Abstract:AIM: To study the efficacy and safety of accelerated collagen cross-linking in keratoconus.

METHODS: Medical records of keratoconic corneas underwent accelerated collagen cross-linking at King Chulalongkorn Memorial Hospital, Thailand between April 2015 and August 2018 were reviewed. Preoperative and postoperative data at 1a of visual acuity, auto-refraction, corneal topography, higher-order aberrations(HOA), topometric indices and corneal densitometry were evaluated. Age of 24 and 30 years old, maximum keratometry value(Kmax)of 55 D, and baseline best corrected visual acuity(BCVA)of 20/40(or 0.3 in LogMAR unit)were used as cut-off values to highlight the cross-linking effects. The effect of age, preoperative Kmax and BCVA were analyzed. The association between the change of corneal densitometry and other factors including preoperative Kmax, Kmean, manifest refraction spherical equivalent(MRSE), visual acuity, thinnest pachymetry, the change in Kmax, and the change of those parameters were also analyzed. P<0.05 was considered statistically significant.

RESULTS: One hundred and fifty-five patients(185 eyes)were included. One hundred and nineteen patients were male and thirty-six patients were female. According to Amsler-Krumeich classification, stages 1 and 2 were dominant(37.84% and 35.14% respectively). At 1a, mean LogMAR uncorrected visual acuity(UCVA)improved by 0.1(P<0.05). The number of eyes of which postoperative BCVA improved more than 0.2 LogMAR was higher in the worse baseline BCVA group(preoperative BCVA ≥0.3)compared to the better baseline BCVA group(preoperative BCVA < 0.3)(78.26% vs 21.74%, P<0.05). Mean Kmax decreased from baseline by 2.36 diopters(D)(P<0.05). Seventy-three percent of the eyes of which Kmax reduced more than 2.0 D had preoperative Kmax ≥55 D. Corneal HOA at 6 mm from corneal apex decreased by 0.40(P<0.05). Corneal densitometry at 0-6 mm zone increased at 1mo and persisted 1a postoperatively(P<0.05). The relationship of the increase in densitometric value and the decrease of thinnest pachymetry at 1a were in linear fashion. Index of surface variance, index of vertical asymmetry, keratoconus index, index of height decentration decreased at 1a(P<0.05). Success rate at 1a was 90.24%. Postoperative corneal haze was found 11.35%, 30.27%, 15.67%, 10.27% and 2.16% at 1wk, 1, 3, 6mo and 1a respectively. No eyes developed corneal edema. There was one case of sterile keratitis.

CONCLUSION: Accelerated collagen cross-linking in keratoconus was effective to flatten, reshape the cornea, improved visual acuity, HOA and topometric indices. Great Kmax reduction was found in advanced keratoconus. The magnitude of Kmax reduction is also greatest among previous reports.

Abstract:AIM: To introduce a technique to improve the excision of primary pterygium and evaluate the surgical outcomes.

METHODS: Recorded of consecutive cases were reviewed of pterygium patients treated with pterygium removal between March 2015 and February 2016 in People's Hospital of Guangxi Zhuang Autonomous Region, China. Primary nasal pterygium patients with at least 3mo follow-up periods were included. Finally, 85 patients(85 eyes)were investigated, 44 eyes were operated with 20% ethanol(the study group)and 41 eyes were operated without 20% ethanol(the control group).

RESULTS: All of the 85 patients enrolled had no intraoperative and postoperative complications. The mean healing time of the corneal epithelium for the study group was statistically significant different of 2.84±0.43d compared with the control group of 3.12±0.64d(P<0.05). Overall, postoperative symptoms(pain, irritation, foreign body sensation and epiphora)were significantly different in postoperative 3d between the two groups(P<0.05). No statistically significant differences in corneal endothelium morphologies were found in two groups between preoperative and 2wk, 1 and 3mo postoperative, or between the two groups at any corresponding time point(all P>0.05). Between the two groups, there were no statistically significant differences in best-corrected visual acuity(BCVA)at preoperative, postoperative 2wk and 1mo(all P>0.05), but statistically significant difference was found in BCVA at the 3mo after surgery(P<0.05).

CONCLUSION: The removal of primary pterygium with 20% ethanol is a simple and safe technique that helps to establish a clear separation plane between the pterygium and the underlying cornea.

Abstract:AIM: To investigate the effect of L-carnitine(LC)on corneal epithelial repair and its regulatory molecular mechanism in the hypertonic and inflammatory environment caused by alkali burn.

METHODS: Ninety-six healthy C57/6J mice were randomly divided into blank control group, phosphate buffered solution(PBS)group and LC group. The blank control group did not receive any treatment, LC group and PBS group were prepared acute alkali burn models. LC group was given 60mmol/L LC eye drops, and PBS group was given PBS eye drops, 6 times/d, for continuous days from one day before alkali burn. The repair of corneal epithelium was observed by fluorescein sodium staining under slit lamp microscope at 0h, 3 and 7d. On the 3d, the expressions of Ki-67 and IL-1β proteins in cornea were detected by immunofluorescence, the total proteins of corneal epithelial were extracted for Western blot to detect the expression of P63, NLRP3, Caspase-1 and phosphorylation level of STAT3.

RESULTS: The results of corneal fluorescein sodium staining showed that on the 3 and 7d after alkali burn, the percentage of residual corneal epithelial defect area in PBS group compared with LC group was(29.38±6.83)% vs(17.78±4.11)% and(14.23±4.51)% vs(4.10±2.10)%, respectively(P<0.01). The repair of corneal epithelium in LC group was faster than that in PBS group. On the 3d, compared with the blank control group, the expressions of pyroptosis related proteins NLRP3 and Caspase-1 in the corneal epithelium of the alkali burn treated mice were up-regulated, the expression of P63 was decreased, and the p-STAT3/STAT3 level was increased, all the differences were significant except cleaved Caspase-1 of blank control group vs LC group. Compared with PBS group, in LC group, the expression of NLRP3, pro Caspase-1 and cleaved Caspase-1 protein were decreased, P63 was up-regulated, and p-STAT3 /STAT3 was increased, all the differences were significant. Immunofluorescence showed that compared with the blank control group,the expressions of IL-1β and Ki-67 were up-regulated in the alkali burned group. Compared with PBS group, the expression of Ki-67 protein was up-regulated and IL-1β was decreased in LC group.

