Abstract:AIM: To evaluate the effectivity of the combination of intracameral moxifloxacin 0.1% with subconjunctival triamcinolone acetonide 4 mg as prophylaxis of infection and inflammation after phacoemulsification in comparison with topical medication treated group.

METHODS: A total one thousand patients with age range from 38 to 70 years old who scheduled for phacoemulsification were divided into 2 groups of no statistically significant differences in age, preoperative intraocular pressure(IOP)and central macular thickness(CMT), P=0.6, 0.9 and 0.8 respectively. The surgeries were done by 2 surgeons each one planned to use one method of prophylaxis at Eye Speciality Private Hospital, Baghdad, Iraq. For the 1^st group of patients(500)a topical moxifloxacin hydrochloride 0.5% and dexamethasone 0.1% eye drops were prescribed four times a day for 1mo postoperatively. For the 2^nd group intracameral(IC)diluted moxifloxacin at 0.1% with subconjunctival(SC)triamcinolone 4 mg in 0.4mL were administered at the conclusion of the surgery. Follow up visits were on the first postoperative day, 1wk, 1mo, and 3mo postoperatively. Anterior chamber(AC)reaction was examined during the 4 visits while IOP was measured during the last 3 and CMT was measured only in the last one.

RESULTS: The current clinical trial study compared 2 samples with 2 different prophylaxis methods. No endophthalmitis case reported in both group. By a 2-Sample t-test, the IC-treated group(group 2)had statistically significant lower AC cells at the 1^st day postoperative visit than the other group while there were no statistically significant differences at 1wk, 1 mo and 3mo visits between the 2 groups. There was no statistically significant difference at 3mo visits in IOP and CMT between the two groups. A breakthrough inflammation rate with the topical medication was 9.6% while in the other group(IC treated )was 4.0%. A significant IOP elevation ≥10 mmHg at 1mo in 2.4% within the topical medication group which was higher than the rate in the other group(0.8%).

CONCLUSION: In addition to the safety and effectivity of the combination of intracameral moxifloxacin and subconjunctival triamcinolone in preventing infection and inflammation after cataract surgery. The majority(480)of our included patients didn't require any topical postoperative medication that is cost saving for the patient, helped patients who were unable to administer topical medication, and decreased chance of complication related to patient poor adherence to postoperative medication.

Abstract:AIM: To evaluate advantages of chandelier illumination system during scleral buckling(SB)procedures for rhegmatogenous retinal detachment(RRD)surgery.

METHODS: In this comparative, retrospective study, data of 72 eyes of 72 patients undergoing SB for RRD at Minerva Hospital(Santa Maria Capua Vetere, Italy), divided in 2 groups of 36 eyes each were collected. In one group(group A)eyes underwent SB with chandelier, in the other one(group B)eyes underwent SB without using chandelier illumination system. Every eye of both groups was checked before surgery and at 1, 3, 7, 14, 30, 90 and 180d follow up. Parameters such as additional procedures, best spectacles visual acuity(BSVA)(measured with Snellen Lines as decimal fraction), surgical time and retinal breaks recurrences had been analyzed before and after surgery and statistical comparison have been run between two groups.

RESULTS: A significant(P<0.01)improvement in BSVA was observed at 6mo follow up in both groups; comparing groups A and B, no significant clinical differences was found in recurrences rate whereas mean surgical time in group A was statistically lower than the group B ones.

CONCLUSION: According to results observed, even if they need to be confirmed in further studies with larger population, chandelier illumination system could be considered a valuable tool for SB surgery in eyes affected by RRD.

Abstract:AIM:To develop a feasible method to correct congenital ptosis in children.

METHODS: Sixty-four patients(102 eyelids)were divided into three groups based on the degree of ptosis: mild(<2 mm); moderate(3-4 mm)and severe(>4 mm). All patients underwent the same levator resection surgery in which the suspensory system of the LPS is retained. After capturing a standard photograph of primary position, the height of the superior palpebral margin was measured preoperatively by using Image J software to calculate its ideal height required during surgery. Postoperative outcome measures included upper eyelid margin height, degree of scleral exposure and exposure keratitis. The patients were followed-up at 1wk, 1mo and 6mo postoperatively.

RESULTS: In the early postoperative period, except two cases with overcorrection, the positions of the eyelid upper margins were normal in all cases in the mild and moderate groups. Six months postoperatively, the eye with overcorrection in the moderate group showed improvement, while the eye in the mild group did not. Seven eyes in the severe group exhibited residual ptosis to varying degrees. The eyelids exhibited appropriate closing functionality; exposure keratitis was absent.

CONCLUSION:Using this preoperative quantification technique to guide surgery not only provided a gauge for LPS shortening under general anesthesia, but also increased the success rate of surgery.

Abstract:AIM:To study the effect of zinc on galactose-induced cell apoptosis in human lens epithelial cells(HLEC).

METHODS:HLEC cell line SRA01/04 cells were cultured in DMEM medium and divided into six groups: control group, galactose treatment group, zinc supplement group, zinc supplementation combined with galactose treatment group, zinc deficiency group, zinc deficiency combined with galactose treatment group. The cell viabilities were assayed by MTT, cell morphology and apoptosis were detected by fluorescence microscope and flow cytometry, respectively.

RESULTS:The cell viabilities induced by galactose(0, 25, 50, 75, 100, 125mmol/L)were(100.0±5.4)%,(97.5±3.2)%,(91.3±5.3)%,(93.4±0.6)%,(86.6±1.4)% and(83.5±0.4)%, respectively. When the concentration of galactose was 100 and 125mmol/L, cell viability was significantly decreased, compared with the untreated cells(P<0.05). Fluorescence microscopy results showed that the cell nucleus remained uniformly stained in control group and zinc supplement group. Nuclear shrinkage, a typical apoptotic morphology, was visible in some cells in the galactose treatment group, zinc supplementation combined with galactose treatment group, zinc deficiency group and zinc deficiency combined with galactose treatment group. The cell apoptosis in the six groups were(1.5±0.1)%,(7.1±0.2)%,(1.4±0.1)%,(4.4±0.2)%,(5.5±0.2)% and(15.8±0.3)%, respectively. The cell apoptosis were significant increased in galactose treatment group, zinc supplementation combined with galactose treatment group, zinc deficiency group and zinc deficiency combined with galactose treatment group, compared with the control group(P<0.05), and those of zinc supplementation combined with galactose treatment group were significant decreased, and zinc deficiency combined with galactose treatment group were increased(P<0.05), compared with the galactose treatment group.

CONCLUSION:Zinc supplementation protects human lens epithelial cells against apoptosis induced by galactose and may have an inhibition effect on cataract formation.

Abstract:AIM: To observe the effects of pyridoxamine(PM)on RAGE, ROS and apoptosis in RPE cells treated with advanced glycation end products(AGEs), and to investigate the protective effect of PM on RPE cells in diabetic retinopathy.

METHODS:Primary cultured human RPE cells, the third generation of cells were synchronized with serum-free Dulbecco-modified Eagle medium for 24h, and then grouped: 1)Control group: cultured with 100mg/L BSA for 48h; 2)AGEs-treated group: cultured with 200mg/L AGEs for 48h; 3)PM group: PM1 group: cultured with 16mg/L PM+200mg/L AGEs for 48h; PM2 group: cultured with 32mg/L PM+200mg/L AGEs for 48h. The expression of RAGE protein was detected by immunohistochemistry. The formation of ROS was observed by fluorescence microscopy. The apoptosis of cells was detected by TUNEL.

RESULTS:The expression of RAGE protein, ROS and apoptosis of RPE cells in PM group were significantly lower than those in AGEs-treated group, and decreased with the increase of PM concentration.

CONCLUSION:Pyridoxamine can inhibit the expression of RAGE and the production of ROS, reduce apoptosis, and have a protective effect on RPE cells.

Abstract:AIM: To study the correlation of β-amyloid(Aβ)plaques in retinas from Alzheimer's model mice in different months and progression of disease.

METHODS: Six-month(n=6)and twelve-month(n=6)old Alzheimer's model mice, together with six-month(n=6)and twelve-month(n=6)old C57 mice were in this experiment. Morris water maze test was to assess the spatial memory. After intragastrical administration of curcumin for consecutive three days, the Aβ plaques in retinas(n=48)from all mice(n=24)were detected by noninvasive in vivo optical imaging.

RESULTS: Morris water maze test: compared with the six-month control group(C6), six-month model mice(AD6)swam longer(P<0.05); and AD6 swam longer distance and experienced more crossing times than C6(P>0.05); compared with the twelve-month control group(C12), twelve-month model mice(AD12)swam longer, swam longer distance(P<0.05)and experienced more crossing times(P>0.05); compared with the six-month model mice(AD6), twelve-month model mice(AD12)swam longer, swam longer distance and experienced more crossing times(P<0.05). Moreover, the result of retinal Aβ plaques: We identified retinal Aβ plaques in postmortem from AD6 and AD12. Two six-month model mice had been detected retinal Aβ plaques, thus the positive rate of retinal Aβ plaques in six-month model mice was 33%; And six twelve-month model mice had been detected retinal Aβ plaques, thus the positive rate of retinal Aβ plaques in twelve-month model mice was 100%; Plaques were undetectable in age-matched non-AD individuals neither in six-month or in twelve-month; the positive rate of retinal Aβ plaques in AD12 was higher than AD6(P<0.05).

