Abstract:AIM: To describe a technique of managing intraocular lens(IOL)with deep dislocation in the vitreous cavity by performing pars plana vitrectomy(PPV)with only one pars plana incision under the direct illumination of the surgical microscope.

METHODS: Patients who had in-the-bag or out-of-the-bag(spontaneous)IOL dislocation after uneventful phacoemulsification cataract extractions, with the dislocated IOL or IOL-capsular bag complex dropping completely into the vitreous since 2013 were included in our studies. The postoperative patients were followed up for 6mo. Detailed description of technique and retrospective description of eight typical cases were demonstrated in this study.

RESULTS:A total of 40 surgeries were conducted using this technique. The main possible predisposing conditions included: post-vitrectomy, posterior capsule rupture or broken zonules, a history of ocular trauma, long axial length, secondary IOL implantation, chronic uveitis, retinitis pigmentosa and post-glaucoma surgery. In all eyes, the IOLs were successfully removed. No intraoperative or postoperative complications related to the procedures occurred. The preoperative corrected distance visual acuity(CDVA)ranged from 20/133 to 20/25, and at 6mo postoperatively, the CDVA was similar or the same. The intraocular pressure was all within the normal range.

CONCLUSION: One-port PPV under direct vision with microscope illumination is a simple and safe surgical technique to managing IOL dislocation, which shortens the surgical time, and largely avoids surgical complications.

Abstract:AIM: To evaluate the effects, advantages, disadvantages, and indications of infrabrow skin excision to correct upper eyelid dermatochalasis in middle-aged and elderly Chinese women.

METHODS: Sixty eyelids in 30 patients were subjected to this surgical procedure from January to June 2018. All patients had upper eyelid dermatochalasis, and the functions of their levator palpebrae were all normal. The primary indications of the procedure were upper lid dermatochalasis with lateral hooding. All 30 patients underwent infrabrow skin excision at Shanxi Eye Hospital. The degree of skin relaxation before and after surgery was evaluated in all patients, and surgical outcomes and postoperative complications were also assessed.

RESULTS: All patients were female, ranging from 40 to 64(mean: 53.20±7.10)years old. Skin relaxation of the upper eyelid was improved in all 30 patients. One month after the operation, 52 lids(86.7%)showed good results and 8 lids(13.33%)showed fair results. The objective Strasser system was applied to evaluate surgical results at 1 and 6mo. All patients had scores between 0 and 1 point, indicating good results. Preoperative unsatisfactory position and shape of the eyebrows were improved, and crow's feet and frontal lines were reduced. All patients were satisfied with the results. No complications related to wound dehiscence, lagophthalmos, or hypertrophic scars were observed.

CONCLUSION: Infrabrow skin excision is a simple, useful operation to reconstruct the upper eyelids in selected patients of Chinese ancestry. This procedure not only retains the advantages of classic blepharoplasty, but also alleviates many eyebrow problems at the same time, and maintains the original shape of the eyelid, minimizes scarring, and produces a smoother, more youthful appearance.

Abstract:AIM: To analyse the association between dyslipidemia and severity of meibomian gland dysfunction(MGD)in a tertiary care hospital of Uttarakhand region.

METHODS: This prospective observational study was conducted over a period of one year including 50 consecutive patients of MGD. Patients underwent detailed history(including Ocular Surface Disease Index Questionnaire)and examination(including meibum quality, expressibility and numerical staining). MGD was graded according to the guidelines submitted by the International Workshop on Meibomian Gland Dysfunction and Management in 2011. Fasting lipid profile of all the patients was done. Various parameters of lipid profile including total cholesterol(TC), triglycerides(TG), low density lipoproteins(LDL), high density lipoproteins(HDL)and very low density lipoproteins(VLDL)were correlated with MGD severity. Chi-square test was done for statistical analysis(P<0.05).

RESULTS: Stage 2 MGD was the most common disease entity(60%, n=30). A significant positive correlation was noted between increasing age and severity of MGD(P=0.004). High TC(>200 mg/dL), TG(>150 mg/dL), LDL(>130 mg/dL)and VLDL(>22 mg/dL)levels had a significant positive correlation with the severity of MGD(P=0.001, 0.019, 0.001, 0.016 respectively).

CONCLUSION: Monitoring the fasting lipid levels may aid in establishing the severity of MGD and further studies may be conducted to establish the role of treatment of dyslipidemia in MGD.

Abstract:AIM: To investigate the effects of different wavelength of blue light on human retinal pigment epithelial(RPE)cells.

METHODS: ARPE-19 cells cultured in vitro were randomly divided into four groups, which were control group, 447nm blue light group, 456nm blue light group and 468nm blue light group. The cells in control group were cultured under normal conditions whereas the cells in blue light group were irradiated with different wavelengths of OLED blue light with the illumination intensity of 200Lux for 72h. Live/Dead staining assay, CCK-8 assay and real-time PCR were performed to compare the effects of different wavelengths of blue light on the morphology, cell viability, proliferation capacity, mRNA expression level of visual cycle biomarkers and inflammatory biomarkers of ARPE-19 cells, respectively.

RESULTS: After blue light irradiation, the abnormal morphology and the decrease of cell confluence of ARPE-19 cells were observed. Furthermore, with the decrease in the wavelength of blue light, the inhibition effect of blue light on RPE proliferation was enhanced, and the mRNA expression of the proliferation marker Ki-67 and visual cycle biomarkers LRAT, CRALBP, RDH and IRBP decreased. In addition, the mRNA expression levels of inflammatory factors MCP-1 and IL-6 in RPE cells were up-regulated with the decrease in the wavelength of blue light.

CONCLUSION: Our data demonstrated that blue light in different wavelengths exerted detrimental effects on RPE cells. The shorter the wavelength of blue light was, the more severe damage it caused on the RPE cells.

Abstract:AIM:To investigate the protective effect of adiponectin on hypoxia-damaged rhesus monkey choroid /retinal vascular endothelial cells(RF/6A)and related mechanisms.

METHODS:In vitro cultured RF/6A cells were randomly divided into the control group, hypoxic injury(induced by CoCl₂ stimulation)group and hypoxic injury + adiponectin(5μmol/L, 50μmol/L and 100μmol/L)group. Cell viability was assessed using the MTT assay and optimal concentration of adiponectin was selected. Western blot was used to detect the expression of Bax and Bcl-2 in RF/6A cells. Reactive oxygen species(ROS)detection kit was used to detect the content of ROS in RF/6A cells.

