Abstract:AIM: To evaluate the results of mitomycin-C(MMC)-augmented viscocanalostomy in patients with open-angle glaucoma.

METHODS: This retrospective study included 104 patients who underwent viscocanalostomy surgery between December 2007 and March 2014. Pre- and postoperative intraocular pressure(IOP), number of glaucoma medications, visual acuity, complications, adjunctive procedure(laser goniopuncture and/or glaucoma medication), and success rate were recorded. Complete success was defined as IOP≤21 mmHg without additional medication, and qualified success was defined as IOP≤21 mmHg with or without glaucoma medication.

RESULTS: Mean preoperative IOP was 27.5±9.2 mmHg and mean postoperative IOP was 14.5±6.6 mmHg at the last visit(P<0.001). Mean visual acuity before and after surgery were 0.42±0.4 and 0.32±0.4, respectively(P=0.726). Qualified success was achieved in 106(86.9%)eyes and complete success was achieved in 62(50.8%)eyes. Laser goniopuncture was performed in 43(35.2%)eyes and glaucoma medication usage rate was 49.1%. The mean postoperative followup period was 27.29±16.78(1-79)mo.

CONCLUSION:Although viscocanalostomy is a safer option due to low complication rates and stable visual acuity, without laser goniopuncture(LGP), surgical success rate is still very low. Further comparative studies are necessary to evaluate the contribution of MMC to viscocanalostomy surgery.

Abstract:AIM: To determine whether there was a significant relationship between eye iris color with axial length, intraocular pressure, retinal nerve fiber layer(RNFL)thickness, macular thickness and choroidal thickness.

METHODS: A prospective cross-sectional study involving 92 eyes of 92 healthy volunteers. These were divided into dark colored-eye(DCE)and light-colored eye(LCE)groups according to iris color. The RNFL and macular thicknesses were analysed with standard optical coherence tomography(OCT)protocol while choroidal thickness was analysed with electronic data interchange(EDI)protocol in all subjects. Choroidal thickness was measured at the fovea, 1500 μm nasal and 1500 μm temporal to the fovea in a horizontal section.

RESULTS: Of the 92 eyes included, 62(67.4%)were dark-colored while 30(32.6%)were light-colored. The mean age was 29.22±5.86y in the subjects with DCE and 28.86±6.50y in those with LCE. No significant difference was detected in mean age, axial length, macular thickness, choroidal thickness and intraocular pressure(IOP)between the groups(P>0.05). However, RNFL thicknesses varied depending on the quadrant measured, and were lower in both global and the nasal and temporal quadrants for individuals with LCE(P≤0.022).

CONCLUSION: No significant differences were found in IOP, macular thickness and choroid thickness between individuals with DCE and LCE. Meanwhile, the RNFL thickness is lower.

Abstract:AIM:To find the severities status of diabetic retinopathy(DR)among the patients with type 2 diabetes mellitus and to determine the association of the severities of diabetic retinopathy with duration of DR, HbA1C levels, history of hypertension, age and gender in the study population.

METHODS:Hospital based cross-sectional studies with sample of 100 patients with DR were selected by using simple random sampling technique with a structured questionnaire was conducted in May to June 2012. The study participants those who with DR aged ≥35 years were included in this study and an oral consent was also collected from the study participants. Descriptive statistics, univariate and multivariate ordinal logistic regression analysis were performed. MS Excel spread sheet was used for data entry and data analysis was done by using SPSS 21.0 version. Statistical significance was taken as P<0.05.

RESULTS:Out of 100 patients, mean age of the patient was found as 53.16±10.81(range 35-78)y. By univariate analysis, there was a positive relationship between diabetic retinopathy severity and age(P<0.01), duration of DM(P<0.001), HbA1C levels(P<0.001), history of hypertension, family history of DM(P<0.05)were highly significant, high density lipoprotein(HDL)(mmol/L)and age were not significant with P>0.05 by Mann Whitney u-test. All these factors were found as independent risk factors with the severity of DR except the factor age.

CONCLUSION:This study was concluded that the duration of DM, HbA1C levels, family history of DM, History of hypertension and gender were independently associated with severity of DR. However, the factors like age and HDL weren't significant with severity of DR in multivariate analysis. Therefore, by using the availability of the existing treatments and controlling in time, which can prevent and free from the vision threatening diseases or delay the occurrence of DR in their life.

Abstract:AIM: To evaluate the feasibility and advantages of two-port 27-gauge pars plana vitrectomy for treatment of recurrent retinal detachment in silicone oil dwelling eyes.

METHODS: A retrospective study. Two-port 27-gauge pars plana vitrectomy was performed in 7 eyes with recurrent retinal detachment without remove of silicone oil. Proliferative membrane peeling, endolaser treatment, and drainage of subretinal fluid were performed. Scleral bulking was performed if necessary.

RESULTS: Sucessful retina re-attachment was accomplishied in all eyes. No visually significant intraoperative complication occurred. All eyes expericend quick recoveray of visual acuity and mild postoperative irritation. One eye developed a recurrent inferior retinal detchment in 20d after the surgery using non-remove technique, and recovered after conventional silicone oil removal and retinal reattachment surgery.

CONCLUSION: Two-port 27-gauge pars plana vitrectomy is an efficacious(and potentially cost-efficient)method to treat early stage recurrent retinal detachment in silicone oil dwelling eyes.

Abstract:AIM: To compare the non-invasive tear break-up time(NITBUT)and tear meniscus height(TMH)measurements in keratoconus patients and normal subjects, and to determine the relationship between these measurements with keratoconus disease by the Oculus Keratograph 5M(K5M).

METHODS:Fifty keratoconus patients(100 eyes)and 50 healthy subjects(100 eyes)participated in the study. The age range in keratoconus group was 15-60(mean ± standard deviation=28.33±8.60)y, and in control group was 18-60(26.25±1.11)y. The measurements of NITBUT and TMH were performed using the K5M.

RESULTS: The mean value of NITBUT between the keratoconus group and the control group showed no statistically significant different(P=0.58). Also, the mean of TMH between two groups was not significantly different(P=0.69). The results of correlation coefficient between the variables of the study demonstrated that there was no significant relationship between the NITBUT and TMH measurements with the two groups(keratoconus group: r= 0.053, P=0.721; control group; r=-0.0501, P=0.7098).

CONCLUSION: Our study shows that the presence of keratoconus has no clinically significant impact on the quality and quantity of tear film.

Abstract:AIM: To remark the effect of Qingguang'an II on expression of PAX6, Ngn1, and Ngn2 mRNA of rats with chronic high intraocular pressure.

METHODS: Totally 40 male SD rats were randomly divided into 6 groups, that was: A: blank group, B: model group, C: Qingguang'an II low dose group, D: Qingguang'an II moderate dose group, E: Qingguang'an II high dose group, F: Yimaikang disket group. B, C, D, E, F groups of experimental rats were established the model of chronic high intraocular pressure(IOP)by cauterizing of superficial scleral vein. Animal model was established successfully by using monitoring IOP consistently keep above 25mmHg for 8wk as cut-off criterion. Tissues of Eyes were obtained after intragastric administration for 2wk and 4wk. The expressions of PAX6, Ngn1, and Ngn2 mRNA were investigated by Real-time PCR.

RESULTS: At the time-point of 2wk, PAX6, Ngn1, and Ngn2 mRNA in group B were statistically expressed in lower level comparing with other groups(P<0.05). Moreover, at the time-point of 4wk, PAX6, Ngn1, and Ngn2 mRNA in group C, D and E were statistically expressed in higher level comparing with group F(P<0.05). Besides, PAX6, Ngn1, and Ngn2 mRNA in group C and D were statistically expressed in lower level comparing with group E(P<0.05). PAX6, Ngn1, and Ngn2 mRNA in group C and D were expressed in similar level(P>0.05).

CONCLUSION: In summar, Qingguang'an II and Yimaikang disket can remarkably increase the expressions of PAX6, Ngn1, and Ngn2, which suggest protecting the optic nerve of rats caused by chronic high IOP. What's more, this study indicated that, in the protection of optic nerve of rats with chronic high IOP, the high dose of Qingguang'an II at the time-point of 4wk was the better choice.

Abstract:AIM: To investigate the protective effect of nerve growth factor combined with Ginkgo biloba extract on retinal ischemia - reperfusion(RIR)injury in rabbits with experimental high intraocular pressure.

METHODS: Establishment of rabbit glaucoma ischemia reperfusion model. Twenty-four New Zealand white rabbits were randomly divided into three groups: nerve growth factor group, Ginkgo biloba extract group and combination group. Respectively, in the continuous administration of 1, 7, 14d. We observed the morphological changes of the tissues of the retina. The levels of superoxide dismutase(SOD), nitric oxide(NO)and malondialdehyde(MDA)in retinal tissue were measured.

RESULTS: Respectively, first, in the continuous administration of 1, 7, 14d, the contents of MDA and NO in Ginkgo biloba extract group and nerve growth group were higher than that in combination group(P<0.05). Secondly, the SOD content of Ginkgo biloba extract group and nerve growth group were lower than that of combination group at each time point(P<0.05). At each time point, the number of HE staining of retinal ganglion cells(RGCs)showed that the loss of RGCs in the combination group was significantly lower than that in the other groups, and the ganglion cell count showed that the Ginkgo biloba extract group and the neuronal growth group were lower(P<0.05).

CONCLUSION: Nerve growth factor combined with Ginkgo biloba extract has better protective effect on retinal ischemia-reperfusion injury. The mechanism may be related to the decrease of free radicals and increase the activity of SOD in retinal tissue.

