Abstract:AIM: To evaluate the safety and efficacy of limbal conjunctival autograft transplantation for treating primary pterygium over a period of 3y.

METHODS: Prospective observational consecutive case series. In this study, 264 eyes of 264 patients(142 males and 122 females)with nasal primary pterygium were treated using the technique of limbal conjunctival autograft. The mean ages of the patients were 54.22±15.24a. After excision of the pterygium patients were followed up on 1, 3, 7d and at 1, 3, 6, 9, 12 and 36mo. Recurrence of pterygium, complications, operation time and corneal epithelialization time were evaluated.

RESULTS: The average surgery time was 25.7±2.6min. With a minimum 3-year of follow-up, postoperative corneal epithelialization was completed in 3.85±0.72d. Complications were observed in 14 cases. Vision-threating complications such as iritis, scleral thinning symblepharon or ulceration were not detected in the study. 5 eyes with graft edema, 3 eyes with granuloma formation and 6 cases with a subconjunctival hematoma in the nasal conjunctiva. By the end of 3-year follow-up, recurrence was detected in 11 cases. The recurrence rate was 4.17%, and the onset of recurrence was 3mo, the average recurrence time was 8mo.

CONCLUSION: There were no severe complications and few recurrences when limbal conjunctival autograft transplantation was performed after long-term follow-up, we suggest that limbal conjunctival autograft transplantation is a safe and effective technique in primary pterygium. We also recommend that 12-month follow-up is optimal on primary pterygium surgery.

Abstract:AIM: To evaluate the outcomes of patients operated for retinal detachment by scleral buckle technique done by trainee doctors pursuing postgraduate course in ophthalmology.

METHODS: This study was a non-comparative retrospective case series to evaluate the demography, clinical features and outcomes of patients underwent rhegmatogenous retinal detachment(RRD)repaired by scleral buckle technique from July 2017 to February 2018 at a tertiary care center in India. Records of all these patients were screened. Statistical analyses were performed and using Fisher's exact test, Mann-Whitney test and Nominal Logistic regression.

RESULTS: Totally of 41 patients were included out of which, 32(78%)were males and 9(22%)were females. In our study primary anatomical success rate was 95%, with significant visual gain. Postoperative complications were raised intraocular pressure(n=2), new breaks(n=2)and re-detachment in 2 patients which was successfully managed by pars plana vitrectomy(PPV)with internal tamponade and laser.

CONCLUSION: The study showed that scleral buckle surgeries done by trainee doctors under supervision can achieve a high success rate in patients of RRD both in terms of postoperative anatomical success, visual acuity and complication rates. Thus, scleral buckle surgery can be an acceptable primary procedure for trainee doctors for management of RRD in selected cases despite the various treatment options now available.

Abstract:The purpose of this study is to run a review on possible superglue injuries to the eye. In this review, previous papers regarding the harmful impacts of superglue were systematically studied. Superglue eye injuries have been common during the three last decades and most of them were accidental and preventable by introducing safety issues and although it may be toxic for the tissues, it is not associated with long term morbidity. This paper addresses the management of superglue injuries and shows the importance of the prevention of ocular superglue injuries.

Abstract:AIM: To observe the effect of AGGF1 on the proliferation, migration and tube formation of retinal endothelial cells in diabetic retinal tissue and high glucose conditions.

METHODS: C57BL/6J mice were randomly divided into the control group and diabetic retinopathy(DR)model group. The cultured rhesus monkey choroido-retinal endothelial cells(RF/6A cells)were randomly divided into the control group(cultured in low-glucose environment)and the high-glucose group(cultured in medium with 25mmol/L D-glucose), and the AGGF1 protein expression in the cells was detected by immunofluorescence assay. RF/6A cells were then divided into the control group and AGGF1 treatment group, and cell proliferation, migration and tube formation was detected by CCK-8, Transwell and Matrigel, respectively.

RESULTS: AGGF1 protein was expressed in all layers of the retinas and in vascular endothelial cells. The expression of AGGF1 in the retinas of DR group(0.17±0.05)was significantly higher than that of the control group(0.07±0.02)(P<0.05). AGGF1 protein was expressed in RF/6A cells in both the high glucose group and the control group, and the expression of AGGF1 in RF/6A cells under high glucose was significantly higher(0.63±0.10)than that in the control group(0.40±0.03)(P<0.05). After 12h of treatment, the cell proliferation rate(114.88%±0.84%)in the AGGF1 group was significantly higher than that in the control group(100.00%±2.17%)(P<0.05). After 24h of treatment, the cell proliferation rate of the AGGF1 group(157.35%±1.89%)was significantly higher than that of the control group(142.77%±0.50%)(P<0.05). After 48h of treatment, the cell proliferation rate of the AGGF1 group(185.39%±1.90%)was significantly higher than that of the control group(160.17%±1.33%)(P<0.05). After 12h of treatment, the number of migrated cells(127.00±7.00)in the AGGF1 group was significantly higher than that in the control group(90.33±6.66)(P<0.05). After 12h of treatment, the number of tube formation(33.67±1.15)in the AGGF1 group was significantly higher than that in the control group(15.33±3.51)(P<0.05). The total tube length in AGGF1 group(8226.33±288.55)μm was significantly higher than that in the control group(6463.33±938.01)μm(P<0.05).

CONCLUSION: The expression of AGGF1 protein was significantly increased in diabetic retinal tissues and retinal vascular endothelial cells induced by high glucose. AGGF1 can promote the proliferation, migration and tube formation of retinal vascular endothelial cells, suggesting that AGGF1 may be involved in retinal neovascularization of DR.

Abstract:AIM: To investigate the effect of d-δ-tocopherol on the growth of human lens epithelial SRA cells and its related molecular mechanism, and to provide experimental basis for the treatment and prevention of posterior cataract with d-δ-tocopherol.

METHODS: The experiment was divided into 6 groups, blank control group and experimental group, that is, five different concentrations of d-δ-tocopherol(40, 60, 80, 100, 120)μmoL/L. The proliferation inhibition rate of each group was detected by thiazolam(MTT)assay. The morphology of human lens epithelial SRA cells was observed under inverted microscope. Cell cycle was detected by flow cytometry and the expression of bcl-2, bax, Cyclin D1, P21 protein was detected by Western Blot(WB).

RESULTS: With the increase of d-δ-tocopherol concentration, the SRA cells decreased significantly compared with the control group; the MTT results showed that with the increase of d-δ-tocopherol concentration, the inhibition rate of cell proliferation increased gradually, the difference was statistically significant(P<0.05); cell cycle: with the increase of the concentration of tocopherol drugs in the experimental group, the proportion of cells in the S phase increased gradually compared with the control group, the cells were blocked in the S phase, the difference was statistically significant(P<0.05); Western blotting: after 48h of d-δ-tocopherol intervention human lens epithelial SRA cells, the P21, Cyclin D1 and bcl-2 expression of human lens epithelial cells gradually decreased, and the expression of bax gradually increased, which was statistically significant(P<0.01).

CONCLUSION: d-δ-tocopherol can significantly inhibit the proliferation of human lens epithelial SRA cells and block the cell cycle in S phase. d-δ-tocopherol can inhibit the proliferation of human lens epithelial cells. The proliferation of human lens epithelial SRA cells may be achieved by inhibiting the expression of bcl-2, P21, Cyclin D1 and inducing the expression of bax.

Abstract:AIM: To explore the protective effect of dexamethasone combined with hypertonic solution on corneal endothelial cells of rabbit eyes.

METHODS: We made four groups of rabbits for different treatments with dexamethasone and hypertonic solution. All groups were treated with low-permeability solution for 10min to maintain anterior chamber perfusion. Group A was treated with 0.2mL dexamethasone subconjunctival injection, and hypertonic glucose eye drop immediately after surgery. Group B(control group)was subjected to 0.2mL of 0.9% saline subconjunctival injection, and balanced salt solution eye drop immediately after surgery. In group C, 0.2mL dexamethasone subconjunctival injection, and hypertonic glucose eye drop were given on the second day of surgery and in group D(control group), 0.2mL of 0.9% saline through subconjunctival injection and balanced salt solution eye drop were given on the second day of the surgery. The edema degree of cornea was observed with slit lamp before the operation and on the 1, 3, 5 and 7d after operation. The cornea were also examined by anterior segment OCT, and the corneal thickness was measured by A-scan ultrasonography.

