Abstract:AIM: To determine the relationship among the macular pigment optical density(MPOD), central macular thickness and body mass index(BMI).

METHODS: This is a comparative cross-sectional study performed in a single institution. Totally 210 volunteers who met the inclusion criteria were included in this study. The subject's MPOD was measured using Macula Pigment Screener II(MPS II, by Electron Technology). Central macular thickness was measured with Spectral Domain Cirrus Optical Coherence Tomography(OCT), Cirrus(Model 4000, Carl Zeiss Meditec). The information of both MPOD and OCT from both eyes were recorded. The data was analysed using Microsoft^© Excel \〖Version 15.12.3(150724)℃2015 Microsoft\〗, SPSS(IBM^© SPSS^© Statistics Version 2.2), and R(version 3.2.1; R Core Team 2015).

RESULTS: There was significant positive correlation between MPOD and central macular thickness(r=0.42, P<0.01)and a significant negative correlation between MPOD and BMI(r=-0.23, P<0.01).

CONCLUSION: Our study showed a significant positive correlation between MPOD and central macular thickness. Further study is needed to look at the detailed structure of the fovea and its relationship with MPOD. Our study also found a significant negative correlation between MPOD and BMI, suggesting that a reduction in BMI may increase the density of macula pigment, which can be helpful in preventing age-retinal pigment epitheliitis(ARMD).

Abstract:AIM: To analyze the clinical features and surgical outcomes of Duane retraction syndrome(DRS)patients.

METHODS: The clinical data of 94 DRS patients were evaluated. Complete ophthalmic data including age, sex, laterality, the type of DRS, angle of deviation, abnormal head posture(AHP), globe retraction, overshoots and the type of surgical approach were recorded.

RESULTS: The average age of patients was 15.4±9.18 years, and there were 78 males and 16 females. Unilateral and bilateral involvement were found in 87% and 13% of patients, respectively. In unilateral DRS patients, 65% left eyes predominance were observed. Of the 94 patients, 59.5% of the patients were type I, 29.7% of the patients were type II, 8.5% of the patients were type III and 2.1% of the patients were type IV. Most of the patients were 36(38%)esotropic and AHP over 10° was noted in 43(96%)patients, preoperatively. There were 40(43%)patients with overshoots which were more common in type II. Surgery was performed to 45(48%)patients.

CONCLUSION: An excellent surgical outcome was obtained in 32(78%)patients that underwent horizontal rectus surgery and AHP improved in 24(53%)patients. Y-splitting and posterior tenon fixation of lateral rectus both have satisfactory outcomes in the presence of significant overshoots. Foster augmentation with vertical rectus transposition achieved optimal results in abduction limitation.

Abstract:AIM: To compare pain level and inflammation between preoperative topical Diclofenac 0.1% and Nepafenac 0.1% in patients undergoing cataract surgery.

METHODS: This research was designed as prospective randomized clinical trial and conducted in June to August 2017 at Dr. Yap Eye Hospital. There were 56 subjects underwent phacoemulsification operation(single operator)and diagnosed as senile cataract and no adverse events were found. Subjects were divided into 2 groups according to preoperative eye drop medication, namely Diclofenac group and Nepafenac group. Participants and phaco-surgeon were blind regarding to the treatment. Inflammation parameters(at 1, 7 and 14d follow up)such as pain, conjunctiva hyperemic, blepharospasm, flare and cell in anterior chamber level as the primary outcome, whereas density and morphology of corneal endothelial cells as the secondary outcome.

RESULTS: There were no statistically difference in conjunctiva hyperemic and blepharospasm level between 2 groups at 1d(P=0.284, effect size=0.29, 95% CI=-0.09 to 0.31; P=0.254, effect size=0.31, 95% CI=-0.13 to 0.49, respectively)and 7d(P=1.000 and P=0.556, effect size=0.18, 95% CI=-0.08 to 0.16, respectively)postoperatively. The pain scores(during surgery, 1d and 14d postoperative)in Nepafenac group was statistically lower than Diclofenac group(P=0.006, effect size=0.77, 95% CI=0.24 to 1.34; P=0.045, effect size=0.39, 95% CI=-0.10 to 0.62; and P=0.014, effect size=0.69, 95% CI=-0.06 to 0.50, respectively). The degree of flare and cell in Nepafenac group was lower at the 1d after phacoemulsification(P=0.029, effect size=0.59, 95% CI=0.02 to 0.36). Reduction of corneal endothelial density between 2 groups were not statistically significant, however the reduction of hexagonal cell percentage at 7d after phacoemulsification was lower than Nepafenac group(P=0.042, effect size=-0.55, 95% CI=-2.33 to -0.03).

CONCLUSION: The pain and flare-cell levels in Nepafenac group was lower when compared with Diclofenac group.

Abstract:AIM: To investigate the effect of intestinal fungal dysbiosis induced by antifungal drug on corneal wound healing in mice.

METHODS: Male C57BL/6J mice(free of eye disease)were divided into two groups randomly: control(Ctrl)group and amphotericin B treated(Amph)group, The Ctrl group was given a normal diet, and the Amph group was supplemented with amphotericin B to induce intestinal fungal dysbiosis. After 4wk intervention, corneal epithelial trauma was implemented in both groups. Corneal fluorescein staining was used to evaluate the corneal wound area dynamically. Immunofluorescence staining was applied to observe the changes of corneal epithelial cells and inflammatory cells. HE staining was used to assess the change of corneal thickness.

RESULTS: Compared with Ctrl group, Amph group had delayed re-epithelialization rate and wound repair, less inflammatory cells and thinner corneal.

CONCLUSION: Intestinal fungal dysbiosis delays the corneal wound healing, leading to a weak inflammatory response.

Abstract:AIM:To investigate the effect of microRNA-152-3p(miR-152-3p)targeting insulin-like growth factor 1(IGF1)gene on high glucose-induced retinal pigment epithelial ARPE-19 cell activity and apoptosis, and to explore its role mechanism.

METHODS: High glucose was induced into ARPE-19 cells and transfected with miR-152-3p mimics. MTT assay was used to detect cell proliferation activity. Flow cytometry was used to detect apoptosis. Fluorescence quantitative PCR(RT-PCR)was used to detect cells. The expression levels of IGF1 and VEGF in the cells were detected by Western blot and the binding relationship between IGF1 and miR-152-3p was detected by the dual luciferase reporter gene.

RESULTS:High glucose can decrease the activity of ARPE-19 cells, increase the apoptosis rate, inhibit the expression of miR-152-3p and increase the expression of IGF1 and VEGF. Over expression of miR-152-3p can up-regulate high glucose-induced cells. Increased activity and increased apoptosis inhibited the expression of IGF1 and VEGF. The dual luciferase reporter gene assay verified that IGF1 is the target gene of miR-152-3p.

CONCLUSION: miR-152-3p can inhibit the inhibition of high glucose-induced ARPE-19 cell activity and increase apoptosis by targeting IGF1 gene.

Abstract:AIM: To explore a new method to induce the animal model of rabbit partial limbal stem cell deficiency(LSCD).