Abstract:AIM:To research the effects of lithium chloride on transforming growth factor beta(TGF-β)and connective tissue growth factor(CTGF)in cultured human Tenon capsule fibroblasts(HTFs)and explore its mechanism.

METHODS: HTFs were cultured and identified by vimentin staining with immunofluorescence and the morphological characteristics. The experimental group was processed 48h with LiCl in concentration of 80mmol/L, the control group without LiCl. The mRNA expression of TGF-β and CTGF in two groups were analyzed with real-time fluorescent quantitative polymerase chain reaction(real time-qPCR)and the protein expression was detected with Western blot.

RESULTS:The cultured HTFs expressed TGF-β and CTGF. The mRNA expression of TGF-β and CTGF significantly decreased compared with the control group(t=20.042, 14.995, P<0.05). the protein expression of TGF-β and CTGF also decreased significantly compared with the control group(t=46.058、12.452, P<0.05)

CONCLUSION: The cultured HTFs can express TGF-β and CTGF in mRNA and proteins' level. LiCl can reduce the expression of TGF-β and CTGF both in gene and proteins' level. LiCl has the potential to modulate wound healing for glaucoma filtration surgery.

Abstract:AIM: To discuss the changes of IL-17, IL-21 in glucocorticoid therapy of active thyroid associated ophthalmopathy(TAO)and analyze the relation with results.

METHODS: The 67 patients(134 eyes)of TAO in our hospital, were divided into activity group(32 patients 64 eyes)and atypical activity group(35 patients 70 eyes)according clinical activity score(CAS)grading standard, and 30 cases of healthy as control group at the same time. The activity group were treated by glucocorticoid therapy treatment, and proceed the CAS scores before and after treatment, measured the degree of exophthalmus and width of palpebral fissure. At the same time, compared the expression level of IL-17 and IL-21 in all groups, and analyzed the correlation between the IL-17 and IL-21 and CAS score.

RESULTS: Compared with control group, expressions of IL-17 and IL-21 in TAO patients were significantly higher(P<0.05). The expressions of IL-17 and IL-21 in active period TAO patients were higher than atypical activity(P<0.05). After glucocorticoid treatment, the expressions of IL-17 in active period TAO patients decreased significantly(P<0.05), and it was significantly positive correlation with CAS score(before treatment: r=0.8847,P=0.042; after treatment: r=0.8886,P=0.0439)the expression of IL-21 in active period TAO patients was significantly positive correlation with CAS score(before treatment: r=0.8893, P=0.0435; after treatment: r=0.8876,P=0.045).

CONCLUSION: IL-17 and IL-21 is closely related to the TAO disease activity, and glucocorticoids impact treatment by reducing IL-17 and IL-21 in activity TAO, IL-17 and IL-21 can be used as one of indexes of predicted curative effect and condition in patients with TAO.

Abstract:AIM: To explore the changes of intraocular pressure measured by noncontact tonometer(IOP_NCT)with high myopia and analyze the relative fators after small incision lenticule extraction(SMILE).

METHODS: A retrospective study. Totally 108 cases(216 eyes)with high myopia received SMILE during March 2015 to October 2016 were involved. The IOP_NCT, corneal central thickness(CCT)and corneal curvature for 3mo were recorded and analyzed by ANOVA, LSD t test. The Pearson correlation analysis and multiple linear regression model analysis were used to evaluate the relationship between IOP_NCT and its influence factors.

RESULTS:(1)There was significant statistical difference in IOP_NCT after SMILE at 1d, 1wk, 1 and 3mo compare with preoperative(t=17.785, P=0.019; t=17.981, P=0.016; t=18.841, P=0.012; t=19.364, P=0.001); the IOP_NCT after SMILE decreased. The IOP_NCT values at every time after SMILE was no statistical difference(t=1.871, P=0.818; t=3.062, P=0.328; t=1.143, P=0.373).(2)The IOP_NCT in high myopia were positive correlated with CCT and corneal curvature after SMILE(r=0.4356, 0.295; P<0.05), respectively.(3)The multiple linear regression model analysis revealed that Y=-14.601+0.348X₁+0.03X₂(Y was IOP_NCT, X₁ was corneal curvature, X₂ was CCT,P<0.001); Y=3.679+0.28X₁+0.012X₂(Y was△IOP_NCT,X₁ was variation of corneal curvature,X₂ was△CCT, P<0.001).

CONCLUSION: The IOP_NCT decreased after SMILE in high myipia, and it showed that there was no significant influence to use glucocorticoid eye drops in short terms. There was positive correlation among IOP_NCT, CCT and corneal curvature after SMILE.

Abstract:AIM: To evaluate the repeatability of axial length(AL)and anterior chamber depth(ACD)obtained by A scan ultrasonography, and to compare AL and ACD obtained by A scan with those obtained by IOL Master.

METHODS: Two hundred and fifty-seven cataract eyes of 170 patients were included. IOL Master and A scan were performed for each eye. Five measurements of IOL Master and 3 measurements of A scan were obtained. All the tested eyes were divided into 5 groups according to AL obtained by A scan: Group A(2129mm, 21 eyes). Cronbach's Alpha coefficient and intraclass correlation coefficient(ICC)were applied to evaluate the repeatability of AL and ACD obtained by A scan. Paired t test and Pearson correlation coefficient were used to analyze the differences and correlations of AL and ACD obtained by the 2 devices, respectively. Bland-Altman plots were presented to analyze the agreements of AL and ACD obtained by the 2 devices.

RESULTS: All the Cronbach's Alpha and ICCs of AL and ACD values were more than 0.98. The differences of AL values between A scan and IOL Master were -0.11±0.08mm in Group A, -0.15±0.10mm in Group B, -0.19±0.15 mm in Group C, -0.29±0.16mm in Group D and -0.45±0.29mm in Group E, respectively(all P<0.01). The differences of ACD values between A scan and IOL Master were -0.10±0.16mm in Group A, -0.06±0.13mm in Group B, -0.06±0.13mm in Group C, -0.19±0.10mm in Group D, -0.18±0.21mm in Group E, respectively(all P<0.01). In all groups, the AL and ACD values obtained by A scan and IOL Master presented good correlations(all r>0.89, all P<0.01).

CONCLUSION: The AL and ACD values in cataract eyes obtained by A scan were repeatable. The AL and ACD values obtained by A scan were smaller than those obtained by IOL Master. With the increase of AL values, the differences of AL values between A scan and IOL Master increased.

Abstract:The corneal reconstruction is tosurgial recover the structure integrity and corneal function after suffered from various trauma, inflammation and degenerative diseases. The corneal diseases caused millions of people worldwide suffering from eyesight damages and even blindness. At present, the corneal transplant is the main therapy for corneal blindness. However, the shortage in donor corneal issue is a worldwide problem and the failure due to the immunologic rejection of host is common. Nowadays, with the development of tissue culture and bioengineering technology, the application prospect of autologous stem cell transplantation is becoming more and more popular which might replace the allogeneic transplantation, becoming an important clinical treatment of regenerative medicine. Human dental pulp stem cells(hDPSCs)is a class of adult stem cell divided from the third molar teeth. Both hDPSCs and corneal cell are from the cranial nerve in embryonic ectoderm. Extensive researches show that the hDPSCs have the potentialities in corneal cell differentiation without causing immunologic rejection of the recipient. These findings manifested the potentials of hDPSCs in the clinical applications related to ocular surface reconstruction. In this paper, the features and current investigation status of hDPSCs in ocular surface reconstruction are reviewed.

Abstract:Posterior capsular opacification(PCO)is the most common complication that leads to loss of vision after cataract surgery. Neodymium doped: Yttrium-Aluminum-Garnet(Nd:Yag)laser capsulotomy is a common treatment for PCO, but still associated with several complications. In the past decades, the prevention and treatment of PCO have always been a hot spot of research in ophthalmology. This review will address the advances in the prevention and treatment of PCO in the aspects of surgical techniques and types of intraocular lens(IOL).

Abstract:The normal growth of blood vessels is the result of dynamic balance of angiogenic factor and inhibitory factor in vascular tissue. However, when the balance is broken, the growth of new blood vessels will be induced. Endogenous angiogenesis inhibitory factor, is a group of negative feedback molecules produced by the body itself that inhibit angiogenesis. Its function of inhibiting angiogenesis is mainly realized by promoting the binding of angiogenic factor to its receptor, or its downstream angiogenesis signal, or promoting vascular endothelial apoptosis. The study of angiogenesis inhibitory factor has potential clinical significance for the prevention and treatment of retinal neovascularization. Recent studies on retinal neovascularization inhibitory factor are reviewed in this paper.

Abstract:Conjunctiva goblet cells are spread out within a stratified epithelium, and keep ocular surface homeostasis by secreting mucin. Previous research has shown conjunctiva goblet cells can secret mucin, remove debris and modulate ocular surface immune function. In this review, we will focus on biological characteristics of conjunctiva goblet cells and the effect of key factors SAM pointed domain Ets factor(SPDEF)on differentiation and function of conjunctiva goblet cells, and further understand relationship between goblet cells and eye health.

Abstract:In view of the anatomical and physiological barrier of the ocular surface and the intraocular structure, the conventional ophthalmic agents cannot efficiently reach the lesion site. Currently, the different types of nanomaterials possess great advantages in delivering drugs due to their characteristics of small size, easy preparation, degradability, strong targeting and less irritation to biological tissue. As drug delivery carriers, nanomaterials have been widely used in ocular drug delivery so as to treat different types of eye diseases. In this paper, the applications of nanomaterials as drug delivery carriers in treating eye diseases are briefly reviewed.

