Abstract:AIM:To observe the protective effect of Danhong injection on retina of diabetic rats and explore its mechanism.

METHODS: From June 2015 to December 2016, sixty male SD rats were randomly divided into four groups: normal group, diabetic group, Danhong intervention group and blank intervention group. The rats in the latter three groups were injected with 50 mg/kg of streptozotocin(STZ)into the abdominal cavity to establish diabetic retinopathy rat model. On the day after successful modeling, Danhong treatment group was injected with 5 ml/kg Danhong injection intraperitoneally every day, while the blank intervention group was treated with intraperitoneal injection of distilled water with the same volume as Danhong treatment group. Therapeutic effects were observed from two levels: retinal vascular disease and nerve injury. Retinal morphology was observed by hematoxylin-eosin(HE)staining at the level of vascular disease. The expression of retinal vascular endothelial growth factor(VEGF)was detected by immunohistochemistry. Neurological injury level: tunel staining was used to observe apoptotic cells, and transmission electron microscopy was used to observe the morphology of retinal ganglion cells.

RESULTS:Vascular level: in the normal group, the structure of retinal tissues showed clear layers. The structure of the diabetic group and blank intervention group was more disordered than that of the normal group, and the Danhong treatment group was better than that of the diabetic group and blank intervention group. Compared with the diabetic group and blank intervention group, the expression of VEGF in Danhong intervention group decreased. Neurological injury level: there was a larger degree of apoptosis of ganglion cells in the diabetic group and the blank intervention group, while the number of apoptotic cells in the Danhong intervention group was lower than the diabetic group and blank intervention group.

CONCLUSION:Danhong injection has protective effect on the retina of diabetic rats. It can improve the condition of retinal ischemia and hypoxia by down-regulating VEGF, reduce the formation of retinal neovascularization. At the same time, it can reduce the apoptosis of retinal nerve cells to acertain extent.

Abstract:AIM: To evaluate the changes of subfoveal choroidal thickness(SFCT)and central macular thickness(CMT)following phacoemulsification cataract surgery in diabetic and non-diabetic patients.

METHODS: In this prospective study, 53 patients with mild or moderate non-proliferative diabetic retinopathy(NPDR)without macular edema and 53 non-diabetic patients underwent uneventful phacoemulsification cataract surgery. Subfoveal choroidal thickness and central macular thickness were measured before and one month and three months after the surgery using enhanced depth imaging optical coherence tomography(EDI-OCT)and the changes of SFCT and CMT were compared between the two study groups.

RESULTS: In diabetic cases, the mean CMT at the baseline was 267±32 μm. The CMT significantly increased after surgery with a mean value of 291±77 μm at 1mo(P=0.034)and 293±75 μm at 3mo(P=0.047). The mean SFCT at the baseline was 199±72 μm. The SFCT significantly increased after surgery with a mean value of 231±73 μm at 1mo(P=0.035)and 248±91 μm at 3mo(P=0.026). In non-diabetic cases, the mean CMT at the baseline was 264±29 μm. The CMT significantly increased after surgery with a mean value of 278±42 μm at 1mo(P<0.001)and 276±56 μm at 3mo(P=0.028). The mean SFCT at the baseline was 236±60 μm. The SFCT significantly increased after surgery with a mean value of 265±64 μm at 1mo(P<0.001)and 240±60 μm at 3mo(P=0.234). The changes of CMT were not significantly different between the study groups(all P>0.05). Although the non-diabetic cases had thicker choroid at the baseline, the change of SFCT was not significantly different between study groups 1mo postoperative(P=0.97)and was borderline 3mo after surgery(P=0.05).

CONCLUSION: CMT and SFCT significantly increased post operatively in both groups. The changes of CMT and SFCT were not significantly different between diabetic and non-diabetic cases.

Abstract:AIM: To observe the effects on four effective components of Qingguang'an on collagen fibers, α-smooth muscle actin(α-SMA)and fibronectin(FN)in rabbits after glaucoma surgery.

METHODS: Apply four kinds of effective components of Qingguang'an and Qingguang'an Chinese medicine suspension to D, E, F, G, H groups after filtration surgery, and pass with group A(blank control group)and group B(model group)Compared with group C(Mitomycin C group), the effects of four effective components of Qingguang'an and Qingguang'an traditional Chinese medicine suspension on collagen fibers, α-SMA and FN in the scar tissue of glaucoma after filtration were observed.

RESULTS: Compare to B group, the ratio of collagen fiber area to E, F, H group, the expressions of α-SMA and the expressions of FN were different(P<0.05).

CONCLUSION: Qingguang'an effective components 2, Qingguang'an effective components 3, mitomycin C and Qingguang'an suspension reduce the proliferation of myofibroblasts and fibroblasts by inhibiting the expression of collagen fibers, α-SMA and FN, and showed obvious anti-glaucoma staining scar after surgery.

Abstract:AIM: To investigate the changes of fibronectin expression in cultured bovine trabecular meshwork cells when cells were stimulated by different concentrations of IL-6 to provide evidence for early diagnosis and new therapy of POAG.

METHODS: We identify third-generation bovine trabecular meshwork cells which were got from tissue mass culture method. Then the relative expression of FN gene and protein in cells were detected by Real-Time PCR and Western-blot after 24h stimulation with 0ng/mL, 0.1ng/mL, 0.5ng/mL IL-6.

RESULTS: The cultured bovine trabecular cells are coincident with what recorded in the book. Real-time PCR and Western blot showed that the amount of FN mRNA produced by cells was 1.000±0.000, 0.213±0.004, 0.056±0.001, 0.019±0.002 respectively, and the protein expression was 1.167±0.012, 0.662±0.009, 0.238±0.011, 0.061±0.011 respectively. There was a significant difference among four groups(P<0.05).

CONCLUSION: Cultured bovine trabecular meshwork cells have a negative correlation with the expression of FN protein after being stimulated by exogenous IL-6, and the results are consistent with the actual state of the disease. We speculate that the IL-6 participate in the pathogenesis and progression of POAG by affecting the expression of FN gene and protein and changing the structure of trabecular meshwork.

Abstract:AIM: To investigate the effect of gene modification on the differentiation of bone marrow mesenchymal stem cells into neuron in treatment of optic nerve injury.

METHODS: Lentivirus carrying the rat ciliary neurotrophic factor(CNTF)coding sequence was transfected into bone marrow mesenchymal stem cells isolated from rat femur. Rats with optic nerve injury constructed by clamp optic nerve method were randomly divided into control group and study group. On the 4, 7, 10 and 13d after successful modeling, the transfused bone marrow were injected into the vitreous cavity of the study group. The control group was injected with the same amount of normal saline. On the 14^th day after successful modeling, the light reflexes of the two groups of rats, the number of retinal ganglion cells and the expression of glial fibrillary acidic protein(GFAP)and Caspase-3 protein were observed.

RESULTS: The recovery rate of the study group was significantly higher than that of the control group(83% vs 25%, P<0.05). The results showed that the retinal cells in the study group were relatively neat. A small amount of vacuoles were observed; the retinal cells in the control group were not well-structured, and obvious vacuoles were observed, and the number of cells was decreased. The results of Western blot showed that the expression level of GFAP and the expression level of Caspase-3 were higher than that of the rats in the study group.

CONCLUSION: Genetic modification induces bone marrow mesenchymal stem cells can effectively treat optic nerve injury in rats.

