Abstract:AIM: To evaluate the one-year outcome of intravitreal conbercept injections for the treatment of choroidal neovascularization secondary to pathological myopia(pm-CNV)by optical coherence tomography angiography(OCTA).

METHODS: The medical records of 26 consecutive eyes of 23 patients who received intravitreal injections of conbercept for pm-CNV with a follow-up of 1y were retrospectively reviewed. All the patients were diagnosed by fundus fluorescein angiography(FFA)and OCTA at the first visit. All approaches were performed as “1+PRN” treatment. Outcomes included best-corrected visual acuity(BCVA), central foveal thickness(CFT)and the mean CNV area by OCTA.

RESULTS: Mean BCVA improved from(0.66±0.51)at baseline to(0.39±0.38)at 1y(t=3.528, P=0.004). The CFT before treatment and after 1y after were(275.08±48.74)μm and(205.15±43.74)μm respectively(t=4.630, P=0.001). The mean pm-CNV areas before treatment and after 1y treatment were(0.48±0.24)mm² and(0.15±0.11)mm² respectively, with a significant difference among them(t=5.329, P=0.000). Twenty-one eyes had no needs after the first treatment. Four eyes received 2 injections and only one eye received 3 injections. No severe adverse events were noted relevant to the therapy.

CONCLUSION: Intravitreal conbercept can improve the vision and relieve CFT and CNV area for the treatment of pm-CNV with “1+PRN” by OCTA for 1y, however, long-term follow-up still need to be performed.

Abstract:AIM:To explore the effect of eccentricity of overnight orthokeratology(OK)lenses on 2-year eye axial growth and visual quality.

METHODS:Based on the degree of eccentricity of OK lenses, patients were divided into three groups: a low degree of eccentricity group(degree of eccentricity ≤0.5 mm), a group of moderate eccentricity(eccentric degree >0.5-≤1.0 mm)and a group with a high degree of eccentricity(eccentric degree >1-≤1.5 mm). The degree of eccentricity of the OK lens, spherical equivalent(SE), the uncorrected visual acuity after wearing OK lenses(UCVA), axial length before and after wearing OK lenses(AL), total higher-order aberrations(HOA), comas, and spherical aberrations(SA)for 3 mm pupils were analyzed. The difference among the three groups for all parameters was compared using the Kruskal-Wallis H Rank-Sum test.

RESULTS:The study retrospectively analyzed 75 cases(139 eyes). In the low eccentricity group(53 eyes), the mean age was 11.4±2.4 years, SE was -3.24±1.48 D, and AL was 24.85±1.01 mm. In the moderate eccentricity group(53 eyes), the mean age was 11.4±2.2 years, SE was -3.22±1.29 D, and AL was 25.15±0.92 mm. In the high eccentricity group(31 eyes), the mean age was 11.5±1.9 years, SE was -3.54±1.43 D, and AL was 24.95±0.84mm. After two years, there was no significant difference in the changes of the axis among the three groups(P=0.089). The HOA, SA, and coma in the high eccentric group were significantly higher than in the middle eccentric group(P<0.05). The HOA, SA, and coma in the high eccentric group were also significantly higher than those in the low eccentric group(P<0.05).

CONCLUSION:For OK lenses, it is unnecessary to strictly require the absolute centralization of the lens position. An unnecessary change of the lenses may delay the eye-axis control. However, the balance between axial control and visual quality should be assessed.

Abstract:AIM: To observe the effects of high glucose-induced environment on Visfatin expression in human retinal pigment epithelial cells and to study the effects of Polyphyllin I on Visfatin expression in high glucose environment.

METHODS: Human retinal pigment epithelial cells were cultured in three groups, normal control group, high glucose group and intervention group of high glucose aggravated PolyphyllinⅠ, testing after 12h of intervention culture. Normal control group:5.5mmol/L glucose concentration routine culture; high glucose group:25mmol/L high glucose was added to the medium to establish the model; high glucose aggravated PolyphyllinⅠdrug intervention group: high glucose 25mmol/L, 3μg/L PolyphyllinⅠdrug was added to the medium. Immunofluorescence staining assays to observe expression of the Visfatin and VEGF in human retinal pigment epithelial cells; real-time PCR assays for relative expression of Visfatin and VEGF mRNA in epithelial cells; and western-blot assays for Visfatin and VEGF proteins in epithelial cells.

RESULTS: Immunofluorescence detection revealed that Visfatin and VEGF were weakly positive in normal retinal pigment epithelial cells. Visfatin and VEGF were strongly positive in high glucose group. Visfatin and VEGF fluorescence in the drug intervention group was significantly weakened in the higher sugar group. RT-PCR showed that the expression level visfatin mRNA high sugar group was significantly higher than that of normal group and intervention group(t=4.24, 3.89, P<0.05). VEGF mRNA expression was significantly higher in high glucose group than in normal group and intervention group(t=3.53, 2.57, P<0.05). Western-blot results showed that the protein expression of visfatin and VEGF in high sugar group was significantly higher than that in control group and intervention group(t=3.62, P=0.01; t=3.79, P<0.01).

CONCLUSION: The high glucose environment can stimulate the increased expression of Visfatin in retinal pigment epithelial cells, Polyphyllin I can inhibit the expression of Visfatin in retinal pigment epithelial cells in high glucose environment, which may provide a new idea for the treatment of diabetic retinopathy.

Abstract:AIM: To evaluate the inhibitory effect of glycyrrhizin(Gly)on acute alkali burn induced corneal neovascularization(CNV)in mice.

METHODS: Corneal neovascularization was established in mice by alkali burn. Sixty mice were then randomly distributed into normal group, Gly group and phosphate buffer solution(PBS)group. The mice were treated with subconjunctival injection of 2g/L Gly solution or vehicle alone every other day for 14d. Corneal inflammation and neovascularization were monitored with a slit lamp microscope. At the end of treatment, the corneas were harvested for hematoxylin-eosin(HE)staining as well as immunohistochemical of CD34 and myeloperoxidase(MPO)staining, microvessel density(MVD), neutrophils were then calculated.

RESULTS: At the 7 and 14d, the CNV area of Gly group were 4.16±0.00 and 7.33±0.13mm² respectively, which were lower than those in PBS group(7.58±0.20 and 9.24±0.08mm²; all P<0.05). The HE pathological staining showed that there were no changes in morphology as well as no neovascularization or inflammatory cell infiltration in the cornea of control group. In the Gly group, blood vessels and inflammatory cell infiltration nearly diminished with collagen in normal shape. While in the PBS group, extensive infiltration of inflammatory cells and neovascularization was examed in the corneal stroma. The immunohistochemical CD34 staining performed that the MVD in the Gly group was 11.13±1.46 bars per square millimeter, which was lower than that in PBS group(34.08±2.46)bars per square millimeter(P<0.001). Additionally, the immunohistochemical MPO staining showed that the number of neutrophils in Gly group was 17.50±1.98 cells per 200-fold field of view, lower than that in PBS group(59.56±4.79, P<0.001).