CONCLUSION: LC can promote the proliferation of stem/progenitor cells in the corneal epithelium of mice and further promote the repair of corneal epithelium after alkali burn by inhibiting the pyroptosis signaling pathway and promoting the activation of STAT3 signaling pathway.

Abstract:AIM:To investigate the protective effects of naringin(Nar)phospholipid complex(NPC)on oxidative injury in retinal pigment epithelium cells(ARPE-19 cells)induced by tert-butyl hydroperoxide(t-BHP)and elucidate the underlying mechanism.

METHODS:The NPC was prepared by solvent method. Experimental cells are divided into seven groups: control group \〖cultured with dimethylsulfoxide(DMSO)\〗, model group(intervention with 200μmol/L t-BHP), nuclear factor erythroid 2-related factor 2(Nrf2)-siRNA group(cell transfection for Nrf2 gene), naringin group(add 200μmol/L t-BHP after pretreatment with 200μmol/L naringin medium), NPC group(add 200μmol/L t-BHP after pretreatment with 200μmol/L NPC medium), Nrf2-siRNA+ naringin group(after 200μmol/L naringin pretreatment, Nrf2 gene interference, then add 200μmol/L t-BHP)and Nrf2-siRNA+ NPC group(after 200μmol/L NPC pretreatment, Nrf2 gene interference, then add 200μmol/L t-BHP). The intracellular levels of superoxide dismutase(SOD), malondialdehyde(MDA)and total antioxidant capacity(T-AOC)were detected, intracellular level of reactive oxygen species(ROS)was detected by DCFH-DA staining method. The mRNA and protein expressions of HO-1, NQO-1, GCL and Nrf2 were detected by real-time PCR and western blot, respectively.

RESULTS:NPC more significantly increased the levels of SOD and T-AOC, reduced the contents of ROS and MDA than naringin in t-BHP-treated ARPE-19 cells. After naringin and NPC pre-protected ARPE-19 cells, the relative expression and protein expression of Nrf2, HO-1, NQO-1 and GCL mRNA were higher than those of the model group and Nrf2-siRNA group. There were statistically significant differences in the relative expression of 4 genes and the expression levels of 4 proteins in the naringin group and the NPC group, the Nrf2-siRNA+naringin group and the Nrf2-siRNA+NPC group. The expression of Nrf2, HO-1 and NQO-1 protein in the Nrf2-siRNA+naringin group was not significantly different than that in the Nrf2-siRNA group. Compared with the Nrf2-siRNA group, the expression of 4 proteins in the Nrf2-siRNA+NPC group was statistically significant, and the effect of NPC was significantly stronger than that of naringin.

CONCLUSION: After naringin forms a phospholipid complex, it can significantly increase the antioxidant capacity in cells and reduce the oxidation level. It up-regulates the expression of Nrf2 and its downstream antioxidant enzymes and phase Ⅱ detoxification enzymes by activating the Nrf2/ARE antioxidative stress pathway to better protect ARPE-19 cells from oxidative damage.

Abstract:AIM: To study the diagnostic value of gene rearrangement detection combined with vitreous fluid interleukin-10(IL-10)and interleukin-6(IL-6)cytokine detection for primary intraocular lymphoma(PIOL).

METHODS: A total of 27 patients with suspected PIOL who were admitted to the hospital between January 2015 and December 2019 were enrolled in this study according to the inclusion and exclusion criteria. Totally 21 cases of PIOL and 6 cases of uveitis were diagnosed by pathological examination of diagnostic vitrectomy. Results of gene rearrangement and cytokine levels were retrospectively analyzed. Receiver operating characteristic(ROC)curves were used to analyze the diagnostic value of gene rearrangement, cytokines detection and the combination of the two in PIOL.

RESULTS: Of the 21 patients with PIOL, 15 had IhH FR2 monoclonal rearrangement, with a positive rate of 71%(15/21), and 4 were detected with TCRG clonal gene rearrangement. ROC curve analysis showed that the area under the curve(AUC)of gene rearrangement for diagnosis of PIOL was 0.857. Its sensitivity and specificity were 71.43% and 100.00%. Patients with PIOL had significantly higher vitreous humor IL-10 and IL-10/IL-6 levels than those with uveitis, but no statistically significant difference was found in the IL-6 level between the two groups(P>0.05). ROC curve analysis showed that the AUC of IL-10 was the highest for diagnosis of PIOL. With 170.90pg/mL as the cut-off value, its sensitivity and specificity of IL-10 in diagnosing PIOL were 66.67% and 100.00%, respectively. With 1.95 as the cut-off value, the sensitivity and specificity of IL-10/IL-6 ratio in diagnosing PIOL were 52.40% and 100.00%. The AUC, sensitivity and specificity of gene rearrangement combined with cytokines detection in diagnosing PIOL were 0.893, 95.24% and 83.33%, respectively.

CONCLUSION: The sensitivity of gene rearrangement alone is poor in diagnosing PIOL. Combined use of cytokines detection can improve the diagnostic sensitivity and specificity.

Abstract:AIM: To evaluate the visual quality between the Tecnis Symfony extended depth of focus intraocular lens(IOL)and Zeiss trifocal IOL(At Lisa tri 839 MP)implantation.

METHODS: Forty-two patients(53 eyes)who underwent cataract phacomulsification with IOL implantation from Jan. 2019 to Dec. 2020 were randomly divided into group A and group B according to the type of implanted IOL. The group A with 22 patients(29 eyes)implanted the Tecnis Symfony extended depth of focus IOL, the group B with 20 patients(24 eyes)implanted Zeiss trifocal IOL. The uncorrected distance visual acuity(UDVA), uncorrected intermediate distance visual acuity(UIVA), uncorrected near distance visual acuity(UNVA), and best corrected distance visual acuity(BCVA)were measured after 3mo of surgery. The defocus curve, the quality of life and the occurrence of complications were also observed.

