Abstract:AIM: To explore whether there is an inflammatory response in the contralateral eye after cataract surgery in the first eye, and try to explore the development of the inflammatory response.

METHODS: In this paired-sample study, aqueous humor samples from 37 bilateral age-related cataract patients were collected just before each cataract surgery. Samples collected during the first-eye cataract surgery were marked as Group A, samples collected during the second-eye cataract surgery were marked as Group B. In addition, the samples were classified into five groups according to different operation intervals between the first and the second cataract surgery. Finally the concentration of 13 selected cytokines(including TNF-α, IL-6, IL-8, CCL2/MCP-1, IL-6 Rα, IL-1 ra, MIP-1α, MIP-1d, CCL4, IL-2, CXCL9, TIMP-1, CCL11)in aqueous humor samples was detected by Luminex-200(RnD)simultaneously in accordance with the manufacturer's instructions.

RESULTS: Among the 13 selected cytokines, there was statistically difference between the first and the second eyes in concentration of IL-6, MIP-1α, CCL2/MCP-1, TNF-α, MIP-1d, IL-2 and TIMP-1(P<0.05), and the expression levels of all these seven cytokines in the second eyes were higher than those in the first eyes, and the concentration of IL-6 and MIP-1α in the second eyes was significantly higher than that in the first eyes(P<0.001). Compared with the first eyes, the concentration of CCL4, CCL11, IL-6Rα, CXCL9, and IL-1ra in the second eyes only showed slightly increase, while IL-8 showed a slight decrease, all with no statistically difference(all P>0.05). The concentration differences of IL-6, MCP-1/CCL2, IL-2, MIP-1d between the first eyes and the second eyes were most obvious at the third week after phacoemulsification combined with intraocular lens implantation(PHACO+IOL)in the first eye.

CONCLUSION: This study revealed that there may be an inflammatory response in the contralateral eye after cataract surgery in the first eye, and the inflammatory response in the second eye appears to be most significant at the third week after phacoemulsification combined with intraocular lens implantation(PHACO+IOL)in the first eye.

Abstract:AIM: To examine the relationship between age-related cataracts(ARC)and comorbid hypertension and diabetes.

METHODS: We analyzed the administrative records of 6 467 patients aged 50 years and older admitted to the ophthalmological department of a tertiary hospital from January 1^st, 2011 to May 20^th, 2017. With either eye considered, an ARC(n=3 343)was defined as the presence of lens opacity or previous cataract surgery without evidence of trauma, congenital anomalies or using certain medications. Patients admitted to the same department during the same period due to ocular traumas without clinical evidence of cataracts(n=379)were recruited as the cataract-free controls. Unconditional Logistic regressions were ran to obtain the odds ratio(OR)of hypertension and diabetes among ARC patients adjusted for age, sex and health care accessibility.

RESULTS: Hypertension was diagnosed in 29.54% of men with any type of cataracts, in 30.12% of men with an ARC, and 10.82% of men of cataract-free controls. Diabetes was diagnosed in 16.64% of men with any type of cataracts, in 16.48% of men with ARC and 4.22% of men of cataract-free controls. Similar patterns were observed among women. After adjusting for age, sex, and health care accessibility, hypertension was weakly \〖OR=1.83(95% CI: 1.23, 2.74)\〗 and diabetes was strongly \〖3.38(1.86, 6.15)\〗 associated with ARCs. The adjusted OR of comorbid hypertension and diabetes among adults with ARC was 18.20(4.38, 75.59).

CONCLUSION: Hypertension and diabetes were independently associated with ARC. Hypertension and diabetes, if co-existing, multiplicatively strengthened the association with ARC.

Abstract:AIM:To evaluate the levofloxacin eye drop into human eye penetration, levofloxacin eye drop concentrations in human ocular aqueous of 33 patients undergoing cataract surgery were measured by high performance liquid chromatography(HPLC).

METHODS:Totally 33 volunteer patients who scheduled for phacoemulsification surgery received one drop of levofloxacin every 6h for 3d before and on the day of surgery, administration of drug was stopped 1h before surgery. Levofloxacin concentration in aqueous humor was measured by HPLC method with fluorescence detector.

RESULTS:A simple, effective and sensitive HPLC method for determination of levofloxacin in human ocular aqueous was validated. Linearity was shown for levofloxacin concentration over a wide range of 1.95×10^-3-1.50 μg/mL. The mean aqueous level of levofloxacin was 0.3399±0.03405 μg/mL.

CONCLUSION:Results from the present study demonstrate that topical administration of levofloxacin 0.5% before cataract surgery with routine dose(one drop every 6h)unable to reach MIC90 for most common microorganism causing acute bacterial endophthalmitis.

Abstract:AIM: To investigate the oxidative damage effect of povidone iodine on corneal epithelial cells.

METHODS:To study the oxidative damage effect of different concentrations of povidone iodine, the cultured epithelial cells were randomly divided into control group, low concentration group, medium concentration group and high concentration group. To study the oxidative damage effect of disinfection time of povidone iodine, the cultured corneal epithelial cells were randomly divided into control group, short time group, medium time group and long time group. Malondialdehyde(MDA)and superoxide dismutase(SOD)were detected by ELISA, cell viability was detected by CCK-8 method and inverted microscope, and apoptotic rate was detected by flow cytometry.

RESULTS: The higher concentration of povidone iodine was associated with the higher MDA content, the lower SOD content, the lower cell activities and the higher apoptotic rate of the corneal epithelial cells, which was in a dose-independent manner. The differences among four groups were statistically significant(all P<0.01). The longer disinfection time of povidone iodine was related with the higher MDA content, the lower SOD content, the lower cell activities and the higher apoptotic rate of corneal epithelial cells, which was in a time-independent manner. The differences among four groups were statistically significant(all P<0.01).

CONCLUSION: The oxidative damage of povidone iodine on corneal epithelial cells were in a dose independent and time dependent manner.

Abstract:AIM: To investigate the role of endoplasmic reticulum stress(ERS)in oxidized low-density lipoprotein(OxLDL)induced retinal pigment epithelium(RPE)cells apoptosis.