Abstract:Late intraocular lens dislocation is one of the most severe late complications after phacoemulsification. It often occurs 3mo after the surgery. Different from early intraocular lens dislocation, late intraocular lens dislocation is caused by zonular dehiscence and contraction of the capsular bag many years after phacoemulsification. In recent years, the incidence of late intraocular lens dislocation gradually increases, having a risk of 0.1% after 10a and 1.7% after 25a. In the long-term follow-up patients who underwent cataract surgery, 90% had zonular insufficiency and capsular contraction. Among the multiple factors which may contribute to zonular weakness and capsular contraction, pseudoexfoliation is the most common cause, accounting for 50% of all the cases. Other risk factors include aging, high myopia, uveitis, trauma, previous vitreoretinal surgery, retinitis pigmentosa, diabetes mellitus, atopic dermatitis, previous acute angle-closure glaucoma attack, and connective tissue disorders. The understanding of these predisposing factors will suggest necessary preventions for high-risk patients in the future.

Abstract:Age-related macular degeneration(AMD)and cataract are the most common causes of low vision worldwide. Nowadays, there is still a controversy about whether cataract surgery should be taken in patients combined with AMD and when should the surgery be taken. The aim of this review is to assess the influence of cataract surgery on the occurrence and development of AMD, to analyze the risk factors, to explore the occasion of cataract surgery in patients with AMD, and joint with anti-vascular endothelial growth factor(VEGF)treatment, also including the development and application of intraocular lens. It helps to avoid and postpone the development and progression of macular degeneration after cataract surgery and get good visual outcome.

Abstract:Posterior ischemic optic neuropathy is a kind of ischemic optic neuropathy, the incidence rate of which is lower with less obviously clinical features, less positive signs and more difficultly diagnosis when compared with anterior ischemic optic neuropathy. Meanwhile, therapeutic method of posterior ischemic optic neuropathy has remained controversial. This article will summarize the research development of the auxiliary examination, diagnosis, differential diagnosis and therapeutic method of posterior ischemic optic neuropathy.

Abstract:AIM: To evaluate 23G vitrectomy for macular edema in eyes with retinal vein occlusion(RVO)combined with vitreoretinal traction(VMT)or epiretinal membrane(ERM).

METHODS: Totally 22 patients(22 eyes)diagnosed with macular edema of RVO combined with VMT or ERM were retrospectively analyzed. Twelve cases performed with 23G vitrectomy together with peeling of inner limiting membrane(ILM)and/or ERM were considered as the observation group or intervention group. Ten cases without vitrectomy were recruited as control group. The best corrected visual acuity(BCVA)and central retinal thickness(CRT)at baseline, 1, 3 and 6mo were recorded and compared.

RESULTS: At baseline, the difference of BCVA and CRT between observation group and control group was not statistically significant(P=0.645, 0.206). After vitrectomy, the BCVA and CRT of RVO patients in observation group were significantly improved compared with baseline at each follow-up(F=2.895, P=0.048; F=16.431, P<0.01). However, the BCVA and CRT in control group remained the same as baseline at every follow-up. Moreover, the BCVA and CRT in observation group were much better than that in control group at both 3 and 6mo after vitrectomy. However, the BCVA and CRT between two groups were not significantly different at 1mo postoperatively.

CONCLUSION: The 23G vitrectomy could markedly improve BCVA and reduce CRT in RVO patients with macular edema combined with VMT and/or ERM.

Abstract:AIM: To study the type, degree and axial distribution of low vision astigmatism in preschool children.

METHODS: A group of 3-6 years old children were selected for astigmatism screening, and statistical analysis was performed on the detected 445 eyes of 308 people.

RESULTS: With more than 0.50D astigmatism criteria, astigmatism examination of 308 people, accounting for 36.2%, of which 137 eyes astigmatism, astigmatism 171 monocular. The five types of astigmatism were compound hyperopia 40.7%, mixed 35.5%, compound myopia 8.5%, myopia 8.3%, simple hyperopia astigmatism degree 7.0%; 69.0% were mild, 16.6% moderate, 14.4% severe. Astigmatism axial distribution was with the rule for 54.9%, against the rule 28.8%, oblique 16.6%. In binocular astigmatism eyes, axial symmetry was in 35.8%, asymmetry in 64.2%.

CONCLUSION: The main type of astigmatism in preschool children are compound hyperopia and mixed astigmatism. Astigmatism degree is mainly mild. With the increase of age, the detection rate of moderate and high astigmatism increased.

Abstract:AIM:To evaluate the percentage of cutting fluctuations of central corneal thickness(CCT)intraoperative used low concentration(0.02%)mitomycin C(MMC)after laser-assisted subepithelial keratomileusis(LASEK).

METHODS: In this prospective study, low and medium myopia group(spherical equivalent≤6.0DS)has 138 patients(276 eyes). Low concentration MMC used topically in 69 patients(138 eyes)randomized after excimer laser ablation; the another traditional LASEK as control. High myopia group(6.0DSt test and their repeatability was assessed using the coefficient of variation(CV).

RESULTS: At 3mo after operation, the difference of central corneal thickness and cutting value between different treatment groups was statistically significant(P<0.05). The percentage of cutting fluctuations, which used to avoid the interference of the individual central corneal thickness between the applying low concentration MMC group and control group: the minimum value achieved at 1mo after LASEK, the maximum value achieved at 3mo after LASEK, the difference was statistically significant compared with the other 5 periods after LASEK within group(P<0.05); the difference in each period after LASEK was statistically significant(P<0.05)between groups with different treatmemt(P<0.05).

CONCLUSION: The study on percentage of cutting fluctuations of central corneal thickness, further confirmed low concentrations MMC in reducing postoperative corneal stromal proliferation reaction, inhibition of haze production.

Abstract:AIM:To compare the accuracy of conventional contact A-scan and IOL Master in measuring axial length and anterior chamber depth, and to evaluate the characteristics of these two different methods.

METHODS:Totally 145 cases(189 eyes)who underwent phacoemulsification and intraocular lens implantation in our hospital from January 2015 to December 2016 were observed prospectively. They were divided into five groups according to ocular axial length measured by IOL Master(Group A: AL≤22mm, Group B:22mm28mm). The axial length and anterior chamber depth were measured by A-scan and IOL Master respectively before operation, corneal curvature was measured by IOL Master. AL≤22mm using Hoffer Q formula to calculate the crystal degree, AL>22mm using Haigis formula to calculate the crystal degree. Analysis of axial length, anterior chamber depth and mean absolute refractive error at 3mo after surgery.

RESULTS:The axial length measured by A-scan and IOL-master: Group A were 21.48±0.41mm and 21.46±0.40mm(P>0.05); Group B were 23.13±0.62mm and 23.14±0.63mm(P>0.05); Group C were 25.24±0.56mm and 25.27±0.59mm(P>0.05); Group D were 26.97±0.59mm and 27.03±0.64mm(P>0.05); Group E were 30.76±1.40mm and 31.01±1.53mm(P<0.05). Mean absolute refractive error(MAE)at 3mo after surgery by A-scan and IOL Master: Group A were 0.50±0.30D and 0.43±0.27D(P>0.05); Group B were 0.48±0.34D and 0.45±0.32D(P>0.05); Group C were 0.56±0.32D and 0.49±0.40D(P>0.05); Group D were 0.64±0.16D and 0.50±0.22D(P>0.05); Group E were 0.91±0.47D and 0.62±0.29D(P<0.05), MAE≤±0.50D were 38.7% and 65%(P<0.05), MAE≤±1.00D were 69.2% and 83.3%(P>0.05). Anterior chamber depth measured by A-scan and IOL Master:Group A were 2.81±0.35mm and 2.82±0.41mm(P>0.05); Group B were 3.04±0.50mm and3.10±0.47mm(P>0.05); Group C were 3.55±0.62mm and 3.60±0.52mm(P>0.05); Group D were 3.42±0.24mm and 3.51±0.30mm(P>0.05); Group E were 3.50±0.28mm and 3.61±0.34mm(P>0.05).

CONCLUSION:IOL Master and contact A-scan have a high degree of consistency in the biological measurement, IOL Master has higher accuracy for patients with high myopia and long axis. It is a simple, accurate, good-repeatable and non-contact measurement tool.

Abstract:AIM: To evaluate changes in tear film stability and meibomian gland function and the clinic efficacy of three different artificial tears in patients with preoperative dry eye after phacoemulsification.

METHODS: All 90 cataract patients(90 eyes)with preoperative dry eye who underwent phacoemulsification randomly divided into three groups(Group A treated with protein-free calf blood extract ophthalmic gel; Group B treated with sodium hyaluronate eye drops; Group C treated with Vitamin A palmitate eye gel). Ocular Surface Disease Index(OSDI), Schimer's I test(SⅠt), tear film break time(BUT), corneal fluorescein staining(FL)and meibography were performed for all patients preoperatively and 7, 30 and 90d postoperatively.