RESULTS: The visual acuity was significantly improved in both groups after 3mo of surgery. There were no significant differences in the UDVA(5m), UIVA(80cm)and BCVA(5m)between the two groups(P>0.05). In group B, the UIVA(60cm)and UNVA(40cm)were better than in group A(all P<0.05). The defocus curve analysis revealed that the group A tended to be stable between +1.0D to -2.0D, and to form a platform, while the group B had double peaks(0D, -2.5D). The distance visual acuity at 0D were no significantly differences between the two groups(P>0.05), but the near visual acuity at -2.5D and -3.5D in group B were significantly higher than in group A(all P<0.01). In both groups over 90% patients were spectacle independent. Patients in the two groups showed different degrees of halo, glare and other optical phenomena, but the overall satisfaction were higher. The scores of satisfactions for reading speed and night vision were significantly better in group A than in group B(all P<0.05).

CONCLUSION: In both groups over 90% patients were spectacle independent, they can obtain good near,intermediate and far distance visual acuity. Symfony extended depth IOL has better continuous intermediate distance visual acuity, patients can also obtain higher satisfaction and have better night vision. The Zeiss trifocal IOL implantation is associated with significantly better near visual acuity, and it is more suitable for near vision.

Abstract:AIM: To study the postoperative optical zone decentration and visual quality by taking visual axis corneal reflect point(VACRP)and corneal vertex(CV)as the ablation center, exploring the femtosecond laser small incision lenticule extraction(SMILE).

METHODS: Prospective randomized controlled trial. Totally 70 myopic patients(140 eyes)who underwent SMILE surgery in our hospital from May to June 2020 were randomly divided into two groups, 68 eyes of 34 cases took the VACRP as the ablation center(VACRP group), and 72 eyes of 36 cases took the CV as the ablation center(CV group). The visual acuity, refractive diopter, offset from corneal ablation center, and high-order corneal aberrations were observed before and 3mo after surgery.

RESULTS: Three months after operation, there was no difference in uncorrected visual acuity, best corrected visual acuity and refractive diopter between the two groups(P>0.05). The ablation center deviation in CV group(0.20±0.13mm)was less than that in VACRP group(0.27±0.14mm, P<0.01). The total corneal high-order aberration(totHOA), spherical aberration(totZ40), vertical coma(totZ3-1)and horizontal coma(totZ31)in CV group were lower than VACRP group(P<0.05). Three months after operation, the totHOA, total high-order aberration change(ΔtotHOA), totZ40, totZ3-1 in VACRP group were correlated with ablation center deviation(r=0.470, 0.486, 0.254, -0.366, P<0.001, =0.001, 0.037, 0.002), totZ31 in CV group was correlated with the ablation center deviation(r=-0.352, P=0.002).

CONCLUSION: SMILE surgery can obtain satisfactory uncorrected visual acuity and the same level of refractive diopter with the VACRP and the CV as the ablation center, but taking the CV as the ablation center can reduce the postoperative decentration and high-order corneal aberrations and obtain better visual quality.

Abstract:Retinal degenerative disease is a major disease that affects human vision. It damages human photoreceptor cells and damages human vision. And the mammalian retina does not have the ability to regenerate, once the disease will seriously affect people's normal life. At present, there is no clear way to prevent and alleviate these diseases, but the transplantation of photoreceptors to supplement the damaged photoreceptors in the retina can treat retinal diseases. In this paper, we will discuss the current situation and techniques of photoreceptor transplantation to restore vision in retinal degenerative diseases.

Abstract:Diabetic retinopathy(DR)has always been considered as microangiopathy. However, a large number of studies have confirmed that DR can not only cause retinal angiopathy, but also cause retinal neurodegeneration. Recently, more and more evidence also shows that retinal neurodegeneration occurred before retinal angiopathy in the early stage of DR, and retinal neurodegeneration may be involved in the occurrence and development of microvascular abnormalities. At present, the mechanism of diabetic retinal neurodegeneration is not very clear. This paper reviews the research progress on the mechanism of diabetic retinal neurodegeneration in recent years.

Abstract:Coats disease is characterized by abnormal dilation of retinal capillaries and exudation of the inner and outer layers of the eye retina. It can be mostly seen in male teenagers. So far, there have no clear etiology and pathological mechanism. The common treatment methods of Coats disease, which are the laser photocoagulation, cryotherapy, drug therapy, combination therapy(anti VEGF drugs combined with laser), surgical treatment(simple vitrectomy and or scleral drainage)and traditional Chinese medicine and other emerging treatment methods. The traditional Chinese medicine and Western medicine on the etiology and pathogenesis of the disease and the treatment of traditional Chinese and Western medicine were systematically reviewed in this paper.

Abstract:Nonarteritic anterior ischemic optic neuropathy(NAION)is caused by ischemia of the short posterior ciliary artery that supplies the lamina area of the optic disc. It usually occurs in over 50-year-old people. It is acute optic neuropathy and featured with acute, monocular, and painless vision loss, which frequently results in severe permanent vision damage and visual field defects. This disease is attracting increased attention of clinical researchers. This paper overviews the current molecular pathology of NAION from these aspects, including pathogenesis, pathological changes, relevant protein molecules and susceptibility genes in previous studies. This paper lays a theoretical foundation for future research on the pathological mechanism and the treatment of NAION.

Abstract:Congenital cataract is one of the leading causes of childhood blindness and congenital membranous cataract is a rare and special type of congenital cataract. The lens fibre of congenital membranous cataract is degenerative and its cortex is absorbed gradually. Congenital membranous cataract also has another name, pseudoaphakia, due to the similar phenotype with posterior capsule opacification after cataract surgery, but without intraocular refractive power. There are few reports on congenital membranous cataract at home and abroad, and the research on the pathogenesis of congenital membranous cataract is even less. Clarifying the pathogenesis of congenital membranous cataract, especially the genetics, is very helpful for us to understand the pathogenesis of congenital cataract and the molecular mechanism of lens development.

Abstract:As one of the important contents of eyes, aqueous humor is always in dynamic circulation. When any part of the outflow is blocked, the aqueous humor outflow(AHO)circulation will break down, and followed by the increase of intraocular pressure, the damaged visual function, and the optic nerve injury. At last, the glaucoma occurs. Therefore, it can promote to locate the blocked part by observing the structure of the AHO and evaluating its function state, so as to clarify the pathogenesis of primary open angle glaucoma. Current imaging techniques for AHO pathway include optical coherence tomography(OCT)and angiography of outflow. This article will review the research progress of structure and function imaging of AHO.