METHODS: The human RPE cell line ARPE19 was cultured in low glucose DMEM medium with 10% fetal bovine serum. Experiments were divided into three groups: control group(normal cultured ARPE19), OxLDL group(with 5, 10, 25, 50, 100μg/mL of OxLDL), and LDL group(with 5, 10, 25, 50, 100μg/mL of OxLDL)and cultured 24h. The CCK8 kit(Cell Counting Kit-8)was used to detect cell activity, the flow cytometry was used to detect the percentage of apoptosis and the Western blotting was used to detect the expression of ERS-related proteins and apoptosis-related enzymes. The confocal microscope was used to observe the phagocytosis of Dil-labeled OxLDL(Dil-OxLDL)in RPE cells.

RESULTS: The results of CCK8 showed that when compared with control group, with cell viability of(100±5.637)%, different concentrations(5, 10, 25, 50, 100 μg/mL)of OxLDL could change cell viability significantly(F=41.20, P<0.05), and cell viability of each group was(105.298±9.395)%、(97.106±5.417)%、(77.015±4.055)%、(67.613±3.853)% and(43.872±9.532)%; However, the same concentrations(5, 10, 25, 50, 100 μg/mL)of LDL treatment had no influence on cell viability(P>0.05), and the cell viability changes were(97.55±6.217)%,(99.640±3.586)%,(90.495±2.786)%,(83.552±9.171)% and(90.910±1.429)% respectively. Flow cytometry results showed that OxLDL with concentrations higher than 25μg/mL could induce apoptosis apparently. The apoptosis rates of the blank group, the OxLDL(25μg/mL)group, and the LDL(25μg/mL)group were(5.271±0.519)%,(41.23±1.686)% and(13.07±2.579)% respectively, and the differences among them were statistically significant(F=329.8, P<0.01); The Western blotting results showed that the expression levels of ERS-related proteins and apoptosis-related enzymes in the OxLDL(25μg/mL)group were significantly higher than those in the control group and the LDL group(Caspase-12:F=50.53, P<0.05; GRP78:F=55.60, P<0.05; CHOP:F=38.22, P<0.05; XBP-1:F=53.94, P<0.05; ATF6:F=20.01, P<0.05), while there was no difference between the control group and the LDL group(P>0.05).

CONCLUSION: ERS is involved in the apoptosis of RPE cells induced by OxLDL, and regulating ERS may achieve the purpose of inhibiting RPE cell apoptosis and thus treating RPE apoptosis-related diseases.

Abstract:AIM: To evaluate the effect of leech extract on human retinoblastoma WERI-RB-1 cells.

METHODS: WERI-RB-1 cells with different concentrations of leech extracts(0.02, 0.04, 0.08 and 0.16U/mL)were cultured in vitro for 0, 24, 48 and 72h. The optimal drug intervention concentration and time were selected by CCK-8 method for subsequent experiments. WERI-RB-1 cells cultured in vitro were divided into control group(normal culture medium)and experimental group(culture medium containing leech extract). Flow cytometry was used to detect the effects of drugs on cell cycle and cell apoptosis, and Transwell invasion assay was used to detect the effects of drugs on cell invasion abilit.

RESUITS: According to the detection results of CCK-8 method, the optimal intervention conditions were 0.04 and 0.08U/mL leech extract for 48h. The cells in the leech extract intervention were mainly blocked at G2/M stage, and the positive cell rates in the 0.04 and 0.08U/mL groups were(12.59±5.36)% and(14.79±4.12)%, respectively, which were significantly higher than those in the control group \〖(3.00±2.32)%, P<0.01\〗. The apoptosis rate of the cells in the 0.04 and 0.08U/mL groups was(37.91±3.44)% and(33.05±2.25)%, respectively, which were significantly higher than that in the control group \〖(4.64±2.56)%, P<0.01\〗. The results of Transwell invasion assay showed that the number of cells under the Transwell chamber in the experimental group was significantly than that in the control group, indicating that the leech extract could inhibit cell invasion.

CONCLUSION: The leech extract can inhibit the proliferation and invasion of human retinoblastoma cells and induce cell apoptosis in vitro.

Abstract:AIM:To observe the expression pattern of Cyclin D1 in human lens epithelial cells(HLECs)after traumatic stimulation in high-glucose culture

METHODS: The activity of HLECs was detected by MTT method after incubate with differernt concentration glucose for 24h in vitro to determine the optimal glucose concentration. qRT-PCR and Western blot were used to detect the high glucose pretreatment group and the non-high glucose pretreatment group. The expression of Cyclin D1 in HLECs at different time points after traumatic stimulation was detected.

RESULTS: The viability of HLECs were increased when treatment with low concentration glucose, but the concentration should not exceed 25.5mmol/L, or it will inhibit the activity of HLECs; The reasult of high glucose pretreatment group reveal that the expression of Cyclin D1 is down-regulated in a time-dependent manner within a certain time range. While the expression of Cyclin D1 was irregular in the non-pretreatment group, it was increased at the time point of 12h and 48h. The score treatment can up-regulate the expression of Cyclin D1 in HLECs in a certain degreen.

CONCLUSION: The effects of glucose on HLECs activity and Cyclin D1 experssion are irrugular. Trauma treatment can stimulate the expression of Cyclin D1 in HLECs to some extent.

Abstract:AIM:To evaluate the effects of Beta-B2 crystallin(CRYBB2)knockout on autophagy of mouse lens.

METHODS:Six-month-old WT and Crybb2^KO mice were selected respectively. The morphological changes of autophagy of lens were observed by transmission electron microscopy. The expression of autophagy related proteins in the two groups were detected by Western blot method.

RESULTS:Compared with the control group, transmission electron microscopy revealed that mitochondria was accumulated and the number of autophagosomes in lens were higher in Crybb2^KO mice. The relative expression of LC3B in Crybb2^KO group was lower(0.09±0.01 vs 0.26±0.05). The P62 protein and p-mTOR(0.64±0.09 and 0.41±0.03)was higher than WT group(0.43±0.07 and 0.27±0.02).

CONCLUSION:The deletion of CRYBB2 may affect the process of lens autophagy by mTOR pathway and lead to cataract formation.