Abstract:AIM: To explore the effects of femtosecond laser and mechanical lamellar blade excision laser in situ keratomileusis(LASIK)on corneal flap thickness stability and dry eye syndrome.

METHODS: Retrospective analysis of 80 patients with myopia who underwent LASIK in our hospital. According to different methods of flapping, it is divided into femtosecond laser group and mechanical laminating knife group. The flap thickness of the two groups of patients at different time points(1h, 1d, 1wk, 1mo, 3mo)were measured. The differences in corneal apex 1, 2, 3mm and corneal apex flap thickness in different directions were compared. The incidence of dry eye syndrome was compared between 1 and 3mo, 1a, 2a after surgery.

RESULTS: The apex thickness of the corneal flap of the femtosecond laser group is 99.62±4.50μm, and the thickness of the apex of the mechanical lamellar knife group is 125.25±12.81μm.The thickness of the corneal flap at different centrifugal points of the femtosecond laser flap is relatively uniform, while the thickness of the corneal flap of the mechanical lamellar knife varies greatly. The OSDI scores of the mechanical lamellar group were higher than those of the femtosecond laser group at 1, 3, 1, and 2a postoperatively(P<0.01). At 2a of follow-up, the incidence of dry eye in the femtosecond laser group was lower than that in the mechanical lamellar group(χ²=4.692, P=0.030). At 1 and 2a postoperatively, the proportion of mild dry eye in the femtosecond laser group was higher than that in the mechanical lamellar group(P=0.044, 0.001).

CONCLUSION: Compared with the mechanical lamellar scalpel, the corneal flap thickness of patients with femtosecond laser LASIK is better, more uniform and less error. And the incidence of dry eye after surgery is lower, with mild dry eyes.

Abstract:AIM: To compare the changes of dry eye symptoms and signs after femtosecond-assisted laser in situ keratomileusis(LASIK)and conventional LASIK by Keratograph 5M.

METHODS: Sixty patients(120 eyes)who underwent corneal refractive surgery from June 2017 to November 2017 were enrolled. Thirty patients(60 eyes)underwent femtosecond-assisted laser LASIK and 30 patients(60 eyes)underwent conventional LASIK. All patients took examinations of Keratograph 5M dry eye related examinations,routine ophthalmological examinations and ocular surface disease index(OSDI)questionnaire before and 1wk, 1mo, 3mo and 6mo after surgery.

RESULTS: One week after operation, the OSDI scores of two groups were significantly higher than pre-operation(P<0.01), but 1mo after operation, the two groups recovered to the preoperative level(P>0.05). Noninvasive tear film break-up time(NI-BUT)in the conventional group was shorter 1wk, 1mo and 3mo after operation(P<0.01), while it was shorter in 1wk and 1mo after operation in femtosecond laser group(P<0.01). There was significant difference between conventional group and femtosecond laser group at 3mo after operation in NI-BUT(P<0.01). Tear meniscus hight(TMH)and the thickness of lipid layers of the two groups all decreased in 1wk and 1mo after operation(P<0.05).

CONCLUSION: Whether femtosecond-assisted or conventional LASIK will affect tear film stability and cause dry eye symptoms. The degree of influence decreases gradually with the time after operation, but femtosecond laser group can recover more quickly.

Abstract:Current formulas tend to select intraocular lens with insufficient power for these patients, resulting in postoperative hyperopia. In addition to the traditional methods to address this problem such as reserving a myopic power in the power calculation, several more accurate and effective solutions have been suggested, including adjusting the axial lengths, using new formulas, and applying intraoperative refractive biometry. This paper will focus on the postoperative refractive error in highly myopic eyes after phacoemulsification and intraocular lens implantation and illustrate the progress of existing solutions.

Abstract:Primary open angle glaucoma is a kind of chronic disease characterized by progressive damage to the optic disc as a result of persistent elevation of intraocular pressure. The complicated and unidentified mechanism of primary open angle glaucoma makes its clinical treatment relatively difficult nowadays. In primary open angle glaucoma, IOP elevation is often a result of reduced aqueous humor flow through the trabecular meshwork, which plays an important regulating role in drainage process. The morphology, quantity, structure and function of trabecular meshwork cell can increase the outflow resistance of aqueous humor, leading to elevation of IOP. Research is proving that induced pluripotent stem cells(iPSCs), bone mesenchymal stem cells(BMSCs)and adipose-derived stem cells(ADSCs)have been used for trabecular meshwork cell differentiation and regeneration, providing a reliable cell source for trabecular meshwork stem cell replacement therapy in primary open angle glaucoma. Recent studies have showed that trabecular meshwork stem cells have absolute superiority in differentiating into trabecular meshwork cells, which provides new target for cell transplantation to treat glaucoma. This marks a new era of stem cell therapy for primary open angle glaucoma and also brings new hope to the treatment of glaucoma. This article reviews different types of stem cells for trabecular meshwork transplantation and may provide novel development of therapeutic strategies for primary open angle glaucoma with cell transplantation in the future.

Abstract:In recent years, advances in dry eye imaging technology have not only been reflected in the ability to evaluate measurements based on clinical practice, but also to define new parameter data while ensuring the objectivity of measurement results. On this basis, it is beneficial to in-depth analysis of structural and functional parameters for diseases of dry eye. This article provides a brief overview of techniques such as tear film interferometry, optical coherence tomography, meibomian gland imaging, non-invasive rupture time, thermal imaging and optical quality assessment, and confocal microscopy used in dry eye diagnosis and treatment.

Abstract:Patients with traumatic or congenital disease lead to lens dislocation and posterior capsule rupture after cataract surgery, etc, which cannot be routinely implanted with intraocular lens, can be implanted with different intraocular lenses according to the condition. This article will introduce a variety of surgical methods for posterior chamber intraocular lens scleral fixation, including sutured scleral fixation, sutureless intrascleral fixation and Fibrin glue-assisted sutureless haptic intrascleral fixation. In addition, the postoperative results and complications of the above procedures will be reported and analyzed.

Abstract:The Micro-invasive glaucoma surgery(MIGS)group of operations has been developed in the recent years to reduce some of complications of most standard glaucoma procedures such as trabculectomy. In order to increase the surgical effect, a new group of surgical manners has emerged that seeks to decrease IOP with lower associated rates of complications. The MIGS of the latest technique and devices are presented by three manners of reducing IOP: aqueous reduction surgery(Endoscopic Cyclophotocoagulation, Ultrasound Cyclo-Plasty); external filtering surgery(Implantation of EX-PRESS miniature glaucoma device, CANALOPLASTY); internal filtering surgery(Trabecular microbypass stent, Ab Interno Trabeculectomy). The article will summarize clinically relevant information of the glaucoma treatment and to describe indications, advantages and disadvantages of the MIGS.

Abstract:Polypoidal choroidal vasculopathy(PCV)in the past referred to as “Idiopathic polypoidal choroidal vasculopathy(IPCV)”. It is a chronic vascular abnormality resulting in multiple, recurrent, serosanguinous retinal pigment epithelial detachments(PEDs)secondary to leakage and bleeding from choroidal vascular lesions. PCV have two types, including hemorrhagic type and exudative type, in which hemorrhagic type is prone to submacular hemorrhage. In recent years, with the widely used of indocyanine green angiography and optical coherence tomography angiography in ophthalmology, the research on this disease has gradually deepened. At present, the diagnosis of this disease is mainly confirmed by dilated pupil fundus examination, optical coherence tomography(OCT), OCTA, fluorescence fundus angiography(FFA)+ICGA and other auxiliary examinations. When complicated with a small amount of SMH, it can be absorbed by itself. When SMH is large, it is difficult to be absorbed by itself and has a great influence on vision. The main treatment included anti-VEGF drugs, PDT, gas, t-PA and combined vitrectomy. This article combining the latest progress in the study of domestic and foreign, the SMH induced by PCV epidemiology, pathogenesis, diagnosis, treatment were summarized, and the treatment methods were discussed and prospected.