METHODS: LSCD was induced through corneal alkali burn, C57 mice and New Zealand rabbits were used to establish the animal models. Corneal alkali burn manipulation was accomplished in experimental animals under general anesthesia combined with surface anesthesia in the operated eye. Specifically, mice(n=30)were used to induce complete LSCD model. In brief, the filter paper(diameter of 3mm)that immersed in 1mol/L potassium hydroxide solution was placed on the central corneal surface of the left eye for 30s, followed by washing with saline. In addition, rabbits(n=19)were utilized to establish the partial LSCD model. Briefly, the nictitating membrane(third eyelid)was resected, and the filter paper(diameter of 5mm)that immersed in 1mol/L potassium hydroxide solution was placed on the superior temporal peripheral corneal surface of the left for 30s, followed by washing with saline. After surgery, the model eyes were treated with 0.5% Levofloxacin Hydrochloride Eye Drops four times a day. In addition, the slit-lamp microscope was adopted for observation and photo-taking before burn, as well as at 1, 2, 4wk and 2mo after burn; meanwhile, complications such as corneal ulcer and perforation were recorded. 2mo after surgery, the corneal goblet cell distribution was detected with impression cytology, and the severity of LSCD was classified according to slit-lamp microscopic findings and corneal impression cytology. The animals were sacrificed 2mo after surgery, cornea and conjunctiva sections were made to observe angiogenesis and goblet cell distribution in cornea. Animals died accidentally were not counted into the total number, and the successful induction rates of complete LSCD and partial LSCD models were compared.

RESULTS: Six out of the 30 mice died accidentally, while 2 developed corneal perforation after burn, and the remaining 22 had developed complete LSCD only, yielding the successful induction rate of 92%. 2mo after burn, extensive angiogenesis distribution in the superficial and deep corneal stromal layers could be observed, and pathological sections revealed corneal angiogenesis. Seven out of the 19 rabbits died accidentally, while the remaining 12 had various degrees of LSCD only(partial LSCD, average involving 1.17±0.39 quadrants). Additionally, no corneal perforation was observed, and the successful induction rate was 100%. The result of Fisher's exact test P value is 0.543, without statistical difference. No goblet cells were observed in the normal corneal region, while goblet cells were observed in the LSCD region, with the average density of 58.60±12.58 cell/HP.

CONCLUSION: Central corneal alkali burn can induce complete LSCD; however, some animals will experience failure in model induction due to corneal ulcer and perforation, LSCD is generally serious and may be combined with angiogenesis in deep cornea. Alkali burn in superior temporal cornea can induce partial LSCD, which may be combined with relatively minor corneal lesion, and the corneal angiogenesis is located in the superficial layer.

Abstract:AIM: To investigate the effect of connective tissue growth factor(CTGF)on the proliferation and migration and transformation in Tenon's capsule fibroblasts(Tfb)of primary open angle glaucoma(POAG)patients.

METHODS: Tfb were cultured from Tenon's tissues in POAG patients in vitro. The free-serum DMEM-F12 containing 1.0, 10.0, 100.0ng/mL of CTGF was added into medium for 24h and 48h in different experimental group respectively, and only equal volume of free-serum DMEM-F12 was added in the negative control group. After 24h, the cell proliferation was analyzed through MTT assay, and migration was evaluated by crutch method. After 48h, Semi-quantitative RT-PCR was used to observed the mRNA expression of α-smooth muscl actin(α-SMA), and expression of α-SMA protein was examined by immunochemistry.

RESULTS: The proliferation values A of the cells in 1.0, 10.0, 100.0ng/mL of CTGF group respectively were 0.436±0.009, 0.643±0.009, 0.679±0.006, and 0.423 ±0.156 in the negative control group. The migrated cell number was 34.600±3.507, 70.400±2.074, 80.000±2.915 in different concentrations of CTGF group respectively, and 31.000±3.536 in the negative control group. And also in different experimental groups respectively, the absorbance ratio of α-SMA/β-actin was 0.873±0.161, 1.213±0.312, 1.352±0.376, and 0.851±0.158 in the negative control group, the expressing levels A of α-SMA protein in Tfb were 0.110±0.026, 0.141±0.017, 0.175±0.027, and 0.108±0.020 in the negative control group. The statistics of the above experimental data showed that, comparing with the negative control group, the 10.0 and 100.0ng/mL CTGF groups was statistically significant different(P<0.05), but there was no statistical different between the 1.0ng/mL CTGF group and the negative control group(P>0.05).

CONCLUSION: The proliferation, migration, and phenotypic transformation of Tfb can be promoted in CTGF group in POAG patients. These findings suggest that CTGF may play a role in the development of filtering bleb scarring.

Abstract:AIM: To investigate the protective effects of berberine on Sprague-Dawley(SD)rat retinal Müller cells with high concentration glucose in vitro.

METHODS: The retinal Müller cells of SD rats were primary cultured by enzyme digestion. The second generation of Müller cells were randomly divided into 7 groups. They were normal glucose concentration(5mmol/L glucose)group, high glucose concentration(25mmol/L glucose)group, high glucose+ berberine group(5, 10, 25, 50 and 100μmol/L). After cultured for 24h, 48h and 72h, the cell proliferative viability was measured by CCK-8 method.

RESULTS: After cultured for 24h, 48h and 72h, compared to the normal glucose concentration group, the absorbance of cells in the high glucose concentration group reduced significantly(All P<0.01). Compared to the high glucose concentration group, the absorbance of cells in different concentration berberine(10, 25, 50 and 100μmol/L)groups increased significantly(All P<0.05). It showed a dose-dependent effect. There was no statistically significant difference on the cells absorbance between high glucose+5μmol/L berberine group and high glucose group(P>0.05).

CONCLUSION: Berberine could reduce the inhibitory effect of high glucose on the proliferative viability of Müller cells to some extent. The intensity of effect was positively correlated with the berberine concentration.

Abstract:AIM: To explore the effect of phacoemulsification combined with goniosynechialysis or trabeculectomy on haemodynamics in patients with primary angle-closure glaucoma(PACG)and cataract.

METHODS: Totally 94 patients(94 eyes)with PACG and cataract who were admitted to Bazhong Central Hospital from January 2015 to June 2017 were divided into phacoemulsification and goniosynechialysis group(Observation group)and phacoemulsification with trabeculectomy group(Control group)by random number table method, 47 cases in each group. The indexes of curative effect were compared between the two groups.

RESULTS:The peak systolic velocity(PSV)and end diastolic velocity(EDV)of Observation group were larger than those of Control group at 1mo and 3mo after surgery. The resistance index(RI)of Observation group was significantly less than that of Control group at 3mo after surgery, while anterior chamber depth and open degree of angle were larger than those of group B(P<0.05).

CONCLUSION:Both goniosynechialysis or trabeculectomy combined with phacoemulsification can effectively reduce intraocular pressure, and promote visual recovery. But goniosynechialysis can better promote opening of angle, and improve hemodynamics.

Abstract:AIM: To analyze the application effects of femtosecond laser assisted cataract surgery(FLACS)in patients with hard nuclear cataract.

METHODS: The clinical data of each 42 cases(eyes)in patients with hard nuclear cataract who underwent FLACS(observation group)and traditional phacoemulsification(control group)were retrospectively analyzed. The operation conditions and postoperative recovery were recorded in the two groups.

RESULTS: The mean ultrasound power, actual phacoemulsification time and effective phacoemulsification time and corneal edema degree at 3d after operation in observation group were lower than those in control group(P<0.05). The changes of postoperative corrected distance visual acuity(CDVA), uncorrected distance visual acuity(UCDVA)and corneal endothelial cell loss rate showed 3d after operation>1wk after operation>1mo after operation, and the changes in observation group were greater than those in control group(P<0.05). The corneal endothelial cell density in observation group at each time point after operation was higher than that in control group(P<0.05).

CONCLUSION: FLACS has significant effects on hard nuclear cataract.

Abstract:AIM: To compare the clinical effects of retinal detachment with choroidal detachment(RD/CD)treatment by posterior subcapsular Tenon injection triamcinolone acetonide and intravenous drip of dexamethasone combined vitrectomy.

