Abstract:AIM: To investigate the expression of connective tissue growth factor(CTGF)and α-SMA in human lens epithelium cell(HLEC)line B3 after transfection by liposome-coated siRNA targeting CTGF.

METHODS: HLECs were transfected with small interfering RNA(siRNA)targeting CTGF, labeled with 5'- fluorescein isothiocyanate(5'-FITC)and coated with lipofectamine. The transfection ratio was evaluated via fluorescence intensity. Cell counting kit-8(CCK-8)assay was performed to assess cytoviability of both non-transfected and transfected HLECs. Quantitative RT- PCR, cell immunochemistry and Western blot analysis were conducted to detect the expression changes of CTGF and α-SMA after transfection.

RESULTS: A highly effective transfection ratio was observed in siRNA co-transfected with lipofectamine. The transfection ratio reached 95% at 24h. The proliferation of HLECs was inhibited by siRNA after 72h transfection. The expression of CTGF and α-SMA significantly decreased in HLECs after transfected by CTGF siRNA for 24h. This effect was not found in negative control siRNA.

CONCLUSIONS: SiRNA targeting CTGF decreased CTGF and α-SMA expression in HLECs, which is a potential therapeutic strategy for posterior capsular opacification.

Abstract:AIM: To study the tilt of the intraocular lens(IOL)after Nd:YAG capsulotomy(YAG)and variation of the axial length(AL)in patients with posterior capsular opacification(PCO).

METHODS: The study involved 18 eyes of 14 patients with PCO after uncomplicated phacoemulsification surgery and IOL implantation. All patients had taken examinations, including testing best corrected visual acuity(BCVA)by using standard logarithmic visual acuity chart, images of ocular anterior segment and AL by OCT. After the examinations, YAG was operated upon all patients. Each eye received one drop of Diclofenac Sodium Eye Drops immediately after YAG, and patients had taken examinations listed above again. One week later, BCVA and OCT were tested as well. Data(BCVA, tilt of IOLs, and AL)were recorded and analyzed statistically by SPSS.

RESULTS: Mean patient age was 73.93±6.94y, including 5 males and 9 females, 8 left eyes and 10 right eyes, altogether 14 patients with 18 eyes. In this study, tilt of IOLs was defined as the angle of anterior surface of IOL and pupil plane(briefly called Tilt, unit:°). Before YAG, mean Tilt was 2.896±2.286°, mean AL was 23.56±0.55mm. 1h after YAG, mean Tilt was 4.702±2.991°, mean AL was 23.40±0.59mm, and BCVA enhanced 3.72±1.74 lines. 1wk after YAG, 9 patients with 12 eyes were involved in the study. The mean Tilt of these 12 eyes was 3.175±1.791° 1h after YAG and 3.434±1.835° 1wk after YAG. There were significant differences between Tilt before YAG and Tilt 1h after YAG. There were no significant differences between AL before YAG and AL 1h after YAG. There were no significant differences between Tilt 1h after YAG and Tilt 1wk after YAG. The lines of enhancement of BCVA 1h after YAG was correlated to differences between Tilt before YAG and Tilt 1h after YAG, of which the correlation coefficient was -0.523.

CONCLUSION: IOLs of patients with PCO tilted after YAG, while AL rarely changed. After YAG, the less IOLs tilted, the more BCVA enhanced.

Abstract:AIM: To evaluate intraocular pressure(IOP)control and visual rehabilitation after placement of the Ex-press^® miniature glaucoma shunt with adjunctive amniotic membrane transplantation(AMT)and mitomycin C(MMC)in patients with post-traumatic open-angle glaucoma during 2y of follow up.

METHODS: This was an interventional, 2-year, observational study. Eighteen eyes were prospectively observed(in 18 patients with traumatic secondary open-angle glaucoma)in which Ex-press miniature glaucoma filtration shunts were implanted with AMT and MMC. The outcome measures included intraocular pressure(IOP), best corrected visual acuity(BCVA), number of antiglaucoma medications, and complications. The progress of all patients was monitored for 24mo.

RESULTS: Complete success(IOP <21 mmHg without glaucoma medications)was seen in 15 of the 17(88.2%)eyes enrolled in the study at 24mo after the operation. IOP decreased from 36.9±4.8 mmHg preoperatively to 15.4±3.5 mmHg at 12mo and 15.5±3.5 mmHg at 24mo postoperatively. Early postoperative hypertension developed in two patients(11.1%)due to postoperative fibrosis. Most of the patients had improved postoperative BCVA values at the final follow-up visit compared to their preoperative measurements. Two patients(11.1%)developed transient hypotony. There were no complications such as hyphema, choroidal effusion, shallow anterior chamber, the device touching the iris, or extrusion of the device.

CONCLUSION: The Ex-press miniature glaucoma filtration shunt with adjunctive AMT and MMC is effective and safe in cases of traumatic open-angle glaucoma. Surgical management is an appropriate surgical treatment in this series of cases.

Abstract:AIM: To identify factors predicting visual improvement post vitrectomy for sequelae of proliferative diabetic retinopathy(PDR).

METHODS: This was a retrospective analysis of pars plana vitrectomy indicated for sequelae of PDR from Jan. to Dec. 2014 in Hospital Sultanah Bahiyah, Alor Star, Kedah, Malaysia. Data collected included patient demographics, baseline visual acuity(VA)and post-operative logMAR best corrected VA at 1y. Data analysis was performed with IBM SPSS Statistics Version 22.0.

RESULTS: A total of 103 patients were included. The mean age was 51.2y. On multivariable analysis, each pre-operative positive deviation of 1 logMAR from a baseline VA of 0 logMAR was associated with a post-operative improvement of 0.859 logMAR(P<0.001). Likewise, an attached macula pre-operatively was associated with a 0.374(P=0.003)logMAR improvement post vitrectomy. Absence of iris neovascularisation and absence of post-operative complications were associated with a post vitrectomy improvement in logMAR by 1.126(P=0.001)and 0.377(P=0.005)respectively. Absence of long-acting intraocular tamponade was associated with a 0.302(P=0.010)improvement of logMAR post vitrectomy.

CONCLUSION: Factors associated with visual improvement after vitrectomy are poor pre-operative VA, an attached macula, absence of iris neovascularisation, absence of post-operative complications and abstaining from use of long-acting intraocular tamponade. A thorough understanding of the factors predicting visual improvement will facilitate decision-making in vitreoretinal surgery.

Abstract:AIM: To determine the frequency of dry eye in computer users and to compare them with control group.

METHODS: This study was a case control research conducted in 2015 in the city of Birjand. Sample size of study was estimated to be 304 subjects(152 subjects in each group, computer user group and control group). Non-randomized method of sampling was used in both groups. Schirmer test was used to evaluate dry eye of subjects. Then, subjects completed questionnaire. This questionnaire was developed based on objectives and reviewing the literature. After collecting the data, they were entered to SPSS Software and they were analyzed using Chi-square test or Fisher's test at the alpha level of 0.05.

RESULTS: In total, 304 subjects(152 subjects in each group)were included in the study. Frequency of dry eyes in the control group was 3.3%(5 subjects)and it was 61.8% in computer users group(94 subjects). Significant difference was observed between two groups in this regard(P<0.001). The frequency of eye symptoms in the control group was 7.9%(n=12), and it was 34.2% in computer users group(n=52), which significant difference was observed between two groups in this regard(P<0.001). Frequency of dry eye syndrome in computer users by gender and age groups showed no significant correlation in this regard(P=0.8). The mean working hour with computer per day in patients with dry eye was 6.65±3.52h, while it was 1.62±2.54h in healthy group(T=13.25, P<0.001).

CONCLUSION: This study showed a significant relationship between using computer and dry eye and ocular symptoms. Thus, it is necessary that officials need to pay particular attention to working hours with computer by employees. They should also develop appropriate plans to divide the working hours with computer among computer users. However, due to various confounding factors, it is recommended that these factors to be controlled in future studies.

Abstract:AIM: To evaluate the comfort and visual performance of Rose K2 soft contact lenses in patients with keratoconus.

METHODS: Fifty eyes of 50 participants were included in this cross-sectional study. Each participant received a full ophthalmologic examination involving refraction, uncorrected visual acuity(UCVA), best spectacle corrected visual acuity(BCVA), slit-lamp biomicroscopy-fundoscopy, break-up time(BUT), corneal topography, and contrast sensitivity. After contact lens was fitted best contact lens corrected visual acuity(BCLCVA), contrast sensitivity, and comfort rating via visual analogue scales(VAS)were performed.

RESULTS: The mean age was 26.2±6.0(range: 16 to 39)y. The mean logMAR UCVA, BCVA, and BCLCVA with Rose K2 soft(in order)were 0.61±0.37(range: 0.15-1.3), 0.42±0.32(range: 0-1.3), and 0.18±0.20(range: 0-1.3). There were significant increases in visual acuities with contact lenses(P < 0.05). The mean contrast sensitivity scores were significantly better with both contact lens in mesopic and photopic conditions(P <0.05). The mean VAS score was 8.02±1.64(range: 5-10)for Rose K2 soft.

CONCLUSION: Rose K2 soft contact lens can improve visual acuity, contrast sensitivity with comfort in patients with keratoconus.

Abstract:AIM: To investigate the influence and mechanism of blue light on the proliferation of human retinal pigment epithelial cells.

