Abstract:AIM:To observe the effect of combined surgery in cataract patients with pterygium.

METHODS:A prospective single centered study was performed on 22 patients(mean age: 59.05±8.70 years)of concurrent cataract and pterygium(size 2-5 mm in length), who attended the outpatient department during the study period of one year, and the minimum follow up was 3mo-1a for all patients. Mean keratometry(K_mean), mean astigmatism, best corrected visual acuity(LogMAR), preoperatively and 3mo postoperatively had been determined. The corneal curvature, pterygium size and the prediction error(PE)were observed.

RESULTS: The amount of PE was <±0.50 D in 18 patients(81.8%)and ±0.50 D to ±1.00 D in 4 patients(18.2%). None of the patients had PE of >1.00 D. The mean axial length did not change significantly(P=0.77)postoperatively. The mean keratometric reading increased from 42.994±1.536 preoperatively to 43.324±1.479 postoperatively but this was not significant(P=0.105). The corneal astigmatism decreased significantly from 2.09±0.789 D preoperatively to 0.523±0.277 D postoperatively(P<0.05). BCVA(LogMAR)significantly improved from 1.007±0.402 preoperatively to 0.024±0.062 postoperatively(P<0.05). No correlation was found between changes in keratometry and PE(r=-0.29, P=0.19). And, there was no correlation was found between pterygium size and PE(r=0.2997, P=0.17).

CONCLUSION: Combined phacoemulsification+foldable intraocular lens(IOL)implantation and conjuctival autograft(CAG)application was safe and effective procedure.

Abstract:AIM: To evaluate the efficacy and safety of preoperative intravitreal injection of ranibizumab(IVR)and panretinal photocoagulation(PRP)combined with conventional trabeculectomy without drainage device in patients with neovascular glaucoma(NVG).

METHODS: The charts of 27 patients(27 eyes)who presented with NVG in our hospital between August 2015 and November 2018 were reviewed. All eyes were treated using the standard protocol of IVR accompanied by PRP, followed by conventional trabeculectomy without drainage device. The main outcomes were intraocular pressure(IOP)control, change in best-corrected visual acuity(BCVA), and surgical complications.

RESULTS: The postoperative follow-up periods for all patients were at least 18(mean 21.7±4.3)mo. The IOP significantly decreased from 45.7±5.1 mmHg(baseline)to 18.4±3.6 mmHg(last visit), and BCVA(LogMAR)improved from 2.42±0.68(baseline)to 1.77±0.93(last visit). The success rate was higher in eyes with peripheral anterior synechiae(PAS)≤50% than in those with PAS >50% after 3mo postoperatively. The main surgical complications were hyphema(11.1%)and hypotony with a shallow anterior chamber(14.8%)during the early postoperative stage, along with encapsulated bleb(37.0%)during the mid-late postoperative stage. Serious intraoperative or postoperative complications were not observed.

CONCLUSION: IVR and PRP combined with conventional trabeculectomy without drainage device is a safe and effective way in NVG treatment, especially for eyes with PAS ≤50%. Preoperative IVR and PRP appear to improve the success rate.

Abstract:AIM:To report our precaution practices for ocular surgeries under local anesthesia during COVID-19 outbreak and evaluate the respiration situation among the patients with medical face masks under ocular surgeries.

METHODS:Sixty Chinese patients needed eye surgery treatment were recruited and given medical face masks as one of the COVID-19 precaution practices during eye surgery with local anesthesia. Oxygen supplementation and negative pressure drainage were applied to relieve the potential respiratory discomfort, and the respiratory comfort score was evaluated.

RESULTS:Patients with medical face masks experienced mild to moderate respiratory discomfort with an overall mean score of 2.34±0.73. Supplementation of oxygen together with negative pressure drainage relieved this discomfort(overall mean score of 0.15±0.75; P<0.001). There is no gender and operation time difference on respiratory discomfort or discomfort relieve. Failure in negative pressure drainage led to severe respiratory discomfort.

CONCLUSION:Negative pressure drainage could maintain the respiratory circulation in patients with medical face mask under eye surgery with local anesthesia. Application of medical face masks in patients under surgeries is recommended to protect the medical practitioners during the operations within COVID-19 outbreak.

Abstract:AIM:To investigate the protective effects of resveratrol(RSV)on inflammation and oxidative stress damage in human corneal epithelial cells(HCECs).

METHODS: The inflammation of HCECs was induced by Tumor necrosis factor-α(TNF-α), and the experiment was divided into: control group, TNF-α group and RSV+TNF-α group. The oxidative stress response of HCECs was induced by H₂O₂, and they were divided into normal group, H₂O₂ group and RSV+ H₂O₂ group. MTT assay was used to detect the viability of HCECs; RT-qPCR and enzyme-linked immunosorbent assay(ELISA)methods were used to detect the expression of IL-1, IL-6 and IL-8; Immunofluorescence staining and Western blot were used to observe the nuclear translocation of NF-κB p65. 2',7'-dichlorofluorescein diacetate(DCFH-DA)fluorescent probe was applied to detect the level of reactive oxygen species(ROS).

RESULTS:In the inflammatory response of HCECs, RT-qPCR and ELISA showed that the expression levels of IL-1, IL-6 and IL-8 were increased significantly in the TNF-α group compared with the control group, the above indicators were lower after pretreatment of RSV than those in TNF-α group; Immunofluorescence staining and Western blot showed that the nuclear translocation of NF-κB p65 was increased in TNF-α group, while it was inhibited after pretreatment of RSV. In the oxidative stress response of HCECs, the results of MTT and DCFH-DA fluorescent probe staining showed that H₂O₂ significantly decreased the viability of HCECs and increased the production of ROS in HCECs. After pretreatment of RSV, cell viability increased significantly, and RSV inhibited the generation of ROS in HCECs induced by H₂O₂.

CONCLUSION: RSV has an inhibitory effect on inflammation and oxidative stress damage in human corneal epithelial cells, and it has been confirmed that RSV inhibits inflammation by inhibiting the activation of the NF-κB pathway.

Abstract:AIM: To investigate whether long-chain non-coding RNA(lncRNA)KCNQ1OT1 affects the proliferation, apoptosis and oxidative stress of retinal epithelial cells induced by high glucose(HG)through miR-19a-3p/TSHZ3.

METHODS: Cell counting kit 8(CCK-8)was used to detect the cell viability of human retinal epithelial cells ARPE-19 stimulated with 5, 15, 45, 135mmol/L HG. The ARPE-19 cells were divided into NC group, 45mmol/L HG group, si-NC+45mmol/L HG group, si-lncRNA KCNQ1OT1+45mmol/L HG group, miR-NC+45mmol/L HG group, miR-19a-3p mimics+45mmol/L HG group, si-con+45mmol/L HG group, si-TSHZ3+45mmol/L HG group, pcDNA+si-lncRNA KCNQ1OT1+45mmol/L HG group, pcDNA-TSHZ3+si-lncRNA KCNQ1OT1+45mmol/L HG group. CCK-8 was used to detect cell viability, qRT-PCR was used to detect the expressions of lncRNA KCNQ1OT1, miR-19a-3p and TSHZ3 mRNA, Western Blot was used to detect TSHZ3, activation-cysteine-containing aspartate proteolytic enzyme 3(Cleaved-caspase-3), B-cell lymphoma/leukemia-2(Bcl-2)related X protein(Bax)protein expressions, and enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of oxidative stress indicators reactive oxygen species(ROS)and malondialdehyde(MDA). The dual luciferase activity was used to detect the targeted binding between lncRNA KCNQ1OT1 and miR-19a-3p, miR-19a-3p and TSHZ3.