RESULTS: In group A, during the entire experimental observation period, the cornea had no edema or only mild edema, the thickness of the central cornea hardly increased, and the number of corneal endothelial cells did not change significantly. There was no significant difference compared with(control group B)before modeling(P>0.05). In groups B, C, and D, corneal edema and corneal thickness increased after the rabbit eyes were modeled. There was a significant difference compared with group A(P<0.05). The number of corneal endothelial cells in the rabbit eyes of groups B and D could not be measured during the observation period due to corneal edema. The number of corneal endothelial cells can be measured in group C up to the 7d after modeling. The number of corneal endothelial cells in group C was significantly reduced as compared with group A(P<0.05), which before modeling and the 7d after modeling.

CONCLUSION: Dexamethasone combined with hypertonic glucose solution has a good protective effect on rabbit corneal endothelial cells. And early application can effectively prevent rabbit corneal edema and this method can also prevent the progression of corneal endothelial decompensation.

Abstract:AIM: To study the effect of high glucose environment on human corneal epithelial cell injury and repair, and to explain the significance of Cyclin D1 protein expression in corneal epithelial cell wound healing in high glucose culture.

METHODS: The high-glucose micro-environment of diabetic corneal lesions was simulated. After human corneal epithelial cells were resuscitated, cultured and passaged, a normal control group of DMEM complete medium of equal volume of distilled water and a high-glucose treated group of DMEM complete medium containing 25mmol/L glucose were set respectively. After the cells were overgrown, the cells were stimulated with scratches. The growth conditions and changes of the cells in each group were observed and compared under an inverted phase contrast microscope. Western glucose was used to analyze high glucose at different time points(0, 12, 24, 48, and 72h)Cyclin D1 Protein expression in cultured corneal epithelial cells. The qRT-PCR was used to analyze high glucose at different time points and each group Cyclin D1 mRNA expression.

RESULTS: Under the conditions of high glucose treatment in vitro, the repair rate of human corneal epithelial cells was slowed down after injury, floating cells increased, cells reattached less, and cell spacing increased. With the increase of high glucose treatment time, the cell state became worse and the growth rate slow; normal group repaired cell damage faster, increased cell density, regular morphology, and smooth cell membrane. Cyclin D1 expression was up-regulated by Western blot, but the up-regulation effect gradually weakened with time. The highest expression of Cyclin D1 in both groups appeared at 12h. The expression of Cyclin D1 in the high glucose treatment group was lower than that in the normal control group. The qRT-PCR results showed that after high glucose treatment, the expression of Cyclin D1 mRNA was up-regulated, but with the increase of high glucose treatment time, the up-regulation effect weakened, and the mRNA level recovered to the same level as the control group at 48h.

CONCLUSION: In the process of corneal epithelial cell wound healing, high glucose negatively regulates and inhibits the expression of Cyclin D1 protein, and is related to the decline of corneal epithelial cell proliferation and apoptosis.

Abstract:AIM: To study the effect of miR-221 on apoptosis of high glucose-induced human retinal vascular endothelial cells and to explore its mechanism.

METHODS: High-glucose-induced HRCECs were established by treatment of HRCECs cells with glucose at 30mmol/L for 48h; HG+miR-NC group(transfected miR-NC), HG+miR-221 group(transfected miR-221 mimics), HG+anti-miR-NC group(transfected anti-miR-NC), HG+anti-miR-221 group(transfected anti-miR-221), HG+miR-221+pcDNA 3.1 group(co-transfected miR-221 mimics and pcDNA 3.1), HG+miR-221+pcDNA 3.1-MDM2 group(co-transfected miR-221 mimics and pcDNA 3.1-MDM2), transfected into HRCECs cells by liposome method, and then treated with high glucose; qRT-PCR method for detection the expression of miR-221, p53 and MDM2; the protein expression of p53 and MDM2 were detected by Western blot. The apoptosis of cells was detected by flow cytometry.

RESULTS: Compared with NG group, the expression of miR-221 and p53 was significantly increased, the expression of MDM2 was significantly decreased, and the apoptosis rate was significantly increased in high glucose-induced HRCECs. Overexpression of miR-221 induced apoptosis of high glucose-induced HRCECs cells is more obvious. Inhibition of miR-221 can down-regulate the apoptosis of high glucose-induced HRCECs and down-regulate p53, up-regulate MDM2; overexpression of MDM2 can reverse the inhibition by miR-221 anti-apoptotic effect of cells and regulation of p53 and MDM2 of high-glucose-induced HRCECs.

CONCLUSION: miR-221 can promote the apoptosis of high-glucose-induced human retinal vascular endothelial cells, and its mechanism is related to p53/MDM2 signaling pathway.

Abstract:AIM: To analyze the consistency and accuracy of the axial position of the astigmatism correction intraocular lens(Toric IOL)measured by OPD scan Ⅲ(optical path difference analyzer)and the traditional slit lamp method.

METHODS: A prospective observational control study. A total of 118 patients with 156 eyes who underwent phacoemulsification combined with Toric IOL implantation in our hospital from July 2018 to October 2019 were selected. The residual astigmatism was followed up at 1wk, 1mo and 3mo after the operation, and the axial position of Toric IOL was measured with OPD scan Ⅲ under the small pupil(Axial intraocular astigmatism method)and after dilated pupils(Axial OPD method), while using traditional slit lamp method to measure Toric IOL axis position(Axial Slit method). Analyze the difference and consistency of the measurement results of the three methods, and calculate the Lens axis deviation(LAD)between the measurement results of the three methods and the target axis.

RESULTS: The residual astigmatism of the patients in this group was significantly lower than that before the operation at 1wk, 1mo and 3mo after operation(P<0.05). The proportion of residual astigmatism ≤ 0.75D at 3mo after surgery was 73.7%. Three months after the operation, the axial position of the Toric IOL measured by the axial Slit method, the axial OPD method, and the axial intraocular astigmatism method were: 111.0°(10, 178)°, 113.5°(12, 180)°, and 113.0°(15, 178)°. Consistency analysis showed that the average value of the difference between the axial OPD method and the axial Slit method, the axial intraocular astigmatism method and the axial slit method, the axial OPD method and the axial intraocular astigmatism method at 3mo after the operation, they were -0.58°, -0.19°, 0.40°, which were all close to 0°, with high consistency. 95% LoA were(-7.01-5.84)°,(-12.44-12.07)°,(-10.69-11.49)°. At 3mo postoperatively, the proportions of patients with LAD ≤5° measured by axial Slit method, axial OPD method, and axial intraocular astigmatism were 82.0%, 80.1%, and 59.0%, respectively.

CONCLUSION: OPD scan Ⅲ can directly measure Toric IOL axial position after dilated pupils. It was an objective and accurate measurement method, which can replace the traditional slit lamp method to measure axial position and avoid subjective limitations. The Toric IOL axial position can also be measured by intraocular astigmatism under the small pupil, which has certain practical application value in ophthalmology clinical work.

Abstract:AIM: To analyze the changes in contrast sensitivity of macular nerve fiber layer and visual function and macular visual field in diabetic patients before diabetic retinopathy.

METHODS: Case-control study, from Jan 2015 to Jan 2017 choose 59 cases of type 2 diabetes without diabetic retinopathy were selected as the observation group, 40 normal persons and 40 patients with mild non-proliferative diabetic retinopathy were selected as the control group. The morphology of the nerve fiber layer in the macular area, the contrast sensitivity of visual function, and the threshold of macular field were compared and analyzed.