METHODS: Cells were divided into two groups, including blue light group and control group. The 35W white light lamp with blue filter was used to establish damaged RPE cell model in vitro. Blue ray wavelength ranged between 470nm and 520nm. And the light intensity was about 2 000Lx. After exposure to blue light, we tested the proliferation of human retinal pigment epithelial cells by CCK-8 kit. And then expression of miR-103 was measured by the real-time PCR.

RESULTS: Exposure to blue light inhibited the proliferation of human retinal pigment epithelial cells and increased the expression of miR-103. Moreover, up-regulation of miR-103 inhibited the proliferation of human retinal pigment epithelial cells, and down-regulates miR-103 promoted the proliferation of human retinal pigment epithelial cells.

CONCLUSION: Blue light inhibits the proliferation of human retinal pigment epithelial cells by the up-regulation of miR-103.

Abstract:AIM: To observe the effect of curcumin on the retinal structure and the expressions of interleukin-23(IL-23)and interleukin-17(IL-17)in the rat retina after retinal ischemia-reperfusion injury(RIRI).

METHODS:A total of 60 male Sprague-Dawley(SD)rats were randomly divided into normal control group(NCG), model group(MG), low-dose curcumin group(LDCG)and high-dose curcumin group(HDCG)(n=15 per group). RIRI was generated by anterior chamber perfusion of normal saline to the right eye. Rats in LDCG and HDCG received an intraperitoneal injection of 20mg/kg/d and 100mg/kg/d curcumin respectively, at 30min before RIRI and once daily after RIRI. Retinal structure and inflammation were evaluated after hematoxylin and eosin-stained(HE)staining. Western-blot and enzyme-linked immunosorbent assay(ELISA)were used to measure the level of IL-23 and IL-17 expressions after RIRI.

RESULTS: The retinal structure of NCG was normal. Retinal edema, empty spaces or loosely packed cells and inflammatory cell infiltration were observed in MG and LDCG groups, whereas the morphological changes in HDCG group were improved as compared to MG and LDCG groups. Western-blot assay and ELISA showed that IL-23 and IL-17 expressions increased significantly after RIRI(vs NCG, P<0.01). Moreover, curcumin reduced IL-23 and IL-17 expressions significantly(vs MG, P<0.01).

CONCLUSION: Curcumin can inhibit leukocytes infiltration and improve the retinal pathologic changes. Furthermore, curcumin can reduce retinal IL-23 and IL-17 expressions significantly in a dose-dependent manner.

Abstract:AIM: To investigate the probably mechanism of amniotic extraction inhibiting haze formation after epipolis laser in situ keratomileusis(Epi-LASIK)in rabbit cornea.

METHODS: Thirty rabbit corneas were performed with Epi-LASIK. All eyes were randomly divided into three groups: eyes treated with amniotic extraction(AE group), eyes treated with 1g/L dexamethasone(hormone group)and eyes treated with solvent(solvent control group). Haze grade evaluation was performed under the slit lamp after Epi-LASIK for 1, 4 and 8wk. The repair of corneal epithelium was observed by using HE staining, and the expression of NF-kB protein P65 was detected by immunohistochemistry. The expression levels of inflammatory cytokines(TNF-α, TGF-β1 and IL-1)and anti-inflammatory cytokines(IL-4, IL-10 and IL-13)were determined by ELISA.

RESULTS: HE staining showed that the basal cells of corneal epithelium were more uniform and arranged regularly in AE groups after Epi-LASIK for 1wk as compared with the hormone group and the solvent control group. After 4wk, there were a few of new collagen fibers in the superficial stroma of AE group, forming a small amount of scar. After 8wk, the corneal stroma of AE group showed a small amount of new collagen fibers, arranged regularly, and rarely formed scar. At the early stage(1 and 4wk), AE treatment has an obviously effect on inhibiting the secretion of inflammatory factors(TNF-α, TGF-β1 and IL-1)and anti-inflammatory factors(IL-4, IL-10 and IL-13), and the difference was statistically significant(P<0.01). Moreover, the activation of the NF-kB signaling pathway was significantly inhibited by treatment with AE in the early postoperative period(1 and 4wk).

CONCLUSION: Amniotic extraction may reduce the inflammatory response in corneal epithelial cells by inhibiting the NF-kB signaling pathway, thereby inhibiting the formation of collagen and scar and the occurrence of haze.

Abstract:AIM: To explore the effect of Bu Shen Yang Xue Ming Mu(BSYXMM)Formula on hydroquinone-induced oxidative stress injury in ARPE-19 cells.

METHODS: The oxidative injury model of ARPE-19 cell was induced by exposure to various concentrations of hydroquinone(HQ)to determine the optimal concentration. Intestinal absorption solutions of BSYXMM Formula were prepared. Effect of intestinal absorption solutions of BSYXMM Formula on the cell viability was detected by CCK-8 assay, and the percentage of apoptotic cells was measured by TUNEL assay. The levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)in ARPE-19 cells were detected by means of chemical colorimetry.

RESULTS: It was found that ARPE-19 cell viability significantly decreased when the concentration of HQ was higher than 90μmol/L. Compared with the model group, 1% and 2% intestinal absorption solutions in the pre-treatment group could significantly alleviate HQ-induced injury(P<0.01)and 0.5% and 5% intestinal absorption solutions in the pre-treatment group could alleviate the injury in certain degree(P<0.05). While in the treatment group 1% and 2% intestinal absorption solutions could alleviate the injury to some extent(P<0.05). TUNEL results showed that the apoptosis rate decreased significantly in the pre-treatment group(P<0.01)and to some extent in the treatment group(P<0.05)compared with the model group. It was shown that both levels of SOD and GSH-Px in pre-treatment group and treatment group were markedly higher than that of model group(P<0.05), and pre-treatment group had more significant effect(P<0.01,P<0.05).

CONCLUSION: BSYXMM Formula could protect against HQ-induced oxidative stress injury in ARPE-19 cells, which may be related with the increasing of antioxidant enzyme in the cells.

Abstract:AIM: To analyze the effect of human amniotic homogenate extract on corneal neovascularization after corneal alkali burn in the process of pigment epithelium derived factor(PEDF)and vascular endothelial growth factor(VEGF)expression and the effect of corneal neovascularization.

METHODS: Totally 32 patients with corneal alkali burn were selected from June 2015 to June 2016 in Foshan, and were randomly divided into Group A and Group B, with a total of 37 eyes. Group A of 17 cases, with a total of 19 eyes, were treated with 40mg/L human amniotic homogenate extract; Group B(n=15), and 18 eyes, treated with 3g/L prednisolone eye drops. In the treatment of 1, 4, 7, 14, 21 and 28d at different time points, we observed the growth of corneal neovascularization, and detected the expression of PEDF and VEGF during angiogenesis.

RESULTS: Group A of patients in the use of human amniotic homogenate extract after the treatment, the expression level of PEDF was significantly higher than that in Group B(P=0.001), after 28d treatment, the expression level of PEDF reached 0.721±0.314. While patients in Group B the expression level of PEDF was only 0.538±0.253. Two groups had significant difference between the expression level of PEDF(P<0.05). The expression level of VEGF in Group A was lower than in Group B at different time points in the test. After the treatment of 28d patients in the Group A, the expression level of VEGF was 0.152±0.020, in Group B the expression level of VEGF was0.302±0.031. Two groups of patients with VEGF expression level between the differences were statistically significant(P<0.05). The patients number in Group A with corneal neovascularization was significantly lower than that in Group B, the difference was statistically significant(P<0.05).

CONCLUSION: Human amniotic homogenate extract can increase the expression of PEDF in corneal neovascularization after corneal alkali burn, inhibit the expression of VEGF and the proliferation of corneal neovascularization.

Abstract:AIM:To investigate the effects of 1.8mm coaxial micro incision phacoemulsification on corneal endothelial injury and postoperative visual acuity.

METHODS: Totally 145 eyes in 120 patients underwent phacoemulsification from July 2013 to July 2015 were randomly divided into observation group 60 cases(73 eyes)and control group 60 cases(72 eyes). The observation group 60 cases were given 1.8mm coaxial micro incision cataract phacoemulsification operation, while the control group were given traditional 3.2mm coaxial micro incision cataract surgery. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), corneal thickness of incision area, incision width, incision length, macular retinal thickness, surgically induced astigmatism, corneal endothelial cell counts and complications of the two groups were compared.

RESULTS: The UCVA and BCVA on 1wk after surgery of the observation group were significantly higher than the control group(t=3.604, 7.109; P<0.05); the width of incision on 1wk and 1mo after surgery of the observation group were significantly less than the control group(t=205.3, 225.2; P<0.05). The length of incision in observation group was significantly greater than the control group(t=3.926, 5.009; P<0.05). Macular retinal thickness 1wk after surgery of the observation group was significantly less than the control group(t=2.817, P<0.05). The surgically induced astigmatism was significantly less than the control group(t=19.43, 22.16; P<0.01); the difference of corneal edema between the two groups was not significant(8.22% vs 11.11%)(χ²=0.348, P>0.05).

CONCLUSION: The 1.8mm micro incision phacoemulsification is helpful to improve the visual acuity of patients with cataract phacoemulsification, which may be related to the reduction of corneal cell injury, enhancement of corneal closure and decrease post-operation corneal original astigmatism.