Abstract:AIM: To study the correlation between retinal nerve fiber layer(RNFL)thickness changes and long-term visual function in Leber hereditary optic neuropathy(LHON)patients with 11778 mutations, and evaluate the role of early RNFL thickness in predicting long-term visual function.

METHODS: A retrospective analysis with 44 eyes from 23 LHON patients who were diagnosed with 11778 G>A/ND4 mutations by mt-DNA sequencing were included. The patients were divided into two groups based on whether BCVA is above LogMAR 0.5(equivalent to 0.3 decimal,WHO Low Vision standard)or not at 30mo follow up. Then, when the RNFL data of the two groups of patients at each predetermined time point(course of disease)were obtained, the candidate cutoffs of RNFL thickness were obtained by comparing the mean RNFL thicknesses of the two groups. Based on the obtained candidate cutoff values, the eyes with different RNFL values were divided into two groups for statistical analysis to determine whether the cutoff values can be used to predict prognosis of BCVA and visual field. Finally, the earliest cutoff value of RNFL thickness that can predict both BCVA and visual field is the target value.

RESULTS: According to the distribution of mean RNFL values in the eyes of patients with different BCVA groups, the candidate cut-off values of RNFL were determined as: 130μm after 2mo, 100μm after 4mo, 80μm after 8mo, and 65μm after 12mo from onset. Further analysis revealed that the RNFL value exceeds 80μm of 8mo after onset can be a better cutoff value to distinguishes the long-term vision, and which can predict both MD and MS of visual field with good distinction(all P<0.05). It was found that the long-term BCVA of 100% of the eyes with RNFL values less than 80μm after 8 months from onset was lower than LogMAR 0.5(equivalent to 0.3 decimal); while for eyes with RNFL thickness higher than 80μm after 8mo from onset, 31% of patients had vision greater than LogMAR 0.1(equivalent to 0.8 decimal), and only 34% of patients had long-term prognosis of low vision. In addition, the BCVA, MD and MS of visual field of the eyes with RNFL value exceeded 80μm were significantly better than those with eyes with RNFL less than 80μm.

CONCLUSION: In this study, whether the RNFL value exceeded 80μm after 8mo from onset can be used as the best predictive cut-off value for judging long-term BCVA and visual field.

Abstract:AIM: To contrast the visual acuity and visual quality after implantation of regional refraction multifocal IOL and aspheric unifocal IOL.

METHODS: The study enrolled 82 cases(96 eyes)of age-related cataract patients, underwent phacoemulsification surgery in our hospital. According to the intraoperative intraocular lens implantation type, they were divided into two groups: the observation group(46 cases, 53 eyes, implanted with Oculentis MF30 regional refractive multifocal IOL)and the control group(36 cases, 43 eyes, implanted with ADAPT AO aspherical unifocal IOL). The total visual acuity and visual quality 3mo after operation were compared between the two groups.

RESULTS: Three months after surgery, compared with the control group, the observation group had significantly improved near and middle vision, significantly increased contrast sensitivity, significantly increased modulation transfer function cutoff frequency, Strehl ratio, objective scatter index and OQAS values, significantly decreased VF-12-CN score(38.16±4.05 vs 45.72±4.69), and significantly increased desorption rate score(11.38±1.04 vs 9.23±0.87)and surgical satisfaction score(3.57±0.36 vs 3.32±0.31)(P<0.05). Age >65 years old, illiteracy, uncorrected distant visual acuity of good eye ≥0.1(LogMAR), implantation of aspheric unifocal IOL are the influencing factors of the quality of life of cataract patients.

CONCLUSION: Compared with aspheric unifocal IOL, Oculentis regional refraction multifocal IOL can provide good overall vision in the short term after operation, and the contrast sensitivity, visual quality, quality of life, glasses removal rate and satisfaction are significantly improved.

Abstract:Long non-coding RNAs(LncRNAs)refer to RNAs that are longer than 200 nucleotides and cannot encode a protein. With the application of next-generation sequencing technology, whole-genome analysis shows that LncRNAs can regulate gene expression in immune response, epigenetic, gene transcription and post-transcriptional levels, thereby participating in the maintenance of cell proliferation and apoptosis, tissue homeostasis and other physiological processes. LncRNAs have been shown to involve in initiation and development of a variety of human diseases in recent years. This article reviews the research progress of LncRNAs in common diseases of ophthalmology, in order to early diagnosis and treatment of related ophthalmic diseases.

Abstract:In recent years, stem cell research and application in the field of ophthalmology has been highlighted, embryonic stem cells and adult stem cells can be targeted induced to differentiate into retinal pigment epithelial cells(RPE cells), which can obtain transdifferentiation of RPE cells source, through the body stem cells and retinal pigment epithelium cells transplantation is expected to be used in a variety of alternative treatment of the degenerative diseases of the retina. In this paper, the methods and application of various stem cells induced differentiation into RPE cells were discussed.

Abstract:Persistent corneal epithelial defect(PED/PCEDs)is an eye disease that fails to form corneal epithelium rapidly even after 10-14d of corneal injury. Corneal protective epithelial destruction and stromal layer damage can easily lead to eye infection, stromal ulcer, perforation, scar formation, and even blindness. At present, clinicians still face considerable challenges in treating PED patients. Standard treatments such as wearing bandaged contact lenses and using artificial tears, while newly developed drugs can promote the formation of various growth factors to re-form the cornea, and further cooperate with the corresponding surgery to provide innervation for the cornea. In order to achieve the effect of treatment. In addition, treatment should be carried out as soon as possible after the diagnosis of PED to avoid secondary complications. This article reviews the epidemiology, etiology, diagnosis, clinical manifestation, treatment and prognosis of persistent corneal epithelial defect.

Abstract:Multifocal electroretinogram(mf-ERG)is a common type of electroretinogram. It can objectively, accurately and quantitatively detect the function of each tiny part of the retina, so it is widely used in clinical, especially in retinal diseases. It not only plays an important role in the diagnosis and efficacy evaluation of retinal diseases, but also has an important value in the follow-up and prevention of diseases, even the scope of its application can be extended to basic research. Therefore, this paper reviews the application of multifocal electroretinogram in retinal diseases.