RESULTS: No statistical differences existed among the three preoperative groups(P>0.05). Except meibomian gland score, there was no statistical significance among preoperatively and 7, 30, 90d postoperatively of the three groups(P>0.05). At 7d postoperatively, SⅠt and BUT of every group were lower than those before treatment, FL scores and OSDI scores were higher than those preoperative(P<0.05); there were no statistical differences among the three groups(P>0.05). At 30d postoperatively, SIt, BUT, OSDI scores in group A and C were better than in group B, which displayed statistical differences(P<0.05); FL scores in group A were significantly better than in group B and C(P<0.05). At 30, 90d postoperatively, SIt, BUT, FL scores, OSDI scores were better than preoperative results, which displayed statistical differences(P<0.05). There were no statistical differences among the three groups at 90d postoperatively(P>0.05).

CONCLUSION: Tear film stability and meibomian gland function were affected by phacoemulsification. Topical application of deproteinised calf blood extract eye gel, sodium hyaluronate eye drops and Vitamin A palmitate eye gel all hase a clearly beneficial effect on subjective symptoms. Deproteinised calf blood extract eye gel and Vitamin A Palmitate Eye Gel had more powerful effect on BUT than sodium hyaluronate, however deproteinised calf blood extract eye gel is more effective in superficial punctuate keratopathy.

Abstract:AIM: To explore efficacy of the different kinds of artificial tears treatment in patients with xerophthalmia after phacoemulsification combined with intraocular lens implantation.

METHODS: Totally 280 patients(280 eyes)with xerophthalmia after operation in our hospital from January 2015 to June 2016 were selected. According to the different treatment methods, they were divided into control group(n=70; treated with tobramycin and dexamethasone eye ointment 3 times per day for 1wk, levofloxacin eye drops 3 times per day for 1wk, pranoprofen eye drops 4 times per day for 1mo), polyacrylic acid group(n=70; besides the treatment of control group, polyacrylic acid was used 4 times per for 1mo), polyethylene glycol group(n=70; besides the treatment of control group, polyethylene glycol was used 4 times per for 1mo)and sodium hyaluronate group(n=70; besides the treatment of control group, sodium hyaluronate was used 4 times per for 1mo). The tear film break up time(BUT), Schirmer Ⅰ test(SⅠt), symptoms of dry eye and corneal staining in four groups were observed.

RESULTS:(1)BUT: The BUT of the four groups significantly increased after treatment(P<0.05); that of polyacrylic acid group, polyethylene glycol group, and sodium hyaluronate group was different compared with control group(P<0.05); the BUT in sodium hyaluronate group was significantly higher than the other groups after 2wk of treatment(P<0.05).(2)SⅠt: SⅠt of the four groups significant increased after treatment(P<0.05); that of polyacrylic acid group, polyethylene glycol group, and sodium hyaluronate group was different compared with control group(P<0.05); and the SⅠt in sodium hyaluronate group was significantly higher than other groups(P<0.05).(3)Xeroma score: the scores of dry eye significantly decreased after treatment in the four groups(P<0.05); that of polyacrylic acid group, polyethylene glycol group, and sodium hyaluronate group was different compared with control group(P<0.05); and the scores of the sodium hyaluronate group after 3wk was significantly lower compared with other groups(P<0.05).(4)Corneal staining score: the scores significantly decreased after treatment in the four groups(P<0.05); at 1 and 2wk after treatment the corneal staining score had not statistically different among the four groups(P>0.05); sodium hyaluronate group was significant lower than other groups in corneal staining score at 3wk and 1mo after treatment(P<0.05).

CONCLUSION: Artificial tears in the treatment of xerophthalmia after cataract phacoemulsification combined with intraocular lens implantation has better clinical efficacy, which contains sodium hyaluronate may be the better than others.

Abstract:AIM: To compare the influence of anterior chamber maintainer and viscoelastic agent on corneal astigmatism and endothelial cells after phacoemulsification.

METHODS: Totally 70 patients(70 eyes)of cataract from April 2013 to April 2015 were randomly divided into the study group and the control group, with 35 cases in each group. The study group were treated with anterior chamber maintainer during phacoemulsification with support system approach, and the control group were treated with phacoemulsification under viscoelastic agent.

RESULTS:The age(t=0.215, P=0.831), the density of corneal endothelial cells(t=-0.352, P=0.726)and corneal luminosity(t=-0.162, P=0.872)of two groups had no significant difference before surgery; there were no significant difference in preoperative visual acuity(t=0.463, P=0.599)and visual acuity(t=1.616, P=0.124)at 1mo after operation. And patients in the study group(t=-21.129, P<0.01)and the control group(t=-12.780, P<0.01)before surgery and 1mo postoperative when compared with the naked eye eyesight showed significant difference. The visual acuity after operations improved significantly. There were significant differences of corneal endothelial cells density(t=8.489, P< 0.01)and corneal astigmatism(t=-2.032, P=0.046)in the study group before surgery and 1mo after surgery; corneal endothelial cell density(t=8.999, P<0.01)and corneal astigmatism(t=-2.167, P=0.034)in the control group before surgery and 1mo after surgery also had significant differences. There was no significant difference in the rate of corneal endothelial cell loss between the two groups(t=0.410, P=0.683).

CONCLUSION: Compared with viscoelastic agent, anterior chamber maintainer during phacoemulsification in patients with cataract won't increase the damage of postoperative surgically induced astigmatism and corneal endothelial cells, which mean the method of anterior chamber maintainer during phacoemulsification in the treatment of cataract is safe and effective.

Abstract:AIM:To evaluate the effectiveness and safety between trabeculectomy with collagen matrix versus trabeculectomy with mitomycin C(MMC)for patients with primary open-angle glaucoma(POAG).

METHODS: In this prospective randomized comparative study from January 2015 to December 2016. Thirty-two eyes presented with POAG were included in this study, 14 eyes treated by trabeculectomy with subconjunctival implant of collagen matrix(study group)and the other 18 eyes treated by trabeculectomy with mitomycin C. Postoperative IOP, the success rate of operation, number of postoperative glaucoma medications and postoperative complications were recorded. Each patient was followed up at least 6mo.

RESULTS: The mean postoperative IOP was statistically different between the study group and the control group after 1d(P<0.05), while not statistically different at 1 and 1mo follow-up(P>0.05), and the mean postoperative IOP was statistically different between the two groups(P<0.05)at 3 and 6mo after surgery. There was no significant difference in the success rate of operation between the two groups at 6mo after operation(P>0.05). The IOP decreased at 1d after openations compared with before, kept stable at 1wk to 6mo. IOP of study group was lowen than control. IOP was controlled by glaucoma medications in the study group by 28% compared to control group by 33% at 6mo after operation, but there was no significant difference. There was no significant difference between the study group and the control group in complications(P<0.05).

CONCLUSION: Trabeculectomy with collagen matrix implant is comparable to the use of MMC with a similar success rate in open-angle glaucoma and the range in reducing intraocular pressure was significantly higher than that of MMC and it can significantly avoid the occurrence of low IOP postoperatively, transient anterior chamber, conjunctival wound leakage complications has no advantages compared with the use of MMC.

Abstract:AIM: To investigate the application of retinal nerve fiber layer(RNFL)thickness detected by OCT in the diagnosis of primary open angle glaucoma(POAG)and its relationship with the mean defect of visual field.

METHODS: A retrospective study was carried out. Totally 158 cases(158 eyes)of patients with POAG were selected as POAG group, including 81 cases in early stage, 47 cases in middle stage and 30 cases in late stage. At the same time, 50 cases of persons without eye related diseases were selected as the control group. The upper, lower, nasal and bitamporal RNFL thickness and mean defect of visual field were detected, and the patients with POAG were followed up for 3mo.

RESULTS: The upper, lower, nasal and bitamporal RNFL in POAG group were thinner than those in the control, and the mean defect of visual field was higher than that in the control group at different time(P<0.05). There was no significant difference in RNFL thickness and mean defect of visual field between patients with early POAG and the control group(P>0.05). The RNFL thickness of various parts was higher than that in patients with middle and late POAG, and the mean defect of visual field was lower than that in patients with middle and late POAG(P<0.05). There was no significant difference in RNFL thickness of various parts and mean defect of visual field in POAG group at different time(P>0.05). Pearson correlation analysis showed that the upper, lower, nasal and bitamporal RNFL thickness was negatively correlated with the mean defect of visual field(r=-0.719, -0.615, -0.681, -0.518, P<0.05).

CONCLUSION: OCT can monitor the change of RNFL thickness in patients with POAG, and has a negative correlation with mean defect of visual field, which can be used for early diagnosis of POAG.

Abstract:AIM: To compare the short-term and long-term curative effect between two implantation methods for treating refractory glaucoma.

METHODS:A total of 150 patients with refractory glaucoma(150 eyes)were divided into Group A(treated by implantation with Ex-press glaucoma drainage device)and Group B(treated by implantation with Ahmed glaucoma valve)according to different implantation methods. Changes of intraocular pressure and anti-glaucoma drugs at different time points, the success rate of surgery, improvement of visual acuity and complications were compared between the two groups.

RESULTS: The intraocular pressure of two groups at 1d, 1wk, 3, 6 and 12mo after surgery was significantly lower than that before surgery(P<0.05). The intraocular pressure of Group A at 3, 6 and 12mo after surgery was significantly lower than that of Group B, while anti-glaucoma drugs at 6 and 12mo after surgery were significantly fewer than those in Group B at the same time point(P<0.05). There were no significant differences between the two groups in 12-month success rate of operation, improvement rate of visual acuity and incidence of postoperative complications(P>0.05).

CONCLUSION:The effects of implantation with Ex-press glaucoma drainage device are similar to those of implantation with Ahmed glaucoma valve in the treatment of refractory glaucoma. However, the intraocular pressure control effect of the former is better than the latter, and used anti-glaucoma drugs are fewer.