Abstract:AIM: To investigate the effectiveness and safety of intravitreal injection of anti-vascular endothelial growth factors(VEGF)drugs to the patients with proliferative diabetic retinopathy before vitrectomy treatment.

METHODS: A Meta-analysis. A comprehensive retrieval was conducted using the database including EMbase, the Cochrane Library, Pubmed, CBM, WanFang Database, CNKI and so on. The retrieval time was limited from the building time of database to Jan. 2017. The randomized controlled trial was adopted with no requirements on languages. The Jadad scale and Cochrance cooperation were used as the tool of the risk and bias evaluation to analyze the literature quality. Quality estimation of evidence-based medicine on the parameters of each evaluation index was made via GRADEpro Software. The publishing biases of enclosed documents were inspected with funnel plot. At last, the Meta analysis was conducted with Review Manager 5.3.

RESULTS: Totally 16 literatures published from 2008-2016 were finally put into randomized controlled trial. A total of 923 cases were included, among which 493 cases were grouped as intravitreal injection of anti-VEGF before the combined operation of PPV group(the experimental group), and 430 cases were involved in simple PPV group(the control group). The results of Meta-analysis show:(1)The probability of intraoperative bleeding was remarkably lower than the control group \〖OR=0.06, 95%CI(0.02, 0.15), P<0.01\〗, with statistically significant differences.(2)The duration of operation was obviously shorter than that of the control group\〖WMD=-29.13, 95% CI(-36.95, -21.30), P<0.01\〗, with statistically significant differences.(3)The probabilities of both early and late postoperative vitreous hemorrhage were lower than those of the control group\〖OR=0.34, 95%CI(0.20, 0.58), P<0.01\〗, with highly statistically significant differences.(4)The best corrected visual acuity after surgery was no better than that of the control group, \〖WMD=-0.51(LogMAR), 95%CI(-1.10, 0.08), P=0.09\〗 with no statistical significance.(5)The occurrence of iatrogenic retinal rupture was lower than that of the control group\〖OR=0.24, 95%CI(0.14, 0.40), P<0.01\〗, with statistically significant differences.(6)Among the 493 patients included in the 16 literature, no case of ocular and general adverse effects due to anti-VEGF injections was reported.

CONCLUSION: It is effective and safe for the patients with proliferative diabetic retinopathy to inject anti-VEGF drugs into vitreous cavity before vitrectomy. And it can reduce the occurrence of complications during and after surgery, improving the general treatment effects. However, the specific implementation plans, such as the injection does, the interval between the injection and the operation and so on, still need further exploration and perfection.

Abstract:Polypoidal choroidal vasculopathy(PCV)is a common disease of the retina, the disease is more found in colored race. In China, the mainly nosogenic population is the female about 60 years old. The pathogenesis of PCV is unknown and there is no specific medicine at present. The funduscopic present is orangered lesions, bleed and exudation. Indocyanine green angiography(ICGA)could make a definite diagnosis of PCV. In recent, the main treatment of PCV includes photodynamic therapy, intravitreal anti-VEGF therapy, surgery for treatment of complications and combined therapy. We review the treatment and diagnosis of PCV, and propose the further research direction.

Abstract:Avellino corneal dystrophy(ACD)is an autosomal dominant eye disorder caused by mutation of R124H in the transforming growth factor-beta induced gene(TGFBI)on chromosome 5, which was responsible for accumulating of abnormal TGFBI. Although the underlying mechanism by which mutations cause abnormal TGFBI deposition is not yet clear, but we have a better understanding of the etiology and possible pathogenesis of corneal dystrophy with the rapid development of human genetics and molecular biology, and summarizes the current achievement of this disease and understand the roles of TGFBI and its interaction with Periostin, which may contribute to further research in ACD.

Abstract:Glaucomais a group of diseases characterized by optic atrophy and visual field defect. In China, primary angle closure glaucoma(PACG)is the most common type of glaucoma. The mechanism of glaucoma has many theories, such as mechanical theory and vascular theory. Recent researches found that inflammation may be involved in the pathogenesis of glaucoma. A variety of proinflammatory cytokines significantly increased in aqueous humor of patients with PACG. In this study, we summarized the methods for the detection of aqueous humor, and analyzed the mechanism of the increasing of proinflammatory cytokines in the aqueous humor of patients with PACG.

Abstract:Epiretinal membrane(ERM)is a relatively common macular disease that forms along the surface of the internal limiting membrane(ILM)of the retina to some reason. The pathogenesis is not clear. Microincision vitrectomy surgery has been confirmed as a minimally invasive and very safe modality of treatment. Deciding when to perform a vitrectomy can be difficult. There are many factors which can affect the postoperative visual acuity, such as age, the thickness of macular, integrity of photoreceptor inner segment/outer segment(IS/OS)junction.

Abstract:Accompanying with the development of technological level, optical coherence tomography plays a more and more important role in predicting the surgical outcome for idiopathic macular hole. Preoperative morphologic parameters like minimum diameter, base diameter, maximum height, macular hole index, hole form factor, tractional hole index, macular hole closure index, photoreceptor inner-outer segment junction, cone outer segment tips line, central subfield retinal thickness and macular hole inner opening diameter were proved correlated to postoperative visual acuity and anatomical results. It has important application value to know these predictors to judge the surgical outcome and deepen understanding of idiopathic macular hole.

Abstract:Optical coherence tomography angiography(OCTA)is a noninvasive angiography technique developed in recent years. Without using contrast medium, this technology can quickly and safely get retinal vascular images with relatively high-resolution. It has been widely used in the diagnosis and management of eye diseases, especially in the vascular diseases, such as diabetic retinopathy(DR), age-related macular degeneration(AMD), retinal central/branch venous obstruction(CRVO/BRVO), choroidal neovascularization(CNV), etc. This article reviews the clinical application of OCTA in diabetic retinopathy.

Abstract:Asteroid Hyalosis(AH)is a common clinical disease, which has been considered a benign disorder as it rarely impairs visual acuity. It was often discovered when the patient was treated for other eye diseases. The mechanism was unclear. Its characteristic B-ultrasound property makes the B-ultrasound a very helpful diagnostic technique. In the case of the patients with other fundus diseases associated with AH, optical coherence tomography(OCT)and fluorescein angiography(FA)may be used to reduce the interference from asteroid bodies, therefore improve the fundus visibility. Recent studies have shown that AH can incorporate with many other eye diseases. For example, in patients with cataracts, asteroid hyalosis can cause surface calcification of silicone plate intraocular lenses, which in most cases may lead to the need for explantation of the calcified intraocular lenses. The efficacy of pars plana vitrectomy(PPV), the removal of some, or all, of the eye's vitreous humor for AH remains controversial. In this paper, we provide a review of the recent literature on AH disease: the etiology, diagnosis and treatment. We hope to thus improve the awareness and outcomes of AH disease.

Abstract:Vitreous liquefaction is an age-related degenerative change, which will further alter the physicochemical properties of the vitreous and its surrounding tissues, resulting in various related eye diseases. The principal pathologic changes of that are the gradual depletion of hyaluronic acid and the collapse of collagen fibrillar network, with a series of biomechanical changes in vitreous body. This article reviews biomechanical properties of normal vitreous, the current measurements of these properties, formation mechanism and changes of biomechanics properties of vitreous liquefaction and correlation between synchesis and related ocular diseases, which provide insight into the ideas for the effective reduction and treatment of vitreous liquefaction.

Abstract:AIM: To investigate the therapeutic effect of a new warm moist air device assisted with eyelid massage in the treatment of office dry eye(ODE).

METHODS: Sixty ODE patients were recruited, and these patients were randomly divided into two groups. One group received artificial tear treatment, and the other group received a new eyelid warm moist air device combined with eyelid massage treatment. Subjects completed the ocular surface disease index(OSDI), which was followed by fluorescein tear breakup time(BUT), corneal fluorescein staining(CFS), Schirmer I test(SⅠt)and meibomian gland secretion function evaluation at baseline, and 2 and 4wk after treatment.

RESULTS: In these 60 patients, 48 patients(23 in artificial tear treated group and 25 in the new warm moist air device assisted with eyelid massage treated group)were positive for meibomian gland dysfunction(MGD). Compared to artificial tear treatment, the new warm moist air device assisted with eyelid massage treatment showed favorable therapeutic effect on OSDI(F_Group=41.63, P<0.01), BUT(F_Group=60.47,P<0.01)and the grade of meibum quality(F_Group=12.12,P<0.01)during 4wk treatment in this study. No significant difference was found in SIT(F_Group=0.17, P>0.05), CFS(F_Group=1.79, P>0.05)and meibomian gland expressibility(F_Group=0.68, P>0.05)between the two groups during 4wk treatment.

CONCLUSION: This new eyelid warm moist air device assisted with eyelid massage has favorable therapeutic effect over artificial tear in ODE treatment.

Abstract:AIM:To compare the effect of recombinant human epidermal growth factor eye drops and deproteinized calf blood extract eye drops on corneal edema after phacoemulsification.

METHODS:Totally 72 cases(72 eyes)of patients undergoing phacoemulsification were selected and divided into the observation group and the control group by random number table method. After surgery, the observation group were treated with deproteinized calf blood extract eye drops while the control group were treated with recombinant human epidermal growth factor eye drops. The degree of corneal edema, subjective symptom score, corneal endothelium count, changes of corneal thickness and postoperative visual acuity recovery were compared between the two groups at different time points after surgery.