METHODS: Totally 52 cases(52 eyes)of RD/CD patients in our hospital from March 2014 to October 2017 were retrospectively reviewed. According to the preoperative intervention methods, the patients were divided into two groups: A group and B group. Group A(27 cases, 27 eyes)received intravenous drip of dexamethasone once a day 3-5d before operation. Group B(25 cases, 25 eyes)received posterior subcapsular Tenon injection triamcinolone acetonide 5d before operation. The intraocular pressure, CD, retinal reattachment, visual acuity and complications were measured before and after the intervention.

RESULTS: After intervention, the intraocular pressure of group B was 8.09+3.56mmHg, which was significantly higher than 5.65+2.19mmHg before intervention in group B and 6.25+2.53mmHg after intervention in group A. The difference was statistically significant(P<0.05). After intervention, the CD height of group A and B was 3.98(1.01, 5.34)mm and 0.92(0.03, 3.88)mm, significantly lower than that in group A and B before intervention, which was 5.22(3.14, 6.64)mm and 5.16(3.34, 7.71)mm. CD loci 6.0(3.0, 10.0)and 3.0(0.0, 6.0)were significantly lower than those of 11.0(9.0, 12.0)and 10.0(8.0, 12.0)before intervention. The CD height and the number of CD loci in group B were lower than those in group A(P<0.05). From the last follow-up, the success rate of retinal reattachment in groups A and B were 78% and 96%, respectively(P>0.05). At 1, 3mo and the last follow-up, the visual acuity of group A was 1.69±0.79, 1.39±0.72 and 1.38±0.61 better than that of group A before intervention 2.06±0.28. The visual acuity of group B was 1.42±0.66, 1.29±0.56 and 0.97±0.51 better than that of group A before intervention 2.02±0.58. The visual acuity of group B was better than that of group A at the last follow-up, with statistical difference(P<0.05). At 1 and 3mo after operation, 4 eyes in group A had high intraocular pressure, which was significantly lower than that of 11 eyes and 12 eyes in group B(P<0.05). At the last follow-up, there was still 1 eye with high intraocular pressure in group A and 2 eyes in group B(P>0.05).

CONCLUSION: In the treatment of RD/CD, the effect of posterior subcapsular Tenon injection triamcinolone acetonide with vitrectomy is better than that of intravenous drip of dexamethasone combined vitrectomy, the intraocular pressure should be monitored after operation. If high intraocular pressure occurs, appropriate drug control or removal of triamcinolone acetonide from the posterior Tenon capsule is required.

Abstract:Choroid neovascularization is the characteristic pathological change of many fundus diseases and is the most common cause for severe vision loss and metamorphopsia. Among the pathogenic factors, VEGF is considered to be the most important and treatment targeting VEGF showed promising results. However, anti-VEGF agents need to be administrated frequently and they are usually expensive. Also, some patients got no response to this treatment. These facts force us to find other pathway that involves in the formation of CNV. This article reviews the latest research on CNV-related signaling pathways so as to provide a deeper look into CNV and hopefully point out new directions for treating diseases that share similar pathogenesis.

Abstract:Optical coherence tomography(OCT)is one of the fastest growing techniques in ophthalmic imaging field. With the gradual improvement and update of OCT technology, optical coherence tomography angiography(OCTA)has emerged. It serves as a valuable diagnostic tool for retinal and choroidal neovascularization-related disease. This article reviews the principles of OCTA, OCTA imaging of microaneurysms(MAs), retinal ischemia, retinal neovascularization(RNV)in patient with different stages of diabetic retinopathy, and the limitations and future prospects of OCTA.

Abstract:Retinal degeneration is the primary cause of visual impairment and blindness. However, in advanced stage of the disease, the majority or all photoreceptors are lost, effective therapeutics has not been established. In recent years, a large number of studies have provided new ways for the replacement of photoreceptors and three-dimensional retinal culture has emerged to produce retinal photoreceptors and tissues of both fetal mouse and human, providing the cell source of photoreceptors replacement therapy for treating retinal degenerative diseases. This review focuses on the development of three-dimensional retinal culture techniques and photoreceptors transplantation experiments, and the existing application strategies and limitations of retinal organoids in the replacement therapy of retinal degeneration, which provide a theoretical reference for the optimization of 3D retina in photoreceptors replacement therapy.

Abstract:At present, the occurrence and development of cataract in patients operated by vitrectomy is more common. The patient, who would be in cataract surgery, is prone to suffering from higher risks and complications in eyes if he had vitrectomy before than those without vitrectomy. Consequently, it is a significant challenge for ophthalmologists to determine the choice of surgery and the operation during surgery. Compared with cataract surgery after vitrectomy without perfusion, phacoemulsification with 25-gauge perfusion is an effective method, which can maintain the intraocular pressure, stabilize the anterior chamber, and reduce the intraoperative and postoperative complications. In conclusion, phacoemulsification with 25-gauge perfusion is a preferred method for cataract patients after vitrectomy.

Abstract:Glaucoma is a multiple factor affecting irreversible blindness. Ocular hypertension is the most important risk factor. It is generally believed that the higher the intraocular pressure is, the greater the intraocular pressure fluctuation, the more serious the glaucomatous optic nerve damage is. Changes in body and local factors may affect the intraocular pressure of patients, and body position is one of the important factors. The influence of body position on intraocular pressure in glaucoma patients is generally greater than that in normal subjects. Therefore, the relationship between position and intraocular pressure plays an important role in the daily diagnosis and management of glaucoma, and it is also getting more and more attention of the ophthalmologists. This article mainly reviews the recent research and possible mechanism of the body position on intraocular pressure.

Abstract:Retinal diseases and optic nerve injury blocked visual signal transduction from retinal neurons to visual cortex, which would cause significant influence on patients' visual function and life quality. In clinic, glaucoma, traumatic optic neuropathy, and retinitis pigmentosa and so on are accompanied with degeneration of retinal neurons or optic nerve. However, efficient neuro-protective treatment is limited. Currently, studies suggested neuro-protective and regenerative effect of electrical stimulation treatment on retinal neurons and optic nerves. In this study, we reviewed the application of electrical stimulation in ophthalmology and summarized the possible mechanism, aiming to promote the development of electrical stimulation in the study and treatment of eye diseases.

Abstract:Silicone oil has been used as a safe and effective long-term vitreous substitute(VS)for more than 50 years. Clinically, it is currently widely used in surgical patients with severe ocular trauma and various complex vitreoretinal diseases, which has improved the prognosis of some previously incurable eye diseases. A series of toxic effects caused by the long-term retention of silicone oil in the vitreous cavity have attracted great attention. Based on the physicochemical properties of silicone oil, this review will analyze and summarize the toxic effects of silicone oil on the optic nerve, as well as its mechanism.

Abstract:Nystagmus refers to a certain kind of diseases with abnormal eye movements, which is characterized by rhythmic, involuntary, conjugate-symmetric. According to the age of onset, it could be divided into congenital nystagmus and secondary nystagmus. The limited means of examinations and treatments which makes it difficult to understand nystagmus. Over recent years, the means of examinations and treatments are developing. We reviewed the recent progress of nystagmus in this article.

Abstract:AIM: To compare anterior segment parameters in eyes with cataracts and different axial lengths measured with Pentacam and IOL Master.

METHODS: This study included 170 eyes of 143 patients diagnosed as cataract at Tangdu Hospital, Air Force Medical University. For each patient, anterior segment parameters were measured before surgery with Pentacam and IOL Master system, respectively.

