen cross-linking with riboflavin in patients with mild to moderate keratoconus.

METHODS:It is a prospective interventional study at tertiary eye care center. Forty-seven eyes of 38 patients with mild to moderate keratoconus who underwent collagen cross linking with riboflavin were enrolled. Preoperative data included eye involved, presenting visual acuity, intraocular pressure(IOP), pachymetry and corneal topography. Postoperative data included the best-corrected visual acuity(BCVA), IOP, pachymetry, corneal topography and postoperative complications.

RESULTS:Study comprised of 47 eyes of 38 patients aged between 16-30y. The average preoperative vision was 0.58±0.40 logMAR which significantly improved to 0.40±0.27logMAR at 2y follow up(P=0.005). The average preoperative keratometry readings were 50.5±4.6 D which significantly decreased during the subsequent follow up and the average keratometry readings at 2y was 48.2±4.1 D(P=0.011). The average IOP significantly increased postoperatively and at 2y follow up was 15.1±3.0mmHg compared to preoperative IOP(12.9±2.5 mmHg)(P=0.035). The average preoperativepachymetry was 467.9±38.8 μm, which decreased significantly and was 465.0±39.3 μm at 2y follow up. No complications were noted in any of our cases.

CONCLUSION:Early treatment with collagen cross-linking with riboflavin provide good long term visual outcomes in patients with mild to moderate keratoconus without awaiting for progression of the keratoconus.

Abstract:AIM: To investigate the efficacy of 577-nm pattern scan laser in panretinal photocoagulation(PRP)treatment in newly diagnosed proliferative diabetic retinopathy(PDR).

METHODS:Prospective and comparative observation was performed in totally 32 patients with high-risk PDR. They were randomly divided into group 1(using pattern scan laser, PSL)and 2(using single spot laser, SSL), each containing 16 subjects to which totally 20 eyes received PRP. Non-perfusion region was identified with fundus fluorescein angiography(FFA)before and 3mo after final PRP. The advantage of PSL was verified in terms of the number and the duration of PRP sessions needed for satisfactory outcomes, and the pain score.

RESULTS: Three PRP sessions were needed for each eye to complete the treatment using PSL, while 4 sessions were needed using SSL. The duration of each session with PSL in group 1 was 7.3±2.3min, which was significantly shorter than that with SSL in group 2(13.2±4.1, t₃₈=5.596, P<0.001). Treatment-related pain score was also significantly lower in group 1 than in group 2(P<0.01). Three months after the final PRP, the number of eyes with retinal non-perfusion regions that required additional treatment was 5(25%)in group 1 and 8(40%)in group 2.

CONCLUSION: PSL showed clear advantages over SSL in the PRP treatment of PDR, not only in the improved efficacy, but also in the reduction of pain and the improvement of effectiveness.

Abstract:AIM:To investigate the influence of posterior capsular opacity(PCO)and its removal on retinal nerve fiber layer(RNFL)thickness measured with spectral domain optical coherence tomography(SD-OCT).

METHODS: Fifty patients underwent RNFL measurements using SD-OCT before and after Nd: YAG laser posterior capsulotomy. The patients were divided into groups according to the value of signal to noise ratio(SNR)measured by SD-OCT as group 1: SNR 3 and 4, group 2: SNR 5 and 6 and group 3: SNR 7 and 8. The other eye served as control(control group).

RESULTS: The mean BCVA, SNR and RNFL measurements significantly increased in eyes underwent Nd: YAG laser capsulotomy. The preoperative and postoperative mean BCVA, SNR and RNFL measurements were significantly different in group 1 and group 2. Although the preoperative and postoperative mean BCVA and SNR were significantly different, the preoperative and postoperative RNFL thickness weren't significantly different in group 3.

DISCUSSION: PCO has an influence on OCT image quality. SNR improved in all cases after removal of the PCO. However, RNFL thickness significantly improved after Nd:YAG laser capsulotomy in patients with preoperative SNR under 7.

Abstract:Optic perineuritis(OPN)refers to a spectrum of conditions involving pathologic inflammation of the optic nerve sheath. The classic triad of OPN consists of unilateral optic neuropathy associated with pain and/or disc oedema, but the condition often mimics other optic neuropathies, resulting in delayed diagnosis and suboptimal treatment. We performed a database search of Medline and Ovid in January 2016 for articles published in any language with the keywords ‘optic perineuritis'. Sixty articles were found, published from 1956 to 2015. Two reviewers(Tai ELM and Tevaraj JMP)performed an independent screening of abstracts. Articles of interest were subsequently examined. In this review, we highlight the salient features of OPN, with particular emphasis on the clinical differences between OPN and optic neuritis. Although the majority of cases of OPN are idiopathic, investigations are required to rule out specific infectious and inflammatory causes of secondary OPN. MRI is an invaluable component of the workup, as radiographic demonstration of peri-neural inflammation is diagnostic of OPN. Corticosteroid therapy results in dramatic and rapid reversal of the signs and symptoms, but prolonged therapy with slow tapering of oral corticosteroids may be necessary to reduce the risk of relapses.

Abstract:AIM: To investigate the effect of NgR mediated oxidative stress on the apoptosis of retinal ganglion cells(RGCs)induced by glucose.

METHODS: RGC-5 cell were divided into 3 groups: control group(DMEM high glucose medium+10% fetal calf serum), high glucose group(DMEM high glucose medium+10% fetal calf serum+30mmol/L glucose),NEP1-40 group(DMEM high glucose medium+10% fetal calf serum+30mmol/L glucose+1μmol/L NEP1-40). Detections were performed after 3d culture: the state of cell growth was observed by microscopy. Cell viability was detected by CCK-8 kit. The apoptosis rate of RGC cells was detected by flow cytometry(FCM). The intensity of ROS of the cells were detected by fluorescence microscopy. Intracellular MDA levels and SOD activity were measured by related kits. Western blot was used to detect the expressions of Bcl-2 and Bax proteins.

RESULTS: Compared with control group, high glucose group had a poor state and cell viability decreased, cell apoptosis rate significantly increased, ROS and MDA levels were significantly enhanced, SOD activity decreased, and the expression of anti-apoptotic protein Bcl-2 was decreased and the expression of pro apoptotic protein Bax was up-regulated. Compared with glucose group, after NgR expression was inhibited by NEP1-40, the oxidative stress reaction was reduced, Bcl-2/Bax was increased, the cell status was improved, the cell viability was increased, and the apoptosis rate was decreased in the NEP1-40 group(P<0.05).

CONCLUSION: High concentration of glucose can induce apoptosis of RGC-5 cells by NgR mediated oxidative stress reaction.

Abstract:AIM: To investigate the effect of p16 protein expression on the proliferation of retinal neovascularization in oxygen-induced retinopathy(OIR).

METHODS: Totally 60 SD rats aged 7d were randomly divided into 4 groups: normal group, model group, intervention group and NS control group. Normal group was raised in a normal air feeding; model group at 75% high oxygen for 5d to establish the model of oxygen induced retinopathy; intervention group was given anti p16 methylation drug 5-aza-CdR(0.25 mg/kg)intraperitoneal injection; NS control group was given the same volume NS intraperitoneal injection. The eyes were taken from each group and the left eyes were removed for observation of retinal neovascularization by HE staining, and immunohistochemistry and immunofluorescence were taken for observations of p16 protein expression. Right retina had been performed real time-PCR to analysis p16mRNA expression.

RESULTS: The normal group were not found retinal neovascularization breaking through internal limiting mebrane. In model group and NS control group, the retinal tissue was obviously thickened, and a large number of new blood vessels were found. In the intervention group, a small amount of new blood vessels were found in the retina. The expression of p16 was low in the model group, the positive cell number was 19.52±2.67, and the number of the positive cells was 36.38±3.16 in the intervention group, the difference was statistically significant(P<0.001). Real time-PCR showed decreased expression of p16 mRNA in the model group(2^-△△ct=0.14±0.01), the expression of p16 mRNA in the intervention group rats retina was significantly higher than that of NS control group rat retina, there was significant difference between two groups(2^-△△ct=0.68±0.08, P<0.001).

CONCLUSION: The abnormal expression of P16 may be closely related to the proliferation of retinal neovascularization. Inhibition of p16 methylation can decrease the proliferation of retinal neovascularization.

Abstract:AIM:To investigate the expression of MTDH and β-catenin in ocular adnexal lymphoma lesions and its clinical significance.