RESULTS: Compared with the control group, the cell viability of RF/6A cells in the hypoxic injury group and each adiponectin pretreatment group decreased(all P<0.01). Compared with the hypoxic injury group, the cell viability of RF/6A cells in each adiponectin pretreatment group was significantly increased(all P<0.05), and adiponectin of 50μmol/L was the appropriate protective concentration. Compared with the control group, the viability of RF/6A cells decreased, the protein expression level of Bax increased, the protein expression level of Bcl-2 decreased, and the content of ROS increased in the hypoxic injury group(all P<0.01). Compared with the hypoxic injury group, the viability RF/6A cells increased, the expression level of Bax decreased, the expression level of Bcl-2 increased, and the content of ROS decreased in the adiponectin pretreatment group(all P<0.01).

CONCLUSION: Our findings suggest that adiponectin can significantly alleviate retinal vascular endothelial cell damage and apoptosis caused by hypoxia, and the mechanism may be related to the inhibition of oxidative stress by adiponectin.

Abstract:AIM:The dry eye model of rat was induced either by lacrimal gland extirpation or injection of botulinum toxin A into lacrimal gland. The clinical manifestations, pathological features and cytokine changes of these two models were compared, then we discussed their advantages, disadvantages and applicable scope.

METHODS:Thirty healthy 8-week-old male Brown Norway rats were randomly assigned into three groups equally. The left eye of group A was blank group, group B was the left lacrimal gland extirpation model, the left tear gland of group C was injected with botulinum toxin A. We compared the data of Schirmer I test, tear break-up time(BUT), and the corneal fluoresceince staining scores at different times(1d before experiment, 3d, 7d, 14d, 28d, and 42d after the surgical process). We observed pathological changes of conjunctiva, cornea and lacrimal gland at 42d, and we used real-time polymerase chain reaction to analyze interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and epithelial growth factor(EGF).

RESULTS:At the 3d, compared with group A, the tear secretion of both group B and group C were continuous decrease(P<0.05). At the 7d, compared with group A, the BUT of both group B and group C began to decreased(P<0.05), and the corneal epithelial staining scores of both group B and group C began to significantly increase(P<0.05). There was no statistical difference in the above clinical data between group B and group C(P>0.05). The corneal epithelial cells in group A was set as normal morphology, while the corneal epithelial cells in group B and group C showed filamentous separation of surface cells to varying degrees, and the number of conjunctival goblet cells was decreased. The lacrimal gland of group C was obviously atrophic. In conjunctival and corneal tissues, the expression of EGF, TNF-α and IL-6 were significantly increased in group B and group C, which was statistically significant compared with group A(P<0.05). The expression of EGF and TNF-α didn't altered significantly between group B and group C(P>0.05), however, the expression of IL-6 in group B was much higher than that in group C(P<0.05).

CONCLUSION:In this study, we proved that both lacrimal gland extirpation and lacrimal gland injection botulinum toxin A could construct a stable aqueous tear deficiency dry eye rat model. The appropriate animal model should be selected according to the experimental design and research purpose.

Abstract:AIM: To investigate the effect of microRNA-96-5p(miR-96-5p)on proliferation and apoptosis of rat retinal vascular endothelial cells induced by high glucose and to explore its mechanism.

METHODS: SD rat retinal vascular endothelial cells(RRVEC)were cultured and the RRVEC was divided into control group(NG)and high glucose group(HG). The high glucose-induced RRVECs were harvested separately or co-transfected with miR-96-5p mimic, miR-NC, si-FOXO4, si-NC. The expression of miR-96-5p and FOXO4 was detected by qRT-PCR and Western blotting, respectively. MTT assay was used to detect the proliferation activity. Flow cytometry was used to detect the apoptosis rate. The dual luciferase reporter assay validated the target gene of miR-96-5p. Western blotting was used to detect the expression of CyclinD1, p21, p27, Bcl-2, Bax and cleaved-caspased-3.

RESULTS:The expression levels of miR-96-5p, CyclinD1 and Bcl-2 in RRVEC were significantly decreased after high glucose treatment, and the expression levels of FOXO4, p21, p27, Bax and cleaved-caspased-3 were significantly increased, inhibiting cell proliferation activity, but promoting apoptosis. Overexpression of miR-96-5p and inhibition of FOXO4 expression increased the expression levels of CyclinD1 and Bcl-2, inhibited the expression of p21, p27, Bax, cleaved-caspased-3, enhanced cell proliferation and inhibited apoptosis. Dual luciferase reporter assay demonstrated that FOXO4 was a target gene for miR-96-5p. Overexpression of FOXO4 reversed the effect of miR-96-5p overexpression on high glucose-induced proliferation and apoptosis of RRVEC.

CONCLUSION:miR-96-5p inhibits high glucose-induced apoptosis of rat retinal vascular endothelial cells and promotes cell proliferation by targeting FOXO4.

Abstract:AIM: To observe the application of light emitting diode(LED)irradiation in rat retinal vascular endothelial cells with high glucose and its effect and mechanism on photobioregulation.

METHODS:Rat retinal vascular endothelial cells were randomly divided into three groups: normal control group, high glucose model group, high glucose model light emitting diode irradiation group, and cells in the high glucose model light emitting diode group began to use light emitting diodes in the incubator 48h after modeling. The cells are irradiated. MTT cell apoptosis experiment was used to detect the apoptosis rate of each group; laser confocal microscope was used to observe the changes of intracellular calcium in retinal vascular endothelial cells; Western blot was used to detect the phosphorylated serine-threonine kinase(P-AKT)protein in each group expression.

RESULTS: The apoptosis rates of normal control group, high glucose model group, and high glucose model light emitting diode irradiation group were 7.54%±2.67%, 31.69%±5.74%, and 21.65%±3.52%, respectively(P<0.05). In the normal control group, the cytoplasm with weak Ca²⁺ fluorescence showed green fluorescence with a pixel value of 192.65±50.54. In the high-sugar model group, the cytoplasm showed a stronger green fluorescence with a fluorescent pixel value of 710.69±100.38. The green fluorescent pixel value was 430.47±80.67, which was significantly higher than the normal control group, but significantly lower than the high-sugar model group. The intra-Ca²⁺ fluorescence pixel values in the three groups were statistically significant(P<0.05). The amount of phosphorylated serine-threonine kinase(P-AKT)protein in these three groups of cells was 10.26±2.47, 2.35±0.16, 7.46±1.64, respectively(P<0.05).

CONCLUSION: High-glucose environment inhibits the activity of threonine kinase pathway, which has an effect on calcium homeostasis of rat retinal vascular endothelial cells and promotes apoptosis. Low-intensity led irradiation can activate threonine kinase pathway and reduce the apoptosis rate caused by high glucose, which is of great application value.

Abstract:AIM: To analyze the effect of 532nm laser panretinal photocoagulation(PRP)combined with calcium dobesilate on fundus microcirculation and macular thickness in patients with diabetic retinopathy(DR), so as to provide experimental data for their clinical treatment.