RESULTS: There were no statistically significant differences in K1 and K2 values of eyes with long axial length(P>0.05). And there were statistically significant differences in K2 values(P<0.01), but not K1 values(P>0.05)of eyes with short and middle axial lengths. There were statistically significant differences in ACD values of eyes with any axial length(P<0.01). The Bland-Altman showed that ACD values of eyes with any axial length and K2 values of eyes with long and middle axial lengths were both in good agreement, and K1 values of eyes with any axial length were in great agreement.

CONCLUSION: Pentacam and IOL Master can be interchanged for keratometry in eyes with long axial length, but the measurements of keratometry in eyes with short and middle axial lengths and ACD of eyes with any axial length should be compared in clinical application.

Abstract:AIM: To compare the visual acuity, contrast sensitivity and visual quality of cataract patients after the implantation of AT LISA tri 839MP multifocal intraocular lenses and CT SPHERIS 209M monofocal intraocular lenses.

METHODS: Fifty-two patients(52 eyes)were involved and divided into two groups in the study. The trail group(26 patients, 26 eyes)received AT LISA tri 839MP multifocal intraocular lens implantation and the control group(26 patients, 26 eyes)received CT SPHERIS 209M monofocal intraocular lens implantation after phacoemulsification. Visual acuity, contrast sensivity at different spatial frequencies(3, 6, 12, 18c/d)in bright and dark circumstances and patient satisfaction questionnaire were monitored at 3mo postoperatively. The postoperative visual acuity included the information of uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA), best corrected distance visual acuity(BCDVA), distance corrected intermediate visual acuity(DCIVA)and distance corrected near visual acuity(DCNVA).

RESULTS: The UCIVA, UCNVA, DCIVA, DCNVA, independent spectacles ratio and satisfaction of the trail group were better than those of the control group 3mo postoper atire(P<0.05). Mean contrast sensitivity at the spatial frequency of 18c/d in dark circumstances of the control group was higher than that of the trail group(P=0.041). The incidence of glare and halo showed no significantly statistical difference between the two groups(P=0.668).

CONCLUSION: AT LISA tri 839MP multifocal intraocular lens provided better intermediate and near visual acuity, independent spectacles ratio and satisfaction compared with CT SPHERIS 209M monofocal intraocular lens.

Abstract:AIM: To investigate the therapeutic effects of panretinal photocoagulation(PRP)with multiple wavelength and multispot pattern scan laser combined with conbercept for proliferative diabetic retinopathy.

METHODS: Retrospective case control study. A total of 102 eyes of 80 cases with proliferative diabetic retinopathy without proliferative fiber membrane from retinal or vitreous hemorrhage were recorded. The eyes were divided into two groups according to the therapeutic methods: group A included 60 eyes of 48 cases received only PRP; group B included 42 eyes of 32 cases received intravitreal injection of 0.5mg conbercept before PRP. All patients were given PRP with multiple wavelength and multispot pattern scan laser(NIDEK MC-500VIXI)and completed in twice with the interval time 3-7d. The patients were received supplementary laser therapy after 3mo according to fundus fluorescein angiography(FFA)results. The therapeutic effect and related complications were observed in two groups, the best corrected visual acuity(BCVA)of 3mo after PRP was recorded and the changes of central macular thickness(CMT)were compared. All patients were followed up for at least 3mo.

RESULTS: Incidence rate of vitreous hemorrhage and macular edema happened or became worse in group A was obviously higher than group B, the difference was statistically significant(P<0.05). The effective rate was 73.33% in group A and 90.48% in group B at 3mo after PRP and the difference was statistically significant(P<0.05). The CMT values at different time points after treatment in the two group showed a significant difference(P<0.05).

CONCLUSION: Intravitreal injection of conbercept combined with PRP with multiple wavelength and multispot pattern scan laser as a treatment for early proliferative diabetic retinopathy can reduce vitreous hemorrhage in the process of PRP and macular edema, and is more effective with better visual acuity recovery compared with only PRP.

Abstract:AIM:To investigate the clinical effect of ranibizumab assisted 25G vitrectomy for proliferative diabetic retinopathy(PDR).

METHODS: Totally 120 patients(120 eyes)from our hospital from October 2014 to November 2017 were selected as subjects, and randomly divided into 2 groups. Sixty patients(60 eyes)in the conventional group were treated with 25G vitrectomy alone. Sixty patients(60 eyes)in the study group were treated with ranibizumab adjuvant 25G vitrectomy. The patients were followed up for 6mo. The duration of operation, intraoperative and postoperative conditions, postoperative complications, and the BCVA, intraocular pressure, central area of the macula in preoperative and postoperative 6mo were compared.

RESULTS: The average duration of surgery in the study group was significantly lower than that in the conventional group(t=5.727, P<0.05). The incidence of postoperative high intraocular pressure, electrocoagulation hemostasis, iatrogenic retinal tears, and INV(iris neovascularization)were significantly lower in the study group than in the conventional group(P<0.05), the overall incidence was significantly lower than the conventional group(5.0% vs 16.7%, χ²=4.227, P<0.05). The intraocular pressure and the thickness of the central area of the macula of the study group was significantly lower than that of the conventional group at 6mo after operation, the BCVA was significantly better than the conventional group(t=3.362, 2.486, 8.028, all P<0.05).

CONCLUSION: PDR patients treated with ranibizumab-assisted 25G vitrectomy can effectively shorten the operation time, improve macular edema, reduce the incidence of postoperative bleeding and complications, and be safe and reliable.

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

METHODS: From July 2017 to Augest. 2018, 238 premature infants(476 eyes)with gestational age of 34wk or less, or birth weight of 2500g or less, were examined by RetCamⅢ for ROP screening. The infants were divided into ROP group and non-ROP group according to the results of screening. Meanwhile, the general condition of the premature infants and maternal health during pregnancy were assessed and recorded to determine the risk factors of ROP.

RESULTS: In 238 infants(476 eyes), ROP developed in 35 infants and the incidence of ROP was 14.7%, which including 14 cases(28 eyes)suffering from stage 1, 11 cases(22 eyes)from stage 2, 8 cases(16 eyes)from stage 3, 2 cases(4 eyes)from stage 4, 0 cases from stage 5. 12 cases(24 eyes)received laser therapy. The gestation age and birth weight in non-ROP group were higher than ROP group, significant difference was found between the two groups(P<0.01). The incidence of ROP was statistically significant between different gestational age groups and different birth weight groups(P<0.01). The ratios of oxygen inhalation>72h, hypoxic-ischemic encephalopathy and mechanical ventilation in non-ROP group and ROP group were statistically significant(P=0.034; P=0.001; P=0.004). However, the significant difference had not been found with other systemic diseases of the premature infants sand maternal health during pregnancy between the two groups(P>0.05).

CONCLUSION: The incidence of ROP in Sichuan Province is 14.7% from July 2017 to Augest 2018. The gestation age, birth weight, oxygen inhalation>72h, hypoxic-ischemic encephalopathy and mechanical ventilation are high risk factors for the occurrence of ROP.

Abstract:AIM: To investigate the effect of intravitreal injection of ranibizumab on the surgical outcomes and complications of PDR patients.

METHODS: We selected 84 patients with 106 eyes who were scheduled to undergo PPV surgery in our hospital from 01-2016/01-2018. According to the random number table method, the observation group and the control group were divided into 42 cases. Both groups were treated with PPV surgery, and the observation group was given a vitreous injection of ranibizumab before surgery. The BCVA, macular foveal thickness, serum VEGF, GAS6, SDF-1, and surgical complications were compared between the two groups before and after surgery.