RESULTS:Corneal edema in the two groups was significantly milder at 1wk after surgery than that on the 1^st day after surgery(P<0.001). There was no significant difference in the degree of corneal edema and test results of visual acuity between the two groups at 1wk after surgery(P>0.05). Compared with 1d after surgery, the subjective symptom score and corneal thickness of the two groups significantly decreased on the 7^th day after surgery(P<0.05). At 7d after surgery, the above indexes were significantly better in the observation group than the control group(P<0.05). At 1mo after surgery, the corneal endothelium count was significantly larger in the observation group than the control group(P<0.001).

CONCLUSION:Both of recombinant human epidermal growth factor eye drops and deproteinized calf blood extract eye drops can significantly relieve corneal edema and improve visual acuity of patients after phacoemulsification. However, the latter has obvious advantages over the former in the repair of corneal endothelial cell injury after surgery.

Abstract:AIM: By comparing the aspheric and multifocal Toric intraocular lens and the aspheric intraocular lens in cataract patients, to observe the patients' visual quality, to evaluate the patients' distance visual acuity, near visual acuity, Pseudo-accommodative power, residual astigmatism, the rotational stability of AcrySof IQ Toric Restor intraocular lens(IOLs), contrast the rate of off-distance glass, the rate of off-near glass and patient satisfaction after the implantation of AcrySof IQ Toric Restor IOL in the cataract patients with preexisting corneal astigmatism.

METHODS:Carried out in 46 patients(48 eyes)with age-rated cataract who receiving phacoemulsification and implantation of artificial lens in our department during February 2014 to June 2016. All the cases were randomly divided into 2 groups: experimental group: 23 cases(24 eyes), AcrySof IQ ReSTOR Toric IOL was implanted after phacoemulsification; control group: 23 cases(24 eyes), AcrySof IQ was implanted. Uncorrected distance visual acuity(UCDVA)and best corrected distance visual acuity(BCDVA), uncorrected near visual acuity(UCNVA)and best-corrected near visual acuity(BCNVA), Pseudo-accommodative power, residual astigmatism, preoperative and postoperative corneal astigmatism, the rate of off-distance glass, the rate of off-near glass and patient satisfaction were measured at 6mo postoperatively follow-up.

RESULTS: BCDVA and BCNVA were not statistically different between the two groups(P<0.05). At 1wk, 1, 3 and 6mo postoperatively of UCDVA the experimental group were statistically better than the control group(P<0.05). UCNVA were also statistically better than the control group(P<0.05). The mean residual astigmatisms 1wk, 1, 3 and 6mo postoperatively were statistically differences between the control group and experimental group(P<0.05). At 6mo postoperatively, patients satisfaction of experimental group were significantly better than control group(P<0.05). Spectacles independence for near vision achieved 83% and 17% in experimental group and control group, experimental group were statistically better than control group(P<0.05). Spectacles independence for distance vision achieved 92% and 67% in experimental group and control group, experimental group were statistically better than control group(P<0.05).

CONCLUSION:The results indicate that AcrySof IQ ReSTOR Toric IOLs may provide a better uncorrected distance visual acuity and uncorrected near visual acuity, which can significantly reduce preexisting corneal astigmatism in cataract surgery, improve spectacles independence for distance vision and spectacles independence for near vision, have a high patient satisfaction.

Abstract:AIM: To study whether there was a correlation between central foveal thickness(CFT)assessed with optical coherence tomography(OCT)and visual acuity of patient with high myopia after phacoemulsification and intraocular lens implantation.

METHODS: Totally 67 patients with high myopia underwent phacoemulsification and intraocular lens implantation were enrolled in the study. Best corrected visual acuity(BCVA)was recorded and CFT was measured using OCT at 1wk, 1 and 3mo after oerations. BCVA and CFT were compared before and after the operation. All patents were divided into two groups by the BCVA at 3mo after operation, BCVA>0.5 in Group A and BCVA≤0.5 in Group B. ANOVA, Spearman correlation analysis and independent t test were used for statistical analysis.

RESULTS: There was a statistically significant difference between preoperative BCVA and postoperative BCVA(F=115.04, P<0.01). Preoperative CFT was different compared with that 1wk and 1mo after operation(P=0.04, 0.02)and was not different with that 3mo after operation(P=0.52). There was a statistically significant difference in CFT of postoperative 3-month compared with that of postoperative 1-week(P<0.01)or that of postoperative 1-month(P<0.01). BCVA showed significant positive correlation with CFT without foveal lesion on postoperative 3mo(r=0.28, P=0.03). CFT of Group A and Group B was significantly different at 3mo after the operation(t=-2.24, P=0.03). There was no significant difference in age and intraocular lens of two groups.

CONCLUSION: Optical coherence tomography allow for objective assessment of retinal construction changes in eyes with high myopia are correlated to visual acuity.

Abstract:AIM: To investigate the clinical effect of one-dose multiple point scanning panretinal photocoagulation(PRP)in the treatment of non-proliferative diabetic retinopathy(NPDR).

METHODS:Selected 78 patients 132 eyes with NPDR in our hospital from January 2015 to June 2016, the patients were randomly divided into observation group(42 patients of 72 eyes)and control group(36 patients of 60 eyes). The observation group was given one-dose multi-point scanning PRP. The control group was given a single point scanning, 3 to 4 times to complete the PRP. To observethe therapeutic effect in two groups, the average visual field threshold, the flash electroretinogram(F-ERG)a, b wave amplitude, the laser energy and so on were observed.

RESULTS:The effective rate of the observation group and the control group were 84.7% and 83.3%, the difference was not statistically significant(P>0.05). In the observation group and the control group, at 6mo after treatment, the leakage area of retinal neovascularization was lower than that before treatment(P<0.05). The visual field threshold and F-ERG a wave amplitude differences were not statistically significant(P>0.05). F-ERG b wave amplitude were 221.94±70.18mV and 219.82±69.56mV in the observation group and the control group at 6mo after treatment which were significantly lower than that before treatment(P<0.05). The laser energy of the observation group was 541.23 ± 56.39mW, significantly higher than the control group 326.39±78.83mW(P<0.05), while the energy density was 0.34±0.14mW·ms/mm², significantly less than the control group 2.01±0.97mW·ms/mm²(P<0.05). The incidence of complications in the observation group and the control group were 8.3% and 15.0%, the difference was statistically significant(P<0.05).

CONCLUSION:The clinical effect of multiple point scanning PRP in the treatment of NPDR is better than single point multiple PRP with advantages of lower energy density and less laser damage.

Abstract:AIM:To study the efficacy and safety of intravitreal injection ranibizumab(IVR)assisted 25G+ minimally invasive vitreoretinal surgery(VRS)in the treatment of severe proliferative diabetic retinopathy(PDR).

METHODS: Totally 61 patients and 74 eyes were selected with severe PDR from March 2015 to June 2016 in our hospital. According to the principle of voluntary, 37 eyes of 31 cases in the VRS before the IVR treatment was set to the joint group, 37 eyes of 30 cases line pure VRS was set to the VRS group. We compared the vitreous volume, logMAR, mean IOP, macular central retinal thickness and complications between the 2 groups.

RESULTS: The blood rate of glass in the combination group was 8% after 1wk of postoperative which was significantly lower than that of the VRS group 27%(χ²=4.573, P=0.032). The glass volume blood rate of the combined group was 0 after 1mo of postoperative while the VRS was 16%(P=0.033). The blood rate of glass in the combination group was 0 at 3mo of postoperative, and 8% in the VRS group(P=0.238). The LogMAR in the combined group was significantly lower than that in the VRS group(t=2.320, P=0.023). There was no significant difference in the mean IOP between the two groups(t=0.516, P=0.608). The mean macular retinal thickness of the combined group was 298.8±78.3μm which significantly lower than the VRS group 357.1±86.2μm(t=3.045, P=0.003). The combined high intraocular pressure rate of the combined group was 14% which was significantly lower than 32% of the control group(χ²=10.385, P=0.001). The rate of anterior membrane of the retina of the combined group, the rate of recurrent traction and the rate of retinal detachment of the newborn were lower than that of the VRS group, but the difference was not statistically significant(P>0.05).

CONCLUSION: IVR assisted VRS, although there is a certain controversy, but in the appropriate dose, frequency and time to achieve significant efficacy, safety is also high.

Abstract:AIM: To explore correlation, consistency and comfort between traditional tear film examination methods and Oculus Keratograph.

METHODS: A retrospective study. Totally 101 cases(101 eyes)were diagnosed myopia and then accepted LASEK(laser epithelial keratomileusis). Non-invasive tear film break-up time(NIBUT), lower tear meniscus height(LTMH)were measured with Oculus Keratograph, fluorescein tear film break-up time(fl-BUT)and Schimer Ⅰ test(SⅠt)were performed on all cases. The correlations analysis between NIBUT and fl-BUT, LTMH and SⅠt were performed by Spearman rank correlation, consistency check between NIBUT and fl-BUT by Bland-Altman analysis. Visual analogue scale(VAS)was applied on evaluating the comfort of two kinds of examination methods.