METHODS: According to the non-randomized clinical concurrent control study and voluntary principle, 174(239 eyes)DR patients were divided into observation group and control group. Both groups were treated with 532nm laser PRP, and the observation group was additionally treated with calcium dobesilate. BCVA(LogMAR)vision, clinical effect, fundus microcirculation, macular thickness and other clinical indexes were compared between the two groups before and after treatment(at 3mo after PRP). The incidence of complications during treatment was statistically analyzed.

RESULTS: After treatment, BCVA in both groups were increased, and it was higher in observation group than control group. The clinical curative effect of observation group was better than that of control group(P<0.001). After treatment, the resistance index(RI)of central retinal artery(CRA)and osterior ciliary artery(PCA)in both groups were decreased(P<0.05), while the peak systolic velocity(PSV)and end diastolic velocity(EDV)were increased(P<0.05). RI in observation group was lower than that in control group, while EDV and PSV were higher than those in control group(P<0.001). After treatment, the macular thicknesses and other clinical indexes(hemangioma, bleeding spots, gray value of visual field)in both groups were decreased(P<0.05), and they were lower in observation group than control group(P<0.001). There was no significant difference in the incidence rate of complications between the two groups(0.8% vs 2.6%)(χ²=0.344, P=0.557).

CONCLUSION: Compared with 532nm PRP in treatment of DR, curative effect of 532nm PRP combined with calcium dobesilate is better. The latter can improve fundus microcirculation and macular thickness more significantly, with high safety.

Abstract:Nucleotide-binding oligomerization domain(NOD)-like receptor family contains Pryrin domain protein 3(NLRP3)inflammasome, which is an intracellular protein complex. Large release of ROS can activate the production of intracellular NLRP3 inflammasome. It consists of NLRP3, a cysteine protease recruitment domain(ASC),and a pro-caspase-1 precursor, can activate caspase-1 while being assembled. Then, the cytokines interleukin-1 and interleukin-18(pro-Il-1/18)are cleaved into mature forms by caspase-1 to perform their pro-inflammatory functions. pyroptosis refers to the programmed cell death of Caspase-1-dependent cells mediated by inflammasome. This article reviews the structure and function of NLRP3 inflammasome, its relationship with pyroptosis, and the research progress in ophthalmic diseases.

Abstract:Iridocorneal endothelial(ICE)syndrome presents a group of ocular pathologies mostly characterized by corneal endothelial abnormalities and iris atrophy. Iridocorneal endothelial syndrome is typically a unilateral and generally not involving genetic condition, frequently affecting women in early to middle adulthood. There is no treatment for absence of symptoms in early stages. When complicated with corneal edema and secondary glaucoma, treatment is mainly symptomatic. In this group of diseases, there are many similarities and some differences in their pathogenesis, clinical manifestations and treatment. So far no universal information on these features has been published. Recent clinical studies on iridocorneal endothelial syndrome are reviewed in this paper.

Abstract:Glaucoma is a major cause of visual dysfunction worldwide. It is a group of diseases involving the optic nerve and related structures. It is characterized by visual field defects and optic disc depression, which ultimately lead to irreversible blindness. Many years of research have found that the pathogenesis of induced glaucoma is mainly mechanical compression theory and vascular theory(microcirculation). In view of the current clinical research and further development of diagnosis and treatment, the latter has become the focus and development direction of modern research. Patients with glaucoma will have a decrease in blood vessel density in the corresponding parts such as the optic papilla and optic disc. Examination techniques such as deep convolutional neural network and OCT-A can objectively explain the changes in the corresponding parameters of their microcirculation and can monitor the progress of glaucoma. Therefore, this article discusses from the aspects of glaucoma and microcirculation, aiming to expand the clinical understanding of glaucoma microcirculation, so as to further guide the clinical.

Abstract:Congenital nasolacrimal duct obstruction(CNLDO)has an incidence rate of 5.7% and there are many clinical treatments for the disease. But these treatments have been taken very randomly. Therefore, it is still a controversial topic on how to choose the best treatment. This paper will discuss the treatments of CNLDO so as to know the characteristics of each treatment for better clinical services.

Abstract:In recent years, artificial intelligence(AI)technology has developed rapidly, and its practice and application in the medical field have brought new possibilities to the development of the medical industry. In the field of general ophthalmology, AI technology based on machine learning(ML)has greatly improved the efficiency of diagnosis, but less progress has been made in pediatric ophthalmology. At present, AI technology has been applied to the automatic detection of retinopathy of prematurity(ROP), pediatric cataracts, inspection of strabismus and refractive error, prediction of high myopia in the future, diagnosis of dyslexia through eye tracking and research of ophthalmic images. This article reviews the current status, progress, and future development of AI in pediatric ophthalmology.

Abstract:Delayed healing of diabetic corneal epithelial wound is a commonly encountered condition, and persistent corneal epithelial defects may give rise to recurrent epithelium erosion, corneal ulceration, and subsequent perforation as well as affecting visual loss. The current review focused on the pathological basis, updates of the pathogenesis, and recent advances in the treatment of delayed healing of diabetic corneal epithelial wounds, wherein the roles of hyperglycemia, tear film, proteases, cytokines, corneal nerves and genes were elaborated, and the latest views on treatment strategies, for the delayed healing were summarized as well. Recent advances in research on delayed corneal epithelial wound healing in diabetes mellitus.

Abstract:Retinal vein occlusion(RVO)is a common disease of retinopathy disorder, which is second only to diabetic retinopathy in the blinding rate. It can result in macular edema, neovascular glaucoma and other serious damage which all impair the visual function, even causing permanent, irreversible vision loss. In recent years, there is a deeper understanding of its occurrence and development with a large number of scholars have further study of RVO. This article reviews the pathogenesis, influencing factors of vision and treatment of RVO.

Abstract:With the advances in cataract phacoemulsification and intraocular lens implantation, more and more attention has been paid to the postoperative effects by both clinicians and patients. Meanwhile, the instruments for the preoperative measurements are also evolving. Various types of ocular biometers have emerged, which have evolved the principles from ultrasound to swept-source optical coherence tomography(SS-OCT). The OA-2000, a new type of SS-OCT based ocular biometer with fully automatic three-dimensional scanning, has the advantages of simple and safe operation, high resolution, excellent repeatability, fast measurement and good tissue penetration. It can obtain multiple ocular biological parameters in one measurement, which enables a wide application prospect. Here, we review the measurement principle and clinical application of OA-2000.

Abstract:AIM: To evaluate the efficacy of rituximab in thyroid associated ophthalmopathy by using a Meta-analysis of the literature.