Abstract:AIM: To discuss the application value of retro-mode imaging by F-10 confocal scanning laser ophthalmoscope(cSLO)for detecting drusen in patients with age-related macular degeneration(AMD).

METHODS: This was a retrospective case study. During the period of October 2015 to December 2016, 67 patients with unilateral AMD(67 affected eyes and 67 fellow eyes)were included in this study. All patients underwent color fundus photography, optical coherence tomography(OCT)and retro-mode imaging by F-10 cSLO. The features of drusen by color fundus photography, OCT and retro-mode imaging were comparatively observed in the affected eyes of patients with unilateral AMD. Positive numbers of drusen in the fellow eyes of patients with unilateral AMD detected by color fundus photography, OCT and retro-mode imaging were calculated and compared.

RESULTS: Retro-mode imaging by F-10 cSLO gave easier to identify images of drusen than color fundus photography and OCT in the affected eyes of patients with unilateral AMD. In the fellow eyes of 67 patients with unilateral AMD, retro-mode imaging showed drusen in 56 cases(84%), color funds photography showed drusen in 36 cases(54%), OCT showed drusen in 48 cases(72%), the difference was statistically significant(χ²=14.31, P<0.05).The positive numbers of drusen detected by retro-mode imaging were significantly higher than color fundus photography, the difference was statistically significant(χ²=13.87, P'<0.0125). There was no statistically significant difference in the positive numbers of drusen detected by retro-mode imaging and OCT(χ²=2.75, P'>0.0125).

CONCLUSION: Retro-mode imaging by F-10 cSLO provides a non-invasive technique and should be useful for detecting and monitoring drusen in AMD.

Abstract:AIM:To explore the association of the mutation in PPP2R3A exons and retinoblastoma.

METHODS: Hospital-based case control study was taken. Retinoblastoma patients(15 cases, as case group)and matched controls(30 controls, as control group)were recruited in this study. Genomic DNA obtained from formalin fixed paraffin embedded(FFPE)and peripheral blood were used as template. PPP2R3A gene exon sequences were detected by PCR-sequencing. Homology analysis was performed using blastn in GenBank.

RESULTS: Analyzing PPP2R3A DNA sequences(1001bp)from 15 cases, two reported SNPs had been detected, including rs34629706 and rs144802055. Rs34629706 also occurred in the control group. Rs144802055 appeared only in the case group.

CONCLUSION: PPP2R3A gene SNPs of rs34629706 is unrelated to the incidence of retinoblastoma. Relations between rs144802055 and RB needs to be further explored.

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

METHODS: Selected 120 cases(240 eyes)of DR diagnosed in our hospital from January 2011 to January 2016 were retrospectively analyzed. According to whether calcium dobesilate was used, the treatment group was divided into two groups. Sixty cases were treated with PRP combined with calcium dobesilate, and 60 cases in the control group were treated with PRP only. The BCVA, CMT and clinical efficacy of the two groups were compared.

RESULTS: Before treatment, there was no significant difference on BCVA between combined group and control group(P>0.05). After treatment, BCVA of combined group was higher than that of the control group(P<0.01). Before the treatment, no statistically significant difference between combined group and control group on CMT, neovascularization and fluorescein leakage area were found(P>0.05); after treatment, the combination group on CMT, neovascularization and fluorescein leakage area value were less than the control group(P<0.01). After treatment, combined group was appearance effect in 65.0%, effective in 30.0%, invalid in 5.0%, the control group was 50.8%, effective 36.7%, invalid 12.5%, all statistically significant differences between the two groups(P<0.05).

CONCLUSION:PRP combined with calcium dobesilate in treatment of DR has a more significant clinical effect than PRP alone.

Abstract:AIM:To understand the clinic effect of intravitreal anti-vascular endothelial growth factor(VEGF)drugs injection in the treatment of fundus disease in the real-world study(RWS).

METHODS: The clinical cases treated with anti-VEGF drugs in our department from September 2012 to June 2015 were enrolled in this study. Retrospective investigation was reviewed to the kinds of diseases, frequency, usage, efficacy, adverse reaction, and the effects on visual acuity, fundus and macular thickness which were treated with intravitreal anti-VEGF drugs injection.

RESULTS: In 305 patients(340 eyes)treated with anti-VEGF drugs, 53 patients(60 eyes, 17.6%)were wet age-related macular degeneration(AMD), polypoidal choroidal vasculopathy(PCV)16 cases(18 eyes, 5.3%), diabetic macular edema(DME)120 cases(134 eyes, 39.4%), branch retinal vein occlusion(BRVO)secondary macular edema 61 cases(68 eyes, 20.0%), central retinal vein occlusion(CRVO)secondary macular edema 29 cases(32 eyes, 9.4%), idiopathic choroidal neovascularization(ICNV)16 cases(18 eyes, 5.3%), high myopia with choroid neovascularization 4 cases(4 eyes, 1.2%), neovascular glaucoma 4 cases(4 eyes, 1.2%), retinal angiomatous proliferation(RAP)1 cases(1 eyes, 0.2%)and optic papillary neovascularization 1 cases(1 eyes, 0.2%). The minimum age was 16 years old, and the maximum age 90 years old. There were 247 cases(275 eyes, 80.9%)were treated with intravitreal ranibizumab injection, 58 cases(65 eyes, 19.1%)intravitreal conbercept injection. The time number of all patients accepted anti-VEGF drugs treatment was 465, with an average of 1.7 times per eye. Which, the "3 + PRN" treatment method in 98 patients(109 eyes, 32.1%), "1 + PRN" treatment in 207 patients(231 eyes, 67.9%). 69 cases(77 eyes, 22.6%)were used alone to receive anti-VEGF drugs therapy, 10 cases(11 eyes, 3.2%)combined with intravitreal triamcinolone injection(TA), 35 cases(39 eyes, 11.5%)combined with vitrectomy, 26 cases(29 eyes, 8.5%)combined with photodynamic treatment(PDT), 165 cases(184 eyes, 54.1%)combined with simple laser treatment. After anti-VEGF drug treatment, majority of patients' the best corrected visual acuity(BCVA), fundus and central macular thickness(CMT)were significantly improved, compared with the pre-treatment, the difference is significant(P<0.05). So that anti-VEGF drugs can effectively improve visual function and ocular fundus for fundus diseses. There were no serious adverse reactions except 3 patients appearling skin redness, itching, rash, 1 patient low low-grade fever and 1 patient acute cerebral infarction during the treatment.

CONCLUSION: Intravitreal anti-VEGF drugs injection can significantly improve the visual function and ocular fundus for patients with fundus diseases, but there are still some adverse events, which should be attached great importance to medical workers.

Abstract:AIM: To investigate the timing and efficacy of vitrectomy for patients with vitreous hemorrhage(VH)due to proliferative diabetic retinopathy(PDR).

METHODS: Retrospective analysis. Patients who presented to our hospital between Feburary 2012 and May 2014 with VH secondary to PDR treated with vitrectomy were included. All patients were divided into three groups according to the duration of VH. A group was less than 1mo for 22 eyes, B group was 1-3mo for 23 eyes, C group was more than 3mo for 25 eyes. All patients underwent intravitreal injection of ranibizumab 1-2wk before vitrectomy, and supplemented or finished panretinal photocoagulation(PRP)intraoperatively or postoperatively. Patients with cataract accepted phacoemulsification and intraocular lens implantation. Eyes filling silicone oil were implanted intraocular lens in the second phase. All patients were followed up 24 to 42mo(mean: 28.7mo). We assessed the intraoperative complications such as hemorrhage, iatrogenic retinal hole, and postoperative complications such as vitreous hemorrhage, neovascular glaucoma. Macular edema and best corrected visual acuity were observed at every follow-up.

RESULTS:There was no significant difference for other baseline data(P>0.05)but DR stage between three groups(P=0.033). There was significant difference of last follow up visual acuity between three groups(P<0.001). The significant difference can be seen between group A and B(P=0.03). The same outcome showed between Group A and C(P<0.001). There was no significant difference between Group B and C(P>0.05). The percentage of visual acuity was 0.5 and above in the three groups were: 41%, 23%, 0 respectively. The patients with visual acuity of less than 0.1 were 5%, 26% and 40% respectively. Silicone oil filling rate of three groups were: 9%, 26%, 40% respectively and there was no significantly difference between three groups on postoperative complications(P>0.05).

CONCLUSION: Patients with VH due to proliferative diabetic retinopathy undergoing early vitrectomy may get better visual acuity than who accepting delayed vitrectomy.

Abstract:AIM:To study the effect of different surgeries for vision and postoperative complications in leprosy patients with lagophthalmos.

METHODS: A retrospective analysis. Totally 68 leprosy patients(97 eyes)with lagophthalmos were selected who treated with different surgeries during May 2007 to September 2015 in our sanatorium. The surgeries included nylon thread correction surgery, tarsorrhaphy, temporalis transposition surgery. We observed and compared the best corrected visual acuity(BCVA)and the rate of postoperative complications, such as epiphora, lacrimal duct injury, hard to open eyes, infection at the inner and lateral canthus and scar formation of lacrimal apparatus.

