Abstract:AIM: To compare the safety between phacoemulsification and manual small incision cataract surgery(MSICS)combined with silicone oil removal in previously vitrectomized eyes.

METHODS:A retrospective comparative no-inferiority study to 162 patients(162 eyes)who undergone cataract surgery, either phacoemulsification or MSICS combined with silicone oil removal which had pars plana vitrectomy.

RESULTS:There were no statistically significant different in hypotony between phacoemulsification group(21 patients; 18.91%)and MSICS group(8 patients; 15.68%)(P=0.666). There was also no statistically significant different between two group in 1mo retinal reattachment rate; 8 patients(7.2%)in phacoemulsification group had redetachment compared with 9 patients(17.64%)in MSICS combined with silicone oil removal group(P=0.055).

CONCLUSION:MSICS combined with silicone oil removal has non-inferiority result to phacoemulsification combined with silicone oil removal in hypotony, leakage, choroidal detachment and retinal reattachment rate.

Abstract:AIM: To compare the difference in corneal endothelial cell density and morphology after phacoemulsification using Ringer lactate(RL)and balanced salt solution(BSS)irrigating solutions.

METHODS: The prospective randomized controlled trial study was conducted between February 2017 and April 2017 in Dr. YAP Eye Hospital, Yogyakarta, Indonesia. There were a total of 52 subjects(52 eyes)who were senile cataract patients further grouped into two, 26 patients undergoing the phacoemulsification procedure using RL irrigating solution and the other 26 patients with BSS irrigating solution, both conducted by one operator. On the 1, 7, and 28d post operative, an evaluation was done to measure the density and corneal endothelial cell morphology, as well as the variable of inflammation in the two groups.

RESULTS: Fifty-two eyes had undergone phacoemulsification with posterior intraocular lens implantation. Both groups were evaluated for the endothelial cell reduction and corneal endothelial cell morphology change, along with post-operative inflammation. On the 28d post-operative, endothelial cell reduction in the BSS group(173.96 cell/mm², 8.12%)was lower than the RL group(253.20 cell/mm², 10.25%), percentage of corneal endothelial cell variation coefficient increase in the BSS group(2.92%, 8.36%)was lower compared to the RL group(3.42%, 9.96%), decrease of hexagonal cells of corneal endothelium cells presentation percentage in the BSS group(4.30%, 8.17%)was lower compared to the RL group(4.84%, 8.97%), and the percentage increase of central corneal thickness in the BSS group(4.69 μm, 0.89%)was almost equal to the RL group(4.53 μm, 0.90%). All of the results regarding difference in density and corneal cell endothelium morphology between the two groups did not reveal any statistically significant difference(P>0.05). Inflammatory variable in the two groups were even.

CONCLUSION: BSS and RL were equal in their capability of maintaining endothelial cell loss and endothelial cell morphologic change in senile cataract patients after phacoemulsification.

Abstract:AIM: To evaluate the efficacy of Bi-Flex toric intraocular lens(T-IOL)(Medicontur, Medical Engineering, Ltd., Inc.)implantation to correct preexisting astigmatism in patients having cataract surgery.

METHODS: This retrospective consecutive study included 22 eyes of 16 patients with more than 2.50 diopters(D)of corneal preexisting astigmatism having cataract. Preoperative and postoperative uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), objective and subjective refraction and keratometric and topographic cylinder were measured. Postoperative the toric IOL axis was evaluated using vector analysis.

RESULTS: Postoperatively, subjective refractive cylinder was reduced significant(P<0.05)from 4.05±1.53D to 1.35±0.86D. The component J₀ reduced in magnitude from -0.81±2.02D to -0.12±0.62D(P<0.05). Both, UCVA and BCVA improved significantly at 1mo after surgery(P<0.05 in both cases). After the surgery, the UCVA and BCVA were 0.24±0.19 and 0.06±0.08, respectively. The mean toric IOL axis rotation was 2.95±5.25 degree, with rotation less than 10 degrees in 86.36% of eyes. No differences in mean keratometric values obtained before and after surgery were found(P >0.05 for J₀ and J₄₅).

CONCLUSION: Implantation of the Bi-Flex toric IOL is a safe and effective method to correct the preexisting regular astigmatism(greater than 2.50D).

Abstract:AIM: To evaluate the role of a single intravitreal injection of tissue plasminogen activator(TPA)alone for treatment of vitreomacular traction and the effect of combined intravitreal TPA and bevacizumab on retinal vascular diseases.

METHODS: In this prospective, interventional case series a total of 24 eyes from 24 patients were studied. There were 5 eyes with symptomatic vitreomacular traction syndrome(VMT)and 19 eyes with retinal vascular diseases including diabetic macular edema(DME), diabetic vitreous hemorrhage(VH), central retinal vein occlusion(CRVO)and neovascular age related macular degeneration(AMD). Measurement of visual acuity, B-scan and OCT were performed at the baseline and 1mo after injections. Three eyes with VMT received a single intravitreal injection of 50 μg and two eyes received 100 μg TPA. And 19 eyes with retinal vascular diseases received combined intravitreal TPA(50 μg)and bevacizumab(1.25 mg).

RESULTS: The mean ages for retinal vascular diseases and VMT patients were 56.8y and 60.4y, respectively. Ten patients(41.7%)were male and 14 patients(58.3%)were female. And 22 eyes(91.7%)were phakic and 2 eyes(8.3%)were pseudophakic. The incidence of posterior vitreous detachment(PVD)was 0(0 of 5)and 57.8%(11 of 19)for VMT and retinal vascular diseases, respectively(P=0.04). Improvement of best corrected visual acuity(BCVA)and decrement of central macular thickness(CMT)were significantly greater in PVD positive eyes compared with PVD negative eyes.

CONCLUSION: Intravitreal injection of TPA was not successful to induce complete PVD in VMT patients. Combined intravitreal injection of TPA and bevacizumab can induce PVD and improve BCVA and decrease central macular thickness in eyes with retinal vascular diseases.

Abstract:AIM: To explore the optimal ways for the collection and preservation of tear proteins.

METHODS: Siliconized microcapillary tube or Schirmer's strips made in China or in the USA were tested. All three carriers were loaded with equal volume and quantity of bull serum albumin(BSA), fetal bovine serum(FBS)or known concentrations of IL1-Ra, IL-6, MIG, IP-10, MMP9, TIMP1, VEGF and HBD1 mixture and kept at 4℃, -20℃ or -80℃. After a desired time of storage, the proteins were eluted with different elution buffer. Micro BCA^TM protein quantitative kit and enzyme-linked immunosorbent assay kits were used to determine total protein concentrations and the concentrations of the above biological molecules, respectively.

RESULTS: Neither protease inhibitors nor detergent were necessary for protein elution from the Schirmer's strip. When stored at -20℃ and -80℃, three tear carriers showed no differences in the recovery of total protein. The recovery of IL-6 from three carriers under different temperature was similar but the higher than other proteins. The recovery rate of IL-1Ra was 98%±6% from the microcapillary tube and 19%±15% from Schirmer's strip. The recovery rate of HBD1 was 93%±8% from the microcapillary tube and 61%±3% from Schirmer's strip. The recovery rate of MIG was 87%±4% from the microcapillary tube and 69%±4% from Schirmer's strip. Microcapillary tube also had less retention for MMP-9(90%±5%)and TIMP1(103%±7%)compared to Schirmer's strip(62%±3% vs 87%±5%). The strips made in China and in the USA showed similar retention to most of the proteins tested here. When stored at -80℃, the recovery rate for VEGF and IP-10 were 82%±5% and 72%±8%, respectively, significantly higher than that when stored at higher temperature.

CONCLUSION: The selection of tear sample carrier is dependent on target proteins to be recovered. Low temperature deep freezing is a preferred way for tear sample storage. microcapillary tube is applicable for most of the proteins. While for those protein with noticeable polarity, like HBD1, pre-experiment is needed.

Abstract:AIM: To provide the morphological evidence for the compound carbomer building high intraocular pressure model successfully.

METHODS: Totally 50 SD rats were divided into experimental group 40 rats, blank group 10 rats by random number method. The rats in experimental group were randomly divided into 3 groups after the model was successful. Experimental model of high intraocular pressure was sacrificed at 1, 2 and 3wk to observe its pathological structure change and ultrastructure change.