Abstract:Age-related macular degeneration(ARMD)is a major cause of irreversible loss of central vision in the elderly. Typical characteristics of ARMD consist of retinal pigment epithelium(RPE), degenerative changes of choroidal capillaries and vitreous warts in macular area. Clinical ARMD is divided into two subtypes: non effusive(dry or atrophic)and effusive(wet or neovascular). The occurrence of the disease is the result of the interaction of many factors, such as age, environment, heredity, smoking, oxidative stress and cardiovascular dysfunction, etc. In view of the important role of RPE cells in pathogenesis of ARMD, the effects and possible mechanisms of blue light, smoking, oxidative stress, lipofuscin accumulation, chronic inflammation and protein homeostasis on the onset of dry ARMD are summarized by focusing on RPE cells. This will provide new ideas to help understand and prevent the occurrence of dry ARMD.

Abstract:Retinitis pigmentosa(RP)is a hereditary retinal disease characterized by degeneration of retina rods and cones photoreceptor cells and degeneration of retinal pigment epithelial cells. The age of onset and progression of RP are genetically related and influenced by the environment. Gene therapy uses vectors in delivering therapeutic genes to genetically modify target cells, so as to correct or replace the disease-causing RP genes. This article introduces the research progress of vectors in RP gene therapy, and review the efficacy and safety of gene therapy on five common genotypes(RHO, PDE6B, MERTK, RLBP1, RPGR).

Abstract:Considering the increased use of electronic devices, the incidence of dry eye disease(DED)has been rising. The condition has seriously affected people's work and lives. DED, the most common ocular surface disease, can be caused by many factors. The meibomian gland dysfunction(MGD)is one of the main factors. Either abnormal secretions from the meibomian gland or an obstruction of the gland ducts can lead to evaporative dry eye. By summarising the relevant literature, this review addresses the aetiology, pathology, diagnosis and treatment of DED associated with MGD.

Abstract:AIM: To evaluate the diagnostic value of optical coherence tomography angiography(OCTA)in detecting the choroidal neovascularization(CNV)of wet age-related macular degeneration(wARMD).

METHODS: PubMed, Embase, Web of science, Cochrane library, CNKI, Wanfang, CBM and VIP databases were searched from inception to October 27, 2020 in diagnosing CNV of wARMD by OCTA. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies by QUADAS-2 standard. Meta-analysis was performed by Meta-Disc 1.4 and Stata 16.0 softwares.

RESULTS: A total of 11 studies involving 995 eyes were included. The results of Meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic ratio, the AUC of sROC and the positive post-test probability were 0.88 \〖95%CI (0.83, 0.92)\〗, 0.95 \〖95%CI (0.85, 0.99)\〗, 18.45 \〖95%CI (5.36, 63.52)\〗, 0.12 \〖95%CI (0.08, 0.18)\〗, 152.73 \〖95%CI (36.39, 641.05)\〗, 0.95 \〖95%CI (0.92, 0.96)\〗 and 0.96 respectively.

CONCLUSION: OCTA has significant diagnostic value for CNV of wARMD, especially for patients with early wARMD.

Abstract:AIM: To evaluate the efficacy evaluation of the combined application of bandage contact lens after pterygium excision surgery by Meta-analysis.

METHODS: Randomized controlled clinical studies on combined application of corneal bandage contact lens after pterygium excision were retrieved from PubMed, Cochrane Library, Wanfang, VIP, CNKI and other databases from May 2014 to May 2020. Data were extracted and Meta-analysis was performed.

RESULTS:Totally 11 randomized controlled clinical studies were included, including 10 in Chinese and 1 in English, with 864 patients. Meta-analysis results showed that 1d postoperative \〖MD= -1.57, 95%CI=(-1.72, -1.41), P<0.00001\〗, 2d postoperative \〖MD= -1.35, 95%CI=(-1.59, -1.11), P<0.00001\〗, 7d postoperative \〖MD= -0.64, 95%CI=(-0.78, -0.50), P<0.00001\〗 combined application of corneal bandage contact lens can better reduce the degree of ocular pain in patients; And 1d postoperative \〖MD= -1.23, 95%CI=(-1.51, -0.95), P<0.00001\〗, 7d postoperative\〖MD= -0.44, 95%CI=(-0.50, -0.39), P<0.00001\〗 combined application of corneal bandage contact lens can better promote the condition of corneal epithelium.

CONCLUSION:The bandage contact lens could markedly release pain response after pterygium excision surgery, promote corneal epithelium recovery, which is beneficial to reduce the symptoms of clinical discomfort.

Abstract:AIM: To discuss the advantages of press-and-chop technique compared with Nagahara phaco-chop technique.

METHORDS: Totally 70 patients(70 eyes)with age-related cataract were randomly divided into 2 groups, press-and-chop technique group(35 patients 35 eyes), phaco-chop technique group(35 patients 35 eyes). In all cases, surgery began with a clear corneal incision, capsulorhexis and hydrodissection. In the press-and-chop technique group, the superficial cortex and epinucleus were aspirated by the phaco tip, then press the center of the lens front surface with the phaco tip. The Nagahara chopper was set around the lens equator, then the phaco tip was driven into the nucleus from the main incision, pull the Nagahara chopper toward the phaco tip. The two instruments were then separated laterally to produce a complete fracture of the nucleus. In phaco-chop technique group, the phaco tip was buried in the center of the endonucleus. The Nagahara chopper was brought through the side-port incision and the equator of endonucleus was engaged by the chopper under the lower edge of the capsulorhexis and pulled toward the phaco tip. The 2 instruments were then separated laterally to produce a complete fracture of the nucleus. The U/S time, preoperative and postoperative corneal endothelial cell density, corneal endothelium loss rate, corneal edema at 1d, 7d, best corrected visual acuity before and after surgery were recorded.

RESULTS: The U/S time of press-and-chop technique group was lower than phaco-chop technique group [12.76(8.76,16.76)s vs 22.87(18.36, 27.38)s, P<0.01]. The corneal endothelial cells density in press and chop technique group was higher than that in phaco-chop technique group 1mo after operation(2133.44±348.58/mm² vs 1957.94±280.54/mm², P<0.05), and the variation rate of corneal endothelial cells in press-and-chop technique group was lower than that in phaco-chop technique group 1mo after surgery [0.15(0.08,0.22)vs 0.22(0.16, 0.28), P<0.01]. The corneal edema in press-and-chop technique group was lighter than that in phaco-chop technique group on the first day after surgery(Z=13.195, P=0.004), and corneal edema in both groups subsided on the 7d after surgery. There was no significant difference between two groups in BCVA on the first day after surgery(Z=-0.48, P=0.63).