CONCLUSION: Gly can eliminate corneal inflammation and inhibit corneal neovascularization in mice with acute corneal alkali burn, which provides a new idea for clinical prevention and treatment of corneal neovascularization.

Abstract:AIM: To establish the model of bone marrow mesenchymal stem cells(BMSCs)over-expressing ciliary neurotrophic factor(CNTF)by applying adenovirus. It may provide novel strategies for in-vitro investigations of retinopathies.

METHODS: GFP-adenovirus and CNTF-adenovirus were synthesized then used to transfect BMSCs of passage 3. Blank control group(without adenovirus transfected group), negative control group(GFP-adenovirus transfected group), and experimental group(CNTF-adenovirus transfected group)were included in this study. On the 1, 2, 3d post-transfected, ELISA assay was applied to examine CNTF protein-secretion in the supernate.

RESULTS: GFP-adenovirus and CNTF-adenovirus models were successfully established. The CNTF protein levels in the supernate were higher in experimental group than those in the blank control group and negative control group(P<0.05).

CONCLUSION: CNTF-modified BMSCs by adenovirus could efficiently secrete CNTF protein in-vitro.

Abstract:AIM: To describe microRNAs(miRNAs)expression pattern in infant and cataract human lens, analyzing the possible difference to assess their function in transparent human lens and cataract formation.

METHODS: The different ages of miRNAs in lens were extracted and samples were divided into four groups: infant lens group(lens from non-ophthalmopathy infant), congenital cataract group(lens from cataract infant), young and middle-aged group(lens from young cataract patients)and senile group(lens from age-related cataract patients). The expression of the 10 miRNAs was detected in the four groups using stem-loop RT-PCR respectively.

RESULTS: In normal infant's lens, the expression of miR-184 was the highest. Compared with the normal infant's lens tissue, the miR-184 and miR-182 in congenital cataract patients increased, the miR-124 and miR-204 decreased. Compared with the children's lens with cataract, the expression of miR-204, 124 and let-7d in young and middle-aged cataract patients increased, while the expression of miR-184, 183 and let-7a decreased. In the lens of senile cataract patients, all of the 10 miRNAs changed. The expression of miR-182, 204, 124 increased, while miR-184, 181b, 183, 125b, let-7a/b/d decreased.

CONCLUSION: There are significant differences in the expression of miRNA in the lens of children and cataract patients of different ages. Some miRNAs are related to the normal morphology, function and certain pathological conditions of the lens. This study provided a theoretical basis of further study on the role of miRNAs in maintaining the normal function of the young children's lens and the formation of cataracts at different ages.

Abstract:AIM: To compare the difference between total and anterior corneal high-order aberrations(HOA)calculated based on the pupil diameters of 4.0mm and the actual measurements in different age groups.

METHODS: A cross sectional study. A Total of 100 subjects between March, 31^th and May, 31^th in 2019 were included. Their total corneal high-order aberrations(THOA)and anterior corneal high-order aberrations(AHOA)were detected on the basis of different machine-provided pupil diameters(2.0-7.0mm)and their photopic pupil diameters were recorded as measured pupil diameters in the room with normal illumination. THOA and AHOA based on the machine-measured pupil diameter was calculated through fitting curves, and compared to the THOA and AHOA at a theoretical 4mm pupil diameter.

RESULTS: The measured pupil diameter was negatively correlated with age(r= -0.587, P<0.001). THOA and AHOA based on measured pupil diameter were both negatively correlated with age(r= -0.191, P=0.002; r=-0.181, P=0.004). At 4mm pupil diameter, THOA was positively correlated with age(r=0.282, P<0.001), while there was no obvious correlation between AHOA and age. In 40-49, 60-69 and 70-79 years old groups, their THOA and AHOA at the measured pupil diameters were significantly lower than those at 4mm pupil diameter(P<0.05), while their THOA were significantly higher than AHOA at the measured pupil diameters(P<0.05). At 4mm pupil diameter, THOA were significantly lower than AHOA in 20-29 years old groups(P=0.006), but higher than AHOA in 60-69 years old groups(P=0.039). In the aged group(include 60-69 and 70-79 years old groups), the proportion of observed value of THOA ≥0.3μm at the measured pupil diameters were significantly lower than those at 4mm pupil diameter(χ²=4.300, P=0.038).

CONCLUSION: THOA and AHOA at the measured pupil diameters in the old subjects are significantly lower than those at 4mm pupil diameter, which could be ascribed to their relatively small actual mean pupil sizes. Our study suggested that the THOA rather than AHOA should be used for the selection of multifocal intraocular lens for cataract patients at measured pupil diameter, so that more aged patients will satisfy the inclusion criteria.

Abstract:AIM:To investigate the influence of myopia on peripapillary retinal nerve fiber layer thickness(RNFLT)using Cirrus optical coherence tomography(OCT)in myopic juveniles aged 12-18 years.

METHODS: Cross-sectional observational study. High-definition(HD), spectral-domain Cirrus OCT(Cirrus HD-OCT; Carl Zeiss, Dublin, CA)was used to analyze RNFLT in 145 healthy juveniles(145 eyes). The data for left eye were selected for analysis. The magnification effect was adjusted by the modified axial length method. The subjects were divided into four groups by spherical equivalent(SE): normal group(52 eyes, -0.25-+0.25D), low myopia group(60 eyes, -0.5--3.0D), moderate myopia group(25 eyes, -3.25--6.0D)and high myopia group(8 eyes,-6.25--12.0D). The correlations between RNFLT and axial length(AL)or SE was tested with linear regression analysis.

RESULTS: The older the age, the longer the eye axis length, the higher the degree of myopia. Comparison of adjusted RNFLT among the four groups: after adjustment, the average RNFLT of the low myopia group and the moderate myopia group were thicker than those of the normal control group(P<0.05). The adjusted RNFLT of temporal quadrant in the moderate myopia group and the high myopia group were significantly thicker than those in the normal group and the low myopia group, as well as the adjusted RNFLT of nasal quadrant in the low, moderate myopia group were significantly thicker compared with those in the normal group(P<0.05). There were statistically significant difference of adjusted RNFLT at 1-4 o'clock, 6 o'clock, 7 o'clock and 9 o'clock among multiple groups(P<0.05). The adjusted values of RNFLT at 1-4 o'clock all showed positively correlated with AL(r=0.220, 0.259, 0.356, 0.237, 0.335, all P<0.01)and negatively correlated with SE(r=-0.386, -0.276,-0.307, -0.254, -0.260, all P<0.01); The adjusted RNFLT at 6, 7 o'clock showed negatively correlated with AL(r=-0.296,-0.327, all P<0.01)and positively correlated with SE(r=0.245,0.295, all P<0.05).