RESULTS: The high intraocular pressure of experimental model in 1, 2 and 3wk all showed the optic nerve and retinal damage. It was to see the optic nerve axon disappear, disorder arrangement of myelin sheath, periodic dissolve or demyelinating degeneration, glial cell proliferation. It showed the cells disordered arrangement of retina, the outer nuclear layer became thick, the inner and outer plexiform layer become thick, the kernel layer became thick, air bubbles, the numbers of ganglion cells reduced, ganglion cells and nerve fiber layer edema, microglia proliferation, vascular membrane capillaries expansion, inflammatory cells appearing. It was to see the retinal ganglion cells layer with microglia proliferation under the electron microscope, ganglion cells structure fuzzy, organelles structures disappear, cell apoptosis, mitochondrial swelling, cytoplasm vacuoles degeneration, membrane plate of outer segment fracture or dissolved. And the damage degree was proportional to the forming time of high intraocular pressure.

CONCLUSION: The morphology change of high intraocular pressure model about the retin and optic nerve proves that it is successful building the model through anterior chamber injection of compound carbomer solution.

Abstract:AIM: To determine the pharmacokinetics and distrubution of methylprednisolone sodium succinate(MPS)and its metabolic product methylprednisolone(MP)in eye tissues and blood plasma after MPS periocular injection in rabbits.

METHODS: After periocular injection of MPS 10mg, the concentrations for MP and its prodrug conmpound were quantified at different time points using mass spectrum-liquid chromatography in plasma and ocular tissues-slera, choroid and retina, vitreous, iris, aqueous humor, lens and optic nerve.

RESULTS: After periocular injection, the time of maximum concentration(T_max)for MPS in ocular tissues was 0.25 to 1h, in blood plasma was 0.25h. Tmax for its metablite MP in ocular tissues was 0.5 to 6h, in blood plasma was 0.5h. The maximum MPS and MP concentration(C_max)and the area under the curve(AUC_0-t)in ocular tissues from high to low in turn was sclera, optic nerve, the choroid and the retina, iris and lens. The drug concentration of lens was not only the lowest among all tissues, but also much lower than others by far the content, and its mean residence time was the longest.

CONCLUSION: Periocular administration of MPS is an effective way to intraocular drug transmission. It achieves a satisfactory drug distribution in sclera, optic nerve, choroid and retina. It is not easily absorbed by lens.

Abstract:AIM:To explore the corneal biomechanical properties of the elderly with different axial length(AL)and corneal curvature by corneal visualization Scheimpflug Technology(Corvis ST).

METHODS: Cross-sectional study. A total of 161 patients(297 eyes)undergoing phacoemulsification were collected in this study. They were divided into 22-24mm, 24-26mm, more than 26mm groups according to axial length(190 eyes, 54 eyes and 53 eyes, respectively). Those of whom axial length was 22-24mm and the corneal curvature was 42-44D were divided into male and female groups(44 eyes and 49 eyes, respectively). Those of whom axial length was 22-24mm were divided into 42-44D group, more than 44D group according to corneal curvature(88 eyes, 102 eyes, respectively). Corvis ST was used to measure the biomechanical parameters of the cornea. The differences in the parameters between different groups were analyzed using the independent-samples t test or one-way analysis of variance and correlation analyses were performed using Pearson correlation analysis.

RESULTS: When comparing the corneal biomechanical parameters, no statistically significant differences were found between male and female groups(P>0.05). The first applanation length and second applanation length among different corneal curvatures were statistically significant(P<0.05). There was statistical significance on the difference of the second applanation velocity, deformation amplitude, central cornea thickness, intraocular pressure in different AL groups(P<0.05). The axial length was positively correlated with deformation amplitude, intraocular pressure(r=0.429, 0.278; P<0.001), but there was negative linear correlation between the patient's axial length and central cornea thickness, the second applanation velocity(r=-0.291, -0.415; P<0.001).

CONCLUSION: The corneal curvature and ocular axial length may be the factors affecting the corneal biomechanical characteristics. The longer axial length, the thinner corneal thickness, the more easily the corneal is deformed, and with the increase of the axial length, intraocular pressure also increases.

Abstract:AIM: To investigate the difference between anterior corneal astigmatism axis and total corneal astigmatism axis, and the related factors.

METHODS: The anterior corneal astigmatism axis and total corneal astigmatism axis in 789 patients(1 141 eyes)of China Medical University Eye Hospital were detected by Petacam and recorded the corresponding age, value of astigmatism, anterior chamber depth, corneal thickness, refraction of cornea and anylized statistically.

RESULTS: We found age was positively correlated with the difference of the anterior corneal astigmatism axis and total corneal astigmatism axis(r=0.139, P<0.001). The value of astigmatism was negatively correlated with the difference of the anterior corneal astigmatism axis and total corneal astigmatism axis(r=-0.293, P<0.05). The anterior chamber depth was negatively correlated with the difference of the anterior corneal astigmatism axis and total corneal astigmatism axis(r=-0.067, P<0.05). And the corneal thickness, refraction of cornea was not significantly correlated with the difference of the anterior corneal astigmatism axis and total corneal astigmatism axis.

CONCLUSION: There is significant difference in the anterior corneal astigmatism axis and total corneal astigmatism axis, and is positively correlated with age, and is negatively correlated with value of astigmatism and the depth of anterior chamber.

Abstract:AIM: To assess the efficacy and safety of orthokeratology for reducing the progression of myopia in Asia children.

METHODS: Seven databases, including the Cochrane Library, Medline, EMbase, CBM, CNKI, VIP, and WanFang Data, were searched. The published languages were limited to English and Chinese. The risk bias tool provided by Cochrance cooperation and methodological index for non-randomized studies(MINORS)scale were used to assess the risk bias of included studies(randomized controlled trials and controlled trials). The published biases of included studies were assessed with funnel plot. Meta-analysis was performed with Review Manager 5.3.

RESULTS: Seven eligible studies, including 478 children, were included, 250 cases in ortho-k group, 228 cases in control group. The Meta-analysis indicated that change in axial length of ortho-k group was significantly less than the control group \〖WMD=-0.31, 95%CI(-0.35, -0.26), P<0.001\〗. Five studies observed adverse effects which all included the effect of positive staining of corneal fluorescein. One study reported chalazion in one child. None of the studies reported severe adverse events.

CONCLUSION: The overall findings suggested that orthokeratology might slow the progression of myopia in children of Asia.

Abstract:Cataract is the first ophthalmological blinding eye disease. In recent years, phacoemulsification has become the preferred method for the treatment of cataract due to its short time and small damage, which is widely used by ophthalmologists. With the continuous improvement of technology, serious complications caused by phacoemulsification become less and less. But the phenomenon of postoperative corneal edema is not uncommon. The incidence of corneal edema is especially high in patients with diabetic cataracts. This paper reviewes the concept of corneal edema, pathogenesis and the related factors of corneal edema after phacoemulsification in diabetic cataract patients.

Abstract:Idiopathic macular hole(IMH)refers to full thickness defect of retinal neurepithelium layer in macular area with unclear reasons. Early IMH can be observed. Vitrectomy combined with internal limiting membrane(ILM)peeling is a conventional method for treating IMH. The continuous improvement and innovation of ILM surgery contribute greatly to the diversity and maturation of IMH treatment. At present, the pharmacological vitreolysis and pneumatic vitreplysis have gradual progress in the prevention and treatment of IMH. In this article we review the current management of IMH.

Abstract:Intraocular pressure(IOP)is a pressure applied to the wall of the eye by equilibrium, which is ranging in a normal shape. Our visual function will be damaged if it brokes the normal high value. In recent years, several researchers had found the potential relationship between the IOP and our daily lifestyle. This review will show the specific relationship between them and it also will provide some important guidelines to the patients with high IOP in some degree.

Abstract:Immune associated ophthalmopathy ranks as one of the major causes of visual handicap in adults, including ocular tumor, uveitis, corneal transplantation rejection, thyroid associated ophthalmopathy, and so on.These conditions are difficult to therapy, bad prognosis, and are an urgent ophthalmic clinical problems to be solved. Immunotherapies have been playing an important role in the comprehensive therapy for immune associated ophthalmopathy. This article reviewed on this study.

Abstract:Blunt ocular can cause persistent change of eye structure and function, the method of detection which is closely related to eye injury including B-can ultrasonography, UBM, OCT, FFA, scanning laser polarimetry, fundus autofluorescence, each examination with particular emphasis. This paper aims to review the advantages and disadvantages of different inspection methods in order to provide reference for clinical diagnosis and treatment of blunt ocular trauma.

Abstract:Therapeutic contact lenses, a great invention on optometry, have been widely used on clinical therapy of ocular surface diseases due to its specialty on material and structure. As a result, relevant researches and development should be focused on the optimization of its material making it more adaptable for clinical therapy. In this review, we discuss the progress in developing material of therapeutic contact lenses and mainly illustrate its mechanism and clinical application together with its complications and potential improvements.

