Abstract:AIM: To evaluate the safety, refractive outcomes and vision after phakic posterior chamber implantable collamer lens(ICL)after keratoplasty(KP).

METHODS: This retrospective single center study evaluated 32(35 eyes)patients who received an ICL for myopia and/or astigmatism after keratoplasty. Patients underwent ICL surgery if they were unable to wear glasses or contact lenses and excimer laser surgery was contraindicated. Data were collected on uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), refraction and complications. Data were analyzed for the preoperative and last postoperative visits(16.7±13mo)(P<0.05).

RESULTS: Preoperatively, spherical equivalent(SE)ranged from -4.00 to -20.00 D and cylinder from -2.00 to -9.00 D. The mean SE decreased statistically significantly from -11.41±3.62 D preoperatively to -1.95±1.78 D postoperatively(P<0.0001). Mean UDVA increased statistically significantly from 20/400 preoperatively to 20/25 postoperatively(P<0.0001). There was a mean improvement in postoperative CDVA of 1.5 lines compared to preoperatively, 37% of eyes had an increase of 2 or more lines. One eye(2.8%)lost ≥ 1 line of CDVA. There were no intraoperative or postoperative complications.

CONCLUSION: Posterior chamber phakic intraocular lens implantation is a safe and effective treatment for post-keratoplasty myopia and astigmatism in patients who are unable to wear spectacles or contact lenses and where corneal refractive surgery is contraindicated.

Abstract:AIM: To investigate the effects of mitomycin C(MMC)on corneal endothelial cells at different exposure time during laser-assisted subepithelial keratomileusis(LASEK).

METHODS: Patients who received LASEK were included and divided into Group T1(15s≤t≤45s)and T2(5sRESULTS: A total of 196 eyes of 98 patients were included with 98 eyes in Group T1 and 98 eyes in Group T2. With the exception of peripheral ACA, central CV and HEX in Group T1 and T2, which significantly changed at 1wk after the surgery(P<0.05), there was no significant difference in central and peripheral parameters within both groups or between the groups(P >0.05).

CONCLUSION: Although transient acute changes in central CV and HEX and peripheral ACA were observed, there is no significant effect on the long-term corneal health status when MMC is applied in a reasonable time range in LASEK surgery.

Abstract:AIM: To evaluate the corneal densitometry in treatment-naive patients with keratoconus and its relevance with anterior and posterior corneal elevation.

METHODS: Keratoconic corneas were examined using the Pentacam. Corneal densitometry was measured over a 12-mm diameter area, divided by annular concentric zones and depths, more over anterior and posterior corneal elevation was measured. Keratoconus was classified according to the topographic keratoconus classification.

RESULTS: A total of 152 subjects \〖72 patients with keratoconus(46 male, 26 female)and 80 healthy control subjects(50 male,30 female)\〗 were included in the study. There were significant differences in corneal densitometry values of the groups in central 2 mm keratoconus(KC)=19.62±4.17 gray scale unit(GSU), N=15.38±1.54 GSU(P<0.0001), and in annulus of 2 to 6 mm in diameter(K=16.40±2.18 GSU, N=15.31±1.25 GSU, P<0.0001). When densitometry values for different depths were examined, the anterior layer presented the highest value(KC=23.69±3.71 GSU, N=20.91±2.52 GSU, P<0.0001), which was significantly higher than the values obtained in the central and posterior layer(KC=14.34±1.70 GSU, N=13.61±1.21 GSU, P=0.001 and KC=11.40±1.23 GSU, N=12.35±0.88, P=0.002 respectively). Analysis of the correlation between corneal densitometry for each layer depth(anterior, central and posterior)with posterior corneal elevation values demonstrated significant association(r=0.293, r=0.278 and r=0.294 respectively). The similar correlation was not found between corneal densitometry for each layer depth and anterior corneal elevation(r=-0.211, r=-0.101, r=0.99 respectively). In the control patients such a significant correlation between posterior/anterior corneal elevation and corneal light backscatter for each layer depth was not found.

CONCLUSION: The densitometry map reveals that light backscatter was higher in the central portion of the anterior keratoconic cornea. Corneal densitometry values of keratoconus patients were correlated with posterior corneal elevation in 0-2, 6-10 and 10-12 annuli and in all anterior, central and posterior layers. The densitometry level was higher in more advanced stages.

Abstract:AIM: To explore the modulation effects of 17-β estradiol(E2)and tamoxifen(TAM)in chronic intraocular hypertension mouse model.

METHODS: We performed anterior chamber injection of magnetic beads to induced chronic ocular hypertension models. Adult C57BL/6 male mice were used in the experiments and randomly divided into four groups: control, Beads group, E2 group and E2+TAM group. The intraocular pressure(IOP)were measured by Tonolab tonometer. Central retinal thickness was evaluated by HE staining. Brn3a as a specific marker of retinal ganglion cells(RGCs), were stained and counted by immunohistochemistry(IHC)staining. Glial fibrillary acidic protein(GFAP)as a marker of proliferation of astrocytes, was quantified using western blotting.

RESULTS: The IOP level was significantly elevated after anterior chamber injection of magnetic beads compared to control group(P<0.05), while in E2 and E2+TAM group, the IOP levels were reduced(P<0.05 vs Beads group), especially in E2+TAM group in 2wk. The RGCs happened to degenerated in Beads group after 2wk, while the effects were reversed by E2+TAM(P<0.05). The central retinal thickness showed no significant statistical difference among the four groups after 2wk(P>0.05). The expression level of GFAP increased caused via beads injection, however, decreased in E2 and E2+TAM group(P<0.05).

CONCLUSION: E2 and E2+TAM could both effectively decrease the IOP level in chronic intraocular hypertension mouse model, increase the survival of RGCs from high intraocular pressure, suppress expression of GFAP, which indicated neuroprotective effects of E2 and TAM in glaucoma through an anti-inflammatory effects.

Abstract:AIM: To study whether autophagy and paraptosis were activated in retinal ganglion cells(RGCs)after acute high intraocular pressure(IOP)in an experimental rat model and to explore the possible underlying mechanisms.

METHODS: A total of 50 male Sprague-Dawley(SD)rats were randomly divided into normal control group, and 3d, 1, 4, 8wk group after acute elevated intraocular pressure(IOP)(n=10 per group). Acute intraocular hypertension model was established by anterior chamber perfusion of normal saline in the right eye. The expression levels of microtubule-associated protein 1 light chain 3(LC3)was measured by immumofluorescence method. To determine whether autophagy and paraptosis were activated. Retinal sections were examined by transmission electron microscopy(TEM). Autophagosomes and cytoplasmic vacuoles in the cytoplasm of RGCs were measured.

RESULTS: TEM analysis revealed that double- and multiple-membrane vacuoles containing electron-dense materials of autophagosomes were found in RGCs. The number of autophagosomes per 50μm² were 0.79±0.43, 2.14±0.36, 2.29±0.47, 1.57±0.51 and 1.21±0.43 in the normal control group and in acute IOP group at 3d, 1wk, 4wk, 8wk, respectively. The number of autophagosomes markedly increased in the cytoplasm of RGCs at 3d, 1wk, 4wk, 8wk groups than those in the normal control group(all at P<0.05). LC3 positive expression was rarely detected in ganglion cell layer(GCL)in the normal control group and percentage of LC3 positive cells was 15.90%. Immumofluorescence analysis showed that the percentage of LC3 positive cells statistically increased in acute IOP groups when compared with control group(P<0.05). The number of RGCs per 200μm in each group of acute IOP injury significantly decreased compared with the normal control group(P<0.05). Cytoplasmatic vacuolization were observed in RGCs at 3d after acute IOP injury and lasting to 8wk. TEM also revealed that a large number of cytoplasmic vacuoles were derived predominantly from the progressive swelling of mitochondria and/or endoplasmic reticulum(ER).

CONCLUSION: Autophagy and paraptosis participate in the death of RGCs under transiently elevated intraocular pressure. Different types of programmed cell death(PCD), coexistence of multiple cell death forms or a single cell death form, participates in the pathogenesis of acute elevation of intraocular pressure.

Abstract:AIM: To screen congenital cataract in the early stage using dual-specific probe technique composed of DNA hybridization and chromogenic probe.