RESULTS: LTMH and SⅠt showed positive correlation(r_s=0.346, P=0.001). NIBUT and fl-BUT showed positive correlation(r_s=0.393, P=0.001), 95% consistency limits range -9.62 to 14.18 in Bland-Altman Figure. There was significant difference between VAS of NIBUT and VAS of fl-BUT(z=-2.324, P=0.020). There was significant difference between VAS of LTMH and VAS of SⅠt(z=-8.845,P=0.001).

CONCLUSION: Oculus Keratograph can objectively measure NIBUT and LTMH, and was more comfortable than traditional tear film examination methods. It can effectively assess tear film function before corneal refractive surgery.

Abstract:AIM: To evaluate the effect of orthokeratology on progression of juvenile myopia and analysis its influencing factors.

METHODS: Totally 97 patients(189 eyes, aging from 8 to 17 years old)who received orthokeratology lenses treatment in our hospital from January 2012 to December 2014, were followed up for 2a. The visual acuity, corneal curvature, diopter, and ocular axial length were observed. Factors of influencing myopia progress in juvenile were analyzed.

RESULTS: At 1mo after receiving orthokeratology contact lenses, the visual acuity and corneal curvature were changed compared with that of before(P<0.001). After 2a of receiving orthokeratology contact lenses, the difference was significant compared with baseline: spherical equivalence(-0.51±0.64D, t=10.864, P<0.001), axial length(0.33±0.31mm, t=14.879, P<0.001), corneal astigmatism(-0.25±0.43D, t=5.375, P<0.001). Statistic analysis showed that there was a negative correlation between the spherical equivalence and age, baseline of diopter or ocular axial length(P<0.05).

CONCLUSION: Orthokeratology can effectively improve the visual acuity of patients. Although there is slightly progression in diopter and ocular length after 2a of wearing orthokeratology contact lenses. Orthokeratology is an effective treatment on controlling progression of juvenile myopia, especially in the elder children who with the longer basic axial length and the greater diopter.

Abstract:AIM: To investigate the change of corrected vision and stereo vision in anisometropic patients after laser in situ keratomileusis(LASIK).

METHODS: The clinical data of 84 cases of anisometropic children(84 eyes)were retrospective analyzed. The changes of corrected visual acuity and stereopsis of different gender, age, type of amblyopia in children anisometropic before treatment, after treatment for 3, 6mo and 1a were analyzed. The stereoscopic vision correction correlation were analyzed.

RESULTS: Corrected Log MAR visual acuity and stereopsis of 84 patients after LASIK surgery treatment for 3mo, and 1a later significantly decreased than before treatment(P<0.05). The corrected Log MAR visual acuity and stereopsis of male and female after treatment for 3, 6mo and 1a was not statistically significant(P>0.05). Corrected visual acuity of age <30 group for 3, 6mo and 1a was significantly lower than the age ≥30 group(P<0.05). After 3, 6mo and 1a stereo vision with hyperopic anisometropia amblyopia decreased more than that with myopic anisometropia amblyopia(P<0.05), but corrected Log MAR visual acuity after treatment was no statistically significant difference(P>0.05). Improved correctted vision of anisometropic patients after LASIK surgery had no connection with the decrease of stereo vision(P>0.05).

CONCLUSION: LASIK surgery can improve visual acuity in patients with anisometropia amblyopia, but the course of treatment of visual acuity and stereopsis affected by age and type of amblyopia.

Abstract:AIM:To enhance the doctors' ability of disease diagnosis and treatment by using standardized patients in neuro-ophthalmology teaching.

METHODS: Graduated students and visiting students accepting neuro-ophthalmology training courses in Department of Ophthalmology during 2014-2016 were enrolled as the research objects. Two groups were randomized allocated and 20 students each group. One group of students was applied standardized patients teaching method and the other group of students was applied traditional teaching method. A questionnaire and exam after the teaching were evaluated. The data were analyzed by SPSS 20.0.

RESULTS: The data of questionnaire included content interest improving, satisfaction for teaching, the key points understanding, theory with practice effective linking, future practice instruction. Comparison questionnaire data between two groups were of statistical significance(P<0.05). The test scores of case analysis of two groups were statistically significant also(P<0.001).

CONCLUSION: Standardized patients teaching method is helpful for students' training on the ability of clinical diagnosis and treatment.

Abstract:AIM: To evaluate the efficacy and safety of corneoscleral separation in the treatment of persistent corneal ulcer.

METHODS: Collected 22 cases(22 eyes)with deep corneal ulcer were treated with drugs. These patients underwent corneoscleral separation or corneal interstitial filling of sterile gelatin sponge, by retrospectively observing the cornea ulcer healing, anterior chamber reaction and separation of new blood vessels grow between the layers, and so on, the surgical indications, surgical techniques, postoperative complications and treatment were evaluated.

RESULTS: Patients were followed up 3 to 6mo, of which 18 eyes cornea were seen a small amount of new blood vessels, anterior chamber empyema after 7-9d. Ulcers gradually narrowed, infection controlled, the surrounding edema relieved, visual acuity improved by varying degrees after 12-15d. Postoperative 4 eyes for the mixed infection, 2 of the 4 eyes were of the rapid progress, neovascularization did not grow into the lesion, ulcers on the verge of perforation and then done penetrating keratoplasty.

CONCLUSION: The aim of this study is to introduce deep limbal vessels into the surrounding of ulcer foci, which to combine with drug therapy is one of the effective methods to treat deep corneal infection.

Abstract:AIM: To investigate the effects of vitrectomy combined with cataract surgery on the corneal endothelial cells in diabetic retinopathy.

METHODS: A retrospective study was designed. 160 patients(160 eyes)with diabetic retinopathy from Jan 2015 to Feb 2017 were divided into two groups according to cataract. 74 patients(74 eyes)were operated on vitrectomy, and 86 patients(86 eyes)on vitrectomy combined with phacoemulsification cataract surgery and capsular bag implantation of foldable intraocular lens. To record the change of corneal endothelial cells density, average cellular area, coefficient of variation and percentage of hexagonal endothelial cell before and after treatment with Topcon corneal specular microscope.

RESULTS: Before and after surgery, the results of corneal endothelial cells density, average cellular area, coefficient of variation and percentage of hexagonal endothelial cell in simple vitrectomy group were no significant difference(P>0.05); After treatment corneal endothelial cells density and percentage of hexagonal endothelial cell were changed with statistical difference as the same as average cellular area and coefficient of variation(P<0.05); There were significantly differences in corneal endothelial cells between two groups(P<0.05).

CONCLUSION: It has certain influence on the corned endothelial cells when using vitrectomy combined with cataract surgery in diabetic retinopathy. For patients with indications, it should be paid attention to protecting the corneal endothelial cells.

Abstract:AIM:To investigate the effect of the size of cataract surgical incision on original astigmatism and tear film stability of corrected cornea.

METHODS: Totally 92 cataract patients(92 eyes)who were admitted to our hospital from July 2014 to July 2016 were randomly divided into the control group and the observation group, 46 cases(46 eyes)in each group. Both groups were treated by clear corneal tunnel incision phacoemulsification combined with intraocular lens implantation. The incision of the control group was 3.0mm while of the observation group was 1.8mm. The uncorrected visual acuity, corneal astigmatism, Schirmer I test(SⅠt)and break-up time(BUT)were detected before surgery and at 1d, 1wk, 1mo and 3mo after surgery. The surgery induced astigmatism(SIA)was recorded at 1d, 1wk, 1 and 3mo after surgery.

RESULTS: There were significant differences in the uncorrected visual acuity between the two groups at 1 and 3mo before surgery(P<0.05), but there were no significant differences at different time points before and after surgery(P>0.05). At 1wk, 1 and 3mo after surgery, SIA of two groups decreased continuously, and the SIA of the observation group was significantly lower than that of the control group at 1d, 1wk and 1mo after surgery(P<0.05). At 1wk after surgery, SⅠt and BUT in the two groups were less or shorter than those before surgery(P<0.05), but there were no significant differences at 1mo, 3mo after surgery, compared with those before surgery(P>0.05). SⅠt and BUT in the observation group were less or shorter than those in the control group at 1wk after surgery(P<0.05)but there were no significant differences at 1 and 3mo after surgery(P>0.05).

CONCLUSION: Compared with 3.0mm standard incision, 1.8mm clear corneal incision can reduce SIA and shorten the time for corneal stability recovery.

Abstract:AIM: To study the effect of torsional mode phacoemulsification on cornea in patient with age-related cataract.

METHODS: Totally 161 age-related cataract patients(196 eyes)were assigned randomly to phacoemulsification by torsional mode(Group A)or conventional ultrasound mode(Group B)in our hospital from January 2012 to December 2014. The intraoperative data of effective ultrasound time(UST)and effective cumulative dissipated energy(CDE)were recorded. Postoperative outcomes and the change of the best corrected visual acuity(BCVA), corneal edema degree(CED), central corneal thickness(CCT)and endothelial cell count were also recorded and compared.

RESULTS: For grade Ⅰ, Ⅱ, Ⅲ and Ⅳ nuclear density, the mean UST and mean CDE were significantly lower in Group A. The average BCVA of Group A was better than Group B at 1 and 7d after surgery. But at 30d postoperative, there was no statistical difference between these two groups(P>0.05). The corneal clarity and the mean change of central thickness showed significantly less corneal edema in Group A than Group B in 1 and 7d postoperatively. This difference was no longer found significantly at 30d after surgery(P>0.05). At 7 and 30d postoperative, the endothelial cells in Group B were lower than in Group A.