Abstract:In modern society, the most popular surgery for correction of myopia and myopic astigmatism are small incision lenticule extraction(SMILE)and femtosecond assisted laser in situ keratomileusis(FS-LASIK). FS-LASIK is widely accepted by myopic patients and corneal refractive surgeons for its excellent safety, efficacy, stability and predictability. With the use of femtosecond laser, SMILE makes the corneal refractive surgery enter a full femtosecond era and become one of the most popular refractive surgery in the world, which is a novel minimally invasive corneal refractive surgery and characterized by flap-free, minimally invasive, small incision, femtosecond. But there is still some controversy about visual acuity, stability of diopter, corneal high order aberration, contrast sensitivity, dry eye, corneal biomechanical property and complication after SMILE and FS-LASIK in correction of myopia. This article reviews the advantages and disadvantages after SMILE and FS-LASIK in correction of myopia and myopic astigmatism among all above mentioned aspects.

Abstract:AIM: To investigate the visual recovery and complications in patients with traumatic cataract treated by intraocular lens Ⅰ phase implantation and Ⅱ phase implantation.

METHODS: Totally 86 patients with traumatic cataract(86 eyes)treated in our hospital from January 2014 to December 2016 were enrolled in the retrospective study, and they were divided into the control group(treated by intraocular lens Ⅰ phase implantation, 46 eyes)and the observation group(treated by intraocular lens Ⅱ phase implantation, 40 eyes). The general situation of surgery, the visual recovery at 6mo after operation and the incidence rate of complications in two groups were observed.

RESULTS:There were no significant differences in surgical time, intraoperative blood loss and hospitalization time between the two groups(P>0.05). There was no significant difference in the excellent and good rate of visual acuity between the two groups before operation between the twogroups(P>0.05). At 6mo after operation, the excellent and good rates of visual acuity in two groups obviously increased(P<0.05), while there was no significant difference in the excellent and good rates of visual acuity at 6mo after operation between the two groups(P>0.05). There was no significant difference between the two groups in the incidence rates of posterior capsule rupture and vitreous body prolapse(P>0.05). The incidence rates of corneal edema, iridocyclitis and posterior capsular opacification in the observation group after operation were significantly lower than those in control group(P<0.05).

CONCLUSION:The effects of IOL Ⅰ phase implantation and Ⅱ phase implantation are similar in patients with traumatic cataract, in terms of the general situation and improvement of visual recovery. However, the incidence of complications after Ⅱ phase implantation is relatively lower.

Abstract:AIM: To investigate the incidence and related factors on effusion of anterior chamber(AC)after phacoemulsification(PE)combined with intraocular lens(IOL)implantation.

METHODS: Totally 359 cases of cataract(375 eyes)underwent PE combined with IOL implantation were collected in our hospital. The incidence of AC exudation after operation and related factors were analyzed by single factor and multiple logistic regression analysis.

RESULTS: The group was included in 359 cases(375 eyes). The incidence of postoperative AC exudation in the study group was 5.9%(22/375). The preoperative intraocular pressure(IOP), visual acuity before and after surgery, nuclear grades, posterior capsular rupture(PCR)rate and ultrasonic accumulated energy complex parameter(AECP)of the study group showed statistically significant difference compared with the control group(all P<0.05). The results of univariate factor analysis showed that high myopia, glaucoma, uveitis, preoperative visual acuity <1, the incidence of intraoperative PCR, preoperative IOP>21mmHg, intraoperative pupil diameter <3mm, ultrasonic AECP >7.25(%×min), the lens nucleus grade ≥ IV were risk factors of AC exudation after PE combined with IOL implantation in patients with cataract(all P<0.05). The multivariate logistic regression analysis showed that high myopia, glaucoma, uveitis, the lens nucleus grade ≥ IV, the incidence of intraoperative PCR, preoperative IOP >21mmHg, ultrasound AECP >7.25 were independent risk factors of AC exudation after PE combined with IOL implantation in patients with cataract(all P<0.05).

CONCLUSION: High myopia, glaucoma, uveitis, the lens nucleus grade ≥ IV, the incidence of intraoperative PCR, preoperative IOP>21mmHg, ultrasonic AECP>7.25 are independent risk factors of AC exudation after PE combined with IOL implantation in patients with cataract, with such risk factors in patients with cataract should be paid closely attention and timely diagnosis and treatment in clinic.

Abstract:AIM: To observe the clinical efficacy of different treatment modalities and the influence on the levels of pigment epithelium-derived factor(PEDF)and vascular endothelial growth factor(VEGF)in patients with neovascular glaucoma(NVG)in high altitude area.

METHODS: Ninety cases of patients(90 eyes)with NVG treated in our hospital were selected as the study objects, and they were divided into Group A and Group B according to different surgery methods, 45 cases in each groups. Group A was given Ex-press glaucoma drainage device implantation, and Group B was given trabeculectomy combined with cyclocryotherapy. We observed the clinical efficacy, intraocular pressure and visual acuity in the two groups, detected the PEDF and VEGF levels in the aqueous humor, and recorded the postoperative complications.

RESULTS: The total effective rate of Group A was 91%, significantly higher than that of Group B 76%(P<0.05). At 2wk, 2 and 4mo after surgery, IOP levels were significantly lower than that before surgery(P<0.05), and those in Group A were significantly lower than those in Group B(P<0.05). There was no significantly difference in IOP levels at 6mo after surgery between the two groups(P>0.05). At 1wk after operation, the incidence of visual reduction in Group A was 7%, significantly lower than that in Group B 22%(P<0.05). At 1wk after operation, PEDF levels were significantly higher than those before operation in the two groups(P<0.05), and that in Group A was significantly higher than that in Group B(P<0.05); VEGF levels were significantly lower than that before operation in the two groups(P<0.05), and that in Group A was significantly lower than that in Group B(P<0.05). The incidence rate of complications in Group A was 4%, significantly lower than that of 18% in Group B at 6mo postoperatively(P<0.05).

CONCLUSION: Ex-press glaucoma drainage device implantation, trabeculectomy combined with cyclocryotherapy can both be used to treat patients with NVG in high altitude area. But the former can effectively maintain visual acuity, and improve PEDF and VEGF levels in aqueous humor, with fewer complications and more accurate curative effect.

Abstract:AIM:To investigate the effect of scleral slap invagination and trabeculectomy combined with amniotic membrane implantation in the treatment of glaucoma.

METHODS: From May 2013 to June 2017, 98 cases(116 eyes)with glaucoma were treated in our hospital. According to the random number table method, the patients were divided into two groups: the observation group of 45 cases(58 eyes)with scleral slap invagination surgery combined with amniotic membrane transplantation into operation, the control group of 53 cases(58 eyes)with trabeculectomy combined with amniotic membrane implantation. Postoperatively patients were followed up for 3mo to observe IOP control; using MEN-C90 type blood rheology analyzer to detect the whole blood viscosity, plasma viscosity, hematocrit and blood viscosity changes, using the Doppler flow imaging(CDFI)technique for the detection of ophthalmic artery end diastolic velocity(EDV), RI, and the peak systolic velocity(PSV)and other hemodynamic parameters change.

RESULTS: One week and 3mo after the surgery, mean IOP of the observation group was 12.18±0.98mmHg,12.23±0.94mmHg, the control group was 14.49±1.64mmHg, 14.62±1.59mmHg, the difference was statistically significant(P<0.05); IOP successful-control rate of observation group after operation was 81.0%, more than that of the control group(61.3%), the difference was statistically significant(P<0.05). At 1wk and 3mo after operation high blood viscosity, plasma viscosity, hematocrit and blood viscosity of two groups decreased significantly compared with the preoperative(P<0.05); those of the observation group were better than those of the control group(P<0.05). At 1wk and 3mo after operation, EDV and PSV of the two groups increased significantly, RI decreased significantly, compared with the preoperative differences were statistically significant(P<0.05), those of the observation group were better than those of the control group(P<0.05).

CONCLUSION: The combination of scleral slap invagination and amniotic membrane implantation has a significant effect on glaucoma patients, the effect of intraocular pressure control is good, the postoperative complications are low, and the safety of the patients is high.

Abstract:AIM: To investigate the clinical efficacy of intravitreal injection of Ranibizumab combined with pars plana vitrectomy(PPV)in patients with proliferative diabetic retinopathy(PDR)complicated with early neovascular glaucoma.

METHODS: Totally 80 patients(80 eyes)of PDR patients with early neovascular glaucoma were selected in the patients went to Ophthalmic Center from July 2014 to December 2016. According to whether the injection of ranibizumab taken, they were divided as pretreatment group(40 patients 40 eyes, preoperative ranibizumab injection combined with PPV treatment), conventional group(40 patients 40 eyes, only taken PPV surgery). The changes of visual acuity, intraocular pressure and other indicators were compared between the two groups.