CONCLUSION: Six-month model mice(AD6)had already a decline of cognition; and the illness gradually increased with the extension of the disease, and the positive rate of retinal Aβ plaques is increasing with progression of Alzheimer's disease.

Abstract:AIM:To evaluate the changes of corneal endothelium after phacoemulsification in diabetic patients with cataract and simple cataract.

METHODS: A total of 92 eyes of 78 patients with cataract were diagnosed from October 2016 to June 2017 in People's Hospital of Guangxi Zhuang Autonomous Region. Two groups were divided into diabetic group and non-diabetic group according to whether there was diabetes or not. The diabetes group had 40 patients(44 eyes)and non-diabetes group had 38 patients(48 eyes). All patients were performed phacoemulsification combined with intraocular lens implantation by an experienced ophthalmologist. And then, corneal endothelial density(CED), hexagonal cell percentage(HCR), coefficient of variation(CV)and central corneal thickness(CCT)were detected by non-contact corneal endothelium count instrument before surgery and 1, 4 and 8wk after surgery. Meanwhile, the morphology of corneal endothelium was detected by confocal microscope before surgery and 4 and 8wk after surgery. And the occurrence of intraoperative floppy iris syndrome in the two groups was observed respectively.

RESULTS: Compared with non-diabetes group, the preoperative percentage of hexagonal cell in diabetes group was decreased, the coefficient of variation was increased, the differences were statistically significant(P<0.05); but there were no significant difference in corneal endothelial density and central corneal thickness(P>0.05). Compared with non-diabetes group, the postoperative percentage of hexagonal cell in diabetes group at different time points was decreased, coefficient of variation was increased, the differences were statistically significant(P<0.05),the difference in corneal endothelial density and central corneal thickness were not statistically significant(P>0.05). Compared with pre-operation, the percentage of hexagonal cell and corneal endothelial density in diabetes group and non-diabetes group at postoperative 1,4 and 8wk were decreased obviously, coefficient of variation was further increased, there were statistical difference(P<0.05); the central corneal thickness at postoperative 1wk was obvious incrassation, there was statistical difference(P<0.05), but there was no significant difference in the central corneal thickness at postoperative 4 and 8wk(P>0.05); comparison of the morphology of corneal endothelium at pre-operation and the morphology of corneal endothelium at postoperative between two groups, the preoperative heteromorphism of morphology of corneal endothelium in diabetes group was obvious, size of a pleomorphic endothelial cell was different; at postoperative 4wk, the heteromorphism of morphology of corneal endothelium was further obviously and so was size of cell body, we could see the big nucleus; at postoperative 8wk, morphology of corneal endothelium in diabetes group recovered more slowly, we still saw many irregular endothelium and large nucleus. The incidence of intraoperative floppy iris syndrome in the diabetic group was 14%, and the non-diabetic group was 0.

CONCLUSION: Diabetes and phacoemulsification can damage corneal endothelium. Meanwhile, phacoemulsification has a great effect on morphology of corneal endothelium in diabetic group, and recovery of morphology of corneal endothelium is slower. Diabetes may be associated with the occurrence of intraoperative floppy iris syndrome.

Abstract:AIM: To analyze the diagnostic value of macular ganglion cell complex(mGCC)in primary glaucoma and explore the correlation between mGCC and peripapillary retinal nerve fiber layer(pRNFL)and visual field, in order to provide scientific reference for the diagnosis and treatment of primary glaucoma.

METHODS: Eighty eyes in 67 primary glaucoma patients admitted to our hospital from January 2015 to December 2016 were included in the observation group. Another 80 eyes in 40 healthy subjects in our hospital were included in the control group during the same period. The mGCC and pRNFL thicknesses of two groups were measured with an optical coherence tomography(OCT). The thickness of mGCC and pRNFL and visual field were compared between the two groups. The diagnostic value of mGCC for primary glaucoma was analyzed. The correlation between mGCC and pRNFL and visual field mean defect was detected.

RESULTS: The superior, inferior and average mGCC thickness in the observation group was significantly lower than that in the control group(P<0.05). The superior, inferior and average pRNFL thickness in the observation group were significantly lower than those in the control group, the difference was statistically significant(P<0.05). The visual field mean defect in the observation group was significantly higher than that in the control group, the difference was statistically significant(P<0.05). Pearson correlation analysis showed that there was a significant positive correlation between mGCC and pRNFL(r=0.58, P<0.01)and there was a significant negative correlation between mGCC and the average visual field defect(r=-0.69, P<0.01)in the observation group. ROC curve analysis showed that the intercept point value of mGCC in the diagnosis of primary glaucoma was 86.39μm. The sensitivity was 82.5% and the specificity was 76.25%.

CONCLUSION: The mGCC has a certain diagnostic value for primary glaucoma. There is positive correlation between mGCC and pRNFL and negative correlation between that and visual field mean defect.

Abstract:AIM: To evaluate the effectiveness and safety of Conbercept for diabetic retinopathy(DR)systematically, in order to provide evidence-based reference for clinical use.

METHODS:We performed a comprehensive search for the randomized controlled trials(RCTs)about Conbercept trail group vs control group in the treatment of DR published from PubMed, Cochrane Library, CNKI and Wanfang Database. Studies obtained from eligible database were filtered according to modified Jadad scale, and data were retrieved from those studies for further analysis. Then, we performed a Meta analysis using RevMan 5.3 statistical software.

RESULTS:A total of 22 RCTs were included, involving 1 878 patients. The results of Meta-analysis showed that visual acuity at 1 and 3mo, the central macular retinal thickness(CMT), operation time, the level of vascular endothelial growth factor(VEGF)and the implicit time of N1 wave were markedly decreased after treatment; the scores of self-care ability, social ability, activity ability, and psychological ability and response rates after treatment were significantly improved; and which were statistically different to control group. As for safety, the incidences of anterior chamber inflammation reaction, corneal edema, ocular hypertension, bleeding in operation, vitreous hemorrhage, iatrogenic visual hiatus and retinal detachment, complication incidence were more significantly decreased than control group. The same results were gained in subgroup.

CONCLUSION:The existing evidence supports that conbercept has good therapeutic efficacy and safety for DR.

Abstract:Glaucoma is the second cause of the blindness in the world, and there is no clear pathogenesis about it. What we can do nowadays is only studying symptomatic treatment including the reduction of the intraocular pressure and so on. Only by this can we reduce the irreversible damage of the optic nerve caused by glaucoma. Aqueous humor contains a large number of cytokines, including pro-inflammatory factors, oxidative stress factors, growth factors, etc. These cytokines play a vital role in the pathogenesis and prognosis of the glaucoma. As one of the most common pro-inflammatory factors, interleukin-6(IL-6)becoming the object of many clinical trials both here and abroad in recent years. This paper summarizes both the mechanism of glaucoma injury and the role of IL-6 in it. And from this article we can analyze the relationship between interleukin-6 and glaucoma for developing new ideas about treatments of glaucoma in the future.

Abstract:Glaucoma filtering surgery is the main treatment for the glaucomatous patients. Typically, surgery failed mary due to wound fibrosis and contracture at the post-surgical site.Myofibroblasts transdifferentiated from other cells via a process known as epithelial-mesenchymal transition(EMT)is a common feature of the fibrotic filtering channel, which can produce excessive amounts of the extracellular matrix(ECM), and then exert tractional forces, resulting in the disruption of tissue architecture and obstruction of filtering channel. In this review, we explain the pathological function of myofibroblast in the wound healing process after glaucoma filtering surgery.

Abstract:Polypoidal choroidal vasculopathy(PCV)is a fundus disease characterized by choroidal anomalous branch vascular network and terminal polypoidal dilatation. Submacular hemorrhages(SMH)and vitreous hemorrhage are devastating complications of PCV. Various techniques are available for the management of SMH, including pneumatic displacement with or without tissue plasminogen activator(t-PA), submacular surgery with vitrectomy and retinotomy/external drainge for clot extraction. This article reviews PCV clinical features, complications and especially new advances in surgery.

Abstract:Anterior ischemic optic neuropathy( AION )is the most common acute optic neuropathy in people over 50 years old, which often causes unilateral acute painless visual loss. Non-arteritis anterior ischemic optic neuropathy(NAION)is the most common type and one of the main causes of blindness or severe visual impairment in the middle-aged and elderly. But at present, because of insufficient understanding of the pathogenesis of this disease, there is still no effective treatment method in clinic. Therefore, it is very important to find a standard and effective treatment method in order to control the disease development and reduce blindness.

Abstract:Strabismus refers to the clinical phenomenon of any deviation from the optic axis, which can be caused by the abnormality of the binocular vision or the neuromuscular abnormalities that control the movement of the eyes. Operation is the important way to strabismus, firstly people focus only on the eye position, but with the gradual observation and follow-up of surgical patients, some researches had found that may change the original refractive status, so the article made a summarize from refractive status, anterior segment parameters,its possible mechanism, and influencing factors. We hope that there will be a more comprehensive understanding of strabismus surgery, and to provide the basis for determining the ideal time for optometry.