METHODS: Databases such as CNKI, Wanfang, Weipu, China Biomedical, PubMed, Web of Science, OVID, Cochrane Library, and ClinicalTrial.gov were searched. From the establishment of the database to December 31, 2019 on rituximab clinical studies on the treatment of thyroid associated ophthalmopathy. The clinical activity score of thyroid associated ophthalmopathy before and after treatment was used as the main judgment index of curative effect. The retrieved clinical studies were analyzed using RevMan 5.3 statistical software.

RESULTS: Six studies were included, two were randomized controlled trials, and four were cohort studies. Meta analysis showed that the application of rituximab in the treatment of moderate to severe thyroid associated ophthalmopathy can significantly reduce the clinical activity score of patients, and has statistical significance \〖SMD=-5.04, 95% CI(-7.08 to -3.01), P<0.00001\〗.

CONCLUSION: Rituximab can significantly reduce the clinical activity score of patients with moderate to severe thyroid associated ophthalmopathy, and has a good effect on disease control.

Abstract:AIM: To evaluate the short-term efficacy and its impact on psychological status in patients with moderate to severe MGD-related dry eye in the treatment of intense pulse laser(IPL).

METHODS:The situations before and after of oneself were compared. From October 2018 to October 2019, 25 patients(50 eyes)with moderate to severe MGD who were admitted to the Ophthalmology Development of Wuhan University People's Hospital were collected. They were given intense pulse laser combined with meibomian gland massage therapy. Before the treatment and one month after the one course of treatment, the changes in symptoms, signs, and mental status of patients were evaluated. The ocular surface disease index(OSDI)questionnaire scoring criteria were used to assess patients' symptoms. Through tear secretion test(S I t), tear meniscus height, mean tear break-up time(Mean BUT), meibomian gland loss degree, and mean scattering index(Mean OSI)measured by Ocassian dual-channel system, the signs of patients were evaluated. By using the Self-Rating Anxiety Scale(SAS)and the center for epidemiological studies depression scale(CES-D), the mental state of the patients was evaluated.

RESULTS: The results of the patients before and after treatment were as follows, OSDI score(58.36±10.34 vs 49.12±8.05), SⅠt(5.64±1.6 vs 8.24±1.71mm/5min), tear meniscus height(0.19±0.04 vs 0.23±0.04mm), Mean BUT(5.65±1.72 vs 7.06±1.84s), Mean OSI(0.89±0.24 vs 0.75±0.23), meibomian gland loss degree score(2.56±0.58 vs 1.84±0.85), SAS score(46.92±8.49 vs 40.2±8.01), CES-D score(21.04±6.11 vs 16.92±4.24), all indicators had statistical significance(P<0.01). OSDI score was negatively correlated with Mean BUT(r_s=-0.511, P<0.01), and positively correlated with Mean OSI(r_s=0.479, P<0.05). OSDI score was positively correlated with SAS score and CES-D score(r_s=0.775, 0.856, P<0.01). SAS score was negatively correlated with SⅠt and Mean BUT(r_s= -0.653, -0.713, P<0.01). SAS was positively correlated with CES-D score(r_s=0.730, P<0.01).

CONCLUSION: IPL is safe and effective for short-term observation of moderate to severe MGD-related dry eye. After treatment, the dry eye symptoms, signs and mental state of patients can be relieved with different degrees. There is the correction between the depression and anxiety of patients and ocular surface symptoms.

Abstract:AIM: To evaluate the predictability of Olsen formula for postoperative refractive power in patients with high myopia complicated with cataract.

METHODS: This retrospective study reviewed 65 patients(101 eyes)with high myopia and who had phacoemulsification combined with intraocular lens implantation from October 10^th 2016 to August 20^th 2019 in our hospital. They were divided into three groups according to the axis length: group A(26mm 30mm)22 cases(31 eyes). The postoperative theoretical diopter(that is, the preoperative predictive diopter of each formula corresponding to the degree of IOL implanted)of intraocular lens was calculated by SRK/T, Haigis and Olsen formulas of IOL-master. The actual postoperative 3mo diopter was recorded and the absolute refractive error(MAE)was calculated.

RESULTS: The postoperative 3mo MAE in the three groups calculated with Olsen formula was 0.15(0.04, 0.22), 0.19(0.14, 0.27), 0.26(0.115, 0.455)D respectively(P>0.05). For patients with the same axial length, the postoperative 3mo MAE of Olsen formula was the smallest. The Bland-Altman method was used to analyze the consistency between the postoperative theoretical diopter and the postoperative 3mo actual diopter. The results showed that the postoperative 3mo actual diopter was the closest to the postoperative theoretical diopter of the Olsen formula, while the postoperative theoretical diopter of the SRK/T formula was the worst.

CONCLUSION: For patients with high myopia and cataract, the accuracy and stability of Olsen formula is better than that of SRK/T and Haigis formula, and Olsen formula is least affected by eye axis length.

Abstract:AIM: To compare the clinical characteristics of cytomegalovirus positive and negative patients with Posner-Schlossman syndrome(PSS), and the clinical efficacy and short-term recurrence of 20g/L ganciclovir eye drops in local treatment of patients with CMV positive PSS were evaluated.

METHODS: Differences between CMV positive(86 cases, 86 eyes)and CMV negative(60 cases, 60 eyes)PSS patients were compared. General information, ocular parameters and distribution, IFN-γ and IL-4 levels in aqueous humor, clinical efficacy and recurrence within 1a were compared between the conventional group(30 cases, 30 eyes)and the experimental group(56 cases, 56 eyes).

RESULTS: Among the 146 PSS patients included, the CMV positive rate was 58.9%. The average intraocular pressure and the difference in the number of corneal endothelial cells between the onset eye and the contralateral eye in CMV positive patients were significantly increased, and the number of corneal endothelial cells in the onset eye was significantly decreased(P<0.05). After treatment, all ocular parameters and distribution in the experimental group were significantly better than those in the conventional group(P<0.05), IFN-γ level in the experimental group was significantly lower than that in the conventional group, and IL-4 level was significantly higher than that in the conventional group(P<0.05). Compared with the conventional group, the experimental group had a high total effective rate, a short cure time, a low recurrence rate within 1a and a long recurrence interval, with statistically significant differences(P<0.05).

CONCLUSION: Patients with CMV positive PSS had higher intraocular pressure and greater damage to corneal endothelial cells than PSS patients with CMV negative. 20g/L ganciclovir eye drops can effectively control intraocular pressure and inflammation by resisting CMV infection, with significant clinical efficacy and not easy to relapse in the short term.

Abstract:AIM: To compare the efficacy and complications of intravitreal injection of conbercept in different perioperative periods, combined with 25G pars plana vitrectomy(PPV)and trabeculectomy in the treatment of neovascular glaucoma(NVG)secondary to proliferative diabetic retinopathy(PDR)with vitreous hemorrhage(VH).