RESULTS: 15, 45, 135mmol/L HG inhibited the survival rate of ARPE-19 cells, and the subsequent select the HG concentration 45mmol/L with a cell survival rate of about 50%. 45mmol/L HG increased the expression levels of lncRNA KCNQ1OT1, TSHZ3 mRNA, TSHZ3 protein, the apoptosis rate, Cleaved-caspase-3 and Bax protein expressions, ROS and MDA levels in ARPE-19 cells, and reduced cell survival rate and the expression level of miR-19a-3p(P<0.05). Low expression of lncRNA KCNQ1OT1, TSHZ3 or high expression of miR-19a-3p improved the survival rate of ARPE-19 cells induced by HG, and reduced apoptosis rate, Cleaved-caspase-3 and Bax protein expressions, ROS and MDA levels(P<0.05). lncRNA KCNQ1OT1 targeted miR-19a-3p, miR-19a-3p targeted TSHZ3, and lncRNA KCNQ1OT13 regulated the expression of TSHZ3 through miR-19a-3p. The effect of lncRNA KCNQ1OT1 low expression on the survival rate, apoptosis and oxidative stress of ARPE-19 cells induced by HG was reversed by the overexpression of TSHZ3.

CONCLUSION: The low expression of lncRNA KCNQ1OT13 promotes the proliferation of retinal epithelial cells induced by high glucose, and inhibits their apoptosis and oxidative stress through miR-19a-3p/TSHZ3.

Abstract:AIM: To investigate the effect of modified Zhujing pill on retinal thickness and apoptosis in form deprivation myopia(FDM)mice.

METHODS: Totally 72 C57BL/6J mice aged 3-week-old were randomly divided into control group 1, model group 1, intervention group 1, control group 2, model group 2 and intervention group 2, with 12 mice in each group. The first three groups were tested for 3wk and the last three groups were tested for 6wk, except for the groups of control 1 and control 2, all the mice used translucent goggles to cover their right eyes for form deprivation. The mice of intervention 1 and intervention 2 were respectively given intragastric administration modified Zhujing pill suspension 0.546g/(kg·d)(0.1mL/d)for 3wk at the beginning and after 3wk of the experiment. Same amount of saline was given to mice in other groups at the same time of modeling. The eye axis was measured before and after the experiment. At the end of the experiment, the eye of mice was taken for HE staining to observe the thickness changes of each layer of retina. Immunohistochemistry(IHC)and western blotting(WB)were used to detect Bcl-2 and Caspase3 expression of protein.

RESULTS: At the end of the experiment, the axis of model group 1 was significantly higher than that of control group 1(P<0.01), the axis of intervention group 1 was significantly lower than that of model group 1(P<0.01), and the axis of model group 2 was significantly higher than that of control group 2(P<0.01), the eye axis of intervention group 2 was significantly lower than that of model group 2(P<0.01); HE staining showed that the thickness of NFL and ONL of model group 1 was significantly thinner than that of control group 1(P<0.01). The thickness of INL of model group 1 was significantly thinner than that of control group 1(P<0.05), and the thickness of NFL, INL and ONL of intervention group 1 was significantly higher than that of model group 1(P<0.05); The thickness of NFL, INL and ONL model group 2 was significantly thinner than that of control group 1(P<0.01); IHC testing showed that the average optical density of Bcl-2 protein in model group 1 was significantly lower than that of control group 1(P<0.05), which in intervention group 1 was significantly higher than that of model group 1(P<0.01), and which in the average optical density of Bcl-2 protein of model group 2 was significantly lower than that of control group 2(P<0.01), which in intervention group 2 was significantly higher than that of model group 2(P<0.01); Caspase 3 protein average optical density of model group 1 was significantly higher than that of control group 1(P<0.01), which in intervention group 1 was significantly lower than that of model group 1(P<0.01), which in model group 2 was significantly higher than that of control group 2(P<0.05), which in intervention group 2 was significantly lower than that of model group 2(P<0.01); WB test proved that the relative expression level of Bcl-2 protein in model group 1 was significantly lower than that of control group 1(P<0.01), which in intervention group 1 was significantly higher than that of model group 1(P<0.01), and which in model group 2 was significantly lower than that of control group 2(P<0.01), which in intervention group 2 was significantly higher than that of model group 2(P<0.01); The relative expression level of Caspase3 protein in model group 1 was significantly higher than that of control group 1(P<0.01), which in intervention group 1 was significantly lower than that of model group 1(P<0.01), the intervention group 2 was significantly lower than that of model group 2.

CONCLUSION: The results show that the modified Zhujing pill can interfere with the pathological changes of retinal thickness thinning in the process of myopia and formed myopia mice by regulating the expression of apoptosis-related proteins Bcl-2 and Caspase3, and alleviating the apoptosis of retinal cells in myopia formation and myopia mice.

Abstract:AIM: To investigate the characteristics of corneal stiffness parameters at the first applanation(SP-A1)in keratoconus patients among different age groups and severity classification groups.

METHODS: A cross-sectional study. Three hundred and forty-five eyes of 247 consecutive keratoconus patients diagnosed in Henan Eye Hospital were enrolled during September 2018 to December 2020. The mean age was(24.51±6.38)years. According to age, the subjects were divided into ≤20 years group, 21-30 years group and ≥31 years group. The severity of keratoconus was divided into AK1, AK2, AK3 and AK4 by Amsler krumeich(AK)classification method. The visual acuity, corneal flat curvature(K1), corneal steep curvature(K2), average corneal curvature(Km)and the thinnest corneal thickness(TCT)were measured. The SP-A1, intraocular pressure(IOP), deformation amplitude max(DA Max), velocity at the first applanation(A1V), time at the first applanation(A1T), time at the second applanation(A2T), velocity at the second applanation(A2V), biomechanical corrected IOP(bIOP), and Radius were measured by Corneal Visualization Scheimpflug Technology(Corvis ST). The correlation between SP-A1 and other parameters were analyzed by Spearman rank correlation, and one-way ANOVA was used to analyze the difference of SP-A1 among different age groups or disease severity groups.

RESULTS: No statistically differences of gender, visual acuity, IOP, K1, K2, Km, TCT and disease severity classification were found among different age groups(P>0.05). The SP-A1 was positively related to age(r_s=0.137, P=0.011). The SP-A1 of keratoconus patients in the ≥31 years group was significantly higher than that in the ≤20 years group and 21-30 years group(P<0.05). SP-A1 was negatively correlated with K1, K2 and Km in patients in the ≤20 years group and 21-30 years group, while SP-A1 was negatively correlated with K2 in patients in the ≥31 years group(P<0.05). In addition, SP-A1 was negatively correlated with DA Max, A1V and A2T, and positively correlated with TCT, IOP, bIOP, A1T, A2V and Radius. With the increase of disease severity, the SP-A1 values gradually decreased in patients in the ≤20 years group and 21-30 years group(P<0.05). The values of SP-A1 between AK1 and AK4, AK2 and AK3, AK2 and AK4 were statistically different(P=0.008, 0.035, 0.001).