Abstract:Amblyopia is the most common cause of poor monocular vision in children. The prevalence of world population is 1%-5% and in China is about 2%-4% with yearly growth trend. Amblyopia mainly occurs in the sensitive period of children's visual development, because the visual development during this period has plasticity that susceptible to a variety of factors, which can lead to different developmental trajectories of visual system. As the age increases, visual plasticity disappears, so the therapeutic effect of amblyopia is insignificant at this moment. Therefore, it's a golden period for amblyopia treatment when the visual system remains plasticity. In recent years, there has been a large number of studies on visual plasticity with the expectation of making full use of this feature to reverse the development of amblyopia.It is known that visual plasticity is affected by many factors such as nerve factors and living environment.This article will start with excitatory neurological factors, brain-derived growth factors, inhibitory neurological factors and environmental influences to summarize current research progress in visual plasticity.

Abstract:AIM: To identify the species and genus of pathogenic nonsporulating molds(NSM)by internal transcribed spacer(ITS)sequences alignment, and reveal the biodiversity of NSM in Hainan Island with tropical climate.

METHODS: Nine teen fungal strains, identified as NSM by conventional method in the laboratory department of Hainan Province Eye Hospital, were involved in this study. All of the strains were isolated from the infectious eye tissues from patients, and cultured with potato-dextrose agar and Sabourand's agar in 37℃ incubator for 7-21d. Any reproductive structure was detected by microscopy for up to 21d. After growth for 3-7d, the genomic DNA of specimens were extracted by grinding method combined with chemical method. Then, ITS sequences in the ribosome were amplified by PCR and analyzed using the National Center for Biological Information(NCBI)GenBank database. Finally, the species and genus were confirmed by sequence alignment.

RESULTS: The corresponding target bars could be observed in all 19 specimens after PCR. The results from genetic alignment classified the 19 specimens into 12 species, including Lasiodiplodia theobromae(6 isolates), Curvalaria lunata(1 isolate), Arthrinium sp.(2 isolates), neodeightonia subglabosa(2 isolates), Earliella scabrosa(1 isolate), Hypocreales sp.(1 isolate), phoma multirostrata(1 isolate), Trichophyton rubrum(1 isolate), Aspergillus westerdijkiae(1 isolate), roussoella siamensis(1 isolate), Ceriporia lacerata(1 isolate), Fusarium solqni(1 isolate).

CONCLUSION: ITS sequence alignment can identify NSM to genus and species level. The NSM in Hainan Island contains varies species, and is associated with multiple infectious diseases of the eye.

Abstract:AIM: To observe the clinical efficacy and safety of regional refractive multifocal intraocular lens SBL-3.

METHODS: Eighty-five senile cataract patients(130 eyes)who underwent phacoemulsification and intraocular lens implantation in our hospital were divided into two groups according to the difference of implanted intraocular lens: patients with regional refractive multifocal intraocular lens(MIOL)42 example(65 eyes)as an observation group, 43 patients(65 eyes)of a single-focus aspheric intraocular lens were used as a control group. Three months after operation, the indicators were: uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA), uncorrected near visual acuity(UCNVA), and spherical equivalent power(SE). The naked eye defocus curve was measured and the patient's subjective visual quality was investigated by questionnaire, including the rate glasses removal, visual interference symptoms and satisfaction.

RESULTS: At 3mo after operation, UCDVA was significantly improved in both groups compared with preoperative, and the difference was statistically significant(P<0.01). However, there was no significant difference between the two groups(P>0.05), while UCIVA and UCNVA in the observation group were significantly better than the control group, the difference was statistically significant(P<0.01). At 3mo after operation, the difference of computerized optometry spherical equivalent power(SE)of the two groups was statistically significant(P<0.01). At 3mo after operation, the naked eye defocus curve of the observation group was stable in the range of +0.50 to -3.00D, the LogMAR visual acuity was below 0.301, and the curve began to rise slowly after -3.50D; the control group showed trough between ±0.5D, both ends are rising rapidly. At 3mo postoperatively, the proportion of patients with visual interference symptoms in the observation group(4/42)was not significantly different from that in the control group(2/43)(P=0.433). The glasses removal rate of the observation group was 97.6%(41/42), control group was 18.6%(8/43), the difference was statistically significant(χ²=4.318, P=0.038). In the observation group, the single eye distance satisfaction was 92.3%, and the control group was 93.8%. The difference was not statistically significant(P=1.000). The observation group had a single eye near fullness of 98.5%(64/65)and the control group was 16.9%(11/65), the difference was statistically significant(χ²=88.526, P<0.01).

CONCLUSION: The regional refraction MIOL can provide good near-intermediate-distance and full-distance uncorrected visual acuity. It can meet the needs of the patients at daily, distance-middle distance-near use. Postoperative visual interference symptoms were fewer and patient satisfaction was higher.

Abstract:AIM: To explore the differences of clinical effects between 3.0mm scleral tunnel incision and 3.0mm clear corneal incision of phacoemulsification(Phaco).

METHODS: The clinical data of 114 patients with cataract(114 eyes)were retrospectively analyzed. All patients were treated with Phaco, and patients with 3.0mm scleral tunnel incision were included in control group(n=30, 30 eyes), and patients with 3.0 mm clear corneal incision were included in observation group(n=84, 84 eyes). The changes of corneal endothelial cell(CEC)density, corneal astigmatism(CA), tear meniscus height(TMH), uncorrected visual acuity(UCVA)and tear epidermal growth factor(EGF)were compared before operation and at 1wk, 1mo and 3mo after operation, and the basic conditions during perioperative period and the occurrence of complications within 3mo after operation were analyzed in the two groups.

RESULTS:At 1wk, 1mo and 3mo after operation, the CEC density in the two groups was decreased significantly compared with that before operation, and the density in observation group was significantly higher than that in control group at the same time(all P<0.05). The levels of CA, TMH and EGF in the two groups were significantly higher than those before operation, and the levels in observation group were significantly lower than those in control group at the same time(all P<0.05). The levels of UCVA in the two groups were significantly decreased than those before operation, and the levels in observation group were significantly lower than those in control group at the same time(all P<0.05).The ultrasound time, cumulative release energy and operative time in observation group were significantly less than those in control group(all P<0.05). Within 3mo after operation, the total incidence rate of postoperative complications in observation group was significantly lower than that in control group(P<0.05).

CONCLUSION: The 3.0mm clear corneal incision Phaco is more appropriate than 3.0mm scleral tunnel incision, and the former one is conducive to promoting postoperative rehabilitation.

Abstract:AIM:To explore the effects of femtosecond laser-assisted cataract surgery(FLACS)on corneal astigmatism and surgically induced astigmatism(SIA)value in patients with age-related cataract.

METHODS: Totally 152 cases of age-related cataract patients(233 eyes)admitted to our hospital were divided into the study group(n=70, 107 eyes, given the FLACS)and the control group \〖n=82, 126 eyes, given the traditional phacoemulsification cataract surgery(TS)\〗 according to the economic conditions and voluntary principles. Corneal astigmatism degree and SIA value were compared between the two groups.

RESULTS: The effective ultrasound time, average ultrasound energy, and total operative time in the study group were less than those in the control group(P<0.05). There was no significant difference in the intraocular pressure between the two groups before operation and at 1 and 3mo after operation(P>0.05). The difference in intraocular pressure was statistically significant of the two groups at different time points(P<0.05). The two groups showed a downward trend in intraocular pressure(P<0.05). There were statistically significant differences in the accumulated energy complex parameter(CDE)values of phacoemulsification between the two groups of grade Ⅱ nuclear and grade III nuclear surgery, and the intraoperative CDE value of grade Ⅲ nuclear in the two groups was higher than that of grade Ⅱ nuclear(P<0.05). The difference in visual acuity and best corrected visual acuity between the two groups at different time points was statistically significant(P<0.05). The uncorrected visual acuity and best corrected visual acuity were significantly improved in the two groups(P<0.05). The uncorrected visual acuity and best corrected visual acuity in the study group were better than those in the control group at 1mo after operation(P<0.05), but there was no significant difference at 3mo after operation(P>0.05). There was no significant difference in corneal astigmatism between the two groups and at different time points(P>0.05). There was no significant difference in surgical astigmatism between-groups at 1 and 3mo after operation(P>0.05).The surgical astigmatism at 3mo after operation was lower than that at 1mo after operation(P<0.05). There were significant differences in corneal endothelial cell counts between the two groups at different time points(P<0.05). There was no significant difference in corneal endothelial cell counts in the study group before operation and at 1mo after operation(P>0.05). The corneal endothelial cell counts in control group at 1mo after operation was lower than that before operation(P<0.05). There was no significant difference in the corneal endothelial cell counts between the two groups before operation and at 1mo after operation(P>0.05). The corneal endothelial cell counts in the study group were significantly more than those in the control group at 3mo after operation(P<0.05). The corneal endothelial loss rate was significantly lower in the study group at 1 and 3mo after operation than that in the control group(P<0.05).