Abstract:Contrast sensitivity(CS)is regarded as one of the most comprehensive index to measure human spatial vision recently, which can completely and accurately reveal the patients' visual function, and provide an important reference basis for the early diagnosis,disease progression and efficacy evaluation of ophthalmopathy. Studies have found that the damage mechanism of CS is different in different ophthalmopathy, and the influence degree to each spatial frequency area is also slightly different. Therefore, this article reviews the research of CS detection in eye diseases.

Abstract:Long non-coding RNA(lncRNA)is defined as untranslatable(non-coding)RNA that is over 200 nucleotides and is transcribed from the human genome. With the successful completion of the human genome sequencing and mapping, in subsequent ENCODE study, we found that about 75% of the genome sequence can be transcribed into RNA, and most of the transcripts are non-coding RNA. New research in recent years has found that lncRNA is involved in many important physiological and pathological processes in the body, such as cell development, cell proliferation, cell differentiation, such as cell cycle regulation, cell metabolism, apoptosis, and reprogramming of induced peripheral stem cells. And epigenetic regulation and other biological functions, and differential expression play an important role in the occurrence of various human diseases, such as malignant tumors, inflammatory and immune diseases. Recent studies have shown that lncRNA is related to the pathogenesis of ophthalmic diseases. This article aims to review the latest progress between the abnormal expression of lncRNAs and eye diseases in recent years.

Abstract:Climatic droplet keratopathy(CDK), an acquired corneal degenerative disease, is characterized by oil droplet deposits and banded opacity in the pre-corneal elastic layer and stroma layer, which can severely affect the visual acuity of patients. Recently, many studies have indicated that various factors caused the occurrence and development of CDK. However, the pathogenesis and specific pathogenesis of the disease remain unclear. So this article aims to summarize four aspects of the CDK, including the epidemiological characteristics, the morphology of corneal lesions, the composition of corneal deposits and the ocular surface micro-environment, and then provide a reference for ophthalmologists to acknowledge and explore CDK deeply.

Abstract:Glaucoma is an eye disease characterized by progressiveretinal nerve damage and impaired vision, which is the top one irreversible blinding eye disease. The pathologic intraocular pressure elevation is its key risk. At present, the clinical medicine with intraocular pressure reducing and retinal nerve protection effects focused on symptomatic therapy with unsatisfied effects. Chinese herb monomers have advantages of both Chinese herbs and chemical drugs. Chinese herbs and Chinese herb monomers have favorable effects on glaucoma therapy, especially on retinal nerve protection, which provides a vast room for new drug development. The paper summarized applications and mechanism of representative anti-glaucoma Chinese herbal formulas, Chinese herbs and especially Chinese herb monomers, which would provide references for clinical therapy and new drug development for glaucoma.

Abstract:Primary angle-closure glaucoma(PACG)is one of the most common types of sight-threatening glaucoma. Patients with PACG often have abnormal ocular anatomical variations when compared to normal subjects. With the development of ophthalmic imaging technology, the knowledge is accumulating on the correlation between ocular biometric parameters and PACG pathogenesis and development. It is now known that parameters such as the anterior chamber(AC)depth, AC area, AC volume, AC width, AC angle parameters, iris parameters, lens thickness and positioning, lens vault, ciliary body positioning and thickness, and choroid thickness are all correlated with the pathogenesis of PACG. The associations between PACG and corneal thickness, corneal curvature and corneal diameter need to be further confirmed. Research on the ocular biometry measurement plays important role in the prevention and treatment of PACG.

Abstract:Diabetic retinopathy and diabetic nephropathy are the two most common and serious microvascular complications in diabetic patients, and they are the main causes of blindness and end-stage renal disease. Retinal blood vessels are the common damage targets of early diabetes and the only living blood vessels in the human vascular system that can be directly observed in naked eye. The changes in their morphological structure or function directly or indirectly reflect the microvascular lesions caused by diabetes. Especially, in recent years, the development of optical coherence tomography angiography(OCTA), a new and non-invasive technology, has made its breakthroughs in angiography resolution, vascular depth and vascular morphology, and it can provide objective quantitative data. It has certain application value in diabetic microangiopathy. Therefore, the purpose of this paper is to review OCTA and its application in diabetic microangiopathy.

Abstract:The formation of neovascularization is not only the common pathological change of many important eye diseases, but also the basis of tumor growth and metastasis. this article introduced the relationship, application and related research of anti-angiogenic drugs in the field of ophthalmology and oncology, it also introduced the new ways of administration, facing problems and challenges now, as well as the benefits and side effects of neovascularization drugs in ophthalmology application. Through the discussion of this article, we should strengthen the communication and cooperation between ophthalmologists and oncologists in basic and clinical aspects.

Abstract:AIM: To systematically evaluate the efficacy and safety of two different kinds of Nd:YAG laser posterior capsulotomy in the treatment of posterior capsular opacification after cataract surgery and provide reliable evidence for the selection of posterior capsulotomy in clinical practice.

METHODS: A literature search was implemented in CNKI, Wanfang database, VIP database, PubMed, Medline and Cochrane Library from 2000-01-01 to 2019-12-31. Two researchers independently performed literature search, screening, quality evaluation, and data extraction. Meta-analysis was performed by RevMan 5.3 software. The mean difference and 95% confidence interval were used to measure the measurement data, including best corrected visual acuity, postoperative intraocular pressure, and laser energy. The odds ratio was used to measure the count data, including the rate of lens damage and the incidence of vitreous floaters.

RESULTS: A total of 7 studies were included, including Nd:YAG laser circular posterior capsulotomy and cruciate posterior capsulotomy in 432 eyes. The Meta-analysis showed that there was no significant difference in postoperative best corrected visual acuity between the circular posterior capsulotomy group and the cruciate posterior capsulotomy group, MD=-0.01(95% CI: -0.03-0.01, P=0.32); there was no significant difference in postoperative IOP between the circular posterior capsulotomy group and the cruciate posterior capsulotomy group, MD=-0.60(95% CI: -1.31-0.11, P=0.10); there was no significant difference in laser energy between the two groups, MD=18.82(95% CI: -11.88-49.51, P=0.23); there was also no significant difference in the rate of lens damage and the incidence of vitreous floaters, OR=0.97(95% CI: 0.50-1.87, P=0.93); OR=2.88(95% CI: 0.28-29.26, P=0.37).