METHODS: The mRNA was isolated from venous blood of 14 congenital cataract patients with autosomal dominant inheritance in 3 chromosomes. Based on genetic mutats of CRYAB gene, DNA probe, capture probe and signal probe were designed. The sandwich structures containing capture probe, DNA probe and signal probe was used to detect genetic mutants in 8 samples from one family; and ELISA was used to detect the contents fluctuation of Crystallin alpha B.

RESULTS: The dual-specific probe technique detected the minimum genetic mutation of Crystallin alpha B in congenital cataract samples, various mutations detection rate was between 99.5% and 99.7%. In ELISA detection, serum Crystallin alpha B level increased, and detection rate was 85.9%. Compared with ELISA assay, this novel assay was more sensitive.

CONCLUSION: The novel dual-specific probe method is quite convenient for detection of genetic mutants of congenital cataract; and for its high sensitivity and repeatability, it is of great potential in clinically prenatal diagnosis, and it might play significant roles in eugenic and superior nurture.

Abstract:AIM: To compare the effect of fixation and select the optimal fixation solution and condition for PAS staining of guinea pig eyes among three different fixation solution: 4% paraformaldehyde solution, 4% glutaraldehyde solution and Davidson solution.

METHODS: Totally 30 healthy guinea pigs were divided into 6 groups: Group I-II were fixed in 4% paraformaldehyde solution and 4% glutaraldehyde solution for 24h, respectively; Group III-V were fixed in Davidson solution for 3, 6 and 24h, respectively; and Group VI were fixed in Davidson solution for 3h and then transferred into 10% neutral formaldehyde solution for 48h. All groups were sectioned by routine section method and undergone PAS staining, and then observed by light microscope.

RESULTS: It was found that the group which was fixed by Davidson solution for 3h, remained the most complete structure for PAS staining(Group III). While the effect of fixation for the group which was transferred into 10% neutral formaldehyde solution for preserving for 48h after fixing in Davidson solution for 3h was also acceptable for PAS staining(Group VI). The retinal cells remained clear and in order for both groups which was mentioned above.

CONCLUSION: The best fixation condition for PAS staining for eyes of guinea pigs is fixation in Davidson solution for 3h among these fixation conditions, while it is also suitable to transfer the eyes into neutral formaldehyde solution after fixing in Davidson solution for 3h for preserving for long periods, which is not severely reduced the effect of fixation for PAS staining.

Abstract:AIM: To investigate the influence of laser photocoagulation and vascular endothelial growth factor(VEGF)antagonists used alone or as combination therapy on clinical efficacy and safety of patients with diabetic macular edema(DME).

METHODS: Totally 150 patients(156 eyes)with DME were chosen in the period from October 2014 to October 2016 in our hospital and randomly divided into both group including Group A(50 patients 52 eyes)with laser photocoagulation used alone, Group B(50 patients 51 eyes)with VEGF antagonists used alone and Group C(50 patients 53 eyes)with combination therapy; and the best corrected visual acuity, macular fovea thickness and retinal neovascularization leakage area before and after treatment and the complications incidence of both groups were compared.

RESULTS: The best corrected visual acuity of Group B and Group C in 3, 6 and 12mo after treatment were significant better than that of Group A(P<0.05). The macular fovea thickness of Group B and Group C in 3, 6 and 12mo after treatment were significant lower than that of Group A(P<0.05). The retinal neovascularization leakage area of Group B and Group C in 3mo after treatment were significant smaller than that of Group A(P<0.05). The retinal neovascularization leakage area of Group C in 6 and 12mo after treatment were significant smaller than that of Group A and Group B(P<0.05). There was no significant difference in the complications incidence among 3 groups(P>0.05).

CONCLUSION: Laser photocoagulation combined with VEGF antagonists in the treatment of patients with DME can efficiently improve visual acuity, reduce macular foveal thickness, control retinal neovascularization leakage and not increase adverse reactions.

Abstract:AIM: To study the clinical curative effect of scleral buckling(SB)combined with intravitreous gas injection in the treatment of rhegmatogenous retinal detachment(RRD)and the influence on serum levels of amino acids and vascular endothelial growth factor(VEGF).

METHODS: The clinical data of 150 RRD patients(150 eyes)in our hospital were retrospectively analyzed. And 81 patients(81 eyes)treated with scleral buckling alone were included into the non-gas injection group while 69 patients(69 eyes)treated with scleral buckling combined with intravitreous gas injection were included in the gas injection group. The surgical effect, serum levels of amino acids and VEGF before and after surgery were compared between the two groups.

RESULTS: There was no significant difference in retinal reattachment rate between the two groups at different time points after surgery(P>0.05). The intraocular pressure of gas injection group at 3d after surgery was significantly higher than that of non-gas injection group(P<0.05)but there was no significant difference in intraocular pressure between the two groups at 5d after surgery(P>0.05). The uncorrected visual acuity of operative eye of the two groups was improved significantly after surgery(P<0.05). Serum levels of histidine, glutamic acid, phenylalanine and VEGF levels in the two groups significantly decreased at 5d after surgery(P<0.05), without significant difference between the two groups(P>0.05). There was no significant difference in serum levels of arginine, leucine, isoleucine and glycine before and after treatment(P>0.05). The total score of visual function related quality of life and scores of different dimensions significantly increased at 1mo after surgery(P<0.05), without significant differences between the two groups(P>0.05). There was no significant difference in the total incidence of postoperative complications between the gas injection group(7.2%, 5/69)and the non-gas injection group(9.9%, 8/81; P>0.05).

CONCLUSION: Scleral buckling combined with intravitreous gas injection can help the early recovery of visual function and intraocular pressure in RRD patients, and reduce the levels of histidine, glutamic acid, phenylalanine and VEGF, and it has high safety.

Abstract:AIM: To evaluate the traditional Chinese medicine(TCM)for the treatment of dry eye effect in the past five years by using meta analysis method.

METHODS: According to the Cochrane evaluation system method, we searched Medline(January 2013 to October 2017), EMbase(2013-2017), Cochrane Library(2017), Wanfang database(2013-2017), VIP(2013-2017), and CNKI(2013-2017)for studies published. We included randomized controlled trials conducted the TCM in the treatment of dry eye. RevMan 5.0 statistical software data extraction and Meta analysis were conducted.

RESULTS: A total of 10 studies were identified, nine were from Chinese literature and one was from English literature, of which including 1 229 eyes. Nine of these studies performed BUT measurements at the end of the course of treatment. The results showed a statistically significant difference(P<0.00001). Nine studies performed tear flow measurements at the end of the course of treatment and the results showed a statistically significant difference(P<0.0001). Two studies performed FL measurements after the end of the course of treatment; the results showed no statistically significant difference(P=0.25). Three studies performed dry eye symptoms after the end of the course of treatment; the results showed that the differences were statistically significant(P=0.0003); the overall efficacy comparison, the difference between the two groups was statistically significant(P<0.00001).

CONCLUSION: TCM treatment can significantly prolong BUT and increase tear flow, and has more advantages in the treatment of dry eye.

Abstract:AIM:To evaluate the effectiveness and safety of Conbercept for exudative age-related macular degeneration(eAMD)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 eAMD published by November, 2017 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 and Stata 12.0 statistical software.

RESULTS:A total of 12 RCTs were included, involving 924 patients. The results of Meta-analysis showed that the central macular retinal thickness(CMT)markedly decreased at 1, 3, 6 and 12mo after treatment; visual acuity at 3 and 6mo and quality of life(QOL)at 6mo were significantly improved; total effective rate of treatment at increased, which was statistically different to control group(P<0.05), but rate of adverse reaction was similar(P>0.05). The long-term effect was better than control group.

CONCLUSION:The existing evidence supports that conbercept has good therapeutic efficacy and safety for eAMD. It can significantly reduce the CMT, improve the visual acuity, the quality of life and the total efficiency of treatment, and the long-term effect is better than control group.

Abstract:RNA interference(RNAi)is the post-transcriptional gene silencing based on sequence-specific degradation of mRNA, and triggered by double-stranded RNA.RNAi technology is widely used in gene therapy and research of gene function and almost become a standardized technical tool with very broad prospect. The eyes with immune privilege are very suitable for the treatment of RNAi, which has been widely used for a variety of eye diseases, especially cataract. This paper briefly introduces the basic principle of RNAi technology and summarizes the recent research and application of this technology in cataract.