CONCLUSION: Teenagers' eyeballs are still in the shaping stage. When judging RNFLT in myopic juveniles, effects of ocular magnification effect, AL and SE should be considered. When adjusted temporal RNFLT at 1-4 o'clock are thinner than normal, glaucoma should be considered.

Abstract:Lysyl oxidase(LOX), an amino oxidase with copper binding site outside the cell, has been confirmed that may be involved in the pathogenesis of many diseases by a large number of studies. At present, although the potential mechanism of common variants of LOX in the development of disease is still unknown, but the potential role may be to affect the biological activity of LOX through tissue-specific alternative splicing or expression regulation.However, no matter under normal or pathological conditions, there is still little information about LOX in eye tissue yet.In recent years, it has been found that LOX may be involved in the occurrence and development of many eye diseases in related studies. Based on this, the review will summarize the research progress of eye diseases in which LOX is involved of recent years.

Abstract:The continuous proliferation and differentiation of limbal stem cells(LSCs)maintain the integrity and homeostasis of the corneal epithelium, which plays an important role in protecting the cornea and maintaining corneal transparency. Currently limbal stem cell deficiency(LSCD)is one of major causes of blindness in corneal diseases, and transplantation of LSCs is the hot therapeutic option. The effectiveness of transplantation mainly depends on the proportion of LSCs to the total transplanted cells, so it is very important to clearly identify LSCs. There are many markers of LSCs, but their specificity is controversial. Therefore, one of the main challenges in LSCs transplantation is the lack of definitive cell markers. In this paper, the latest research progress of LSCs markers is reviewed.

Abstract:Microbial keratitis(MK)is a common corneal blind eye disease in the world. Severe keratitis can cause irreversible complications and even lead to blindness. Rapididentification of pathogen is the key for early and accurate MK treatment and a large of clinical data indicated that identifying the type of infected microorganisms accurately and quickly is still a challenge for ophthalmologists. The in vivo confocal microscopy(IVCM)is a non-invasive imaging technology that can provide high-resolution images of all corneal layers in a fast and real-time manner, has been used in the diagnosis and follow-up of corneal diseases. In recent years, with the intersection and integration of disciplines, artificial intelligence has been used to identify the characteristic structures in microbial keratitis IVCM images, which has brought important value for accurate and rapid diagnosis of microbial keratitis. Therefore, this article will review the characteristics of confocal microscopy in the diagnosis of microbial keratitis and the application of artificial intelligence in the diagnosis of microbial keratitis. It is of great significance to promote the diagnosis and treatment of keratitis in the future.

Abstract:The virus-related corneal endotheliitis has diverse inducement, complex etiology, unclear pathogenesis, diverse clinical manifestations. There is no unified classification at present. Auxiliary diagnosis technology is improving constantly, loop-mediated isothermal amplification and all kinds of PCR have a certain auxiliary role in the diagnosis of this disease. But the diagnosis also mainly relys on history and clinical manifestation in clinic. Anti-viral drug and glucocorticoid are the main treatment. Virus-related corneal endotheliitis has high recurrence rate, so there is an urgent need to research new drugs and new treatment. Experiment researches of genetic engineering drugs, such as vaccines, unwinding-primers enzyme inhibitors, and chemokine receptors, bring hope to the treatment of virus-related corneal endotheliitis. The purpose of this article is to review the related research of virus-related corneal endotheliitis.

Abstract:Retinal degenerative disease can lead to decreased vision, which is a blinding ophthalmopathy caused by irreversible damage or apoptosis of retinal pigment epithelium(RPE)cells or photoreceptor cells, often resulting in visual impairment or even blindness. Human embryonic stem cells(hESCs)are a kind of multi-directional differentiation cells. By appropriate methods, hESCs can be differentiated into various retinal cells. Since human PRE cells cannot be regenerated, studies have shown that the clinical treatment of retinopathy with stem cell derived RPE cell transplantation has practical prospects and has made a breakthrough in recent years. Due to the limitations of multiple factors, the selection of methods and the complexity of induction conditions, the efficiency of induced differentiation of RPE and the survival rate after transplantation vary greatly and are unstable. Therefore, the current researches should focus on how to integrate different culture methods, take advantages and eliminate disadvantages, so as to improve the directed differentiation efficiency of hESCs, as well as the number and quality of induced cells, thus reducing culture pollution and immune rejection and so on. Here, we will summarize the current examples of various culture methods and give a review from different perspectives.

Abstract:Age-related macular degeneration(ARMD)is a major cause of irreversible visual impairment in the elderly in developed countries. Recent studies have shown that mitochondrial ferritin(FTMT)is thought to have an antioxidant effect through iron regulation. Therefore, this paper discusses the effects of FTMT on HIF-1α, FTMT gene mutation, and FTMT protection against oxidative stress on the progression of ARMD, so as to better understand the pathogenesis of the disease and contribute to the prevention or evaluation of the disease.

Abstract:Diabetes mellitus(DM), as one of the most serious health problems all over the world, can cause the corneal nerve damage, changes in tear composition, tear film dysfunction, increased tear osmotic pressure, immune inflammation, and apoptosis in the eye, thus increasing the risk of ocular surface diseases. Among which, the ocular surface disease is marked by the high incidence of dry eye. In this article, the relevant factors, prevalence and pathogenesis of diabetes-related dry eye are reviewed to provide ideas for clinical treatment.

Abstract:Chronic dacryocystitis(CD)is a disease caused by microorganism infection secondary to nasolacrimal duct stenosis or obstruction. Its pathological changes are of great significance to the diagnosis, treatment and prognosis of patients. This paper summarizes the characteristics of the pathological changes of the lacrimal drainage system and surrounding tissues by reading a large number of domestic and foreign literatures on chronic dacryocystitis in recent years, aiming at improving clinicians' understanding, doing better diagnosis, treatment and prognosis judgment, and providing ideas for further research.

Abstract:Anterior segment ischemia(ASI)is a rare but serious complication after extraocular muscle surgery. Due to its complex clinical manifestations, it is easy to be misdiagnosed. If not treated in time, it may lead to blindness such as vision loss. This paper mainly reviews the concept, clinical manifestations, pathogenesis, risk factors, diagnosis and treatments of ASI after extraocular muscle surgery, so as to improve people's understanding of ASI and minimize or avoid the occurrence of ASI in clinical work.