Abstract:Phacoemulsification and intraocular lens implantation combined vitrectomy(phacovitrectomy)cannot only correct refractive error but also treat vitreoretinal diseases. Due to its advantages of clearer intraoperative vision, postoperative visual function improvement and avoiding secondary procedures, phacovitrectomy has been increasingly used in patients with retinal and vitreous diseases combined with cataracts. Compared with traditional staged surgery, phacovitrectomy require special equipment and is higher technique-demanding and more complications. Several studies have shown that refractive error is commonly reported after surgery. In this article, the relevant influencing factors, formation mechanism and updated control strategy of RE were summarized to provide reference for the indication selection, avoidance of complications and more satisfactory postoperative visual function.

Abstract:Dexamethasone intravitreal implant is a biodegradable dexamethasone(DEX)0.7mg slow-release implant that progressively dissolves in the vitreous gel. DEX implant now is approved for macular edema(ME)secondary to retinal vein occlusion(RVO), diabetic macular edema(DME)and non-infectious uveitis(NIU). The most common treatment-emergent adverse events are intraocular pressure(IOP)elevation and cataract. Therefore, DEX implant is still second choice level in treatment of RVO-ME and DME. It is reasonable to switch to DEX implant when anti-vascular endothelial growth factor(VEGF)therapy fail. However, DEX implant may be recommended as a first choice for selected cases, such as for pseudophakic eyes, anti-VEGF-resistant eyes, or patients reluctant to receive intravitreal injections frequently. Recent studies suggest dexamethasone implant is safely and effectively improves uveitis-related ME but the role of DEX implant in the management of NIU has yet to be defined. This article reviews the recent progress of DEX implant and focusing on its efficacy and safety.

Abstract:AIM: To develop the correlation of patients in age-related macular degeneration and TFR2 gene polymorphism in the Han people of northeast China.

METHODS: Totally 200 patients with ARMD(dry-ARMD 100 individuals and wet-ARMD 100 individuals)and 100 healthy control people were chosen as the experiment team and control team. Peripheral venous blood were collected and anticoagulated dealed with EDTA. Then we extraced genome DNA and amplificate rs2075674, which was the polymorphic locus of TFR2 gene according to the primer sequences provided by references, for polymerase chain reaction(PCR). The group representativeness of samples is identified according to hardy Weinberg equilibrium principle.

RESULTS: We found that the difference between ARMD group and control group in the polymorphism of TFR2 gene rs2075674 is statistically significant(χ²=6.494, P=0.011). There was significant difference between the wet ARMD group and control group(χ²=11.054, P=0.001). There had no significant differences when it comes to the dry ARMD group and the control group(χ²=1.418, P=0.234).

CONCLUSION: The above findings indicate that polymorphism of TFR2 gene increases the risk of ARMD in the Han population of Northeast China. It is concluded that rs2075674 is significantly correlated with wet-ARMD.

Abstract:AIM: To investigate the related factors of pupil diameter changes in femtosecond laser-assisted cataract surgery in patients of different ages and their effects on the operation time and surgical efficacy of patient interface.

METHODS: One hundred and one patients(101 eyes)with femtosecond laser assisted cataract surgery were enrolled in this study from March 2017 to June 2018, the age group was divided into middle-aged group(46 cases)and old age group(55 cases). Routine mydriasis was carried out in every patient. The operation time of patient interface, docking time, nucleus radius and pupil diameter before, during and after interface operation, best corrected visual acuity before and after surgery were recorded. The state anxiety questionnaire was used to assess the state anxiety symptoms during interfacing operation and evaluate the clinical efficacy.

RESULTS: The age of patients with femtosecond laser assisted cataract surgery was significantly negatively correlated with the diameter of the pupil before, during and after the interface operation, the radius of the nucleus, and the state anxiety score. The interface operation time and the state anxiety score were significantly negative correlation. The pupil diameters of the middle-aged patients(8.89±0.57, 7.52±0.52, 8.96±0.54mm)were significantly greater than those of the elderly group(8.43±0.73, 7.14±0.55, 8.44±0.75mm)before, during and after the interface operation,and the state anxiety score(42.19±9.27)was significantly greater than that of the elderly group(39.80±9.15 points)(P<0.01), however there was no difference in interface operation time, docking time and total effective rate of treatment between the two groups(P>0.05).

CONCLUSION: The pupillary changes in middle-aged femtosecond laser-assisted cataract patients are more sensitive and these patients are prone to anxiety, which has certain influence on the progress of the surgery.

Abstract:AIM:To compare the effects of manual small incision cataract surgery and phacoemulsification combined with intraocular lens implantation on corneal endothelial cells in diabetic patients with age-related cataract.

METHODS: Totally 128 eyes of 128 diabetic patients with age-related cataract treated in our hospital from July 2015 to December 2017 were divided into manual small incision group and ultrasound group according to different surgical methods. The visual acuity, astigmatism, morphology and function of corneal endothelial cells were observed before and 1 and 6wk after operation.

RESULTS: The preoperative LogMAR visual acuity of manual small-incision group and ultrasound group were 0.75±0.30 and 0.80±0.29, which decreased to 0.14±0.05 and 0.15±0.04 at 6wk after surgery(P<0.05). The astigmatism were 0.87±0.28D and 0.84±0.27D before surgery, which increased to 1.64±0.52D and 1.52±0.42D at 1wk after surgery, and 1.33±0.44D and 1.23±0.38D at 6wk after surgery. The preoperative corneal thickness of manual small-incision group and ultrasound group were 529.15±42.51μm and 528.17±39.64μm, respectively, increasing to 548.14±36.54μm and 544.56±40.14μm at 1wk after surgery, decreasing to 531.01±42.15μm and 529.64±44.12μm at 6wk after surgery. The postoperative endothelial cell density were 2948.14±335.45/mm², 2894.17±365.21/mm², decreasing to 2714.15±431.01/mm², 2689.22±333.45/mm² at 6wk after surgery. The proportions of hexagonal cells were 52.16±10.11% and 49.51±11.07% before surgery, decreasing to 37.48±11.24% and 39.31±10.47% at 6wk after surgery. The preoperative corneal variation coefficients were 38.45±5.64 and 40.17±5.69, increasing to 43.27±4.85 and 44.01±4.91. There were significant differences in corneal thickness, endothelial cell density, hexagonal cell ratio and corneal variation coefficient at differences time points in the same groups(P<0.05).There was no significant difference between the two groups(P>0.05).

CONCLUSION: Manual small incision cataract and phacoemulsification combined with intraocular lens implantation can improve the visual acuity of diabetes mellitus patients with age-related cataract. There is no significant difference in visual acuity recovery and corneal endothelial cell injury after operation. The efficacy and safety are comparable.

Abstract:AIM: To explore the factors affecting visual acuity recovery after phacoemulsification for high myopia complicated with cataract.