Abstract:Endoplasmic reticulum(ER)is a place where it folds and synthesizes the proteins. ER stress was induced when a variety of physiological and pathological factors happened, under which the protein misfolding occurred, the unfolded protein accumulated and the calcium ion imbalanced in the ER. The ER of high-glucose environment can change the protein redox state and produce reactive oxygen species, which affects the ER channel function and chaperone protein buffer; meanwhile changes the balance of calcium ions; finally induces the formation of ER stress. More and more studies have confirmed that ER stress in high glucose environment can cause a variety of ophthalmic diseases. So we review the recent articles about ER stress of high glucose environment and its related ophthalmic diseases.

Abstract:Blepharokeratoconjunctivitis(BKC)refers to a group of inflammatory lesions secondary to chronic blepharitis in cornea and(or)conjunctiva, is very common in clinic. At the same time, this kind of disease is easily misdiagnosed and missed diagnosed, which causing the management of patient were delayed. The characteristic of BKC is that the patient's condition is prolonged unhealed and unreasonable treatment can result in irreversible damage to the visual function of the patient. In recent years, with the public's understanding of ocular surface diseases has deepened, they also emphasized the influence of BKC to eye health. Although a large number of clinical studies have been carried out on the diagnosis and treatment of BKC, at present there is no unified standard of diagnosis and treatment for it. Consulting the relevant literature and combined with current research status, the diagnosis and treatment of BKC are reviewed in this paper.

Abstract:Ocular surface squamous neoplasia(OSSN)is a type of ocular surface tumor, which is difficult to diagnose because of its low incidence is low and it is easy to be confused with pterygium. In recent years, the improvement of various diagnostic techniques and the extensive application of interferon(IFN)to OSSN therapy have greatly reduced the recurrence rate, and the diagnostic and therapeutic methods of OSSN tend to be diversified. Understanding the current causes of OSSN and the ways of treatment can better guide the OSSN study.

Abstract:Meibomian gland dysfunction(MGD)is one of the common diseases in ophthalmology clinic. The diagnosis of MGD ought to be evaluated according to symptoms, signs and corresponding assistant examinations. Traditional examination methods, such as slit-lamp examination, break-up time of tear film, Schirmer tear test and so on, have definite value in the diagnosis of MGD. In 2017, the experts on the diagnosis and treatment of Meibomian gland dysfunction in our country have reached consensus that some novel clinical examination methods such as Meibomian gland loss rate and tear film lipid layer thickness are also worked as auxiliary diagnostic criteria for MGD. The combination of traditional methods and new detection techniques will lead to more comprehensive and accurate conclusions for the diagnosis of MGD.

Abstract:Cornea is an important part ofhuman's refractive system. Corneal biomechanics plays an important role in corneal ectasia and related diseases. The corneal biomechanics measured in vitro and in vivo and its clinical application in system diseases and elastic corneal disease, glaucoma, myopic are reviewed in this literature summary.

Abstract:Alzheimer's disease(AD)is a neurodegenerative disease and is the most common type of dementia. It impairs the quality of life of a person and their family, posing a serious economic and social threat in developed countries. A high degree of clinical suspicion is needed to correlate problems in cognition with the changes in the eye. But relations between sensory functions and Alzheimer's disease are still under explored. When function of cognitive decline, patients perceive the world around them with their visual sense, while the brain can't integrate the sensory information to understand the surrounding environment. Visual dysfunction has long been recognized as a manifestation of Alzheimer's disease(AD). To further explore the changes in its visual function, it is now reviewed in various literatures to explain the visual impairment of patients with Alzheimer's disease.

Abstract:AIM:To investigate the influence of monovision design of cataract surgery on the prognosis visual quality in cataract patients.

METHODS: Totally 84 cases cataract patients(168 eyes)who receiving cataract surgery were enrolled from February 2016 to February 2017 in our hospital to conduct a prospective study. According to the different near addition in the monovision design, patients were divided into low near addition group(1.25D-1.75D)and high near addition group(2.25D-2.75D), each group was 42 cases. At postoperative 6mo, the binocular uncorrected near visual acuity, uncorrected intermediate visual acuity, uncorrected distance visual acuity and stereoscopic vision were compared between two groups. The visual function survival quality score before and after treatment were compared.

RESULTS: The binocular uncorrected intermediate and distance visual acuity in the low near addition group respectively was 0.27±0.20, 0.09±0.08, and that in the high near addition group respectively was 0.29±0.25, 0.10±0.07, which had no statistically significant difference between two groups(P>0.05). The binocular uncorrected near visual acuity in the high near addition group was 0.03±0.06, which was significantly better than the low near addition group 0.07±0.04, the difference was statistically significant(P<0.05). Before the treatment, the visual function-14(VF-14)score in each two group respectively was 27.93±4.52, 28.24±4.91; after the treatment, VF-14 score in each two group respectively was 82.04±14.31, 81.22±13.70, which had no statistically significant difference between two groups(P>0.05). After treatment, the VF-14 score both significantly increased in the two groups(P<0.05). The proportion of patients with the normal stereoscopic vision, peripheral stereovision and macular stereovision in the low near addition group respectively was 47.6%, 31.0%, 21.4%; and that in the high near addition group respectively was 42.9%, 23.8%, 33.3%, which had no statistically significant difference between two groups(P>0.05).

CONCLUSION: Two kinds of near addition have similar advantages to cataract patients after cataract surgery on uncorrected visual acuity, the quality of visual function and stereopsis.

Abstract:AIM: To explore the effect and mechanism of latanoprost on open-angle glaucoma.

METHODS: Totally 100 patients with open angle glaucoma who had been seeking treatment in our hospital between August 2015 and August 2017 were selected as the research subjects. These patients were divided into an observation group and a control group according to the random table method, with 50 cases in each group. The control group was treated with timolol maleate eye drops, 1 drop per time, 2 times a day, treated consecutively for 12wk. The observation group was given latanoprost eye drops for treatment, 1 drop per time, 1 time a day, for a continuous treatment of 12wk. The IOP, ocular hemodynamics, visual field defects and adverse reactions in the two groups were compared.

RESULTS: Before treatment, there was no statistically significant difference found on the intraocular pressure between the two groups(P>0.05); at 4, 8, 12wk after the treatment, the intraocular pressure at different time points in the observation group was shown to be lower than that in the control group, where the difference was statistically significant(P<0.05). There was no statistically significant difference shown in the artery hemodynamics indexes of CRA and PCA before and after treatment in the control group(P>0.05); the indicators of EDV and PSV of CRA, PCA indicators in the observation group significantly increased, while the RI index decreased significantly, with the difference being statistically significant(P<0.05). Before treatment, there was no statistically significant difference in all of the visual field defects between the two groups before treatment(P>0.05); after treatment, however, the scope of visual field defects was shrunk in both groups, with changes in the observation group more significant than the control group, and the difference was statistically significant(P<0.05)There was no statistically significant difference registered in the incidence of adverse reactions between the two groups(P>0.05).

CONCLUSION: For patients with open angle glaucoma, latanoprost eye drops is with significant curative effects and of relatively high value, which can significantly reduce the intraocular pressure, improve the ocular hemodynamics, and reduce the scope of eye damage with high safety.

Abstract:AIM:To investigate the clinical efficacy of phacoemulsification(Phaco)and intraocular lens(IOL)implantation combined with goniosychialysis in the treatment of acute primary angle-closure glaucoma(APACG)with cataract.

METHODS: In this prospective randomized clinical trial, 60 eyes of 60 patients with APACG and coexisting cataract were randomized to the control group(30 patients, 30 eyes)or the study group(30 patients, 30 eyes)and completed the trial. All the two groups were treated with phacoemulsification and intraocular lens implantation, and the control group(30 patients, 30 eyes)was combined with trabeculectomy, while the study group(30 patients,30 eyes)was treated with the goniosychialysis. All patients were followed up for 2mo. The preoperative and postoperative best corrected visual acuity(BCVA), intraocular pressure(IOP), anterior chamber depth(ACD), anterior chamber angle(ACA)and complications were compared.

RESULTS: There were no statistically significant differences between the 2 groups in BCVA, IOP, ACD, ACA before surgery(P>0.05). The postoperative BCVA, IOP, ACD and re-opening anterior chamber angle(ACA)in two groups were all improved, and the differences had statistical significance(P<0.001). BCVA, ACD, re-opening ACA of research group were significantly better than those of the control group(P<0.05). The decreased IOP of the study group were more than the control group and the complications of the control group were more than the study group, but there was no statistical difference in the postoperative IOP and complications between two groups(P>0.05).