CONCLUSION: FLACS can effectively improve the postoperative visual acuity in patients with age-related cataract, and it will not increase the postoperative corneal astigmatism and SIA.

Abstract:AIM: To investigate the effect of crystal turbidity on retinal oxygen saturation in patients with diabetic cataract.

METHODS:This was a cross-sectional study. Totally 68 patients with 68 eyes of diabetic cataract admitted to our hospital from June 2017 to December 2017 were selected as subjects. Retinal oximetry was used to measure the blood oxygen saturation of the retinal veins, veins, and their supraorbital, nasal, subnasal, and infraorbital branches. The objective scatter index(OSI)of the eye was measured by Visual Quality Analysis System II, and the degree of opacity of the lens was graded according to OSI.

RESULTS:The blood oxygen saturation of the retinal artery and its branches in this group were 101.39%±10.84%, 106.19%±11.40%, 103.22%±10.91%, 102.36%±20.31%, and 101.29%±13.88%, respectively. The oxygen saturation of the retinal vein and its branches were 62.51%±8.95%, 66.37%±10.74%, 64.81%±8.97%, 58.37%±13.85%, and 58.66%±19.94%, respectively. The difference between arteriovenous oxygen saturation was 40.72%±12.08%. In this group of patients, 68 patients with 68 eyes had an OSI value of 4.21±3.14. Among them, 15 eyes were turbid at the first stage, 14 eyes were turbid at level 2, 23 eyes were turbid at level 3, and 16 eyes were turbid at level 4. Pearson correlation analysis showed that the retinal veins, veins and their branches were negatively correlated with OSI(both P<0.01). The difference in retinal arterial and venous oxygen saturation was positively correlated with OSI(P<0.01). There were significant differences in the blood oxygen saturation between the retinal veins, veins and their branches in patients with different degrees of lens opacity(P<0.05). The retinal arterial, venous and branch oxygen saturation of patients with opacity of lens 4 was significantly lower than that of patients with opacity of lens 1, 2, and 3, and the difference was statistically significant(P<0.05). There were no significant differences in blood oxygen saturation between the patients with opacity of lens 1, 2, and 3(P>0.05). There was no significant difference in the difference of arteriovenous oxygen saturation between the patients with different degrees of lens opacity(P>0.05).

CONCLUSION: In patients with diabetic cataract, when the degree of lens opacity is 1 to 3, the degree of abnormality of retinal blood oxygen metabolism is not obvious. When the degree of lens opacity reaches 4, the blood oxygen saturation of the retinal veins, veins and their branches will decrease.

Abstract:AIM:To investigate the influences of Nd:YAG laser capsulotomy with different size on visual acuity(VA), intraocular pressure(IOP), refraction, anterior chamber depth(ACD), and macular thickness(MT)in patients with posterior capsular opacification(PCO).

METHODS: In this retrospective, constantly study, 41 eyes of 41 patients treated with Nd:YAG laser posterior capsulotomy for PCO were divided into 2 groups according to the different incision sizes of capsulotomy: the patients received capsulotomy with the incision diameter less than or equal to 3.5mm were enrolled into group 1, while those received operation with incision diameter more than 3.5mm went to group 2. All patients were followed up before Nd:YAG laser capsulotomy, 1wk, 1 and 3mo after Nd:YAG laser capsulotomy, and the best-corrected visual acuity(BCVA), refraction, IOP, ACD, and MT were compared between two groups.

RESULTS: In both groups, BCVA were significantly improved postoperatively compared with base line(P<0.001), but there was no significant difference between two groups(P>0.05). The diopter(SE)of the two groups were not significantly different before and after operation(P>0.05). Intraocular pressure in group 2 was higher than those in group1 at 1wk(t=-2.609, P=0.013). ACD decreased significantly at 1wk postoperatively(P<0.01), but with no significant difference at 1 and 3mo(P>0.05). Both groups had increased macular thickness lightly at 1wk postoperatively, but with no statistical significance(P>0.05), and there was no significant difference between the two groups at 1wk, 1 and 3mo postoperatively(P>0.05).

CONCLUSION: The increase in intraocular pressure is more pronounced when the size of posterior capsulotomy was larger. However, the changes of BCVA, ACD, refraction, MT are not related with the incision size of posterior capsulotomy.

Abstract:AIM:To compare the effects after two different surgical methods on visual field and retinal nerve fiber layer(RNFL)thickness in patients with glaucoma.

METHODS: Clinical data of 69 cases patients(82 eyes )with glaucoma between December 2015 to May 2017 in our hospital for anti-glaucoma surgery were collected. According to operation method, they were divided into EP group(EX-PRESS glaucoma shunt implantation)and XQ group(trabeculectomy). Intraocular pressure, anterior chamber depth(ACD), anterior chamber capacity(ACV), anterior chamber angle width(ACA), optical pupil diameter(PD), visual acuity, visual sensitivity index mean defect(MD), visual correction pattern standard deviation(CPSD), mean sensitivity(MS)and retinal nerve fiber layer thickness(RNFLT)were observed in the preoperative, postoperative 1mo and postoperative 3mo, and the postoperative complications were compared.

RESULTS: Hospitalization time of 3.08±0.42d in the EP group was significantly lower than 4.53±1.28d in the XQ group(t=6.124, P<0.05). The visual recovery time of 3.26±0.30d in the EP group was significantly lower than 4.96±1.36d in the XQ group(t=6.920, P<0.05). The ACA, ACD and ACV after surgery of two groups were significantly higher than those before operation, and the PD after surgery was lower than before operation, and the differences were not statistically significant between two groups after surgery(P>0.05).The postoperative RNFLT, MD and CPSD were all decreased in both groups(P<0.05), and postoperative MS increased(P<0.05); compared with XQ group, the postoperative CPSD after surgery in EP group was significantly reduced(P<0.05).The total incidence of postoperative complications of EP group was 38%, which was significantly lower than 70% in XQ group, the difference was statistically significant(χ²=8.094, P=0.004).

CONCLUSION: Compared with trabeculectomy, EX-PRESS glaucoma shunt implantation is more effective to slow the progress of vision, and it is more conducive to recovery of the patient's vision after surgery with higher security. The improvement of the thickness of the retinal nerve fibers after EX-PRESS glaucoma shunt implantation is consistent with trabeculectomy.

Abstract:AIM:To investigate the effect of anti-vascular endothelial growth factor(VEGF)combined with pan retinal photocoagulation(PRP)on neovascular glaucoma(NVG)and its effect on VEGF and platelet-derived growth factor-C(PDGF-C)in aqueous humor.

METHODS: A total of 90 patients with NVG(93 eyes)who underwent examination and treatment in our hospital from November 2016 to November 2017 were randomly divided into control group and observation group. The control group was treated with PRP, and the observation group was treated with laser photocoagulation combined with vitreous injection of ranibizumab. The clinical efficacy, iris neovascularization and visual recovery were compared between the two groups after treatment. And we compared the retinal vein circulation time, intraocular pressure, retinal nerve fiber layer thickness, visual field defect value, VEGF and PDGF-C levels in aqueous humor and adverse reactions before and after treatment.

RESULTS: At 1mo after treatment, the clinical efficacy, iris neovascularization and visual recovery were better than the control group(P<0.05). After treatment, the retinal vein circulation time, intraocular pressure, visual field defect, aqueous humor VEGF and PDGF-C levels were significantly lower in the observation group than in the control group, and RNFL was significantly higher than the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).

CONCLUSION: The use of PRP combined with anti-VRGF drugs for NVG can inhibit angiogenesis and restore retinal function more effectively, which may be better because the combination therapy has better down-regulation of VEGF and PDGF-C.

Abstract:AIM: To analyze the association of extracellular matrix metalloprotease 9(MMP-9)single nucleotide polymorphism(SNP)with genetic susceptibility of primary angle-closure glaucoma(PACG)in a Han Chinese population.

METHODS: Totally 200 PACG patients(PACG group)and 200 healthy people(normal control group)were collected in our hospital from January 2014 to December 2016. Peripheral venous blood was collected and extracted for genomic DNA, the polymerase chain reaction-restriction fragment length polymorphism technique(PCR-RFLP)was applied to detect the alleles and genotypes of rs2250889, rs2274755 and rs2664538 sites in MMP-9 gene. The frequency distribution of alleles and genotypes in the two groups were calculated by chi-square test, and its association with genetic susceptibility of PACG was analyzed.

RESULTS: There were no statistical differences in age, gender, body mass index, diastolic blood pressure and systolic blood pressure in the two groups(P>0.05). The genotype frequencies of rs2250889, rs2274755 and rs2664538 sites in MMP-9 gene were in line with Hardy-Weinberg equilibrium. The genotype and allele frequency distribution of rs2250889 and rs2664538 sites were significantly different between the PACG group and the normal control group(P<0.05), while the genotype and allele frequency distribution of rs2274755 sites in the two groups had no statistical difference(P>0.05). The subjects whose rs2250889 site carrying the CC genotype was susceptible to PACG. Similarly, the rs2664538 site carrying the GG genotype was susceptible to PACG.