RESULTS: The operation time, neovascular bleeding times, coagulation times of pretreatment groups were significantly lower than those of the conventional group, the differences were statistically significant(P<0.05). The differences of preoperative intraocular pressure, BCVA between the two groups were not statistically significant(P>0.05). At 1wk, 3mo after the surgery, the BCVA of pretreatment group was better than that of conventional group(P<0.05). At 1wk after the operation, the IOP of pretreatment group were lower than that of conventional group(P<0.05). The preoperative VEGF in aqueous humor of the two groups was not significantly different(P>0.05). At 1mo after operation, VEGF in aqueous humor of the pretreatment group was significantly lower than conventional group(P<0.05). At 3mo after operation, the fovea retinal thickness of pretreatment group was lower than that of the conventional group(P<0.05).

CONCLUSION: Ranibizumab combined with PPV can significantly reduce the difficulty of operation in PDR patients with early neovascular glaucoma, improve the postoperative visual acuity, and reduce the level of VEGF in aqueous humor.

Abstract:AIM: To explore the effect of preoperative bevacizumab assisted 23G vitrectomy combined with endolaser photocoagulation in the treatment of severe proliferative diabetic retinopathy.

METHODS: A retrospective analysis of 90 cases with severe proliferative diabetic retinopathy in our hospital from January 2014 to June 2015, which were all monocular lesion, and all patients received 23G vitrectomy combined with endolaser photocoagulation, 40 cases without preoperative injection of bevacizumab were set as the control group, 50 cases with preoperative injection of bevacizumab were set as the study group. All patients were followed up for 6 to 12mo, the operative time, postoperative intraocular pressure, visual acuity, the change of macular thickness were compared between the two groups, and we observed postoperative complications.

RESULTS: There were significant differences in overall BCVA between the two groups(P<0.01). However, there was no significant difference in BCVA between the two groups after operation(P>0.05).There was no significant difference on postoperative IOP in both groups(P> 0.05). There was significant difference between the two groups on macular thickness(P<0.05). The thickness of the macula significantly decreased in both groups at 1d after operation, and the thickness of the macula was stable at 3mo after operation. There was no significant difference between the two groups(P> 0.05). The operation time of the study group was shorter than that of the control group, with significant difference between the two groups(P<0.05). And the incidence of iatrogenic retinal tears and retinal detachment in study group were significantly lower than those in control group(P<0.05).

CONCLUSION: Compared with single vitrectomy, preoperative bevacizumab assisted 23G vitrectomy combined with endolaser photocoagulation in the treatment of severe proliferative diabetic retinopathy has certain effect and short operation time, and can reduce intraoperative and postoperative complications.

Abstract:AIM: To investigate the prevalence and awareness of diabetic retinopathy(DR)among patients with diabetes mellitus in the Huamu Community of Shanghai.

METHODS: A total of 545 diabetic patients in the community's chronic disease file were enrolled in the Ophthalmologic Examination and DR Prevention Questionnaire. To know the prevalence rate of DR and to use chi-square test to check analysis the difference of prevalence rate. The descriptive statistical analysis of DR prevention and treatment knowledge was carried out in diabetes.

RESULTS: The prevalence of DR was 23.5%. And the prevalence of non-proliferative retinopathy and proliferative retinopathy was 20.9% and 2.6%. The patients with diabetes in the Huamu Community lacked sufficient awareness of DR prevention and treatment methods.

CONCLUSION: Using the chronic disease file for eye tests in diabetes can help prevent DR from beginning in the community. Awareness of DR in diabetic patients also needs to be improved.

Abstract:AIM:To investigate the clinical effect of compound Xueshuantong capsule combined with calcium dobesilate in the treatment for patients with early diabetic retinopathy(DR).

METHODS: According to the random table method, 54 cases of DR patients(68 eyes)in the ophthalmological clinic of our hospital from February 2015 to November 2016 were divided into control group and research group with 27 cases(34 eyes)in each group. Patients in the control group were treated with calcium dobesilate tablets, while patients in the research group were treated with compound xueshuantong capsule based on the control group. The duration of treatment was 5mo in both groups. The total clinical efficiency of the two groups was calculated, and the visual, blood glucose and inflammatory factors of the two groups were detected before and after treatment, in addition the adverse reaction and recurrence rate were observed.

RESULTS: The total clinical efficiency of the patients in the research group was 91%(31/34), which was significantly higher than 68%(23/34)of the control group(P<0.05). Compared with before treatment, the vision, the volume of hemangioma, macular thickness, plaque area, grey value view, blood glucose and inflammatory factor levels of two groups of patients after treatment dropped significantly, meanwhile the vision, blood sugar and inflammation index levels of research group were better than control group, and the differences were statistically significant(P<0.05). No adverse reactions occurred during the treatment of the two groups. The recurrence rate of research group was 3%(1/31), which was significantly lower than that of the control group as 26%(6/23)(P=0.039).

CONCLUSION: The curative effect of compound xueshuantong capsule combined with calcium dobesilate in the treatment of patients with early DR is significant. It can significantly improve eyesight, blood glucose and inflammatory response and has a good forward curative effect.

Abstract:AIM: To investigate the relationship between serum levels of oxidation and inflammatory factors in type 2 diabetic patients with retinopathy and its clinical significance.

METHODS: Totally 54 cases of patients with diabetic retinopathy was selected as subjects, including 31 patients with diabetes and non-proliferative retinopathy(NPDR group)and 23 patients with diabetes and proliferative retinopathy(PDR group). Another 30 cases of diabetes patients without DR(DM group)and 30 normal people(NC group)was selected as control. The level of fasting blood glucose(FPG), 2h postprandial blood glucose(2hPG), glycosylated hemoglobin(HbA1c), serum malondialdehyde(MDA)and heme oxygenase -1(HO-1), tumor necrosis factor α(TNF-α)and interleukin-6(IL-6)and C reactive protein(CRP)was detected, and variance test detect the difference between 4 groups, and SNK-Q was used to multiple comparison. Pearson correlation analysis was used to compare the correlation between oxidation markers(MDA and Ho-1)and the level of inflammatory factors(TNF-α, IL-6 and CRP). COX multivariate analysis was used to investigate the risk and protective factors of diabetic retinopathy.

RESULTS: The levels of FPG, 2hPG, HbA1c, MDA, TNF-α, IL-6 and CRP in DM group, PDR group and NPDR group were significantly higher than that in NC group(P<0.05), and HO-1 was lower than that in NC group(P<0.05). The levels of MDA, TNF-α, IL-6 and CRP in PDR group and NPDR group were significantly higher than that in DM group(P<0.05), and HO-1 was significantly lower than that of DM group(P<0.05). MDA and TNF-α in PDR group were significantly higher than that in NPDR group(P<0.05), and HO-1 was lower than that in NPDR group(P<0.05). The level of MDA was positively correlated with the level of TNF-α and CRP(P<0.05), and the level of HO-1 was negative correlated with the level of IL-6, TNF-α and CRP(P<0.05). COX multivariate analysis showed that both MDA and TNF-α were risk factors of retinopathy, and HO-1 was the protective factor of retinopathy.

CONCLUSION: Oxidative stress is closely related to the expression of inflammatory factors in serum of patients with diabetes mellitus, and is an important risk factor of DR, and related indicators can be used as markers for DR diagnosis.

Abstract:AIM:To investigate the dry eye prevalence, tear film function and corneal status in patients with thyroid associated ophthalmopathy(TAO).

METHODS: Totally 218 patients(436 eyes)with TAO admitted to our hospital from September 2014 to August 2016 were selected and divided into two groups according to TAO's clinical activity score(CAS): score≥ 4 divided into active patients, 72 cases of 144 eyes; score <4 points were inactive patients, a total of 146 cases of 292 eyes; according to the patient's course of the situation was divided into three groups, less than 1a for the short course of disease, a total of 133 cases of 266 eyes; course of disease in the 1-2a in the medium course group, there were 40 eyes of 80 eyes and 45 eyes of 90 eyes in more than 2a, as long course group. Contrast patients were examined by corneal fluorescein staining(FL), tear film break-up time(BUT)and tear secretion test(SⅠt)Happening.

RESULTS: In 218 patients, 138 cases of 276 eyes were diagnosed as dry eye. The prevalence rate of active period patients was higher than that of inactive patients, and the difference was statistically significant(P<0.05). The prevalence rate in the short course group was higher than that of the middle course group and the long course group, and the difference was statistically significant compared with that in long course group(P<0.05). There was no significant difference between any two of the three groups in BUT and SⅠt detection(P>0.05), and the differences was statistically significant in the detection of FL(P<0.05). The differences of FL, BUT and SⅠt between the inactive patients and the active patients were statistically significant(P<0.05).