Abstract:AIM:To review the objective visual quality after multifocal intraocular lens implantation.

METHODS:The PubMed, The Cochrane Library, CNKI, Sinomed, Metstr, Wanfang Database were searched for Meta-analysis of the literature on the objective visual quality after multifocal intraocular lens implantation. The retrieval time limit is from the establishment of the database to December 31, 2019. The objective visual quality was evaluated based on the objective visual quality analysis system Ⅱ(OQAS Ⅱ), which included object scatter index(OSI), modulation transfer function cut off(MTF cut off), Strehl ratio(SR), predicted 100% contrast visual acuity(OV100%), predicted 20% contrast visual acuity(OV20%), and predicted 9% contrast visual acuity(OV9%).

RESULTS: A total of 8 articles met the inclusion criteria of this study, a total of 432 cases(567 eyes). Meta-analysis showed that there was significant difference between multifocal intraocular lens and monofocal control group in OSI \〖MD=0.66, 95% CI(0.42-0.90), P<0.05\〗, but there was no significant difference in MTF cut off \〖MD=-1.94, 95% CI (-5.58-1.70), P=0.30\〗, SR\〖MD=0.00, 95%CI (-0.02-0.02), P=0.87\〗, OV100% \〖MD=-0.02, 95%CI(-0.14-0.11), P=0.76\〗, OV20% \〖MD=-0.03, 95% CI(-0.14-0.08), P=0.60\〗, OV9% \〖MD= -0.01, 95% CI (-0.09-0.07), P=0.82\〗.

CONCLUSION: The increase of objective scattering after multifocal intraocular lens implantation may lead to the decrease of visual quality, and the other parameters have no significant difference with the control group. However, no patient follow-up was reported in the included studies. Due to the changes and adaptability after operation, the long-term evaluation of objective visual quality of patients after multifocal intraocular lens implantation needs further research.

Abstract:AIM:To evaluate the efficacy, safety and economy of conbercept and ranibizumab in the treatment of macular edema(ME)secondary to retinal vein occlusion(RVO).

METHODS:The comparative studies on macular edema secondary to RVO were collected in Wanfang database, CNKI, Pubmed, The Cochrane Library, Google scholar and other databases. The best corrected visual acuity, macular fovea retinal thickness, the number of adverse reactions and the number of injections were systematically evaluated. Compare the effects of the two. RevMan 5.3 statistical software was used to analyze the data.

RESULTS:A total of 1 337 patients were included in 16 studies. The results of systematic evaluation showed that in 1+PRN injection regimen and in the treatment of BRVO secondary ME patients, the regression effect of ME was more obvious, and the injection times were less in 3+PRN injection regimen and treatment of CRVO secondary ME patients. In comparison with the effect of ranibizumab, there was no significant difference in the improvement of visual acuity and the occurrence of side effects when 3+PRN injection was used to treat ME secondary to CRVO. When 1+PRN injection was used to treat Brvo secondary ME, the total number of injections was not statistically significant.

CONCLUSION:Compared with ranibizumab, conbercept showed better effect in different injection regimens and different types of vein occlusion that is less injection times or better ME regression effect.

Abstract:AIM: To compare the therapeutic effects of phacoemulsification respectively combined with diffractive multifocal intraocular lens(IOL)and monofocal IOL implantation in the treatment of cataract.

METHODS: A total of 99 cataract patients(145 eyes)who underwent phacoemulsification combined with IOL implantation in the hospital from January 2015 to February 2019 were divided into observation group(n=51, 75 eyes)and control group(n=48, 70 eyes)according to the non-randomized clinical trial and patient voluntary principles. The observation group was treated with diffractive multifocal IOL implantation, while the control group was treated with monofocal IOL implantation. The visual acuity, corneal endothelial cell count, loss rate of corneal endothelial cells, results of corneal topography, and contrast sensitivity(CS)in daytime, day glare time, nighttime and night glare time were compared between two groups. The complications and spectacles-independent rate were counted.

RESULTS: At 1wk, 1mo and 3mo, there were no significant differences in the best corrected distance visual acuity(BCDVA)and best corrected near visual acuity(BCNVA)between two groups(P>0.05). However, the uncorrected distance visual acuity(UCDVA)at 1wk and 1mo, the uncorrected near visual acuity(UCNVA)and the distance corrected near visual acuity(DCNVA)at 1wk, 1mo and 3mo of the observation group were significantly lower than those of the control group(P<0.05). After surgery, corneal endothelial cell counts and astigmatism of two groups decreased significantly. No significant differences were found in corneal endothelial cell count, loss rate of corneal cells and astigmatism between two groups(P>0.05). CS in daytime of 1.5c/d frequency band, in day glare time of 1.5c/d, 3c/d and 6c/d frequency bands, in nighttime of 3c/d and 18c/d frequency bands, in night glare time of 3c/d, 6c/d and 18 c/d frequency bands were significantly lower, while CS in daytime of 12c/d frequency band was significantly higher in the observation group than in the control group. There was no significant difference in the incidence of complications between two groups(P<0.05), but the spectacles-independent rate was significantly higher in the observation group than in the control group(P<0.05).

CONCLUSION: Phacoemulsification combined with diffractive multifocal IOL implantation can obtain good total range visual acuity, with a higher spectacles-independent rate and relatively low CS after surgery.

Abstract:AIM: To compare effects of combined glaucoma-cataract surgery on pseudoexfoliation glaucoma(PXG)and primary open angle glaucoma(POAG).

METHODS: This was a retrospective case-control study conducted the hospitalized patients at department of glaucoma from January 2015 to January 2018. The PXG group included 40 eyes of 38 cases, with 46 eyes of 36 cases on POAG group, which were matched for baseline data. Visual acuity, intraocular pressure(IOP), number of anti-glaucoma medications used and occurrence of complications were observed in both groups after trabeculectomy + phacoemulsification + IOL implantation. Surgical success was defined according to the following 2 criteria: criterion A: IOP≤21mmHg, criterion B: IOP≤18mmHg. Complete success, and qualified success is defined as patients met these criteria with medical treatment(≤3 medications).

RESULTS: The visual acuity was improved, with IOP and the number of anti-glaucoma medications used both reduced in both group after surgery. There was no statistically significant difference in complete and qualified success rates between the two groups at 1 and 3mo after surgery(P>0.05). Postoperative 6mo, 1 and 2a, for criterion A: the qualified success rates in PXG group(90%, 80%, 74%)were slightly lower than that of POAG group(91%, 86%, 82%, P>0.05). The complete success rates in PXG group(50%, 40%, 29%)were significantly lower than that of POAG group(85%, 64%, 61%, P<0.05). For criterion B: the qualified success rates in PXG group(70%, 70%, 59%)were slightly lower than that of POAG group(80%, 80%, 75%, P>0.05). The complete success rates in PXG group(45%, 30%, 18%)were significantly lower than that of POAG group(78%, 61%, 54%, P<0.05).