CONCLUSION: The value of SP-A1 in keratoconus was positively correlated with age. In patients less than 30 years old, the SP-A1 decreased with the increase of disease severity.

Abstract:AIM: To analyze the effects of vitrectomy and macular epiretinal membrane dissection combined with or without internal limiting membrane(ILM)peeling on choroid thickness, vision and metamorphopsia in patients with idiopathic macular epiretinal membrane(IMEM).

METHODS: Totally 88 patients(88 eyes)with IMEM admitted to the hospital were selected between January 2016 and January 2020. They were divided into group A and group B by random number table method with 44 eyes in each group. Patients in group A were treated with vitrectomy and macular epiretinal membrane dissection combined with ILM peeling, while patients in group B were treated with vitrectomy and macular epiretinal membrane dissection. The choroid thickness, vision, metamorphopsia, central macular thickness(CMT), ellipsoid zone(EZ)continuity were compared between the two groups.

RESULTS: Compared with preoperative, the sub-foveal choroidal thickness(SFCT), choroidal thickness 1 000μm from nasal side central of fovea(NFCT)and choroidal thickness 1 000μm from temporal side central of fovea(TFCT)were significantly reduced in the two groups at 3mo and 6mo after operation(P<0.05), but there was no statistically significant difference between the groups(P>0.5). Compared with preoperative, the best corrected visual acuity(BCVA)LogMAR was reduced, while mean sensitivity(MS)was increased in the two groups. The number of scotoma points(SP)increased in group A and decreased in group B. Group A had significantly lower MS and higher SP than group B at 1mo, 3mo, and 6mo after operation(P<0.05). Compared with preoperative, the M scores(Angle of view when horizontal and vertical variability begins to disappear)and average M scores of the two groups were significantly reduced at 3mo and 6mo after operation, without statistically significant differences between the groups(P>0.05). Compared with preoperative, CMT was significantly reduced in the two groups at 1, 3 and 6mo after operation. The ratio of EZ continuity in group A at 1mo after operation was significantly lower than that before operation. The CMT of group A was larger than that of group B at 3mo and 6mo after operation(P<0.05). No statistically significant differences were found in the ratio of EZ continuity and the incidence of complications between the groups(P>0.05).

CONCLUSION: Vitrectomy and macular epiretinal membrane dissection combined with or without ILM peeling both can improve vision and metamorphopsia in patients with IMEM, with similar effects on choroid thickness and safety. However, combined use of ILM peeling will lower MS and increase SP as well as CMT. Therefore, it has no significant advantages in the treatment of patients with IMEM.

Abstract:Innate immunity plays an important role in viral keratitis. Recently, it has been found that surfactant proteins(SP)A and D in the innate immune system are essential in viral keratitis. SP can inhibit virus adhesion to host cells and further promote phagocytosis of virus through high affinity for virus ligands. In order to ensure the normal function of tissues in the early stage of virus infection, SP regulates immune cells to maintain a non-inflammatory state. However, when pathogen invasion increases, SP promoted inflammation and increased the immune cells to kill the pathogens. SP-A and SP-D could be expressed in cornea, conjunctiva. To play the role of anti-adenovirus, herpes simplex virus, cytomegalovirus and other major eye pathogenic viruses, SP-A and SP-D combine with the virus to prevent entry into cells, promote phagocytosis, and directly kill the virus. SP-A and SP-D may be used as clinical diagnostic tools for viral infection. In the future, recombinant SP is expected to be used as an important means for the treatment of viral keratitis. Here, we review the innate immune function of SP-A and SP-D in ocular viral infection.

Abstract:Since first proposed by O'Malley in 1972, the revolutionary vitrectomy has brought ophthalmic surgery into a new era, bringing hope to countless patients with vitreoretinal diseases. With the development of surgical techniques, increased safety and effectiveness, and expanded surgical indications, vitrectomy has become the most common surgical treatment for various posterior segment diseases. Though there is a trend of decreasing in postoperative complications, the occurrence and progression of cataract remains the most common complication after vitrectomy. As cataract would compromise the postoperative vision and fundus observation, cataract extraction surgery is always inevitable, which seriously increases the burden of patients. The pathogenesis of cataract is till inconclusive. There are currently many hypotheses including increased oxygen partial pressure around the lens, destruction of the vitreous structure, and phototoxicity. This article reviews the incidence, mechanism and influencing factors of cataract occurrence or progression after vitrectomy, aiming to provide more evidence for further investigation of pathogenesis, prevention and treatment for post-vitrectomy cataract.

Abstract:Currently, the early diagnosis of glaucoma and monitoring of disease progression is difficult and requires assessment of structural(fundus photo/ optical coherence tomography scan)and functional damage(visual fields)of the optic nerve head(ONH). It requires the clinical knowledge of glaucoma experts and is highly labor intensive. Artificial intelligence(AI)applications have been proposed to improve the understanding of glaucoma and help to reduce the time and manpower required for such clinical tasks. With the advent of deep learning(DL), many tools for ophthalmological image enhancement, segmentation and classification have also emerged. Especially in the last three years, a large number of algorithms suitable for analyzing the ONH structure and/or function, which have been proposed to help in glaucoma detection. AI tools have also been developed to predict the early progression of the disease. Bring the possibility of personalized precision treatment. However, these algorithms are yet to be tested in the real world. This review summarizes the diverse landscape of AI algorithms developed for glaucoma. We also discuss the current limitations and challenges that we need to overcome.

Abstract:Amblyopia is a common eye disease in children. If not corrected and treated in time, it will cause irreversible damage to children's vision, resulting in loss of vision in one or both eyes. The pathogenesis of amblyopia is complex, and the specific pathogenesis is not clear at present, mainly focusing on the central theory and peripheral theory. Traditionally, there was no obvious organic change in the fundus of amblyopia patients. In recent years, optical coherence tomography(OCT)technology has developed rapidly. As a convenient and intuitive ophthalmic examination method, OCT has been increasingly used in retinal examination of amblyopia patients due to its advantages of safety, non-invasive, non-contact and rapid and clear. The abnormal anatomy structures of the amblyopia patients in fundus structure are also gradually been found. Providing some evidence and basis for peripheral theory of pathogenesis of amblyopia, amblyopia examine, postoperative evaluation and prognosis. In this article, the applications of OCT in retinal thickness, choroid thickness and vessel density are reviewed.

Abstract:In recent years, metagenomics(MGS)is the fastest growing fields in microbiology, and has been broadly applied in the detection of pathogenic microorganisms. Comparing with the traditional poly merase chain reaction(PCR)-based detecting technology which relies on microbial culture, MGS can directly detect the sequences of the total microbial DNA from uncultured samples with the high-throughput sequencing platform. It can help the doctors identify the involved pathogens more quickly and provide better medication guidance. Among the known ophthalmic diseases, a lot of them are caused by the infection of pathogens and have many difficulties in clinical diagnosis and treatment. The development of metagenomics provides us a more effective and reliable way for detecting the pathogens of ophthalmic diseases. This article was aimed to review the development of MGS, applications and in the field of ophthalmology, as well as its current deficiencies and the possible development directions in the future.