METHODS: Resected specimens were collected from patients suffering from B-cell non-Hodgkin lymphoma(NHL)(n=40)and lymphadenosis(n=20)of ocular adnexal in Affiliated Hospital of Qingdao University from June 1995 to December 2015. Lymphadenosis of ocular adnexal was acted as the control group. PCR and immunohistochemistry were employed to examine the MTDH and β-catenin mRNA and protein expression respectively. The relationship between the MTDH and β-catenin protein expression level and the clinical pathological characteristics were analyzed.

RESULTS:The expression of mRNA and protein of MTDH and β-catenin in ocular adnexal lymphoma lesions were higher than that in control group(P<0.05). The expression of MTDH and β-catenin proteins were related to pathologic type of tumors, but not related to age, gender or pathogenic site. With the increase of pathologic grade, MTDH and β-catenin labeling frequency increased gradually. And there was a positive correlation between MTDH and β-catenin(r=0.389, P=0.036).

CONCLUSION: Over expression of MTDH and β-catenin may play a significant role in the ocular adnexal lymphoma. The expression of MTDH and β-catenin has a positive relationship.

Abstract:AIM: To investigate therapeutic effect of lateral temporal corneal incision phacoemulsification combined with intraocular lens(IOL)on cataract and its effect on intraocular pressure(IOP)and tear film.

METHODS: The clinical data of patients with cataract who received treatment in our hospital from March 2014 to December 2015 were retrospectively analyzed. According to the location of the incision, they were divided into temporal corneal incision group and upper corneal incision group. We observed the incidence of complications of the two groups, compared the intraocular pressure, visual acuity, refraction and tear film break-up time of the two groups before and after surgery.

RESULTS: The operation time and postoperative pain score of the two groups had no significant difference(P>0.05). The IOP and visual acuity between the two groups before operation had no significant difference(P>0.05). At the intraocular pressure of the two groups was lower than that before operation, and the visual acuity was higher than before operation, and the changes of the anterior lateral incision group were more obvious(P<0.05). The diopter, tear film break-up time of the two groups had no significant difference. At 1mo after operation, the diopter of the two groups all increased, tear film break-up time was lower than before the surgery and temporal corneal incision group changes more obvious(P<0.05). There was no significant difference in the incidence of anterior chamber, corneal edema and anterior chamber exudation in the two groups of patients with corneal incision group.

CONCLUSION: The temporal corneal incision phacoemulsification combined with intraocular lens implantation has a good therapeutic effect on cataract patients, can effectively improve the intraocular pressure and tear film stability, improve eye function, promote the recovery of the body after surgery.

Abstract:AIM: To discuss the prognosis effects of vascular endothelial growth factor(VEGF)inhibitors combined with laser therapy in patients with diabetic retinopathy.

METHODS: Totally 120 patients(129 eyes)with diabetic retinopathy were selected from September 2014 to December 2015 in our Hospital. According to the random distribution, all patients were divided into inhibitor-laser group(60 case with 65 eyes)and laser group(60 case with 64 eyes). The laser group was treated with conventional laser treatments. Inhibitor-laser group patients were given VEGF inhibitors treatment besides laser. The international standard was used to charted the visual acuity and enzyme-linked immunosorbent(ELISA)was used to detect the plasma VEGF levels. All patients were followed up for 6mo, analyzed before and after the treatment for curative effect, the lesion center concave thickness(CMT), retinal neovascularization leakage area(RNV), plasma VEGF levels and adverse reactions, and the best corrected visual acuity(BCVA)before and 1, 3, 6mo after treatment.

RESULTS: Efficient rate of inhibitor-laser group was obviously higher than that of the laser group, with statistical difference(P<0.05). CMT, RNV, plasma VEGF level of inhibitor-laser group after treatment were lower than those of laser group, with statistically significant(P<0.05). BCVA at 1, 3 and 6mo after treatment in inhibitor-laser group were obviously higher than those of laser group, with statistical difference(P<0.05). Incidence of adverse reactions of the two groups were basically the same, there was no significant difference(P>0.05).

CONCLUSION: VEGF inhibitors combined with laser therapy can effectively improve the curative effect of patients with diabetic retinopathy. It can effectively improve the retinal thickness and leakage of new blood vessels, and the patient's vision, with good security.

Abstract:AIM:To systemically evaluate the clinical efficacy and safety of treating allergic conjunctivitis with olopatadine eye drops and other therapies.

METHODS: We performed a comprehensive search for the randomized controlled trials(RCTs)about the olopatadine eye drops and other therapies vs. olopatadine eye drops monotherapy for treating allergic conjunctivitis published by April, 2016 from PubMed, EMbase, Cochrane Library, VIP Chinese periodical Database, CNKI and Wan Fang Chinese periodical Database. Studies obtained from eligible database were filtered according to the criteria, and data were retrieved from those studies for further analysis. Then we performed a Meta-analysis using RevMan 5.3 software.

RESULTS: A total of 28 RCTs were included. Among all 3568 patients involved in, 1 799 were in the treatment group, while the other 1 769 were in the control group. The results of Meta-analysis showed that the olopatadine eye drops and other therapies was superior to monotherapy for patients with allergic conjunctivitis in clinical effects \〖OR=3.54,95%CI(2.71,4.61),P<0.001\〗.

CONCLUSION: The existing evidence supports that the prognosis of the olopatadine eye drops and other therapies is better than olopatadine eye drops monotherapy for treating allergic conjunctivitis. For the quality and quantity limitations of the included studies, more well-designed and double blind RCTs are required to further prove this conclusion.

Abstract:The lens is a transparent tissue without vessel, which is mainly composed of a layer of epithelium cells and differentiating fiber cells. With aging, lens opacity can deteriorate vision significantly and even result in blindness, which is termed as age-related cataract(ARC). A fully developed treatment method of ARC is surgery, while a few cataracts in the initial stage can be suppressed via drugs efficiently.This paper introduced relevant drugs and important ingredients that can suppress and prevent ARC, and then summarizes clinical applications and existing researches with respect to drug treatments in the process of cataract suppression and treatment.

Abstract:In the field of cataract, there is such a widespread phenomenon: the majority of patients have complained thatthe second-eye phacoemulsification is often more painful than the first-eye surgery. Recent studies on this phenomenon have found that after cataract surgery in the first eye, in the second-eye aqueous humor there is a high expression of cytokines which is monocyte chemotactic factor-1.It is the focus of the present study to analyze the mechanism of the increase of pain in the second eye with cataract surgery from the molecular level. Monocyte chemotactic factor-1(monocyte chemoattractant protein, MCP-1)which is considered to be a new member of the family of pain,is an important factor resulting in pain, and its specific receptor CCR2 binding exerts its biological activity. This is a review of the inflammatory cytokine research progress on the increase of pain during the second-eye cataract surgery.

Abstract:Glaucoma is the second major causes of blindness after cataract. The conventional trabeculectomy and shunt implantation is still the most common surgical procedure in treatment of glaucoma. However, the limitations of the treatments are the security and failure rate. Micro-invasive glaucoma surgery(MIGS)is an emerging category which shares the following five characteristics compared with traditional glaucoma surgery:(1)an interno microincision,(2)micro-invasion,(3)definite curative effect,(4)high safety, and(5)rapid recovery. moreover, it can also reduce the use of glaucoma medication after operation. This kind of surgery can be conducted in three different space, such as Schlemm canal, the suprachoroidal space, and the subconjunctival space. This article reviews briefly the new techniques of micro-invasive glaucoma surgery.

Abstract:Uveal melanoma(UM)is the most common primary intraocular malignant tumor of adult. The traditional treatment is enucleation, but it cannot completely avoid metastasis, and on the contrary, it stimulates to distant metastasis of tumor cells to some extent. According to the statistic of latest 30a, survival rates of UM patients with metastasis is still very low. Recently, many researches devoted to targeted therapy, immune therapy and radiotherapy, which have achieved gratifying results. We summarized these relative researches in this paper.

Abstract:Idiopathic macular hole(IMH)is unequivocal inducement lead to limiting full-thickness defect of retinal neurepithelium layerin macular region. It's one of the most important fundus macular degeneration. According to the different causes and the anatomical site, the lesion has a different classification, and its etiology and pathogenesis are diverse and complex. But along with the continuous renewal of ophthalmologic examination instrument and the continuous improvement of surgical technique, treatment of IMH is diversified and treatment effect is more obvious. Not only that, IHM preventive treatment also gradually get used in clinical. In this paper, we reviewed the progress of IMH in terms of the pathogenesis, relative examination, surgical treatment, preoperative prognostic evaluation and so on.