METHODS: Prospective randomized controlled clinical trial. 28 cases(30 eyes)of NVG in stage Ⅲ secondary to PDR with VH were enrolled in the study. All patients received 25G PPV combined with trabeculectomy. They were randomly divided into two groups: group 1(14 eyes)received intravitreal injection of 0.5mg/0.05mL of conbercept(IVC)3d before operation and group 2(16 eyes)received IVC after operation; the operation time, intraoperative bleeding and postoperative complications were compared between the two groups. The differences of pain relief, the regression of iris neovascularization(INV), the best corrected visual acuity(BCVA)and intraocular pressure(IOP)control rate were observed.

RESULTS: The two groups all completed the operation and were followed up 12.40±2.21mo and 12.23±2.11mo respectively(P>0.05). The incidence of intraoperative and early postoperative hyphema of group 1(29%, 14%)was lower than group 2(75%, 56%, P<0.05). There was no significant difference in operation time, shallow anterior chamber, choroidal detachment and vitreous rebleeding between the two groups(P>0.05). The pain was relieved in all patients 3d after operation. In group 1, 93% of INV completely disappeared 3d after IVC and 94% of INV completely disappeared 7d after PPV in group 2. At the last follow-up, one eye in each group remained a little atrophic INV. At 1wk, 1mo, 3mo, 6mo postoperation, the IOP control rate of group 1 was 93%, 79%, 64% and 57% respectively, and that of group 2 was 94%, 75%, 50%, 44% respectively(each time period, P>0.05). IOP of the two groups at different time points after operation was significantly lower than that before operation(P<0.05). At the last follow-up, the IOP of the two groups were 20.45±10.55 and 22.63±7.24mmHg respectively, which were significantly lower than those of 42.21± 9.11 and 44.88±11.83mmHg before operation(P<0.05). BCVA in two groups at different follow-up time after operation has no significant difference compared with that of preoperation(P>0.05).

CONCLUSION: Compared with IVC after operation, IVC before operation combined with 25G PPV and trabeculectomy for NVG secondary to PDR with VH could reduce the incidence of intraoperative hemorrhage and early postoperative hyphema. The IOP control rate of the two methods is equal and gradually decreases with time, but after timely treatment can finally get better results.

Abstract:AIM: To investigate the relationship between vitamin D receptor gene polymorphism and retinopathy in patients with type 2 diabetes mellitus.

METHODS: Totally 198 T2DM patients admitted to our hospital from February 2018 to January 2019 were selected as the study objects and divided into DR group(n=108)and non DR group(n=90). The polymorphisms of rs1544410 and rs2228570 were detected by PCR restriction fragment length polymorphism. The relationship between rs1544410, rs2228570 gene polymorphism and retinopathy in type 2 diabetic patients was analyzed by unconditional Logistic regression.

RESULTS: The frequencies of T allele at rs1544410 and A allele at rs2228570 in DR group were significantly higher than those in non DR group(P<0.05). There were 130 cases of CC genotype, 52 cases of CT genotype, 16 cases of TT genotype, and there were statistical differences between CC genotype and CT+TT genotype(P<0.05); 121 cases of GG genotype, 59 cases of GA genotype,18 cases of AA genotype, and there were statistical differences between GG genotype and GA+AA genotype(P<0.05); CT+TT genotype of BSMI gene and GA+AA genotype of FokI gene were risk factors of DR(P<0.05).

CONCLUSION: The polymorphism of VDR gene BSMI and FokI is significantly related to type 2 diabetic retinopathy, which may be the susceptible gene locus of type 2 diabetic retinopathy.

Abstract:AIM: To analyze the refraction status,ocular biological parameters and the relationship between them in 3-12 years old children.

METHODS: Totally 1 138(2 276 eyes)children aged 3-12 years old were enrolled in this study from January 2016 to October 2017. Equivalent spherical degree, axial length, corneal curvature and corneal thickness were measured.

RESULTS: The average spherical diopter of 1 138 children is -0.67±2.66D, the average corneal curvature is 43.37±1.72D, and the axial length is 23.65±1.41mm. The average corneal curvature of boys is 42.98±1.86D and that of girls is 43.81±1.42D. The axial length of boys is 23.94 ± 1.36 mm and that of girls is 23.32±1.40mm. The central corneal thickness of boys is 541.83±33.73μm and that of girls is 536.10±31.49μm. The corneal astigmatism of boys was 1.53±0.99D and that of girls is 1.65±1.02D. There is a significant difference between boys and girls. Axial length and central corneal thickness are lower in 3-6 age group than those in other age groups. Equivalent diopter and corneal astigmatism are higher than those in other age groups(P<0.05). Axial length and central corneal thickness are in positive correction with age. Axial ratio is positively correlated with age and negatively correlated with spherical equivalent.

CONCLUSION: The axial length and corneal curvature are the main factors affecting the refraction status in children. With the growth axial length, the curvature of cornea also changes to some extent. AL/CR can predict this change.

Abstract:AIM: To evaluate the differences between the estimated and measured corneal ablation thickness in myopic eyes with different refractive errors in small incision lenticule extraction(SMILE)and investigate the precision of corneal ablation thickness in SMILE.

METHODS: This prospective study included 234 eyes(143 myopic patients), who had undergone SMILE in our hospital from January 2017 to August 2019. The patients were divided into three groups according to a manifest refraction spherical equivalent(MRSE): low myopia(-0.50 to -3.00D, 78 eyes), moderate myopia(>-3.00 to -6.00D, 78 eyes), and high myopia(>-6.00D, 78 eyes). Observe the uncorrected distance visual acuity(UDVA)and MRSE before and after operation. The central corneal thickness(CCT)was measured by Pentacam preoperatively and postoperatively at 1mo. Compare the discrepancy between estimated corneal ablation thickness and measured corneal ablation thickness of three groups to discuss the precision of corneal ablation thickness in different refractive errors in SMILE.

RESULTS: The UDVA was 0.8 or better in all eyes and 1.0 or better in 98.3% eyes postoperatively. The average measured corneal ablation thickness was significantly lower than average estimated corneal ablation thickness(84.92±23.15μm vs 100.07±26.83μm, P<0.01). The average cutting error was 15.15±10.34μm. The measured corneal ablation thickness of low myopia, moderate myopia and high myopia was significantly lower than the estimated corneal ablation thickness, respectively(P<0.01). The cutting error of low myopia, moderate myopia and high myopia was 8.81±7.78, 15.59±9.27, 21.05±10.03μm respectively. The average MRSE of all patients was -4.85±2.15D preoperation, there was a linear regression relation between MRSE and cutting error(Y= -2.2495X+3.9287, R²=0.1589). The cutting error increased with MRSE(t=-6.620, P<0.001).