CONCLUSION: The phacoemulsification and IOL implantation combined with goniosychialysis can improve the vision of patients, decrease IOP, increase ACD, and re-opening anterior chamber angle(ACA)in patients with APACG combined with cataract. It has a positive clinical effect.

Abstract:AIM: To investigate the efficacy of the combined treatment of Conbercept and panretinal photocoagulation(PRP)for neovascular glaucoma(NVG)with central retinal vein occlusion(CRVO).

METHODS: The clinical data of 100 NVG patients with CRVO treated in our hospital from May 2014 to May 2017 were retrospectively analyzed. In those, 50 patients treated with glaucoma filtering surgery combined with PRP were selected as control group, and based on this, 50 patients treated with intravitreal injection of conbercept were included in the observation group. The best corrected visual acuity(BCVA)before treatment, and after 7d, 1, 3, and 6mo treatment were compared. The intraocular pressure IOP of each period with the non-contact tonometer were also compared, the effect of surgery was evaluated by slit-lamp examination of neovascularization combined with intraocular pressure, and then recurrence rate and complication was recorded during 6mo follow-up.

RESULTS: No statistically significant difference was found between preoperative and after surgery at each time point(P>0.05). The intraocular pressure of the two groups was significantly lower than that of before the surgery, the observation group was significantly lower than that of the control group 7d and 1mo after surgery, and the difference was statistically significant(P<0.05). There was no statistically significant difference on IOP the 3 and 6mo after surgery between two groups(P>0.05). The operation success rate was 100% in the observation group and was 92% in the control group, the difference was statistically significant(P<0.05). The complete success rate of the observation group was 84%, which was significantly higher than 66% of the control group, the difference was statistically significant(P<0.05). The hyphema and recurrence rate of the observation group were significantly lower than those of the control group, the difference was statistically significant(P<0.05). There was no significant difference in the incidence of shallow anterior chamber and low intraocular pressure(P>0.05).

CONCLUSION: Preoperative intravitreal injection of conbercept combined with panretinal photocoagulation for neovascular glaucoma after central retinal vein occlusion make the pressure recovery and neovascularization time shorter with better surgical results, and can control the anterior chamber hemorrhage and reduce the recurrence rate.

Abstract:AIM: To investigate the retinal nerve fiber layer thickness(RNFL)in normal subjects and primary open angle glaucoma(POAG)patients by optical coherence tomography(OCT), and to provide a theoretical basis for the diagnosis of POAG.

METHODS: Totally 100 patients(123 eyes)with POAG treated in our hospital from November 2014 to November 2017 were selected as the observation group, and 50 cases(100 eyes)matched with age and sex were selected as the control group. Patients with POAG were divided into the early group(36 cases, 44 eyes), the advanced group(40 cases, 50 eyes)and the late group(24 cases, 29 eyes)according to the mean defect(MD). The average RNFL and the MD of the whole visual field, temporal visual field, nasal visual field, inferior visual field, and upper visual field were measured by OCT and automatic perimetry respectively, then their corrections were analyzed.

RESULTS: The average RNFL of the whole visual field, temporal visual field, nasal visual field, inferior visual field, and superior visual field of the observation group were significantly lower than those of the control group, the difference was statistically significant(P<0.001). The MD of the whole visual field, temporal visual field, nasal visual field, inferior visual field, and superior visual field of the observation group were significantly higher than those of the control group, with a statistically significant difference(P<0.001). The mean RNFL of the early group, the advanced group and the late group were thinned successively, paired comparison showed a statistically significant difference(P<0.001). The MD of the early group, the advanced group and the late group increased successively, paired comparison showed a statistically significant difference(P<0.001). The average RNFL of the whole visual field, temporal visual field, nasal visual field, inferior visual field, and superior visual field were negatively correlated with those fields of the MD(r=-0.675, -0.667,-0.560, -0.711, -0.660; all P<0.001).

CONCLUSION: OCT examination shows that the RNFL of POAG patients is thinner than that of the normal people, and the RNFL becomes thinner with the progression of the disease. And it has a close relationship with MD.

Abstract:AIM: To investigate the effect of macular focal/grid laser photocoagulation with Ranibizumab on the treatment of diabetic macular edema(DME).

METHODS: Totally 70 patients(99 eyes)with DME treated in our hospital from August 2014 to August 2016 were randomly divided into the observation group and the control group, with 50 eyes and 49 eyes, respectively. Patients in control group were treated with macular focal/grid laser photocoagulation, and based on this, the observation group was treated with intravitreal injection of ranibizuma at 5-7d before operation. The best corrected visual acuity(BCVA)before and after operation was compared between the two groups. Central macular thickness(CMT)was examined by optical coherence tomography(OCT), and fluorescein fundus angiography(FFA)was used to examine the leakage area of retinal neovascularization(RNV)and macular edema.

RESULTS: The BCVA in both groups increased significantly after operation, and the BCVA in observation group was significantly higher than that of the control group at each time point after operation, the difference was statistically significant(P<0.05). After treatment, the CMT and leakage area of RNV in both groups significantly decreased, and the leakage area of the observation group were significantly less than those in control group at each time point(P<0.05). There were different degrees of macular edema leakage in the two groups before operation, and the proportion of eye with macular edema and leakage in observation group was significantly lower than that in control group, the difference was statistically significant(P<0.05). No obvious complications occurred in the two groups.

CONCLUSION: Compared with macular focal/grid laser photocoagulation, the combination of macular focal/grid laser photocoagulation and ranibizumab has better curative effect on DME and RNV reduction. Moreover, the patients' visual acuity improve significantly with a higher safety.

Abstract:AIM:To compare the clinical curative effect of triamcinolone acetonide and Ranibizumab on diffuse diabetic macular edema(DME).

METHODS: We collected 84 cases of patients with diffuse DME treated in our hospital from February 2016 to May 2017. According to 1:1 matching method, they were divided into Ⅰ, Ⅱ groups. They were all treated with laser photocoagulation. Preoperative auxiliary application of triamcinolone acetonide was given to Group Ⅰ, while Group Ⅱ received preoperative application of ranibizumab. After treatment, the efficacy of the two groups were analyzed and compared.

RESULTS: The total clinical efficiency of Group Ⅱ at 3mo after treatment was 93%, higher than that of Group Ⅰ(77%; χ²=4.981, P=0.025). Compared with before treatment, BCVA and CMT of the two groups at each time after treatment were significantly improved(P<0.05). BCVA of Group Ⅱ at 1 and 3mo after treatment was better than that of Group Ⅰ(P<0.05); CMT of Group Ⅱ at 1, 3 and 6mo after treatment improved more than that of Group Ⅰ, with significant difference(P<0.05); occurrence rate of adverse reactions Group Ⅰ and Group Ⅱ were 17% and 13% with no significant statistical difference(χ²=0.243, P=0.621). There were no serious adverse reactions such as retinal detachment, endophthalmitis or cataract in the two groups.

CONCLUSION: Compared with triamcinolone acetonide, the effect of ranibizumab on diffuse diabetic macular edema is better, and has high clinical value.

Abstract:AIM: To investigate the incidence and risk factors of retinopathy of prematurity(ROP)in preterm infants.

METHODS: The wide-field digital pediatric Retinal imaging system was used to screen 2 203 preterm infants with gestational age <37wk or birth weight ≤2 000g in NICU and the Ophthalmology Department of Northwest Women and Children Hospital from January 15, 2015 to October 15, 2017. The screening results were used to calculate the incidence of ROP and to analyze the risk factors.

RESULTS: Totally 367 infants(621 eyes)were diagnosed as retinopathy among 2 203 premature infants and the incidence of ROP was 16.66%; 236 cases(399 eyes)of ROP(26.61%)were detected in 887 cases of premature infants in accord with screening standard of the Chinese Premature Retinopathy Screening Guidelines(2014), and 131 cases(222 eyes)of ROP(9.95%)was detected in 1 316 cases of premature infants outside the screening standard. In our research, the incidence of ROP was related with gestational age, birth weight, oxygen duration and mechanical ventilation. However, the relationship had not been found with artificial insemination, caesarean birth, gender, polyembryony, acute respiratory distress syndrome(ARDS), hypertensive disorders in pregnancy, gestational diabetes mellitus, intrauterine infection, intrauterine distress, premature rupture of membrane. The incidence of ROP was statistically significant between different gestational age groups, different birth weight groups and different oxygen groups(P<0.05). Logistic analysis showed that gestational age, birth weight, oxygen duration and mechanical ventilation were independent risk factors of ROP.