Abstract:Perimenopausal women have a very high risk suffering from dry eye. Local disorder such as inflammation or estrogen deficiency were usually attributed as the main mechanism in recent researches. However, the author believes that comparing with other types of dre eye, there are some others risk factors should be noticed. This article reviewed recent literatures on causes of dry eye in perimenopausal women, including lacrimal gland and conjunctiva dysfunction, hormones deficiency, psychological disorder, systemic diseases, as well as living conditions and personal habits.

Abstract:Nuclear factor-kappa B(NF-κB)is a nuclear transcription factor with multi-directional and multi-effect regulation, existing in almost all cells. It participates in the regulation of physiological and pathological processes, such as cell proliferation, differentiation, adhesion, apoptosis, inflammation and immune response, and plays an important role in body growth and development, inflammation, immune response, tumor growth and other aspects. In recent years, studies have indicated that NF-κB occupies an important place in the pathogenesis of eye related diseases, especially in ocular surface disease, cataract, glaucoma, uveitis, ocular fundus diseases and so on. There is a possibility that inhibition of NF-κB activation may become a novel target for the treatment of eye diseases. This paper will review the research reports of NF-κB in the field of ophthalmology.

Abstract:With the development of society, the new requirements for visual health are put forward. In the past, visual acuity and contrast sensitivity were used to evaluate the visual function of human eye, but it is subjective and limited, not really reflecting human eye's visual function. In order to pursue a more sensitive and accurate objective evaluation method, experts at home and abroad make some exploratory research on visual quality. The study confirmed that the scattering is an independent factor affecting the visual quality of human eye, it can make a more scientific evaluation of visual function.This article summarizes the influence of scattering for the visual quality of human eye, according to related research at home and abroad in recent years.

Abstract:AIM:To evaluate the safety and efficacy of Ex-press implantation in primary open angle glaucoma(POAG)patients.

METHODS: This was a retrospective study of 37 eyes in 28 POAG patients who were treated with Ex-press implantation in Changsha Aier Hospital from August 2013 to July 2015. All subjects had a minimum 6-month follow-up(mean 15.0±5.5mo). Success was defined as intraocular pressure(IOP)was 6-21mmHg without complications, with or without glaucoma medicines. Life-table analysis was used to assess the cumulative probabilities of success in different follow-up time. Cox regression analysis was performed to estimate the relations between survival outcomes and multiple predictors.

RESULTS: The follow-up ranged from 6-24mo(mean 15.0±5.5mo). Visual acuity was significantly different between preoperation and the final follow-up(z=-2.40, P=0.016). The preoperative IOP was 37.4±12.7mmHg, and the postoperative IOP at 1d, 1wk, 1, 3, 6mo, 1, 1.5, 2a were 11.9±7.0, 9.4±3.9, 12.2±9.2, 11.5±6.4, 10.9±3.6, 11.5±5.8, 10.7±2.9 and 9.6±2.3mmHg, respectively. IOP was significantly different between preoperation and the final follow-up(F=24.45, P<0.05). The number of anti-glaucoma medications was significantly reduced from 2.24±1.21 at preoperation to 0.05±0.23 postoperative(Z=-2.02,P<0.05). The cumulative probabilities of success at 1d, 1wk, 1, 3, 6mo, 1, 1.5, 2a were 86.5%, 78.4%, 64.9%, 62.2%, 59.5%, 56.8%, 56.8% and 56.8%. The number of anti-glaucoma medications was identified as a risk factor for surgical failure by the Cox hazard model(P=0.02).

CONCLUSION: Ex-press implantation is effective and relatively safe for controlling the IOP in the POAG eyes. The procedure is simple and has fewer postoperative complications.

Abstract:AIM: To observe the interaction of Ranibizumab and laser in the treatment of proliferative diabetic retinopathy(PDR).

METHODS: From December 2014 to August 2015, synchronous PDR patients with macular edema were divided into two groups. Thirty patients(48 eyes)were treated with Ranibizumab and laser, and 28 patients(45 eyes)were treated with laser alone. In the combined treatment group, FFA was reexamined 1wk after intravitreal injection of Ranibizumab. The patient then received panretinal photocoagulation(PRP). PRP was performed in the laser group alone. The best corrected visual acuity(BCVA)at 1, 4 and 8wk after treatment was observed and recorded. Macular thickness was measured by OCT.

RESULTS: The BCVA and macular thickness were significantly different between the two groups at 1, 4 and 8wk after treatment(P<0.05). In the laser alone group, the visual acuity decreased and the thickness of the macular thickness increased after 1wk. After treated 4 and 8wk, visual acuity improved, macular thickness decreased. After 1wk of intravitreal injection, FFA showed retinal leakage improvement in all eyes in the combined treatment group, with neovascularization retracted in varying degrees.

CONCLUSION:Ranibizumab combined with photocoagulation, can improve early vision, and reduce macular edema. Anti-VEGF therapy and photocoagulation may play a synergistic role to some extent. Drugs antagonized VEGF, improved macular edema and microvascular function. It can enhance the laser effect.Effective photocoagulation can further improve retinal ischemia and hypoxia, inhibit the excessive expression of VEGF.

Abstract:AIM: To evaluate the clinical effect of phacoemulsification and intraocular lens(IOL)implantation in the treatment of proliferative diabetic retinopathy(PDR)with cataract.

METHODS: Totally 261 patients(266 eyes)with PDR complicated with cataract in our hospital were selected and randomly divided into control group(133 eyes in 130 patients)and study group(133 eyes in 131 patients). The control group underwent vitrectomy combined with laser photocoagulation, phacoemulsification and intraocular lens implantation. The study group received intravitreal injection of bevacizumab before vitrectomy, laser photocoagulation, phacoemulsification and intraocular lens implantation. Clinical curative effect of two groups was analyzed.

RESULTS: The postoperative complications of the control group were higher than that of the study group, and the difference was statistically significant(P<0.05). In study group, 67 eyes received photocoagulation again, iris neovascularization occurred in none eyes. In control group, 76 eyes received photocoagulation again, iris neovascularization occurred in 17 eyes(22.4%).The difference between the two groups was significant(P<0.05). The visual acuity of the study group was better than that of the control group(P<0.05). The incidence of macular edema in the control group was significantly higher than that in the study group(P<0.05).

CONCLUSION: Intravitreal injection of bevacizumab with vitrectomy, phacoemulsification and IOL implantation for cataract has good clinical effect for PDR.

Abstract:AIM: To estimate the efficacy and safety of intravitreal injections of 0.5mg conbercept combined with 532-laser retinal photocoagulation for retinal vein occlusion(RVO).

METHODS: Totally 122 cases(122 eyes)checked in hospital for RVO were randomly divided into two groups by using the random number list during May 2015 to March 2016. The research group with 58 cases(58 eyes)comprised of 24 cases(24 eyes)diagnosed as central retinal vein occlusion and 34 cases(34 eyes)diagnosed as branch retinal vein occlusion. The control group with 64 cases(64 eyes)comprised of 26 cases(26 eyes)diagnosed as central retinal vein occlusion and 38 cases(38 eyes)diagnosed as branch retinal vein occlusion. All the cases were treated with intravitreal conbercept injections while the research group combined with treatment of received 532-laser retinal photocoagulation pre-injection. Optical coherence tomography(OCT)was adapted pre and 1,3 and 6mo after intravitreal injection. The best corrected visual acuity(BCVA), thickness of macular central concave and retinal pigment epithelium uplift area were compared between the two groups.

RESULTS: BCVA of all cases were increased 1, 3 and 6mo after treatment, and the difference had statistical significance(P<0.05). The research group had a better improvement of BCVA than control group, and there were significant differences between the two groups 3, 6mo after treatment but 1mo. Thickness of macular central concave and retinal pigment epithelium uplift area of two groups were decreased 1, 3 and 6mo after treatment, the difference had statistical significance(P<0.05). The research group had a bigger decrease value than the control group as for thickness of macular central concave and retinal pigment epithelium uplift area, there were significant differences between two groups 3, 6mo after treatment but 1mo. No adverse events occurred during the treatment.

CONCLUSION: Intraviteal conbercept injection can increase the visual acuity and decrease both the thickness of macular central concave and retinal pigment epithelium uplift area of patients with retinal vein occlusion. Combined with 532-laser retinal photocoagulation will achieve better outcome than intravitreal injection only.

Abstract:AIM: To investigate the clinical effect of panretinal laser photocoagulation combined with calcium hydroxide in the treatment of diabetic retinopathy(DR).

METHODS: Selected 120 cases(204 eyes)of DR patients who were treated in our hospital from January 2014 to December 2015 were randomly divided into study group(116 eyes in 66 patients)with calcium hydroxide, control group(88 eyes in 54 patients). Two groups were treated with panretinal laser photocoagulation, and the clinical effect of the two groups were compared.