CONCLUSION: Compared with Nagahara phaco-chop technique, press-and-chop technique is simple and safe with less complications.

Abstract:AIM: To explore the efficacy of Qiju Dihuang decoction combined with sodium hyaluronate eye drops in the treatment of xerophthalmia after cataract surgery.

METHODS: A total of 120 patients with xerophthalmia after cataract surgery admitted to our hospital were selected between January 2018 and January 2020, and randomly divided into control group and observation group, with 60 cases in each group. The control group was treated with sodium hyaluronate eye drops alone, and the observation group was given Qiju Dihuang decoction combined with sodium hyaluronate eye drops, and they were treated for 1mo. The clinical efficacy, Traditional Chinese Medicine(TCM)syndromes scores, tear film break-up time(BUT), Schirmer Ⅰ test(SⅠt), corneal fluorescein staining(FL)and quality of life \〖25-item National Eye Institute Visual Function Questionnaire(NEI-VFQ-25)\〗were compared between the two groups.

RESULTS:After treatment, the total effective rate of treatment was 93% in observation group and was 75% in control group(P<0.05). After 1mo of treatment, the scores of TCM syndromes(dry eyes, foreign body sensation, photophobia, blurred vision), BUT, SⅠt and FL in the two groups were improved compared with those before treatment, and the TCM syndromes scores after treatment in observation group were lower than those in control group, the BUT time was longer than that in control group, the SⅠt level was higher than that in control group while the FL score was lower than that in control group(all P<0.05). During 3mo of follow-up, the NEI-VFQ-25 scores(general health status, mobility impairment, visual impairment)in the two groups were increased compared with those before treatment, and the scores of dimensions of NEI-VFQ-25 during 3mo of follow-up in observation group were higher than those in control group(P<0.05).

CONCLUSION: Qiju Dihuang decoction combined with sodium hyaluronate eye drops has exact efficacy in treating xerophthalmia after cataract surgery, and it can effectively alleviate the symptoms of ocular discomfort, improve tear film function, and promote the quality of life of patients.

Abstract:AIM:To explore the risk factors for diabetic retinopathy(DR)in patients with type 1 diabetes mellitus(T1DM).

METHODS: A total of 204 patients with T1DM in recent 10a were enrolled. The patients were divided into DR group(n=71)and non-DR group(n=133). The clinical information was collected and relevant biochemical indices were detected. Univariate and multivariate Logistic regression were used to assess the relationship between potential risk factors and DR/proliferative diabetic retinopathy(PDR). The value of risk factors in predicting DR/PDR was evaluated by drawing receiver operating characteristic curve(ROC).

RESULTS: The age of onset, longer duration of diabetes, HbA1c, hypertension, hyperlipidemia, diabetic nephropathy(DN), diabetic peripheral neuropathy(DPN)were related to DR(P<0.05)in patients with T1DM. Longer duration of diabetes, body mass index(BMI), systolic blood pressure(SBP), hyperlipidemia, DN, DPN were related to PDR. Logistic regression analysis indicated that longer duration of diabetes(OR=1.130, P<0.001)and HbA1c(OR=2.734, P<0.001)were risk factors of DR. Longer duration of diabetes(OR=1.144, P=0.005)and DN(OR=6.500, P=0.001)were risk factors of PDR. The results of ROC curve analysis showed that the area under the curve(AUC)of the disease course and HbA1c predicting the occurrence of DR were 0.720 and 0.727, respectively. The cutoff values were 15.1a and 8.2%, respectively. The sensitivity was 50.7% and 76.1%, and the specificity was 86.5% and 59.4%, respectively. The AUC for predicting PDR was 0.713, the best cutoff value was 18.5a, the sensitivity was 73.9%, and the specificity was 60.4%.

CONCLUSION: Retinopathy is associated with age of onset in patients with T1DM. Duration of disease and hyperglycemia are the major influencing factor for DR. HbA1c is associated with DR. DN is associated with PDR occurrence.

Abstract:AIM:To evaluate the effect of the vault on corneal endothelial cells after implantation of central hole implantable lens(ICL)V4c without viscoelastic microincision.

METHODS: Prospective non-randomized controlled study. A total of 70 patients(137 eyes)with myopia who underwent ICL V4c implantation in our hospital from November 2017 to February 2018 were divided into low vault group(100μmRESULTS:At 1wk after operation, the anterior chamber depth, anterior chamber volume and anterior chamber angle of the three groups were all decreased compared with those before operation(P<0.05). There was no significant difference in corneal endothelial cell count among the three groups at different time points before and after surgery. The loss rate of corneal endothelial cells in the low vault group at 1wk, 3mo and 1a after surgery were about 1.2%, 1.5% and 1.7%, respectively. The loss rate of corneal endothelial cells in the middle vault group were about 0.5%, 0.7% and 1.0%, respectively. The loss rate of corneal endothelial cells in the high vault group were about 1.1%, 1.3% and 1.4%, respectively.

CONCLUSION:The vault in early period after ICL V4c implantation without viscoelastic microincision had no significant effect on corneal endothelial cells.

Abstract:AIM: To study the effects of small-incision lenticule extraction(SMILE)and femtosecond laser-assisted excimer laser in situ keratomileusis(FS-LASIK)on early postoperative corneal higher order aberrations(HOAs)and visual quality in patients with high myopia.

METHODS:Totally 102 patients(204 eyes)with high myopia who underwent corneal refractive surgery between August 2018 and August 2020 in the hospital were selected as study subjects for the prospective study, and they were randomly divided into SMILE group(51 cases, 102 eyes)and FS-LASIK group(51 cases, 102 eyes). The postoperative visual acuity, corneal HOAs and objective visual quality were compared between the two groups, and the correlation between corneal HOAs and objective visual quality was analyzed.