RESULTS: There was no difference in BCVA between the two groups before operation(P>0.05). At 3mo after operation, the BCVA of the observation group was significantly better than that of the control group(P<0.05). At 1wk postoperatively, the foveal thickness of the observation group was smaller than that of the control group(P<0.05). At 3mo after operation, there was no difference in the thickness of the foveal fove between the two groups(P>0.05). There were no differences in serum VEGF, GAS6 and SDF-1 levels between the two groups before surgery(P<0.05). At 1wk postoperatively, the serum levels of VEGF, GAS6 and SDF-1 in the observation group were lower than those in the control group(P<0.05). The complication rate of the observation group was lower than that of the control group(5.9% vs 20.0%, P<0.05).

CONCLUSION: Intravitreal injection of ranibizumab in patients with PDR can significantly reduce macular thickness, serum VEGF, GAS6, and SDF-1 levels, improve visual acuity after surgery, and reduce the incidence of surgical complications.

Abstract:AIM: To explore the clinical effect of micro-pulse laser at 577nm threshold in treatment of diabetic macular edema(DME).

METHODS: The clinical data of 48 patients with DME(64 eyes)were retrospectively analyzed. The patients with micro-pulse laser at 577nm threshold were included in observation group(26 cases, 35 eyes), and the patients who underwent conventional grid-like laser were included in control group(22 cases, 29 eyes). The best corrected visual acuity(BCVA)(LogMAR visual acuity chart), central macular foveal thickness(CFT), mean tetinal sensitive(MS)and mean visual deviation(MD)were compared before surgery and at 1, 3 and 6mo after surgery. And duration of fundus hard exudate and the occurrence of complications after surgery were analyzed in the two groups.

RESULTS: At 1, 3 and 6mo after surgery, the LogMAR visual acuity test results and CFT levels in the two groups were significantly decreased compared with those before surgery, and the indexes in observation group were significantly lower than those in control group at the same time(0.30±0.09 vs 0.35±0.10, 0.19±0.07 vs 0.26±0.09, 0.13±0.04 vs 0.18±0.05; 349.26±21.80 μm vs 364.37±23.91μm, 314.46±20.49μm vs 335.07±22.68μm, 328.35±21.74μm vs 352.43±23.60μm)(all P<0.05). Compared with preoperative, the MS and MD levels in observation group were significantly increased, and significantly higher than that in control group at the same time(5.83±1.16dB vs 4.22±1.04dB, 6.38±1.29dB vs 4.49±1.17dB, 6.75±1.22dB vs 4.68±1.20dB, -5.53±1.41dB vs -7.66±1.52dB, -5.09±1.30dB vs -7.26±1.39dB, -4.68±1.14dB vs -7.05±1.26dB)(all P<0.05). The duration of fundus hard exudate in observation group was significantly lower than that in control group(3.39±0.80mo vs 4.25±1.14mo)(P<0.05). Within 6mo after surgery, the incidence rate of eyeball pain in observation group was significantly lower than that in control group \〖3%(1/35)vs 24%(7/29)\〗(P<0.05), but there were no statistically significant differences in the incidence rates of anterior chamber inflammatory response, visual field defect, intraocular hypertension and corneal edema.

CONCLUSION: Micro-pulse laser at 577nm threshold is safe and effective for DME.

Abstract:AIM:To observe the effect of timolol on refractive regression after high myopia surgery at different time points in LASIK operation.

METHODS: Prospective study. Totally 180 eyes of 90 patients with high myopia who were admitted to our hospital from August 2015 to August 2016 were randomly divided into control group and observation group. Each group had 45 cases and 90 eyes. Both groups were treated with loxacin eye drops and tobramycin dexamethasone eye drops for 1wk. The control group was treated with timolol eye drops 7d after operation, and the observation group was treated with timolol eye drops 1d after operation. The uncorrected visual acuity, spherical equivalent, intraocular pressure, corneal surface curvature and corneal stroma thickness were measured and compared before and 7d, 1, 3 and 6mo after operation.

RESULTS: There were differences in naked vision and spherical equivalent between the two groups at different time points after operation(P<0.05). At 6mo after operation, the naked vision and spherical equivalent of the observation group were better than those of the control group(0.03±0.01 vs 0.08±0.01; 0.15±0.33D vs -0.17±0.36D; all P<0.05). There was no difference in corneal stroma thickness and corneal surface curvature between the two groups at different time points(P>0.05). The intraocular pressure of the observation group was significantly lower than that of the control group at 7d, 1 and 3mo after operation(all P<0.05). The intraocular pressure of the two groups tended to be stable at 6mo after operation.

CONCLUSION: Early application of timolol after LASIK can effectively reduce intraocular pressure, maintain relatively long-term stability of intraocular pressure, prevent corneal swelling, and thus prevent refractive regression.

Abstract:AIM: To investigate the related factors influencing the myopia control effect in adolescents with orthokeratology.

METHODS: This study selected 102 adolescents who wearing ortho-k lens in the First Affiliation Hospital of Xi'an Jiaotong University during July 2014-October 2017.Their axial elongation, refraction, wearing time were observed.

RESULTS: After 3a treatment, the axial elongation of 102 adolescents increased 0.42±0.37mm. Among the low myopia, the middle and high myopia groups, the axial elongation increased 0.65±0.35mm, 0.32±0.37mm and 0.30±0.29mm, respectively. The axial elongation in the high myopia groups was the most slowest(the combination of orthokeratology and spectacles); There was an interaction between the wearing time and the initial refraction, the wearing time and the initial age(all P<0.001). It is suggested that the axial elongation is slower in middle-high myopia than that in the low myopia. The axial elongation was slower in the older adolescents than that in the younger adolescents; There was no interaction between wearing time and gender(F=0.292, P=0.695). The axial elongation has no difference between male and female.

CONCLUSION: The initial refraction and the initial age of myopic adolescents were important factors influencing axial elongation. The combination of orthokeratology and spectacles has effection in controlling axial elongation.

Abstract:AIM: To evaluate the accuracy of qualitative prediction of cataract surgery by double-pass optical quality analysis system(OQAS^TMⅡ).

METHODS: A retrospective study was conducted. Totally 57 cataract patients(67 eyes)were randomly selected from October 2018 to December 2018 in Renmin Hospital of Wuhan University. According to the objective scattering index(OSI), they were divided into group A(28 eyes, OSI>8.0), group B(28 eyes, OSI≤8.0), and group C(11 eyes, OSI could not be detected due to severe lens opacity). The effect of surgery was predicted by Predicted VA100% and preoperative BCVA.

RESULTS: In group A, 26 eyes(93%)comply with the standard, and in group B, 24 eyes(86%)comply with the standard. There was no significant difference between the two groups(P=0.669). Besides, no correlation was found between Predicted VA100% and postoperative 2wk BCVA(r_s=0.103, P>0.5).

CONCLUSION: The OQAS^TMⅡ system can objectively, accurately and intuitively predict the effect of cataract surgery.

Abstract:AIM: To observe the eye development and complications after primary intraocular lens implantation(IOL)in infantile cataract.

METHODS: The postoperative complications, corrected vision, refractive state, ocular axis of 46 patients(92 eyes)with congenital cataract treated by IOL implantation within 10y were retrospectively analyzed.

RESULTS: Five eyes(5%)had postoperative complications. In this study, the average corrected visual acuity was 0.40±0.10 at 3a follow-up after surgery, 0.51±0.01 at 5a follow-up after surgery, and 0.71±0.01 at 7a follow-up; The axial length of the eyes was 20.04±0.02mm at 3a after surgery, 22.09±0.09mm at 5a after surgery, and the axial length of the eyes was 22.96±0.06mm at 7a after surgery; The mean refractive state(equivalent spherical lens degree)at 3a after surgery was observed to be +5.37±0.12 DS, +3.20±0.20 DS at 5a after surgery, and +0.92±0.20 DS at 7a after surgery.