CONCLUSION: The combined glaucoma-cataract surgery in PXG and POAG patients can significantly improve visual acuity and reduce intraocular pressure. The short-term success rates of both types of glaucoma were similar, however the long-term success rates of PXG patients was significantly lower, and it was difficult to achieve a low level IOP.

Abstract:AIM: To analyze the therapeutic effects of anti-vascular endothelial growth factor(VEGF)drugs on patients with macular edema secondary to central retinal vein occlusion(CRVO-ME)in different age groups.

METHODS: The study retrospectively reviewed 102 patients(102 eyes)with CRVO-ME treated with intravitreal injection of ranibizumab in ophthalmology department of the hospital between February 2017 and March 2019. The subjects were divided into CM1 group(under 50 years old, 50 cases, 50 eyes)and CM2 group(50 years old or older, 52 cases, 52 eyes), and were followed up for 12mo after treatment. The best corrected visual acuity(BCVA), central macular thickness(CMT), intraocular pressure, average injection times, first injection interval, and complications were recorded.

RESULTS: After treatment, the BCVA of both groups was improved, and the CMT decreased. Besides, CM1 group had better BCVA and CMT than CM2 group at 9mo and 12mo(P<0.001). At 1mo, 2mo, and 3mo, the intraocular pressure of both groups was higher than that before treatment(P<0.01). The intraocular pressures of both groups was lower at 6mo and 9mo than at 3mo after treatment(P<0.05), which returned to the pre-treatment level at 12mo(P>0.05). Additionally, CM1 group had lower intraocular pressure than CM2 group at 1mo, 2mo, and 3mo after treatment(P<0.01). The average injection times in CM1 group was(3.24±0.35), more than(2.38±0.26)in CM2 group, and the first injection interval(1.75±0.19mo)was shorter than(4.13±0.42mo)in CM2 group(P<0.01). No serious complications such as cataract aggravation, retinal detachment, and endophthalmitis were observed in the two groups during follow-up.

CONCLUSION: The treatment with anti-VEGF drugs(ranibizumab)for CRVO-ME can significantly improve the patients' visual acuity, and reduce CMT. The condition can be significantly improved within 1mo after injection, without significant influence on intraocular pressure. Compared with patients over 50 years old, patients under 50 years old can obtain better results after treatment with ranibizumab, more significant improvement of visual acuity, significantly thinner CMT, smaller intraocular pressure fluctuations and shorter first injection interval.

Abstract:AIM: To study the application value of magnetic resonance(MR)high-definition readout segmentation of long variable echo-trains diffusion weighted imaging(RESOLVE-DWI)in the diagnosis of thyroid associated ophthalmopathy(TAO)and its predictive value for the activity of TAO activity.

METHODS: A total of 82 patients(155 eyes)with TAO admitted to the hospital from January 2017 to December 2019 were selected as TAO group. Another 50 patients(100 eyes)with Graves disease without TAO who were admitted during the same period were selected as control group. According to the clinical activity score(CAS)the patients with TAO were divided into active period and inactive period. All the participants were examined by magnetic resonance(MR). The difference of RESOLVE-DWI apparent diffusion coefficient(ADC)values between TAO Group and control group was compared. The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of the ADC measurement of RESOLVE-DWI for TAO. Count the related factors that may affect the activity of TAO, and use Logistic regression analysis to clarify the risk factors. ROC curve was used to evaluated the predictive value of RESOLVE-DWI ADC for TAO activity.

RESULTS: The ADC value of the TAO group was greater than that of the control group(P<0.001). ROC curve showed that the best cut-off point of RESOLVE-DWI ADC value in diagnosing TAO was 1.302×10^-3mm²/s, and the sensitivity, specificity and AUC were 87.10%, 81.94% and 0.895, respectively. The age, grading standard promulgated by the American Thyroid Society(NOSPECS)and ADC value of TAO in active period were higher than those in inactive period, and the differences were statistically significant(P<0.05). Logistic regression analysis showed that age, NOSPECS grade and ADC value were the risk factors of TAO activity, and the differences were statistically significant(P<0.05). ROC curve analysis showed that the best cut-off point of RESOLVE-DWI ADC value in predicting TAO activity was 1.522×10^-3mm²/s, and the sensitivity, specificity, and AUC were 82.58%, 76.77%, 0.801, respectively.

CONCLUSION: The best cut-off points of RESOLVE-DWI ADC value in diagnosing TAO and predicting activity are 1.302×10^-3mm²/s and 1.522×10^-3mm²/s, respectively, and use the best cut-off point for TAO diagnosis and activity sexual prediction has high clinical value.

Abstract:AIM:To investigate the clinical effect of wearing rigid gas permeable contact lens(RGPCL)to correct the irregularity of anterior corneal surface after deep anterior lamellar keratoplasty(DALK).

METHODS: A prospective case-control study. 28 patients accepted RGPCL or frame glassed after DALK surgery during 2017-07/2019-01 in the General Hospital of Northern Theater Command were selected. We divided them into 2 groups according to the principle of non-random voluntariness. 18 patients(18 eyes)accepted RGPCL while 10 patients(10 eyes)accepted frame glasses were selected. Data were collected preoperative, 3mo, 6mo and 1a later, including uncorrected distant visual acuity(UCVA), corrected distant visual acuity(CDVA)and refractive diopter. Furthermore, the Oculus Pentacam Three-dimensional Anterior eye Analyzer was used to examine the corneal morphology. We calculated corneal anterior surface smooth curvature(K1), steep curvature(K2), maximum curvature(Kmax), anterior corneal surface astigmatism, Index of Surface Variance(ISV), Index of Height Asymmetry(IHA), Index of Vertical Asymmetry(IVA)and Index of Height Decentration(IHD).

RESULTS: We found no statistically significant differences between the two groups in UCVA, SE, K2, Kmax, anterior corneal surface astigmatism, IVA and IHD(P>0.05), but we found significant differences in CDVA, K1, ISV and IHA(P<0.05). In terms of CDVA, the data at 3mo was(0.38±0.16, 45.40±3.19D, 35.48±18.46, 27.91±17.19), 6mo was(0.37±0.16, 43.73±3.39D, 30.48±16.28, 25.18±16.66)and 1a was(0.34±0.21, 43.64±3.30D, 25.97±15.23, 23.46±15.24)in the RGPCL group. The data at 3mo was(0.65±0.16, 45.82±3.52D, 49.39±15.73, 28.45±16.96), 6mo was(0.60±0.15, 45.11±3.06D, 48.18±15.13, 25.95±15.93)and 1a was(0.58±0.16, 45.61±3.30D, 46.67±15.45, 25.48±15.51)(P<0.05).