CONCLUSION: The rs2250889 and rs2664538 polymorphisms of MMM-9 are correlated with the risk of PACG in a Han Chinese population, while the rs2274755 polymorphism is not related to genetic susceptibility of PACG.

Abstract:AIM: To study the effect of residual triamcinolone acetonide(TA)to intraocular pressure(IOP)and retinal thickness in patients after vitrectomy.

METHODS: Retrospective study. The medical data of 83 patients(83 eyes)after vitrectomy in our hospital from October 2016 to October 2017 were analyzed retrospectively. The 83 patients were treated with TA as vitreous dyeing. Vitreous cavity was not filled with silicone oil or gas. Totally 32 eyes were observed that triamcinolone acetonide was residual in vitreous cavity, 51 eyes were not observed the residual, and after 1wk and 3mo, intraocular pressure and macular center concave thickness(CMT)of two groups was compared.

RESULTS: There was no statistical difference in preoperative average intraocular pressure between two groups(t=0.56, P>0.05). After 1wk, IOP of no residual group was 15.48±3.8mmhg, IOP of residual Group was 20.09±6.14mmhg. IOP of residual group were higher than IOP of no residual group, the difference was statistically significant(t=3.81,P<0.05). After 3mo, postoperative average IOP was 13.75±2.35mmhg, IOP of residual Group was 16.26±2.52mmhg, IOP of residual group was higher than IOP of no residual group, the difference was statistically significant(t=4.54, P<0.05). After 1wk, the average CMT of no residue group was 240.57±42.69μm, that of residual group was 215.03±18.38, and the difference was statistically significant(t=3.75,P<0.05). After 3mo, there was no statistical significance on the average CMT between no residual group and residual group(t=0.21, P>0.05).

CONCLUSION: The residual triamcinolone acetonide as a dyeing agent during vitrectomy may raise the risk of postoperative intraocular pressure in short term, and after 3mo without any significant effect on the thickness of macular center.

Abstract:AIM: To explore the clinical effect of small incision lenticule extraction(SMILE)and femtosecond laser in situ keratomileusis(FS-LASIK)in correcting high myopia and the effect on cornea and tear film stability.

METHODS: Totally 120 patients with high myopia treated in the hospital from August 2016 to February 2017 were selected as the research subjects. According to the surgical methods, the patients were divided into SMILE group and FS-LASIK group, 67 cases 134 eyes in SMILE group and, and 53 cases 106 eyes in FS-LASIK group. Group SMILE was treated with SMILE, and group FS-LASIK was treated by FS-LASIK. The influence of normal vision and stability of cornea and tear film.

RESULTS: There was no significant difference in uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and diopter between two groups after 1mo and 3mo(P>0.05). There was no significant difference in BUT and SⅠt between the two groups of patients before and 1mo after operation(P>0.05). After 3mo between the two groups, BUT and SⅠt in the two groups were statistically different, and the SMILE group was significantly better than the FS-LASIK group(P<0.001). There was no significant difference between the two groups of corneal thinning point height and posterior vertex height at preoperative and postoperative 1 and 3mo(P>0.05).

CONCLUSION: SMILE and FS-LASIK are equally safe and effective and have good predictability and stability. The postoperative tear film stability is superior to FS-LASIK, and there is no significant difference in the biomechanical stability of the two kinds of methods.

Abstract:AIM: To survey and analyze clinical prevalence of glaucoma in Baoding.

METHODS: Totally 4 960 residents in Baoding were selected through cluster sampling between May 2017 and December of 2017 for glaucoma screening. The incidence of different types of glaucoma and the age and sex distribution were analyzed. The eye lesions of patients with diagnosed and newly diagnosed glaucoma were compared.

RESULTS: The prevalence of glaucoma was 2.72%(135/4960), among which the prevalence of primary angle-closure glaucoma(PACG), primary open angle glaucoma(POAG), congenital glaucoma(CG)and secondary glaucoma(SG)was respectively 51.85%, 20.00%, 17.04%, and 11.11%, and the ratio of male to female for which was 1:1.92, 3.50:1, 2.83:1, and 1:1.14 respectively. There was no significant difference in the ratio of males and females in glaucoma patients(P>0.05). The composing proportions of patients with PACG, POAG, SG and CG over 40 were 95.71%, 51.85%, 52.17% and 0 respectively, and the composing ratios of patients with PACG, POAG, SG, and CG in age brackets of ≤49 years, 50-69, and ≥70 years were 1:5.63:2.13, 4.5:1.25:1, 4.67:2:1 and 15:0:0 respectively, with statistically significant difference(P<0.05). There was no significant difference in the changes of visual field and intraocular pressure >21mmHg in diagnosed and newly diagnosed glaucoma patients(P>0.05). The incidence of monocular low vision and monocular blindness in patients newly diagnosed with glaucoma was lower than that in patients diagnosed with glaucoma, and the incidence of optic nerve changes in the former was higher than that in the latter, with statistically significant difference(P<0.05).

CONCLUSION: The prevalence of glaucoma in Baoding is 2.72%, of which PACG has the highest prevalence rate, followed by POAG, SG, and CG, and its incidence is not correlated with gender. Except for CG, which occurs in certain populations, PACG has the highest incidence among those of 50-69 years old. The prevalence of POAG and SG reduces with age, and the incidence of blindness is relatively low in new diagnosis patients with glaucoma, but the progression of the disease is more serious.

Abstract:AIM: To discuss the influencing factors of interface operation in femtosecond laser assisted cataract surgery(FLACS).

METHODS: From March 2016 to October 2017, 44 patients(44 eyes)were enrolled in this study who had adverse cases occurred in interface operation in femtosecond laser assisted cataract surgery. A questionnaire survey was conducted to find out the relevant factors.

RESULTS: The patient's emotion, comfort and external environment can influence the process and safety of interface operation in femtosecond laser assisted cataract surgery. The positive detection rate of patients with state anxiety was 73%, with mild and moderate status anxiety, among which there was no statistical difference between male and female state(P>0.05). The patient's comfort level was 89% and the satisfaction rate was 96%.

CONCLUSION: The emotional, comfort, and environmental factors of patients in femtosecond laser assisted cataract surgery may affect the process and safety of interface operations, effective nursing and management measures can be implemented to improve patient surgical coordination and comfort, and reduce intraoperative complications.

Abstract:AIM: To evaluate the ocular parameter changes following scleral buckling(SB)for rhegmatogenous retinal detachment(RRD).

METHODS: This retrospective, non-randomized case-control study included 46 eyes of 23 patients who underwent SB for RRD. Best corrected visual acuity(BCVA), diopter, intraocular pressure(IOP), anterior chamber depth(ACD), the number of corneal endothelial cells, axial length and the degree of exophthalmos were evaluated in the operated eyes and the follow eyes postoperatively at 3mo.

RESULTS: After SB surgery, retina reattachment was achieved without any obvious complications or adverse reactions in all follow-up patients. Among all parameters, the significant decrease in BCVA of 0.15(LogMAR BCVA, P=0.007), in anterior chamber depth(ACD)of 0.29mm(P=0.011)and increase in the degree of exophthalmos of 0.54mm(P=0.047)were observed; the surgery-induced changes for other parameters, including diopter, IOP, counts of endothelial cells and axial length, were not significantly different(P>0.05).

CONCLUSION: SB is a good technique for repairing RRD. It brings SB-induced changes in ACD and the degree of exophthalmos.

Abstract:AIM:To analyze the clinical features of a Usher syndrome family and explore the pathogenic gene of the disease.

METHODS: A Chinese family with Usher syndrome was involved in our study. After informed consent, careful clinical examinations were taken and 4mL blood were obtained. The whole genome DNA was extracted and target-captured next generation sequencing of the proband was performed to identify suspected mutations. We used Sanger sequencing to verify the detected mutations in all the members of the family, as well as in 100 normal controls.

RESULTS: In addition to typical retinitis pigmentosa, the patients suffered from mild to moderate sensorineural deafness. Sequencing results revealed compound heterozygous mutations(c.2310_2311insA and c.8559-2A>G)of USH2A gene in the patients, and either of the mutations was found in normal relatives that had consanguinity with the patients. Both of the mutations were not found in other members of the family and normal individuals.

CONCLUSION: USH2A is the pathogenic gene of the disease in this family. The mutation c.8559-2A>G(IVS42)is a previously reported mutation, while the mutation c.2310_2311 insA(p.E771Rfs*8)is a novel mutation. The study has expanded the mutation spectrum of USH2A gene resulting in Usher syndrome.

Abstract:AIM:To investigate the clinical effect of scleral allograft combined with conjunctival flap autograft for refractory purulent corneal ulcer.

METHODS: Twenty patients(20 eyes)with purulent corneal ulcer admitted to our hospital during June 2015 to June 2017 were selected. The results showed that the drug treatment was not effective and could not be performed by penetrating keratoplasty, and then allogeneic scleral transplantation combined with conjunctival flap autograft covering was performed. A retrospective analysis was carried out. The intraoperative complications, postoperative scleral and conjunctival flap growth and postoperative complications of this palliative operation were observed.