METHODS: From March 2015 to October 2017, 86 eyes of 70 patients with high myopia complicated with cataract were treated by phacoemulsification, and the factors affecting the visual acuity recovery after phacoemulsification for high myopia complicated with cataract were analyzed.

RESULTS: There was no correlation between posterior vitreous detachment and postoperative visual acuity recovery. Axial length, corneal astigmatism and macular disease were correlated with visual acuity recovery. Axis length, corneal astigmatism and macular disease were the risk factors affecting the outcome of surgery.

CONCLUSION: Phacoemulsification can effectively improve the visual acuity of patients with high myopia complicated with cataract. Macular lesion, excessive axial length and corneal astigmatism are the three main factors affecting the poor outcome after operation.

Abstract:AIM: To compare the clinical efficacy and safety of dexmedetomidine with phenobarbital sodium in the perioperative period of cataract surgery.

METHODS: A prospective study. Selected 120 cases of patients underwent cataract surgery under topical anesthesia. Before surgery, patients were administed dexmedetomidine nasal spray and phenobarbital sodium intramuscularly, respectively. Observed postoperative Visual Analogue Scale(VAS), Iowa Satisfaction with Anesthesia Scale(ISAS), perioperative vital signs and intraocular pressure, intraoperative complications and adverse drug reactions.

RESULTS: Compared with the phenobarbital sodium group, the dexmedetomidine group had lower VAS score and higher ISAS score, more stable intraoperative systolic blood pressure, better reduction of intraoperative intraocular pressure, lower incidence of complications and adverse drug reactions.

CONCLUSION: Compared with phenobarbital sodium, the administration of dexmedetomidine nasal spray in the perioperative period of cataract surgery has beneficial sedative and analgesic effection, which can improve the satisfaction of patients and increase the safety of surgery.

Abstract:AIM: To compare the effects of trabeculectomy and phacotrabeculectomy on the ocular surface using ocular Keratograph 5M.

METHODS: Totally 62 eyes of 62 patients with coexisting primary angle-closure glaucoma(PACG)and cataract were recruited. Thirty-two eyes accepted trabeculectomy, and the remaining thirty eyes accepted phacotrabeculectomy. Ocular surface parameters, including noninvasive first tear film break-up time(NifTBUT), noninvasive average tear film break-up time(NiaTBUT), corneal fluorescein staining scores(CFS)and tear meniscus height(TMH), were analyzed preoperatively, 3d, 1mo and 3mo postoperatively, with ocular Keratograph 5M.

RESULTS: There was no significant difference in ocular surface parameters between the two groups preoperatively(P>0.05). The values of NifTBUT, NiaTBUT, CFS and TMH in phacotrabeculectomy eyes were at the worse levels, i.e. 10.13±1.48s, 12.59±1.96s, 0.80±0.22 and 0.31±0.02mm, respectively at 3d postoperatively, then improved gradually at 1mo postoperatively, but did not return to the preoperative levels at 3mo postoperatively.

CONCLUSION: Ocular Keratograph 5M can be used to evaluate the changes of tear film in combined anti-glaucoma surgery accurately. The effects of phacotrabeculectomy on ocular surface are worse than that of trabeculectomy during 3mo after surgery. It is suggested that more eye care should be paid during that period of time.

Abstract:AIM: To investigate the clinical effect of ranibizumab combined with vitrectomy in treatment of diabetic retinopathy(DR)with neovascular glaucoma(NVG).

METHODS: Selected 198 patients from 2016-01 to 2018-02 DR merger NVG eye treated in our hospital according to the different treatments were divided into observation group(103 cases)and control group(95 cases). Preoperative observation group used by licensed joint resistance for the treatment of vitreous cut, for the treatment of the control group only with vitreous cut, vitreous cut after 10-15d Ⅱ period implementation Ahmed aqueous humor drainage valve implantation. The changes of intraocular pressure, BCVA and VEGF in the two groups after treatment were observed.

RESULTS: The time of vitrectomy, the number of neovascularization and electrocoagulation in the observation group were all lower than those in the control group(P<0.001). Observation group in the vitreous cut postoperative 1wk and Ⅱ Ahmed, a aqueous humor drainage valve implantation after 1mo BCVA, intraocular pressure was significantly lower than control group(P<0.001). Observation group stage Ⅱ Ahmed aqueous humor drainage valve implantation before VEGF and postoperative 1mo macular center thickness of the concave is lower than the control group(P<0.001). The total complication rate in the observation group was lower than that in the control group(10.7% vs 28.4%, P<0.05).

CONCLUSION: Licensed joint resistance for the treatment of vitreous cut DR merger NVG curative effect is distinct, and made them Ⅱ period Ahmed aqueous humor drainage valve implants difficulty falling, recovery of patients' visual acuity, intraocular pressure level is good.

Abstract:AIM: To investigate the effect of calcium oxybenzenesulfonate dispersible tablets combined with Mingmu Dihuang pills on clinical evaluation indexes, retinal angiogenesis factors and blood lipid levels in patients with non-value-added diabetic retinopathy.

METHODS: Totally 100 cases of non-proliferative diabetic retinopathy(NPDR)patients treated in our hospital from January 2017 to March 2018 were selected as the study subjects. They were randomly divided into observation group(n=50)and control group(n=50). The control group was treated with calcium oxybenzosulfonate dispersible tablets, the observation group was treated with Mingmu Dihuang pills on the basis of the control group. The clinical evaluation indexes, retinal angiogenic factors and blood lipid levels of the two groups before and after treatment were observed and compared.

RESULTS: Before treatment, there were no significant differences in clinical evaluation indexes, retinal angiogenic factor and blood lipid levels between the two groups(P>0.05).After treatment, the visual field gray value, hemangioma volume, macular thickness, hemorrhage area, vascular endothelial growth factor(VEGF), insulin-like growth factor-1(IGF-1), tissue factor(TF), total cholesterol(TC), triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)levels in the two groups were significantly lower than before treatment(P<0.05). Visual acuity, pigment epithelial-derived factor(PEDF)and high-density lipoprotein cholesterol(HDL-C)were significantly higher than before treatment(P<0.05). The levels of VEGF, IGF-1, TF, TC, TG and LDL-C in the observation group were significantly lower than those in the control group(P<0.05), and the levels of visual acuity, PEDF and HDL-C were significantly higher than those in the control group(P<0.05).

CONCLUSION: Calcium oxybenzosulfonate dispersible tablets combined with Mingmu Dihuang pills can significantly improve the clinical evaluation index, inhibit angiogenesis and improve the level of blood lipid.

Abstract:AIM: To investigate the clinical value of epalrestat combined with compound anisodine in treatment of non-proliferative diabetic retinopathy(NPDR).

METHODS: According to the random remainder method, they were divided into A, B and C three groups. Group A was treated with calcium dobesilate, group B was treated with epalrestat, and group C was treated with epalrestat combined with compound anisodine. All groups were treated for 6mo. The BCVA and fundus color photos, fundus fluorescein angiography(FFA), oscillatory potentials of electroretinogram(ERG-Ops)and optical coherence tomography(OCT)were performed before and after 1mo, 3mo and 6mo of treatment. The therapeutic effect was evaluated.