Abstract:The thickness of the central cornea has an important influence on various eye diseases and operations such as keratoconus and other corneal diseases, glaucoma, and corneal refractive surgery. Obtaining accurate central corneal thickness is a topic that clinicians have been paying close attention to. It decides the operation method and operation parameters(cutting depth, cutting optical area size, etc.)of refractive surgery. Accurate measurement of central corneal thickness is a great concern to clinicians. At present, there are two kinds of measurement of corneal thickness: the first is ultrasonic measurement, such as traditional Type A ultrasonic corneal thickness meter and ultrasonic biological microscope; the second is optical measurement, including Pentacam, corneal endokeratoscope, optical coherence tomography, etc. Different measuring methods and instruments have their own advantages and disadvantages. However, the ultimate goal of developing corneal thickness measurement is easy operation and good repeatability. Therefore, based on the summarization of current clinically-used corneal thickness measurement instruments and of research progress of corneal thickness measurement, this paper aims at providing theoretical guide for clinical oculists.

Abstract:In recent years, with the extensive development of phacoemulsification and the gradual application of femtosecond laser technology in the field of cataract surgery, femtosecond laser-assisted cataract surgery(FLACS)has become popular year by year, and has been recognized and promoted by more and more doctors. Femtosecond laser technology has high accuracy, automation and repeatability, so it is quite suitable for cataract surgery characterized by precision operation, it can be used in cataract surgery for corneal incision and limbal incision, anterior capsule incision, lens fragmentation and other key operations. FLACS has broad application prospects and can greatly improve the predictability and safety of surgery. The emergence of FLACS is one of the most important developments in modern cataract surgery. With the continuous development of FLACS, cataract surgery will usher in new technological innovations. However, FLACS are relatively new, and longer term, more comprehensive data are still needed to better demonstrate their effectiveness in the future. We review the current research progress of FLACS.

Abstract:Proliferative vitreoretinopathy(PVR)is a serious complication arisen from ocular trauma, diabetic retinopathy, vascular retinopathy, inflammatory retinopathy and other ocular diseases. It is also the most important reason for the failure of rhegmatogenous retinal detachment surgery, which is a great threat of visual function. A large number of studies have proved that the main risk factor for PVR is the damage of blood-retinal barrier, in which retinal pigment epithelial(RPE)cells are stimulated by cytokines in the vitreous cavity. RPE cells underwent epithelial-mesenchymal transition(EMT), which transformed into fibroblasts. The cell morphology changed, the tight junctions between cells disappeared, the cell polarity lost, and the proliferation, migration, and invasion abilities were enhanced. A contractile fibrous proliferative membrane is formed on the anterior surface or under the retina. The fibrous proliferative membrane will lead to the retina folds, pull the retina and lead to retinal detachment, which will eventually lead to vision loss or even blindness. Nowadays, plenty of studies investigating the prevention and treatment of PVR have been carried out at home and abroad. In this review, we briefly illustrated the signaling pathways related to epithelial-mesenchymal transformation in RPE cells and the treatment of PVR.

Abstract:Scleral lenses(SL)are large diameter rigidgas permeable contact lenses with vault cornea and limbus and used for daytime wear. In recent years, the study of SL has been gradually deepened, and SL are becoming increasingly used for the ophthalmology clinical practice. Compared with corneal rigid gas permeable contact lenses, SL rest on the sclera and form a fluid reservoir between the posterior surface of the lens and the anterior surface of the cornea, creating an ideal eye surface environment and with the advantages of non-contact cornea and corneal limbus, protecting cornea, correcting corneal irregular astigmatism, reducing high-order aberrations, delaying or avoiding part of ophthalmic-related surgical, correcting visual acuity of patients with irregular cornea, wide range of application, good stability and comfortable wearing. With the improvement of material, lens design technology, fitting techniques and ophthalmic imaging technology, the clinical application of SL is gradually increasing. This review will give a brief introduction of the historical development, indication, fitting and complications of SL.

Abstract:AIM: To assess and compare the effectiveness of selective laser trabeculoplasty(SLT)in preventing primary open angle glaucoma(POAG)with various stages.

METHODS: Fifty-one eyes of 27 patients 51 eye with POAG were included in this retrospective study. All the cases were divided into three groups depending on the mean deviation(MD): the early stage group(MD>-6dB, 15 eyes), middle stage group(-12dB≤MD≤-6dB, 15 eyes)and late stage group(MD<-12dB, 21 eyes). All subjects underwent SLT on 360° of the angle between July 2018 to March 2020. The laser parameters of a 532nm, Q-switched, frequency-doubled Nd: YAG laser, with 3ns pulse time, 400μm spot diameter were set to selectively target pigmented trabecular meshwork cells without visible damage to the adjacent non-pigmented tissue. Intraocular pressure(IOP)reduction was observed at 1h, 1d, 1, 3, 6 and 12mo after the laser procedure. Meanwhile, the ratio of the IOP reduction, visual field index(VFI), MD, medication, adverse reactions and efficiency were assessed as well.

RESULTS: Within the 12mo post-SLT, there were no statistically significant differences for the IOP and IOP decline rate between each group(all P>0.05). There were significant differences in VFI and MD among early, middle and late groups(P<0.001), within the 12mo post-SLT, no statistically significant differences were detected for the decline of VFI and MD in each group. In terms of the early stage group, the effective rates of SLT at 1, 3, 6 and 12mo after treatment were 100%, 93%, 87%, 67%, respectively. For the middle stage group and late stage group, the effective rates were 87%, 80%, 93%, 60%, and 67%, 71%, 62%, 19%, respectively.

CONCLUSION: SLT was an effective treatment for POAG patients in various stages, while the effective rate decreased with time.

Abstract:AIM: To compare binocular visual quality of bilateral implantation of a toric bifocal intraocular lens(IOL)or a nontoric bifocal IOL and mix-and-match implantation of a toric bifocal IOL and a nontoric bifocal IOL.

METHODS: A cross-sectional study. One hundred and eight eyes of 54 cases were included from January 2020 to January 2021. All participants were divided into three groups according to preexist corneal astigmatism and IOL type. In group A, cornea astigmatism was less than 1.0D in both eyes of 21 cases and bifocal IOLs were implanted. In group B, cornea astigmatism was more than 1.0D in both eyes of 15 cases and toric bifocal IOLs were implanted. In group C, 18 cases of one eye with cornea astigmatism less than 1.0D were implanted with bifocal IOLs, and the other eye with astigmatism more than 1.0D were implanted with toric bifocal IOLs. Preoperative intraocular pressure(IOP), monocular uncorrected distance visual acuity(UDVA), equivalent spherical, postoperative binocular corrected distance visual acuity(CDVA), UDVA, uncorrected intermediate visual acuity(UIVA), uncorrected near visual acuity(UNVA), residual astigmatism, defocus curve and contrast sensitivity were compared among the three groups. Postoperative questionnaire was conducted to evaluate the visual quality of the three groups.

RESULTS: There were no significant differences in preoperative UDVA and IOP among the three groups(P>0.05). The postoperative residual astigmatism in group A was significantly higher than the other two groups(P=0.012, P<0.05). Binocular UDVA of group B and group C were better than those of group A(all P<0.05), binocular UNVA of group B and group C were better than those of group A(all P<0.01), but the binocular UIVA of group A was better than that of group B and group C(all P<0.01). Contrast sensitivity of group A was significantly lower than that of groups B and C in bright light glare of 6, 12c/d, dark light of 6, 12, 18c/d and dark light glare of 1.5, 3, 6, 12, 18c/d(all P<0.05). There was no statistical difference in the postoperative visual function questionnaire among the three groups(P>0.5).