RESULTS: The effect on BCVA of patients treated with nylon thread correction surgery and tarsorrhaphy: the preoperative and postoperative BCVA was significantly different of the two groups(Z=-4.193, -4.213; P<0.05); the preoperative and postoperative BCVA was not significantly different of the patients underwent temporalis transposition surgery(Z=-1.532, P >0.05). The postoperative complications:(1)epiphora: there was 91% in patients underwent nylon thread correction surgery, 89% in patients underwent tarsorrhaphy, 59% in patients underwent temporalis transposition surgery, the difference was statistically significant(χ²=12.198, P<0.05);(2)lacrimal duct injury: there was 66% in patients underwent nylon thread correction surgery, 95% in patients underwent tarsorrhaphy, 41% in patients underwent temporalis transposition surgery, the difference was statistically significant(χ²=22.415, P<0.05);(3)hard to open eyes: there was 56% in patients underwent nylon thread correction surgery, 55% in patients underwent tarsorrhaphy, 22% in patients underwent temporalis transposition surgery, the difference was statistically significant(χ²=8.795, P<0.05);(4)infections: there was 84% in patients underwent nylon thread correction surgery, 3% in patients underwent tarsorrhaphy, 11% in patients underwent temporalis transposition surgery, the difference was statistically significant(χ²=60.858, P<0.05).

CONCLUSION: There are certain clinical efficacy for lagophthalmos caused by leprosy after surgery, especially patients after temporalis transposition surgery can close eyes by oneself. And their vision does not change significantly, which suggests that this surgery may prevent exposure injury for cornea. But the iatrogenic injury, the vision decrease in patients underwent other surgeries and the ocular tissue damage, such as epiphora, lacrimal duct injury, hard to open eyes, infection at the inner and lateral canthus and scar formation of lacrimal apparatus should be pay more attention to.

Abstract:AIM: To investigate the differences of clinical signs and pathological structure of unilateral nasal pterygium and unilateral double pterygium

METHODS: Retrospective study. Totally 11 unilateral nasal pterygium and 11 unilateral double pterygium were collected to observe the size of the tissue area, the classification of blood vessels, the transparency and the break-up time of tear film. The 11 surgically excised double pterygia(11 eyes)and 6 samples of normal conjunctiva were collected for the study. With 40g/L paraformaldehyde fixation, paraffin sections were stained with Haematoxylin-Eosin, to observe the differences with nasal and temporal pathology under light microscope.

RESULTS: In unilateral double pterygium, the tear break-up time was significantly shorter than that of unilateral nasal pterygium(t=3.410, P=0.003). In unilateral nasal pterygium, there was a significant negative correlation between tear film break-up time and tissue size(r=-0.927, P<0.01)and transparency(r=-0.764,P<0.01). In unilateral double pterygium, the tear break-up time was significantly negatively correlated with the growth time(r=-0.661, P<0.05), tissue size(r=-0.775, P<0.01)and transparency(r=-0.671,P<0.05). In unilateral double pterygium, compared with the temporal side, the quantity of the layers of corneal epithelial cells(t=-7.351, P<0.05), vessels(t=-7.400, P<0.05)and inflammatory cells(t=-7.481, P<0.05)increased.

CONCLUSION: Compared with unilateral nasal pterygium, the tear film break-up time of unilateral double pterygium was poor. In unilateral double pterygium, with high activity, the degree of proliferation of squamous epithelium, hyperplasia and inflammatory reaction are significantly higher than those of the temporal side.

Abstract:AIM: To observe the transplantation of acellular porcine corneal stroma on the treatment of superficial keratitis by drug-resistant fungal.

METHODS: We performed a retrospective analysis of 16 cases of fungal keratitis received the transplantation of acellular porcine corneal matrix from June 2015 to March 2016 with a follow-up of 6mo. We analyzed on items as postoperative visual acuity, corneal graft status, postoperative recurrence and postoperative complications.

RESULTS: We observed a healing time of corneal epithelium in 7 to 10d postoperatively generally and the absence of corneal edema in 1mo, while the cornea gradually returned transparent in the 16 cases. Two cases required medication for an epithelial recovery and 3 cases received intervention for decreasing intraocular pressure to a certain level. During the follow-up we observed no cases of cornea degeneration, recurrence of infection or rejection. The vision acuity showed 1.27±0.22, 1.11±0.13, 0.79±0.22 in 1, 3 and 6mo after operation respectively. There was no statistical difference between vision in 1mo and the vision before surgery(P=0.06); while we found a statistical difference when comparing the vision of 3 and 6mo with vision before surgery(P=0.01,0.001). The vision in 6mo increased with a statistic difference to the vision at 1 and 3mo(P<0.001)while no statistic difference was observed between 1 and 3mo(P=0.11).

CONCLUSION: Transplantation of acellular porcine corneal matrix is a safe and efficient treatment for fungal keratitis.

Abstract:AIM: To investigate the efficacy and safety of the treatment of exfoliation syndrome combined with cataract(XFSC).

METHODS: A retrospective analysis of XFSC in 130 patients(140 eyes)from January 2012 to March 2016.All patients received surgical treatment. Observation of patients with intraoperative complications, postoperative complications, postoperative visual acuity, occur of suspensory ligament abnormalities were taken.

RESULTS: The small pupil, shallow anterior chamber, anterior chamber too deep, and other complications appeared during the operations. Postoperative corneal edema, persistent corneal edema decompensation, posterior synechia, cystoid macular edema, capsular shrinkage and other complications appeared. There were 11 eyes of abnormal suspensory ligament before operation, and there were about 27 eyes with this during operations. All the 130 patients were followed up after surgery, the visual acuity when the patients left our hospital and visual acuity of the patients at 6mo after operation were improved compared with the preoperative visual acuity(P<0.05). Postoperative follow-up showed that the visual acuity of 5 eyes were light perception to 0.02, 15 eyes were 0.03-0.1, 27 eyes were 0.12-0.3, 83 eyes were 0.4-0.6, 10 eyes were ≥0.8 at 6 mo after operation. IOL was at normal position in 129 eyes, different degree of deviation in 6 eyes, 5 eyes of dislocation; capsular contraction in 17 eyes; capsular tension ring(CTR)in 32 eyes were at the normal position, 3 eyes with CTR decentration. There were 120 eyes were cured, 15 eyes better, 5 eyes ineffective.

CONCLUSION: XFSC surgery is difficult, perfect preoperative examination and reasonable and effective method of treatment can reduce the incidence of complications, beneficial to the recovery of postoperative visual function.

Abstract:AIM:To investigate the effect of small incision non-phacoemulsification cataract surgery on corneal endothelial cell.

METHODS: Totally 140 cataract patients(152 eyes)treated in our hospital from August 2013 to March 2016 were selected. All of the patients underwent small incision non-phacoemulsification cataract surgery. Before surgery and at 1wk, 1mo and 3mo after surgery, we measured the corneal endothelium of upper cornea, the central cornea and the lower part of cornea. The proportion and density of hexagonal cells, loss rate and cell area in corneal endothelial cells were calculated and compared.

RESULTS: Postoperatively 36 eyes had posterior elastic layer folds, aqueous flare, which disappeared after treatment. After surgery, corneal incision was found to have mild corneal edema. No other complications were found. A total of 128 patients(137 eyes)were followed up for a total of up to 3mo, with a loss of follow-up in 12 patients(15 eyes). After surgery, corneal endothelial cell density of the upper part of the cornea, the central cornea and the lower part of cornea, was statistically significantly different with each other(F=3.526, P=0.031), the difference in different time points was statistically significant(F=4.111, P=0.018). The postoperative corneal endothelial cell loss rate was statistically significant different between the three groups(F=3.526, P=0.031), at different time pionts(F=4.111, P=0.018). There was statistical significance of percentage of hexagonal cells between the three groups(F=4.348, P=0.014), the difference was significantly different between different time points(F=4.964, P=0.008). There was statistical significance of corneal endothelial cell area between the three groups(F=3.180, P=0.044), the difference was significantly different between the time points(F=3.511, P=0.032).

CONCLUSION: After small incision non-phacoemulsification cataract surgery, corneal endothelial cell density decreased, hexagonal cell proportion decreased, corneal cell area expanded.

Abstract:AIM: To explore the application effect of pranoprofen combined with tobramycin and dexamethasone ophthalmic suspension in cataract extraction after IOL implantation.

METHODS: Retrospective analysis of the clinical data of cataract patients treated from May 2015 to June 2016 in our hospital. According to the treatment methods, patients were divided into tobramycin and dexamethasone ophthalmic suspension with pranoprofen group(combined treatment group)and pranoprofen treatment group. The difference of visual acuity, intraocular pressure, anterior chamber flash change, satisfaction rate and symptom score before and after treatment in two groups were observed.

RESULTS: The vision of the two groups before treatment had no difference(P>0.05). At 1wk and 1mo after treatment, the visual acuity of the two groups all improved compared with before treatment, there was no significant difference between the two groups(P>0.05). Before treatment, the anterior chamber flare of the two groups had no difference(P>0.05). At 1wk and 1mo after treatment, the anterior chamber flare of combined treatment group was lower, the difference was statistically different(t=2.435, 1.864; P<0.05). The symptom score of the two groups before treatment had no difference(P>0.05). After treatment, the symptoms and signs of combined treatment group was significantly lower than that of pranoprofen group(t=2.586, 7.820; P<0.05). The satisfaction rate of the combined treatment group patients was 100%, significantly higher than pranoprofen group.

CONCLUSION: Pranoprofen and tobradex in the treatment of cataract extraction and intraocular lens implantation has good application effect, can significantly improve the patient's symptoms and signs.

Abstract:AIM: To compare the two techniques of pre-chop and non-pre-chop, and discuss the technical advantages of the capsulorhexis forceps assisted pre-chop.