RESULTS: Before treatment, there was no statistical difference among the three groups in BCVA, Ops wave amplitude or central macular thickness(P>0.05). The BCVA was improved, Ops wave amplitude was increased and the central macular thickness was decreased in the three groups after 1mo, 3mo and 6mo of treatment. Compared with the same group before treatment, there were statistically significant differences(P<0.05). The improvement of visual acuity at different time and the increase of Ops wave amplitude were better in group B than group A, better in group C than group B, while the decrease of central macular thickness was greater in group B than group A, greater in group C than group B(all P<0.05). The total effective rate among the three groups were significant difference(P<0.05), and the total effective rate of group C was better than that of group B and group A(P<0.0167).

CONCLUSION: Epalrestat combined with compound anisodine is effective in treatment of DR. The combined treatment can significantly improve the visual acuity, relieve macular edema and promote the recovery of retinal function.

Abstract:AIM: To investigate the retinal thickness, choroidal thickness and optic disc nerve fiber layers thickness in high myopia amblyopia eyes and high myopia eyes with the similar diopter by using enhanced depth imaging optical coherence tomography(EDI-OCT).

METHODS:Nineteen Chinese children, 26 eyes were recruited. Those patients were divided into high myopia amblyopia group(11 eyes)and high myopia group(15 eyes). The thickness in the retina and choroid in different regions, as well as the thickness of optic disc nerve fiber layer were measured by EDI-OCT.

RESULTS: The retinal thickness at the 1.0mm, 1.5mm, 2.0mm, 2.5mm, 3.0mm to the fovea, in most directions, retinal thicknesses were statistically different between the two groups(P<0.05). At the 3.0mm inferior to the fovea, the choroidal thickness in high myopia amblyopia was significantly thinner than high myopia(P=0.012). In the optic disc nerve fiber layer, there was no statistical difference between high myopia amblyopia and high myopia(P>0.05).

CONCLUSION: In the same diopter range, the retinal thickness around the fovea in the high myopia amblyopia was significantly thinner than high myopia, and the occurrence and development of amblyopia may be involved in its change process.

Abstract:AIM: To observe the dry eye and high-order aberrations(HOAs)before and after laser in situ keratomileusis(LASIK)and to evaluate their effects on visual quality.

METHODS: Totally 58 myopia patients(116 eyes)were enrolled from June 2008 to June 2010, who were interviewed before and on 1a, 3a, 5a after operation. Their total HOAs, third-order coma, third-order trefoil and fourth-order spherical aberration of the corneal surface 0s and 10s after blinking were measured, and uncorrected visual acuity(UCVA), spherical equivalent(SE), corneal fluorescent staining, S I t were taken. OSDI questionnaire was scored, dry eye was diagnosed and graded.

RESULTS: Five years after LASIK, OSDI scores gradually increased from 10.003±1.462 to 20.252±2.540, BUT decreased from 8.402±2.640s to 6.897±3.408s and S I t decreased from preoperative level 14.382±6.241mm/5min, but recovered to preoperative level of 13.432±4.206mm/5min. The HOAs obtained 10s after blink were higher than 0s, and the augment of spherical aberration was the most significant. As to the same time point, the post operative HOAs were higher than that before operation, and the elevation of spherical aberration was still the most significant. 5a after operation, there was no difference between dry eye and non-dry eye patients on HOAs obtained 0s after blinking(all P>0.05). There was no significant difference between mild dry eye and preoperative HOAs 10s after blink 5a after operation(all P>0.05). However, the HOAs of moderate and severe dry eye patients were higher than non-dry eye patients(all P<0.05). 5a after surgery, the HOAs differences between two time points of dry eye patients had positively correlated with OSDI scores.

CONCLUSION: The instability of tear film caused by dry eye in patients long-term after LASIK increases patient's HOAs and ultimately impair patient's visual quality, which mainly owe to the significant increase of spherical aberration.

Abstract:AIM: To evaluate the effects of femtosecond laser in situ keratomileusis(FS-LASIK)on visual quality of myopia with different refractive degrees using the Optical Quality Analysis System(OQAS).

METHODS: A total of 65 myopic patients(130 eyes)who received FS-LASIK were collected, which were divided into three groups of low, medium and high myopia. The changes of visual quality parameters before and after surgery were compared by OQAS system.

RESULTS:The values of OV100% and MTF cutoff in the low myopia group at 10d after surgery were higher than those in the high myopia group, and the values of OV20% and OV9% were higher than those in the medium and high myopia group(all P<0.017). At 1d after surgery in low myopia group and at 1d, 10d and 30d after surgery in medium and high myopia group had significantly higher OSI and Mean OSI, while MTF cutoff, SR, OV100%, OV20% and OV9% were significantly lower than those before surgery(all P<0.0083). Mean OSI was negatively correlated with OV100%, OV20%, OV9%, SR, MTF cutoff and positively correlated with OSI(all P<0.05).

CONCLUSION:Optical quality decreases in the early period after FS-LASIK for correction of distinct refractive errors, and the visual quality recovery after the operation of low myopia is faster than that of medium and high myopia. The changes of tear film function and visual quality after FS-LASIK were consistent.

Abstract:AIM: To observe and analyze the ocular surface parameters in patients with type 2 diabetes mellitus and/or hypertension using non-contact ocular comprehensive surface analyzer.

METHODS: Totally 160 patients were divided into four groups. And 40 patients were diagnosed with type 2 diabetes mellitus, 40 patients with hypertension, 40 patients with type 2 diabetes mellitus and hypertension, and 40 patients without type 2 diabetes mellitus and hypertension were selected from our hospital from January 2017 to December 2018. OSDI scores, tear meniscus height, eye red index, corneal fluorescein sodium staining scores, non-invasive tear film rupture time(first tear film rupture time and average tear film rupture time)were analyzed and compared among the four groups.

RESULTS: The subjective perception of eye discomfort was more obvious in patients with T2DM. Patients with T2DM and/or hypertension were more likely to have eye congestion. Compared with the patients without T2DM and hypertension, the tear meniscus height and average tear film rupture time of T2DM patients were significantly reduced(P<0.05). However, the first tear film rupture time and corneal fluorescein sodium staining score were not statistically different among the four groups(P>0.05).

CONCLUSION: Non-contact comprehensive ocular surface analyzer can observe the ocular surface characteristics of the patients non-invasively and provide relatively objective quantitative examination results. Ocular stability in patients with T2DM is lower than in patients without T2DM and hypertension, and ocular surface homeostasis of these patients is more likely to be broken.

Abstract:AIM: To investigate the application of PBL(problem based learning)teaching mode in ophthalmology nursing teaching.

METHODS: Totally 90 students from two classes of Ophthalmology nursing major were included in the study. The mid-term examination of ophthalmological nursing as baseline. LBL group received traditional teaching(LBL). On the basis of LBL group, PBL+LBL group received PBL. The final examination, course satisfaction and self-subjective feelings of the two groups were compared.

RESULTS: There was no significant difference in final scores of basic examinations, operation skills and case analysis between LBL group and its baseline(P>0.05). In PBL+LBL group, the final scores of basic examination, operation skills and case analysis were significantly improved(P<0.05). Compared with LBL group, the final scores of basic examination, operation skills and case analysis in PBL+LBL group were significantly higher(P<0.05). The interest and satisfaction of students in PBL+LBL group were significantly higher than those in LBL group(P<0.05). The percentages who felt making progress in active learning, communication, teamwork, self-study and problem-solving ability in PBL+LBL group were significantly higher than those in LBL group(All P<0.05).

CONCLUSION: The combination of PBL and LBL can effectively improve the teaching effect of ophthalmic nursing for higher vocational students and lay a solid foundation for clinical work.