CONCLUSION:In the treatment of posterior capsular opacification after cataract surgery with Nd:YAG laser posterior capsulotomy, there is no significant difference in efficacy and safety between circular posterior capsulotomy and cruciate posterior capsulotomy.

Abstract:AIM:To systematically evaluate the efficacy and safety of lifitegrast in the treatment of dry eye disease, and to provide the basis for the selection of drug treatment for dry eye disease.

METHODS: Randomized controlled trials about lifitegrast in the treatment of dry eye disease were searched in CNKI, VIP, CBM, PubMed, Embase and The Cochrane Library databases from inception to March 2019. The collected literatures were strictly screened according to the established inclusion and exclusion criteria, and the Cochrane collaborative network bias risk assessment tool was used to evaluate the quality of the included studies, RevMan 5.3 software was used for meta-analysis of efficacy and safety indicators.

RESULTS: A total of 5 randomized controlled trials that met the inclusion criteria were included in this study, with a total sample size of 2 465 participants. According to the result of Meta-analysis: compared with placebo, after 84d of treatment, the score of corneal staining(CSS)\〖MD= -0.17, 95% CI (-0.29, -0.05), P=0.006\〗, the score of eye dryness(EDS)\〖MD= -7.95, 95% CI (-11.96, -3.93), P=0.0001\〗, all the differences were statistically significant. It showed that lifitegrast eye drops had better effect than placebo in the treatment of dry eye disease. In terms of safety, the incidence of severe adverse reactions \〖OR=0.95, 95% CI (0.50, 1.81), P=0.88\〗; in terms of common adverse reactions, the incidence of adverse reactions such as instillation site irritation, instillation site reaction and dysgeusia were higher than that of placebo(P<0.05).

CONCLUSION: Lifitegrast is effective and safe in the treatment of dry eye disease.

Abstract:AIM: To explore the characteristics of refractive changes in patients with age-related cataract and shallow anterior chamber after phacoemulsification.

METHODS: A retrospective study was conducted. 96 patients(112 affected eyes)with age-related cataract who were admitted to the hospital between March 2018 and June 2019 were divided into the shallow anterior chamber group(ACD≤2.20mm, 52 patients with 62 affected eyes)and the control group(ACD between 2.21 and 2.90 mm, 44 cases with 50 affected eyes)according to the anterior chamber depth(ACD). All subjects were treated with phacoemulsification. The diopter, ACD and anterior chamber volume(ACV)were measured before surgery, at 1d and 3mo after surgery. Pearson linear correlation analysis was performed to analyze the relationship between the refractive status and anterior chamber parameters in patients with age-related cataract and shallow anterior chamber after phacoemulsification.

RESULTS: The diopter error in the shallow anterior chamber group was higher than that in the control group at 3mo after surgery(P<0.001). The variations of ACD and ACV in the shallow anterior chamber group before surgery, at 1d and 3mo after surgery were higher than those in the control group(P<0.001). In the control group, there was no obvious correlation between the diopter error at 1d, 3mo after surgery and preoperative ACD, preoperative ACV, variations of ACD or ACV at different time after surgery(P>0.05). In the shallow anterior chamber group, the diopter error at 3mo after surgery was negatively correlated with preoperative ACD(P<0.05). The diopter error of at 3mo after surgery was positively correlated with variations of ACD at 1d and 3mo after surgery(P<0.05), but there was no obvious correlation with variations of ACV(P>0.05).

CONCLUSION: There is hyperopic shift in patients with age-related cataract and shallow anterior chamber after phacoemulsification. The degree of hyperopic shift is negatively correlated with preoperative ACD and positively correlated with postoperative ACD, namely, the smaller the preoperative ACD, the larger the postoperative ACD, the severer hyperopic shift.

Abstract:AIM: To analyse the characteristic of macular microcirculation detected by optical coherence tomography angiography(OCTA)in nonproliferative diabetic retinopathy(NPDR).

METHODS: Vessel density of 3mm×3mm centered on the fovea(3mm×3mm VD), parafoveal vessel density(parafoveal VD)and foveal vessel density(foveal VD)were measured by OCTA in healthy people, NDR, mild NPDR, moderate NPDR, and severe NPDR groups.

RESULTS: Deep 3mm×3mm VD, deep parafoveal VD and deep foveal VD were decreased gradually in groups. There was statistically significant difference between moderate NPDR, severe NPDR and others in deep 3mm×3mm VD and parafoveal VD(P<0.01). There was statistically significant difference between severe NPDR and control group in deep foveal VD(P=0.006). Superficial 3mm×3mm VD and superficial parafoveal VD are statistically significant in groups. There was statistically significant difference between moderate NPDR group and control group in superficial 3mm×3mm VD and parafoveal VD(P<0.01). There was statistically significant difference between severe NPDR group and others except moderate NPDR group in superficial 3mm×3mm VD, parafoveal VD(P<0.01). There was a significant correlation of deep and superficial 3mm×3mm VD,deep and superficial parafoveal VD, deep parafoveal VD with VA.

CONCLUSION: Deep vessel density decreased more significantly in moderate NPDR and severe NPDR groups and deep parafoveal vessel density might be a potential biomarker of DR.

Abstract:AIM:To investigate the clinical effect of ultrasonic atomization of Shenmai Runmu formula on dry eyes related to meibomian gland dysfunction(MGD).

METHODS: Totally 120 cases of MGD related dry eye patients in our hospital patients were randomly divided into two groups: treatment group(ultrasonic atomization of Shenmai Runmu group)and control group(OPT intense pulse phototherapy), 60 cases each, both groups were combined with meibomian gland massage. The ocular surface comprehensive analyzer was used to detect various indicators: average non-invasive tear break-up time(NITBUTav), lower tear meniscus height(LTMH), meibomian gland score, etc. Subjective symptoms of patients' eyes were scored by questionnaire survey, and the clinical data were statistically processed.

RESULTS: There was no statistical difference between the treatment group and the control group in terms of gender, age, course of disease before treatment, and the indicators in the period from treatment start to 6mo after the treatment end(P>0.05); The total effective rate was about 94.9% in the treatment group and 96.6% in the control group(P>0.05).