RESULTS: Of the 20 patients, 18 had good growth of sclera and conjunctival flap, the cure rate was 90%. One case had bad healing of conjunctival flap and was cured by amniotic membrane transplantation; 1 case had enucleation because of severe vitreous cavity infection; 2 cases had lens prolapse, the incidence rate was 10%. Secondary glaucoma occurred in 3 cases with an incidence of 15%, which was cured by cryociliary surgery.

CONCLUSION:Scleral allograft combined with conjunctival flap autograft is a palliative operation. It is an effective way to control the corneal infection and maintain the appearance of the eyeball in the patients with severe purulent corneal ulcer, which is ineffective in drug treatment and unable to perform penetrating keratoplasty. It can replace the previous enucleation of the eye contents to control the infection. It can not only avoid the eye pain and psychological trauma caused by the loss of eyeball, but also save money for improving the appearance in the later stage.

Abstract:AIM: To investigate the effects of amniotic membrane transplantation combined with limbal stem cell autograft transplantation on ocular surface repair time, repair rate and complications in patients with ocular burns.

METHODS: The clinical data of each 61 cases(61 eyes)of patients with ocular burns who were treated by limbal stem cell autograft transplantation(control group)or amniotic membrane transplantation combined with limbal stem cell autograft transplantation(observation group)were retrospectively analyzed. The postoperative ocular surface repair rate, repair time, and visual acuity and complications(symblepharon, corneal neovascularization, and keratohelcosis)at 12wk after operation were recorded in the two groups, and the levels of cytokines \〖vascular endothelial growth factor(VEGF), transforming growth factor-β1(TGF-β1), insulin-like growth factor-1(IGF-1)\〗 were compared between the two groups before operation and at 2wk after operation.

RESULTS: The postoperative ocular surface repair rate in observation group was higher than that in control group(P<0.05)while the repair time was less than that in control group(P<0.05). At 12wk after operation, the visual acuity in observation group was significantly better than that in control group(P<0.05), and the total incidence rate of postoperative complications in observation group was significantly lower than that in control group(P<0.05). At 2wk after operation, the levels of serum VEGF, TGF-β1 and IGF-1 in the two groups were significantly higher than those before operation(P<0.05), and the levels in control group were higher than those in observation group(P<0.05).

CONCLUSION: Amniotic membrane transplantation combined with limbal stem cell autograft transplantation has significant treatment effects on patients with ocular burns, and it can promote ocular surface repair, improve postoperative visual acuity, and can also regulate corneal neovascularization, and it also has positive significance in reducing the risk of postoperative complications.

Abstract:AIM: To investigate the central corneal thickness(CCT)distribution of the children with ametropia in the non-contact tonometry(NCT), and the different intraocular pressure(IOP)measurements with Goldmann applanation tonometry(GAT)and the OCULUS Corvis ST(CST)corneal biomechanical analyzer, meanwhile, to evaluate the correlation between IOP and CCT.

METHODS: NCT was used to measure 39 children(78 eyes)of non-glaucomatous ametropia with single eye or binocular IOP higher than 21 mmHg. The IOP was measured again with CST and GAT. The two instruments were measured in random order and the CCT was measured by CST and corrected the IOP according to the CCT. The eyes were divided into the normal group and the thicker group according to the CCT. The three IOP values were analyzed by the ANOVA, and the IOP and CCT was analyzed by the Pearson correlation coefficient.

RESULTS: In the normal CCT group, the IOP by CST was lower than that the GAT and NCT measurements and the difference was statistically significant(F=5.12, P=0.01). In the thicker group, the comparison of the three intraocular pressure measurement methods was statistically significant(F=15.72, P<0.001). IOP by NCT and GAT were significantly correlated with CCT(r_NCT=0.298, P_NCT=0.04; r_GAT=0.408, P_GAT=0.01). There was no significant correlation between CST corrected intraocular pressure and CCT(r_CST=0.062, P_CST=0.593).

CONCLUSION: The CCT of ametropia children with high IOP by Topcon tonometry were thicker. The corrected intraocular pressure of CST is lower than NCT and GAT. NCT and GAT were positively correlated with CCT. For children with thicker CCT, CST corrects intraocular pressure was closer to the real intraocular pressure value than NCT and GAT.

Abstract:AIM:To document the change in pattern of topical anti-glaucoma medicine by retrospective analysis in the outpatient of a local tertiary eye hospital(Second People's Hospital of Foshan)in China during 2009-2016.

METHODS: The data of topical anti-glaucoma medications in outpatients in our hospital were collected from January 1^st 2009 to December 31^st 2016. These data were analyzed retrospectively. The main outcome measures were the percentages of prescriptions for all kinds of anti-glaucoma medications, the ratio of the mono-therapy and combination therapies, and the defined daily doses.

RESULTS: The ratio of beta-adrenergic receptor blocker declined from 81.51% in 2009 to 69.37% in 2016. The use of cholinergic agent decreased from 12.04% in 2009 to 3.78% in 2016. The prostaglandin derivatives increased from 8.40% in 2009 to 31.40% in 2016. Alpha 2 adrenergic receptor agonists increased from 0 in 2009 to 29.44% in 2016. Local carbonic anhydrase inhibitors changed slightly. The proportion of mono-therapy was reduced from 65.83% in 2009 to 46.22% in 2016. The ration of two agents combination increased from 32.49% in 2009 to 38.77% in 2016. The three medications combination was increased from 1.68% in 2009 to 12.96% in 2016. The proportion of four medications combination increased from 0 in 2009 to 1.97% in 2016, while the combined use of five drugs was an isolated case.

CONCLUSION: The proportion of topical anti-glaucoma agents has changed remarkably. The beta-adrenergic receptor blockers and cholinergic medications are decreasing, while the prostaglandin derivatives and alpha 2 adrenergic receptor agonists are increasing. The proportion of mono-therapy is declining, while the combined therapies are rising.

Abstract:AIM:To evaluate the efficacy of EX-PRESS glaucoma filtration device combined with phacoemulsification and intraocular lens implantation for refractory glaucoma complicated with cataract.

METHODS: Totally 60 patients(60 eyes)of refractory glaucoma were chosen as the research objects between January 2013 and January 2016 in our hospital, who were divided into research group and the control group according to the operation method. Research group(29 patients 29 eyes)was given EX-PRESS glaucoma drainage device combined with phacoemulsification and intraocular lens implantation; control group(31 patients 31 eyes)was given trabeculectomy combined with phacoemulsification and intraocular lens implantation. The visual acuity, intraocular pressure(IOP), the successful rate and other clinical indicators were observed and analyzed.

RESULTS: The surgery of all the 60 patients achieved success.The successful rate of research group was 93%, that of control group was 81%, while the difference was not significant(P=0.26). The best corrected visual acuity(BCVA)of both groups was better than before treatment at 6mo after surgery without statistically significant. The postoperative BCVA was not different between the two groups. The IOP between the two groups was significantly different(P<0.05). The IOP of research group at 1d, 1 and 3mo was significantly lower than control group(P<0.05). The IOP at 6mo after surgery was not significantly between the two groups. The IOP at different time was significantly different(P<0.05). The IOP at 1d after surgery was significantly different compared to that at 6mo(P=0.007).

CONCLUSION:It has good clinical effect that EX-PRESS glaucoma filtration device combined with phacoemulsification for refractory glaucoma complicated with cataract. It is a treatment with high feasibility, safety and effectiveness.

Abstract:AIM:To explore the effects of EX-PRESS glaucoma drainage device implantation and trabectome on visual acuity, intraocular pressure, central anterior chamber depth(ACD)and postoperative complications in patients with primary open angle glaucoma(POAG)complicated with cataract.

METHODS: The clinical data of 64 patients(64 eyes)with POAG complicated with cataract in our hospital from March 2015 to January 2017 were retrospectively analyzed. Among them, 34 patients(34 eyes)were given EX-PRESS glaucoma drainage device implantation and cataract phacoemulsification(the Group A)and another 30 cases(30 eyes)were given trabectome combined with cataract phacoemulsification(the Group B). The visual acuity \〖best corrected visual acuity(BCVA)\〗, intraocular pressure, ACD and the thickness of macular ganglion cell complex(GCC)were compared between the two groups before operation and at 5mo after operation, and the differences of postoperative complications were also recorded between the two groups.

RESULTS: At 5mo after operation, the BCVA, intraocular pressure(IOP)was lower than that before operation(t _{Group A}=39.359, 21.045; t _{Group B}=23.126, 16.863; P<0.01), and the Group A was lower than that in the Group B(t=9.452, 2.761; P<0.01). There was no significant difference in the ACD level before and after operation between-groups and within-groups(P>0.05). At 5mo after operation, there was no significant difference in the thickness of macular GCC in the Group A compared with that before operation(P>0.05), but the thickness of macular GCC in the Group B was lower than that before operation(t=3.851, P<0.05)and was lower than that in the Group A(t=2.269, P<0.05). The incidence rate of postoperative complications in the Group A was significantly lower than that in the Group B(χ²=7.883, P<0.05).