Abstract:AIM:To analyze and compare the influence of different injury sites and injury types on surgical repair of canalicular laceration.

METHODS: A retrospective study was conducted on 87 cases(87 eyes)of traumatic canalicular laceration from January 2016 to August 2017, who were treated with silicone lacrimal drainage tube implantation. Lacrimal irrigation were performed 3mo and 6mo after surgery, and their respective operation results were evaluated. 3mo after surgery, lacrimal drainage tube were removed. Statisical analysis was proceeded on injury types, distances as well as the success rate of lacrimal passage irrigation.

RESULTS: Among the 87 cases of canalicular laceration, 29 eyes(33%)were in the PCL(proximal canalicular laceration)group, 41 eyes(47%)were in the MCL(medial canalicular laceration)group, and 17 eyes(20%)were in the DCL(distal canalicular laceration)group. There were 22 eyes(25%)of lacrimal canaliculi fracture caused by sharp instrument injury, including 18 eyes in the PCL group, 2 eyes in the MCL group and 2 eyes in the DCL group. There were 65 eyes(75%)of lacrimal canaliculi fracture caused by blunt trauma or collision, including 11 eyes in the PCL group, 39 eyes in the MCL group and 15 eyes in the DCL group. Six months after surgery, 72 eyes of lacrimal passage irrigation were successful, including 20 eyes in the PCL group, 36 eyes in the MCL group, and 16 eyes in the DCL group. The success rate of postoperative anatomic reduction in the three groups was 69%、88%、94%, respectively(P=0.047). There were 19 eyes of acute injury and 53 eyes of blunt injury with successful lacrimal duct irrigation respectively. The success rate of anatomical reduction was 86%、82%(P=0.605), respectively.

CONCLUSION: The canalicular laceration closed to lacrimal punctum is more vulnerable to cutting injury, while the canalicular laceration, which is near the lacrimal sac or between the lacrimal sac and center part of lacrimal punctum, can be more likely caused by lacerated wound. The success rate after operation is higher for patients with distal or medial canalicular laceration, and lower for those who with blunt wound location near the lacrimal punctum.

Abstract:AIM: To investigate the correlation between horizontal corneal diameter(WTW), horizontal anterior chamber diameter(HACD)and horizontal ciliary sulcus diameter(S-S).

METHODS: A total of 62 cases(115 eyes)with high myopia were collected from those who were examined in our hospital from August 2015 to August 2016. Their WTW and HACD were measured with SIRIUS, while S-S was measured with UBM, and the results were compared and analyzed.

RESULTS: In all patients, WTW was 11.91±0.37mm, HACD was 12.45±0.43mm, S-S was 11.78±0.46mm. There was negative correlation between HACD or S-S and age(r=-0.423 and r=-0.386 respectively, all P<0.05). Correlation comparison with central anterior chamber depth(ACD)showed in group with ACD≤3.5mm, WTW and HACD were related with S-S; while in group with ACD>3.5mm, there was no significant correlation between WTW or HACD and S-S.

CONCLUSION: 1)WTW and S-S has better correlation, but due to the influence of age and anterior chamber depth, S-S is recommended to be measured with reference to the UBM to determine ICL when the patient is equal to or over 40 years old or with ACD>3.5mm; 2)SIRIUS Anterior Segment System is safe, simple and repeatability in measuring WTW and HACD.

Abstract:AIM: To observe the safety and efficacy of epithelium-off corneal collagen cross-linking(CXL)combined with rigid gas permeable contact lens(RGPCL)in treatment of progressive keratoconus.

METHODS: From January 2015 to January 2017, 51 cases(51 eyes)of patients diagnosed with keratoconus and epithelium-off CXL treatment at the Eye Hospital of Nanjing Medical University were collected. The patients were divided into two groups according to whether they wore RGPCL or not after treatment. Group A: 30 eyes, epithelium-off CXL was removed and wear a framed mirror after treatment; Group B: 21 eyes, epithelium-off CXL was removed and RGPCL was worn after the condition was stable. Observed the best corrected visual acuity(BCVA), spherical equivalent(SE), minimum keratometry of the anterior corneal surface(K1), maximum keratometry of the anterior corneal surface(K2), mean keratometry(Km), maximal keratometry(Kmax), corneal vertex thickness, thinnest corneal thickness(TCT)before and 12mo after treatment.

RESULTS: No statistically significant differences were found before the therapy between the two groups in BCVA, SE, K1, K2, Km, Kmax, corneal vertex thickness, and TCT between the two groups(P>0.05). 12mo after treatment, BCVA in group B was significantly higher than that in group A(0.11±0.03 vs 0.26±0.16), the corneal vertex thickness of group B was lower than that of group A(431.8±14.41μm vs 461.38±32.68μm)(P<0.05), there was no significant difference in other parameters between the two groups.

CONCLUSION: Epithelium-off CXL can effectively delay or control the progression of keratoconus. Wearing RGPCL after treatment can effectively improve BCVA.

Abstract:AIM: To observe the morphology of corneal incision between femtosecond laser-assisted cataract surgery(FLACS)with 2.4mm micro-incision and conventional phacoemulsification cataract surgery(CPCS)with 2.4mm micro-incision, evaluating the safety and stability of the incision.

METHODS: This was a prospective controlled study. A total of 89 cataract patients(99 eyes)who underwent cataract surgery were collected. All patients were divided into two groups: 44 cases(49 eyes)in FLACS group and 45 cases(50 eyes)in CPCS group. Morphology of clear corneal incision was observed by OCTA postoperative.

RESULTS: There was no external wound dehiscence in FLACS group on 1d postoperative, while 10% patients had external wound dehiscence in CPCS group(P<0.05). There were no external wound dehiscence in both groups on 1wk, 1mo and 3mo postoperative. On 1wk and 1mo postoperative, the incidences of internal wound dehiscence in FLACS group(47% of 1wk and 10% of 1mo)were lower than that in CPCS group. There were statistically significant difference(68% of 1wk and 26% of 1mo)(P<0.05). On 1d and 3mo postoperative, there were no significant difference in internal wound dehiscence in both groups. There were no significant differences in descemet membrane detachment(DMD)in both groups.

CONCLUSION: Femtosecond laser-assisted cataract surgery(FLACS)is benefit for wound closure and reducing abnormal incision construction.

Abstract:AIM: To evaluate the clinical efficacy of femtosecond laser-assisted cataract surgery combined with trifocal intraocular lens(IOL)implantation.

METHODS:From September 2016 to November 2017, 42 cases(59 eyes)of cataract patients receiving trifocal IOL implantation in Shanxi Eye Hospital were retrospectively enrolled in this study. Moreover, the visual and refractive outcomes, defocus curve, refractive stability, high order aberrations, patient satisfaction, and spectacle independence were evaluated at 1wk, 1mo, 3mo and 6mo after surgery, respectively.

RESULTS: All patients had attained good visual acuity of >0.1 LogMAR at different distances during the follow-up period; besides, the visual acuity at each distance was remarkably higher compared with that before surgery(P<0.05). The defocus curve had displayed no significant decrease between 0D to -2.5D at 6mo postoperatively, with the visual acuity better than 0.8. At 6mo postoperatively, 63%(37 eyes)eyes had a spherical equivalent(SE)of ±0.25D, and 88%(52 eyes)eyes had a SE of ±0.50D. The incidences of high order aberrations, coma, spherical aberration and trefoil of all eyes were evidently lower than those before surgery, and the difference was statistically significant(P<0.05).