RESULTS: At 6mo after surgery, BCVA of study group was higher than that of control group, the difference was statistically significant(P<0.05); at 3 and 6mo after operation, fluorescein leakage area of the study group were lower than that of control group, the difference was statistically significant(P< 0.05); at 3 and 6mo after surgery, central macular thickness(CMT)of the study group was lower than that of control group, the difference was statistically significant(P<0.05); the study group had complications after surgery in 4 eyes(3.4%)and 5 eyes(5.7%)in control group, the difference was not statistically significant(P>0.05).

CONCLUSION: Compared with simple laser photocoagulation, panretinal laser photocoagulation combined with calcium hydroxide for III - IV stage DR reduce fluorescein leakage area and CMT.

Abstract:AIM: To explore the factors that influence the pupil dilated in patients with type 2 diabetes mellitus.

METHODS: Totally 85 patients with type 2 diabetes were collected from April 2016 to August 2016 in department of Endocrinology in our hospital. Compound tropicamide was instilled in the right eyes of the 85 patients,then pupil diameters were measured 30min after instillation. They were divided into different groups according to the duration of diabetes, glycosylated hemoglobin levels, the degree of retinopathy and peripheral neuropathy. Influencing factors of the dilated pupil were analyzed.

RESULTS: In the three groups as the duration of diabetes was 5a, 5-10a or 10a or more respectively, the pupil diameters were 6.98±0.78mm, 6.18±0.67mm and 6.00±0.73mm, and the difference between the three groups was statistically significant(P<0.01). In non-proliferative diabetic retinopathy group, the pupil diameters(6.05±0.92mm)was significantly lower than that in the pre-clinical group(6.75±0.76mm), the difference between the two groups was statistically significant(P=0.001). The normal group of the ankle-knee conduction velocity(6.70±0.84mm)was significantly higherthan that in the abnormal group(6.23±0.81mm), and the difference was statistically significant between the two groups(P<0.05). In the three groups as the level of glycosylated hemoglobin was less than 8.4%, 8.4%～13.4% or more than 13.4%, pupil diameters were 6.60±0.82mm, 6.53±0.86mm and 6.73±0.73mm, the difference between the three groups was not statistically significant(P=0.708).

CONCLUSION: The main factors influencing the pupil are duration of diabetes, diabetic retinopathy and peripheral nerve lesions. In order to improve the effect of diabetes mellitus on the pupils, it is necessary to discover and treat the diabetic patients as early as possible. Diabetes patients with small pupil should more pay attention to the fundus examination, in order to avoid missed diagnosis of diabetic retinopathy.

Abstract:AIM: To investigate the correlation between intraocular pressure(IOP)changes pre- and post-hemodialysis(HD)and the biometric structure of the anterior chamber in patients of chronic renal failure.

METHODS: Fifty-two patients(take right eye as study one)with hemodialysis that were diagnosed with chronic renal failure by nephrology in our hospital from January 2015 to December 2015 were collected. Fifty-two eyes were divided into four groups based on Shaffer classification combined with ultrasound biomicroscopy(UBM)and gonioscopy manifestations: wide angle group, narrow angle group, extremely narrow group and close angle group. Venous blood was collected to get plasma colloid osmotic pressure before HD and within 60s after HD. IOP was measured with rebound intraocular pressure gauge in a supine positon approximately 30min before starting HD, 2h after HD begin and approximately 30min after HD ending. Approximately 30min before and after HD, central corneal thickness was measured with corneal endothelial cell counter, central anterior chamber depth and lens thickness were taken by A scan, angle opening distance, trabecular iris angle, iris thickness and ciliary body thickness were measured by UBM.

RESULTS: Plasma osmotic pressure reduced after HD, the difference was statistically significant(t=3.04, P<0.05). The means of IOPs among three measurement points were not all the same(F=41.69, P<0.01). The IOP in 2h after HD had significant difference compared with before HD(P<0.01).The IOP in 30min after HD ending had significant difference compared with 2h after HD(P<0.01). The means of IOPs among three groups were not all the same(F=6.44, P<0.01). The IOP in extremely narrow angle group had significant difference compared with that in wide angle group and narrow angle group(P<0.05). Ciliary body thickness decreased after HD in every group, while only in wide angle group showed significant change after ending HD(t=2.61, P<0.05). Central corneal thickness, central anterior chamber depth, angle opening distance, trabecular iris angle and iris thickness decreased, while lens thickness increased after HD. But all these changes between before HD and after HD in every group had no significant difference.

CONCLUSION: The influence of hemodialysis on IOP is related to the biometric structure of the anterior chamber. And extremely narrow angle is risk factor of elevated IOP during hemodialysis, narrow angle may be a risk factor. While patients with wide angle is relatively safe. We suggest to take ocular examination as early as possible for patients with hemodialysis, and focus on patients with narrow angle.

Abstract:AIM: To explore the therapy efficacy of different drugs for dry eyes after cataract surgery.

METHODS: Collected from June 2014 to June 2016 in patients with dry eyes in our departments of cataract surgery, a total of 60 cases with 120 eyes, according to the doctor order divided into pure sodium hyaluronate eye drops group 20 cases(40 eyes, sodium hyaluronate eye drops combined pranoprofen eye drops group 20 cases(40 eyes), sodium hyaluronate eye drops combined pranoprofen eye drops and Qiju Dihuang pill group of 20 cases(40 eyes). All patients were treated for 1mo. Observation of break up time(BUT), Shimmer Ⅰ test(SIt)and fluorescein corneal staining(FI)were recorded before the treatment and 1, 2wk, 1, 3mo after treatment.

RESULTS: Difference of efficient rates of three groups 1mo after treatment were statistically significant(P<0.05). BUT: there was no statistically significant difference among three groups before treatment(P>0.05); at 1, 3mo after treatment compared with before treatment, the differences of the three groups were statistically significant(P<0.05); among the three groups 1, 2wk and 1mo after treatment, the differences were statistically significant(P<0.05); at 3mo after treatment the difference among the three groups was not statistically significant(P>0.05); but sodium hyaluronate eye drops combined pranoprofen eye drops and Qiju Dihuang pill group(12.14±1.97s)was superior to pure sodium hyaluronate eye drops group(10.54±1.88s)and sodium hyaluronate eye drops combined pranoprofen eye drops group(12.05±1.63s).SIt: there was no statistically significant difference among three groups before treatment(P>0.05); at 1, 3mo after treatment compared with before treatment, the differences of the three groups were statistically significant(P<0.05); among the three groups 1, 2wk and 1mo after treatment, the differences were statistically significant(P<0.05); but sodium hyaluronate eye drops combined pranoprofen eye drops and Qiju Dihuang pill group(14.24±1.89mm/5min)was superior to pure sodium hyaluronate eye drops group(12.22±2.54mm/5min)and sodium hyaluronate eye drops combined pranoprofen eye drops group(12.27±2.31mm/5 min).FL: there was no statistically significant difference among three groups before treatment(P>0.05); at 1, 3mo after treatment compared with before treatment, the differences of the three groups were statistically significant(P<0.05); among the three groups 1, 2wk and 1mo after treatment, the differences were statistically significant(P<0.05); at 3mo after treatment the difference among the three groups was not statistically significant(P>0.05).

CONCLUSION:Sodium hyaluronate eye drops combined pranoprofen eye drops and Qiju Dihuang pill in the treatment of dry eye after cataract surgery is better than that of sodium hyaluronate eye drops combined pranoprofen eye drops group and simple application of sodium hyaluronate eye drops, which can better improve the visual function, improve tear film stability, get better treatment effect.

Abstract:AIM: To observe and compare the accommodative responses of myopic teenagers with orthokeratology lenses and frame glasses.

METHODS: One hundred and twenty myopic teenagers(240 eyes)aged 10-16y were selected and divided into experimemtal group(orthokeratology lens group)and control group(frame glasses group), with 60 cases(120 eyes)in each group. The accommodative response before and after correction of all the cases in the two groups were followed up and compared after 1, 3, 6 and 12mo.

RESULTS: A total of 113 patients(226 eyes)completed the experiment, including 54 patients(108 eyes)in the experimental group and 59 patients(118 eyes)in the control group. Both the two groups showed accommodative lag which gradually decreased with the wearing time. The accommodative lag before and after correction in the experimental group and control group were respectively(1.22±0.47, 0.91±0.39, 0.77±0.40, 0.65±0.32, 0.51±0.22),(1.23±0.48, 1.05±0.41, 0.90±0.49, 0.83±0.46, 0.69±0.33)D. The effects of measurement time on accommodative lag of each group were significant(F=195.229, 142.361, 323.484, P<0.05). The interaction between the group and the measurement time also had significant effects(F=11.222,P<0.05). But the interaction between eye and measurement time had no significant effects(F=0.025,0.023,P>0.05).The accommodative lags in the orthokeratology group were smaller than the frame glasses group after correction(t=-2.587, -2.241, -3.522, -4.587, P<0.05),but no significant difference before correction(t=-0.07,P>0.05).