CONCLUSION: Mix-and-match implantation of a toric bifocal IOL and nontoric bifocal IOL can effectively improve postoperative binocular visual quality in cataract patients. Correcting astigmatism helps improve the visual contrast sensitivity, however, when astigmatism is completely corrected, it may result in a loss of intermediate vision in patients after surgery.

Abstract:AIM: To observe the early visual quality of the tri-focal and the mono-focal intraocular lens(IOLs)implantation in patients with age-related cataract, under comparison and analysis.

METHODS: A retrospective research design. Totally 168 eyes of 119 age-related cataract patients who underwent cataract phacoemulsification combined with tri-focal and mono-focal IOLs implantation surgery in the cataract department from June 2018 to January 2021 were enrolled. In tri-focal and mono-focal group, 61 eyes of 44 cases and 107 eyes of 75 cases. One month after phacoemulsification combined with IOLs implantation, visual acuity, visual quality and contrast sensitivity were inspected. All data were under statistical analysis.

RESULTS: On LogMAR uncorrected distance visual acuity(UDVA),uncorrected intermediate visual acuity(UIVA), uncorrected near visual acuity(UNVA), best corrected distance visual acuity(BDVA), distance corrected intermediate visual acuity(DIVA), distance corrected near visual acuity(DNVA), tri-focal group were extremely better than mono-focal group(all P<0.001). In terms of visual quality, the scores of modulation transfer function(MTF)cut-off frequency, optical scatter index(OSI), Strehl ratio(SR), tri-focal group were significantly higher than mono-focal group(all P<0.05). On 18 cycle/degree(cpd)spatial frequency under dark and light adaptation conditions, contrast sensitivity scores of the mono-focal group was significantly better than those of the tri-focal group(P<0.001). Based on the questionnaire with the VF/QOF scale, the daily life experience scores and off-glass index, the tri-focal group was significantly better than that of the mono-focal group(P<0.05), and incidence of glare was no significant difference between the two groups(P>0.05).

CONCLUSION: Tri-focal IOLs can provide a full range of relatively better vision and visual quality in patients after age-related cataract phacoemulsification combined with IOLs implantation, and perform well under different conditions.

Abstract:AIM: To compare the curative effect of retropupillary iris claw intraocular lens(IOL)implantation and posterior chamber ciliary scleral suture fixed IOL in the aphakic eyes without capsular support.

METHODS: The present retrospective study included 70 aphakic eyes without capsular support. According to the different surgical methods, the patients were divided into two groups, including group A(35 eyes)with treatment of retropupillary iris claw IOL implantation, group B(35 eyes)with treatment of posterior chamber ciliary scleral suture fixed IOL. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure(IOP)and corneal endothelial cell density(CECD)of the two groups were documented and compared before operation and 3d, 1, 3, 6mo and 1a after operation. Furthermore, the stability of IOL in both groups, as well as the intraoperative and postoperative complications were recorded.

RESULTS: The patients in the present study were followed up for 12 to 14mo. 3d after surgery, UCVA in group A was significantly improved compared with that before surgery(P<0.01), while BCVA had no difference compared with that before surgery(P=0.073).UCVA in group B showed no difference(P=0.097), while BCVA was worse(P=0.002). UCVA and BCVA in both groups were significantly elevated 1mo after surgery(P<0.05), and remained stable 6, 3mo later,respectively. Furthermore, IOP in both groups remained in normal level during the follow up period, 0.7% and 2.3% reduction of CECD in A group and B gruop was observed at 1a after operation respectively(P<0.05). Both IOP and CECD between the two groups have no significant differenc at each time point during the follow up period(P>0.05).There was no significant difference between whole eye astigmatism and corneal astigmatism in A group and B gruop at 1 and 6mo after operation(P>0.05). Additionally, There was 1 case of IOL dislocation in each group after operation, which was further recovered by operation. Significant tilt and deviation of IOL were not observed in the rest of the patients during the follow up period. The other postoperative complications were mild with no difference in complications between the two groups(P>0.05).

CONCLUSION: For aphakic eyes without capsular support, both retropupillary iris claw IOL implantation and posterior chamber ciliary scleral suture fixed IOL are safe and effective surgical methods. Retropupillary iris claw IOL implantation has relatively simple operation, lower damage to the eyeball tissue, the shorter operation time, and the quicker recovery of postoperative visual acuity, which is one of the effective clinical treatments.

Abstract:AIM:To analyze the effects of corneal surface morphology and tear-film with different incisions guided by corneal topography after phacoemulsification.

METHODS: Retrospective study. Totally 56 patients(60 eyes)were selected and divided into clear corneal incision group and angle scleral margin incision group who were treated by phacoemulsification in our hospital from June 2019 to December 2020. Best corrected visual acuity(BCVA), ocular surface disease index(OSDI)questionnaire, tear film break-up time(TBUT), corneal surface regularity index(SRI), corneal surface asymmetry index(SAI)and corneal surface astigmatism(CYL)were measured preoperatively and postoperatively, the results were statistically analyzed.

RESULTS: BCVA in both groups increased after operation(P<0.01). The OSDI score of the two groups increased significantly after surgery(P<0.01). TBUT was shortened to varying degrees after surgery(P<0.05). SAI and SRI increased to varying degrees in both groups after surgery, and SAI value of angle scleral margin incision group in 1wk and 1mo postoperatively was significantly lower than that in clear corneal incision group(P<0.05). The corneal astigmatism at 1wk postoperatively was significant increased in both groups(P<0.05). The astigmatism increase of clear corneal incision group at 3mo postoperatively was still higher than that before surgery.

CONCLUSION: Angle scleral margin incision has less effect on stability of tear film and corneal surface morphology, which is reliable on phacoemulsification.

Abstract:AIM: To investigate the curative effect of microincision phacoemulsification and ultra-thin artificial lens implantation combined with trabeculectomy in the treatment of age-related cataract complicated with acute primary angle-closure glaucoma(PACG).

METHODS: Totally 85 elderly cataract patients(85 eyes)with acute PACG admitted between January 2017 and July 2020 were enrolled. According to the operation method, they were divided into study group(46 cases, 46 eyes)and control group(39 cases, 39 eyes). The control group was treated with 1.8mm microincision phacoemulsification and ultra-thin artificial lens implantation, while the study group was treated with trabeculectomy on the basis of the treatment of control group. The best corrected visual acuity(BCVA), intraocular pressure, anterior chamber angle width classification, corneal endothelial cell count and surgical complications of the two groups were compared.

RESULTS: Compared with the same group before operation, the BCVA(LogMAR)of the two groups was significantly reduced at 1, 3 and 6mo after operation(all P<0.05), and the study group had lower LogMAR BCVA than the control group(all P<0.05). At 1, 3 and 6mo after operation, intraocular pressure of the two groups was significantly reduced(P<0.05), and the study group had lower intraocular pressure than the control group(P<0.05). Meanwhile, the proportion of anterior chamber angle width grade NⅠwas increased, and the proportion of grade N Ⅳ was reduced in the two groups(P<0.05). The proportion of grade NⅠwas higher in the study group than in the control group(P<0.05). No significant differences were found between the two groups in terms of corneal endothelial cell count(P>0.05)and the incidence of complications(28% vs 26%; P>0.05).