RESULTS: At 1mo after surgery, the spherical equivalent degrees in SMILE group and FS-LASIK group were significantly reduced(P<0.05), and there was no statistically significant difference in the proportion of patients with postoperative uncorrected visual acuity≥preoperative best corrected visual acuity between the two groups(95.1% vs 92.2%, P>0.05). The corneal HOAs in the two groups were significantly increased(P<0.05), and the overall spherical aberration(SA), trefoil and higher HOAs in SMILE group were lower than those in FS-LASIK group(all P<0.05). The objective scattering index(OSI)was significantly increased in the two groups while the MTF cutoff frequency(MTF_cutoff), Strehl Ratio(SR)and contrast visual acuity(VA100%, VA20%, VA9%)were significantly decreased(all P<0.05). The OSI of SMILE group was lower than that of FS-LASIK group while MTF_cutoff and VA9% were higher than those of FS-LASIK group(all P<0.05). The corneal HOAs in patients with high myopia were negatively correlated with MTF_cutoff and were positively correlated with OSI(P<0.05).

CONCLUSION:Both SMILE and FS-LASIK can effectively correct high myopia, and SMILE has a smaller increase in early postoperative corneal HOAs, and it is of great significance to relieve visual quality impairment.

Abstract:AIM:To observe curative effect and safety of slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia.

METHODS:This study included 29 patients who underwent slanted bilateral lateral rectus recession for convergence insufficiency-type intermittent exotropia in our hospital between October 2017 and November 2019 with a follow-up of 6mo, the deviation, the surgical success rate, the binocular vision function and the complications were observed.

RESULTS:In our study, the mean near deviations, the mean distance deviations and the near-distance deviation differences reduced from -41.72±3.35PD, -23.28±9.75PD and 16.90±2.47PD before surgery to -5.97±4.85PD, -2.66±4.78PD, 3.28±1.10PD 6mo after surgery, the surgical success rate was 76%. The Grades I and Ⅱ binocular vision function improved 6mo after surgery(P<0.05), the distance stereopsis and the near stereopsis were not statistically significant(P>0.05). None of the patients developed A-V pattern, limitation of eye movement, restrictive strabismus, vertical strabismus, and rotated diplopia, some patients had transient horizontal diplopia, which disappeared within 2-3wk after surgery.

CONCLUSION:Slanted bilateral lateral rectus recession may successfully reduce the near exodeviations, the distance exodeviations and the near-distance deviations difference without obvious complications, proved to be a safe and effective procedure for the treatment of convergence insufficiency-type intermittent exotropia.

Abstract:AIM:To investigate the correlation between demodex infection with corneal cell density changes and ocular surface function in patients with blepharo kerato conjunctivitis(BKC).

METHODS: Ninety-four patients with BKC(BKC group)at Department of Ophthalmology of our hospital from July 2019 to July 2020 were selected as the research objects, in addition, 80 matched healthy volunteers were selected as control group. The BKC patients were divided into infected group(45 cases)and uninfected group(49 cases)according to whether they were infected with demodex. According to the number of demodex detected in eyelashes, there were 17 cases of suspicious infection, 18 cases of moderate infection and 10 cases of severe infection. All subjects were examined by laser confocal microscopy, and the cell density in the superficial stromal layer of the central cornea and peripheral cornea was calculated. The ocular surface function \〖Schirmer test, Ocular Surface Disease Index(OSDI)\〗, eyelid margin abnormality score, corneal fluorescence stain and tear film break-up time(TF-BUT)of patients with BKC were examined, and the correlation between demodex infection with corneal cell density and ocular surface function in patients with BKC was analyzed.

RESULTS: Compared with those in the control group, the cell density in the superficial stromal layer of the central cornea and peripheral cornea was lower in the BKC group(P<0.05), and the OSDI, eyelid margin abnormality score and corneal fluorescence stain score were higher(P<0.05); the cell density in the superficial stromal layer of the central cornea and peripheral cornea of patients in uninfected group, patients with suspicious demodex infection, moderate demodex infection and severe demodex infection decreased in turn(P<0.05), and the OSDI, eyelid margin abnormality score and corneal fluorescence stain score increased significantly in turn(P<0.05); the degree of demodex infection was negatively correlated with the cell density in the superficial stromal layer of the central cornea and peripheral cornea in patients with BKC(P<0.05), and was positively correlated with OSDI, eyelid margin abnormality score and corneal fluorescence stain score(P<0.05).

CONCLUSION: The severity of demodex infection has a significant negative correlation with the cell density in the superficial stromal layer of the central cornea and peripheral cornea in patients with BKC, has a significant positive correlation in patients with ocular surface dysfunction.

Abstract:AIM: To investigate the clinical effect of transepithelial rapid cross-linking combined with wearing rigid gas permeable contact lens(RGPCL)in keratoconus patients.

METHODS: This was a retrospective study of patients with progressive keratoconus diagnosed in the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine in October 2014, and underwent transepithelial rapid keratoplasty. After surgery 16 patients(25 eyes)used RGPCL. Average age was 25.31±5.92 years old, maximum preoperative corneal curvature was 58.96±6.76D, thinnest corneal thickness was 439.52±53.24μm. Rapid cross-linking was performed using riboflavin and 45mW/cm² ultraviolet light(UV)irradiation with a total energy of 7.2J/cm². RGPCL was used after surgery. Follow up of 3-6a, average follow-up time was 52.44±11.39mo. The best corrected visual acuity \〖(BCVA), in RGPCL\〗, corneal curvature of flat meridian(K₁), corneal curvature of steep meridian(K₂), maximum corneal curvature(Kmax), corneal refractive power(MPP), Baiocchi Calossi Versaci index of anterior and posterior surface(BCVf and BCVb)asymmetry index of anterior surface curvature(SIf), asymmetry index of posterior surface curvature(SIb), the highest point of anterior cone cornea(KVf), the highest point of posterior cone cornea(KVb), the change of corneal thickness(ThkMin), lens opacity, and corneal endothelial cell count were observed.

RESULTS: All patients had a successful operation, and no intraoperative complications. On the first day after surgery, all cases felt slight tingling and slight photophobia tears. After 1d of operation, the corneal epithelium was removed in two eyes. While 3d after re-wearing the bandage, the epithelium healed. None of lens in the patients was opacified during follow-up, and there was no significant difference in corneal endothelial cell count compared with preoperative(P>0.05). The BCVA(wearing RGPCL)after operation is obviously improved compared with preoperative. All postoperative Kmax, SIf, KVf, BCVf, BCVb were lower than preoperative(P<0.05).

CONCLUSION: Transepithelial rapid corneal cross-linking combined with RGPCL is safe and effective in controlling the progress of keratoconus. And the long-term effect is stable.