CONCLUSION: Both frame glasses and orthokeratology can improve accommodative response and reduce accommodation lag of juvenile myopia, but the effect of wearing orthokeratology is superior to frame glasses.

Abstract:AIM: To investigate the effect of anterior transposition of inferior oblique muscle on the treatment of dissociated vertical deviation(DVD)in children with inferior oblique overaction(IOOA)and unequal inferior oblique transposition of the treatment of IOOA with the eyes of the asymmetry of DVD efficacy, associated with the lower oblique hyperfunction DVD patients to provide more effective treatment.

METHODS: Eighty patients with hyperfunction who were treated in our hospital from January 2014 to December 2015 were randomly selected and treated with anterior transposition of inferior oblique muscle. Patients were followed up for 1 to 30mo. We compared the vertical incline at the original incline from far(5m), near(33cm)distance and IOOA degree before and after operations, and the correlation between the two. We also compared the vertical incline at the original incline from far(5m), near(33cm)distance and IOOA degree before and after operations in 30 eyes(20 patients)with bilateral asymmetry DVD and IOOA who received unequal inferior oblique transposition. The incidence of antielevation syndrome(AES)was observed after operations.

RESULTS: The mean prism diopters(PD)at 5m before operations was 19.5±0.15, the average PD after operations was 3.5±0.18, at 5m the original incline was 16±0.21PD. The mean PD at 33cm was 18.6±0.20 before operation, 4.5±0.26 after operations, and 14.1±0.16 at 33cm the original incline, the difference was statistically significant(P<0.05). Preoperatively, inferior oblique muscle hyperfunction +2 and +3 was 50 eyes, + 1 was 20 eyes, and 12 eyes still showed inferior oblique muscle hyperfunction after operation, but the degree of hyperactivity was +1. There was a significant positive correlation between the degree of IOOA and the vertical inclination(33cm: r=0.554, P<0.01; 5m: r=0.454, P <0.01). There were significant differences(P<0.05)in the vertical incline in 20 patients(30 eyes)with bilateral asymmetry DVD and IOOA and the degree of IOOA was significantly lower. In contrast, 18 patients(24 eyes)underwent anterior transposition of the inferior oblique muscle had AES in different degrees, which had statistically significant difference(P<0.05)compared with patients(30 eyes)with IOOA treated with unequal inferior oblique transposition.

CONCLUSION: Anterior transposition of the inferior oblique muscle has a good therapeutic effect on isolated vertical strabismus patients with inferior oblique hyperfunction. While the incidence of postoperative AES is low in patients received unequal inferior oblique muscle transposition.

Abstract:AIM: To study the quality of life in patients with thyroid associated ophthalmopathy in China, to analyze the factors related to the decline of quality of life and to provide evidence for the clinical diagnosis and treatment.

METHODS: Totally 125 patients diagnosed with thyroid associated ophthalmopathy from January 2015 to January 2016 at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were included. Clinical data including gender, age, eyelid, conjunctival hyperemia and edema, lacrimal caruncle swelling, degree of proptosis, eyelid retraction volume, vision, diplopia were recorded. TAO-QOL questionnaire were investigated. The content was divided into two dimensions: visual function and appearance. Each dimension contains eight related questions. Final indicators for each dimension was the score. Independent t test, ANOVA and multiple regression analysis were performed using SPSS tactics 22.0 software.

RESULTS: Eighty-eight valid questionnaires were included. The average score of visual function was 72.6±28.3 and that of appearance was 66.8±26.0; 28 cases(28/88)were in active phase while 60 cases(60/88)were in inactive phase. Visual function and appearance scores were 59.4±28.8 and 56.1±26.0 in active group; 78.8±26.1 and 71.8±24.6 in inactive group. Active group has decreased score for both visual function sore and appearance score(P=0.002 and P=0.008). The score of patients with mild TAO(26/88 )was 86.2±17.1 and 82.1±17.8; 70.3±28.3 and 63.3±25.5 for moderate-severe patients(55/88), 41.1±34.6 and 37.6±22.7 for extremely severe patients(7/88). The score of both visual function and appearance in severe group were significantly lower than those in the moderate-severe group(P=0.006 and P=0.007).Compared to mild group, those of moderate-severe group were significantly lower(P=0.012, P=0.001).The visual function score of patients in constant diplopia group were significantly lower than the no diplopia group, horizontal or vertical gaze diplopia and inconstant diplopia group(P<0.001, <0.001, =0.002). By multivariate regression analysis, we found the factors that influence visual function score were visual acuity and diplopia(R²=0.470), and those correlated to appearance score were exophthalmos, retraction and diplopia(R²=0.375).

CONCLUSION: TAO-QoL can be used as a simple and effective tool to evaluate the quality of life in TAO patients. The QoL score is related to disease staging and grading. Thus, shortening the course of active phase, decreasing the degree of diplopia and improving visual acuity are critical ways to improve the quality of life in TAO patients.

Abstract:AIM:To investigate the situation of amblyopia in preschool children, and to provide evidence for the protection of visual acuity and prevention of amblyopia in children.

METHODS: From 2010 to 2015, a total of 236 203 school aged children in our hospital in Chengdu were examined with routine visual acuity. This study was performed by the professional eye doctor in our hospital using the international standard visual acuity chart and statistically analyzed.

RESULTS: There were 18.85%(44 516/236 203)of the subjects in the children with refractive errors, and the rate of amblyopia was 6.12%(14 453/236 203). In anisometropic amblyopia type the rate was 68.19%(9 856/14 453), significantly higher than the proportion of other types, and the difference was statistically significant(P<0.05). The composition ratio of mild amblyopia and medium amblyopiawas 53.69%(7 760/14 453)and 41.38%(5 980/14 453), which were significantly higher than that of severe amblyopia constitute 4.93%(713/14 453). Central monitor amblyopia proportion, 80.09%(11 575/14 453), was significantly higher than that of non center, and walk the proportion of amblyopia. The subjects were grouped according to their age. Amblyopia children who was <5 years old was 5.48%(6 254/114 213), higher than 5.33%(6 499/121 990)in ≥5 years old amblyopia children, but the difference was not statistically significant(P>0.05).

CONCLUSION: School-age children with anisometropic amblyopia type constructed the main body of amblyopia children in our city. Mild to moderate amblyopia and the central vision amblyopia were large proportion of children with amblyopia. We should strengthen the visual inspection of school-age children in our city and do the work of prevention and early treatment of amblyopia.

Abstract:AIM:To explore clinical characteristics of supracho-roidal hemorrhage(SCH)complicated by intraocular surgery and to observe visual prognosis.

METHODS:A total of 13 eyes(13 cases)with SCH related to intraocular surgery from June 2005 to June 2015 were included and respectively studied. The age of our cases ranged from 22 to 76. Of all, 4 eyes(31%)were concomitant with hypertension, 6 eyes(46%)with high myopia and 6 eyes(46%)with oculi hypertonia, respectively. Intraoperative expulsive SCH occurred in 8 eyes, while postoperative delayed SCH in 5 eyes. The most SCH(7 eyes)happened during the surgery of removing silicone oil, 4 eyes with SCH were related to extracapsular cataract extraction(ECCE), 1 SCH eye was complicated by ECCE combined with trabeculectomy and 1 SCH eye by lensectomy and vitrectomy. As for treatment, 5 eyes took medication alone, 4 eyes were performed drainage sclerotomy and gas tamponade, while the other 4 eyes were accomplished vitrectomy with adjunctive perfluoro-carbon liquids and silicone oil tamponade.

RESULTS:At the 10-month of follow-up, all eyes with SCH were resolved. Except 1 eye with no light perception owing to abandoning treatment, the sights of the other 12 eyes were between light perception and 0.4.

CONCLUSION:SCH complicated by intraocular surgery was rare but with devastating outcome. Aged patients, hypertension, high myopia and oculi hypertonia may be risk factors. In addition, surgical methods in the early years were likely correlated to the occurrence of SCH. Certain sight of the patients with SCH may be maintained after positive treatment.

Abstract:AIM:To observe the clinical effects of the small incision non phacoemusification cataract surgery in 462 Sudanese cataract cases(536 eyes).