METHODS: Totally 149 cases of age-related cataract were randomly divided into using pre-chop(Group A)and non-pre-chop(Group B)techniques groups, for Group A patients received phacoemulsification after pre-chop by using capsulorhexis forceps. The ultrasonic energy, average phacoemulsification time, intraoperative complications, 1d, 1wk uncorrected visual acuity(UCVA)and 1d, 3d,1wk postoperative corneal edema were recorded and compared.

RESULTS: The subgroups of the same group of nuclei were compared in the two groups. The ultrasonic time in Group A was lower than that of Group B, and the difference was significant(P<0.01). Also the corneal edema in the former was lighter than that of the latter(P<0.05). There was difference in uncorrected visual acuity(UCVA)between groups(P<0.05).

CONCLUSION: Compared with non-pre-chop, the time of ultrasound in pre-chop group was shorter, the degree of corneal edema was lighter and early postoperative UCVA was better.

Abstract:AIM: To investigate the value of 3D- optical coherence tomography(OCT)in the diagnosis of macular disease before phacoemulsification.

METHODS: Clinical records of 423 cataract patients(512 eyes)who underwent phacoemulsification combined with intraocular lens implantation in our hospital from June to December in 2015 were retrospectively analyzed. In addition to preoperative routine examination of fundus, Topcon 3D-OCT 2000 was used to examine the macula, the detection rate of macular disease was compared, risk factors of cataract combined with macular disease were analyzed.

RESULTS: The OCT image results of 305 cases(384 eyes, 72.1%)were successfully obtained, 133 cases showed macular disease(146 eyes), the detection rate was 28.5%(95%CI: 27.64%-29.40%); the macular disease of 35 cases(37 eyes)were detected by routine examination of fundus before operation, the detection rate was 7.2%(95%CI: 6.72%-7.74%); the detection rate of 3D-OCT was significantly higher than routine examination of fundus for macular disease(χ²=79.05, P<0.01). Female, over 65 years old, surgical history of diseased eye, and high myopia were risk factors of cataract combined with macular disease, the relative risk was 1.705(95%CI:1.091,2.664), 1.893(95%CI:1.219,2.939), 6.593(95%CI:2.027,21.447)and 95%CI: 5.130(2.841,9.263)respectively, the risk of cataract combined with macular disease showed an increasing trend with rising age.

CONCLUSION: In preoperative examination of cataract patients, 3D-OCT has higher sensitivity in the detection of macular disease, especially for women, over 65 years old, high myopia and surgical history of diseased eye, 3D-OCT can be used as a routine preoperative examination.

Abstract:AIM: To explore the cataract suspensory ligament rupture and artificial lens implantation suture fixation into capsular bag without capsular tension ring(CTR).

METHODS: We reviewed 20 cases of 20 cataract suspensory ligament rupture without CTR intraocular lens(IOL)implantation fixation in our department from Jan.2012 to Dec.2016. The needle crossed into ocular ciliary sulcus, in the equator of the eye ball which suspensory ligament rupture from, then the needle crossed out 1.5mm away from the angle of sclera. Sutures fixed on the IOL, then the artificial lens implantation in the pouch, carried out in accordance with the “Z” type suture, or to the beforehand prepared triangle scleral flap. The visual acuity, intraocular pressure, the anterior chamber and the IOL position were measured after operations.

RESULTS: All of the postoperative visual acuity improved different level. The postoperative best corrected visual acuity(BCVA)was ≥0.8 in 4 eyes(20%), 0.5-0.6 in 7 eyes(35%), 0.3-0.4 in 8 eyes(40%), 0.1 in 1 eye(5%)because of the glaucoma optic atrophy. There were 12 cases with mild corneal endothelium edema, 4 cases exudation membrane in the pupil area, 2 cases hyphema, all of which recovered after treatment. There were 2 eyes with vitreous prolapse in the pupil, 1 case appeared mild IOL center deviation and no special treatment for the vision did not be involved. Followed up for 6mo, displaced stitches or artificial lens shift did not occur.

CONCLUSION: Without CTR, the IOL implantation and suture fixation in capsular bag during cataract surgery is a surgical method for basic-level hospitals.

Abstract:AIM: To analyze curative effect of laser treatment for diabetic retinopathy(DR).

METHODS: A total of 100 patients(136 eyes)with DR who were admitted to our hospital during January 2015 to December 2016 were enrolled in the study. All patients were given 532nm laser treatment. Changes of visual acuity and the incidence of complications were statistically analyzed after treatment, and the macula central fovea retinal thickness and hemodynamic changes of affected eyes were compared before and after treatment. The effects of laser treatment were compared among patients with different types of diabetes, patients in different DR stages and patients with different glycosylated hemoglobin(HbAlc)levels.

RESULTS: After treatment, the macula central fovea retinal thickness, end diastolic velocity(EDV), pulsatility index(PI)and central retinal artery(CRA), mean flow velocity(Vm)significantly decreased(P<0.05). After treatment, there were 2 cases(2 eyes)of bleeding and 2 cases(2 eyes)of tractional retinal detachment. The effective improvement rate of visual acuity was 83.1%. There were significant differences in the improvement rate of visual acuity among patients with different types of diabetes \〖type 1(60.0%)vs type 2(84.9%)\〗, patients in different DR stages \〖preproliferative diabetic retinopathy(NPDR)92.3%, early proliferative stage(PDR)85.1%, high-risk PDR 54.2%\〗 and patients with different HbAlc levels(< 8% 91.8% vs ≥8% 73.0%)(P<0.05).

CONCLUSION: The 532nm laser treatment is effective for DR. It can significantly improve the retinal hemodynamics and visual acuity and relieve macular edema. Types of diabetes mellitus, stages of DR and blood glucose control effect may affect the effects of laser treatment.

Abstract:AIM: To investigate the clinical effects of traditional Chinese medicine, Si Ling San, on acute central serous chorioretinopathy(CSC).

METHODS: We retrospectively analyzed the clinical data of 48 patients(48 eyes)with CSC, among whom 24 were given oral Si Ling San(as treatment group)and the other 24 did not receive any treatment(control group). The baseline and 1 or 3mo follow-up data for the best corrected visual acuity(BCVA), central macular thickness(CMT)and maximum height of subretinal fluid(SRF)were collected and then compared between the two groups.

RESULTS: BCVA of the treatment group was not statistically different from the baseline level at 1mo(P>0.05), but it was significantly improved at 3mo(P<0.05). BCVA was better at 3mo than that at 1mo(P<0.05). In the control group, however, no significant improvement of BCVA was found at 1 or 3mo compared with baseline(both P>0.05). The BCVA of the two groups was not significantly different at baseline and 1 and 3mo follow-up(all P>0.05). In the treatment group CMT and SRF at 1 and 3mo were significantly lower than baseline(both P<0.05). CMT and SRF at 3mo were significantly lower than that at 1 month(both P<0.05). In the control group, CMT and SRF at 1mo were not different from baseline level(both P>0.05), while they were significantly decreased at 3mo follow-up(both P<0.05). CMT and SRF at 3mo were significantly lower than that at 1mo(both P<0.05). In addition, CMT and SRF of the treatment group at both 1 and 3mo were statistically lower than that of the control group(all P<0.05).

CONCLUSION: This study preliminary suggest that oral Si Ling San has the potential to treat acute CSC. But further trials are warranted to study its role in improving the visual function, shortening the duration and reducing the recurrence of CSC.

Abstract:AIM: To observe the image features of Vogt-Koyanagi-Harada disease(VKH)and multiple central serous chorioretinopathy(CSC)by fundus fluorescein angiography(FFA)and optical coherence tomography(OCT).

METHODS: Thirty-two eyes of 17 patients with VKH and thirty-five eyes of 30 patients with multiple CSC were collected from 2009 to 2016 in my hospital.

RESULTS: All the eyes with VKH were found small and dense fluorescein leakage in the early stage. The 17 eyes(53%)with VKH were found fluorescein accumulation in the final stage; 24 eyes(75%)with VKH were found high fluorescence of optic disc. All of eyes with multiple CSC were found multifocal leakage in the early stage. And 2 eyes(6%)with multiple CSC were found high fluorescence of optic disc. There were 28 eyes(14 patients)with VKH and 25 eyes(22 patients)with multiple CSC had been done OCT in my hospital. Retinal pigment epithelial fold was only found in VKH. Fluctuation of internal limiting membrane(ILM)and membrane structure had higher sensitivity to diagnostic VKH from to multiple CSC, with sensitivity of 54% and 68% respectively.

CONCLUSION: There are some similarities as well as differences between FFA and OCT in diagnosis of VKH and multiple CSC. A combination usage of FFA and OCT can be more effective in distinguishing VKH from multiple CSC.

Abstract:AIM: To improve accuracy of the diagnosis of primary conjunctival masses(PCM)through analyze the clinicopathological characteristics and pathogenic causes of 422 cases of PCM.

METHODS: Clinical manifestations, histological characteristics and immunopheno types were reviewed. Relevant literatures were reviewed.

RESULTS: Benign conjunctival masses were 403 cases(95.5%). Those included masses from squamous cell papilloma(71 cases, 17.6%), conjunctival cyst(68 cases, 16.9%), inflammatory masses(62 cases, 15.4%), pigmented nevus(60 cases, 14.9%), lipoma(58 cases, 14.4%). Malignant conjunctival neoplasms were 19 cases(4.5%). Those included tumors from B Cell Lymphoma(6 cases,31.6%), melanoma(6 cases,31.6%), and squamous cell carcinoma(5 cases, 26.3%). Different types of primary conjunctival masses were induced by the same cause.