CONCLUSION: By reducing the effective UST and CDE intraoperatively, the main effect of torsional mode phacoemulsification on cornea shows less damage to endothelium cells, and patients get better prognosis. But the damage to cornea by torsional mode phacoemulsification isn't fundamentally solved.

Abstract:AIM: To investigate and analyze the changes of corneal biomechanics of normal eyes, forme frusta keratoconus eyes, subclinical keratoconus eyes and clinical keratoconus eyes by Corneal visualization Scheimpflug technology(Corvis ST), and provide clinical basis for early diagnosis of keratoconus.

METHODS: Case-control study. We randomly selected 40 normal eyes as normal group, 15 forme frusta keratoconus eyes as forme frusta keratoconus group, 23 subclinical keratoconus eyes as subclinical keratoconus group, and 40 clinical keratoconus eyes as keratoconus group. The biomechanical parameters of each group were measured by Corvis ST. The receiver operating characteristic(ROC)curves was plotted to distinguish keratoconus from the normal cornea.

RESULTS: There was no significant difference in the parameters of biomechanics between normal group and forme frusta keratoconus group (P>0.05). Compared to normal group and subclinical keratoconus group, the parameters second applanation length(AL2), first velocity of applanation(AV1), central curvature radius at highest concavity(HC-radius), deformation amplitude(DA)were revealed statistically significant differences(P<0.05). The biomechanical parameters of the keratoconic group were significantly different from those of normal group except for the second velocity of applanation(AV2), time from the start until the highest concavity(HC-time), peak distance(PD). ROC curve showed that the DA(area under the curve:0.891±0.028)was the best predictive parameter to distinguish keratoconus from the normal eyes.

CONCLUSION: The corneal biomechanical parameters of forme frusta keratoconus group are not changed compared with normal group. The changes between normal group and subclinical keratoconus group should combine with other technology to further improve subclinical keratoconic screening. Compared with normal corneas, keratoconus has a great change in biomechanics, which DA diagnosis of the highest efficiency.

Abstract:AIM: To investigate the clinical effect of cataract combined lens dislocation greater than 2 quadrants' patients after having phase I intracapsular cataract extraction and anterior vitrectomy, postoperative corrected vision greater than 0.3, and then taking phase II small incision suture-fixation of intraocular lens suspension.

METHODS: Totally 34 cases with cataract combined lens dislocation greater than 2 quadrants had been treated in our hospital from July 2014 to December 2016. We investigated their 1wk, 1 and 3mo postoperative complications and the uncorrected visual acuity, best corrected visual acuity, intraocular pressure, corneal astigmatism who took phase II small incision suture-fixation of intraocular lens suspension with corrected vision greater than 0.3 after having phase I intracapsular cataract extraction and anterior vitrectomy.

RESULTS: Along with the recovery time extension, patients' uncorrected visual acuity and best corrected visual acuity increased obviously than preoperative in each phase. On the 3mo postoperatively, the best corrected visual acuity of 1 eyes was between 0.3 and 0.1, 8 eyes was between 0.5 and 0.3, 16 eyes was between 0.7 and 0.5, and 9 eyes was better than 0.7. The best corrected visual acuity was achieved or near the best corrected visual acuity before surgery. Intraocular pressure rechecked became in the normal range at 1wk, 1 and 3mo postoperative. Surgery did not significantly increase the corneal astigmatism.

CONCLUSION: It is a safe and effective way in improving eyesight effectively, with stable intraocular pressure and fewer complications towards cataract combined lens dislocation greater than 2 quadrants' patients having phase I intracapsular cataract extraction and anterior vitrectomy, whose postoperative corrected vision greater than 0.3, and then phase II small incision suture-fixation of intraocular lens suspension.

Abstract:AIM: To observe the efficacy and safety of small incision manual nuncleofragmentation technology in hard-nucleus cataract.

METHODS: Fifty-four patients(54 eyes)were performed with small incision manual nucleofragmentation and intraocular lens implantation. Uncorrected-visual acuity, corrected-visual acuity and astigmatism were measured before and after surgery. Anterior segment of eye, retina, surgical complications were observed.

RESULTS: Preoperative uncorrected vision(LogMAR)was 1.095±0.171, corrected vision(LogMAR)was 0.994±0.158. Postoperative uncorrected vision(LogMAR)was 0.321±0.214 and corrected vision(LogMAR)was 0.276±0.179 at 1wk after operation. Both had statistical significance compared with uncorrected vision(LogMAR)(t=27.052, P<0.01)and corrected vision(LogMAR)(t=29.211, P<0.01)after cataract operation. Average preoprative corneal astigmatism was 0.93±0.34D, average postoprative astigmatism was 0.95±0.29D at 3mo, there was no statistical significance of astigmatism before and after surgery(t=1.048, P>0.05). No severe complications occurred in all cases.

CONCLUSION: The technology of small incision manual nuncleofragmentation in hard-nucleus cataract is proved to be safe and effective.

Abstract:AIM:To study the changes of tear film and ocular surface after the coaxial incision 2.5mm and 3.0mm in the phacoemulsification.

METHODS: Seventy patients(92 eyes)from February 2015 to February 2016 in our hospital were enrolled. The patients were randomly divided into two groups. Thirty-four patients(46 eyes)in Group A: coaxial 2.5mm incision phacoemulsification cataract extraction and intraocular lens(IOL)implantation. Thirty-six patients(46 eyes)in Group B: the conventional coaxial 3.0mm small incision phacoemulsification cataract extraction and IOL implantation. The break up time(BUT), Schirmer's Ⅰ test(SⅠt)and lid-parallel conjunctival folds(LIPCOF)were assessed preoperatively and postoperatively.

RESULTS: At 1wk, 1 and 3mo 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=3.089, 4.497, 4.322; 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=-6.286, -3.992, -3.278; all P<0.05). The LIPCOF score in two groups increased after operations, the LIPCOF score of Group B was significantly higher than those of Group A and the differences were statistically significant(t=-6.552, -5.131, -3.652; all P<0.05). At 6mo postoperatively, compared with the preoperative data, the BUT, SⅠt and LIPCOF score in Group A showed no statistically significant differences(t=0.646, 0.551, 0.165; P>0.05). The BUT, SⅠt and LIPCOF score in Group B showed statistically significant differences(t=-4.059, 3.629, 4.211; all P<0.05).

CONCLUSION: Ocular surface has less damage and tear film has little influence at early stage after the coaxial 2.5mm incision phacoemulsmcation, compared with the conventional coaxial 3.0mm incision phacoemulsification surgery.

Abstract:AIM:To observe the preliminary efficacy of conbercept injected intravitreally for the treatment of wet age-related macular degeneration(wAMD).

METHODS:Seventeen wAMD patients(18 eyes)were selected to receive conbercept injection. All patients were given a single conbercept injection every month, 3 times. Before and after 1, 2, 3mo of the injection, the best corrected visual acuity(BCVA), intraocular pressure(IOP, measured by Non-contact tonometer), fundus photography, fundus fluorescein angiography(FFA), indocyanine green angiography(ICG), optical coherence tomography(OCT)examination and the complications incidence were compared.

RESULTS:Three months after conbercept injection, the BCVA improved in 15 eyes(83%), stable in 3 eyes(17%). Before treatment, the average central macular thickness was 421.72±54.43μm, at 1 and 2 and 3mo after treatment, the average central macular thickness was 337.89±25.88μm, 293.56±26.87μm, 266.89±19.10μm respectively. There were significant differences compared with before and after injection(P<0.05). In the final follow up, FFA and ICG showed that the leakage in macular area disappeared in 15 eyes(83%), still existed in 3 eyes(17%), in those 3 eyes the injection was given for one or two times till the leakage disappeared. Elevated intraocular pressure occurred in 2 cases(26mmHg, 23mmHg), after 1d down to normal. Another patient showed postoperative envy, given left ofloxacin eye drops after 2d,then back to normal. There was no serious ocular adverse reactions.

CONCLUSION:Intravitreal injection conbercept for wAMD can significantly improve the visual function, reduce the macular edema and the leakage with higher safety and less complications. However the prolonged efficacy needs further observation.

Abstract:AIM: To evaluate the repeatability and reproducibility of thickness profile measurement of intra-retinal layers determined by an automated algorithm applied to OCT images from Cirrus optical coherence tomography(OCT)instrument.

METHODS: In this prospective cross-sectional study, retinal thickness images at 6mm×6mm around fovea were obtained from 86 eyes of 43 normal subjects with Cirrus HD- OCT instrument. The retinal images from patients were analysis by Cirrus automated algorithm GCA software, including ganglion cell layer and inner plexiform layer(GCIPL). During this study, operator A would make 2 times measurements to all patients, after that operator B would make another 2 times measurements by Repeat scan model. All the data, including GCL average thickness, min thickness, 12 clock average thickness, 2 clock average thickness, 4 clock average thickness,6 clock average thickness, 8 clock average thickness and 10 clock average thickness were measured by SPSS 15.0 software. Standard deviation(SD), coefficient of variation(CV)and interclass correlation coefficient(ICC)were calculated from the results of three-times tests by different examiner to evaluate the repeatability and from the results of two different examiners to assess the reproducibility. Written informed consent was obtained from each subject prior to any medical procedure.