CONCLUSION: Ultrasonic atomization combined with meibomian gland massage can improve the subjective symptoms and objective indexes of MGD related dry eyes. Compared with the modern medical treatment, the therapeutic effect of this method is basically the same, safe and effective, but it is more convenient and economic, which is worth popularizing in clinical application.

Abstract:AIM: To investigate the clinical effect of tea tree oil eye patch combined with eyelid margin deep cleaning device in treating demodex blepharitis.

METHODS: This was a prospective, randomized and self-controlled study. Thirty-two patients(sixty-four eyes)diagnosed in demodex blepharitis were enrolled in the study. We randomly assigned one eye of the participants to the study group, which received tea tree oil eye patch once a day combined with monthly eyelid margin deep cleaning, and the other eye to the control group, which received tea tree oil eye patch therapy only. OSDI score of each subject, demodex mite counts, eyelid margin cleanness degree, eyelid margin abnormal score, non-invasive tear break-up time-first, tear meniscus height, redness, meibography score and Schirmer I test of each eye were evaluated before, and three months after the treatment.

RESULTS: Three months after treatment, demodex mite counts in both groups were significantly decreased(P<0.05), the counts were lower in the study group(P<0.05). Significant improvements were observed in the eyelid margin cleanness degree of the two groups(P<0.05), and the degree was lower in the study group(P<0.05). The OSDI score decreased significantly after treatment(P<0.05). The NITBUT-first, redness and FL of the study group were significantly improved after treatment(P<0.05), and the redness and FL of the control group were significantly improved after treatment(P<0.05), NITBUT-first was longer after treatment but there was no statistical difference. The tear film parameters were no significant differences between the two groups. No significant changes were found in tear meniscus height, Schirmer I test and meibomian gland loss score after treatment. No obvious complications were observed in the study.

CONCLUSION: Tea tree oil eye patch therapy is effective in treating demodex blepharitis. With eyelid margin deep cleaning device combining, can further strengthen the efficacy of tea tree oil in eliminating mites and cylindrical cuffs, maintain the eyelid margin cleanness, and improve the abnormality of eyelid margin, which is a convenient,effective and safe treatment for demodex blepharitis.

Abstract:AIM: To investigate the effect of strabismus surgery on tear film and the incidence of dry eye.

METHODS: A total of 66 eyes of 58 patients admitted and underwent surgery in our hospital between September 2018 to September 2019 with concomitant strabismus were enrolled. The patients were divided into two groups based on surgical methods: Group 1 included 25 cases(33 eyes)who underwent a single horizontal rectus cut; Group 2 included 33 cases(33 eyes)who underwent both horizontal rectus cut in. The noninvasive tear film break-up time(NIBUT)was examined with sirius anterior analysis system at the time of 1d preoperatively and 3d, 1wk, 2wk and 3wk after operation. In addition, the tear film break-up time(BUT), Schirmer I test(SⅠt)and corneal fluorescein examination were tested. The patients were diagnosed with dry eye in both groups according to the consensus of clinical experts specialized in the diagnosis and treatment of dry eye.

RESULTS: There were no statistically significant differences when compared to SⅠt between the two groups before and after surgery(P>0.05). The BUT of group 1 was higher than group 2 at postoperative 3d, 1wk and 2wk(P<0.05), while there was no difference between the two groups at 3wk postoperative(P>0.05); BUT returned to baseline by 2wk after surgery in group 1 and by 3wk after surgery in group 2. There were no differences between the NIBUT measured by sirius anterior segment analysis system and the BUT measured by traditional method before and after operation(P>0.05). The lowest incidence of dry eye was found at postoperative 2wk and 3wk in group 1(24%, 18%). The lowest incidence of dry eye was found at postoperative 3wk in group 2(15%). Besides, the incidence of dry eye in group 2 was higher than that in group 1 at postoperative 2wk(52% vs 24%, P<0.05).

CONCLUSION: There was no obvious influence on the SⅠt after strabismus surgery; the surgical effect on tear film was mainly reflected in BUT. The fewer muscles operated, the lesser tear film was affected and the tear film was recovered faster. The incidence of dry eye decreased as time went by.

Abstract:AIM: To explore the possible application of quadrant classification in retinopathy of premature infants at threshold and type 1 pre-threshold stage.

METHODS: Thirty-two preterm infants with retinopathy at the threshold and type 1 threshold preterm stage in the Affiliated Eye Hospital of Nanchang University from April 2017 to January 2018 were recruited for retrospective case analysis. The main location and stage of the retinopathy in these premature infants were divided into three categories by the quadrant method: only one quadrant(above the nose, subnasal, supratemporal, and subtemporal)recorded as “1 quadrant”; distributed in two quadrants(supertemporal+infratemporal, supra-nasal+sub-nasal, supra-nasal+super-temporal, sub-nasal+sub-temporal, supra-nasal+sub-temporal, sub-nasal+super-temporal)were recorded as “2 quadrants”; distributed more than two quadrants recorded as “>2 quadrants”. The clinic characteristics of all cases and the responses to intravitreal injection of ranibizumab were observed according to the quadrant method.

RESULTS: Totally 32 cases with 62 eyes of premature infants recruited in the study. Only 2 eyes were in 1 quadrant before surgery, and the efficiency of a single injection was 100%. A total of 25 eyes were distributed in 2 quadrants, and with a single injection, the effective rate was 100%. 35 eyes with a distribution “2 quadrants” had a single injection rate of only 74% and a recurrence rate of 26%.

CONCLUSION: The main lesions in most cases are distributed in “2 quadrants”(supertemporal+subtemporal). The more of quadrants accumulated for the major lesions and the more severe of the condition; the higher recurrence rate after intravitreous anti-VEGF therapy.

Abstract:AIM: To investigate the effect of fine capsule treatment on the visual quality of diffractive multifocal intraocular lens.