CONCLUSION: The incidence of ROP is 16.66% in this study, and there is still a certain proportion outside the screening standard of the Chinese Premature Retinopathy Screening Guidelines(2014). Gestational age, birth weight, oxygen duration and mechanical ventilation are high risk factors for ROP.

Abstract:AIM:To investigate the efficacy and safety of short-term application of pranoprofen eye drops in the treatment of dry eyes in senile patients.

METHODS: Totally 100 elderly patients with dry eyes treated in our hospital from June 2016 to May 2017 were randomly divided into 2 groups. All cases were bilateral onset, and the right eyes were marked as the observation eyes. The 50 eyes in the observation group were treated with 1g/L pranoprofen eye drops combined with 1g/L sodium hyaluronate eye drops, while 50 in the control group were treated with 1g/L sodium hyaluronate eye drops. The results of Schirmer Ⅰ, ocular surface disease index(OSDI), break-up time(BUT), ocular surface staining(OSS), human leukocyte antigen-DR(HLA-DR)and CD11b in conjunctival epithelial cells before and at 2wk after treatment, and adverse reactions in 2 groups were observed.

RESULTS: Before treatment, results of Schirmer I, OSDI, BUT, OSS, HLA-DR and CD11b in the two groups were similar, there were no statistically significant differences(P>0.05). After treatment, OSDI, OSS, HLA-DR, CD11b significantly decreased, BUT significantly increased in both groups, the differences were statistically significant(P<0.05). After treatment, OSDI, OSS and HLA-DR in the observation group were significantly lower than those in the control group, BUT in the observation group was significantly higher than those in the control group, the differences were statistically significant(P<0.01). The expression of HLA-DR was positively correlated with OSDI and OSS, and negatively correlated with BUT, and the correlations were statistically significant(P<0.05).

CONCLUSION: Short term application of pranoprofen eye drops can effectively enhance the efficacy in treating elderly patients with dry eyes, release clinical symptoms, and the therapeutic mechanism may be related to the inhibitory effect on HLA-DR.

Abstract:AIM:To investigate the prevalence and related factors of dry eye in primary school pupils in Lanzhou, Gansu Province.

METHODS: From October to November 2016, 1 347 pupils in two primary schools in Lanzhou, Gansu Province, were randomly selected as subjects. Every pupil was carried on the questionnaire of dry eye and eye inspection to confirm the diagnosis of dry eye. Besides, the prevalence and influencing factors of dry eye in pupils were analyzed by chi-square test, Mann-Whitney U test and logistic regression model.

RESULTS: A total of 1 268 pupils took part in this study and the inclusion ratio was 94.14%; 271 individuals were diagnosed as dry eye, and the prevalence rate was 21.37%. Statistical analysis showed that the risk factors of dry eye were male, senior pupils, often using eye drops, poor reading habits, wearing contact lenses, video terminals last for a long time, learning pressure.

CONCLUSION: Dry eye has become one of the main diseases that plagued pupil's life and learning. It should cause wide attention. Considering the above factors, rational use of eye and improve lifestyle will help to reduce the damage to eye of pupils.

Abstract:AIM: To investigate the prevalence of juvenile myopia and factors affecting its occurrence in Linxia Prefecture.

METHODS: Totally 8 683 juvenile students who were 6-18 years old were extracted as respondent with stratified cluster sampling method. The eyesight, diopter and axial length were detected, and the gender, age, ethnicity, eye behavior were collected by self-made questionnaire.

RESULTS: The prevalence of myopia was 42.80%. The myopic rates of all ethnic groups were as follows: Tibetan Nationality: 59.05%, Han Nationality: 46.71%, Dongxiang Nationality: 46.36%, Tu Nationality: 45.24%, Sala Nationality: 41.30%, Baoan nationality: 40.61%, Hui Nationality: 31.97%. Myopia rate between each ethnic groups had statistical difference(χ²=44.08, P=0.007). Multivariate analyses revealed that outdoor activities during the break was the protect factor for myopia; age, using electronic products on weekends and holidays, using the same lighting in room while studying were risk factors for myopia.

CONCLUSION: The prevalence of myopia increase with age in Linxia. The prevalence in different ethnic groups is different. Education department and family should make joint efforts to increase the outdoor time, improve the environment for teenagers to reduce the occurrence and development of myopia.

Abstract:AIM: To analyze the clinical effect of intravitreal injection of Conbercept combined with retinal laser photocoagulation in the treatment of patients with diabetic macular edema(DME).

METHODS: Totally 73 patients(80 eyes)with type 2 diabetes and DME were enrolled in our hospital from June 2015 to December 2016, according to different treatment methods, and they were randomly divided into control group and treatment group. The control group were treated with retinal laser photocoagulation, and the treatment group were treated with intravitreal injection combined with laser photocoagulation. We observed the best corrected visual acuity(BCVA), retinal thickness and complications during the operation before treatment and 3mo after treatment.

RESULTS: At 3mo after treatment, the improvement of BCVA, the decreased value of average retinal thickness and retinal thickness at inferior, superior, temple and nasal in the treatment group were better than those in the control group and those after treatment was better than before(P<0.05). There was no statistically significant difference in the incidence of complications occurrence between the two groups(P>0.05). None of the patients had severe ocular complications such as corneal edema, anterior chamber inflammatory reaction, retinal hemorrhage, neonatal vascular glaucoma, endophthalmitis, etc. during follow up period.

CONCLUSION: Compared with applying laser photocoagulation alone, intravitreal injection of conbercept combined for DME is more effective with improved visual acuity, restored retinal function, and has good safety.

Abstract:AIM: To investigate the clinical efficacy of intravitreal injection of Ranibizumab combined with retinal photocoagulation(523 laser)in the treatment of central retinal vein occlusion(CRVO)with retinal neovascularization and macular edema.

METHODS: The subjects of this study were 70 patients(70 eyes)with CRVO and retinal neovascularization and macular edema treated in our hospital from January 2016 to January 2017. There were 35 patients(35 eyes)treated with intravitreal injection of ranibizumab combined 523 laser and enrolled in the observation group; 35 patients(35 eyes)treated with 523 laser alone and selected as the control group. The medical records were retrospectively analyzed. The best corrected visual acuity and intraocular pressure(IOP)were observed before treatment and 3mo after treatment. The central retinal thickness(CRT)was measured by optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)to evaluate the changes of retinal lesions progress and follow-up observation of the incidence of complications after treatment.

RESULTS: After 3mo of treatment, the best corrected visual acuity remained unchanged in both groups. There was no significant difference between the two groups in best corrected visual acuity improved by 1 lines, 2 lines, 3 lines and above(P<0.05). There was no significant difference in intraocular pressure before and after operation, and in those between the two groups(P>0.05). There was significant difference of CRT between the two groups, before and after treatment(P<0.01); postoperatively CRT of observation group was significantly lower than that of the control group, the difference was statistically significant(P<0.01). There were 25 cases(71%)of macular edema subsided detected by OCT and FFA 3mo after operation, which was significantly higher than that of the control group(19 eyes, 54%), the difference was statistically significant(χ²=6.292, P=0.012). Neovascularization significantly relieved in both groups at 1mo after the operation. In the observation group, 2 cases recurred 1mo after operation, the recurrence rate was 6%; 10 cases recurred in the control group, and the recurrence rate was 29%. In the observation group, there were 3 cases of recurrence 3mo after operation, the recurrence rate was 9%, the recurrence of the control group was 19 cases, the recurrence rate was 54%, the difference was statistically significant(P<0.05).

CONCLUSION: Intravitreal injection of ranibizumab combined with 523 laser can significantly improve visual acuity in patients with CRVO, which can effectively prevent the formation of retinal neovascularization and accelerate the exudation bleeding and edema absorption.

Abstract:AIM: To investigate the effects and safety of intravitreal injection of Conbercept combined with macular grid pattern photocoagulation for macular edema secondary to non-ischemic branch retinal vein occlusion(BRVO).