CONCLUSION: EX-PRESS glaucoma drainage device implantation or trabectome combined with cataract phacoemulsification can receive good treatment effects in treating POAG patients with cataract, but the former one has better effects on reducing IOP and improving visual acuity than those in the latter one. And EX-PRESS glaucoma drainage device implantation can reduce the incidence rate of postoperative complications, and it is also beneficial to the reduction of retinal ganglion cells(RGCs)damage and the disease prognosis.

Abstract:AIM: To take a contrastive analysis of glaucoma patients' clinical prognosis and complications after the usage of mitomycin(MMC)or 5-fluorouracil(5-FU)combined with adjustable sutural trabeculectomy.

METHODS: Retrospective case series reseach was undertaken. We divided the 71 cases(including primary open angle glaucoma and primary chronic angle-closure glaucoma)into two groups: MMC group(36 cases)and 5-FU group(35 cases). Both were treated with combined adjustable sutural trabeculectomy with the usage of MMC or 5-FU anti-cicatricial treatment, and followed up to compare intraocular pressure, filtered bubble form and complications.

RESULTS: The intraocular pressure of MMC group was lower than 5-FU group with statistical significance(P<0.05); there was no significant difference in total surgical success rate between groups(P>0.05). Functional filtering bleb formation rate in MMC group was higher than 5-FU group while the formation rate of nonfunctional filtering bleb in MMC group was lower than 5-FU group(P<0.05), which showed no significant difference in complication rate between groups(P>0.05), but the types of complications were different.

CONCLUSION: Both MMC and 5-FU can improve the success rate of glaucoma trabeculectomy as anti-cicatricial drugs. MMC can lower the intraocular pressure, is superior to 5-FU in the formation of functional filtering bleb. There was no significant difference in the incidence of complications between MMC and 5-FU according to personalized surgical protocols based on patients. When 5-FU is used, it is necessary to separate the filtering blebs repeatedly after operation and to reinject 5-FU under conjunctiva.

Abstract:AIM: To explore the factors and analyze the occurrence of neovascular glaucoma(NVG)after vitrectomy for proliferative diabetic retinopathy(PDR).

METHODS:Retrospective analysis on the clinical materials from January 2013 to December 2017, including 233 PDR patients(237 eyes)treated with vitrectomy in which 20 patients(20 eyes)occurred NVG after vitrectomy surgeries. The factors might lead to NVG were investigated.

RESULTS: Totally 20 patients(20 eyes)developed NVG, in which there were 12 eyes combined with cataract surgeries, of the 12 eyes, 6 eyes had posterior lens capsule deficiency; 14 eyes complicated with hypertensions; 16 eyes complicated with hyperlipoidemia; 6 eyes had reoperations of vitrectomy surgeries; 2 eyes were silicone oil-filled eyes or silicone oil-removed eyes. There were correlations between the combinations of the cataract surgeries, posterior lens capsule deficiency, and vitrectomy with the occurrences of NVG after PDR surgeries; vitreous silicone oil filling might inhibit the occurrence of NVG to a certain extent. There was no statistical significance in hypertensions, high plasma lipids and reoperations of vitrectomy surgery for occurrence of NVG after PDR surgery.

CONCLUSION: There is positive significance in correctly grasping the timing of lens surgery, and properly selecting the vitreous cavity filler.

Abstract:AIM: To evaluate the effectiveness of pars plana vitrectomy(PPV)combined with inverted internal limiting membrane(ILM)flap technique for macular hole retinal detachment(MHRD)of high myopia.

METHODS: This was a retrospective case series. Totally 27 patients(27 eyes)who were diagnosised with MHRD of high myopia and underwent vitrectomy combined with inverted ILM flap covering technique were eIlrolled in this study. The diopter was ≥-6.00D and axial length was ≥26mm. The mean age was 53.69±7.23 years. And there 9 males and 18 females. The logarithm of the minimum angle of resolution(LogMAR)best-corrected visual acuity(BCVA)was 1.41±0.28. All patients were performed PPV with inverted ILM flap, resected the vitreous gel and cortex completely. Bright blue G stained the ILM around the fovea. The ILM was peeled off around the MH, and some portion of the ILM flap was left attached to the edge of the MH. Covering the MH with the ILM flap.Then, C₃F₈ gas or silicone oil was injected into the vitreous cavity. The mean follow-up was more than 6mo and BCVA, MH closure, retinal reattachment, complications were retrospectively observed.

RESULTS: After surgery, visual acuity improved in 21 eyes(78%), unchanged in 4 eyes(15%), decreased in 2 eyes(7%). The mean LogMAR BCVA was 0.84±0.40, the difference was significant(t=7.32, P<0.05). The macular hole closure rate was 89%(24 eyes)and retinal reattachment rate was 93%(25 eyes). No severe complicationwas observed.

CONCLUSION: PPV combined with inverted internal limiting membrane flap is an effective and safe management for the MHRD of high myopia.

Abstract:AIM: To investigate the axial length(AL)of normal premature infants, and to analyze the associations with gender, gestational age, birth weight, and postmenstrual age and other ocular biometry parameters.

METHODS: To analyze AL and other relevant data obtained from the first examination within 4-6wk after birth, 400 cases(800 eyes)of normal preterm infants were included who were screened for retinopathy of prematurity(ROP)in Department of Ophthalmology of Northwest Women and Children Hospital from March 2016 to October 2016.

RESULTS: Totally 400 cases(800 eyes)of normal preterm infants were included in this study, while the AL of right and left eyes were respectively 16.11±0.58mm and 16.13±0.53mm, with no statistically significant difference(P>0.05). Therefore, the mean value(16.12±0.55mm)of the binocular AL was taken as the AL of the group. In this study, AL differences of premature infants between different genders were not statistically significant(P>0.05). Pearson correlation analysis showed that AL was positively correlated with the gestational age, birth weight, postmenstrual age, anterior chamber depth and vitreous length(r=0.427, 0.401, 0.635, 0.691, 0.878; P<0.01), and negatively correlated with lens thickness(r=-0.153, P<0.01). By incorporating the above factors into the multiple linear regression analysis, it was found that AL was significantly correlated with gestational age, anterior chamber depth, and vitreous length, and the regression equation Y=4.109+0.029X₁+0.481X₂+0.978X₃(Y=AL, X₁=gestational age, X₂=anterior chamber depth, X₃=vitreous length)was obtained.

CONCLUSION: In the early stage of normal premature infants, the mean AL was 16.12±0.55mm, which was not related to gender, but positively correlated with gestational age, birth weight, postmenstrual age, anterior chamber depth, and vitreous length, and negatively correlated with lens thickness.

Abstract:AIM:To study the application value of magnetic resonance hydrography(MRH)technology in diagnosis, treatment and prognostic evaluation of epiphora.

METHODS: Before treatment, 40 patients(52 eyes)with epiphora underwent MRH examination, flushing and probing of lacrimal ducts to ascertain the causes of lacrimal duct obstruction, and identify the local anatomical changes and dysfunction. Then a individualized treatment plan was developed on the basis of comprehensive analysis of the aforementioned examination results. And then, after the operation, the therapeutic effect was evaluated by reexamination of MRH and flushing and probing of lacrimal ducts.

RESULTS: Ten of all enrolled patients(14 eyes)had functional epiphora, the remaining 30(38 eyes)had lacrimal duct obstruction. MRH examination showed that the level of obstruction was located in lacrimal canaliculus(9 cases 9 eyes), ductus nasolacrimalis(18 cases 26 eyes), lacrimal canaliculus plus ductus nasolacrimalis(3 cases 3 eyes), and some dacryocysts of the disersed side were dilated and deformed in varying degrees. The results from ophthalmological examination and combined examination of flushing and probing of lacrimal ducts showed that some could be touched scleroid block(3 cases 3 eyes)and some soft tissue of lacrimal punct area were red and swollen(3 cases 3 eyes). There were three kinds of secretions, including purulent, serous and mucous, from flushing of lacrimal ducts. Three different surgical programs had been formulated by combining all the inspection information. Postoperative MRH showed that the lacrimal ducts had been unobstructed and the dacryocystis had been narrowed in varying degrees.

CONCLUSION: A comprehensive analysis of the inspection information was taken from MRH and the results from flushing and probing of lacrimal ducts, and combined the individual patient's condition, the ophthalmologists formulated some differentiated and individualized surgical programs, and evaluated the curative effect. According to the study, we have provided a set of safe, accurate and practical methods of inspecting the lacrimal duct obstruction and evaluating their curative effect.

Abstract:AIM: To investigate the effect of retrograde lacrimal intubation combined tobramycin dexamethasone eye ointment on the treatment of adult nasolacrimal duct obstruction.

METHODS: During May 2012 to November 2016, a total of 46 eyes of 34 cases with nasolacrimal duct obstruction were treated with lacrimal intubation combined tobramycin dexamethasone eye ointment. The postoperative follow-up was 6-18mo to observe the treatment effect and complications.

RESULTS: The patients were successfully treated with lacrimal intubation and tube was drawn out 2-3mo after operation. Treatment was succeed in 39(85%)eyes. Functional improvement was achieved in 5 eyes(11%). Relapse occurred in 2 eyes(4%). The complications included mild epistaxis in 39 eyes(85%), eyelid edema in 15 eyes(33%), itch of inner canthus in 11 eyes(24%), and fall off of the tube in 1 eye(2%).