RESULTS: The average thickness of the fovea(FT)in normal group, DR0 group and DR1 group were 244.45±22.863, 237.53±18.240, 240.78±23.946μm. There was no statistically significant difference in the average FT, retinal nerve fiber layer thickness in foveal central field(RNFL-C), RNFL thickness in perifovea among the three groups(P>0.05). The foveal volume(FV), RNFL thickness in parafove between the three groups was statistically significant(P<0.05). Visual function contrast sensitivity test: the differences in contrast sensitivity of normal group, DR0 group and DR1 group at 3, 6, 12, 18c/d spatial frequency were statistically significant(P<0.05). Visual function of macular field: the difference in visual acuity threshold of the macular centers MS, MS1-4, MS5-16, MS1-16 in the normal group, DR0 group and DR1 group is statistically significant(P<0.05).

CONCLUSION: Before diabetic retinopathy, diabetic patients will have macular nerve fiber thinning and fovea volume reduction, visual function contrast sensitivity decline and visual field changes. OCT, contrast sensitivity and visual field examination can be diabetic retinopathy. Early screening and intervention provide important evidence.

Abstract:AIM: To investigate the clinical significance of changes of refractive and lenticular accommodation parameters in children with myopia of retinopathy of prematurity(ROP).

METHODS: A retrospective study was conducted in 98(192 eyes)1-6 year-old children with ROP who recovered spontaneously without treatment during outpatient follow-up between October 2018 and September 2019. According to the refractive screening results, the subjects were divided into myopia group(41 cases with 80 affected eyes)and non-myopia group(57 cases with 112 affected eyes). Meanwhile, 40 emmetropic premature infants(80 eyes)of the same age and without ROP were selected as the control group. Refractive parameters \〖spherical equivalent(SE), corneal curvature(CR), axial length(AL), anterior chamber depth(ACD), vitreous depth(VITR), lens thickness(LT)\〗 and lenticular accommodation parameters(SE and LT before and after mydriasis and their change values)in different groups were compared. Refractive parameters in myopic children with ROP in different age groups were analyzed, and the relationship among SE, refractive parameters and lens adjustment parameters in preschool myopic children with ROP was discussed.

RESULTS: SE and LT of myopia group(-3.95±1.31D, 4.21±0.34mm)were higher/larger than those of non-myopia group(1.32±0.36D, 4.08±0.21mm)and control group(1.39±0.42D, 3.71±0.41mm), while ACD(2.42±0.39mm)was lower than that of non-myopia group(2.61±0.24mm)or control group(3.11±0.32mm). Besides, LT of non-myopia group was larger than control group, and ACD was lower than control group(all P<0.001). SE of myopia group before and after mydriasis(-3.95±1.31, -3.02±0.97D)were higher than those of non-myopia group(1.32±0.36, 2.67±0.81D)or control group(1.39±0.42, 2.61±0.76D). and the difference value of SE(0.93±0.30D)was lower than that of non-myopia group(1.31±0.31D)or control group(1.25±0.19D)(P<0.001). LT before and after mydriasis(4.21±0.34, 3.95±0.22mm)were larger than those of non-myopia group(4.08±0.21, 3.71±0.37mm)or control group(3.71±0.41, 3.35±0.16mm), and the difference value of LT(0.26±0.08mm)was lower than non-myopia group(0.37±0.12mm)or control group(0.36±0.11mm). Moreover, LT of non-myopia group before and after mydriasis were larger than those of control group(all P<0.001). For subjects under 3 years old, SE, CR and LT of myopia group were higher and ACD was lower than those of non-myopia group. For subjects between 3 and 6 years old, SE and LT of myopia group were higher than those of non-myopia group(all P<0.05). SE was positively correlated with CR and LT in myopic children with ROP under 3 years old, but it was negatively correlated with the difference value of LT before and after mydriasis(P<0.05); SE was positively correlated with LT in myopic children with ROP between 3 and 6 years old, but was negatively correlated with the difference value of LT before and after mydriasis(P<0.05).

CONCLUSION: Refractive changes of preschool myopic children with ROP are characterized by lens thickening and shallow anterior chamber. Patients under 3 years old are accompanied by steep CR, and lens thickening appears after the age of three. CR is related to the occurrence of myopia of ROP in children under 3 years old. LT and lenticular accommodation are leading factors for myopia of ROP in children between 1 and 6 years old.

Abstract:Calcium is an important messenger in the mammalian nerve cells which mediates a variety of intracellular signal transduction pathways and plays critical roles in regulating the neuronal functions. Calcium signaling exerts its highly specific function in a defined sub-region of the cell, especially in the visual cortex of the brain. Detection of calcium signals in neurons is particularly important for the studying of neuronal function. The two-photon microscope has a unique advantage in the detection of calcium signal in the superficial cortex. In this paper, the application of two-photon in the in vivo detection of the visual cortical Ⅱ/Ⅲ layer of model animals are reviewed.

Abstract:The lens plays a crucial part in the etiology of primary angle-closure glaucoma(PACG). The changes in the thickness and position of the lens have been related to common structural deviations observed in PACG eyes such as: shallow anterior chamber, pupillary block and crowded anterior chamber angle. Lens extraction has long been used to treat PACG, which combined with anti-glaucoma surgeries remains a commonly employed therapy. This article aims to summarize the medical outcome and role of phacoemulsification with or without anti-glaucoma surgeries in the treatment of PACG.

Abstract:Cataract is the most common blinding eye disease in our country. Cataract phacoemulsification combined with intraocular lens implantation is the first choice for cataract surgery, with advantages of a small incision, mild anterior chamber reaction, repaid recovery and small astigmatism of corneal. However, there are still some patients failed to achieve ideal visual quality after surgery due to various reasons even if the surgery is successful. Cystoid macular edema(CME)is one of the common complications in pseudophakic eyes affecting postoperative visual quality after cataract surgery. Recent studies on pseudophakic cystoid macular edema(PCME)are reviewed in this paper.

Abstract:Optic neuritis(ON), which is the blinding optic nerve diseases that the young and middle-aged population are most susceptible to, is an optic neuropathy caused by various factors. Idiopathic optic neuritis(ION)occurs most frequently asmultiple sclerosis related optic neuritis(MS-ON)and neuromyelitis optica related optic neuritis(NMO-ON). ION has the characteristics of acute onset, easy recurrence, and serious dysfunction. Inflammation is an important mechanism of ION. By mediating inflammatory responses and participating in immune responses, proinflammatory cytokines, as one of cytokines which is a general term for a class of small molecule soluble peptides that regulate the immune system, have caused widespread concern in the pathogenesis of ION. This article reviews and discusses researches on the pathogenesis of proinflammatory cytokines-mediated ION at home and abroad in an effort to promote an in-depth study of the pathogenesis, diagnosis and treatment of ION.

Abstract:Ocular Demodex infection is mainly manifested as ocular surface diseases, including meibomian gland dysfunction, dry eye disease, Demodex blepharitis, chalazion, keratoconjunctivitis, etc. The diagnosis is relatively simple and can be realized under the microscope, but it is easy to be misdiagnosed due to the subjective and objective factors such as similar symptoms, missing examination, experience diagnosis and treatment. There are many treatment methods for ocular Demodex infection, including external tea tree oil and other plant extracts, oral or external drugs, physical therapy(represented by strong pulse light therapy, moxibustion therapy), combined therapy, etc. In this paper, we reviewed the diagnosis and treatment of Demodex related ocular surface diseases, and discussed the latest research trends of this disease.

Abstract:Dry eye syndrome is one of the most common ophthalmology diseases. With the improvement of non-invasive tear extraction methods, tear protein analysis becomes a best choice for the diagnosis and evaluation of efficacy of dry eye. Methods that have been used for tear proteomics research include protein chip technology and mass spectrometry. The relationship between the protein in the tear fluid and its concentration and different pathological conditions has important value in the research of dry eye syndromes. This article reviews the latest developments in the field, the application of tear proteomics research and current practical issues,it will provide highlights for the understanding of molecular mechanism of dry eye syndromes and benefits for potential molecular diagnosis of dry eye syndromes in the future.

Abstract:The global incidence of high myopia is increasing year by year. High myopia is closely related to cataract, but high myopia is accompanied by special pathological changes,which make the operative difficulty and the incidence of postoperative complications of high myopia with cataract is much higher than common cataract. With the advent of the era of refractive cataract, postoperative visual quality requirements of patients are higher, and the challenges to ophthalmologists are also greater. Therefore, we need to pay more attention to the management of patients with high myopia combined with cataract. In this paper, the surgical methods, preoperative biological measurements, common complications during and after the operation of high myopia with cataract were reviewed.