METHODS:From September 2013 to August 2015, we analyzed the 462 Sudanese cataract cases(536 eyes)performed cataract surgery by the way of the small incision non phacoemusification with intraocular lens(IOL)implantation and summarized the intraoperative and postoperative complications, the eyesight and intraocular pressure(IOP)of the eyes in 1d, 1wk and 1mo after operation.

RESULTS: Intraoperative complications: posterior capsular ruptured and vitreous prolapsed in 18 eyes(3.4%), iris prolapsed in 10 eyes(1.9%), suspensory ligament of the lens ruptured in 7 eyes(1.3%), not implanted IOL in 5 eyes(0.9%), descent's membrane detachment in 3 eyes(0.6%), iridodialysis in 1 eye(0.2%). Postoperative complications: corneal edema in 47 eyes(8.8%), anterior chamber inflammatory reaction in 32 eyes(6.0%), pupil oval or slightly upward in 12 eyes(2.2%), the upper iris incarcerated in the tunnel incision in 3 eyes(0.6%),hyphema in 2 eyes(0.4%), infective endophthalmitis in 1 eye(0.2%). Visual acuity: uncorrected visual acuity were ≤0.1 in 52 eyes(9.7%), >0.1-<0.3 in 97 eyes(18.1%), 0.3-<0.5 in 129 eyes(24.1%), and ≥0.5 in 258 eyes(48.1%)in 1d after operation. Uncorrected visual acuity was ≤0.1 in 28 eyes(5.2%), >0.1-<0.3 in 66 eyes(12.3%), 0.3-<0.5 in 150 eyes(28.0%), and ≥0.5 in 292 eyes(54.5%)in 1wk after operation. At 1mo after operation, some patients did not follow-up on time, uncorrected visual acuity of reviewer above 0.5 in 321 eyes. IOP: in 1d after operation, IOP above 20 mmHg in 26 eyes(4.9%). In 1wk after operation, IOP above 20 mmHg in 2 eyes(0.4%). In 1mo after operation, 1 eye was still poor control with traumatic cataract surgery, and IOP returned to normal after the reoperation of trabeculectomy.

CONCLUSION:The small incision non phacoemusification cataract surgery with IOL implantation has the advantages of small incision, short operation time, relatively safe, easy to mastered, no-suture, quick visual function recovery and low cost. And, the operation equipments are simple and do not need many expensive medical equipments, supplies and professional staffs. So, the small incision non phacoemusification cataract surgery with IOL implantation is suitable for the anti-blind work of cataract in the foreign aid and remote areas.

Abstract:AIM: To compare the pre-and postoperation results of flash visual evoked potential(FVEP)and pattern visual evoked potential(PVEP)and to discuss the significance of FVEP and PVEP examinations in assessing postoperative visual acuity in senile cataract patients.

METHODS: During the period of June 2015 to May 2016, 68 cases of senile cataract patients(79 eyes)were treated in our hospital. This research analyzed the changes of pre- and postoperative FVEP and PVEP results and compared the preoperative FVEP, PVEP, FVEP combined with PVEP results with the postoperative best corrected visual acuity(BCVA).

RESULTS: There was no statistically significant difference in the incubation time of P2 wave and the amplitude of N2-P2 wave of FVEP pre-and postoperative examination(t=0.448, -0.492; P>0.05), there was statistically significant difference in the incubation time of P100 wave and the amplitude of N75-P100 wave of PVEP pre-and postoperative examination(t=2.505, -5.462; P<0.05).The incubation time of P2 and P100 wave before operation were significantly negatively correlated with the postoperative BCVA(r=-0.694, -0.402; P<0.05). The amplitude of N2-P2 wave before operation was significantly positively correlated with the postoperative BCVA(r=0.607,P<0.01). There was no significant correlation between the amplitude of N75-P100 wave before operation and the postoperative BCVA(r=0.237,P>0.05).Consistent rate of FVEP examination was 83.54%, that of PVEP was 66.67%, the difference was statistically significant(χ²=5.11,P<0.05).Consistent rate of FVEP combined with PVEP examination was 90.74%, that of PVEP was 66.67%, the difference was statistically significant(χ²=9.34,P<0.01).

CONCLUSION: By comparision, FVEP is better and more accurate than PVEP in predicting the postoperative visual acuity. Preoperative FVEP together with PVEP examinations can effectively and objectively assess postoperative visual function recovery of senile cataract patients whose corrected visual acuity of the proposed surgical eyes before operation is ≥0.1.

Abstract:AIM:To observe the clinical effects of intravitreal injection of conbercept combined with complex trabeculectomy and panretinal photocoagulation(PRP)in the treatment of neovascular glaucoma.

METHODS: Eleven patients(11 eyes)with neovascular glaucoma were injected with conbercept 0.50mg/0.05mL in vitreous chamber. Complex trabeculectomy was performed after the neovascularization dissipated, and PRP was performed in all cases at the right time. The follow-up time was 6mo. The vision, intraocular pressure(IOP)and complications were observed after complex trabeculectomy.

RESULTS: The IOP were all decreased at 1wk, 1, 3 and 6mo after operation, and the difference was statistically significant(P<0.01). After 6mo, the best-corrected visual acuity of 2 eyes(18%)was improved, 8 eyes(73%)were stable, and 1 eye(9%)was declined. The postoperative complications included hyphema, shallow anterior chamber, and vitreous hemorrhage.

CONCLUSION: Intravitreous injection of conbercept combined with complex trabeculectomy and PRP can control the IOP and preserve the visual function effectively in patients with neovascular glaucoma.

Abstract:AIM: TO observe the efficacy of goniosynechialysis in the treatment of angle closure glaucoma.

METHODS: Totally 82 patients(82 eyes)with angle-closure glaucoma were selected in our hospital from May 2008 to February 2012. The screening conditions were that the lenses were opacity with IOP could be controlled to normal, angle closure ≤1/2 circle and vision ≤0.3.The groups were randomly divided into 2 groups, the first group, in which the phacoemulsification, intraocular lens(IOL)implantations and goniosynechialysis were performed; the second groups, in which phacoemulsification and IOL were performed. IOP, visual acuity, anterior chamber depth and gonioscope findings before and after operation were recorded and analyzed.

RESULTS: On postoperative visual acuity, there were no significant differences between the 2 groups(P<0.05). There was no significant difference in IOP and anterior chamber depth between the 2 groups after operations. In the first group, anterior chamber angle fully opened in 32 cases(78%). In second groups, anterior chamber angle fully opened in 23 cases(56%). The difference between the two groups were statistically significant(P<0.05).

CONCLUSION: Phacoemulsification and IOL implantation combined with goniosynechialysis is an effective treatment for glaucoma surgery. Not only can improve visual acuity, but also can effectively develop the angle, and control intraocular pressure.

Abstract:AIM: To observe the efficacy and safety of cyclophoto-coagulation through 23G minimally invasive scleral incision in the treatment of refractory glaucoma.

METHODS: Totally 23 patients(23 eyes)were taken the surgery-the cyclophotocoagulation-through 23G minimally invasive scleral incision. We observed the changes of intraocular pressure(IOP), the best corrected visual acuity(BCVA), the quantity of drugs reducing intraocular pressure and complications in the pre-and post-operation.

RESLUTS: Comparing with preoperative, the postopera-tive IOP, BCVA and the number of IOP-decreased drugs were statistically significant(P<0.05); the complication was fewer.

CONCLUSION: The 23G minimally invasive scleral incision cyclophotocoagulation is a new type of safe and effective surgical method for the treatment of refractory glaucoma.

Abstract:AIM:To investigate the effect of photodynamic therapy(PDT)combined with intravitreal injection of ranibizumab on circumscribed choroidal hemangioma(CCH).

METHODS:A retrospective study was performed for 6 eyes(6 cases)diagnosed as CCH. Before treatment, OCT examination showed macular cystoid edema and retinal neurepithelium layer detachment in all patients. All patients underwent photodynamic therapy, then intravitreal injection of ranibizumab 0.5mg(0.05mL)were administered at 48h after PDT. The best corrected visual acuity(BCVA), examination of the ocular fundus, fundus photography, fluorescence fundus angiography(FFA), indocyanine green angiography(ICGA), eye B ultrasonic and optical coherence tomography(OCT)were performed respectively at 1, 3 and 6mo after treatment.

RESULTS:The patients were followed up for 4 to 10mo, the final vision of follow-up increased than before, it was raised 7 lines. The images of ICGA revealed hypofluorescence or no leakage in focal area. Eye B ultrasonic showed that hemangioma shrunk or faded. The images of ICGA revealed macular region retinal reattached well and edema disappeared completely. Mean flow-up was 6mo postoperative. There had no evidence of recurrence.