CONCLUSION: The measured corneal ablation thickness was lower than estimated corneal ablation thickness,the higher the refractive power was, the larger the cutting error would be in SMILE. Although there was significant discrepancy between measured corneal ablation thickness and estimated corneal ablation thickness, the effect of this surgery was ideal, the mismatch did not influence the precision of different refractive errors.

Abstract:AIM: To evaluate the difference and consistency of pupillary offset measured by the Pentacam anterior segment analyzer and Keratron Scout corneal topographer.

METHODS: Three hundred and eleven patients(604 eyes)who underwent excimer laser in situ keratomileusis from November 2017 to February 2018 were randomly selected. Before surgery, the pupillary offset values were measured by Pentacam and Keratron, and the differences and consistency of the values between the two instruments were compared.

RESULTS: The pupillary offset values of the right eyes, left eyes, and both eyes between Pentacam and Keratron were statistically different(P<0.05). There were no significant statistical differences in the offset orientations of right eyes, left eyes and both eyes between the two instruments(P>0.05). The 95% consistent line(LoA)of offset value and offset orientation in the right eyes, left eyes and both eyes between the two instruments were -0.11-0.19mm and -157.01°-135.35°, -0.12-0.18mm and -150.16°-158.22°, -0.11-0.19mm and -154.30°-147.10°, respectively.

CONCLUSION: The pupillary offset measured by the Pentacam was smaller than that measured by the Keratron, but the difference was within the clinically acceptable range. The accurate pupillary offset can be obtained, and be the mutual reference, correction and supplement in the both instruments.

Abstract:AIM: To study the effect of preoperative meibomian gland physiotherapy on ocular surface after cataract surgery in patients with meibomian gland dysfunction(MGD).

METHODS: Totally 76 eyes of 76 cataract patients with MGD were selected and divided into two groups by random grouping method in our hospital. Patients in the experimental group was given eyelid hot compress and meibomian gland massage before operation(after a full set of treatment in the hospital, patients were instructed to have family hot compress and meibomian gland massage every night), and patients in the control group was not given any treatment. Cataract phacoemulsification and intraocular lens implantation were performed in both groups. The non-invasive tear break-up time(NITBUT)and the tear meniscus height(TMH)were examined by ocular keratograph, the thickness of lipid layer(LLT)were examined by LipiView, and the Ocular Surface Disease Index(OSDI)questionnaire was conducted at 1wk before operation and 1wk, 1mo after operation.

RESULTS: The NITBUT, TMH and OSDI were significantly different between the two groups before and after operation(P<0.05). The NITBUT were significantly lower than in both groups 1wk and 1mo after operation than those before operation(P<0.05). The NITBUT in the control group were significantly lower than those in the experimental group 1wk and 1mo after operation(P<0.05). The TMH was significantly lower one week after operation in the experimental group than those before operation(P<0.05), and returned to the preoperative level 1mo after operation(P>0.05). The OSDI were significantly improved after operation compared with those before surgery in both groups 1wk and 1mo(P<0.05). The OSDI in the control group were significantly higher than those in the experimental group 1wk and 1mo after operation(P<0.05).

CONCLUSION: Phacoemulsification of cataract can destroy the function of meibomian gland and the ocular surface condition in patients with meibomian gland dysfunction. However, preoperative meibomian gland physiotherapy can significantly improve the ocular surface condition of patients with meibomian gland dysfunction after cataract surgery, and improve the satisfaction of patients.

Abstract:AIM: To observe the safety and efficacy of phacoemulsification combined with goniosynechialysis in treatment of primary angle-closure glaucoma(PACG)with intraocular pressure out of control after trabeculectomy.

METHODS: We retrospectively reviewed 31 cases(32 eyes)of acute or chronic PACG with uncontrolled intraocular pressure from June 2015 to April 2019. The history of trabeculectomy was 3mo to 12a. All of them were complicated with different degrees of cataract. Phacoemulsification combined with intraocular lens implantation and goniosynechialysis were performed in all patients. The patients were followed up for 6mo. The IOP, the best corrected visual acuity(BCVA), the depth of central anterior chamber and the peripheral anterior synechia(PAS)of anterior chamber angle were observed preoperatively and 1, 3 and 6mo postoperatively. The corneal endothelial cell count and the thickness of the retinal nerve fiber layer(RNFL)were observed 6 months after the operation. The complications during and after operation were observed.

RESULTS: The IOP was significantly decreased on 1wk, 1, 3, 6mo postoperative(14.38±3.04, 18.26±3.12, 15.21±2.84, 15.42±3.09mmHg)compared with preoperative(36.52±12.26mmHg)(P<0.01). The BCVA(LogMAR)(0.241±0.148)was increased postoperative after 6 mo compared with preoperative(0.678±0.297). The depth of central anterior chamber was increased on 1, 3, 6mo postoperative(4.18±0.22, 4.21±0.24, 4.16±0.25mm)compared with preoperative(1.45±0.25mm). All of above observation indexes was significantly different from that of preoperation(P<0.01). The angle of anterior chamber was widened and the range of PAS was reduced. The PAS did not increase after 3mo. There was no statistical difference between preoperative and postoperative about the corneal endothelial cells count and the mean or the four quadrant RNFL thickness(P>0.05). Corneal edema in 7 eyes and anterior chamber inflammatory exudation in 3 eyes disappeared within 7d after treatment. The IOP of 3 patients(3 eyes)with chronic PACG was 21-30mmHg which was controlled by 1 to 3 anti-glaucoma eye drops.

CONCLUSION: Phacoemulsification combined with goniosynechialysis is a safe and effective method in the treatment of PACG combined with cataract with intraocular pressure out of control after trabeculectomy.

Abstract:AIM: To observe the clinical effect of ranibizumab injection combined with vitrectomy,panretinal photocoagulation(PRP)and trabeculectomy in the treatment of neovascular glaucoma(NVG).

METHODS: Retrospective study. From March 2017 to October 2018, 44 NVG patients(44 eyes)were treated, 22 patients(22 eyes)were treated with intravitreal injection of ranibizumab + vitrectomy + PRP+trabeculectomy(group A), and 22 patients(22 eyes)were treated with intravitreal injection of ranibizumab + trabeculectomy+PRP(group B).The patients were followed up for 6mo, the visual acuity, intraocular pressure(IOP), IOP control rate, neovascularization and complications were observed.

RESULTS: There was no significant difference in IOP between the two groups before treatment(46.2±9.41mmHg vs 49.1±10.15mmHg, P>0.05). The IOP of group A was lower than that of group B at 1wk, 1mo and 6mo after treatment(P<0.05). 6mo after treatment, the visual acuity, IOP control rate(95%)and neovascularization regression(91%)in group A were better than those in group B(P<0.05), but there was no difference in the incidence of complications between the two groups during the follow-up period(P>0.05).