RESULTS: The average GCIPL thickness of OD was 85.12±3.95μm; the minimum average GCIPL thickness was 83.21±4.41μm; the standard deviation of OD in clock map was from 3.79μm to 4.84μm; CV(95%CI)was between 0.26 and 0.93; ICC was from 0.939 to 0.989. The average GCL+IPL thickness of OS was 84.65±8.73μm; the minimum average GCPL thickness was 81±13.08μm; the standard deviation of OS in clock map was from 8.24μm to 10.56μm; CV(95%CI)was between 0.92 and 4.94; ICC was from 0.264 to 0.968.

CONCLUSION: Cirrus HD-OCT GCA software with automated algorithm can offer accurate and repeatable thickness profile of OCT retinal image. GCA is a useful and reliable approach to the measurement of intra-retinal layer thickness, which may improve the diagnosis and monitoring of retinal diseases.

Abstract:AIM: To study the clinical curative effect of 2mm micro incision phacoemulsification combined with 23G minimally invasive vitrectomy for cataract and vitreoretinal diseases.

METHODS: Retrospective analysis of 92 patients(99 eyes), including 49 male(53 eyes), 43 female(46 eyes)with mean age was 57.1±1.9 years, in our hospital for cataract and vitreoretinal treatment of the disease from February 2013 to February 2016. All patients underwent 2mm micro incision phacoemulsification combined with 23G minimally invasive vitrectomy. Curative effect and complications were observed.

RESULTS: Combined surgical procedures were carried out smoothly. posterior capsule rupture did not occurred. seven eyes were filled with BSS fluid, 46 eyes with C₃F₈, 49 eyes with intraocular lens at phase Ⅰ, 21 eyes placed intraocular lens when silicone oil was removed. The visual acuity improved in 84 eyes(85%), unchaged in 15 eyes(15%). Postoperative complications included transient high intraocular pressure in 18 eyes(18%), anterior chamber reaction in 7 eyes(7%)and corneal edema in 8 eyes(8%).

CONCLUSION: The 2mm micro incision phacoemulsification combined with 23G minimally invasive vitrectomy is a safe and effective surgical method with less injury, fewer complications.

Abstract:AIM: To observe the structure changes of vitreous and retina after YAG laser ablation in patients with physiological vitreous floaters.

METHODS: The selected 40 patients of physiological vitreous floaters, before YAG laser ablation, were checked for best corrected visual acuity, non-contact intraocular pressure, took their anterior segment photos, measured their foveola thickness(FT)and retinal nerve fiber layer(RNFL)by OCT. The YAG laser ablation was completed by one experienced surgeon. After the YAG laser ablation, all patients were checked for non-contact intraocular pressure and gave pranoprofen eye drops tid for 3d. At 2d, 1wk, 1 and 3mo after the surgery, they were reviewed for best corrected visual acuity, non-contact intraocular pressure. At 3mo later anterior segment photos were taken. At 1wk, 1 and 3mo after the surgery, FT and RNFL were measured again.

RESULTS: The postoperative 2d, 1wk, 1 and 3mo, best corrected visual acuity, non-contact intraocular pressure of the patients had no significant difference with preoperative(P>0.05). The preoperative anterior segment photos showed obvious single or sheet opacity of vitreous, the postoperative 3mo photos showed that vitreous opacities decreased or disappeared, no other abnormal changes were found. The preoperative OCT data showed that FT was 214.60±9.35μm, the postoperative 1wk, 1 and 3mo FT were 213.75±9.07μm, 213.40±8.83μm, 213.85±9.22μm. The preoperative RNFL were upper 130.26±14.23μm, lower 133.15±14.46μm, nasal 82.48±13.50μm, temporal 75.40±11.89μm; The postoperative 1wk RNFL were upper 130.02±14.02μm, lower 132.99±14.05μm, nasal 82.35±13.07μm, temporal 75.42±11.66μm. The postoperative 1mo RNFL were upper 130.28±14.43μm, lower 133.08±13.99μm, nasal 82.31±13.72μm, temporal 75.45±12.03μm. The postoperative 3mo RNFL were upper 130.43±14.30μm, lower 133.22±14.20μm, nasal 82.27±13.11μm, temporal 75.46±11.91μm. The differences of preoperative and postoperative 1wk, 1 and 3mo FT and RNFL had no statistical significance(P>0.05).

CONCLUSION: YAG laser ablation has no adverse effects to vitreous and retinal structure in patients with physiological vitreous floaters, it is effective and safe.

Abstract:AIM: To discuss the effects of preoperative vitreous cavity injection of ranibizumab on 25G minimally invasive vitreoretinal surgery(VRS)in patients with proliferative diabetic retinopathy(PDR).

METHODS: From February 2013 to December 2015, 74 patients with PDR received VRS(82 eyes)were retrospectively analyzed. Patients were divided into VRS + IVR group and VRS group according to preoperative VRS treatment. VRS+IVR group: preoperative injection of ranibizumab(10mg / mL)at 3-5d before operation; VRS group: VRS only. We recorded VRS operation time, filling situation, iatrogenic retinal hole and so on.

RESULTS: The operation time and coagulation times of VRS+IVR group were significantly lower than VRS group. The two groups in operation time and coagulation times were statistically significant(all P<0.05). In the VRS+IVR group, the number of cases of iatrogenic retinal hole and the use of silicone oil were lower than those of VRS group, the difference between the two groups was statistically significant(P<0.05). While the use number of C₃F₈ and perfusion fluid were not statistically significant(P>0.05). In VRS-IVR group within 3mo after operation, 4 eyes appeared to vitreous body hematocele, VRS group was 13 eyes, the difference was statistically significant(χ²=4.966, P<0.05).

CONCLUSION: PDR patients with 25G minimally invasive VRS with preoperative therapy can reduce postoperative ocular bleeding, rate of retinal injury and silicone oil filling, shorten the operation time, the incidence rate and improve the success rate of surgery and reduce eye bleeding, postoperative complications such as adhesion.

Abstract:AIM: To study the clinical value of fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)in the diagnosis and treatment of uveitis.

METHODS: From April 2014 to April 2016 in our hospital for treatment of patients with uveitis were 140 cases, including 104 cases of patients with binocular incidence in 208 eyes and 36 patients with unilateral disease. All of patients after history, slit lamp, direct ophthalmoscopy and B-scan examination was the diagnosis of uveitis. Based on the anatomy of uveitis was divided into: 72 cases of patients with anterior uveitis in 132 eyes, 24 cases of patients with intermediate uveitis in 48 eyes, posterior uveitis in 28 eyes of 40 patients, 16 patients with panuveitis in 24 eyes. FFA and OCT were used to detect the pathological changes of the fundus of the patients.

RESULTS: The detection of anterior uveitis was 46.2%, the detection rate of 43.8% intermediate uveitis, posterior uveitis detection rate was 45.0%, the detection rate of 54.2% panuveitis. Patients with anterior uveitis diseased were mainly in peripheral fundus, inflammation, posterior uveitis and panuveitis patients were mainly located in the posterior pole position, and were accompanied by vascular leakage.

CONCLUSION: FFA objectively reflects the effect of uveitis on the retina, helping doctors to understand the extent of their choroidal, optic nerve and retinal lesions, and thus the use of appropriate methods for treatment; OCT for patients with an objective and direct means of evaluation.

Abstract:AIM: To investigate the infection factors, diagnosis and treatment of endophthalmitis after intraocular foreign body injury.

METHODS: Totally 256 cases with intraocular foreign bodies including the occurrence of endophthalmitis in 42 cases were analyzed retrospectively.

RESULTS: The incidence of endophthalmitis after intraocular foreign body injury was 16.4%. Posterior segment foreign bodies and combined with traumatic cataract were the risk factors of endophthalmitis after intraocular foreign body injury(all P<0.05). Intravitreal injection of vancomycin hydrochloride and ceftazidime in the treatment of intraocular foreign body injury reduced the incidence of endophthalmitis(P<0.05). Types and sizes of intraocular foreign bodies,the time of extraction and the condition of wound had no significant effect on the incidence of endophthalmitis(all P>0.05). Vitrectomy was the main treatment of endophthalmitis.

CONCLUSION: Posterior segment foreign bodies and combined with traumatic cataract were the risk factors of endophthalmitis after intraocular foreign body injury. It should be kept the integrity of the posterior capsule of lens in traumatic cataract surgery. Intravitreal injection of vancomycin and ceftazidime is recommended in emergency surgery. Vitrectomy should be performed as soon as possible when confirmed endophthalmitis.

Abstract:AIM: To analyze the clinical features of children ocular penetrating trauma, and hope to effectively assist to prevent pediatric ocular trauma

METHODS: The data of 145 cases(145 eyes)with ocular penetrating trauma, hospitalized in Xijing Hospital from January 2012 to December 2016, were collected and retrospectively analyzed. All the data of injury factors and environment, age and gender of patients, lesions, treatment and prognosis were detailed studied.

RESULTS: In all the 145 pediatric patients with ocular penetrating trauma, accounted for 8.5% of all the ocular trauma patients, there were 95 cases of male, and 50 of female. Penetrating injuries mainly occurred in age of 3-9. The main injuries of ocular perforating in children were scissors, and sharp objects of wooden and iron. The wound was often located in the cornea or the anterior sclera. Traumatic cataract, vitreous hemorrhage and endophthalmitis were the common complications. The visual acuity was severely damaged, and 90 cases(62.1%)of the children recovered better than 0.1 after effective treatment.