CONCLUSION:For CCH patients, hemangioma got smaller obviously by PDT. Intravitreal ranibizumab injection promote effusion absorption under the retina. Combining use of the two therapies could improve visual acuity in a short-term.

Abstract:AIM: To observe the choroidal thickness in nonarteritic anterior ischemic optic neuropathy(NAION)measured by enhanced depth imaging optical coherence tomography(EDI-OCT)and evaluate its clinical significance.

METHODS: Totally 30 patients diagnosed with NAION were studied and 60 individuals with normal fundus were set as control. Choroidal thickness was measured by EDI-OCT. Choroidal thickness of the affected eye and contralateral eye in patient group and right eye of the control group were evaluated and recorded.

RESULTS: Differences in age, gender and refractive status between NAION group and control were not significant(P>0.05). Choroidal thickness near fovea and optic disc in affected eye and contralateral eye in patient group was thinner compared to these of control group(P<0.01). No statistical differences were observed in the choroidal thickness between affected eye and contralateral eye(P>0.05).

CONCLUSION: In NAION patients, choroidal thickness of affected eyes and unaffected contralateral eyes were significantly thinner compared to these of control group. Diminish of the observed choroidal thickness in this study might be explained by small vessels occlusion in posterior ciliary artery, which would affect the blood supply of the choroid.

Abstract:AIM: To further investigate the etiology and treatment strategies of diabetic macular edema(DME)by studying the correlation between responses to intravitreal injection of Ranibizumab(IVR)and diabetic retinopathy(DR)extent in DME patients.

METHODS: This study comprised 33 eyes of 27 non proliferative diabetic retinopathy(NPDR)patients with DME and 34 eyes of 32 PDR patients with DME, who had been followed for at least 6mo after IVR. We compared the responses to the anti-VEGF treatment between the two groups.

RESULTS: NPDR patients had strong statistical improvement in best corrected visual acuity(BCVA)and central macular thickness(CMT)after both 3-month treatment and 6-month treatment(P<0.05), While PDR patients had not(P>0.05). There were also statistical differences(P<0.05)in BCVA and CMT between NPDR group and PDR at a time when the patients had received both 3-month treatment and 6-month treatment.

CONCLUSION: Different extents of DR have influence on DME responses to anti-VEGF.

Abstract:AIM: To investigate the diagnostic value of fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)in the diagnosis of diabetic macular edema(DME).

METHODS: From January 2015 to January 2016, selected 62 patients(101 eyes)with diabetic retinopathy(DR)in our hospital, underwent FFA and OCT respectively. We compared the results of the two methods.

RESULTS: The detection rate of DME by FFA was 84.2%, and the detection rate of DME by OCT was 77.2%, the difference was not statistically significant(P>0.05). In 101 eyes, OCT and FFA all showed macular edema in 76 eyes, and no macular edema in 14 eyes, the diagnostic accuracy of OCT and FFA was 89.1%, Kappa was 0.653, and the consistency was higher(P<0.05). Macular central retinal thickness difference was statistically significant in patients with different FFA features(P<0.05), the diffuse edematous retinal thickness was 301.43±62.44SymbolmA@m, which was significantly thicker than the other patients.

CONCLUSION:OCT can objectively examine the structural changes of the macular area in diabetic patients, but it cannot replace the role of FFA in the diagnosis of macular edema, the combination of the two methods is helpful in the diagnosis of DME.

Abstract:AIM: To analyze and study the electrophysiological and clinical features of non-arteritic anterior ischaemic optic neuropathy(NAION)patients.

METHODS: Totally 68 cases(81 eyes)of NAION in our hospital from June 2015 to June 2016 were selected as the research object. All the subjects were divided into the control group(36 cases with 39 eyes), the observation group(32 cases with 42 eyes), according to the age, the age of the control group was at 50, the age of patients in the observation group was over 50. The demographic characteristics, clinical characteristics, risk factors, visual evoked potential and visual acuity of the two groups were compared and analyzed.

RESULTS: Clinical symptoms of the disease onset of the control group were occlusion, contralateral eye involvement, which was significantly lower than that of the patients in the observation group(P<0.05). Patients in the control group at 1° and 15 'spatial frequency were significantly better than those of the control group, there were obvious differences between groups(P<0.05). There was no significant difference between the control group and the observation group in the initial visual acuity(P>0.05). The final visual acuity of the control group was significantly better than that of the observation group(P<0.05).

CONCLUSION: For NAION patients, the clinical symptoms will be affected by age, occlusion, and contralateral eye involvement at the onset and other factors. The 1° and 15 'spatial frequency delay are relatively serious, and the final visual acuity is not very good. Thus, electrophysiological examination for the NAION patients help to diagnose the disease, clinicals should also strengthen the follow-up of NAION patients, reduce the contralateral eye.

Abstract:AIM: To study the role of xylometazoline hydrochloride nasal spray in combination therapy of nasolacrimal duct obstruction and to investigate the effect of nasal inflammation on nasolacrimal duct obstruction.

METHODS: Totally 279 patients with nasolacrimal duct obstruction were collected, who received lacrimal passage irrigation, CT angiography for lacrimal passage and nasal endoscope before treated by lacrimal laser forming and artificial nasolacrimal duct implantation combined with xylometazoline hydrochloride nasal spray. In group A, 137 patients were treated with antibiotic eye drop and non-steroidal anti-inflammatory drugs after operations. In group B, 142 patients were treated with xylometazoline hydrochloride nasal spray besides the same treatment for group A.

RESULTS:In the 279 patients 217(77.8%), in which 105 cases(76.6%)were in group A and 112 cases(78.9%)were in group B, were suffered with nasal inflammation, including nasal mucosal hyperemia, inferior turbinate hypertrophy, middle turbinate hypertrophy. At 3mo after the ducts were drawn, efficacy of group B was 95.8%, which was significant better than that of group A(86.1%, P<0.05).

CONCLUSION: Nasal inflammation was an important factor in the incidence of nasolacrimal duct obstruction, which shoud pay more attention in the process of diagnosis and treatment. Combination therapy could improve the cure rate of nasolacrimal duct obstruction.

Abstract:AIM: To observe the clinical effects of modified endoscopic dacryocystorhinostomy(EDCR)for chronic dacryocystitis and try to find out an effective adjuvant method to improve the long-term effect of the modified surgery.

METHODS: Totally 136 cases(158 eyes)of chronic dacryocystitis were enrolled in the study and randomly divided into two groups:treatment group(80 eyes)and control group(78 eyes).The treatment group underwent the modified EDCR(intraoperative mytomycin C combined with silicone tube implatation and the use of tobramycin and dexamethasone eye ointment).The control group was only applyed mytomycin C during EDCR.The postoperative follow-up period was for 3-12mo.

RESULTS: At 6mo postoperatively,the cure rate and total effective rate of the treatment group were 95.0%, 98.8% respectively,and the control group of it were 75.6%, 93.6%.The effective rate of the treatment group was higher than that of the control group significantly(χ²=11.90,P<0.05).

CONCLUSION: The modified EDCR is a new surgical method which can prevent postoperative cicatricial adhesion and elevate surgical effective rate, and it has clear field, minimal invasion, quick recovery, exact effect and less recurrence.

Abstract:AIM: To discuss the feasibility and clinical efficacy of endoscopic endonasal dacryocystorhinostomy(EN-DCR)combined with stent implantation for treatment of acute dacryocystitis.

METHODS: A total of 31 patients(32 eyes)presenting with acute dacryocystitis were treated with EN-DCR combined with stent implantation under antibiotic cover from April 2014 to December 2015. These patients were followed up for 3 to 12mo.

RESULTS: The medial canthal edema and erythema was gradually reducing within 48h in all patients. The hospitalization time took 2 to 8d(average 3.8±1.6d). Patients underwent removal of stent about 3mo after surgery. Thirty-one eyes showed no symptoms such as lacrimation or pus discharging, and irrigation of lacrimal duct was unobstructed. Irrigation of lacrimal duct was passable in 1 of 32 patients who has a relative narrow ostial. Results in this series, 31 cases were cured,1case improved, the total cure rate was 97%.

CONCLUSION: There is no evidence shown that EN-DCR combined with stent implantation can increase the risk of spreading infection through tissue planes, causing septicemia, and exacerbating inflammation. Instead, it has advantages like gradual reduction in inflammatory symptoms, economic benefits of reduced patient stay, maintenance of the orbicularis muscle lacrimal pump and absence of external scar. It is indicated that EN-DCR combined with stent implantation is a safe and feasible surgical procedure for patients with acute dacryocystitis.