CONCLUSION: The appropriate surgical strategies can give safely and effectively opportunity for the patients with infantile cataract, which also have relatively normal refractive development.

Abstract:AIM: To investigate the clinical features and stepwise treatment method of malignant glaucoma after phacoemulsification.

METHODS: A retrospective analysis was made on clinical data of 16 cases(18 eyes)with malignant glaucoma after phacoemulsification with in-the-bag IOL placemen from June, 2010 to May, 2018 in Gansu Provincial Hospital. Malignant glaucoma was treated by a stepwise treatment method. First, the combination of ciliary muscle paralysis and hypotensive drugs were used to treat malignant glaucoma, followed by laser iridozonulohyaloidotomy, then anterior chamber reformation, and finally with surgical iridozonulohyaloidovitrectomy. Data of diopter, anterior chamber depth, anterior chamber angle and intraocular pressure were analyzed before and after treatment.

RESULTS: Malignant glaucoma tends to occur after phacoemulsification and in-the-bag IOL placement 4.1±2.3wk. One eye received drug therapy alone,7 eyes received YAG laser crystal posterior capsule incision, 6 eyes received anterior chamber angioplasty, and 4 eyes received crystal posterior capsule incision+front vitrectomy. After treatment, the diopter was +0.48±0.89D, the anterior chamber depth was 3.14±0.33mm, the intraocular pressure was 15.3±4.7mmHg, 14 eyes with wide anterior chamber angle.

CONCLUSION: The stepwise treatment of malignant glaucoma after phacoemulsification showed a reduction in myopia, deepening of the central anterior chamber, opening of the anterior chamber, and decreased intraocular pressure.

Abstract:AIM: To investigate the clinical effect of combined laser peripheral iridectomy for primary angle-closure glaucoma.

METHODS: A total of 82 eyes were included in 82 patients with primary angle-closure glaucoma who visited our hospital from August 2015 to October 2017. They were randomly divided into two groups. Patients in the simple laser group were performed Nd:YAG laser only. In the combined laser group, 532 semiconductor laser combined with Nd: YAG laser were used for laser peripheral iridectomy. Intraocular pressure(IOP)was measured preoperative and postoperative. Laser energy was recorded. Iridemia were observed.

RESULTS: Postoperative IOP increased significantly in the simple laser group compared with the combined laser group, and the differences between the two groups 1h, 1d and 1wk after operation were statistical significances(P<0.01). The IOP of the two groups was basically restored to the preoperative level at 1mo postoperatively. The success rate of single laser surgery was significantly lower than that of combined laser surgery(73% vs 100%, P<0.05). The total energy of Nd:YAG laser was significantly higher than that of the combined laser group(40.16±13.43mJ vs 23.23±6.70mJ, P<0.05). There was no significant difference in intraoperative iris bleeding rate between the two groups(33% vs 26%, P>0.05).

CONCLUSION: Totally 532 semiconductor laser combined with Nd: YAG laser for peripheral iridectomy has a high rate of penetration, especially for patients without iris recess. It can significantly decreases laser energy, reduces the difficulty of laser operation and relieves intraocular inflammation.

Abstract:AIM: To observe the clinical effect of intravitreal injection of ranibizumab combined with vitrectomy in the treatment of proliferative diabetic retinopathy(PDR).

METHODS: A retrospective study. Sixty patients(66 eyes)with PDR who underwent vitrectomy in our hospital from May 2016 to May 2017 were divided into two groups according to different treatment methods, 30 cases(33 eyes). ranibizumab were injected into vitreous cavity 3-5d before operation in group A, but not in group B. The incidence of iatrogenic retinal holes, intravitreal hemorrhage, visual acuity and complications were compared between the two groups.

RESULTS:Iatrogenic retinal hiatus and intravitreal hemorrhage occurred in both groups during operation. The number of eyes with iatrogenic retinal hiatus and the incidence of intravitreal hemorrhage in group A were less than those in group B(P<0.05). The visual acuity of group A was better than that of group B(P<0.05). After operation, the number of eyes with intravitreal hemorrhage, high intraocular pressure and macular edema in group A was less than that in group B(P<0.05).

CONCLUSION: Preoperative intravitreal injection of ranibizumab combined with vitrectomy for PDR can effectively reduce iatrogenic retinal hiatus and intravitreal hemorrhage. Postoperative complications are less, which is conducive to the recovery of patients.

Abstract:AIM: To investigate the efficacy and safety of conbercept intravitreal injection combined with selective laser photocoagulation for central retinal vein occlusion(CRVO).

METHODS: A retrospective study was performed on 66 patients with CRVO in our department of ophthalmology. Among them, 30 patients received only conbercept's intravitreal injection and served as a control group. On this basis, another 36 patients were combined with selective laser photocoagulation and as an observation group. The differences of central macular thickness(CMT), BCVA(LogMAR)and complication rate after treatment were compared between the two groups.

RESULTS:The CMT and BCVA of the two groups were significantly improved after treatment(P<0.05). The CMT and BCVA of the observation group were significantly better than the control group at 6^th month after treatment(P<0.05). The number of intravitreal injections in the observation group was significantly lower than that in the control group(P<0.05). There was no significant difference in the complications(P>0.05).

CONCLUSION: The combination therapy has a more significant effect on CRVO and is safe.

Abstract:AIM:To observe the correlation between serum level of platelet derived growth factor -BB(PDGF-BB)and diabetic retinopathy(DR)in type 2 diabetic patients.

METHODS: Seventy-five cases of healthy subjects underwent physical examination were taken as control group. Diabetic patients were divided into non-diabetic retinopathy group(NDR, 25 cases), non-proliferative diabetic retinopathy group(NPDR, 25 cases)and proliferative diabetic retinopathy group(PDR, 25 cases). Serum level of each group was measured using Enzyme-Linked Immunosorbent Assay(ELISA). Correlation between serum PDGF-BB level and stages of diabetes mellitus, macular thickness, glycosylated hemoglobin, and other biochemical indexes in serum were analyzed.

RESULTS: Serum level of PDGF-BB in control group(400.28±44.55pg/mL), NDR(409.65±50.37pg/mL), NPDR(535.67±69.21pg/mL)and PDR subgroup(551.60±103.46pg/mL)were significantly different(F=14.259, P<0.01). Serum level of PDGF-BB in NPDR group and PDR group were higher compared to control group and NDR subgroup. Multiple regression analysis showed that serum level of PDGF-BB positively correlated with fasting blood glucose(FBG), triglycerides(TG)and stages of diabetes(P<0.05). Serum level of PDGF-BB in PDR subgroup correlated with the thickness of macular(r=0.613, P<0.05). Whereas, this correlation was not observed in other groups(r_C=0.013, r_NDR=0.051, r_NPDR=0.062; P>0.05).

CONCLUSION: Serum PDGF-BB level was observed to rise with severity of DR and relevant to macula edema. It was also positively correlated to FPG, TG and stages of diabetes. PDGF-BB could be recommended as diagnostic biomarker for DR.

Abstract:AIM: To investigate the clinical significance of serum CMKLR1 level in patients with diabetic retinopathy.

METHODS: A total of 140 patients with type 2 diabetes(T2DM)treated in our hospital were selected from February 2015 to March 2018, including 45 patients with type 2 diabetes(T2DM group)and 95 patients with DR(54 patients with NPDR and 41 patients with PDR). And 40 healthy volunteers were collected. Clinical data was collected and serum levels of CMKLR1 were detected.