CONCLUSION: The visual function of pediatric p0atients was seriously threatened after penetrating injuries. However, the damage of vision and the rate of blindness can be reduced effectively after timely and correct diagnosis and treatment. It is the most important that active and effective prevention in keep children away from penetrating injuries.

Abstract:AIM: To investigate the situation of patients with mechanical ocular trauma and the possible influencing factors related to the prognosis.

METHODS: Totally 260 patients(286 eyes)with mechanical ocular trauma from January 2011 to January 2016 in Xiaogan Central Hospital were selected and retrospective studied. Sociology and clinical data including gender, age, career, injury causes, injury nature, treatment time and visual acuity on admission in these patients were univariate analyzed, then the positive factors were analyzed using Logistic regression.

RESULTS: The middle-aged and young males were domain in 260 patients. The causes were mainly sharp instrument injury, while perforating injury of eyeball was the majority in injury nature. Univariate analysis showed that injury causes, injury nature, treatment time and eyesight on admission were influencing factors, while multivariate analysis by Logistic regression showed that visual acuity on admission and orbital contusion were independent influencing factors for patients ocular trauma.

CONCLUSION: Ocular trauma is a majoy cause of monocular blind, there are close associations between prognosis of ocular trauma and orbital contusion and visual acuity on admission. But the majority of ocular trauma is preventable and treatable, the relevant measures should be developed to prevent the ocular trauma.

Abstract:AIM: To observe the clinical effects of moisturizing eye decoction combined with artificial tears in the treatment of ophthalmoxerosis.

METHODS: A randomized controlled clinical research method was employed. One hundred-sixty patients diagnosed with ophthalmoxerosis were equally divided into a treatment group and a control group. In the treatment group, patients were given one dose per day of the moisturizing eye decoction as well as artificial tear drops three times a day. The patients in the control group were treated with artificial tears drops three times a day. The course of treatment was 3mo. Dry-eye symptoms, tear break-up time(BUT)by the slit lamp, the time of tear secretion(Schirmers Ⅰ test), corneal fluorescein staining(FL), and curative effects were observed before treatment as well as in the first and third months after treatment.

RESULTS: There were no significant differences between the two groups in terms of BUT, SⅠt, and FL before treatment(P>0.05). After treatment in the first and the third months, the BUT, SⅠt, FL, and curative effects were significantly different between the two groups(P<0.05).

CONCLUSION: Moisturizing eye decoction combined with artificial tears in the treatment of ophthalmoxerosis can improve efficacy.

Abstract:AIM: To investigate the clinical features of dry eye with type 2 diabetic patients, and to analyze the correlation between the clinical features of dry eye and the disease condition.

METHODS: Retrospective case series study. Dry eye cases with type 2 diabetic were analyzed from March to December in 2016. And the clinical features of patients were summarized. Dry eye examination including tear break-up time(BUT)and Schirmer test(schirmer Ⅰ test, SⅠt). Patients were divided into <60 years and≥60 years group by the age. And patients were divided into <5 group, 5-9 years group, ≥10 years according to the duration of diabetes. According to the condition of blood glucose, patients were divided into glucose controlled group and the group blood glucose uncontrolled. The results were statistically analyzed with gender, age, duration of diabetes and blood glucose level.

RESULTS: There were 178 cases collected. All cases were diagnosed as dry eye both eyes. The patient's age ranged from 32 to 85 years, with an average 58.41±13.06 years. There were 110(61.8%)male cases, and 68(38.2%)female cases. In all cases, the mean value of BUT was 4.52±2.31s, and the mean value of SⅠt was 4.25±1.99mm/5min. The value of women were more than men, but the differences were not significant statistically. Patients of ≥60 group were less than the age group of <60 patients, and the difference was significant statistically(t=4.153, 4.021; P<0.01). In different course, all groups were lower than the normal. The value of≥10 years group was the least, <5 years group was the highest, and 5-9 years group was middle one. The differences were statistically significant(F=68.884, 60.204; P<0.01). The value of blood glucose controlled group was significantly higher than the group blood glucose uncontrolled, and the difference was statistically significant(t=-6.615, -5.918; P<0.01).

CONCLUSION:There were two types dry eye in 2 diabetic patients: the instability of tear-film and the reduction of tear secretion. The clinic features of dry eye were related to age, the course of the disease, and the level of blood glucose.

Abstract:AIM: To observe the clinical effect of the tonifying kidney pills with mingmuwuzi treating evaporative dry eyes.

METHODS: This study adopted the positive drug control, prospective study, random number remainder grouping method to 65 cases of outpatient patients diagnosed with evaporative dry eyes which were divided into the treatment group 32 cases(64 eyes)and the control group 33 cases(66 eyes). The treatment group took the decoction of kidney pills with mingmuwuzi, combined with sodium hyaluronate eye drops. The control group simply use sodium hyaluronate eye drops, both group were set to 4wk for a course of treatment. To observe the symptoms and signs of two groups before and after the treatment, the change of the evaluation index and curative effect were evaluated.

RESULTS: The effectiveness of the treatment group was 87.5%, the control group was 78.8%, the difference was statistically significant(z=-3.149, P<0.05).

CONCLUSION: The treatment of the kidney pills with mingmuwuzi combined with sodium hyaluronate eye drops to evaporative dry eyes is more effective than the simple use of sodium hyaluronate eye drops.

Abstract:AIM: To explore the curative effect of different ways of silicone tube catheter for the treatment of children's lacrimal canaliculi rupture.

METHODS: A retrospective analysis from January 2014 to December 2015 were taken. According to admission time sequence, 42 children with lacrimal canaliculi rupture was divided into two groups. One group was treated with single silicone tube insertion, the other was treated with annular silicone tuber insertion. The treatment results were comparatively analyzed.

RESULTS: There were 4 eyes in single silicone tube group occurred fall off in 2wk to 1mo after operations because of improper nursing and the second operations were taken. There was no eye with this in annular silicone tuber groups, the difference between the two groups was significant(P<0.05). In single silicone tube group, 16 eyes were cured, 1 eye improved, 3 eyes unchanged which were the 3 eyes with fall off. Those 3 eyes were 1 patient bitten by dog, 2 bombed; the effective rate was 85%. In annular silicone tuber insertion, 20 eyes were cured, 2 eyes improved and the effective rate was 100%, the difference between the two groups was significant(P<0.05).

CONCLUSION: Children's lacrimal canaliculi rupture should be timely given surgical treatment, reasonable surgical treatment can achieve good operation effect. Annular silicone tube has good stability, fewer complications than single silicone tube, and clinical treatment effect is good.

Abstract:AIM: To analyze the reasons of low vision and blindness in elderly patients and the application of optical aids in rehabilitation.

METHODS: Totally 87 elderly patients which had 74 cases of low vision, 13 cases of blind, including 53 males and 34 females. Routine internal and external eye examinations should be performed, and special removal examinations should be performed if necessary. Both refractive correction, and try with far and near optical aids, check after wearing a typoscope distant and near vision, distant vision ≥0.05 out the blindness, distant vision ≥0.3 out the disability. Near vision ≥ 0.5 was valid, <0.5 was invalid.

RESULTS: Among 87 elderly patients with low vision, high myopia was the leading cause of blindness, followed by macular degeneration, cataracts, glaucoma and diabetic retinopathy. The visual acuity after refractive correction increased ≥ 2 lines in 62 cases(71%), visual acuity was not correct or corrected for ≤ 1 of 25 cases(29%). With aids, far visual was ≥0.3 of the 70 cases(80%), ≥0.05 in 10 cases(11%), <0.05 in 7 cases(8%), residue removal rate of 92%. With reading glasses near and near visual acuity was >0.5 effective in 60 cases(69%), <0.5 ineffective in 27 cases(31%). Typoscope was often used in 58 cases, not often used 18 cases, 11 cases rarely used or give up.

CONCLUSION: High myopia is the leading cause of low vision and blindness in the elderly, followed by macular degeneration. The application of visual aids is still reliable and economical and effective treatment method, patients should be encouraged to use visual aids to improve the utilization rate of aids, so as to improve the quality of life of patients.

Abstract:AIM:To explore the differences between unilateral recess-resection(R & R)and bilateral lateral rectus recession(BLR-rec)in the treatment of basic intermittent exotropia.

METHODS: A retrospective analysis of treatment of basic intermittent exotropia in 89 patients, in which 49 cases underwent unilateral recess-resection, 40 cases underwent bilateral lateral rectus recession of external rectus retroperitoneal surgery January 2013 to January 2015 in our hospital. The stereopsis and strabismus were observed in 1d, 1, 6mo, 1 and 2a after operation.

RESULTS: There was no significant difference in the success rate and oblique degree between the two groups after 1d, 1, 6mo, 1 and 2a(all P>0.05), but the success rate of the operation was reducing as time passed. After 2d of the operation, the drift of the R & R group was 12.10±5.74PD and the drift of the BLR-rec group was 7.78±4.21PD, the difference was statistically significant(P=0.021). The R & R group was more likely to cause lateral slanting than BLR-rec group. Two groups of patients with nearly stereopsis were both significantly improved, there was no significant difference between the two groups in the two groups(χ²=4.530, P=0.210).

CONCLUSION: The long-term stability of BLR-rec is superior to R & R.