CONCLUSION: Most patients with TAO have inadequate tear secretion and tear film instability. The corneal epithelium of 1/3 TAO patients is damaged and the incidence of dry eye disease is significantly higher than that of normal subjects.

Abstract:AIM:To investigate the effect of neuropathic factor(NGF)on visual acuity and visual evoked potential(VEP)in patients with optic nerve contusion.

METHODS:Totally 78 patients(78 eyes)with optic nerve contusion were selected. From January 2013 to June 2016, 39 cases(39 eyes)were divided into observation group and control group respectively according to the random number table method. Prednisone, vitamins and mecobalamin tablets treatment were given to both groups, based on that, the observation group was given NGF treatment, continuous treatment of 2 courses(21d for a course of treatment).

RESULTS: There was no significant difference in visual field defect and visual field sensitivity between the observation group and the control group before treatment(P>0.05). After treatment, the visual field defect degree of the observation group was smaller, the visual field sensitivity was better than that of the control group(P<0.05). There was no significant difference in P100 wave latency and P100 wave amplitude between the observation group and the control group before treatment(P>0.05). After treatment, the P100 wave latency of the observation group was significantly shorter than that of the control group(P<0.05). The amplitude of P100 wave in the observation group was higher than that in the control group(P<0.05). After treatment, the visual acuity and visual field sensitivity of the observation group was significantly better than that of the control group(P<0.05).

CONCLUSION: NGF treatment for optic nerve contusion can significantly improve the patient's visual acuity, VEP indicators, reduce visual field defects, improve visual field sensitivity.

Abstract:AIM:To observe the influence of wearing nocturnal orthokeratology lens on sleep quality in myopic patients.

METHODS:Totally 30 myopic patients(58 eyes)wearing nocturnal orthokeratology lens, who received medical treatment at the Department of Ophthalmology of Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, were included in study(treated group). And 30 myopic patients wearing spectacles at the same time were randomly selected as the control group. Sleep quality of two groups were assessed with Pittsburgh sleep quality index(PSQI)before and after wearing the lens in the first and the third months, and compared.

RESULTS: Equivalent diopter of the 30 patients wearing nocturnal orthokeratology lens was -2.78D±0.90D before treated with orthokeratology lens, -0.30D±0.31D after 1mo of treatment, and -0.28D±0.30D after 3mo of treatment. There was significant difference between the equivalent diopter got before treated with orthokeratology lens and that got after 1mo of treatment(P<0.05), and between the equivalent diopter got before treated with orthokeratology lens and that got after 3mo of treatment(P<0.05). The total scores of PSQI of 30 myopic patients got before wearing nocturnal orthokeratology lens and after 1 or 3mo of that were respectively 2.13±1.36, 2.47±1.98, and 1.74±1.39. There only was significant difference in scores of subjective sleep quality got after 3mo of treatment between treated group and control group(P<0.05), but no significant difference in scores of total PSQI, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction(P>0.05).

CONCLUSION: Wearing nocturnal orthokeratology lens has no significant effect on the overall sleep quality index of myopic patients, but the subjective sleep quality decreased in the early stage of wearing the lens.

Abstract:AIM:To investigate the clinical effect of excimer laser in situ keratomileusis(LASIK)for high myopia and its effects on central corneal thickness(CCT), corneal endothelial cell density, and contrast sensitivity.

METHODS: Totally 120 cases(240 eyes)in Ophthalmic Center in our hospital with high myopia were retrospectively analyzed from November 2014 to July 2016. According to the operation method, those cases were divided into LASIK group(60 cases 120 eyes), laser assisted sub-epithelial keratectomy(LASEK)group(60 cases 120 eyes), and treatment effect between the two groups was compared.

RESULTS: After surgery, at 1, 3, 6 and 12mo, visual acuity, refraction spherical equivalent value between the two groups were not significantly different at each time point(P>0.05); spherical equivalent refractive power were significantly improved compared with preoperative values in the two groups(P<0.05); at 1a after surgery, the CCT, corneal endothelial cell density of the LASIK group were greater than those of the LASEK group, the difference was statistically significant(P<0.05). Before surgery, contrast sensitivity with 3c/d, 6c/d, 12c/d, 18c/d spatial frequency was not statistically significant between the two groups(P>0.05); at 1a after the operation, contrast sensitivity of LASIK group with 6c/d, 12c/d spatial frequency was significantly lower than that of the LASEK group, the difference was statistically significant(P<0.05).

CONCLUSION: The clinical effect of LASIK on high myopia is certain, and it has little effect on CCT and corneal endothelial cell density, but it has obvious influence on the contrast sensitivity.

Abstract:AIM: To observe the long-term effect of visual perceptual learning to correct anisometropic amblyopia in children.

METHODS: The clinical data of 200 children(200 eyes)with anisometropic amblyopia were retrospectively analyzed, which were divided into 2 groups according to therapeutic methods, and 82 children treated with traditional integrative therapy were distributed to the control group, while 118 children treated with visual perceptual learning were distributed to the observation group. After 1 year's treatment, the corrected vision, contrast sensitivity and stereo sharpness of patients were compared between groups.

RESULTS: After 1 year's treatment, the effective rate of the observation group was higher than the controls(90.7% vs 75.6%, P<0.05), and after 1 year's follow up, there was 92.5% patients maintained stabilization in the observation group, while that in the control group was 80.6%, and the observation group was higher than the controls too, the difference between groups had statistical significance(P<0.05). Before treatment, there was no significant difference in contrast sensitivity between groups(P>0.05). After 6 and 12 months' treatment, the contrast sensitivity of both groups increased(P<0.05), and the observation group was higher than the controls after 12 months' treatment, the difference between groups had statistical significance(P<0.05). Before treatment, there was no significant difference in stereopsis acuity between groups(P>0.05). After treatment, the stereopsis acuity of the observation group was better than the controls, and the difference between groups had statistical significance(P<0.05).

CONCLUSION: The long-term curative effect of visual perception learning to correct children's refractive aberration is better than traditional comprehensive therapy.

Abstract:AIM: To analysis of cataract prevalence and operation status in people aged 65 years old in the eastern Fengxian of Shanghai.

METHODS: In the period of January to December 2015, random stratified sampling in the whole group was taken in 3 050 people over 65 years, in Situan and Fengcheng, two towns at the Eastern District of Fengxian Town. Ophthalmologic examination and questionnaire survey were given to those people, including slit lamp microscopy and visual acuity(LogMAR)and the conditions on cataract surgery.

RESULTS: Totally 1244 cases of cataract were found in 3050 subjects, the prevalence rate was 40.79%. The prevalence rates in the subjects of different ages were different, as the age increases, the prevalence rate was rising. The difference of prevalence rate in different age groups was statistically significant(χ²=558.6, P<0.001); the prevalence rate of male and female were 31.06% and 49.94%, the difference was statistically significant(χ²=112.4, P<0.001); the rate of illiterate and literate was 52.04% and 38.76% respectively with significantly difference(χ²=28.78, P<0.001). Cataract surgery was taken in 765 cases, surgical coverage rate was 61.25%; difference on age, gender was not statistically significant; the degree of education: the rate in literate was significantly far higher than in the illiterate, the difference was statistically significant(χ²=39.72, P<0.001). Postoperative corrected visual acuity ≥0.3 was considered as removing from disable and postoperative corrected visual acuity ≥0.05 as removing from the blind. The rate removing from disable was 71.50%, the rate removing from the blind was 95.29%. In 765 eyes receiving surgery, postoperative complications occurred in 29 eyes, 3.79% of the total eye receiving surgery.

CONCLUSION: Cataract is the common blind causing disease in the elderly, and the prevalence rate of cataract in eastern Fengxian of Shanghai is high. Although in recent years, the Restoring Vision Project has been developed, the surgical coverage has been improved, and the prevention and control of cataract is still the primary task of blind prevention.

Abstract:AIM: To compare fungal culture and in vivo confocal microscopy(IVCM)in the diagnosis of non-primary fungal keratitis.

METHODS: The clinical data of 31 cases(31 eyes)with non-primary fungaI keratitis from September 2016 to February 2017 in our HospitaI were retrospectiveIy reviewed. The positive rate of the two methods was compared by chi-square test.

RESULTS: The positive rate by fungal culture was 58%(18/31)and IVCM was 19%(6/31); the positive rate comparison difference was statistically significant between fungal culture and IVCM(χ²=7.56,P<0.01). In the 13 eyes with positive culture results, 2 eyes were positive by IVCM; in the 25 positive IVCM eyes, 14 eyes were positive in culture.