Abstract:AIM: To evaluate the application of optical coherence tomography(OCT)in evaluation of the differences in macular area and peripheral nerve fiber layer thickness(RNFL)of the binocular anisometropic amblyopia of adolescents and children with monocular anisometropic amblyopia, so as to provide a basis for exploring the pathogenesis of amblyopia and guiding the diagnosis and treatment of amblyopia.

METHODS: Retrieved Chinese and English databases such as Weipu, WanFang, PubMed, EMBASE etc, and carried out relevant clinical research on the use of OCT to examine macular area and RNFL of adolescents and children with monocular anisometropic amblyopia from 1995-01-01/2019-12-08 screening, evaluation and data extraction, including the thickness of central fovea, central area of macular fovea with diameter 1mm, the inner ring area with 1-3mm, the thickness of the outer ring area with 3-6mm, and the RNFL of monocular anisometropia amblyopia patients into studies, then do Meta-analysis with the RevMan 5.3 software.

RESULTS: Results of the time-domain OCT(TD-OCT)study showed that the thickness of macular fovea in the amblyopic eyes and the thickness of the central area of the macular fovea with diameter 1mm were greater than those of the contralateral non-amblyopic eyes(P<0.05), and the average thickness of RNFL in amblyopic eyes was thicker in the contralateral eye(P>0.05). Results of the study using frequency domain OCT(SD-OCT)showed that the thickness of macular fovea and the thickness of each zone in amblyopic eyes were greater than those of the contralateral non-amblyopic eyes, except for the central area of the macular fovea with diameter 1mm and the outer ring area below 3-6mm. In addition, the rest of the comparisons were different(P<0.05); the average thickness of RNFL and the thickness of each zone of the nose in amblyopic eyes were larger than those of the contralateral non-amblyopic eyes(P<0.05).

CONCLUSION: Thickness of the macular area and RNFL of the amblyopic eye of monocular anisometropic amblyopia is higher than that of the contralateral non-amblyopic eye, and amblyopia mainly causes the thickness of the macular fovea to increase within 1mm diameter.

Abstract:AIM:To investigate the in vitro interaction between antifungals and tacrolimus acting alone or in combination against Fusarium solani.

METHODS: According to Clinical and Laboratory Standards Institute(CLSI)M27-Ed4 and M38-A3, 22 strains of Fusarium solani were used to perform drug sensitivity tests with chessboard microdilution method by cyclosporin A combined with 4 kinds of antifungal drugs in vitro.

RESULTS: The MIC ranges of natamycin, voriconazole, amphotericin B and fluconazole against 22 strains of Fusarium solani were 2-8, 1-8, 1-8 and 8-512μg/mL respectively. When combined with tacrolimus in vitro, the synergistic effects of fluconazole and Amphotericin B were observed in 64% and 41% strains respectively. There were no antagonistic effects observed in all combined drug tests. With the combination, the sensitivity of Fusarium to amphotericin B was significantly increased from 4.5% to 68.2%(P<0.001).

CONCLUSION: Fusarium solani is sensitive to natamycin in vitro and is partially sensitive to voriconazole. When combined with cyclosporine A, it can produce synergistic effects with fluconazole and amphotericin B, and significantly increase the sensitivity of Fusarium solani to amphotericin B drugs.

Abstract:AIM:To evaluate the effect of two incision-making methods on operation and postoperative effect in manual small incision cataract surgery(MSICS)for patients with hard nucleus aged cataract and evaluate the advantages and disadvantages of two incision methods.

METHODS: A retrospective analysis of 56 patients with senile cataract with hard nucleus from February 2017 to February 2019 in our hospital was made, which was divided into two groups according to the different surgical methods. group A(31 eyes)with long incision(about 7-8mm), long tunnel(central 5mm length 3.5-4mm, internal incision of both sides extending about 1-1.5mm to the back of the side, making the front end of the incision trapezoid), thick scleral flap(about 2/3 film thickness). group B(25 eyes)with short incision(about 5.5mm), short tunnel(long 3mm, regular flush of internal incision, linear), and regular thickness scleral flap(about 1/2 film thickness). The best corrected visual acuity recovery of 1d, 1wk, 1mo and 3mo after operation, central corneal thickness after 1d, 1wk operation and corneal astigmatism degree, corneal endothelial cell loss degree after 3mo operation were compared.

RESULTS: The best corrected visual acuity(greater than or equal to 0.5)for 1d, 1wk, 1mo and 3mo after operation in the two groups(77%, 90%,94% and 94% in the A group and 32%, 72%, 88% and 88% in the B group)was statistically significant \〖β=-1.338, Exp(β)=0.262, P<0.05\〗. The central corneal thickness of the two groups had time difference and interaction effect before and after operation(P<0.05), and there was no difference between the two groups(P>0.05). There was a statistically significant difference in corneal endothelial cell density(2159.84±245.20/mm² in the group A and 2019.68±203.97/mm² in the group B)between the two groups after 3mo of operation(t=2.289, P<0.05). There was no significant difference in corneal astigmatism between the two groups(group A 1.57±0.74D and group B 1.39±0.71D)after 3mo of operation(t=0.930,P>0.05).

CONCLUSION: MSICS with long incision, long tunnel, thick scleral flap and trapezoidal internal incision has less damage, quicker recovery and better effect on patients with hard nucleus aged cataract than short incision, short tunnel and linear internal incision.

Abstract:AIM: To investigate the curative effect of 3.0mm incision phacoemulsification and 1.8mm coaxial micro-incision phacoemulsification and the influence on corneal endothelial cells.

METHODS: A total of 78 patients(78 eyes)with age-related cataract who were hospitalized in the hospital from December 2016 to December 2018 were selected as subjects. They were divided into the standard incision group and the micro-incision group with 39 cases(39 eyes)in each group. Patients in the standard incision group were treated with 3.0mm standard incision phacoemulsification and intraocular lens implantation, while the patients in the micro-incision group were treated with 1.8mm coaxial micro-incision phacoemulsification and intraocular lens implantation. The surgical outcome and corneal endothelial cell parameters were compared between the two groups.

RESULTS: The phacoemulsification time of the standard incision group and the micro-incision group were(7.05±0.98)s and(7.22±0.96)s, respectively. The phacoemulsification energy was(17.01±1.89)% and(16.89±1.53)%, respectively(P>0.05). The LogMAR of naked eyes of both groups decreased significantly at 1d, 1wk and 1mo after surgery(P<0.001), while the degree of astigmatism increased(P<0.001). The naked vision and astigmatism of the micro-incision group were better than those of the standard incision group at 1d and 1wk after surgery(P<0.05). Endothelial cell density was significantly decreased at 1d, 1wk and 1mo after surgery(P<0.05). The coefficient of variation of corneal endothelial cells and the thickness of central cornea increased. There was no significant difference between the standard incision group and the micro-incision group at each time poilt(P>0.05). There were no severe complications in either group. There was one patient with transient high intraocular pressure in the standard incision group, and the intraocular pressure returned to normal after drug treatment.

CONCLUSION: Both coaxial micro-incision phacoemulsification and standard small incision surgery have certain effects on the morphology and function of endothelial cells. Besides, there is no significant difference between them. However, coaxial micro-incision phacoemulsification can minimize the surgical incision and reduce the degree of surgically induced astigmatism, and patients can recover quickly after surgery. It is a relatively safer surgical procedure.

Abstract:AIM: To evaluate the clinical effect of anti-VEGF and combined with compound trabeculectomy in the treatment of neovascular glaucoma(NVG).