METHODS: Ninety-eight patients(120 eyes)with DMIOL implanted in cataract Department of Hebei Eye Hospital from March 2017 to April 2018. They were randomly divided into A group and B group. 60 eyes in each group. Group A patients were treated with anterior and posterior capsular polishing and posterior continuous circular capsulorhexis, while in B group the fine capsule treatment was not performed. The UCDVA, UCIVA, UCNVA, visual quality, intraocular lens neutrality and PCO incidence were compared 6mo after operation.

RESULTS: At 6mo after operation, UCDVA, UCIVA and UCNVA in group A were superior to those in group B. The difference was statistically significant(P<0.05). At 6mo after operation, the amount of eccentric intraocular lens in group A was less than that in group B. The difference was statistically significant(P<0.05). PCO incidence: group A: 0 eyes; group B: 5 eyes(8.3%)in gradeⅠ, 3 eyes(5.0%)in grade Ⅱ, 2 eyes(3.3%)in grade Ⅲ.

CONCLUSION: In order to enhance the stability of IOL and maintain the long-term transparency of the optic axis, we performed fine polishing of the anterior and posterior capsule and continuous circular capsulorhexis of the posterior capsule. These could improve the visual quality and satisfaction of patients after surgery.

Abstract:AIM: To investigate the effect on vision and complications of Conbercept combined with EX-PRESS glaucoma drainage device implantation for patients with neovascular glaucoma(NVG).

METHODS: Totally 128 cases of patients with NVG admitted to ophthalmology in our hospital from February 2016 to October 2018 were selected and divided into EX-PRESS group(n=66)and Trabeculectomy group(n=62)according to their treatment methods. Patients in both groups received conbercept intravitreal injection, patients in EX-PRESS group were treated with EX-PRESS glaucoma drainage device implantation, and patients in Trabeculectomy group were treated with Trabeculectomy. The surgical efficacy, postoperative intraocular pressure, visual acuity improvement and complications were compared between the two groups.

RESULTS: At 12mo postoperatively, the total successful rate of surgery in the EX-PRESS group and Trabeculectomy group were 81.8%(54/66)and 72.6%(45/62), respectively. There was no significant difference on the surgical efficacy between the two groups(P>0.05). At 1d, 7d, 1mo, 3mo, 6mo, 12mo postoperatively, the two group were significantly lower than preoperation(P<0.05), but there was no significant difference on intraocular pressure between the two groups(P>0.05). At 6mo, 12mo postoperatively, the vision improvement of EX-PRESS group was significantly better than that of Trabeculectomy group(P<0.05). The total postoperative complication rate of EX-PRESS group and Trabeculectomy group were 27.3%(18/66)and 37.1%(23/62), respectively(P>0.05).

CONCLUSION: The effectiveness and safety of conbercept intravitreal injection combined with EX-PRESS glaucoma drainage device implantation is similar to combined trabeculectomy for patients with NVG, and the former is more advantageous in improving eyesight.

Abstract:AIM: To investigate the related factors of visual field progression in patients with primary open angle glaucoma(POAG), and to provide novel ideas for more accurate and efficient follow-up of clinical patients.

METHODS: A prospective study that includes thirty-nine patients(77 eyes)with POAG who were followed up every three months for 7 consecutive times. After inquiring the history in detail, intraocular pressure(IOP), visual field examination and nerve fiber layer(RNFL)thickness were measured. During follow-up the family history, smoking and drinking history, age, gender, surgery, IOP fluctuation, baseline visual field defect and RNFL thickness change were analyzed.

RESULTS: During the follow-up period, the degree of RNFL thinning was positively correlated with visual field progression(P<0.05). The baseline visual field defect was associated with visual field progression. Moderate baseline visual field defect has the greatest correlation with the progression of visual field damage, the second is mild, and the least is severe.

CONCLUSION: Changes in RNFL thickness may provide useful information and progressive judgment of patients with mild and severe visual field defects should be combined with other information besides visual field.

Abstract:AIM:Comparison of curative effect of different surgical methods on children with meibomian cyst.

METHODS: Totally 150 children who needed meibomian gland cyst surgery were selected and divided into traditional group and cauterization group. The traditional group used traditional surgical excision and the cauterization group took cysts to remove povidone-iodinated cotton tablets. The average operation time, the probability of hematoma, cure rate, recurrence rate and family satisfaction.

RESULTS:There was no significant difference in general data of children in traditional group and cautery group(P>0.05). The average operation time of the traditional group and the cautery group were(14.5±2.58)min and(12.29±1.53)min(P<0.05); the probability of hematoma was 21.3% and 9.3%, and the cautery group had less compared with the traditional group(P<0.05); The total effective rates of the cautery group and the traditional group were 97.3% and 89.3% respectively(P>0.05), there were fewer children in the cautery group(P>0.05); the satisfaction of the family members of the children in the cauterization group was 97.3%, better than the traditional group 86.7%(χ²=4.832, P<0.05).

CONCLUSION:The use of cyst curettage plus povidone-iodine cotton tablets for cauterization can reduce the operation time and hematoma rate of meibomian gland cysts, and the curative effect is high. It is worthy of clinical application.

Abstract:AIM:To evaluate the clinical effect of human fibrin glue in pterygium excision combined with fresh amniotic membrane transplantation and its clinical value.

METHODS: This study was a prospective analysis of 153 pterygium excision patients(153 cases, 153 eyes)from March 2018-October 2018. The patients were randomly and evenly divided into two groups: observation group(78 eyes)and control group(75 eyes). In fibrin glue group, patients(78 eyes)underwent pterygium excision, and the bare selera was covered with fresh amniotic membrane using fibrin glue for graft adherence, while in suture group, patients(75 eyes), the an amaiotic membrane grafts was attached to the selera using 10-0 nylon sutures after pterygium excision. Record the surgical time and the degree of pain after surgery were evaluated at 2h, 1, 3, 5 and 10d(before sutures out)after surgery.

RESULTS: Average surgical time(14.5±3.6)min in fibrin glue group was significantly less than suture group(18.3±4.2)min(P<0.05). The scores of 2h and 1, 3, 5 and 10d(before thread removal)pain levels were statistically significant(F=39.939, 419.026, 28.410, all P<0.01). After surgery, the degree of pain of treatment group was significantly decreased compared to control group, the difference was statistically significant(P<0.01). There were significant differences in pain scores at different time points in each group(P<0.01). There were no significant differences in the 2 groups comparing treatment outcomes of the recurrence rate at the end of 12-month follow-up(P>0.05).