RESULTS: The duration of diabetes in patients with PDR was longer than that in the patients with NPDR and NDR, and the patients with NPDR was longer than the patients with NDR(all P<0.05). The FPG and serum level of TG in the patients with T2DM were elevated, and the level of LDL-C in the patients with DR was higher than that in the patients with NDR and the healthy volunteers(all P<0.05). The serum level of CMKLR1 in the patients with PDR was higher than that in the patients with NPDR, T2DM and the healthy volunteers, and the patients with NPDR was higher than the patients with NDR and the healthy volunteers, the patients with NDR was higher than the healthy volunteers(all P<0.05). The serum level of CMKLR1 in patients with DR was positively correlated with the duration of diabetes, HbA1c and LDL-C(r=0.374, 0.248 and 0.304; all P<0.05). The duration of diabetes and the serum level of CMKLR1 were risk factors for DR(OR=1.594 and 1.830, all P<0.05).

CONCLUSION: The serum level of CMKLR1 in patients with DR was increase, and related to the progression of the disease. It was an important risk factor affecting the occurrence and progression of DR.

Abstract:AIM: To evaluate the efficacy and safety of VEC combined with laser in treatment of retinoblastoma(RB)in children with different ages.

METHODS: Totally 63 children with RB intraocular phase in our hospital were selected as subjects. According to their ages, they were divided into 1 year old group(n=23, 36 eyes), >1 year old group(n=40, 66 eyes). All of them were treated with VEC combined with laser therapy. Indirect ophthalmoscope and ultrasound were used to measure the thickness and diameter of tumor and tumor base before treatment and after 6 treatment courses.

RESULTS: The remission rate in the 1 year old group was 75.0%, and that in the >1 year old group was 92.4%(P<0.05). In the 1 year old group, 5 eyes were developed, and in the >1 year old group, 1 eye was removed. The average tumor thickness and average base diameter of the remaining eyes after treatment were significantly smaller than those before treatment(P<0.05). The mean thickness and mean diameter of base of >1 year old group were smaller than those of 1 year old group(P<0.05). Two groups of children had mild nausea and vomiting and other gastrointestinal symptoms and hair loss,1 year old group had 1 case of mild myelosuppression and liver function damage, >1 year old group had 2 cases of mild myelosuppression,1 case of mild liver function damage.

CONCLUSION:VEC combined with laser is safe and feasible in the treatment of children with intraocular RB. >1 year old group is better than 1 year old group.

Abstract:AIM:To analyze the clinical features of ectopic demodex infection in patients with meibomian gland dysfunction.

METHODS: A retrospective study. Totally 220 patients(440 eyes)with meibomian gland dysfunction were selected from November 2016 to June 2018. They were divided into uninfected group and infected group according to the concurrence of eyelash demodex infection. 110 patients(220 eyes)in each group. The ocular function indexes of the two groups were tested and compared, and the clinical characteristics of eyelash demodex infection were evaluated.

RESULTS: The incidence of itching, foreign body sensation, eye pain, dryness and astringency in the infected group was significantly higher than that in the non-infected group(P<0.05), and there was no significant difference in the incidence of symptoms such as redness, secretion increase, fatigue and photophobia(P>0.05); the average tear film rupture time and basic tear secretion in the two groups were significantly lower than that in the normal level, and the infected group was significantly lower than that in the non-infected group(P<0.05). Corneal staining score and tarsal gland secretion function score in non-infected group were significantly lower than those in infected group(P<0.05).

CONCLUSION: Patients with tarsal gland dysfunction are more likely to suffer from itching, dryness, eye pain and other symptoms after eyelash demodex infection, which increases the damage of corneal and conjunctival epithelium. It is of great significance to pay attention to demodex infection examination for patients with tarsal gland dysfunction.

Abstract:AIM:To evaluate the function of therapeutic contact lenses used in pterygium surgery combined with limbal conjunctival autograft transplantation(LCAT).

METHODS: Prospective randomized controlled study. Ninety-two patients(ninety-two eyes)with primary pterygium who underwent pterygium surgery combined with LCAT in Ophthalmology of the First Affiliated Hospital of Xi'an Jiaotong University from November 2017 to October 2018. The patients were randomly divided into a therapeutic contact lenses group and a tight bandage group. The corneal epithelial wounds were observed on the 1^st, 4^th, and 7^th day after operation by slit lamp microscope. Then, the postoperative pain was evaluated by the visual analog scale. Last, the questionnaire was used to evaluate the eye comfort level.

RESULTS:There was no significant difference in corneal epithelial healing between the two groups on the first and seventh day after surgery. On the fourth day after surgery, the corneal epithelial healing was better in the therapeutic contact lenses group than in the tight bandage group(P<0.05). In addition, the postoperative pain score in the therapeutic contact lenses group was lower than that in the tight bandage group(P<0.05), and the eye comfort level was also higher than that in the tight bandage group(P<0.05).

CONCLUSION: The therapeutic contact lenses can not only effectively promote corneal epithelial healing, but also effectively reduce pain, improve eye comfort level and improve postoperative quality of life.

Abstract:AIM: To evaluate the early postoperative efficacy of SMART for myopia and compare it with TransPRK.

METHODS: Retrospective non-randomized controlled study. Totally 120 eyes of 60 patients with myopia who underwent SMART and TransPRK in our hospital from January to August 2018 were selected respectively. The uncorrected visual acuity(UCVA), visual quality, pain score, corneal epithelial healing and subepithelial haze were compared between two groups.

RESULTS: There was no statistical differences between two groups regarding the proportion of UCVA reaching or exceeding 1.0 at 5d, 1mo and 3mo after operation(P>0.05), but the visual quality of SMART group was better than that of TransPRK group at 5d after operation(P<0.05), and with the prolongation of time, the visual quality of the two groups gradually improved. There was a significant difference in pain scores between the TransPRK group and SMART group(3.56±0.96 vs 3.07±1.07; 1.22±0.61 vs 0.84±0.59)on the 1^st day and 3^rd day after operation(P<0.01). 5d after operation, the complete recovery rate of corneal in TransPRK group was lower than that in SMART group(69.2% vs 83.3%, P<0.05). At 1^st and 3 mo after operation, there was no difference in haze between the two groups(5.0% vs 5.0% and 8.3% vs 10.0%; P>0.05).

CONCLUSION: There is no significant difference between SMART and TransPRK in the speed and stability of visual acuity recovery, but the early postoperative pain of SMART is lighter, the corneal epithelium is healed faster, and the visual quality is better.

Abstract:AIM: To study the recovery of cornea sensitivity after small incision lenticule extraction(SMILE)surgery by different incision sites.

METHODS: Totally 30 SMILE patients(60 eyes)were selected from 05/12/2016-01/18/2018. The incision in the right eye was designed at 135° while that in the left eye was designed at 90°. Cornea sensitivity were examined and noted by an experienced examiner preoperative, 1d, 7d,1mo and 3mo 3mm from central cornea postoperative at 3, 6, 9,12 o'clock and the central cornea. The eye surface disease index(ocular surface disease index, OSDI)was also noted at the same time.

RESULTS: The comparison of corneal sensitivity results from different eyes showed that there was no significant difference on all time points at different position(P>0.05). After further comparison, cornea sensitivity of both eyes was found to be lower on 1d postoperative than that preoperative, 1mo postoperative and 3mo postoperative(P<0.05), while restored to the level of preoperative at 1mo and 3mo(P>0.05). The OSDI scores on different time points are 10.739±7.576, 15.003±11.296, 16.357±14.467, 14.020±10.128, 11.968±7.586 respectively. The comparison showed no significant difference(F=1.583, P=0.204).