CONCLUSION:The pathological types of primary conjunctival masses are various and the majority of which is benign. For the diagnosis of primary conjunctival masses, morphological analysis, immunohistochemical examination shoud be combined to increase the diagnostic accuracy and decrease misdiagnosis rate.

Abstract:AIM: To investigate the effect of intravitreal injection of anti-vascular endothelial growth factor(VEGF)drugs combined with other methods in the treatment of Coats disease.

METHODS: Selected 13 patients 13 eyes with Coats disease in our hospital from May 2013 to May 2016. All eyes were treated with intravitreal injection of ranibizumab and combined with scleral drainage, laser photocoagulation and so on. We observed visual acuity and retinal reattachment.

RESULTS: In 13 eyes, the treatment of 4 eyes with intravitreal injection of ranibizumab and combined with scleral drainage, 3 eyes combined laser photocoagulation, 6 eyes combined vitrectomy, membrane peeling, freezing, silicone oil filling or other treatments. Eyeball retention rate was 100%. Visual acuity at 6mo after treatment significantly improved compared with before treatment(P<0.05). The visual acuity was ≥0.05-0.1, 0.01-<0.05, counting finger, light perception and hand moving before treatment in 0, 0, 38%, 38% and 23%, after treatment were 23%, 23%, 38%, 15% and 0. Complete retinal reattachment was achieved in 5 eyes, accounting for 38%; basic reset in 3 eyes, accounting for 23%; 5 eyes were not reset, accounting for 38%.

CONCLUSION: Intravitreal injection of anti-VEGF drugs combined with other methods for the treatment of Coats disease have a certain effect, can improve or maintain the limited visual function, avoid enucleation of eyeball due to disease progression.

Abstract:AIM: To evaluate the application and effect of bandage contact lens in pterygium excision combined with conjunctival transplantation(CAT).

METHODS: In a prospective, randomized, controlled clinical study, 110 patients(110 eyes)diagnosed with primary pterygium were collected in PLA NO.474 Hospital from January 2015 to January 2016. The 110 patients enrolled in the study in turn, and divided into two groups by the odd and even number. The odd number divided into bandage contact lens group(CAT + bandage contact lens, n=55), while the even number divided into control group(CAT, n=55). Visual analog scale(VAS)and corneal irritation were evaluated on 1, 3 and 7d after operation. Cornea fluorescent staining testing was carried out on 3d after operation. Following-up all the patients with 1a at least observed the recurrence of pterygium.

RESULTS:The score of VAS in bandage contact lens group less than that in control group on 1d(4.13±2.06 vs 5.80±1.93, t=4.391, P<0.001)and 3d(2.09±1.36 vs 3.65±1.65, t=5.422, P<0.001)after operation, while there was no significant difference between two groups on 7d(t=1.295, P=0.198)after operation. The corneal irritation in bandage contact lens group less than that in control group on 1d and 3d after operation(P<0.05), while there was no significant difference between two groups on 7d after operation(P=0.052). Cornea fluorescent staining testing area in bandage contact lens group was less than that in control group on 7d after operation(0.33±0.37mm² vs 2.73±2.21mm², t=7.921, P<0.01). There was no significant difference in recurrence rate between two groups after 1a operation(P=1.000).

CONCLUSION:Bandage contact lens could significantly release pain and corneal irritation, promote the healing of the corneal epitheliums in the defected area, and increase the postoperative comfort level in patients after operation.

Abstract:AIM: To compare the curative effect of conjoint fascial sheath suspension and the simple frontalis muscle suspension for moderate or severe ptosis.

METHODS:In March 2013 to March 2016 in our hospital, 46 patients with moderately severe ptosis(68 eyes)were taken as the research objects. According to random number table method, they were divided into study group and the control group, 23 cases in each group. Study group(34 eyes)received the joint fascial sheath suspension(CFS), the control group(34 eyes)received frontalis muscle suspension. The degree of ptosis correction, upper eyelid retracted, satisfaction and complications of two groups were compared.

RESULTS:The corrected rate of the treatment group was higher than that of the control group, the difference was statistically significant(P<0.05). After treatment, the upper eyelid retracted of the study group was significantly lower than that of the control group, the difference was statistically significant(P<0.05). The satisfaction of the treatment group was higher than that of the control group, the difference was statistically significant(P<0.05). The incidence of complications in the study group was significantly less than that in the control group, and the difference was statistically significant(P<0.05).

CONCLUSION: Conjoint fascial sheath suspension is more effective on the treatment of severe ptosis than the simple frontalis muscle suspension, and has advantages such as less trauma, repeatable, and less complication.

Abstract:AIM: To study the clinical effect of silica gel drainage tube combined with lomefloxacin hydrochloride eye ophthalmic gel in the treatment of lacrimal duct obstruction.

METHODS: Totally 86 cases(138 eyes)of lacrimal duct embolism treated in our hospital from February to December 2015 were divided into 43 cases(68 eyes)as control group and 43 cases(70 eyes)of the observation group according to whether they were treated with lomefloxacin hydrochloride eye ophthalmic gel. Patients in the control group were treated with silica gel drainage, while the observation group was treated with lomefloxacin hydrochloride eye ophthalmic gel on the basis of the control group. The total effective rate, serum hypersensitivity C-reactive protein(h-CRP)level, complications and recurrence rate were observed and compared between the two groups.

RESULTS: The total effective rate in the patients with obstructive nasolacrimal duct, common lacrimal duct obstruction, and lacrimal duct obstruction in observation group were 95.2%, 100.0%, 96.7%, higher than those in control group(P<0.05). There was no significant difference between the two groups in preoperative serum h-CRP levels(P>0.05). The serum levels of h-CRP in patients in the observation group at 3d and 7d after operation respectively were 2.40±0.84g/mL, 1.94±0.84g/mL, lower than those of control group at the same time(P<0.05). The complication rate of the observation group was 1.4%, which was lower than that of the control group(P<0.05). Follow up for 6-18mo, the recurrence rate was 11.4% in the observation group, which was significantly lower than the control group(P<0.05).

CONCLUSION: The combination of silica gel drainage tube and lomefloxacin hydrochloride eye ophthalmic gel in the treatment of obstruction of lacrimal duct has good clinical efficacy, low inflammatory reaction, low complication rate and low recurrence rate.

Abstract:AIM: To evaluate the clinical efficacy and safety of balloon dilatation in infants with lacrimal passage obstruction.

METHODS: Totally 86 patients(116 eyes)with lacrimal duct obstruction from July 1, 2015 to June 30, 2016 were randomly divided into two groups according to the digital table. The observation group(43 cases, 60 eyes)were operated with balloon dilatation and the control group(43 cases, 56 eyes)were treated with duct exploratory operation. The patients were followed up for 6mo to compare the efficacy.

RESULTS: At the 6mo postoperatively, the primary cure rate and total cure rate in the observation group were significantly higher than those in the control group. There was significant difference between the two groups(P<0.05).

CONCLUSION: Balloon dilatation operation is safe, and its clinical efficacy is better than lacrimal duct exploratory operation, is an effective way to treat lacrimal duct obstruction in infants.

Abstract:AIM: To evaluate the short-term efficacy of posterior chamber phakic intraocular lens implantation for moderate to high myopia.

METHODS: Fifty-three eyes of 27 patients with moderate to high myopia(-3.25 to -21.5D)were received posterior chamber phakic intraocular lens implantation with 2.8mm clear corneal incision. Changes of visual acuity, intraocular pressure(IOP), counts of endothelial cells and surgically induced astigmatism at 1mo after surgery were observed.

RESULTS: The preoperative best corrected visual acuity(BCVA LogMAR)were 0.05±0.18, the postoperative BCVA at 1d were 0.02±0.14, the postoperative BCVA at 1wk were -0.05±0.11, the postoperative BCVA at 1mo were -0.07±0.10. The postoperative BCVA were statistically significant differences in different time(P<0.05). The preoperative endothelial cell count was 2932.5±270.8/mm², the postoperative endothelial cell count at 1d was 2917.1±299.0/mm²; the postoperative endothelial cell count at 1wk was 2902.5±288.6/mm²; the postoperative endothelial cell count at 1mo was 2855.3±284.2/mm². The postoperative endothelial cell count was not statistically significant differences in different time. The preoperative IOP was 15.8±2.5mmHg; the postoperative IOP at 1d was 15.3±2.9mmHg; the postoperative IOP at 1wk was 17.4±5.8mmHg; the postoperative IOP at 1mo were 15.8±2.6mmHg. The preoperative IOP was significantly different compared with postoperative IOP at 1d, 1wk and 1mo. The postoperative IOP at 1d and 1wk were statistically significant differences(P<0.05). The surgically induced astigmatism at 1d was 0.74±0.39D; the surgically induced astigmatism at 1wk was 0.57±0.28D; the surgically induced astigmatism at 1mo was 0.44±0.21D. The postoperative IOP were statistically significant differences in different time(P<0.05). The preoperative anterior chamber depth was 3.26±0.25mm; the postoperative central vault at 1d were 654.5±345.2μm; the postoperative central vault at 1mo were 683.0±211.7μm. The postoperative central vault were significantly different between that at 1d and 1mo after operations. Operations went without serious complications.

CONCLUSION: Posterior chamber phakic intraocular lens implantation for moderate to high myopia were safe, effective and predictability. But long-term effect remains needed to be further follow-up.