Abstract:AIM: To compare the differences of corneal curvature and astigmatism measured by Pentacam, IOL Master and iTrace of cataract patients.

METHODS:In this prospective clinical trial,68 cataract patients(82 eyes)received treatment at the ophthalmology department of our hospital. In the treatment process, used the IOL Master, Pentacam and iTrace to measure the patient's corneal curvature(K1, K2, Km)and astigmatism(J0, J45). The difference, correlation and consistence among three instruments were analysed.

RESULTS: Differences analysis showed that in the measurement of K1, K2, Km, there was no difference among Pentacam, IOL Master and iTrace(P>0.05). Pearson correlation analysis showed that K1, K2, Km were highly correlated among three instruments(|r|>0.5, P<0.01). J0, J45 were moderately correlated between IOL Master and Pentacam, so as IOL Master and iTrace(0.3<|r|<0.5, P<0.01). J0, J45 were weakly correlated between Pentacam and iTrace(0.1<|r|<0.3, P<0.05). The Bland-Altman showed that the corneal curvature and astigmatism vectors examined by these three devices had non-comparable results.

CONCLUSION: K1, K2, Km, J0, J45 were correlated among the three devices, but the three devices all cannot directly interchanged, targeted selection is required for the measuring the corneal curvature and astigmatism by these three different instruments in the actual clinical process.

Abstract:AIM: To quantify and evaluate the capsular adhesion to intraocular lens(IOL)in subjects with high myopia by the latest anterior segment optical coherence tomography(AS-OCT).

METHODS: Retrospective case observation study was designed. Sixty eyes of 60 patients who received extra-capsular extraction combined with IOL implantation in Shenzhen Eye Hospital from October 2019 to December 2019 were divided into two groups by axial length(AL), of which 30 eyes were highly myopic(AL>26mm)and 30 eyes were emmetropic(22mmRESULTS: In the emmetropic group, the AREAP was(0.81±0.37),(0.33±0.19)and(0.14±0.06)mm² at 1, 7, and 30d after operation, respectively. The residual side lengths of posterior capsule not adhesion were(7.93±3.03),(3.95±2.44)and(1.26±0.08)mm. The ratios of posterior capsule attached to IOL were 33%, 67% and 83%. In the highly myopic group, the AREAP were(3.29±0.43),(1.54±0.66)and(0.62±0.28)mm² at 1, 7, and 30d postoperatively, respectively. The residual side lengths of posterior capsule not adhesion were(13.56±4.02),(8.13±3.90)and(3.78±2.51)mm. The ratios of posterior capsule attached to IOL were 0, 7% and 23%. There were statistically significant differences between the two groups in AREAP, residual side lengths of posterior capsule not adhesion and the ratios of posterior capsule attached to IOL(P<0.05).

CONCLUSION: There is more space between posterior capsule and IOL after cataract surgery in highly myopic patients. The new generation of AS-OCT can clearly display the image of the posterior capsule of the lens, which is expected to be an effective examination device for the study of lens-related diseases.

Abstract:AIM:To comparatively analyze the results of ultra-wide-field fluorescein angiography and standard 7-field imaging in diabetic retinopathy(DR), so as to provide a basis for early diagnosis and treatment of the disease.

METHODS: A retrospective study was conducted. The clinical data of 120 patients with DR admitted to Tangshan Eye Hospital between June 2018 and June 2020 were collected. All patients were subjected to ultra-wide-field fluorescein angiography and standard 7-field imaging. Taking fundus examination results as the golden standard, the value of the two methods in differential diagnosis of fundus lesions and staging of DR was analyzed.

RESULTS: Compared with standard 7-field imaging, the retinal view area, retinal non-perfusion(NP)area, retinal neovascularization(NV)area, panretinal laser photocoagulation area and structure changes of macular arch observed by ultra-wide-field fluorescein angiography were significantly larger(P<0.05), and the graph obtaining time was significantly shorter(P<0.05). The accurate detection rate of DR by ultra-wide-field fluorescein angiography was 94.8%(165/174), significantly higher than 87.4%(152/174)by standard 7-field imaging(P<0.05).

CONCLUSION: Ultra-wide-field fluorescein angiography has more advantages over standard 7-field imaging in the diagnosis of DR, especially in the time and space of examination. Besides, the former can better display macular and optic disc lesions, which is conducive to evaluation of DR, thereby providing more reference for early diagnosis and treatment of DR.

Abstract:AIM: To explore the efficacy and safety of foldable capsular vitreous body(FCVB)in the treatment of severe ocular trauma and silicone oil dependent eyes.

METHODS:A retrospective study. Totally 20 patients who were underwent FCVB implantation due to severe ocular trauma and silicone oil reliance conducted in our hospital from May 2018 to October 2019 were select as observation group, 10 previous severe eye trauma patients without FCVB implantation as control group. The visual acuity(VA), intraocular pressure(IOP), exophthalmos, eye axis length, retinal reattachment, and complications of preoperative and postoperative in observation group and control group were recorded. A 1a follow-up was carried out to compare the changes in the observation indicators of each group so as to evaluate the effectiveness and safety of the FCVB.

RESULTS: Before and 1a after operation, there were no statistically significant differences in VA, eyeball protrusion, and axial length of the observation group, but IOP was significantly increased. The preoperative eyeball protrusion and axial length of the control group were larger than those of the observation group, but they were smaller than those of the observation group during the 1a follow-up. The eyeball protrusion and axial length of the control group were also significantly reduced 1a after the operation compared with the preoperative baseline. Retinas were well attached, silicone oil emulsification, secondary glaucoma, endophthalmitis and any other severe adverse event were not even occurred in the observation group.

CONCLUSION:FCVB could effectively and safely prevent eyeball atrophy in the treatment of severe eye trauma and silicone oil dependent eyes.

Abstract:AIM: To observe the changes of tear film osmolarity(TFO)and inflammatory cytokines after wearing orthokeratology lens.

METHODS: Prospective randomized controlled trial. Totally 79 cases of adolescent myopia(-1.00D to -5.00D)were selected from May 2016 to February 2019. Then they were randomly divided into the experimental group(39 cases)and the control group(40 cases). The experimental group wore orthokeratology lens, and the control group wore frame glasses. Their average noninvasive Keratograph tear breakup time(NIKBUTav), TFO, concentrations of IL-1β, IL-6, TNFα in tear samples were observed for 1a.