CONCLUSION: For patients with senile cataract complicated with acute PACG, trabeculectomy based on microincision phacoemulsification and ultra-thin artificial lens implantation can significantly lower intraocular pressure, relieve glaucoma, and reduce visual impairment, with little damage to corneal endothelial cells and few complications. Besides, the clinical effect is marked.

Abstract:AIM: To observe the therapeutic efficacy of intravitreal injection of conbercept for macular edema in different types of retinal vein occlusion(RVO).

METHODS: Retrospective cohort study of 79 patients 79 eyes in different types of RVO(BRVO:54; non-ischemic CRVO: 16; ischemic CRVO: 9)received intravitreal injection of conbercept. After 3mo injection of conbercept(IVIC), a pro re nata(PRN)strategy was adopted. The best-corrected visual acuity(BCVA,LogMAR)and central macular thickness(CMT)were recorded at baseline and at 1d, 1, 2, 3, 4, 5, 6mo post-treatment.

RESULTS: At 6mo, in different types of RVO, the BCVA were improved significantly than baseline(0.22±0.23 vs 0.70±0.32; 0.24±0.19 vs 0.73±0.27; 1.20±0.37 vs 1.92±0.23; all P<0.05). CMT were decreased significantly than baseline(199±27 vs 422±162μm; 195±16 vs 550±158μm; 231±55 vs 583±152μm; all P<0.05). In three different treatment time groups, CMT in different types of RVO were decresed than the baselineat different time points after treatment(P<0.05), and there was no difference between groups(P>0.05). In three different treatment time groups, BCVA in BRVO and non-iCRVO were improved than the baseline in three groups(P<0.05), but in iCRVO there were little improved in >90d group.

CONCLUSION: Intravitreal injection of conbercept can effectively treat macular edema caused by RVO. Early and timely treatment of anti-VEGF may help improve and maintain the stability of long-term vision, and delayed anti-VEGF treatment may reduce the space for the improving vision.

Abstract:AIM: To study the clinical effects and safety of iontophoresis of xueshuantong injection combined with anti-vascular endothelial growth factor(VEGF)in the treatment of retinal vein occlusion(RVO)with macular edema(ME).

METHODS: Totally 106 patients(106 eyes)with RVO and ME in the hospital between June 2017 and June 2019 were divided into observation group and control group according to the random number table method with 53 cases(53 eyes)in each group, and they were all given intravitreal injection of conbercept, and observation group was additionally given iontophoresis of Xueshuantong injection for intervention, and they were treated for 3mo. Both groups were followed up for 1a and given supplementary therapy according to the condition of the disease. The best corrected visual acuity(BCVA), central retinal thickness(CRT)in macular area, supplementary therapy status, VEGF level in aqueous humor and adverse drug reactions were observed and compared between the two groups before and after treatment.

RESULTS: After treatment, the BCVA of the two groups was significantly improved(P<0.05)while the CRT in macular area was significantly thinned(P<0.05), and the BCVA on the 3, 6 and 12mo of treatment in observation group was better than that in control group while the CRT was thinner than that in control group(P<0.05). The macular volume and VEGF level in aqueous humor were significantly reduced in the two groups after treatment(P<0.05), and the macular volume and VEGF level on the 1, 3, 6 and 12mo of treatment in observation group were lower than those in control group(P<0.05). The injection frequencies of conbercept and triamcinolone acetonide and the proportion of patients with laser photocoagulation in observation group were lower than those in control group(P<0.05). During treatment, there was 1 eye of intraocular pressure increase and 3 eyes of subconjunctival hemorrhage in observation group, and there were 2 eyes of subconjunctival hemorrhage and 1 eye of endophthalmitis in control group(P>0.05).

CONCLUSION: Xueshuantong iontophoresis combined with intravitreal injection of conbercept for RVO with ME can effectively inhibit the expression of VEGF, reduce the ME and improve the visual acuity of the affected eyes. The efficacy and safety are worthy of recognition.

Abstract:AIM: To observe the curative effect of pterygium resection and autologous limbal stem cell transplantation(LSCT)combined with amniotic membrane transplantation(AMT)in the treatment of pterygium.

METHODS: Totally 177 patients(187 eyes)with pterygium treated in ophthalmology clinic of the hospital between January 2017 and January 2020 were selected and randomly divided into group A(59 cases, 64 eyes), group B(59 cases, 60 eyes), and group C(59 cases, 63 eyes). All were treated with pterygium resection. On this basis, patients in the three groups were treated with autologous LSCT, AMT, and autologous LSCT combined with AMT, respectively. All subjects were followed up for 12mo after surgery. Visual acuity, corneal epithelial repair, and neovascularization of the three groups were comparatively analyzed. Postoperative recurrence rate, ocular symptoms, complications, and survival of grafts were statistically analyzed.

RESULTS: Visual acuity changes and repair time of corneal epithelial defect showed no statistically significant difference among the three groups(P>0.05). 1mo after surgery, the corneal fluorescein staining(FL)value of group C was significantly lower than that of group A or group B(all P<0.05). No angiogenesis or recurrent true pterygium was observed. 6mo and 12mo after surgery, the grades of conjunctival fibroplasia in group A and group C were significantly different from that in group B(P<0.05). There was no statistically significant difference in the wet length of the filter paper in Schirmer I test in terms of time, inter-group and interaction effects(P>0.05). 1mo after surgery, the tear film breakup time(BUT)of group C was significantly longer than that of group A or group B(all P<0.05). There were different degrees of conjunctival edema in the three groups after surgery, which disappeared within 2wk after suture removal. Grafts all survived, vascularization of amniotic membrane grafts ended.

CONCLUSION:Autologous LSCT, AMT and autologous LSCT combined with AMT all are effective in the treatment of pterygium. However, autologous LSCT combined with AMT can achieve better short-term effect, with milder conjunctival fibroplasia and dry eye symptoms.

Abstract:AIM: To compare the change of refractive power and corneal high-order aberrations after femtosecond laser-assisted excimer laser in situ keratomileusis(FS-LASIK)and FS-LASIK combined with accelerated corneal cross-linking(FS-LASIK Xtra)for high myopia correction, and to evaluate the early effects of two surgical methods to correct high myopia.

METHODS:Retrospective case-control study. Totally 42 patients(84 eyes)with high myopia underwent FS-LASIK Xtra and FS-LASIK in our hospital from April 2019 to April 2020 were followed up for 3mo, including 21 patients in each group(42 eyes). The uncorrected visual acuity(UCVA), spherical equivalent(SE), astigmatism and corneal high-order aberration of the two groups were analyzed and compared.

RESULTS: The UCVA of the FS-LASIK Xtra group was significantly lower than that of the FS-LASIK group at 1d after surgery(P<0.01), there was no statistical difference in UCVA at the other time points after surgery between the two groups(P>0.05). The postoperative SE of the two groups was significantly lower than that before surgery, at 3mo after surgery, 38 eyes(90%)in the FS-LASIK Xtra group and 41 eyes(98%)in the FS-LASIK group had SE within ±1.00D. In both groups, 35 eyes(83%)had residual astigmatism within 0.50D after surgery. The total corneal high-order aberrations, spherical aberrations, coma and clover aberrations in the two groups were increased at 3mo after surgery, the total high-order aberration and clover aberration in the FS-LASIK Xtra group were greater than those in the FS-LASIK group(all P<0.05).