CONCLUSION: The positive rate of fungal culture in non-primary fungal keratitis is higher than that of IVCM. Fungal culture is an essential auxiliary examination in the diagnosis of non-primary fungal keratitis. With the characteristics of fast, noninvasive and repeatable, IVCM also plays an important role in the diagnosis of non-primary fungal keratitis. The combination of the two methods can improve the positive rate of diagnosis.

Abstract:AIM: To explore the risk factors for endophthalmitis in age-related cataract patients undergoing phacoemulsification, in order to provide reasonable intervention countermeasures to reduce the incidence of eddophthalmitis after phacoemulsification, increase the surgery efficacy.

METHODS: The 4 500 cases(6 180 eyes)of age-related cataract patients with phacoemulsification in our hospital were analyzed, and cases of endopathalmitis needed to have vitreous puncture to collect the sample for analysis, the infectious bacteria, funfal distribution and the operation time, patients age, complications, surgical incision were analyzed for the risk factors of endophthalmitis in senile cataract patients. Data were statistically analyzed by SPSS 18.0.

RESULTS: In our study, among the 4500 cases(6180 eyes)with phacoemulsification, the endophthalmitis infection rate was 0.19%(12/6180), the incidence of endophthalmitis was significantly higher in patients with age ≥75 years, with diabetes, hypertension, coronary heart disease history, and the temporal transparent corneal tunnel incision surgery(P<0.05). The vitreous overflow and the posterior capsule broken in the operative process of the endophthalmitis infection were 60.00%(9/15)and 66.67%(8/12), more higher than patients with no symptoms obviously(P<0.01).

CONCLUSION: For the cataract patients over 75 years old or with diabetes, interventions should be done well before surgery. Surgical incision should be selected in the surgical procedure and avoid complications such as vitreous overflow and posterior capsular rupture in order to reduce the incidence of intraocular infection and improve the postoperative recovery.

Abstract:AIM:To investigate the change regulation of macular thickness and volume on 1d preoperatively and 1d postoperatively in diabetic cataract patients affected by cataract surgery using stratus optical coherence tomography(OCT).

METHODS: Totally 50 patients with type 2 diabetes mellitus(non proliferative retinopathy)requiring phacoemulsification and intraocular lens implantation were enrolled. This study was designed as self-controlled of 1d preoperatively and 1d postoperatively eyes. OCT was used to examine the macular thickness, volume, and total macular volume.

RESULTS: No abnormal retinal morphology of macular region was found in any of the patients by OCT. Maldistribution was observed in the thickness and volume of the macular inner ring A, central B and outer ring C. The volume presented a basin distribution from the interior to the exterior. At 1d after surgery, of the nine compartment of the macular region, the macular mean B2, C2, C3 and C4 was thicker than that 1d before surgery. And the difference was statistically significant(P<0.05). There was no significant difference in the mean retinal thickness of macular within 1mm(A)at 1d before and after surgery(P>0.05). Moreover, at 1d after operation, the average volume of macula in A, B4, C1, C2 and C4 increased significantly compared with that at 1d before operation(P<0.05), whereas there were no obvious changes in total volume after operation than before(P>0.05).

CONCLUSION: Diabetic cataract surgery affects the macular thickness and volume.

Abstract:AIM: To discuss the clinical effect of 23-gauge pas plana vitrectomy(PPV)for delay-onset endophthalmitis following cataract surgery.

METHODS: This retrospective chart review study included patients with delay-onset endophthalmitis that was present 6wk or more after cataract surgery, who underwent 23-gauge PPV from January 2010 to January 2016 at Renmin Hospital of Wuhan University. The diagnosis was made according to clinical symptoms and signs. The postoperative follow-up results were recorded, including anterior segment examinations, fundus examinations, and best-corrected visual acuity.

RESULTS: Totally 15 patients(15 eyes)were included. The average time between cataract surgery and their eye symptoms of endophthalmitis was 5.13±2.41mo. The culture isolates revealed that 9 eyes(60%)were cultured positive, anaerobes in 4 eyes(44%), fungal infections in 3 eyes(33%), aerobes in 2 eyes(22%). The mean follow-up period was 12mo. The final visual outcomes were as follows: 11 eyes(73%)achieved a better vision with PPV; 3 eyes(20%)achieved a better vision with PPV, total capsulectomy(TC)and IOL removal; 1 eye(7%)with PPV, silicone oil tamponade, total capsulectomy(TC)and IOL removal was enucleated because of uncontrolled inflammation.

CONCLUSION: The 23-gauge PPV is safe and effective for the management of delay-onset endophthalmitis following cataract surgery. Recurrence rate might be decreased with total capsulectomy and IOL removal.

Abstract:AIM: To evaluate the clinical effects of secondary suspensory foldable intraocular lens(IOL)implanted in aphakia eyes after vitrectomy.

METHODS: The clinical data were retrospectively analyzed in 25 eyes of 25 patients treated with secondary suspensory intraocular lens implantation after vitrectomy. The surgery was performed through a incision 2.4mm away from corneal edge, followed by solarometer positioning 8:00 and 2:00, and foldable intraocular lens was loaded and implanted by an injector, after that suspension line knot of lens was made, which length was equal to the distance between the loops of intraocular lens. The intraocular lens was fixed to sclera by a "W" shaped suspension suture. The patients were followed up for 3～26mo postoperatively, and visual acuity, intraocular pressure, cornea, anterior chamber reaction, intraocular lens position, fundus were observed.

RESULTS: All patients received preoperatively best corrected visual acuity at 1wk after surgery, and the refractive condition was within±1.5 DC. The intraocular pressure was all normal. The number of corneal endothelial cells(n/mm²)was 2394.33±201.31 before surgery, and was 2283.30±217.82 at 3mo(P>0.05). The percentage of corneal hexagonal endothelials was52.67%±6.28% preoperatively, and came to 51.81%±6.41% at 3mo(P>0.05). The central corneal thickness(mm)was 541.10±40.31 at the beginning, and was 543.10±41.77 at 3mo(P>0.05). Small amount of bleeding under choroid occurred in one eye, and intraocular lens dropped into vitreous body in another. Dislocation or shifting of intraocular lens, corneal decompensation or retinal detachment was not observed.

CONCLUSION: The clinical effect of secondary suspensory foldable intraocular lens implanted in aphakia eyes after vitrectomy was satisfactory. Minimal invasive surgery through small incision and accurate implantation are applied to increase safety while reducing complications, thus improve the effects of surgery.

Abstract:AIM: To investigate the risk factors of primary angle-closure glaucoma(PACG)by questionnaires.

METHODS: By 1:2 matched case-control study, we selected 30 primary angle-closure glaucoma in Department of Ophthalmology, Affiliated Hospital of Xiangnan University from January 2015 to January 2017 and other 60 cases, the latter were no common pathogenic factors of glaucoma.

RESULTS: Using SPSS 17.0 software for statistical analysis, single factor logistic regression analysis showed that living in rural areas, the low cultural level, high blood pressure, long time use the eye, hyperopia and asthenopia, disharmony of family relationship, family members with glaucoma were eight variables associated with the onset of PACG. Multifactor conditional logistic regression analysis showed five variables associated with the onset of PACG(P<0.05), including the place of residence, long time use the eye, hyperopia and asthenopia, family relationship.

CONCLUSION: PACG is affected by various pathogenic factors, and it is helpful to analyze risk factors to reduce the incidence of PACG.

Abstract:AIM: To investigate the efficacy of anti-vascular endothelial growth factor(VEGF)drugs in the treatment of choroidal neovascularization(CNV)and its effects on intraocular pressure, best corrected visual acuity(BCVA)and multifocal electroretinogram(mfERG).

METHODS:Totally 44 cases(44 eyes)of idiopathic CNV patients treated in our hospital from February 2015 to January 2017 were selected. All patients were treated with intravitreal injection of anti-VEGF. BCVA, intraocular pressure, mfERG and central retinal thickness(CRT)were observed after treatment.

RESULTS: At 1 and 3mo after treatment, BCVA and CRT were significantly improved than those before treatment(P<0.05). At 3mo after treatment BCVA and CRT were 0.60±0.15 and 278.43±40.10μm, both significantly lower than that in 1mo after treatment(P<0.05). There was no significant change in intraocular pressure at 1 or 3mo after treatment than before treatment(P>0.05). At 1 and 3mo after treatment, amplitudes of Ring1, Ring2 and Ring4 NI-P1 were higher than those before treatment(P<0.05); at 3mo after treatment, the amplitude of Ring3 NI-P1 were higher than those before and 1mo after treatment(P<0.05); at 1mo after treatment, the amplitude of Ring5 NI-P1 were higher than those before and 3mo after treatment(P<0.05). The amplitude of Ring6 NI-P1 did not change significantly at 1 and 3mo after treatment, compared with before treatment(P>0.05).