METHODS: A study was performed on the related data of 42 NVG patients(43 eyes)who were admitted to Department of Ophthalmology, the Fourth People's Hospital of Shenyang from January 2017 to June 2019. Blood routine, urine routine, electrocardiogram, visual acuity, intraocular pressure, and Scheimpflug photography were taken after all patients were enrolled, and fundus examination was completed according to the state of the refractive condition. According to the intraocular pressure, lowering intraocular pressure and antibiotic eye drops were taken before surgery. On the third day of admission, the patients were treated with anti-VEGF treatment. The patients divided into the lucentis group and conbercept group according to patient choice. Compound trabeculectomy was performed 72h after injection(subconjunctiva and scleral flap were locally infiltrated with fluorouracil + adjustable suture line+goniosynechialysis). Visual acuity and intraocular pressure were recorded 1d, 1wk, 2wk, 1mo, 2mo, 3mo and 6mo after surgery. Analysis of variance for repeated measurements to compare data before and after surgery, the independent sample t-test was used to compare the differences between groups at each time point.

RESULTS: Both lucentis and conbercept could suppress iris neovascularization. There was no significant difference between two groups. The intraocular pressure significantly decreased in most patients 1d, 1wk, 2wk, 1mo, 2mo, 3mo and 6mo after surgery. Vision acuity could be improved in some patients.

CONCLUSION: Anti-VEGF and combined with compound trabeculectomy is effective in the treatment of lowering intraocular pressure for NVG. Vision acuity and the quality of life could be improved in some patients.

Abstract:AIM: To investigate the differences of the choroidal vascularity index between type 2 diabetes with diabetic retinopathy and non-diabetes patients.

METHODS: A retrospective cross-sectional study was performed at Beijing Friendship Hospital. Enhanced depth imaging spectral-domain optical coherence tomography(EDI-OCT)scans of 68 eyes of 68 type 2 diabetes who with diabetic retinopathy were compared with those of right eyes of 34 age- and gender-matched healthy controls. The choroidal images were binarized into luminal areas(LA)and stromal areas(SA). CVI was defined as the ratio of LA to total circumscribed subfoveal choroidal area. Mean choroidal thickness, mean retinal thickness and mean CVI between patients and controls were compared using t-test.

RESULTS: There were no significant differences in total circumscribed subfoveal choroidal area(0.53±0.14mm² vs 0.49±0.15mm²), LA(0.35±0.09mm² vs 0.32±0.10mm²), SA(0.17±0.05mm² vs 0.17±0.06mm²), or subfoveal choroidal thickness(347.9±76.9μm vs 325.9±92.9μm)between patients with DR and controls(P>0.05). However, there was a significantly lower CVI in patients with diabetes as compared to controls(64.33%±3.25% vs 67.04%±2.46%, P<0.001). The critical value was 63.59%.

CONCLUSION: CVI is a kind of biological indicators which can directly reflect the changes of choroidal internal structure, and it is more stable and reliable than SFCT. For type 2 diabetic patients who with diabetic retinopathy, CVI is lower than that of healthy people.

Abstract:AIM: To preliminary evaluate retinal sensitivity and the fixation alterations in patients with diabetic macular edema(DME)under Xiaozhong decoction combined intravitreal conbercept therapy.

METHODS: The 40 patients with DME were randomly divided into two groups. Treatment group: 20 patients(20 eyes), Xiaozhong decoction combined with conbercept group and treatment group; 20 patients(20 eyes), placebo combined with conbercept group in our hospital from January to October in 2017. The two groups were taken oral Chinese medicinals or placebo for 3mo respectively. BCVA(ETDRS visual acuity test)and CRT(OCT)of the two groups were observed, and the retinal sensitivity and fixation stability(P1, P2)were measured by MAIA microperimetry.

RESULTS: After 3mo of treatment, BCVA of treatment group and control group increased by 4(-1, 11.5)and 0(-4, 0.75)letters compared with baseline(P<0.05), and CRT decreased by 123.5±42.61 and 18.1±12.84μm respectively(P<0.05). The retinal sensitivity increased slightly after treatment in the two groups, but there was no significant difference between the two groups and over the course of treatment in control group(P>0.05). The sensitivity of retina in treatment group was the highest(20.11±4.98dB)at 2mo. P1 and P2 in the two groups increased significantly after treatment. The increase of P1 in the treatment group was significantly higher than that in the control group at 2mo(P<0.05). But there was no difference in the increase of P2 between the two groups after treatment(P>0.05).

CONCLUSION: Intravitreal conbercept could improve the fixation stability in DME patients, combined with Xiaozhong decoction was conducive to maintain fixation stability.

Abstract:AIM: To explore the dynamic distribution of pupil size and center, the eccentricity distribution of corneal light reflection, and its correlation analysis about suitable for femtosecond laser combined with excimer laser in situ keratomileusis.

METHODS: Randomly selected 225 patients(407 eyes)who underwent femtosecond laser combined with excimer laser in situ keratomileusis at Yanbian University Hospital in 2019 from January to May, preoperative use of Wavelight Allegro Topolyzer Corneal Topography to measure the pupil size and center position, the German Wavelight EX500 excimer Laser(500Hz)records the deviation between the pupil center and the coaxially sighted corneal light reflex when the patient is supine.

RESULTS:The average displacement distribution between the center of the cornea and the center of the pupil is 0.322±0.194mm, and 64% of the eyes are ≤0.40mm. The average displacement distribution of P-Dist(the eccentricity between the pupil center and the coaxially sighted corneal light reflex point)is 0.225±0.102mm, and 80% of the eyes are ≤0.30mm. The coaxially sighted corneal light reflex point is mainly deviated to the superior temporal side of the corneal center(34%). The X-axis of the left eye in low light conditions: -0.061±0.084mm, and the X-axis of the right eye: -0.016±0.059mm(P=0.002)(the left eye shifted to the temporal side in the dark light). The corneal transverse diameter(WTW)was positively correlated with changes in pupil diameter(dark pupil diameter-bright pupil diameter)(r=0.270, P<0.001).

CONCLUSION: The left eye should be adjusted to a position of the machining center within 0.061mm. If the cornea is too large, try to maintain a dark light environment during the operation to improve the efficiency of pupil matching. This study further confirms the necessity of rationally positioning the cutting center under different angle kappa states.

Abstract:AIM: To explore the clinical application of Pentacam anterior segment analyzer in early keratoconus diagnosis.

METHODS: Selected 49 patients(49 eyes)with early keratoconus who were treated in our hospital from February 2019 to December 2019.According to the Rabinowitz diagnostic criteria, they were divided into 27 cases(27 eyes)in the clinical keratoconus group and 22 cases(22 eyes)in the subclinical keratoconus group. Another 20 cases(20 eyes)of normal eyes with myopia and astigmatism were selected as the control group. The Pentacam anterior segment analyzer was used to determine the index of surface variance(ISV), keratoconus index(KI), index of vertical asymmetry(IVA), central keratoconus index(CKI), index of highest decentration(IHD), index of highest asymmetry(IHA), aberration coefficient, minimum sagittal curvature(Rmin), corneal astigmatism(CYL), corneal anterior surface height(AE), maximum refractive power of the cornea and corneal posterior surface height(PE). Compare the detection values of the three groups of indicators, and draw the ROC curve, and analyze the clinical value of various indicators in diagnosing keratoconus.

RESULTS: The three groups of ISV, KI, IVA, CKI, IHD, IHA, ABR, Rmin, CYL, AE, Kmax and PE detection values were significantly different(P<0.05). Compared with the control group, the ISV, KI, IVA, CKI, IHD, IHA, ABR, Rmin, CYL, AE, Kmax and PE detection value in the clinical keratoconus group were statistically significant(P<0.05). Compared with the control group, the ISV, KI, IVA, CKI, IHD, IHA, ABR, Rmin, CYL, AE, Kmax and PE detection value in the clinical keratoconus group were statistic significant(P<0.05). The results of ROC curve analysis showed that the sensitivity and specificity of keratoconus in the clinical phase of IVA, KI, AE, PE, Rmin, IHD, Kmax, ISV and ABR were higher. IVA, Rmin, AE and PE diagnosis of subclinical keratoconus sensitivity and specificity were higher.

CONCLUSION: The Pentacam anterior segment analyzer accurately measures the morphological parameters of the anterior and posterior surface of the cornea, which plays an important role in the early clinical diagnosis of keratoconus.

Abstract:AIM: To observe the changes of anterior chamber angle after posterior chamber intraocular lens(ICL)V4c implantation for high myopia.