CONCLUSION: It is safe and effective to treat NVG with intravitreal ranibizumab injection combined with vitrectomy, PRP and trabeculectomy, which can control IOP steadily and improve visual acuity of some patients.

Abstract:AIM: To analyze the correlation between subjective mean sensitivity and visual function via macular microperimetry.

METHODS: Totally 164 eyes of 127 patients with macular edema were involved in this study. According to different diseases, they were divided into 3 groups: age-related macular degeneration(AMD)(38 eyes), retinal vein occlusion(RVO)(43 eyes)and diabetic macular edema(83 eyes)groops. All patients underwent the examinations of optometry, optical coherence tomography scanner(OCT)and microperimeter. Correlation analysis was performed using Pearson, and t-test among groups.

RESULTS: Mean sensitivity(MS)values and fixation rate(P1, P2)of total patients with macular edema were significantly correlated with their BCVA, meanwhile the CRT was negatively correlated. MS values were significantly correlated with BCVA in AMD group, but the P1, P2 and CRT were not correlated. In DME and CRVO groups, MS values and P1, P2 were significantly correlated with BCVA, and CRTs were negatively correlated in DME but not correlated in CRVO. In BRVO group, MS values and CRTs were all not correlated with BCVA.

CONCLUSION:Microperimetry is probably a better subjective assessment for AMD macular function than OCT, and could be combined with OCT for function follow-up in DME and CRVO patients. For BRVO microperimetry might indicate certain macular dysfunction that could not be detected by VA or CCT. Microperimetry could be a subjective examination for the assessment of macular edema combined with OCT.

Abstract:AIM: To quantitatively analyze the macular area blood perfusion and retinal thickness of school-age children in each ametropia group by using OCT angiography technology, in order to evaluate the effect of the changes of refractive state on the macular area blood perfusion and retinal thickness during the growth and development of school-age children.

METHODS: In this study, 174 eyes were randomly selected from school-age children who were treated in the ophthalmic clinic from July 2018 to March 2019. The superficial retinal capillary of vessel density(SCPVD), deep retinal capillary of vessel density(DCPVD), central retinal thickness(CRT)and average retinal thickness(ART)were quantitatively analyzed using by OCT angiography technology. Additionally, the correlation between blood vessel density in macular area and retinal thickness was analyzed.

RESULTS: After quantitatively analysis, compared with emmetropia group, the SCPVD value of the high myopia group was decreased(P<0.001). The DCPVD value of the hyperopia group was increased(P=0.004). The ART value of high myopia group was decreased(P<0.001).There was no significant difference in CRT values between the ametropia group and the emmetropia group(P>0.05). SCPVD was positively correlated with ART as an independent factor(r=0.274, P<0.01).

CONCLUSION:In the process of refractive development, SCPVD of children with high myopia decreases and ART becomes thinner. Moreover, SCPVD can be an independent factor positively correlated with ART during the whole refractive development. This suggests that the retina of school-age children with high myopia has presented pathological changes.

Abstract:AIM:To study the microscopic changes of visual pathology in ocular hypertension(OHT)patients using magnetic resonance diffusion tensor imaging(DTI)technology and three-dimensional optical coherence tomography(3D-OCT)technology.

METHODS: Twenty-six patients with 52 eyes diagnosed as OHT in our hospital from January 2016 to October 2019 were included in the case group. Twenty-six healthy patients who were matched with age and gender in the same period were included in the control group. All eyes were examined for best corrected visual acuity, central corneal thickness(CCT), non-contact intraocular pressure, while all eyes were examined by optical disc 3D-OCT combined optic nerve, optic chiasma, optic tract, and optic radiation DTI. Compared the differences between the two groups.

RESULTS: The CCT of the OHT group was thinner than that of the normal control group; the intraocular pressure was higher than that of the normal control group, and the difference was statistically significant(all P<0.05). The optic disc area of the OHT group was larger than that of the normal control group, while the optic cup area was increased, and the average CP-RNFL thickness and nasal CP-RNFL thickness were thinner than those of the normal control group(all P<0.05). There was no statistic difference in the superior, inferior and temporal CP-RNFL(all P>0.05). The FA values of bilateral optic nerve and optic radiation decreased compared with the normal control group, and the difference was statistically significant(all P<0.05). There was no significant difference of optic chiasma, bilateral visual tract's FA value, and bilateral visual pathway ADC value between the two groups(all P>0.05).

CONCLUSION: 3D-OCT can obtain the thickness of CP-RNFL and the parameters of optic disc, DTI can reconstruct the intracranial visual pathway and can detect the microscopic changes of optic nerve, optic chiasma, optic tract, and optic radiation at early stage. Combining 3D-OCT and DTI technology can effectively understand the microscopic changes of the visual pathway and provide new models for clinical research of ocular hypertension patients.

Abstract:AIM: To explore the influence factors of the mid-long-term postoperative eye position of patients with intermittent exotropia(IXT).

METHODS: Retrospective analysis was performed on the clinical data of 78 patients with intermittent exotropia admitted to the ophthalmology department of our hospital during 2017-01/2018-08. Data of patients with strabismus type,operation age, preoperative binocular vision function and the eye position of preoperative and postoperative day one were collected, to explore the influence factors of the mid-long-term postoperative eye position.

RESULTS: The result display that 47 cases(60%)had positive eye position in the mid-long-term after operation. There were 43 cases of insufficient collection type, 18 cases(42%)cured in eye position. The operation was successful in 26 of the 31 cases(84%)of basic type; 3 of 4(75%)divergence excess type were successful after operation. The results of univariate analysis showed that the difference of strabismus type and preoperative eye position between the two groups was statistically significant(P<0.05). Multivariate logistic regression analysis showed that type of strabismus(OR: 5.769, 95% CI: 1.790-18.595), was independent influencing factors of the eyes position in the mid-long-term after operation(P<0.05).

CONCLUSION:The strabismus type was independent predictors of the eyes position in the mid-long-term after operation, which should be paid more attention in clinical practice.

Abstract:AIM:To evaluate the application value of artificial intelligence diagnosis system for fundus disease screening based on deep learning.

METHODS:A total of 1 345 patients(2 690 eyes)in our hospital were recruited from July 2018 to December 2018. The accuracy, specificity, consistency and sensitivity of the artificial intelligence diagnosis system were determined by comparison with ophthalmologist diagnosis and artificial intelligence diagnosis system which based on multi-layer deep convolution neural network learning.