CONCLUSION: RGPCL is safe and effective to improve CDVA and correct the regularity of anterior corneal surface after DALK and has advantage over frame glasses.

Abstract:AIM: To determine the risk factors of age-related macular degeneration(ARMD)in high altitude areas and establish Nomoto prediction model.

METHODS:Using the method of cluster random sampling, the subjects were selected from some communities in Xining City, with an average altitude of 2 100m. The subjects were ≥40 years old, and the investigation method was field investigation. Single factor and multi factor analysis were used to determine the risk factors of ARMD, and R software was used to draw Nomoto.

RESULTS: The actual number of subjects in this survey is 2 595. Age, cataract, living time at high altitude, smoking, drinking, high blood pressure and mobile phone use are risk factors of ARMD. Old age was the most risk factor for ARMD(OR: 53.078, 95% CI: 28.405-77.183, P<0.001), followed by long-term use of mobile phones(OR: 9.142, 95% CI: 1.906-43.846, P<0.001). The DCA decision curve showed that when the Nomo score existed, the probability of predicting ARMD was almost the same as that of actual ARMD.

CONCLUSION: The risk factors of ARMD are old age, high altitude living time, cataract, smoking, drinking, high blood pressure and mobile phone using time, especially the old people who live in high altitude for a long time. Nomo scoring system can accurately predict ARMD and provide theoretical basis for clinicians to intervene ARMD in high altitude areas.

Abstract:AIM: To investigate the effect of IOP of emmetropes and different types of myopia induced by accommodation.

METHODS: A descriptive study. A total of 88 volunteers were included from January to April 2018. Among them, 28(28 eyes)were in the emmetropia group, 60(60 eyes)were in the myopia group, and the myopia group was divided into stable myopia group(myopia progression is less than or equal to 0.50D per year in the past two years)and progressive myopia group(myopia progression is greater than 0.50D per year in the past two years)according to the refractive stability. Meanwhile, the myopia group was also divided into three groups according to the degree of myopia: low myopia group(-0.5D≤SE<-3D), moderate myopia group(-3D≤SE<-6D)and high myopia group(SE≥-6D). A rebound tonometer was used to measure the IOPs of all subjects while relaxed(0D)and accommodated(3D). Statistical analysis was performed on IOPs before and after accommodate.

RESULTS: There was no significant difference in IOPs among emmetropia group(16.54±2.12mmHg), stable myopia group(17.15±2.23mmHg)and progressive myopia group(16.88±2.37mmHg)when relaxed(P>0.05), so did the emmetropia group, low myopia group(16.41±2.21mmHg), moderate myopia group(17.11±2.27mmHg)and high myopia group(17.60±2.35mmHg)(P>0.05). The IOPs of progressive myopia group and high myopia group were significantly increased with 3D accommodation(P<0.05). However, the IOPs did not drop significantly in stable myopia group, low myopia group and moderate myopia group(P>0.05).

CONCLUSION: Accommodation could increase the IOPs of progressing myopes and high myopes, and it suggested that the increase of IOP was related to the progression of adult myopia.

Abstract:AIM: To quantitatively measure and evaluate the VEGF-A, platelet derived growth factor(PDGF)and pigment epithelium derired factor(PEDF)in the aqueous humor of patients with neovascular glaucoma(NVG).

METHODS: Prospectively clinical study. This study involved 23 eyes of 23 patients with advanced NVG and 23 control subjects with age related cataract. Protein concentrations of VEGF-A, PDGF and PEDF in aqueous humor and plasma were determined by enzyme-linked immunosorbent assay(ELISA)tests.

RESULTS: The VEGF-A and PDGF concentrations in aqueous humor from NVG patients were(1130.56±69.32)ng/L and(221.95±56.08)ng/L, respectively. Both of them were significantly higher than control subject(226.45±37.46)ng/L,(36.25±7.12)ng/L(P<0.01). Aqueous PEDF was significantly lower in the NVG group(195.69±42.00)ng/L than that in controls(497.89±12.52)ng/L(P<0.01). However, levels of VEGF-A, PDGF and PEDF in the serum of NVG were(226.45±37.46)ng/L,(29.57±6.31)ng/L and(13.24±1.76)ng/L, respectively, which were similar with control subjects(219±34.89)ng/L,(28.28±7.24)ng/L and(12.96±2.08)ng/L(P>0.05). The concentrations of VEGF-A were closely positive correlated with levels of PDGF in the aqueous humor of patients with NVG(r=0.502, P=0.015). However, the concentrations of VEGF-A were closely negative correlated with levels of PEDF in the aqueous humor of patients with NVG(r=-0.480, P=0.020).

CONCLUSION: There were higher levels of VEGF-A and PDGF, and lower level of PEDF in the aqueous humor of patients with NVG. There was a positive correlation between VEGF-A and PDGF, a negative correlation between VEGF-A and PEDF. The combination of anti-VEGF agent, PDGF inhibitor and PEDF may provide a new idea for the treatment of NVG.

Abstract:AIM: To evaluate the changes of anterior chamber structure in patients after combined surgery of glaucoma and cataract with viscoelastics injection under the sclera valve by OCT.

METHODS: The cataract with acute glaucoma patients who underwent combined surgery of glaucoma and cataract from 2016 to 2018 were enrolled. The patients were divided into the viscoelastics group and the control group. The anterior chamber depth(ACD), the angle opening distance(AOD₅₀₀)and the trabecular iris angle(TIA)were examined to compare the changes of the anterior chamber structure between the two groups.

RESULTS: At 1 and 3d after surgery, the ACD(3.82±0.51,3.71±0.63, 3.78±0.33mm), the angle opening distance(AOD₅₀₀: 0.25±0.04, 0.24±0.04, 0.25±0.05mm)and the TIA(25.13°±8.06°, 26.18°±8.06°, 29.25°±6.22°)were statistically different between two groups. There was no significant difference on the ACD, the AOD₅₀₀ and the TIA of the two groups 7d after surgery(P<0.05).

CONCLUSION: Viscoelastics injection under the sclera valve can deepen the anterior chamber effectively after combined surgery of glaucoma and cataract. It avoids the occurrence of shallow anterior chamber in the early postoperation and maintains the opening of anterior chamber.

Abstract:AIM: To observe the clinical effect of vitrectomy(PPV)combined with internal limiting membrane(ILM)peeling in the treatment of refractory diabetic macular edema.