METHODS: A total of 38 patients(38 eyes )with macular edema following non-ischemic BRVO were retrospectively analyzed. All patients were given best corrected visual acuity(BCVA), intraocular pressure, slit lamp with preset lens, optic coherent tomography(OCT)and fluorescence fundus angiography(FFA)examination. The BCVA and central macular thickness(CMT)were observed before and 1wk, 1, 2, 3, 6, 9 and 12mo after treatment. The change in pre-treatment and post-treatment were compared, and the related complications were recorded.

RESULTS:BCVA before treatment and 1wk, 1, 2, 3, 6, 9 and 12mo after treatment were 0.89±0.62, 0.64±0.59, 0.55±0.62, 0.46±0.43, 0.53±0.67, 0.43±0.38, 0.42±0.29, 0.40±0.30, the difference was statistically significant between that before and after treatment(P<0.001), while the BCVA after treatment showed no significant difference with each other(P>0.05). CMT were 683.25±236.47, 298.65±116.12, 276.89±107.28, 281.55±99.62, 251.41±119.47, 240.58±88.62, 231.74±75.36, 209.51±84.68μm, the difference was statistically significant between that before and after treatment(P<0.001), while the those after treatment showed no significant difference with each other(P>0.05). There were 11 eyes received one injection, 18 eyes with two injections, 2 eyes with 3, 3 eyes with 4, and 4 eyes more than 4, the average injection was 2.01±1.42. The CMT decreased after every injection. The intraocular hypertension and other complications were not seen after treatment.

CONCLUSION: Intravitreal injection of conbercept combined with macular grid pattern photocoagulation for macular edema to non-ischemic BRVO can reduce the macular edema and improve BCVA, which is effective and safety.

Abstract:AIM: To investigate the correlation between retinal thickness(CSRT)in the macular region and glycosylated hemoglobin(HbA1c)of patients with type 2 diabetes mellitus.

METHODS: Totally 39 cases of patients with diabetes(77 eyes)who screened from May 2016 to March 2017 were selected, and were divided into two groups according to the levels of HbA1c, which the 24 cases(47 eyes)in the low HbA1c group(HbA1c<8%)and 15 cases(30 eyes)in high HbA1c group(HbA1c≥8%). Other 22 cases of normal people(normal control group)and who for healthy physical examination were selected in the same period. Then, the correlation between HbA1c level and CSRT were analyzed by the Spearman correlation analysis.

RESULTS: In the high HbA1c group, HbA1c was(10.45±1.30)%, FBG was 10.67±1.64mmol/L and 2hPG was 15.98±1.38mmol/L, which was higher than that in the low HbA1c group, and there was significant difference between the two groups(P<0.05). The CSRT in the normal group was lower than the low HbA1c group and the high HbA1c group, and there was significant difference between the groups(P<0.05). According to the analysis of the Spearman method, there was positive correlation between HbA1c and CSRT, macular volume, average macular thickness, FBG and those parameters, 2hPG and them(P<0.01).

CONCLUSION: The HbA1c level is associated with retinal thickening in the macular region of patients with diabetes, which could predict the severity of diabetic retinopathy and provide important guidance for prevention and treatment.

Abstract:AIM: To investigate the clinical effect of Ranibizumab combined with photodynamic therapy(PDT)for wet type age-related macular degeneration(wAMD)and the effect on the serum neovascularization factors.

METHODS: Totally 68 cases(68 eyes)of wAMD patients treated with PDT in our hospital from January 2014 to June 2016 were analyzed retrospectively. Among them, 34 patients were treated by photodynamic therapy(control group)and 34 patients were treated by combination of photodynamic therapy and ranibizumab(treatment group). Comparison of BCVA, mean retinal thickness and central macular thickness(CMT)and serum neovascularization regulatory factors before and after treatment were taken between the two groups.

RESULTS: Before treatment, there was no significant difference on the BCVA, the average retinal thickness and the CMT value between the two groups(P>0.05). At 3, 6 and 12mo after treatment, the BCVA, average retinal thickness and CMT in both groups were significantly lower than those before treatment(P<0.05). At 3, 6 and 12mo after treatment, the BCVA, the average retinal thickness and the CMT value of the patients in the treatment group were significantly lower than those in the control group(P<0.05). There was no significant difference of vascular endothelial growth factor(VEGF), platelet derived growth factor(PDGF), matrix metallo-proteinase inhibitor(TIMP)-1 and endostatin(ES)between the two groups before treatment(P>0.05). Three months after treatment, VEGF, PDGF and ES in both groups were significantly lower than those before treatment(P<0.05). Three months after treatment, the levels of VEGF, PDGF and ES in the treatment group were significantly lower than those in the control group(P<0.05).

CONCLUSION: The wAMD patients treated with ranibizumab combined with photodynamic therapy can achieve a more significant clinical effect, and more effectively reduce the level of serum neovascularization regulators.

Abstract:AIM: To compared the therapeutic effect of improved macular hole surgery to traditional macular hole surgery for idiopathic macular hole(IMH).

METHODS: From April 2014 to June 2017, 28 eyes of 28 IMH patients who were treated in our hospital were selected consecutively and received surgical treatment independently performed by the same physician in our hospital. The patients were divided into A(traditional group)and B(improvement group)groups. All 13 cases in Group A were treated with traditional vitrectomy internal limiting membrane peeling and C₃F₈ tamponade, while all 15 cases in Group B were treated with improved indocyanine green-assisted internal limiting membrane peeling combined with macular hole reconstruction and air tamponade. All patients were reviewed at 1wk, 1, 3, and 6mo after surgery. The best corrected visual acuity(BCVA)before and after the operation, operation time, closure rate of the macular hole during the last review and prone time were compared between the two groups of patients.

RESULTS: There was no significant difference in closure rate between the two groups(P>0.05). Postoperative BCVA increased in both groups compared with preoperatively and the differences were statistically significant(P<0.05). But there was no significant difference on BCVA between the two groups both preoperatively and postoperatively(P>0.05). The operation time in Group B was significantly shorter than that in Group A(P<0.05). Prone time in Group B was significantly shorter than that in Group A, the difference was statistically significant(P<0.05).

CONCLUSION: This study shows that compared with the traditional group, the improved indocyanine green-assisted peeling of internal limiting membrane combined with macular hole reconstruction and air tamponade can achieve similarly high closure rates while the operation procedure was simplified and the operation time was shortened. Reduced number of instruments into and out of the incision can reduce the incidence of complications. The postoperative patient's prone time is significantly shortened, with high comfort and good compliance.

Abstract:AIM: To observe the curative effect of different operative methods on acquired lacrimal point stenosis or adhesion, and to investigate the better treatment method for them.

METHODS: Totally 52 cases(72 eyes)suffered from acquired lacrimal point stenosis or adhesion, were divided into treatment group and control group by random number table, in which 27 cases(36 eyes)in treatment group were treated by modified tear incision combined with silicone tube implantation, 25 cases(36 eyes)in control group were treated by silicone tube implantation. All cases were followed up for 12mo.

RESULTS: The total effective rate of the treatment group was 94%. The total effective rate of the control group was 78%. The difference between two groups was statistically significant(P<0.05). Silicone tube shedded in two eyes in treatment group and three eyes in control group. The rate of silicone tube shedded in two was 6% and 8%, respectively. The difference between two groups was not statistically significant(P>0.05). None case had lacrimal point tear in two groups.

CONCLUSION: Modified tear point incision combined with silicone tube implantation is the better operative methods on acquired lacrimal point stenosis or adhesion. It is easily operating, less damage with quick recovery. And effective rate is high.

Abstract:AIM:To investigate the effect of sodium hyaluronate eye drops combined with vitamin A palmitate ophthalmic gel on levels of tear film stability and inflammatory cytokines in patients with dry eye.

METHODS: A total of 100 patients with dry eye treated in our hospital from January 2015 to February 2017 were randomly divided into control group and observation group, 50 cases in each group. Patients in the control group were treated with sodium hyaluronate eye drops. Patients in the observation group were given vitamin A palmitate ophthalmic gel on the basis of the control group, and then the clinical efficacy, tear film stability and the level of inflammatory cytokines were detected in the two groups.