CONCLUSION: Anti-VEGF drugs are effective in the treatment of idiopathic CNV, which can improve vision and macular retinal function, decrease the retinal thickness, and do not affect the intraocular pressure.

Abstract:AIM: To observe the effect of 25G-assisted scleral buckling under direct vision in the treatment of retinal detachment in silicone oil-filled eyes.

METHODS: In the retrospective case study, 15 eyes of 15 patients who had retinal detachment after silicone oil filling were treated with 25G-assisted scleral buckling under direct vision. Experimental patients were followed up for 3-6mo to observe the retinal reattachment, visual acuity and intraocular pressure.

RESULTS: There were 15 eyes of 15 patients with inferior retinal detachment before operation. Retinal reattachment was achieved in 13 eyes(13 patients), and retina failed to be reattached in 2 eyes(2 patients)after operation. Furthermore, postoperative visual acuity was found to be improved more than one line in 11 eyes(11 patient), unchanged in 3 eyes(3 patients), and decreased more than one line in 1 eye(1 patient). Meanwhile, early postoperative intraocular pressure increased in some patients and returned to normal after drug control.

CONCLUSION: The 25G-assisted scleral buckling under direct vision has a definite curative effect in the treatment of retinal detachment in silicone oil-filled eyes.

Abstract:AIM: To investigate the value of ultrasonography in diabetic retinopathy(DR).

METHODS: Totally 103 cases(103 eyes)of type 2 diabetes mellitus were selected from May 2015 to May 2017 in our hospital, there were 32 patients 32 eyes with non diabetic retinopathy(NDR), 40 patients 40 eyes with non proliferative diabetic retinopathy(NPDR), and 31 patients 31 eyes with proliferative diabetic retinopathy(PDR), 40 healthy volunteers(40 eyes)were selected as control group, the maximum systolic blood flow velocity(PSV), end diastolic velocity(EDV)and resistance index(RI)of the central retinal artery(CRA), posterior ciliary artery(PCA)and ophthalmic artery(OA)were detected by color Doppler ultrasound.

RESULTS: The difference of PSV, EDV and RI of CRA, PCA and OA in each group was statistically significant(P<0.05). The PSV of CRA, PCA and OA in NDR group were 12.38±2.10cm/s, 13.36±2.55cm/s and 32.04±6.07cm/s, significantly higher than that of NPDR group(9.70±1.67cm/s, 12.20±2.01cm/s and 27.40±4.32cm/s)and PDR group(7.13±1.40cm/s, 10.31±1.82cm/s and 22.10±3.51cm/s)(P<0.05). EDV were 4.67±1.20cm/s, 5.61±1.25cm/s and 8.40±1.51cm/s, significantly higher than that of NPDR group(3.52±1.19cm/s, 5.01±1.30cm/s and 6.61±1.67cm/s)and PDR group(2.48±1.02cm/s, 4.11±1.04cm/s and 4.01±1.52cm/s)(P<0.05). And RI were 0.63±0.07, 0.60±0.04 and 0.77±0.05, was significantly lower than that of NPDR group(0.72±0.06, 0.67±0.05 and 0.81±0.03)and PDR group(0.80±0.09, 0.74±0.06 and 0.86±0.04)(P<0.05).

CONCLUSION: Color Doppler ultrasound monitoring the hemodynamic changes of ocular blood vessels in diabetes can provide evidence for early detection of diabetic retinopathy.

Abstract:AIM: To analyze the clinical effects of preoperative intravitreal Conbercept combined vitrectomy for proliferative diabetic retinopathy(PDR)patients.

METHODS: From June 2014 to May 2017, 57 patients(65 eyes)diagnosed with PDR. The patients were divided into two groups according to whether received preoperative intravitreal conbercept: intravitreal group(27 cases, 31 eyes), control group(30 cases, 34 eyes). Intravitreal group was treated with 0.05mg(0.05mL)conbercept intravitreal injection 3d before vitrectomy, while control group was treated with vitrectomy alone. The overall surgical time, intraoperative bleeding, use of endodiathermy, iatrogenic retinal hole, and silicone oil, postoperative vitreous hemorrhage and the best corrected visual acuity were recorded and analyzed.

RESULTS: The average surgical time of intravitreal group was lower(P<0.05), while intraoperative hemorrhage rate, rate of endodiathermy application, iatrogenic hiatal incidence, rate of silicone oil application, incidences of recurrent vitreous hemorrhage of intravitreal group were lower than those of control group(all P<0.05). Intravitreal group got better postoperative best corrected visual acuity than control group(P<0.05).

CONCLUSION: Intravitreal conbercept for proliferative diabetic retinopathy before 25G vitrectomy decreased surgical complications, reduced the surgical time and postoperative vitreous hemorrhage, and improved the potoperative best corrected visual acuity.

Abstract:AIM: To investigate the clinical features of fundus diseases of familial congenital nystagmus.

METHODS: Totally 40 eyes of 20 nystagmus patients from 3 congenital nystagmus families were enrolled in our study. The eye position, refractive error, anterior segment and fundus, including fundus photograph, optical coherence tomography(OCT), and visual evoked potential(VEP)were performed on them.

RESULTS: There were 8 patients in Family A, all of which were horizontal nystagmus, in that 6 cases of strabismus(2 of which combined with compensatory head posture), 2 cases of nuclear cataract, 2 cases of posterior polar cataract, 1 case of retinopathy of prematurity, 2 cases of severe ametropia. There were 6 patients in Family B, all of which were horizontal nystagmus, in that 3 cases of albinism(2 of which combined with macular hypoplasia), 2 cases of severe ametropia, 1 case of achromatopsia, 1 case of nuclear cataract. There were 6 patients in Family C(5 of which were horizontal nystagmus and 1 rotatory nystagmus), 2 cases of Leber congenital amaurosis, 1 case of familial exudative vitreoretinopathy, 2 cases of posterior polar cataract, 1 case of iris atrophy, 2 cases of strabismus.

CONCLUSION: We have to do detailed examinations on patients suffered from familial congenital nystagmus to understand its causes and to improve their visual functions as well as possible.

Abstract:AIM: To investigate the effect of indwelling time of lacrimal silicone drainage tube on chronic dacryocystitis and its effect on visual acuity.

METHODS: The clinical data of 92 patients(110 eyes)with chronic dacryocystitis treated with lacrimal drainage tube in our hospital from January 2013 to December 2016 were retrospectively analyzed. According to the indwelling time, the patients were divided into 6wk group(42 patients 50 eyes)and 12wk group(50 patients 60 eyes). Comparison of two groups on clinical efficacy, vision, overflow symptoms, complications and recurrence was taken.

RESULTS: The effective rate was significantly higher in the 6wk group than in the 12wk group(P<0.05). The visual acuity and incidence of epilepsy symptoms at 3mo after extubation was not signifcantly different(P<0.05). The incidence of complication was 14.0%(7/50)at 3mo after extubation in 6wk group and significantly lower than that in the 12wk group which was 38.3%(23/60, P<0.05). The recurrence rate was 2.0%(1/50)in the 6wk group, which was significantly lower than that in the 12wk group(18.3%, 11/60; P<0.05).

CONCLUSION: The clinical efficacy of lacrimal silicone drainage tube for 6wk and 12wk is similar to patients with chronic dacryocystitis. There is also little difference in the visual acuity of patients with dacryocystitis, but with the prolongation of the lacrimal duct drainage tube, rinse patency rate, increase the difficulty of extubation, complications and recurrence rate, the clinical situation should be based on the patient as much as possible to shorten the lacrimal duct silicone drainage tube retention time.

Abstract:AIM: To study the roles of tumor necrosis factor alpha(TNF-α), interferon gamma(IFN-γ)in pathogenesis of primary pterygium and to explore the mechanism of tears in pterygium.

METHODS: Concentrations of TNF-α and interferon gamma IFN-γ were quantified by enzyme-linked immunosorbent assay(ELISA)in asymptomatic control group(30 eyes of 30 healthy volunteers)and 60 primary pterygium patients(30 eyes of the 30 progressive cases, 30 eyes of the 30 quiescent cases). The data was analyzed by analysis of variance.

RESULTS: The concentration of TNF-α and IFN-γ in the patients with primary pterygium were statistically significant(P<0.05), compared with the normal control group. Tear concentration of TNF-α was significantly higher in primary pterygium compared with the control group. Tear concentration of IFN-γ was significantly reduced in primary pterygium compared with the control group(P<0.05).

CONCLUSION: TNF-α and IFN-γ may be important in the pathogenesis and development of pterygium tissues. It can provide some new directions and ideas for the treatment of primary pterygium.