CONCLUSION: There is no significant difference on cornea sensitivity between two eyes after SMILE surgeries. The corneal sensitivity declined at 1d postoperative and the recovery was faster at about 1mo.

Abstract:AIM: To study the efficacy of AMSPL on myopia control, and confirm the security of wearing AMSPL, through comparing the impacts on visual parameters between myopic children wearing spectacle lens designed to reduce peripheral hyperopic defocus(AMSPL)and myopic children wearing the standard design control lens(SPL).

METHODS: Totally 50 children aged 8 to 14 years wearing spectacle lens designed to reduce peripheral hyperopic defocus(AMSPL)were collected into the AMSPL group, and other 50 children in the same age, the same degree of myopia and the same glasses time wearing standard design control lens(SPL)were selected into normal control group randomly(SPL group). We reviewed their documents and exam all patients. The examination include intraocular pressure, refraction under cycloplegia, distant strabismus and near strabismus, AC/A ratio.

RESULTS: The children wearing spectacle lens designed to reduce peripheral hyperopic defocus(AMSPL)had lower feeling of comfort than SPL group, mainly in peripheral vision confused, but no difference between them 1mo later. The AMSPL group's average growth of refractive error is -0.62±0.50D, the SPL group's average growth of refractive error is -0.77±0.48D(P=0.072). In myopic children aged 8 to 10 years, the AMSPL group's average development of refractive error is -0.71±0.41D, lower than the SPL group that of -1.05±0.39D, the difference was significant(t=2.164, P=0.041). Between the two groups, there was no significant difference(P>0.05)in visual parameters of distant strabismus, near strabismus, AC/A ratio.

CONCLUSION: Wearing spectacle lens designed to reduce peripheral hyperopic defocus(AMSPL)can delay the progression of myopia to a certain extent, especially for myopic children aged 8 to 10 years. It suggests that wearing AMSPL has the same safety with SPL for myopic children.

Abstract:AIM: To observe the curative effect of vision therapy on children with functional visual loss.

METHODS: Totally 22 children with functional vision loss were enrolled in our department between January 2018 and June 2018, including 12 males and 10 females, the mean age 7.5±0.8 years old. All patients had routine eye examinations, refraction and binocular visual function examinations. Children with or without astigmatism whose diopter spherical mirror was between±1.00D and were accompanied by astigmatism less than ±1.00D participated in personalized vision therapy. Paired t test was used to analyze the binocular visual function before and after vision therapy.

RESULTS: The average visual acuity of the 22 children were improved, but the diopters before and after vision therapy were -0.011±0.573D and -0.057 ±0.338D drespectively, without statistical significance(P=0.633). The average of the distant level phoria(DLP)before and after vision therapy were -3^△ ±2.97^△ and -1.18^△ ±1.6^△, which was not statistically significant(P=0.089). The near level phoria(NLP)were -6.27^△ ±4.56^△ and -2.82^△ ±2.56^△; the near point of convergene(NPC)were 7.73±2.15 and 3.05±0.69cm; the accommodation convergence/accommodation(AC/A)were 2.00±1.55, 3.64±0.5 before and after the training respectively(P<0.05); The negative relative accommodation(NRA)and positive relative accommodation(PRA)before vision therapy were 1.61±0.41 and -1.98±0.71D; after training they were 2.09±0.23 and -3.89±0.71D respectively; binocular crossed-cylinder(BCC)was 0.09±0.38D, which improved to 0.39±0.13D after therapy; the average of amplitude of accommodation(AMP)were 9.55±2.54 and 11.55±1.13D; binocular accommodation facility(BAF)were 3.36±2.73 and 9.64±1.5cpm respectively before and after therapy.

CONCLUSION:It is necessary to perform binocular visual function examination base on the refractive examination for children with functional vision loss. Visual therapy can improve visual acuity and binocular vision function.

Abstract:AIM: To investigate the related factors of orthokeraology(ortho-K)decentration.

METHODS: Within a prospective study, 88 eyes of 88 patients who visited to our center between July 2014 and December 2016 were enrolled. To verify the possible role of the spherical equivalent(SE), the corneal astigmatism(CA), e value, steep K, flat K, front curvature asymmetry index(SIf)and age in the ortho-K location prediction.

RESULTS: This study included 24 eyes of grade Ⅰ decentration, 26 eyes with grade Ⅱ, 25 eyes with grade Ⅲ, and 13 eyes with grade Ⅳ, by which based on the decentration system that published by our team. One-way ANOVA showed that there was statically significant difference of SE, Ks and Kf in different grading groups(P<0.05). Multiple linear regression analysis showed SE was negatively correlated with the decentration(P<0.01). The others factors such as the CA, e, Ks, Kf, SIf, age has weak correlation with the ortho-K decentration.

CONCLUSION: The SE might be the main factor which lead to the ortho-K decentration.

Abstract:AIM: To explore the effects of red light flashing therapeutic instrument combined with distance visual training through reading red visual acuity chart on myopic amblyopia in children.

METHODS: Totally 112 cases of children patients with myopic amblyopia treated in our hospital were assigned to the control group and the observation group. The control group was given short covering method and short-range visual function training, and the observation group was given red light flashing therapeutic instrument combined with distance visual training through reading red visual acuity chart on the basis of the above treatment. The clinical efficacy, refractive dynamic changes, the BCVA and amblyopia recurrence rate were compared between the two groups.

RESULTS: The total clinical effective rate in the observation group was significantly higher than that in the control group(P<0.05). Before and after treatment, the myopic diopter was no significant difference in the observation group(P>0.05), the control group gradually increased myopic diopter with time(P<0.05). The myopic refraction, the change value of average annual refraction and the recurrence rate of amblyopia after 1y of treatment in the observation group was lower than that in the control group(P<0.05). The BCVA after 1y of treatment was significantly higher than that after 6mo of treatment(P<0.05).

CONCLUSION: Red light flashing therapeutic instrument combined with distance visual training through reading red visual acuity chart for children patients with myopic amblyopia can effectively reduce the change value of average annual refraction, correct the best visual acuity, and reduce the risk of amblyopia recurrence.

Abstract:AIM: To compare the efficacy of invisible occlusion mirror and depressant membrane therapy in treatment of elderly amblyopia.

METHODS: Prospective study. Totally 112 cases(112 eyes)of monocular amblyopia aged 10-14 years were selected from June 2015 to December 2016 in our hospital. Among them, 55 cases(Group A)were treated with depressant membrane therapy and 57 cases(Group B)were treated with invisible concealer. The treatment compliance and efficacy of the two groups were evaluated, and the changes of corrected visual acuity before and after treatment were observed.

RESULTS: For 3, 6 and 12mo, there was no significant difference in treatment compliance between group A(98.2%, 96.4%, 92.7%)and group B(94.7%, 91.2%, 89.5%)(all P>0.05), but the effective rate of treatment(27.8%, 50.9%, 76.5%)was significantly lower than that of group B(46.3%, 71.2%, 92.2%), and the amblyopic corrected visual acuity of group B was better than that of group A(P<0.05). After 12mo treatment, the total and actual cure rates of group A(52.7% and 56.9%)were significantly lower than those of group B(71.9% and 80.4%).

CONCLUSION: The treatment of monocular amblyopia over 10 years old with invisible occlusion mirror is superior to that of depressor membrane occlusion in improving visual acuity and curing rate.