METHODS: Prospective study. ICL V4c implantation was performed on 150 cases(300 eyes)with high myopia, and the changes of visual acuity, intraocular pressure,vault and anterior chamber angle were recorded before and 1d, 1mo, 3mo, 6mo and 1a after operation. Repeated measurement analysis of variance and LSD-t test were used to analyze the data.

RESULTS: After 1d, 1mo, 3mo, 6mo, 1a operation, the recovery of UCVA was significantly higher than that before operation(F=98.2, P<0.01); there were statistically significant differences in AOD500, AOD750, TISA500, TISA750 and SSA of nasal side before and after operation(F=108.256, 112.342, 164.856, 316.549, 115.338, P<0.01); there were statistically significant differences in AOD500, AOD750, TISA500, TISA750 and SSA of temporal side before and after operation(F=102.68, 548.47, 93.37, 316.549, 117.698, all P<0.01); the parameters of each angle decreased gradually in the 1d, 1mo and 3mo after operation on both sides, and there was statistical difference in the two comparisons(all P<0.05), but there was no statistical significance in the parameters of each angle in the 3mo, 6mo and 1a after operation(all P>0.05).

CONCLUSION: After ICL V4c implantation, the anterior chamber angle parameters in the horizontal direction of 1d, 1mo, 3mo, 6mo and 1a were smaller than those before operation, and tended to be stable after 3mo.

Abstract:AIM: To assess the clinical efficacy of phacoemulsification, intraocular lens implantation with goniosynechialysis(PEI+GSL)for acute angle closure glaucoma(AACG)and cataract with extensive angle closure synechiae.

METHODS: A retrospective study, we studied 35 eyes of 32 patients with AACG and cataract in our hospital. The extent of anterior chamber angle-closure synechiae was defined as an eye with >180°. All patients underwent PEI+GSL and completed an ophthalmologic examination including vision, intraocular pressure(IOP), anterior chamber depth(ACD), angle-opening distance(AOD₅₀₀), trabecular-iris space area(TISA₅₀₀)were observed at 1d, 1wk, 1mo and 3mo after cataract surgery. The angle closure range and retinal nerve fiber layer(RNFL)thickness changes at postoperative 1mo and 3mo were observed, and recorded complications.

RESULTS: Postoperative 3mo BCVA(0.334±0.154)and IOP(14.63±3.59mmHg)were improved compared with preoperative(0.914±0.290, 42.54±8.06mmHg)(P<0.05). ACD(3.203±0.214mm), OCT angle parameters AOD₅₀₀ and TISA₅₀₀(0.308±0.014, 0.315±0.015mm, 0.134±0.013, 0.139±0.018mm²)were significantly increased compared with preoperation. The extent of angle closure with gonioscopy(72.32±28.33°)decreased compared preoperation(215.29°±30.66°), and RNFL thickness thinner than preoperation(P<0.001). Changes in AOD₅₀₀ and TISA₅₀₀ for both nasal and temporal were negatively correlated with IOP, but not with changes in ACD, and no significant complications occurred in the 3mo after surgery.

CONCLUSION: The treatment of PEI+GSL can improve vision, deeper ACD and effectively open ACA in the early stage, thus controlling IOP.

Abstract:AIM: To investigate the effect of panretinal photocoagulation(PRP)combined with intravitreal injection of conbercept as an adjuvant to neovascular glaucoma secondary to central retinal vein occlusion(CRVO).

METHODS: This was a prospective case-control study. Patients diagnosed with neovascular glaucoma(stage Ⅰor Ⅱ)secondary to CRVO in our hospital from January 2014 to March 2019 were enrolled and randomly divided into two groups. Patients in combination group were treated with both PRP and intravitreal conbercept injection. In the other group(PRP only group)patients were treated with PRP only. Changes of best corrected visual acuity(BCVA), intraocular pressure(IOP)and iris neovascularization(NVI)were observed before treatment, 1wk, 1mo, 3mo, 6mo and 9mo after treatment.

RESULTS: Sixty patients 60 eyes were enrolled, with the mean age of 54.45±6.08 years. 56.67% were males. There were no significant difference between two groups in age and gender. After treatment, all the indexes of the two groups improved obviously with significant different(F=154.992, 92.519, 30.696, 82.374, all P<0.001), visual acuity improved, IOP decreased, and NVI decreased at different time points. The difference was statistically significant compared with the control group one week after treatment(F=50.870, 24.265, 13.125, 11.829, all P<0.001), and it was maintained continuously.

CONCLUSION: For eyes with CRVO secondary with neovascular glaucoma, intravitreal injection of conbercept combined with panretinal photocoagulation PRP is better than panretinal photocoagulation PRP only.

Abstract:AIM: To investigate the change of macular pigment optical density(MPOD)in the patients of obstructive sleep apnea-hypopnea syndrome(OSAHS).

METHODS: Totally 70 OSAHS patients as observation group and 32 healthy subjects as control group with their right eyes were enrolled from Chongqing Emergency Medical Center during January to December of 2019. All the subjects used Visucam 200 to measure the mean/max MPOD.

RESULTS: Both mean/max MPOD(0.0916±0.0149, 0.2675±0.0419Log unit)of OSAHS group are significantly lower than the control group(0.1193±0.0159, 0.3235±0.0400Log unit, P<0.001).There are significant difference of mean/max MPOD between mild(n=12)/moderate(n=17)/severe(n=41)groups divided by AHI(P<0.001). The increasing severity of OSAHS lead to lower mean/max MPOD.Furthermore there is negative correlation between mean/max MPOD and AHI(r=-0.685, -0.492; P<0.001).

CONCLUSION: Our study results suggest that the mean/max MPOD were reduced in the patients of OSAHS. Moreover, the decreased degree of mean/max MPOD is positively related to the severity of OSAHS. It shows that the MPOD of OSAHS have already changed before they feel the significant syndrome. The reducing of MPOD may cause dysfunction of macular and finally rise up to macular disease.

Abstract:AIM: To evaluate the clinical efficacy of heads-up 3D vision system in surgery for proliferative diabetic retinopathy with traction retinal detachment.

METHODS: We retrospectively reviewed 32 patients(38 eyes)of PDR complicated with local TRD(no traction retinal hole)who underwent 25G minimally invasive vitrectomy in our hospital from August 2018 to March 2019. The patients were divided into two groups according to the observation system during the operation. 19 eyes of 16 patients in the experimental group were operated with heads-up 3D vision system, and 19 eyes of 16 patients in the control group were operated with traditional microscope. The operation time, iatrogenic retinal hole and silicone oil injection were recorded in the two groups. The patients were followed up for at least 6mo to observe the best corrected visual acuity and the occurrence of postoperative complications.

RESULTS: In the experimental group, iatrogenic retinal hole and silicone oil injection occurred in 1 eye during operation. The retina was completely reattached after operation. One day after operation, vitreous hemorrhage occurred in 4 eyes, which was self-absorbed after 2-4wk. Intraocular hypertension occurred in 6 eyes in postoperative 2wk, which could be controlled by drug treatment. Vitreous hemorrhage occurred in 2 eyes after 6wk and the best corrected visual acuity of 6mo was more than 0.3 in 15 eyes. In the control group, iatrogenic retinal hole occurred in 4 eyes, silicone oil was injected in 5 eyes during operation. The retina was completely reattached after operation. One day after operation, vitreous hemorrhage occurred in 6 eyes, which was self-absorbed after 2-4wk. Intraocular hypertension occurred in 5 eyes in postoperative 2wk, which could be controlled by drug treatment. Vitreous hemorrhage occurred in 3 eyes after 6wk, and the best corrected visual acuity of 6mo was more than 0.3 in 14 eyes. The operation of all patients was completed successfully, and no serious complications such as endophthalmitis occurred, but the operation time of the experimental group was significantly shorter than that of the control group(37.3±4.8min vs 41.2±5.1min, P=0.020).

CONCLUSION:Application of heads-up 3D vision system in PDR combined with TRD vitrectomy can shorten the operation time and improve the operation efficiency.