Abstract:AIM: To analyze and compare the clinical effect in treatment of degenerative entropion of lower eyelid with blepharochalasis between the modified orbicularis oculi muscle shortening procedure and orbicularis muscle shortening procedure.

METHODS: From January 2012 to August 2014, ninety-three cases(108 eyes)diagnosed as involutional entropion of lower eyelid with blepharochalasis were enrolled in our study. According to different surgical methods, patients were divided into observation group(52 eyes in 47 cases)and control group(56 eyes in 46 cases). The observation group was performed on the modified orbicularis muscle shortening procedure, and the control group was using a simple orbicularis muscle shortening method. The general datum, short-term clinical effect and long-term clinical effect were collected to compared between two groups.

RESULTS:The age, gender and the course of disease were no significance differences between the observation group and the control group(P>0.05). There was no statistical significance on the short-term effective rate(P>0.05)between the observation group and the control group(98% vs 95%, respectively). The long-term recurrence rate of the observation group was 2%, while the control group was 14%. It had a significance statistical difference between two groups(P=0.033).

CONCLUSION: The clinical curative effect of modified orbicularis oculi muscle shortening procedure, in the treatment of lower eyelid entropion with blepharochalasis, is better than the orbicularis muscle shortening procedure's.

Abstract:AIM: To explore the clinical value of 25-gauge vitrectomy in the treatment of traumatized eyes with non-light perception.

METHODS: Forty-six patients(46 eyes)who diagnosed as traumatized eyes with non-light perception treated with 25-gauge vitrectomy, which collected in our hospital from July 1, 2013 to June 1, 2017. Their sex, age, residence area, traumatic nature, causes of injury, duration from the injury to intervention, location and size of the wound, visual acuity and prognosis was retrospectively studied and analyzed statistically in this study.

RESULTS: In the 46 patients, 38 were males, 8 were females(M:F=4.75:1). The age of the patients was between 7 and 77 years(mean 37.96±18.99 years). Among them, there were 26 case(57%)in the young group(<45 years), 14 case(30%)in the middle age group(45-60 years), 6 cases(13%)in the older age group(>60 years). The cause of injury included blunt trauma(18 cases, 39%), sharp instrument injury(8 cases, 17%), plant injury(6 cases, 13%), explosion injury(6 cases, 13%), impact injury(4 cases, 9%), limb impact injury(2 cases, 4%), traffic accident injury(2 cases, 4%). There were 33 cases(72%)with ocular rupture, 12 cases(26%)with perforating injury of eyeball and 1 case(2%)with ocular contusion. There were 44 cases(96%)with vitreous hemorrhage, 30 cases(65%)with retinal detachment, 18 cases(39%)with intraocular foreign body(IOFB), 22 cases(48%)with cilio-choroidal detachment, 18 cases(39%)with endophthalmitis and 12 cases(26%)with retinal hemorrhage. The postoperative best-corrected visual acuity improved to light perception or better than light perception in 30 cases(65%), and 16 cases(35%)still had no light perception.

CONCLUSION: The patients who had no light perception after ocular trauma were almost young and middle-aged people in rural areas. The factors that affected the visual acuity of the postoperative included the type of injury, the location and size of the wound, the retinal detachment, the cilio-choroidal detachment, the duration from the injury to intervention, the endophthalmitis and whether the merger of intraocular foreign body or not. The 25-gauge vitrectomy could make most of the visual acuity from no light perception to light perception or over the light perception, which had a high clinical value in curing traumatized eyes with no light perception.

Abstract:AIM: To observe and compare the changes of macular retinal thickness in patients with pathologic myopia complicated with choroidal neovascularization(CNV)after anti-vascular endothelial growth factor(VEGF)therapy or photodynamic therapy(PDT)alone, and to explore an effective treatment method for CNV.

METHODS: The clinical data of 43 pathologic myopia patients(45 eyes)complicated with CNV treated in our hospital from November 1, 2014 to June 30, 2015 were retrospectively analyzed and their curative effect of different treatment methods were compared through the analysis. In them, 20 patients(22 eyes)treated with anti-VEGF alone were set as the observation group and 23 patients(23 eyes)treated with PDT were set as the control group. The visual acuity of the two groups after 6mo of treatment was compared, and OCT examination was performed to compare their macular retinal thickness, CNV strong reflection of regional changes and subretinal fluid absorption. The fluorescein angiography(FFA)and indocyanine green angiography(ICGA)were used to compare the CNV leakage and the adverse reactions between the two groups. The width, height, distance from the fovea and the incidence of adverse reactions of the CNV breakthrough retinal pigment epithelium(RPE)before and after treatment were compared between the two groups.

RESULTS: The eye ratio of the visual acuity in the observation group increased by two lines was 82%, which was significantly higher than 74% of the control group, and the difference was statistically significant(P<0.05); OCT showed no significant difference in retinal thickness before treatment between the two groups(P>0.05), but after the treatment, the retinal thickness was significantly lower in the observation group than in the control group(P<0.05). The FFA and ICGA examination showed that the proportion of CNV in the observation group was 86%, and the leakage was reduced by 14%, which was significantly different from that in the control group(74%, 22%), and the difference was statistically significant(P<0.05). The incidence of adverse reactions in the observation group was 14% and 17% in the control group, there was no significant difference between two groups(P>0.05). After treatment, the width, height and distance from the fovea of the CNV breakthrough RPE of both groups decreased, and the observation group was significantly lower than that of the control group(P<0.05).

CONCLUSION: Compared with PDT treatment, anti-VEGF treatment alone can significantly improve the visual acuity of patients with pathologic myopia complicated with CNV, reduce macular retinal thickness with a better effect of stopping leakage.

Abstract:AIM:To investigate the changes of corneal biomechanical indexes after femtosecond laser-assisted in situ keratomileusis(LASIK), so as to provide theoretical basis for the safety study of femtosecond laser LASIK.

METHODS: Totally 85 myopia patients(170 eyes)treated in our hospital from June 2014 to June 2016 were selected and underwent femtosecond laser LASIK surgery. The medical records of patients met the inclusion criteria were retrospectively analyzed. Corneal compensated intraocular pressure(IOPcc)and corneal resistance factor(CRF), corneal hysteresis(CH)and Goldmann correlated to IOP value(IOPg)before operation, and at 3 and 6mo after surgery were measured by the ocular response analyzer, and central corneal thickness was measured by A type ultrasonic measuring instrument.

RESULTS: At postoperative 3 and 6mo, central corneal thickness was sharply lower than that before surgery, with a statistical significance(P<0.05); postoperative IOPcc, CRF, CH, IOPg and other corneal biomechanical parameters decreased distinctively, with statistical meaning(P<0.05); data at postoperative 3 and 6mo showed no evident differences(P>0.05); the cornea cutting thickness was 98.67±7.56μm, CH and CRF variation were 3.40±0.34mmHg, 3.55±0.43mmHg respectively, the cornea cutting thickness was positively correlated with CH, CRF variation(r=0.232, 0.254; P<0.001).

CONCLUSION: Femtosecond laser LASIK can apparently reduce corneal thickness as well as the corneal biomechanical indexes, the data at postoperative 3mo tends to be stable.

Abstract:AIM: To assess the changes in higher order aberrations after wavefront guided femtosecond laser assisted laser in situ keratomileusis(FS-LASIK)for moderate to high astigmatism.

METHODS: Eighty-eight eyes of 50 myopia patients with moderate to high astigmatism were included in this prospective study. There were 51 eyes with moderate astigmatism(≥-1.50D and <-3.00D)and 37 eyes with high astigmatism(≥-3.00D). All patients underwent wavefront guided FS-LASIK. Uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), keratometry, central corneal thickness(CCT)and higher order aberrations(HOAs)were evaluated before operation and 3mo postoperatively.

RESULTS: At the 3mo after operation, the mean UDVA of all eyes was above 20/20, better than before operation(P<0.05), but CDVA remained unchanged(P=0.36)and no eyes lost ≥2 lines of CDVA. Mean astigmstism of 85 eyes(97%)was reduced below -1.00D, mean astigmatism of 70 eyes(80%)was reduced below -0.50D(P<0.05). The average corneal curvature was flatter by 3.81±1.97D and CCT was reduced by 78.66±37.22μm, postoperatively(P<0.05). Coma and trefoil aberrations remained unchanged(P=0.078, 0.065). The spherical aberration, secondary astigmatism and the HOA root mean square(RMS)increased from 0.19±0.06, 0.05±0.02 and 0.42±0.12, preoperatively to 0.32±0.17, 0.26±0.08 and 0.78±0.28(P<0.05), postoperatively.

CONCLUSION: Wavefront-guided FS-LASIK is a safe and effective option for the patients with moderate to high astigmstism although parts of HOAs increased.