Abstract:AIM: To investigate the effect of lacrimal passage laser combined with drainage tube implantation on tear film rupture time and corneal fluorescein sodium staining in patients with lacrimal duct obstruction so as to improve the therapeutic effect of lacrimal laser combined drainage tube implantation.

METHODS: From January, 2013 to December, 2015, 200 cases(200 eyes)of lacrimal passage obstruction were treated with lacrimal passage laser combined with lacrimal drainage tube implantation in our hospital. Before and 1mo after operation, after the tube was draw out, ocular surface was assessed. The test included tear film rupture time, tear secretion, corneal fluorescein staining and dry eye syndrome questionnaire.

RESULTS: There was no significant difference in tear film rupture time between the two groups before and after 1mo, after the tube was draw out(P>0.05). The amount of tear secretion increased at 1mo after operation and the amount of tear secretion decreased after extubation. The difference was statistically significant(P<0.05). There was no significant difference in the corneal fluorescein staining before and after operation, after extubation(P>0.05). The dry eye symptom questionnaire showed that the tearing laser combined drainage tube implantation significantly improved the tearing symptoms.

CONCLUSION: The lacrimal duct laser combined drainage tube implantation has no significant effect on tear film rupture time and corneal fluorescein sodium staining. This kind of operation can improve the postoperative tearing symptoms of the patients, and is of great significance in the treatment of lacrimal passage obstruction.

Abstract:AIM: To investigate the clinical characteristics and follow-up of 191 patients with lacrimal glandoccupying lesions.

METHODS: We selected 191 patients(221 eyes)with lacrimal gland occupancy from January 2011 to August 2015. All patients underwent lacrimal gland tumor removal and were followed up for 1a.

RESULTS: In the 191 patients(221 eyes), 44 were male(49 eyes)and 147 were female(172 eyes). There were inflammatory lesions in 171 eyes, constituted by IgG₄ sclerosing dacryocystitis 66 eyes, 27 eyes of chronic lacrimal gland, lacrimal gland prolapse with inflammatory enlargement 54 eyes, Grave's disease in 24 eyes; 16 eyes of lymphoid hyperplastic lesions, constituted by malignant lymphoma in 6 eyes, benign lymphoid hyperplasia in 10 eyes; epithelial lesions in 34 eyes, constituted by pleomorphic adenoma in 26 eyes, 2 eyes of pleomorphic adenocarcinoma, adenoid cystic carcinoma in 3 eyes, 3 eyes of adenocarcinoma. Lacrimal glandoccupying lesions with IgG₄ sclerosing dacryocystitis, lacrimal gland prolapse associated with inflammatory enlargement were the most common, of which 159 eyes of Han, Uighur 36 eyes, Kazak 16 eyes, 10 eyes of Mongolian. After surgery, mainly symptoms were dry eye, crying with no tears, with bilateral lacrimal gland removed significantly, but the local use of artificial tears can ease those symptoms with no serious adverse reactions.

CONCLUSION: History and imaging characteristics of lacrimal gland-occupying lesions give a great help to the diagnosis and differential diagnosis. In Xinjiang region, lacrimal gland, with non-epithelial lesions is the most common, followed by epithelial lesions, occurred in the Han, Uighur patients, and rare occurred in other ethnic. Dry eye after surgery and crying with no tears are the main symptoms. Patients with short course of disease and dry eye tend to delay the removal of patients.

Abstract:AIM: To investigate the clinical effect of allogeneic scleral graft in reconstruction of defective tarsus after resection of malignant tumor of eyelid.

METHODS: We replaced the tarsus with allogeneic sclera and performed eyelid reconstruction in 24 eyes(24 cases)with defective tarsus after eyelid malignant tumor operation. In these cases, the length of defective tarsus was greater than 1/2 and the allogenic sclera material was selected from eyebank.

RESULTS: All patients were followed up for 3-12mo after operations. The shape was good after eyelid reconstruction and there was no dissolution or rejection in allograft sclera. The choroid was covered with conjunctival cells. Allogeneic sclera and skin join closely together and the defective area was completely repaired. Four eyes have mild to moderate eye lids margin inversion, and the inverted eyelid were corrected. Two eyes were with different degrees of eyelid ball adhesion so the separation operation was taken.

CONCLUSION: The allogeneic sclera has the advantages of good material stability, good biocompatibility, convenient conservation of materials, and easy operation. The eyelid is with good function and satisfactory appearance after operation, which is the ideal substitute material of tarsus.

Abstract:AIM: To analyze the application value of corneal limbus stem cells transplantation in the treatment of pterygium.

METHODS: Totally 300 patients(318 eyes)with pterygium were divided into 2 groups according to treatment methods. Patients of the control group(70 patients with 77 eyes)were given simple surgical resection, while patients of the observation group(230 patients with 241 eyes)were given corneal limbus stem cells transplantation after surgical resection. The postoperative recurrent rate, corneal epithelium incision healing time, corneal epithelium healing degree, pain score and tear film break-up time were observed.

RESULTS: The corneal epithelium incision healing time of the observation group and control group were respectively 5.2±1.9d and 6.4±1.7d, and the difference had statistical significance(P<0.05). There was no patient recurred in the observation group, while there were 7 eyes(9.1%)recurred in the control group, and the difference between groups had statistical significance(P<0.05). At 1wk after treatment, there was no significant difference in corneal epithelium healing degree and pain score between groups(P>0.05). At 2wk after treatment, the corneal epithelium healing degree of the observation group was better, and the pain score of the observation group was lower than those of the control group, the differences between groups had statistical significance(P<0.05). Before treatment, there was no significant difference in tear film break-up time between groups(P>0.05). At 1 and 2wk after treatment, the tear film break-up time of the observation group was longer than that of the control group(P<0.05).

CONCLUSION: Corneal limbus stem cell transplantation can prevent postoperative recurrence of pterygium effectively, and its postoperative tissue repair effect is superior to simple surgery.

Abstract:AIM: To analyze the influence factors of high intraocular pressure after laser epithelial keratomileusis(LASEK), and to discuss the clinical treatment and prognosis of the high intraocular pressure patients.

METHODS: A retrospective study was used. From August 2013 to February 2016, 160 LASEK patients(160 eyes)in our hospital were selected. Visual acuity after operation was recorded. The incidence and influence factors of high intraocular pressure were investigated. The treatment method and prognosis of high intraocular pressure were recorded.

RESULTS: In the 160 patients, all patients had complete epithelial flap and different degree of photophobia. There were 19 patients with postoperative photophobia, conjunctival hyperemia and foreign body sensation significantly. At postoperative 3mo, average intraocular pressure were 18.40±4.98mmHg, which was higher than that of preoperative, 16.27±2.24mmHg(P<0.05), and at postoperative 3mo, visual acuity was significantly higher than preoperative(P<0.05). There were 9 patients with postoperative steroid induced ocular hypertension, the incidence rate was 5.6%; Multiple linear regression analysis showed that the cutting depth(OR=3.209), maximum diameter of curvature(OR=3.071)and fundus C/D(OR=9.224)value were the main risk factors leading to postoperative steroid induced ocular hypertension(P<0.05).

CONCLUSION: The postoperative steroid induced ocular hypertension in LASEK is common, but has no obvious effect on visual acuity. The cutting depth, maximum diameter, curvature fundus C/D value were the main influencing factors, so we should careful use the hormone drugs in treatment and prevention. Periodic review and detection for change of intraocular pressure are needed.

Abstract:AIM: To study eye position control ability in patients with different types of intermittent strabismus.

METHODS: Totally 146 patients with intermittent strabismus treated in our hospital from September 2013 to April 2015 were enrolled in the study. The patients were divided into three groups according to the different types of the patients with intermittent strabismus. Fifty-five patients who had been separated from the strong type were used as part of the strong group,the basic type of 48 cases as the basic group,44 cases of collection insufficiency patients were set up as collection insufficiency group. Visual function and postoperative eye correction of the three groups were analyzed.

RESULTS: There were no differences in visual function among the three groups before operation, and the visual function of the three groups were improved after operation, and there was no difference among the three groups(P>0.05).The positive rates were 83.3%,81.2% and 54.6% of the strong group, basic group and collection insufficiency group respectively. There was no difference between the strong group and basic group,(P>0.05).There were significant differences between the strong group, basic group with collection insufficiency group(P<0.05).

CONCLUSION: Operations for intermittent external strabismus is different according to different types. The prognosis of the strong group and basic group is good and the prognosis of collection insufficiency group is poor.