Abstract:AIM: To investigate the prevalence on peripheral retinal degeneration and to provide theoretical support for the medical examination of civil aviation pilots recruitment.

METHODS: Two thousand four hundred and fifty prospective flight students(Four thousand nine hundred eyes)who received medical examination in Civil Aviation General Hospital from February 2018 to May 2019 were divided into three groups according to diopter after fully mydriatic with tropicamide phenylephrine eye drops(Group A: +3.00 to <-0.50D, Group B: -0.50 to <-3.00D, Group C: -3.00 to -4.50D). The prevalence of peripheral retinal degeneration in each eye was examined, and the results were statistically analyzed.

RESULTS:There were five hundred and seventy five students with different types of peripheral retinal degeneration in 2 450 checked students, the prevalence was 23.5%. There was statistical difference in the prevalence of peripheral retinal degeneration in different diopter groups(χ²=65.386, P<0.01). There was statistical difference in the prevalence of different types of peripheral retinal degeneration(χ²=351.276, P<0.01). There was statistical difference in the prevalence of peripheral retinal degeneration in different parts(χ²=563.712, P<0.01).

CONCLUSION: Peripheral retinal degeneration is not rare in civil aviation recruitment. The prevalence increases with the progression of myopia, and the lesions are mostly in bitamporal quadrant. It is suggested to identify according to different types.

Abstract:AIM:To observe the effect of different time of wearing overnight orthokeratology lens(OOK lens)on the meibomian gland and detection rate of demodex.

METHODS:Case-control study. Totally 47(91 eyes)patients who wearing keratoscopy were enrolled from June 2019 to December 2019 in Hanyang Aier Eye Hospital. According to the wearing time, they were divided into short-term group(wearing time <2a)and long-term group(wearing time≥2a). Meanwhile, patients wearing frame glasses with gender, age and diopter matching with the two groups above were selected as the control group. All patients had non-invasive tear film rupture time(NI-BUT)examination, meibomial gland infrared photography, bulbar redness score(BRS), and eyelash sampling.

RESULTS: The three groups of NI-BUT were 12.68±4.59s, 12.37±4.97s, 10.45±6.04s,(P>0.05). BRS respectively were 0.99±0.41, 0.90±0.37, 0.84±0.35,(P>0.05). Meibomian gland score for all three groups: 1(0, 1)(P>0.05). In the three groups, the detection rate and quantity of demodex were 42%, 1(1, 2); 39%, 2(1, 2); 33%, 1(1, 2),(P>0.05). Among the patients with corneal staining, 5 were mite positive and 11 were mite negative(P>0.05). Meibomian gland score: 4 eyes were 0 grade, 12 eyes were 1 grade above(P>0.05). Short-term group 6 eyes, long-term group 10 eyes(P>0.05).

CONCLUSION:There was no significant effect on meibomian gland, the detection rate and quantity of demodex in patients wearing OOK lens. Whereas no significant relationship between meibomian gland score/ demodex detection rate and corneal staining.

Abstract:AIM: To investigate the related factors that affect the efficacy of dacryocystorhinostomy performed with a nasal endoscope in the treatment of dacryocystitis.

METHODS:We retrospectively analysed the clinical data and postoperative results of 380 patients with dacryocystitis who were treated by dacryocystorhinostomy with a nasal endoscope in our hospital from July 2015 through April 2019. We observed the functional recovery of the lacrimal bursa, nasal cavity, anastomotic orifice and lacrimal passage and analysed the related factors that may affect the postoperative condition in cases of dacryocystitis.

RESULTS: In this study, 380 patients(413 eyes)with dacryocystitis were followed up for more than 6mo. The curative effect was measured by the function of the lacrimal passage after 6mo. Twenty-seven eyes of 27 cases(6.5%)showed no healing. The results of univariate analysis indicated that the severity of nasal septum deviation, the presence of a small lacrimal sac, repeated probing of the lacrimal passage, laser treatment or catheterization of the lacrimal passage and recurrent dacryocystitis(whether discovered in a routine revisit after the operation or in the early stage of the operation)influenced the curative effect of dacryocystorhinostomy in the patients. The results of Logistic regression analysis showed that the severity of nasal septum deviation, the presence of small lacrimal bursa and regular revisits after the operation were the main risk factors affecting the curative effect of nasal dacryocystitis under a nasal endoscope.

CONCLUSION: Dacryocystorhinostomy with a nasal endoscope is effective in the treatment of dacryocystitis, including difficult cases, and the postoperative cure rate is high. Skilled surgical technique, standard postoperative treatment and good compliance by patients are crucial to the success of the operation.

Abstract:AIM: To explore the correlation between plasma insulin level and refractive development.

METHODS: Collected 293 adolescents aged 11-12 who were examined in our hospital from January to June 2019.According to the refractive power, they were divided into emmetropia group(76 cases), low and moderate myopia group(144 cases), high myopia group(35 cases), and hyperopia group(38 cases). Measure and compare the plasma insulin and related indexes(blood sugar, glycosylated hemoglobin, C-peptide levels)of the four groups of subjects on an empty stomach and 2h after a meal. Person correlation was used to analyze the correlation between plasma insulin and its related indexes and diopter. The receiver operating characteristic(ROC)curve was used to explore the diagnostic value of plasma insulin levels for refractive dysplasia.

RESULTS: The average levels of insulin, blood glucose, glycosylated hemoglobin, and C-peptide in the low and moderate myopia group and the high myopia group on an empty stomach or 2h after a meal were higher than those in the emmetropia group and the hyperopia group. The levels of insulin, blood sugar and glycosylated hemoglobin in the high myopia group were higher than those in the low and moderate myopia group(all P<0.01). Plasma insulin, blood glucose, glycosylated hemoglobin, and C peptide levels were negatively correlated with diopter 2h after a meal(r=-0.691, -0.756, -0.546, -0.311, all P<0.05). The ROC curve showed that the cut-off value of plasma insulin level 2h after meal for identifying refractive errors was 0.367, the maximum area under the curve was 0.708(P<0.001, 95% CI: 0.576-0.840), the sensitivity was 63%, and the specificity was 73.7%.

CONCLUSION: Elevated plasma insulin level may affect refractive development, the higher the level, the higher the degree of myopia. Therefore, regular high-glycemic carbohydrate diets during the growth period may lead to the development of refractive errors and permanent visual impairment.

Abstract:AIM:To investigate the clinical effect of rectus muscle release and recession combined with orbital fat resection on restrictive strabismus of thyroid associated ophthalmopathy.

METHODS: From March 2018 to June 2019, 27 cases of restrictive strabismus with thyroid associated ophthalmopathy were retrospectively analyzed, 34 eyes in total. Under general anesthesia, all patients underwent rectus muscle release and orbital fat resection. The range of orbital fat resection was selected according to the degree of the ophthalmologic process in the subnasal, subtemporal, superior nasal, or superior temporal quadrants.Inferior rectus recession was performed in 25 eyes, medial rectus recession in 5 eyes and superior rectus recession in 4 eyes. According to the degree of exophthalmos, he internal and external fat of inferior nasal, infratemporal, Supranasal or supratemporal quadrant muscles were excised respectively during the operation. According to the preoperative strabismus degree and the degree of contraction of external rectus muscle, the recession amount of rectus operation was designed,and the strength of passive rotation test was estimated intraoperatively. The amount of fat removed during the operation was designed according to the degree of protrusion before operation, and it was designed to remove about 1mL fat and retract the eyeball by 1mm.The postoperative follow-up time was once a week, once a month after 1mo, and irregular follow-up after 3mo. All patients were followed up for more than 6mo.