RESULTS:The accuracy of artificial intelligence diagnosis system is 62.82%. There are 1-5(1.38±0.67)diagnoses among the patients, among which the accuracy of one diagnosis is 56.09%, the accuracy of two diagnosis is 77.96%, the accuracy of three diagnosis is 84.61%, the accuracy of four diagnosis is 86.95%, and the accuracy of five diagnosis is 60.00%; The consistency kappa value without obvious abnormality and leopard pattern fundus was 0.044 and 0.169 respectively. The sensitivity was 3.00% and 99.6% respectively, the specificity was 99.7% and 14.2% respectively. The consistency Kappa value of other diagnosis was as high as 0.57-1.00, the sensitivity was as high as 65.1%-100%, and the specificity was as high as 93.0%-100%.

CONCLUSION:This study shows that the artificial intelligence diagnosis system based on multi-layer deep convolution neural network learning is a reliable alternative to diagnose retina diseases, and it is expected to become an effective screening tool for primary medical treatment.

Abstract:AIM: To evaluate the clinical effects and safety of surgical techniques in Descemet stripping automatic endothelial keratoplasty(DSAEK)in bullous keratopathy.

METHODS: A retrospective analysis of 10 patients with bullous keratopathy treated in our hospital from December 2018 to December 2019 in our hospital, including 4 males(4 eyes), 6 females(6 eyes). Descemet stripping automatic endothelial keratoplasty(DSAEK)was performed with every patient. In addition to the conventional surgical procedures, the surgical technique such as the setting of the anterior chamber perfusion tube, the design of the incision, and the peripheral corneal puncture during the operation were performed. Follow-up for 6mo, the recovery of corneal grafts and postoperative dislocations, double anterior chambers, and other complications were observed, including best corrected visual acuity(BCVA), anterior segment optical coherence tomography, corneal endothelial cell count and incidence of postoperative complications.

RESULTS: All patients had smooth surgery, no intraoperative complications occurred, and no postoperative dislocations or interlaminar effusions occurred; postoperative intraocular pressure was normal, and the BCVA was improved to different degrees than before surgery. The symptoms such as tearing and photophobia gradually reduced from 1d after surgery, and completely relieved after 2wk. Corneal stroma edema decreased within 1mo after operation, and the central corneal thickness(596.8±19.11μm)was significantly thinner than that before operation(874.0±58.64μm). During the follow-up period, all patients were stable and the corneal grafts remained transparent, but the corneal endothelial counts were reduced to varying degrees.

CONCLUSION: The application of surgical techniques in DSAEK can significantly reduce intraoperative and postoperative complications, improve the safety of surgery, and has clinical value in bullous keratopathy.

Abstract:AIM: To evaluate the postoperative visual effects of assisted techniques such as cystic membrane stainin, iris hooking, and iris incision to treat cataract patients with corneal opacities, and analyze the safety and effectiveness of the surgery.

METHODS: A retrospective collection of 105 cases(105 eyes)of cataract patients with corneal opacities who underwent cataract phacoemulsification combined with intraocular lens implantation at the Army Eye Center of Xinjiang Military Region General Hospital from January 2014 to March 2019. All patients received cataract phacoemulsification removal and intraocular lens implantation. Apply the trypan blue capsule staining agent during the operation and observe the anterior capsule staining, the success rate of continuous annular capsulorhexis, the rupture of the posterior lens capsule and the implantation of the intraocular lens capsule. Patients were followed up at 1d, 1wk, 1 and 3mo after surgery. Observe the success rate of capsulorhexis during operation, the best corrected visual acuity(BCVA, LogMAR)before and after surgery, and postoperative complications.

RESULTS: All patients underwent phacoemulsification with intraocular lens implantation. During the operation, all continuous ring-shaped capsulorhexis were successfully completed through the application of trypan blue capsule staining(trypan blue)dye, and other measures including application of iris hook and irisotomy were taken. A foldable intraocular lens was implanted in 105 eyes. After 3mo of follow-up observation, the BCVA of the operation eye was 0.82±0.10 compared with the preoperative BCVA 3.12±0.14,and there were statistical differences(t=174.893, P<0.01).

CONCLUSION: Cataract phacoemulsification can safely and effectively improve the vision of patients with cataract and corneal opacity. The application of assistive technologies such as capsule staining, iris hooking, and iris resection can effectively reduce the risk of cataract surgery in patients with cataract and corneal opacity, improve the safety of surgery, and increase the success rate of surgery.

Abstract:AIM: To investigate the advantages of ultra-wide-field fluorescein angiography(UWFA)over the standard fundus examination in the evaluation of diabetic retinopathy(DR).

METHODS: Forty-five cases(90 eyes)with DR in Xi'an No.3 Hospital from October 2016 to June 2018 were analyzed retrospectively, including 25 males and 20 females, aged from 45-76(59.52±15.78)years. There were 25 males and 20 females. Average age were 59.5 years. All patients were examined with ophthalmoscope and UWFA.

RESULTS: Depending on ophthalmoscope, 12 eyes with no DR, 42 eyes with nonproliferative diabetic retinopathy(NPDR), and 36 eyes with proliferative diabetic retinopathy(PDR), diagnosed by the standard method. 22 eyes of 90 eyes received retinal photocoagulation, including 8 eyes received panretinal photocoagulation(PRP). Depending on UWFA images, peripheral microaneurysms were demonstrated in 8(67%)of 12 eyes with no DR. Peripheral retinal neovascularizations were detected in 4(10%)of 42 eyes with NPDR and in 12(33%)of 36 eyes with PDR. Peripheral vascular nonperfusions were found in 28(67%)of 42 eyes with NPDR and in 26(72%)of 36 eyes with PDR. Peripheral vascular nonperfusions and peripheral retinal neovascularizations also were found in 4(50%)of 8 eyes, which treated by PRP.

CONCLUSION: UWFA demonstrates peripheral lesions beyond standard fields, which can allow early detection of DR, and a close evaluation of eyes with retinal photocoagulation.

Abstract:AIM:To evaluate the short-term efficacy and safety of intravitreal dexamethasone implant(IDI)for patients with retinal vein occlusion-related macular edema(RVO-ME)by using optical coherence tomography(OCTA).

METHODS: Seventeen eyes in 17 patients with RVO-ME were treated with intravitreal injection of sustained-release IDI. The best corrected visual acuity(BCVA), central macular thickness(CMT)and superficial retinal vascular network were observed at baseline, 1d, 1mo, 2mo, 3mo, 4mo and 6mo.

RESULTS: CMT was significantly reduced from baseline by 24h after injection and improved further during the 3mo follow-up, and the improvement of visual acuity was consistent with that of CMT. OCTA showed improvement from baseline in terms of decreased number and size of cysts and restoration of the retinal vascular network. A slight increase in intraocular pressure was observed in 2 eyes after injection. There were no systemic side effects associated with injection or medication during follow-up.

CONCLUSION: CMT reduced as early as 24h after the injection of IDI, with further reduction during follow-up, and OCTA could visually observe the changes of retinal vascular network in macular area.