CONCLUSION:FS-LASIK and FS-LASIK Xtra have good effectiveness and predictability in correcting high myopia in the early postoperative period, the total high-order aberrations of the cornea both increased in the early postoperative period, and the patients who underwent FS-LASIK Xtra were increased significantly.

Abstract:AIM: To evaluate the refractive errors after phacoemulsification combined with intraocular lens(IOL)implantation in previously vitrectomized eyes.

METHODS: Thirty-eight patients(40 eyes)with cataract who had undergone vitrectomy were divided into two groups: vitrectomy alone as group A(22 eyes), vitrectomy combined with inert gas(C₃F₈)tamponade as group B(18 eyes). In addition, normal eyes(20 eyes)without vitrectomy history who required cataract surgery were included as a control group C. Axial length(AL), keratometric value(K), anterior chamber depth(ACD), and white-to-white(W-W)were measured with IOL Master 500 before the surgery. The power of IOL was calculated with the online Barrett Universal Ⅱ formula. Phacoemulsification combined with IOL implantation by an iris hook assistance technique was used to treat groups A and B, group C was treated only with phacoemulsification and IOL implantation. There were no complications, such as posterior capsule rupture. The postoperative refraction was obtained three months after surgery. The prediction error(PE), absolute prediction error(AE), and median absolute error(MedAE)among the three groups were compared.

RESULTS: There was no significant difference among the three groups in AL, K value, and IOL power. A significantly deep ACD was noted in groups A and B compared with group C(P<0.01). There was a significant difference in the prediction error among the three groups(P=0.042). Group B showed a significant hyperopic shift compared with group C. AE and MedAE among groups showed no significant difference.

CONCLUSION: There was no significant difference in the refractive results of patients with phacoemulsification sequential to vitrectomy alone compared with the normal control group. However, a hyperopic shift was found in patients with phacoemulsification sequential to vitrectomy with inert gas tamponade comparing with the normal eyes. Undercorrection should be avoided when selecting IOL power.

Abstract:AIM:To investigate the risk factors of high intraocular pressure after cataract surgery for phacolytic glaucoma(PLG).

METHODS: The clinical data of 148 PLG patients(148 eyes)who underwent cataract surgery were analyzed retrospectively. According to the occurrence of postoperative high intraocular pressure, the patients were divided into non-high intraocular pressure group and high intraocular pressure group. Logistic regression analysis was used to evaluate the risk factors of high intraocular pressure after cataract surgery in PLG patients. Nomogram model was constructed, whose predictive ability was evaluated by receiver operating characteristic curve(ROC).

RESULTS: There was no significant difference in age, gender, BMI, cataract lens nucleus grade, combined with hypertension, and surgical methods between two groups(P>0.05); the proportion of diabetes, high myopia, preoperative uveitis, preoperative ocular trauma and intraoperative complications in high intraocular pressure group were higher than those of non-high intraocular pressure group, with the difference was statistically significant(P<0.05). Logistic regression analysis showed that diabetes, high myopia, preoperative uveitis, preoperative ocular trauma and intraoperative complications were independent influencing factors for high intraocular pressure after cataract surgery in PLG patients. The nomogram model constructed in this study had good fitting effect, and the area under the ROC curve was 0.906(0.890-0.921), indicating that it had strong predictive ability.

CONCLUSION: PLG patients with intraoperative complications, preoperative uveitis, ocular trauma, diabetes and high myopia had higher risk of high intraocular pressure after cataract surgery. Clinical doctors should pay more attention to these patients in order to improve the treatment prognosis.

Abstract:AIM: To observe the clinical efficacy of 25G lens resection combined with anterior vitrectomy in the treatment of congenital cataract.

METHODS: This retrospective case series study included 55 eyes of 38 children with congenital cataract, age from 3mo to 5 years old, who were recruited between May 2013 and August 2017. The children were divided into two groups according to the different surgical methods. Group A(25 eyes of 17 children)received a 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy, and group B(30 eyes of 21 children)received a cataract phacoemulsification combined with capsulotomy and anterior vitrectomy. The mean follow-up time was 43.4(range: 36-74)mo. The postoperative best corrected visual acuity(BCVA), axial length, and complications were compared.

RESULTS: The age, sex distribution, duration, preoperative BCVA, and preoperative axial lengths were not significantly different between the two groups(P>0.05). The BCVA improved significantly at postoperative compared with BCVA at baseline in both gorups(Group A: P<0.001; Group B: P<0.001). The BCVA was better in Group A than Group B at 6mo postoperatively(P=0.043). No statistically significant difference was found in BCVA between the two groups at 12, 24 and 36mo after initial treatment(P=0.727, P=0.286, P=0.889). No statistically significant difference was found in axial lengths between 6mo of postoperation and preoperation in both groups(Group A: P=0.206, Group B: P=0.082). The mean postoperative axial lengths at 12, 24 and 36mo were longer than that at baseline in both group(Group A: P=0.023, P=0.015, P<0.01, Group B: P=0.018, P<0.01, P<0.01). There were no significantly different in mean axial length after operation between the two groups(6mo: P=0.195, 12mo: P=0.313, 24mo: P=0.485, 36mo: P=0.089). The rate of postoperative complications was lower in Group A than Group B(P=0.042).

CONCLUSION: 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy is an effective and safe treatment method for congenital cataract, the visual acuity after treatment was improved significantly.

Abstract:AIM: To explore the postoperative axial length(AL)and corneal curvature(K)shift in high myopia silicone oil patients complicated cataract after silicone oil removal combined with cataract surgery as well as the relationship.

METHODS: From August 2020 to November 2020 in the Affiliated Eye Hospital of Nanchang University, 45 patients(48 eyes)with silicone oil eye complicated cataract were divided into 2 groups: 20 eyes of 20 patients(refraction ≥-6.00D and AL ≥26mm)in high myopia group and 28 eyes of 25 patients(refraction < -6.00D or AL <26mm)in non-high myopia group. Record the general information and IOL-Master measurement data AL and K, statistical analysis was performed.

RESULTS: There was no difference in preoperative and postoperative K value of two groups(all P>0.05). The AL of the patients in the high myopia group was 28.35±1.68mm after silicone oil removal combined with cataract surgery, which was shorter than 28.08±1.53mm before the operation(P<0.001), yet not statistically significant in non-high myopia group(P>0.05). The median ΔAL of patients in the high myopia group was \〖-0.28(-0.44, -0.08)\〗 compared with the non-high myopia group \〖-0.06(-0.20, 0.15)\〗, which was statistically different(P<0.05), but no significant difference in both ΔK(P>0.05). There was no correlation between |ΔAL| and |ΔK|, or and preoperative K values(P>0.05)in two groups. Preoperative AL was moderately positive correlated with |ΔAL| in the high myopia group(r=0.702, P=0.01), but not in the non-high myopia group(P>0.05).

CONCLUSION: There was no significant shift in K value of high myopia group with silicone oil eye complicated cataract after the silicone oil removal combined with cataract surgery. The longer preoperative AL in high myopia group, the more likely become shorter after surgery, meanwhile the longer AL, the greater AL shift.

Abstract:AIM: To observe the efficacy of aflibercept and ranibizumab in the treatment of diabetic macular edema(DME).