CONCLUSION: Femtosecond laser-assisted cataract surgery combined with trifocal IOL implantation can provide patient with a comfortable and natural full-range vision, which can greatly improve the postoperative satisfaction of patients.

Abstract:AIM: To observe the clinical efficacy of intravitreal injection of conbercept combined with trabeculectomy and conbercept combined with Ahmed glaucoma valve implantation in treatment of neovascular glaucoma(NVG).

METHODS: Totally 40 cases(40 eyes)of NVG patients selected from our hospital from February 2016 to June 2017 were retrospectively analyzed. According to the treatment methods, they were divided into group A(conbercept with trabeculectomy+ panretinal photocoagulation)and group B(conbercept combined with Ahmed glaucoma valve implantation+ panretinal photocoagulation), 20 cases(20 eyes)in each group. The visual acuity, intraocular pressure, intraocular pressure control rate, neovascularization were observed after 6mo follow-up.

RESULTS: Before treatment, there was no significant difference in intraocular pressure between the two groups(P>0.05). The intraocular pressure in group B was lower than that in group A(P<0.05)at 6mo after treatment, but there was no significant difference in visual acuity, intraocular pressure control rate and the regression of neovascularization between the two groups(All P>0.05).

CONCLUSION: Intravitreal injection of conbercept combined with Ahmed glaucoma valve implantation and conbercept combined with trabeculectomy for NVG are safe and effective, but the former is more effective in reducing intraocular pressure.

Abstract:AIM: To investigate the effect of long-term application of prostaglandin analogue eye drops on conjunctival flora in glaucoma patients.

METHODS: Totally 69 patients(113 eyes)with glaucoma treated with latanoprostaglandin from June 2016 to June 2017 were selected, and the sensitivity of conjunctival flora and staphylococcus epidermidis to antibiotics was examined after admission, 3mo and 1a.

RESULTS: The number of bacterial eyes detected at admission, 3mo and 1a were 63, 66 and 67 respectively(χ²=2.496, P=0.287). There was no difference in the detection rates of staphylococcus epidermidis, streptococcus, staphylococcus aureus, staphylococcus hominis, staphylococcus hemolyticus and moraxella at the time of admission, 3mo and 1a(P>0.05). The ratio of MRSE at 3mo was higher than that at entry(χ²=3.063, P=0.062). The ratio of MRSE at 1a was higher than that at 3mo(χ²=38.945, 24.984, all P<0.001). The susceptibility of staphylococcus epidermidis to levofloxacin, gatifloxacin, moxifloxacin, ceftazidime, tobramycin, cefmethime and erythromycin at 3mo was lower than that at the time of admission, but there was no difference(P>0.0167), while the susceptibility of staphylococcus epidermidis to chloramphenicol at 3mo was lower than that at entry(P<0.0167). The sensitivity of staphylococcus epidermidis to levofloxacin, gatifloxacin, moxifloxacin, ceftazidime, cefmethime, tobramycin, chloramphenicol and erythromycin at 1a was lower than that at 3mo(P<0.0167).

CONCLUSION: The long-term application of latanoprostaglandin will not affect the detection rate of conjunctival flora, but can increase the incidence of MRSE. Clinically, patients who need long-term application of latanoprostaglandin should be considered comprehensively to prevent the emergence of drug-resistant strains in order to prevent uncontrollable infection.

Abstract:AIM: To observe the clinical features of non-posterior retinal multiple-tear detachment and to explore the outcomes of vitreoctomy and scleral buckling in this type of retinal detachment.

METHODS: A retrospective clinical comparative study. Totally 40 eyes of 40 patients with retinal multiple-tear detachment were included in the study. According to surgical methods, the patients were divided into vitrectomy group(PPV group, group A, 18 eyes)and scleral buckling group(SB group, group B, 22 eyes). All patients were followed up for 3 to 6mo to observe the postoperative outcomes of the two groups.

RESULTS: At the end of follow-up, the rate of retinal reattachment in the A group was 100%(18/18). Retinal reattachment rate after removal of silicone oil-filled eyes was 56%(10/18).The rate of complete retinal reattachment in the B group was 86%(19/22), respectively. The difference was not statistically significant in the final retinal reattachment rate comparison(including silicone oil filled eyes)(P>0.05). There was a statistically significant difference in retinal reattachment rate after removal of silicone oil-filled eyes(P<0.05).

CONCLUSION: Non-posterior retinal multiple-tear detachment are mostly caused by extensive retinal degeneration or combined with vitreous traction. Vitrectomy should be chosen in complex cases, but multiple operations are required, while the long-term result of scleral buckling is stable. The choice between vitrectomy and scleral buckling needs comprehensive consideration, and it should be avoided to enlarge the indications for vitrectomy blindly. However, scleral buckling should be preferred if possible, for younger or special groups such as those with one eye.

Abstract:AIM: To analyze the risk factors of early bleeding after 23G vitrectomy for proliferative diabetic retinopathy(PDR).

METHODS: A retrospective analysis was made on the clinical data of 100(100 eyes)PDR patients who were underwent 23G vitrectomy from June 2016 to January 2018. According to whether vitreous hemorrhage occurred in the early stage of operation(within 1mo), the patients were divided into early vitreous hemorrhage group(27 cases)and non vitreous hemorrhage group(73 cases). The risk factors of early vitreous hemorrhage were analyzed.

RESULTS: There were significant differences in age, preoperative anti-vascular therapy, preoperative fibrovascular membrane proliferation, intraoperative optic disc neovascularization hemorrhage and intraoperative gas injection between the two groups(P<0.01). Preoperative fibrovascular membrane proliferation and intraoperative optic disc neovascularization hemorrhage were independent risk factors for early postoperative hemorrhage.

CONCLUSION: Early vitreous hemorrhage after 23G vitrectomy for PDR mainly occurs in patients with severe fundus lesions. Preoperative fibrovascular membrane proliferation and intraoperative optic disc neovascularization hemorrhage increase the risk of vitreous hemorrhage.

Abstract:AIM: To compare the efficacy and safety of 577nm subthreshold micropulse laser(SML)and photodynamic therapy(PDT)in patients with chronic central serous chorioretinopathy(cCSC).

METHODS: Thirty patients(30 eyes)with cCSC were treated in our hospital from February 2015 to April 2018. And 15 patients(15 eyes)were treated with SML(577 nm)while the others were treated by PDT. The BCVA and CMT as well as complications were observed at 1, 3, 6mo after treatment.

RESULTS: At 1mo after treatment, BCVA was increased to 0.37±0.13 in SML group and 0.20±0.11 in PDT group(t=-3.93, P<0.001); CMT was decreased to 382.80±76.54μm in SML group and 247.60±28.46μm in PDT group(t=-6.41, P<0.001). Although improvements of BCVA and CMT were both achieved in two groups, improvements in PDT group were better than those in SML group. At 3mo and 6mo after treatment, both BCVA and CMT were no significant difference between the two groups(P>0.05). During the follow-up period, there were no obvious complications or recurrence observed.

CONCLUSION: Both SML(577nm)and PDT were effective and safe in the treatment of cCSC, but the theraputic effects of PDT was slightly quicker than SML. Further, with the prolongation of recovery time, the curative effects of these treatments were similar. Additionally, SML(577nm)costs was much cheaper than PDT and had no risk of injury or allergy for patients, and patients with cCSC could also be treated repeatedly using it.