METHODS: The data of 56 eyes(56 patients)with refractory diabetic macular edema accepted PPV combined with ILM peeling were collected and retrospectively analyzed. The patients were divided into Group A(no posterior vitreous detachment): 35 cases(35 eyes)and Group B(with posterior vitreous detachment): 21 cases(21 eyes). The best corrected visual acuity(BCVA)and central macular thickness(CMT)before and 1, 3, 6mo after operation were compared and analyzed.

RESULTS: The mean CMT and LogMAR BCVA of Group A at 1, 3 and 6mo after operation were significantly different from those before operation(P<0.05); There was no significant difference in BCVA between those before and 1, 3, 6mo after operation in Group B(P>0.05). The mean CMT of 1mo after operation was significantly different from that before operation(P<0.05). There was no significant difference in mean CMT between 3 and 6mo after operation and before operation(P>0.05). CMT and BCVA were significantly different between the two groups at 1,3 and 6mo postoperatively(P<0.05).

CONCLUSION: PPV combined with ILM peeling can effectively treat refractory diabetic macular edema without posterior vitreous detachment, improve the patient's vision; However, PPV combined with ILM peeling was not effective in patients without posterior vitreous detachment.

Abstract:AIM: To explore the clinical application value of optical coherence tomography angiography(OCTA)in patients with retinal vein occlusion(RVO).

METHODS:Retrospective case study. From January 2018 to December 2019, 40 cases with 40 eyes of RVO patients diagnosed in the Eye Center of the Affiliated Hospital of Weifang Medical University were selected, and 40 healthy subjects with 42 eyes matching the age and gender of RVO patients were selected as normal control group. OCTA was used to measure the papillary vessel density of the two groups, differences in parameters were evaluated.

RESULTS: The blood vessel density in the areas of the whole image blood vessels(t=-2.953, P<0.001), the peripapillary blood vessels(t=-3.533, P=0.001), the whole image capillaries(t=-3.192, P=0.003), the peripapillary capillaries(t=-3.930, P<0.001), inferior nasal(t=-2.854, P=0.007), inferior tempo(t=-3.696, P=0.001), tempo inferior(t=-3.418, P=0.002), tempo superior(t=-3.170, P=0.003), superior tempo(t=-3.082, P=0.004)and superior nasal(t=-2.912, P=0.006)in the eyes of patients with RVO was significantly lower than that of the fellow eyes of patients with RVO. The blood vessel flow density in the all areas of in the eyes of patients with RVO was significantly lower than that of the normal control group. The blood vessel density in the areas of the whole image blood vessels(t=-2.213, P=0.032), the blood vessels inside disc(t=-2.270, P=0.028), the whole image capillaries(t=-2.192, P=0.033), capillaries inside disc(t=-2.449, P=0.018)and tempo superior(t=-2.147, P=0.037)in the fellow eyes of patients with RVO was significantly lower than that of the normal control group.

CONCLUSION:Quantitative OCTA reveals a decrease in the vessel density of papillary area of patients with retinal vein occlusion, suggesting that papillary area with quantified OCTA has clinicalapplication value for the assessment of the severity and prevention of the fellow eyes with retinal vein occlusion disease.

Abstract:AIM: To evaluate the efficacy of intravitreal injection of ranibizumab combined with macular grid photocoagulation for diabetic macular edema.

METHODS: In this prospective cohort study, total 78 patients(101 eyes)diagnosed with diabetic macular edema in Dongguan People's Hospital from October 2016 to December 2018 were randomly divided into two groups. 40 patients(52 eyes)were in combination therapy group and 38 patients(49 eyes)were in monotherapy group. The changes of best corrected visual acuity(BCVA), central retinal thickness(CRT)and frequency of injections in two groups were compared after 12mo follow-up.

RESULTS: At the end of 12mo follow up, the BCVA(0.44±0.22 vs 0.55±0.23)and CRT(335.3±65.9μm vs 370.4±84.4μm; P<0.05)were better in combination therapy group than that in monotherapy group. Fewer injections were required in combination therapy group compared with that in the monotherapy group(4.04±1.08 vs 5.83±1.92 injections, t= -5.722, P<0.05). There was no significant difference between two groups(13.87±2.55 vs 14.04±2.69mmHg, P>0.05)in intraocular pressure.

CONCLUSION: Combination therapy of ranibizumab and macular grid photocoagulation was an effective treatment for DME patients, could significantly reduced the frequency of injections, and represent a superior therapeutic approach to DME patients.

Abstract:AIM: To investigate variations in macular blood flow density and morphological structural in early age-related macular degeneration(ARMD)by using optical coherence tomography angiography(OCTA).

METHODS: The retrospective review included 35 patients(35 eyes)which were first diagnosed with wet age-related macular degeneration(wARMD)in one eye and the fellow eye with early ARMD in our hospital at February 2018. A total of 35(35 subjects)healthy eyes with matched age were enrolled in the control group. All the patients with early ARMD eyes were imaged by OCTA at two points: baseline and 2y later. To obeserve the change of the range of 3mm×3mm macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillaries layer, foveal avascular zone area, perimeter and acircularity index, and the macular thickness of the full layer, inner layer, outer layer retina and ISOS-BRM.

RESULTS: The range of 3mm×3mm macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillaries layer in early ARMD patients were lower in early ARMD eyes than controls(P<0.05), and the macular thickness of the full layer and inner layer were reduced(P<0.05), while the thickness of ISOS-BRM increased(P=0.37). There was no significant change in the area of macular foveal, perimeter and acircularity index(P>0.05). Two years after the initial diagnosis, the blood flow density of deep retinal layer and choroidal capillaries layer in early ARMD patients further increased than before(P=0.02), ISOS-BRM thickness increased further than before(P=0.18). There was no significant change in the area of macular foveal, perimeter and acircularity index(P>0.05). In addition, the blood flow density of the choroidal capillary layer in early ARMD patients was positively correlated with the blood flow density in superficial retinal layer and deep retinal layer at baseline and two years after frist definite diagnosis.

CONCLUSION: Compared with the control group, the macular blood flow density of superficial retinal layer, deep retinal layer and choroidal capillary layer, and the thickness of inner layer retina in the patients with early ARMD decreased significantly, it is clinical reference significance for the early detection and intervention of ARMD.

Abstract:AIM: To evaluate ocular surface functions in pregnant women with gestational diabetes mellitus(GDM)using Keratogragh 5M.

METHODS: Pregnant women with GDM and normal pregnant women were enrolled. All subjects were asked to answer ocular surface disease index(OSDI)questionnaire survey, and then underwent ophthalmic examination including tear meniscus height(TMH), average noninvasive Keratograph tear film break-up time(NIKBUTav), ocular redness analysis, and meibomial gland analysis.