METHODS: Patients with DME who visited the ophthalmology department of Xingtai People's Hospital for the first time from November 2019 to February 2020 were included in the study. They were randomly divided into the aflibercept group and the ranibizumab group. 3+PRN(pro re nata)was used, and the interval time between two injections was at least 4wk. All patients were given three injections first. During follow-up, the patient's best corrected visual acuity(BCVA)and central foveal thickness(CFT)were used to determine whether to inject again. All patients were followed-up for 12mo. The changes of BCVA, CFT, intraocular pressure and injection times were recorded in two groups before and after treatment.

RESULTS: During preoperative and postoperative follow-up, there were statistical differences in LogMAR BCVA and CFT of the two groups respectively(P<0.05). The comparison between the two groups showed no statistical significance during the BCVA and the CFT follow-up(P>0.05). At the end of follow-up, there was a statistical difference in the number of injections between the two groups(t= -6.403, P<0.05). The average number of injections was 6.094±0.689 in the aflibercept group and 7.231±0.652 in the ranibizumab group. No ocular complications or systemic adverse reactions occurred in all patients.

CONCLUSION: Compared with intravitreal injection of ranibizumab and aflibercept for the treatment of DME can achieve similar treatment effect, but the number of injections is less in the aflibercept.

Abstract:AIM: To explore the incidence and high risk factors of retinopathy of prematurity(ROP).

METHODS:Retrospective study. A total of 161 neonates in Gaozhou People's Hospital from January 2018 to January 2021 who met the screening guidelines for retinopathy of prematurity in China(2014)were selected as subjects. Retcam Ⅲ was used for fundus screening. Clinical data of neonates and their mothers were analyzed retrospectively. Univariate analysis and Logistic regression analysis were used to analyze the risk factors for ROP.

RESULTS: Among 161 neonates meeting the inclusion criteria, 26(16.1%)were in the ROP group and 135(83.9%)were in the non-ROP group. Gestational age, neonatal red blood cell count, birth weight, maternal age, gestational hypertension, method of conception showed statistical significance between the two groups(P<0.05)in Univariate analysis. Multivariate Logistic regression analysis revealed that age(OR=0.549, 95%CI: 0.391-0.770, P=0.001)is a protective factor of ROP, however, hypertension during pregnancy(OR=3.947, 95%CI: 1.049-14.852, P=0.042)and assisted reproductive(OR=4.632, 95%CI: 1.112-19.305, P=0.035)are risk factors of ROP.

CONCLUSION: Gestational age is a protective factor for ROP, and assisted reproduction is a risk factor for ROP. High attention should be paid to the neonates with low gestational age, assisted reproductive technology and whose mother has hypertensive disorders of pregnancy. Early screening, early detection, and early treatment of neonatal fundus may reduce blindness caused by ROP.

Abstract:AIM: To explore the characteristics and application value of ultra-wide-field auto-fluorescence in Stargardt disease.

METHODS: A retrospective study of clinical characteristics and genetically confirmed Stargardt disease patients, using Optos P200Tx for ultra-wide-field auto-fluorescence imaging, and comparing the imaging features of traditional fundus color photographs, fundus 55° auto-fluorescence, and optical coherence tomography, to evaluate the ultra-wide-field auto-fluorescence in Stargardt disease image characteristics and advantages of clinical application.

RESULTS:All 76 eyes(100%)had high posterior auto-fluorescence, while only 42 eyes(55%)of traditional 55° auto-fluorescence showed obvious posterior high auto-fluorescence. Sixty-six eyes(87%)of the 76 eyes showed different numbers of spots, which were distributed from the posterior pole to the peripheral retina. UWAF can show clearer and more number of retinal spots than fundus color photographs, and more completely shows the number and distribution of spots area. All 76 eyes(100%)of the patients showed the oval low auto-fluorescence area induced by retinal pigment epithelium(RPE)atrophy in the center of the macula. As the disease progressed, the atrophy area expanded and the low fluorescence area expanded accordingly. Ultra-wide-field auto-fluorescence can completely display the atrophy range and area, but it cannot display in dystrophy depth. In 48 eyes(63%)ultra-wide-field auto-fluorescence, strong background auto-fluorescence was seen extending from the macula to the nasal and inferior temporal of the optic disc, forming a clear approximately vertical dividing line below the optic disc.

CONCLUSION: Ultra-wide-field auto-fluorescence changes in Stargardt are not limited to the posterior pole and may extend more peripherally. Ultra-wide-field imaging is a useful tool for the assessment of patients with Stargardt macular dystrophy.

Abstract:AIM: To compare the effects of tear film after conjunctival autograft transplant(CAT)and limbal conjunctival autograft transplant(LCAT)for primary pterygium.

METHODS: In a prospective study, 150 patients(150 eyes)diagnosed with primary pterygium were collected in Beijing road medical area of Xinjiang Military Region General Hospital from September 2018 to May 2019. The 150 patients enrolled in the study in turn, and divided into two groups by the odd and even number. The odd number underwent CAT and the even number underwent LCAT. Respectively before surgery and 1, 3, 6mo and 1a after surgery, tear film break-up time(TBUT), SchirmerⅠtest(SⅠt)and ocular surface disease index(OSDI)were checked. The date were compared and analyzed.

RESULTS:Totally 129 patients(129 eyes)completed the follow-up of 1a, including 64 patients(64 eyes)from the CAT group and 65 patients(65 eyes)from the LCAT group. Four patients(4 eyes, recurrence rate 6.2%)in the CAT group and 3 patients(3 eyes, recurrence rate 4.6%)in the LCAT group developed recurrence. However, there was no significant in recurrence rate between CAT group and LCAT group(P=0.718). There were significant differences between before surgery and after surgery in each group(P<0.05), and there were significant differences between 1mo after surgery and 3, 6mo and 1a after surgery in each group(P<0.05), while there was no significant different among 3, 6mo and 1a after surgery in each group in TBUT, SⅠt and OSDI(P>0.05). Also there was no significant different between CAT group and LACT group in each time in TBUT, SⅠt and OSDI(P>0.05).

CONCLUSION:Both CAT and LCAT could effectively treat primary pterygium with low and similar recurrence rate, and the degree of improvement of tear film after primary pterygium operation is similar between the two surgical methods.

Abstract:AIM: To analyze the characteristics of the contrast-enhanced ultrasound in orbital retrobulbar tumors, and to explore the application value of the contrast-enhanced ultrasound in the diagnosis of orbital retrobulbar tumors.

METHODS: The contrast-enhanced ultrasound data of the 52 patients(52 eyes)with orbital retrobulbar tumors in the Fourth People's Hospital of Shenyang from March 2012 to May 2015 were retrospectively analyzed. According to the pathological results, 41 eyes were divided into benign group and 11 eyes were malignant group. The time intensity(TI)curve and quantitative data were obtained by SonoLiver software.

RESULTS: The TI curve of benign group mainly showed fast in and slow out mode, while that of malignant group mainly showed fast in and fast out mode. Quantitative data: rise time(RT)and mean transit time(mTT)in malignant group were lower than those in benign group, while there was no significant difference in maximal intensity(IMAX)between the two groups(P>0.05).

CONCLUSION: Contrast-enhanced ultrasound can provide imaging basis for the differential diagnosis of orbital retrobulbar tumors which is helpful for the preoperative qualitative diagnosis.