Abstract:AIM: To observe the effect of ultrasonic atomization of Shufeng Mingmu Decoction on tear film stability and index of tear fluid in patients with allergic conjunctivitis.

METHODS: Totally 140 patients with allergic conjunctivitis were randomly divided into 2 groups. 70 patients in the control group were treated with olopatadine hydrochloride eye drops combined with normal saline atomization therapy, while the 70 patients in the observation group were treated with ultrasonic atomization of Shufeng Mingmu Decoction combined with oldpatadine hydrochloride eye drops. After 14d of continuous treatment, the single symptoms(lacrimation, itching, photophobia, foreign body sensation), the stability of tear film(BUT, FL), and the index of tear fluid(ECP, HA, IgE)of the two groups were compared and analyzed. The clinical effects of the two groups were compared.

RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(90.7% vs 74.3%, P<0.05). After treatment, the scores of single symptoms in both groups were lower than those before treatment, and those in the observation group were lower than those in the control group(P<0.05). After treatment, the index of BUT in both groups were significantly higher than before treatment(P<0.05), while the index of FL was significantly lower than before treatment, and the improvement degree of which in the observation group was better than that of control group(P<0.05). After treatment, the levels of HA, ECP and IgE in the two groups were significantly lower than before treatment, and the improvement degree of which in the observation group was better than that in the control group(P<0.05).

CONCLUSION: Ultrasonic atomization treatment of Shufeng Mingmu Decoction can improve the index of tear fluid of allergic conjunctivitis patients and the stability of tear film, which help relieve local allergy and improve clinical symptoms of patients.

Abstract:AIM: To compare the intraoperative bleeding and the postoperative therapeutic effect of two nasal mucosal incisions in nasal endoscopic dacryocystorhinostomy.

METHODS: Retrospective study. Sixty-three patients(66 eyes)with chronic dacryocystitis diagnosed by ophthalmology and treated by nasal endoscopic dacryocystorhinostomy in our hospital from June 2016 to May 2018 were collected. According to the different grouping of the base of nasal mucosal flap, dacryocystorhinostomy was performed through nasal mucosal incision with middle turbinate axilla as base in group A, and dacryocystorhinostomy was performed through nasal mucosal incision with maxillary line as base in group B. The patients were followed up to 6mo after operation, and the intraoperative bleeding and postoperative efficiency were compared between the two groups.

RESULTS: There was significant difference in intraoperative bleeding between the two groups.(χ²=11.803, P<0.05). The postoperative efficiency of patients in the two groups was not statistically significant(82% vs 73%, P>0.05).

CONCLUSION: The nasal mucosal incision with the middle turbinate axillary region as the base was associated with more bleeding during the operation, while the nasal mucosal incision with the maxillary line as the base was less bleeding during the operation, and there was no significant difference in the postoperative treatment effect.

Abstract:AIM: To explore the association between serum complement C3 and C4 with optic neuritis.

METHODS: Case-control study design. Optic neuritis subjects(n=137)and control subjects(n=147)who attended the Eye-ENT Hospital of Fudan University from January to August 2018 were recruited. The levels of serum complement C3 and C4 was detected by Roche automatic biochemical analyzer. Univariate analysis and multivariate Logistic regression analysis were performed to compare the level of serum complement C3 and C4 between optic neuritis group and control group. ROC analysis was performed to analysis the diagnosis value of C3 and C4 to distinguish optic neuritis patients.

RESULTS: The levels of serum complement C3 and C4 was significant lower(P<0.05)in optic neuritis group(96.17±17.93mg/dL),(22.41±7.53mg/dL)compared with control group(108.85±15.94mg/dL),(24.55±6.37 mg/dL). Multivariate logistic regression analysis shown that decreased level of complement C3(OR=1.048, P<0.001, 95%CI:1.031-1.065)and C4(OR=1.045, P=0.014, 95%CI: 1.009-1.083)was a risk factor for optic neuritis.

CONCLUSION: The levels of serum complement C3 and C4 was decreased which suggested that the decreased level of complement C3 and C4 was risk factor for optic neuritis.

Abstract:AIM: To observe the early clinical effects of smart pulse technology(SPT)-assisted transepithelial photorefractive keratectomy(TPRK).

METHODS: This was a retrospective non-randomized research. There were 260 patients(508 eyes)who were underwent SPT-assisted TPRK surgery. The best corrected visual acuity(BCVA)was recorded at 1 to 2wk before surgery. The uncorrected visual acuity(UCVA)was recorded at 1mo and 3mo after surgery. Corneal epithelial growth status and haze grade were recorded after surgery. Record the degree of pain within 3d after surgery and satisfaction surveys in all patients.

RESULTS: After 1mo and 3mo, UCVA(-0.080±0.0798, -0.108±0.089)achieved or even better than preoperative BCVA(-0.050±0.0561). Corneal epithelial wounds were completely repaired in all patients during 5d after operation. In the follow-up of 1mo and 3mo after operation, the corneas of most patients are clear except for 3 cases who had haze in 0-1 grade. Very satisfied patients accounted for 93.0%.

CONCLUSION: SPT-TPRK surgery is safe. The average postoperative UCVA can reach or even exceed the preoperative average BCVA.

Abstract:AIM: To study the incidence, clinical features and pathological types of ocular adnexal lymphoma(OAL), in order to improve the level of clinical diagnosis and treatment.

METHODS: There were 147 cases of OAL in West China Hospital from August 2005 to July 2013. We collected clinical data such as general conditions, clinical manifestations, clinical examination(imaging, pathology)results, treatment and prognosis for retrospective study.

RESULTS: This study consist of 147 patients with OAL, including 91 males(61.9%)and 56 females(38.1%); aged from 3.5 to 87 years old; the course of disease range from 20d to 10a; the most common location of disease is orbit(106/147).The most common clinical manifestations including ocular mass, eyelid swelling and exophthalmos. Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue were most common(112/147), it also had the best prognosis while diffuse large B-cell lymphoma, extranodal NK/T-cell lymphoma,nasal type showed the worst prognosis.

CONCLUSION: The pathological types of OAL were complex, which also had diverse location of disease and clinical manifestations. Immunohistochemically staining is an important basis for the differential diagnosis of OAL, and the prognosis of which is closely related to pathological type.

Abstract:AIM: To study the relationship between optical coherence tomography angiography(OCTA)and eye axis in adolescents.

METHODS: Prospective non-randomized clinical study. The clinical data of 33 cases(66 eyes)were collected and analyzed. All the subjects underwent naked vision, diopter, corrected visual acuity, axial measurement and OCT examination. SPSS 19.0 software was used to analyze the relationship between the results of OCTA and the eye axis.

RESULTS: The mean axial length was(24.46±1.50)mm, the mean vascular density in macular area was(47.88±2.56)%, and the mean thickness of nerve fiber layer in macular area was(278.61±15.08)μm. The mean perioptic vessel density was(57.79±2.99)%, and the mean capillary density was(53.08±3.49)%. There was a negative correlation between the length of the eye axis and the thickness of the nerve fiber layer in the macular area(P=0.006), but there was no correlation between the axial length and the other results.

CONCLUSION: There was a negative correlation between the thickness of nerve fiber layer in macular area and the eye axis, but there was no correlation between the blood vessel density and the eye axis in the detection of fundus OCTA in adolescents.