RESULTS: After treatment, the levels of BUT and SⅠt in both groups increased significantly compared with that before treatment, and FL was significantly lower than that before treatment. The levels of BUT and SⅠt in the observation group after treatment were 11.24±0.22s and 11.4±0.17mm/5min respectively, which was high than that of control groups(P<0.05). FL level was 1.78±0.10 points, which was significantly lower than that of the control group after treatment(P<0.05). After treatment, the levels of IL-1β and TNF-αsignificantly decreased in both groups. The levels of IL-1β and TNF-α in the observation group were 34.38±5.58ng/L and 134.47±12.14ng/L, significantly lower than those of the control group after treatment, the difference was statistically significant(P<0.05). The total effective rate of observation group after treatment was 91.7%, significantly higher than that of the control group after treatment, the difference was statistically significant(P<0.05).

CONCLUSION: Sodium hyaluronate eye drops combined with vitamin A palmitate ophthalmic gel can relieve the symptoms of patients with dry eye effectively, increase the stability of tear film, and reduce the levels of inflammatory factors in tears, which is reliable in clinical application.

Abstract:AIM: To analyze the clinical effect of different surgical approaches for orbital tumors.

METHODS: A total of 52 patients(56 eyes)with orbital tumors who were admitted to the hospital from January 2012 to June 2017 were examined by brain MRI and orbital sectional CT scan to identify the relationship between tumors and surrounding anatomical structures. They were treated by orbitotomy, and the approaches included anterior conjunctival approach, lateral approach and combined medial and lateral approach. The removal of tumors, recovery of visual acuity, postoperative early complications and follow-up recurrence were statistically analyzed.

RESULTS: Among the 52 patients, there were 7 cases 8 eyes(14%)with residual tumors. The rate of residual tumors after anterior conjunctival orbitotomy(23%)was higher than that after lateral orbitotomy or combined medial and lateral orbitotomy(6%, 7%; P<0.05). The visual acuity was improved in 28 cases 30 eyes(54%), no change in 18 cases 19 eyes(34%)and decreased in 6 cases 7 eyes(13%). The incidence of early complications was 23%, including 2 cases 2 eyes with accidental loss of vision, 2 cases 2 eyes with pupil changes, 3 cases 3 eyes with ptosis and 5 cases 6 eyes with eye movement disorders, which mainly occurred in the elderly. The recovery of visual acuity and the incidence rates of complications(23%, 19%, 29%)of the three kinds of surgical approaches were close(P>0.05). During the follow-up period, there were 3 cases 3 eyes(5%)with recurrence in the 52 patients, and the recurrence rate after combined medial and lateral orbitotomy(14%)was significantly higher than that after anterior conjunctival or lateral orbitotomy(4%, 0; P<0.05).

CONCLUSION: The appropriate surgical approach can successfully remove the orbital tumors, improve or stabilize the visual function, and reduce complications and recurrence.

Abstract:AIM: To assess the effect of bandage contact lens on the corneal epithelium healing condition, degree of pain and corneal surface after recurrent pterygium excision.

METHODS: Retrospective case-series study. A total of 64 patients(64 eyes)with recurrent pterygium who received treatment in the First Affiliated Hospital of Huzhou University from September 2015 to September 2017 were divided into Group A(34 cases with bandage contact lens group)and Group B(30 cases without bandage contact lens group). The healing status of corneal epithelium was evaluated by fluorescent staining between the two groups at 1d and 1wk after surgery. The degree of pain was assessed between the two groups at 2h, 1d and 1wk after recurrent pterygium excision by visual analogue score. Computerized corneal topography was performed on all cases with recurrent pterygium before and 1mo after successful excision surgery. Statistical analysis of surface regularity index(SRI), surface asymmetry index(SAI)and corneal astigmatism(CA), was done before and 1mo after surgery.

RESULTS: Average scores of corneal epithelium healing condition at 1d and 1wk were better in Group A than that in Group B(P<0.01). The mean scores of pain values at 2h, 1d and 1wk after surgery in Group A were significantly lower than that in Group B respectively(P<0.01). The indicators reflecting corneal surface at 1mo after surgery, including SRI, SAI, CA, were significantly lower in Group A than that in Group B(P<0.01), while they were not significantly different before surgery between the two groups(P>0.05).

CONCLUSION: Bandage contact lenses could significantly promote the healing status of corneal epithelium, release pain response and improve corneal refractive status after recurrent pterygium excision.

Abstract:AIM: To investigate the effect of pterygium transplantation combined with amniotic membrane transplantation plus bandage type contact lenses.

METHODS: Totally 72 patients(80 eyes)with pterygium treated in our hospital from December 2014 to December 2016 were enrolled and divided into observation group and control group according to the randomized method, with 37 cases(41 eyes), 35 cases(39 eyes)respectively. The control group was treated with pterygium transplantation combined with amniotic membrane transplantation. On the basis of this, the observation group received bandage contact lens. The postoperative visual acuity, curative effect, recurrence rate, and corneal healing time were recorded during the postoperative 1-year follow-up. Non contact tonometer was used to detect intraocular pressure(IOP)before operation and after operation 1d, 1, 3, 6, and 12mo. Then the incidence of postoperative complications was recorded.

RESULTS: In order to determine the curative effect, a 4-grade standard was devised, from Ⅰ to Ⅳ. The postoperative efficacy of observation group consisted of 19 eyes in grade Ⅰ, 11 eyes in grade Ⅱ, 8 eyes in grade Ⅲ, 3 eyes in grade Ⅳ, while the control group had 16 eyes in grade Ⅰ, 12 eyes in grade Ⅱ, 8 eyes in grade Ⅲ, 3 eyes in grade Ⅳ, with no significant difference between two groups(P>0.05). Visual acuity in the observation group increased in 20 eyes, remained in 17 eyes, and decreased in 4 eyes. In control group, visual acuity increased in 16 eyes, remained in 17 eyes, and decreased in 6 eyes, with no significant difference between two groups(P>0.05). The corneal healing time was 3.43 ±1.03d in the observation group and 5.13±1.16d in the control group, which was significantly higher in the observation group than in the control group(P<0.05). The IOP of the two groups before operation and after operation 1d, 1, 3, 6, and 12mo showed no significant difference(P>0.05). After the operation, only 1 eyes of corneal scar were found in the control group, and no other complications were found in the two groups such as intraocular pressure and corneal astigmatism.

CONCLUSION: Compared with pterygium transposition alone, combined amniotic membrane transplantation plus bandage contact lens is an effective and safe way to improve corneal healing time for patients with pterygium.

Abstract:AIM:To evaluate the safety and efficacy at early stage after femtosecond laser-assisted excimer laser in situ keratomileusis(FS-LASIK)combined with collagen cross-linking.

METHODS: Totally 30 myopia patients(60 eyes)received FS-LASIK combined with collagen cross-linking from July 2016 to August 2017 in our hospital were tested the uncorrected visual acuity(UCVA), Ks, Kf, surface regular index(SRI), surface asymmetry index(SAI)by corneal topography(TMS)preoperatively, 1, 3mo after operation. The corneal compensated intraocular pressure(IOPcc), Goldmann correlated IOP value(IOPg), corneal resistance factor(CRF), corneal hysteresis(CH)tested by ocular response analyzer(ORA)were also observed. Ziemer Galilei Dual Scheimpflug Analyzer detected the anterior diopter and the corneal thickness. Endothelial cell density were examined.

RESULTS:The postoperative UCVA remained beyond 0.8 including 26 eyes(43%)of 1d, 55 eyes(92%)of 1mo, 50 eyes(83%)of 3mo. IOPcc, IOPg, CRF, CH at postoperative 1mo significantly decreased comparing with preoperative(P<0.01). IOPcc, IOPg, CRF, CH at postoperative 3mo did not change significantly comparing with 1mo(P>0.05). The corneal topographic map parameters of Ks and Kf significantly decreased at postoperative 1mo(P<0.01), while SRI and SAI increased significantly(P<0.01)on comparison of 1mo and preoperative. Ks of postoperative 3mo was significantly higher than that of 1mo(P<0.05), while Kf did not change significantly(P>0.05). There was a significant decrease in SRI and SAI between 3mo and 1mo after operation(P<0.05). In Galileo analysis on comparison of 3mo and 1mo, Sim Ks, Sim Kf had 0.94D, 0.95D growth and the front and back surface value of Kf increased more at 3mo postoperative(P<0.01), while Ks was no significant difference(P>0.05). There was no statistically significant difference in corneal thickness between the central point and the thinnest point(P>0.05). There was no significant endothelial cell loss throughout follow up(3059.95±247.87/mm² vs 3052.87±267.71/mm²; t=0.279, P>0.05).