RESULTS: The amount of fat removed was 2.1-3.4mL, with an average of 2.6mL.The visual(LogMAR)acuity was 0-0.2 in the 1mo after operation, with an average of 0.11±0.16. The visual acuity was 0-0.3 in the 6mo after operation, with an average of 0.12±0.17.There was no significant difference in visual acuity before and after operation(P>0.05). The degree of eyeball protrusion was 13-16mm, with an average of 14.4±0.8mm, and the degree of corrected eyeball protrusion was 2-4mm, with an average of 2.4mm(q=10.737, P<0.01). The degree of eyeball protrusion at 6mo after surgery was 13-15.5mm, with an average of 14.5±0.6mm, showing no significant difference from 1mo after surgery(q=0.624, P=0.173). 1mo after surgery, the strabismus was 2^△-10^△, with an average of 6.7^△±2.3^△, all of which were under correction(q=18.068, P<0.01). Before surgery, all the patients had diplopia at the first sight, and the first diplopia disappeared one month after surgery. All patients showed significant improvement in compensatory head position. The strabismus(undercorrection)of the patients at 6mo after surgery was 0^△-7^△, with an average of 3.4^△±1.2^△, and the difference was statistically significant compared with 1mo after surgery(q=5.385, P=0.015). The patient had no diplopia at the first and lower transitory position. The mean intraocular pressure after surgery(17.12±1.89mmHg)was lower than that before surgery, and the difference between preoperative and postoperative intraocular pressure was statistically significant(q=4.258, P=0.018).The mean intraocular pressure at 6mo after surgery was 17.53±1.67mmHg, with no significant difference from 1mo after surgery(q=0.729, P=0.154).

CONCLUSION: Orbital fat resection can improve the protrusion of the eyeball, but has no significant influence on the surgical design and effect of restrictive strabismus. It is a kind of controllable operation scheme to treat the limited strabismus with exophthalmos of thyroid associated ophthalmopathy with rectus muscle release and recession combined with orbital fat resection.

Abstract:AIM: To observe and analyze the therapeutic effect of fine training combined with virtual reality brain vision training in amblyopic children.

METHODS: Case control study. 232 cases(416 eyes)of amblyopia were diagnosed in Baoding children's Hospital for the first time. They were randomly divided into two groups. Group A was treated with fine training, while group B was treated with fine training combined with visual training. Duration of treatment was 6mo. The patients were followed up for 6mo. Objective to observe the clinical efficacy of amblyopia in children of different ages and degrees.

RESULTS: The total basic cure rate was 35.6%(74/208)in group A and 51.4%(107/208)in group B, which was higher than that in group A(P<0.01). The total effective rate was 80.8%(168/208)in group A, 91.3%(190/208)in group B, which was higher than that in group A(P=0.006). Therapeutic effect of each age group: the basic cure rates of group A were 55.9%(38/68), 34.9%(30/86), 11.1%(6/54)(r_s=-0.76, P<0.01), respectively. The basic cure rates of group B were 70.6%(48/68), 54.6%(47/86), 22.2%(12/54)(r_s=-0.78, P<0.01), respectively. The basic cure rate of group A and group B decreased with age. The effective rates of group A were 100%(68/68), 81.4%(70/86), 55.6%(30/54)(r_s=-0.67, P<0.01), respectively. The effective rates of group B were 100%(68/68), 93.0%(80/86), 77.8%(42/54)(r_s=-0.64, P<0.01), respectively. The efficiencies of A and B groups decreased with age. Therapeutic effect of amblyopia degree groups: the basic cure rates of group A were 63.3%(50/79), 25.0%(22/88)and 4.9%(2/41)(r_s=-0.93, P<0.01), respectively. The basic cure rates of group B were 81.0%(64/79), 44.3%(39/88)and 9.8%(4/41),respectively(r_s=-0.89, P<0.01). The basic cure rate of groups A and B was negatively correlated with the degree of amblyopia. The effective rates of group A were 83.5%(66/79), 79.5%(70/88), 78.0%(32/41)(r_s=0.00, P=12.316), respectively. The effective rates of group B were 91.1%(72/79), 89.8%(79/88), 95.1%(39/41)(r_s=0.00, P=15.603), respectively. There was no significant correlation between amblyopia severity and efficiency in groups A and B.

CONCLUSION: Fine training combined with virtual reality brain vision training is a safe and effective way to treat amblyopia. There is a certain correlation between the clinical efficacy and the age and the degree of amblyopia.

Abstract:Corona virus disease 2019(COVID-19)epidemic caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has broken out with a vengeance, seriously threatening the global public health security. Due to the lack of specific effective drugs, effective and positive protective measures are still the most effective ways to prevent COVID-19. Clinical studies had shown that patients with COVID-19 might develop conjunctivitis symptoms. An animal experiment had also confirmed that the conjunctiva was one of the routes of SARS-CoV-2 transmission. However, current studies have gotten different or even contrary conclusions, and the relationship between SARS-CoV-2 infection and the occurrence of conjunctivitis has not been elucidated. Therefore, this article combines the latest clinical and animal studies to further elaborate the relationship between SARS-CoV-2 conjunctivatransmission and conjunctivitis, and explore the significance of conjunctiva transmission of SARS-CoV-2 protection.

Abstract:AIM:To explore the different forms of persistent pupillary membrane(PPM)treatment.

METHODS:For single filamentous PPM film laser excision. A single thick, reticular or palisade remnant film is applied to both ends of the broken membrane with a laser pulse under the pupil. The membrane-like remnant membrane is made of transparent corneal incision, which is free of residual membrane and lens surface by injecting viscoelastic agent.

RESULTS:The average follow-up time was 3.8a. Pupil area transparent, no residual membrane remains, pupil rounded center, sensitive to light, lens anterior capsule pigment residue 8 eyes, pupils are not round 5 eyes. The intraocular pressure of 33 eyes increased in varying degrees after operation, with a difference of 1.04kPa(4mmHg)before and after treatment and returned to normal after reduced intraocular pressure treatment. No anterior chamber bleeding, lens injury and other complications.

CONCLUSION:For PPM, which has a single filamentous or strip effect on visual function, is treated by laser. Severe membranous or reticular PPM affects the development of visual function in patients. Surgery is an effective method for the treatment of PPM. Early detection, early treatment is conducive to patients to obtain useful vision, for some patients with amblyopia visual function training, or combined with fundus disease treatment to provide favorable conditions.

Abstract:AIM: To investigate the application of rectusmuscle transplantation optimization in the treatment of refractory supraventricular insufficiency in one eye caused by double supraventricular paralysis with inferior rectus restriction and high original vertical strabismus.

METHODS: Retrospective analysis was performed on 6 cases of double superior muscle palsy admitted to our hospital from January 2015 to January 2019. After the failure of conservative treatment, rectus muscle transplantation optimization was adopted to observe the improvement of preoperative and postoperative eye position, vertical strabismus, motor function of upper and lower rotation of paralytic eye, as well as the improvement of pseudo ptosis and compensated head position.

RESULTS: After the restriction was lifted, rectusmuscle transplantation optimization was performed. The original in situ vertical strabismus degree before surgery, one month and six months after surgery were(49.83 ± 6.55)PD,(2.67±2.07)PD, and(1.83±2.40)PD. There was a significant difference in vertical strabismus before and after 1mo and 6mo of operation(P<0.001). There was no significant difference in the comparison of vertical strabismus between 1mo and 6mo of operation(P=0.899). All patients had the orthotopic position in postoperative position, and the paralysis function of the paralyzed eyes improved significantly after the operation; Pseudopterygoptosis in four cases and compensatory head position in two cases before operation were significantly improved after operation.

CONCLUSION: Optimization of rectus muscle transplantation is suitable for unilateral superior rotation deficiency with limitation of inferior rectus, which can effectively improve the superior rotation function of affected eye with stable curative effect.

Abstract:AIM: To investigate the clinical effect of laser-assisted endoscopic dacryocystorhinostomy combined with stent intubation in treatment of chronic dacryocystitis.

METHODS:Totally 30 cases(32 eyes)of chronic dacryocystitis were selected between January 2014 to June 2016, all of them were treated with laser-assisted endoscopic dacryocystorhinostomy combined with mitomycin C and stent intubation. The stent was moved at 6wk after surgery in generally. The clinical effect was observed.

RESULTS: After 6-15mo of follow-up, 28 eyes were cured(88%), 3 eyes were improved(9%), and 1 eye was ineffective(3%). The total effective rate was 97%.

CONCLUSION: Laser-assisted endoscopic dacryocystorhinostomy with stent intubation is effective and safe in the treatment of chronic dacryocystitis.