CONCLUSION: It not only significantly reduces the surgical time, but also minimizes postoperative discomfort when we use fibrin glue in pterygium excisions. But it cannot decrease the recurrence rate.

Abstract:AIM: To report the data of 28 cases of congenital nasolacrimal duct obstruction who failed in the first probing of lacrimal passage in our hospital, summarize the strategy of retreatment.

METHODS: Retrospective study, selected 591 cases of children with 28 cases in our hospital from Feb. 1, 2013 to Dec. 31, 2017, all were for the first time of probing of lacrimal passage through failure of children with congenital nasolacrimal duct obstruction(not including traumatic and lacrimal duct abnormalities), collect the case history, the nasal situation, the age of the first time to probing of lacrimal passages, information such as case data before and after treatment.

RESULTS:In 28 cases, 15 cases with probing of lacrimal passage joint tube insertion second time, take the tube after cured, 10 cases treated with inferior turbinate, again with probing of lacrimal passage joint tube insertion, take the tube after cured, 2 cases of children with acute dacryocystitis often strikes, under general anesthesia with transnasal endoscopic dacryocystorhinostomy, 1 cases of children with bony nasolacrimal duct obstruction and strictures, with tears spill without overflow pus, pay a follow-up visit, sinus fully developed after the age of 13 under transnasal endoscopic dacryocystorhinostomy.

CONCLUSION: Congenital nasolacrimal duct obstruction of lacrimal duct exploration for the first time failed again take personalized ladder solution treatment, reasonable treatment of the disease.

Abstract:AIM: To investigate the prevalence and risk factors of dry eye in children under 14 years old in Changdu.

METHODS: A cross-sectional study was conducted in August 2019 to investigate the epidemiology of primary and secondary school students under 14 years old in Changdu city, and the prevalence and risk factors of xerophthalmia in children under 14 years old in this area were analyzed by self-made questionnaire.

RESULTS:There were 2 648 children in this study, 2 389 of them were investigated in the course of investigation, the overall investigation rate was 90.22%, 413 of them had dry eye symptoms(17.29%), 331 of them were diagnosed as dry eye disease, and the prevalence rate of dry eye disease was 13.86%. The univariate analysis showed that there were significant differences in age, gender, history of eye surgery, history of eye trauma, preference for fruits and vegetables, allergic conjunctivitis, trichiasis, ametropia, trachoma, blepharitis, reading and writing posture, contact lens, computer or hand machine time, passive smoking, antibiotic eyedrop between children with dry eye and children without dry eye(P<0.05). The results of multivariate Logistic analysis showed that age, allergic conjunctivitis, blepharitis, ametropia and passive smoking were the risk factors(P<0.05).

CONCLUSION: The incidence of dry eye is high in children under 14 years old in Changdu city, and the age, allergic conjunctivitis, blepharitis, ametropia and passive smoking are the risk factors of children's dry eye in Changdu city.

Abstract:AIM:To explore the relationship among bone age, age, height, weight and ocular biological parameters of myopic children in Whenzhou.

METHODS: Totally 410 cases(820 eyes)of myopic children with age distribution of 5-11 years old were collected. The height, weight, bone age and axial length(AL)of each child were measured, and body mass index(BMI)was calculated. Refractive was measured by medical optometry after rapid mydriasis, and the spherical equivalent(SE)was calculated. Children of each age group were divided into groups according to bone age difference(biological age-life age), and the prevalence of myopia in each group was statistically analyzed and compared among different bone age groups.

RESULTS: There was an association among the age, height, weight, BMI, SE and axis length(r_s=0.853, 0.776, 0.291, -0.274 and 0.312; P<0.05). There was no significant correlation between the age and the bone age(r_s=0.045, P>0.05). 40.5% of myopic children are ahead of their bone age, 40.2% of them are in the normal range, 19.3% of them are behind(χ²=21.576, P<0.05). Among the myopic children aged 5-11, 46.3% were boys and 53.7% were girls(χ²=17.322, P<0.01). The proportion of girls was much higher than boys in children with advanced bone age.

CONCLUSION: There was an association between the age and height, weight, BMI, SE, axis length in Whenzhou. Among the children with low age myopia, there are more children with advanced bone age, especially girls.

Abstract:AIM:To investigate the characteristics of color Doppler sonography and MRI in orbital solitary fibrous tumor(SFT).

METHODS: It was a retrospective case series study. A total of 12 cases of orbital solitary fibrous tumors were recruited from April 2013 to August 2018 in Tianjin Medical University Eye Hospital. Color Doppler sonography and MRI plain scan and DCE-MRI were applied in all cases.

RESULTS: Of 12 cases, 7 cases were males and 5 were females, with the duration of symptoms ranged from 3mo-20y, with an average course of 3.2y; 6 cases were the primary cases and 6 cases were relapse cases. All lesions involved one side of the orbit, of which 8 cases were in the left orbit and 4 in the right. Of 12 cases, there were 5 tumors in intraconal space, 3 in the extraconal space, and 4 in intra and extraconal space. Well-circumscribed lesions showed oval shape in 9 cases and the left 3 were irregular. 12 cases showed hypoechoic and 2 cases heterogeneous signal on color Doppler sonography; All cases had flow signals on CDFI, and showed arterial spectrum on PW. On T1WI, all lesions demonstrated isointense. On T2WI, 5 lesions showed hypointense, 3 lesions showed isointense and 4 lesions slight hyperintense, of which 3 lesions showed heterogeneous signal. After contrast enhancement, all cases demonstrated markedly enhancement, with homogeneous enhancement in 10 cases and heterogeneous enhancement in 2 cases. The time-intensity curves(TIC)of 7 cases exhibited a rapid washout pattern, and 5 cases a rapid plateau pattern on DCE-MRI.

CONCLUSION: Color Doppler sonography features of orbital SFT include hypoechoic and flow signals. Heterogeneous signals on T2WI, marked enhancement, and a rapidly enhancing and slow washout pattern TIC on DCE-MRI are the typical MRI features of orbital SFT.