CONCLUSION: Lacrimal intubation combined tobramycin dexamethasone eye ointment is an effective treatment for nasolacrimal duct obstruction in adult and can successfully reduce occurrence of complications.

Abstract:AIM: To compare the changes of corneal shape and astigmatism before and after surgery in children with congenital ptosis in different degrees and different ages, and to provide a certain clinical basis for the timing of ptosis surgery and the time of refractive correction.

METHODS: The study consisted of 83 patients(114 eyes, 52 cases in one eye and 31 cases in both eyes)who were diagnosed with congenital ptosis and received frontalis muscle aponeurosis in our hospital from September 2015 to August 2016. The corneal topography and retinoscopy results were collected before and 1, 3, and 6mo after surgery. Corneal topography and 10g/L atropine ophthalmic gel retinoscopy were performed on all subjects, and the changes in the amount of astigmatism before and after surgery were compared between different degrees, different age groups, and different follow-up periods.

RESULTS: The corneal astigmatism measured by corneal topography after moderate to severe ptosis was not statistically different from that before the operation(P>0.05). In the 3 to less than 5 year old age group, cases with moderate to severe ptosis was observed after 6mo of Cyl, C value decrease compared with preoperative. In 5 to less than 12 year old age group, Cyl increased at first then decreased gradually 1mo after surgery compared with preoperative in patients with moderate ptosis, and decreased lower after surgery in 6mo, but C value increased compared with preoperative. In patients with severe ptosis, Cyl values showed a gradual decline after a significant increase in 1mo postoperatively, no significant changes compared with before surgery at 6mo, but the C value increased compared with preoperative.

CONCLUSION: Patients with congenital ptosis with 3 to less than 5 years of age undergo surgical treatment. The postoperative astigmatism has a large decrease, which is a suitable age for operation. The early astigmatism changes greatly after ptosis and it is recommended to increase the follow-up frequency and perform refractive correction in time.

Abstract:AIM: To provide a reference for the selection of surgical methods for the clinical treatment of blepharophimosis-ptosis-epicanthus inversus syndrome by analyzing the efficacy and patient satisfaction of congenital blepharoplasty patients.

METHODS: A retrospective analysis of blepharophimosis-ptosis-epicanthus inversus syndrome staging surgeries included 23 cases(46 eyes), in which 6 patients(12 eyes)had family history, 2 patients(4 eyes)of strabismus, 1 patients(2 eyes)of nystagmus. First-stage surgery of “Y-V” plasty and Ammon canthoplasty were performed at average age of 5±1.9; second-stage surgery of frontal muscle flap suspension were performed at average age of 6±2.7. Postoperative follow-up lasted for 12mo. We evaluated and analyzed the efficacy, asked the patients to give the score to the surgeries.

RESULTS: Palpebral fissure length(PFL)was extended from 17.83±3.1mm in the right eye and 17.87±2.9mm in the left eye to 23.59±1.7mm and 23.59±1.8mm after surgeries. The palpebral fissure height(PFH)was increased from 2.91±1.4mm in the right eye and 2.91±1.2mm in the left eye to 7.89±0.9mm in the right eye and 7.89±0.7mm in the left eye after surgeries. The length of epicanthus was reduced from 18.7±2.1mm to 7.8±1.8mm after surgeries. The width of epicanthus was reduced from 3.9±0.8mm before surgeries to 1.3±0.8mm after surgeries. The inner canthal spacing(IICD)was shortened from 37.70±3.3mm before surgeries to 30.70±2.6mm after surgeries. The distance from the upper eyelid margin of the corneal reflector to the upper eyelid(MRD1)increased from -1.67±1.6mm of the right eye before surgery, and -1.80±1.6mm of the left eye to the postoperative +3.35±0.7mm in the right eye and +3.35±0.6mm in the left eye. IICD/PFL decreased from 2.1±0.2 to 1.3±0.4 postoperatively. The satisfaction score was 47±2.1(full score was 60), and the patient was more satisfied with the curative effect and postoperative beauty.

CONCLUSION: The surgical treatments of blepharophimosis-ptosis-epicanthus inversus syndrome can be divided into the first-stage of “Y-V” plasty and Ammon lateral canthoplasty and the second-stage frontal muscle flap, which can get satisfaction of the patients.

Abstract:AIM: To study the effect of orthokeratology lens on myopia patients and their corneal morphology and diopter.

METHODS: Totally 150 cases of myopia children admitted to our hospital from January 2016 to January 2017 were selected and divided into the orthokeratology lens group and the spectacles group according to the wishes of the patients and their families. Visual acuity of all patients was examined before and 1a after treatment. corneal curvature, corneal thickness and diopter were recorded and the complications during treatment was observed as well.

RESULTS: The uncorrected visual acuity of orthokeratology lens group was significantly better than that of spectacles group(P<0.05). The corneal curvature of orthokeratology lens group was significantly lower than that of spectacles group(P<0.05). There was no significant difference in central corneal thickness of the two groups before and after treatment(P>0.05). There was no significant difference in diopter between the two groups before treatment(P>0.05); the diopter of orthokeratology lens group was significantly lower than that of spectacles group(P<0.05). The incidence of complications in orthokeratology lens group was 14.3%, which was significantly higher than that in spectacles group 4.9%(P<0.05).

CONCLUSION: The treatment of myopia with orthokeratology lens has a significant effect, but there are many complications in the patients. Therefore, in the clinical application process, specific precautions should be taken against the factors that may cause complications, so as to make the treatment process safer.

Abstract:AIM: To investigate the clinical efficacy of multimedia training system in the treatment of ametropic amblyopic in children of different ages.

METHODS: One hundred and twenty children(161 eyes)with ametropic amblyopia were selected from March 2015 to March 2016 in our hospital. According to their age, they were divided into three groups: 40 cases(54 eyes)with 4-6 years of age as pre-school group and 40 cases(52 eyes)with 7-9 years of age as school age group A, and 55 eyes(40 cases)with 10-12 years of age as school age group B. All of them were treated with multimedia training system. The clinical efficacy and compliance were analyzed.

RESULTS: After one course of treatment, the total effective rate of preschool group, school age group A, and school age group B was 96.3%, 82.7%, and 78.2%, respectively, and the difference was statistically significant(χ²=7.875, P<0.05), in which the total effective rate of pre-school group was higher than that of school age group A and school age group B. Correlation analysis showed that there was a certain correlation between age and treatment effect(χ²=7.875, P=0.017). Pearson column number r=0.216. The treatment adherence rates of preschool group, school age group A, and school age group B were 85.0%, 87.5%, and 90.0%, respectively, and the difference was not statistically significant(χ²=1.142, P>0.05).

CONCLUSION: Multimedia training system can improve the compliance of children with ametropic amblyopia. The efficacy is more remarkable in children of 4-6 year old.

Abstract:AIM: To observe the changes of intraocular pressure(IOP), ocular perfusion pressure(OPP), central anterior chamber depth(CACD)and subfoveal choroidal thickness(SFCT)in peri-hemodialysis in patients with end-stage diabetic nephropathy(ESDN), for evaluating the influences of hemodialysis(HD)on ocular blood supply of the ESDN patients.

METHODS: Totally 42 cases(84 eyes)of ESDN patients treated with HD in the Department of Nephrology were observed. Systolic and diastolic blood pressure, IOP with the hand-held rebound tonometer were measured at 30min before HD, 2h after HD duration and 30min after HD completion. OPP was calculated(OPP= 4/9 diastolic pressure + 2/9 systolic pressure - IOP). CACD measured by optical coherence measuring instrument(IOL-Master)and SFCT measured by optical coherence tomography(OCT)were observed at 30min before HD and 30min after HD completion. The outcomes were assessed by analysis of homogeneity test of variance, one-way ANOVA, LSD-t test and t-test, to look for differences of the parameters in various time of HD.

RESULTS: Totally 84 eyes of ESDN patients: in 30min before HD, 2h after HD duration and 30min after HD completion, systolic blood pressure was no statistically significant(F=0.254, P=0.783), and diastolic blood pressure was no statistically significant(F=0.114, P=0.896), and IOP was statistically significant(F=7.527, P=0.001), and OPP was statistically significant(F=4.692, P=0.027). In 2h after HD duration and 30min after HD completion, IOP was statistically significant(t=-3.646, P=0.001), and OPP was statistically significant(t=2.321, P=0.022). In 30min before HD and 30min after HD completion, increase of IOP was statistically significant(t=-2.977, P=0.003), and OPP was no statistically significant(t=0.219, P=0.872), and decrease of CACD was statistically significant(t=6.291, P<0.05), and decrease of SFCT was statistically significant(t=5.736, P<0.05).

CONCLUSION: IOP increasing, OPP transiently decreasing, CACD shallow and SFCT thin were presented in peri-hemodialysis. It is important to evaluate eye conditions of ESDN patients before HD, and to take effective preventive measures to reduce the possible risk factors in peri-hemodialysis.