RESULTS: There were no statistically significant differences in OSDI, TMH, NIKBUTav, eye redness analysis and meibomial gland analysis between the GDM group and the normal pregnant group(P>0.05). The OSDI scores were 8.02±4.25 and 7.50±4.28(P=0.557), TMH values were 0.22±0.05 and 0.20±0.04mm(P=0.158), NIKBUTav values were 8.01±2.15s and 8.02±1.53s(P=0.971).

CONCLUSION: There was no statistically significant difference between the GDM group and the normal pregnant group in ocular surface indexes. GDM had no negative effects on ocular surface, which may be related to good controlling of the blood glucose.

Abstract:AIM:To explore the diagnostic effect of hematoxylin-eosin staining(HE)and Giemsa staining in the diagnosis of bacterial and allergic conjunctivitis in children.

METHODS:Totally 422 children with conjunctivitis diagnosed by conjunctivitis from the ophthalmology department of our hospital during 2016-10/2019-10 as the research objects. HE and Giemsa staining methods were used to stain the conjunctival scratches, and the staining results were used to diagnose bacterial/allergic conjunctivitis. Observe the positive detection rate of the two staining results for bacterial/allergic conjunctivitis and the staining situation.

RESULTS: The positive rate(33.0%)and coincidence rate(63.6%)of HE staining for the diagnosis of bacterial conjunctivitis were significantly lower than Giemsa staining(90.7% and 88.8%, P<0.001), while the positive rate of allergic conjunctivitis was not significantly different 90.8% vs 87.2%, P>0.05).

CONCLUSION: The Giemsa staining method can accurately diagnose bacterial conjunctivitis in children and the method is simple. Both HE and Giemsa staining methods have good diagnostic effects on allergic conjunctivitis, which can provide a basis for improving the clinical diagnosis efficiency and early treatment options.

Abstract:AIM: To evaluate the effects and complications of retractor repair combined with a lateral tarsal strip procedure and retractor repair alone for treating lower eyelid involutional entropion.

METHODS: This was a prospective study. Totally 79 cases(91 eyes)with involutional lower eyelid entropion who were hospitalized from January 2015 to February 2018 were divided randomly into observation group(41 cases 46 eyes, underwent combined procedure)and control group(38 cases 45 eyes, underwent retractor repair procedure). The clinical effects and the complications of the two groups were compared.

RESULTS: At 3mo postoperatively, there was no significant difference in the clinical effective rate(100% vs 98%, P=0.495)between the two groups. At 24mo postoperatively, the observation group had a higher clinical effective rate(98% vs 84%, P=0.030). There were no complications occurred in the observation group, significantly fewer than the control group(11%, P=0.026).

CONCLUSION: Compare to retractor repair procedure, the combined procedure has a higher clinical effective rate and a lower complications rate.

Abstract:AIM: To investigate the effect of comprehensive treatment of ocular alkali burn in different periods.

METHOD: A retrospective analysis was performed on 124 cases(166 eyes)of ocular alkali burns admitted to our hospital from January 2019 to December 12. According to the severity of the disease, a number of comprehensive measures were taken to treat the ocular alkali burn with drugs and surgery respectively. The patients were followed up for 6-12mo to observe the healing of ocular alkali burn and the final outcome of disease.

RESULTS: After treatment, the symptoms of all patients were relieved, the corneal conjunctiva healed, and no infection occurred. The average hospitalization time was 13d, totally 118 eyes were cured(71.1%), 43 eyes were improved(25.9%), 5 eyes were ineffective(3.0%). There was no complication in degree I and degree II of ocular alkali burn patients, degree III was better than degree IV, and the complication rate in degree III was lower than that in degree IV.

CONCLUSION: According to the corneal conjunctiva and eyelid injury evaluation of ocular alkali burn degree, choose appropriate time to take corresponding treatment measures, and give systemic and local drug treatment. Combined with ocular surface irrigation, anterior chamber puncture, amniotic membrane transplantation, conjunctival flap covering, corneal transplantation, limbal stem cell transplantation and other comprehensive treatment methods can obtain good clinical effect.

Abstract:AIM: To summarize the characteristics and treatment of primary acute angle-closure glaucoma during the outbreak of corona virus disease 2019(COVID-19)in Wuhan.

METHODS: Five patients(9 eyes)with primary acute angle-closure glaucoma(APACG)of our hospital were enrolled. Eight eyes with sustained high intraocular pressure(IOP)were given phacoemulsification with goniosynechialysis and one eye in preclinical phase was given YAG laser iridectomy from March 3-20, 2020. The preoperative and postoperative IOP, visual acuity, hospitalization days and complications were reviewed and analyzed.

RESULTS: Three out of five APACG cases were binocular attack. The onset time was 12-40(25.2±11.82)d. The IOP(48.38±3.22mmHg)of eight eyes decreased significantly after surgeries(12.63±1.68mmHg), the difference was statistically significant(t=12.192, P<0.01). The hospitalization time was 2-6(3.8±1.48)d. No COVID-19 infection or severe complications were observed.

CONCLUSION:During the epidemic of COVID-19, phacoemulsification with goniosynechialysis is able to reduce IOP of APACG patients who suffered from longer, heavier and binocular attack in the epidemic area effectively and safely. Strict prevention management can effectively ensure the safety of medical staff and patients, but also increase the difficulty of the surgeries meanwhile.

Abstract:AIM: To explore the feasibility and efficacy of punctoplasty combined with lacrimal ductule blocking core implantation in the treatment of puncta stenosis.

METHODS: Fifty-six patients(88 eyes)who had epiphora due to puncta stenosis or atresia from March 2018 to July 2019 were enrolled in Jinan mingshui eye hospital. All patients underwent punctoplasty by using trabeculectomy punch combined with a lacrimal ductule blocking core. The core was removed at 2wk after operation. A follow-up of 3mo was taken for final analysis. The epiphora scores, the gradation of punctal morphology and fluorescein staining disappearance test were analyzed pre- and postoperatively.

RESULTS: The epiphora scores 3mo after surgery was decreased compared with the preoperative ones. Both the punctal morphology and the fluorescein staining disappearance test were significantly improved 3mo after surgery. One patient had second puncta atresia due to scar hyperplasia after removing the core. The total effectiveness was 98%, of which 81 eyes(92%)were cured compeletely and 5 eyes(6%)were improved significantly. Only 2 eyes(2%)had no effect. No intraoperative complications were observed and minor complications rate was 7%.

CONCLUSION: Punctoplasty combined with lacrimal ductule blocking core implantation is a safe and effective new method for the puncta stenosis, which is easy to perform and improve the effect of punctoplasty.