CONCLUSION: Refractive corneal surgery combined with collagen cross linking for high degree, thin cornea, uneven thickness of the cornea, topographic anomalies except for the patients with keratoconus, play a role in stabilizing corneal shape and increasing corneal biomechanics early.

Abstract:AIM: To observe the surgical results of large astigmatism with small incision lenticule extraction(SMILE)for 2a.

METHODS: Totally 33 eyes of 17 consecutive patients were enrolled in this retrospective study, aged from 18 to 36 years old, which included 24 eyes of 12 patients with astigmatism within -3.50D to -4.00D and 9 eyes of 5 patients within -4.25D to -5.00D, 7 eyes of 4 patients with sphere within 0 to +1.00D and 26 eyes of 13 patients within -1.00D to 0. Intended cap diameters was 7.3-7.5mm, lenticule diameter was 6.6-6.8mm, the thickness of cap was 120μm, the surgical incision was 2mm. We observed the results after 1d, 1wk, 1, 3, 6mo, 1 and 2a. Preoperative best corrected visual acuity, spherical equivalent refraction, postoperative uncorrected visual acuity, SimK equivalent value and SimK value was observed.

RESULTS: Compared with preoperation, uncorrected visual acuity showed significant difference statistically at 1d postoperatively(P<0.05). Compared with 1wk postoperatively, uncorrected visual acuity showed no significant difference statistically at postoperative 1, 3, 6mo, 1 and 2a(P>0.05). Uncorrected visual acuity did not increase or decrease more than two lines. The target diopter was +0.25D. Compared with 1d postoperatively, the spherical equivalent refraction and residual astigmatism showed no significant difference statistically at each postoperative period(P>0.05). postoperative SimK equivalent value and SimK value difference showed no significant difference statistically compared with each postoperative period(P>0.05).

CONCLUSION: It is both safe, effective, predictable and stable to correct large astigmatism with SMILE by long-term observation, postoperative 2a. The corneal morphology is good and worthy of clinical application.

Abstract:AIM: To investigate the effect of long-term wearing rigid gas permeable(RGP)contact lenses on the stability of tear film, and to observe its safety.

METHODS: Totally 60 myopia patients(120 eyes)wearing RGP in our hospital from October 2014 to January 2016 and 30 low myopia patients(60 eyes)without a history of wearing RGP were selected. There were 26 patients(52 eyes)wearing RGP at daytime were included into daytime wearing group; 34 patients(68 eyes)only wearing RGP at night were set as the night wearing group. And patients without wearing RGP were set as control group. Schirmer Ⅰ test(SⅠt), tear film fern experiments, and break-up time(BUT)of tear film were performed before wearing RGP, wearing for 1mo, wearing for 6mo, wearing for 1a, wearing for 2a, respectively.

RESULTS: After wearing RGP, the BUT and SⅠt of daytime wearing group and night wearing group significantly decreased, and were significantly lower than those of the control group at the time points, the difference was statistically significant(P<0.05). After wearing for 6mo, 1a and 2a, the BUT and SⅠt of daytime wearing group was significantly lower than that of the night wearing group, the statistic found significant difference(P<0.05). The three groups had no statistically significant differences in tear fern classification experiment before wearing RGP and wearing for 1 and 6mo(P>0.05). The number of the eyes ≥ Ⅲ in daytime wearing group and night wearing group was significantly higher than that of the control group after wearing for 1 and 2a, the difference was statistically significant(P<0.05), but the difference between daytime wearing group and night wearing group found no significant difference(P>0.05).

CONCLUSION: Wearing RGP can result in reducing tear secretion and decreasing the stability of tear film.

Abstract:AIM: To analyze the clinical features of binocular visual function in children with intermittent exotropia before and after operation, so as to provide theoretical basis for surgical treatment of intermittent exotropia.

METHODS: Enrolled forty patients with intermittent exotropia in our hospital from January 2016 to January 2017, in which 64 eyes received operation. All patients underwent surgical treatment and were followed up for 6wk, to compare the proportion of patients with Ⅰ, Ⅱ and Ⅲ of visual function before and after the treatment. Seeing WORTH four hole lamp near and far respectively were used to compare central and peripheral fusion before and at 2wk and 6wk after operation. Yan's random dot stereogram(Stereoscopic Test Charts, STC)was used to evaluate the near stereopsis, and synoptophore(STC)picture for distant stereopsis evaluation before and at 2wk and 6wk after operation.

RESULTS: There were 26 cases(65%), 9 cases(22.5%), 5 cases(12.5%)with preoperative vision function of Ⅰ, Ⅱ and Ⅲ respectively; 10 cases(25%), 17 cases(42.5%)and 13 cases(32.5%)at 2wk after operation; 8 cases(20%), 18 cases(45%), 14 cases(35%)at 6wk after surgery; the differences between the proportion before and 2wk after operation, before and 6wk after operation were significant(P<0.05). WORTH four hole lamp examination showed preoperative proportion of patients with central fusion was significantly lower than that at 2wk and 6wk after surgery; the proportion at 2wk was significantly lower than that at 6wk after surgery, the difference was statistically significant(P<0.05). The proportion of patients with peripheral fusion at 2 and 6wk after operation was significantly higher than that before operation(P<0.05), but the proportion at 2wk was not different from 6wk(P>0.05). The near stereopsis at 2 and 6wk after operation was significantly improved than that before operation(P<0.05), but that at 2wk was not different from 6wk(P>0.05). The proportion of patients with distant stereopsis at 2wk(24 cases, 60%)and 6wk(39 cases, 97.5%)after operation was significantly higher than that before operation(6 cases, 15%, P<0.05), but the proportion at 2wk was not different from 6wk(P>0.05).

CONCLUSION: Intermittent exotropia correction surgery can significantly improve the binocular single vision and save the deterioration of patients with far, near stereopsis and central fusion.

Abstract:AIM: To explore the effect of levodopa and visual stimulation training in the treatment of adolescent ametropic amblyopia.

METHODS: Sixty-four adolescents(68 eyes)with ametropic amblyopia who treated in our hospital from May 2013 to May 2016 were included into this study, and the patients were randomly divided into the observation group(n=32, 33 eyes)and the control group(n=32, 35 eyes). The patients in the control group received visual stimulation training therapy, and the patients in the observation group were given levodopa on the basis of the control group. After treated for 24wk, the clinical effects and changes of P-VEP and visual sensitivity before and after treatment were compared.

RESULTS: After treated for 24wk, the total effective rate of the observation group(91%)was significantly higher than that of the control group(71%), and the difference was statistically significant(P<0.05). Although the amplitude of P-VEP P100 in the control group increased and the latency was shortened, the effect of the observation group was more significant, and the difference was significant(P<0.05).

CONCLUSIONS: Levodopa combined with visual stimulation training has significant effect in the treatment of adolescent ametropic amblyopia, it can better correct the visual sensitivity, and improve optic nerve conduction function.

Abstract:AIM: To discuss the effect of mental image network training on binocular visual function recovery in children with concomitant strabismus.

METHODS: Totally 100 children with concomitant strabismus were selected from March 2013 to March 2017 in our Hospital. According to the random distribution, they were divided into mental group and control group, 50 cases in each group. Mental group was given the mental image network training, control group was given no training. The visual function of the two groups of binocular vision, the near stereoscopic visual acuity and the eye position of the two groups were compared.

RESULTS: The proportion of patients with vision function by synoptophore at Ⅰ, Ⅱ, Ⅲ after treatment of mental group and control group were significantly higher than those before treatment, the after treatment of mental group was significantly higher than that of control group, the difference was statistically significant(P<0.05). In the aspect of rate of ceses without stereovision by Titmus near stereoacuity, that after treatment of mental group and control group were significantly lower than those of the before treatment, that after treatment of mental group was significantly lower than control group; in the aspect of central fovea, macular hole, peripheral stereoscopic vision, those after treatment of mental group and control group were significantly higher than those of the before treatment, those after treatment of mental group was significantly higher than that of control group, the difference was statistically significant(P<0.05). During the follow-up for 6mo, the ocular position maintenance rate of mental group was significantly higher than that of control group, the difference was statistically significant(P<0.05).

CONCLUSION: Mental image network training can effectively promote the recovery of visual function in children after concomitant strabismus surgery. It is beneficial to maintain the position of the eye of children.