RESULTS: NIKBUTav and TNFα after wearing orthokeratology lens for 6mo, 1a and stopping wearing for 4wk were different from that pre-wearing orthokeratology lens(P<0.001). TFO after wearing orthokeratology lens for 1, 3, 6, 12mo were different from that pre-wearing orthokeratology lens(P<0.001). IL-1β and IL-6 in tears after wearing orthokeratology lens for 3, 6, 1a were different from that pre-wearing orthokeratology lens(P<0.001). One year later, NIKBUTav of orthokeratology group(8.54±1.92s)was lower than that of glasses group(12.93±2.22s)(P<0.001). The levels of TFO, IL-6 and TNFα in the orthokeratology group were higher than those in the glasses group(P<0.01). However, there was no difference in IL-1β between the orthokeratology group(16.60±4.32ng/mL)and the glasses group(14.67±4.43ng/mL)(P=0.053).

CONCLUSION After wearing orthokeratology lens, NIKBUTav decreased, and TFO, IL-1β, IL-6, TNFα increased, but they were reversible.

Abstract:AIM: To compare the visual quality of cataract patients with high myopia after regional refraction or diffraction refraction multi-focal intraocular lens(MIOL)implantation by using objective optical quality analysis system(OQASⅡ).

METHODS: Retrospective study. From January 2019 to January 2020, 38 patients with 44 eyes diagnosed as cataract with high myopia that had underwent femtosecond laser-assisted phacoemulsification combined with intraocular lens implantation in our hospital were selected. Regional refraction MIOL group includes 19 cases 22 eyes, and diffraction refraction MIOL group includes 19 cases 22 eyes. After 3mo follow up, OQASⅡ measured objective visual quality and questionnaire surveys were conducted on the subjective visual quality of the patients. Record the patient's subjective near spectacle independence, visual disturbance symptoms, and satisfaction.

RESULTS: After 3mo follow-up, the uncorrected distance visual acuity(UCDVA), uncorrected intermediate visual acuity(UCIVA)and uncorrected near visual acuity(UCNVA)had no difference(P>0.05), and the best corrected distance visual acuity(BCDVA), best corrected intermediate visual acuity(BCIVA)and best corrected near visual acuity(BCNVA)had no difference(P>0.05). The objective scattering index(OSI)values of regional refraction MIOL group and diffraction refraction MIOL group were 1.97±1.10 and 2.07±1.02(P=0.755). The MTF cut off of regional refraction MIOL group and diffraction refraction MIOL group were 31.89±14.61 and 33.17±9.83c/deg, respectively(P=0.734). There was no statistically significant difference in OV100%, OV20%, OV9% between the two groups(all P>0.05).

CONCLUSION: Cataract patients with high myopia can obtain better distance, middle and diffraction refraction MIOL implantation, and OQASⅡ can objectively reflect the visual quality after cataract surgery.

Abstract:AIM: To observe the clinical efficacy between SMILE and FS-LASIK with monovision design to treat the presbyopia.

METHODS: According to the methods of operation, the presbyope with myopia were divided into two groups, who received the treatment with monovision design. SMILE group had 10 patients(20 eyes),the average age were 45±2.83 years old and myopia degree was -5.42±1.74D. FS-LASIK group had 9 patients(18 eyes), the average age were 45±1.97 years old and myopia degree was -5.60±1.84D. The far vision and the near vision of monocular and binocular of preoperative and postoperative between two groups were observed.

RESULTS: SMILE group in preoperative: the preoperative subjective eye's far visual acuity was 0.05±0.04, the subjective eye's near vision was 0.36±0.15; the objective eye's far visual acuity was 0.35±0.11, the objective eye's near visual acuity was 0.16±0.11; the binocular far visual acuity was 0.05±0.05 and the binocular near visual acuity was 0.18±0.09. Preoperative FS-LASIK group: preoperative subjective eye's far visual acuity was 0.09±0.09, subjective eye's near vision was 0.42±0.17; the objective eye's far visual acuity was 0.44±0.11, the objective eye's near visual acuity was 0.19±0.10; the binocular far visual acuity was 0.03±0.04 and the binocular near visual acuity was 0.19±0.11. The result of before surgery between the two groups had no statistical difference(P﹥0.05). Postoperative SMILE group: the far visual acuity of subjective eye was -0.01±0.06, the near vision of subjective eye was 0.32±0.14; the far visual acuity of objective eye was 0.16±0.18, the near visual acuity of objective eye was 0.12±0.12; the binocular far visual acuity was -0.04±0.07, the binocular near visual acuity was 0.10±0.11. Postoperative FS-LASIK group: the far visual acuity of subjective eye was 0.03±0.03, the near vision of subjective eye was 0.45±0.13; the far visual acuity of objective eye was 0.20±0.15, the near visual acuity of objective eye was 0.24±0.12; the binocular far visual acuity was 0.01±0.03 and the binocular near visual acuity was 0.22±0.09. The comparisons of after surgery between the two groups were statistical differences in the binocular far vision(t= -2.383, P=0.034), and the binocular near vision(t= -2.424, P=0.027). The vision comparisons between preoperative and postoperative in SMILE group, there were all statistically significant in the far visual acuity of subjective eye(t=3.914, P=0.004), the far visual acuity of objective eye(t=4.894, P=0.001), the binocular far visual acuity(t=4.870, P=0.001)and the binocular near visual acuity(t=2.388, P=0.041). That means the vision of postoperative was better than the expected vision before operation. The far visual acuity of objective eye were compared between preoperative and postoperative in FS-LASIK group, the differences was statistically significant(t=4.068, P=0.004).

CONCLUSION: To presbyope with myopia, the treatment of SMILE and FS-LASIK all can get expected results with monovision design. But the patients after SMILE would have better binocular far vision and binocular near vision than after FS-LASIK.

Abstract:AIM:To investigate the classification and cause of visual impairment among students in Tianjin Visual Impaired School, and analyze the rehabilitation effect of different kinds of visual aids to provide guidance for the visual impairment rehabilitation.

METHODS:A total of 86 students in Tianjin Visual Impaired School were recruited in August and September, 2019. The classification and main cause of visual impairment were evaluated by visual acuity, refractive test and eye examination. The rehabilitation effects of 3 kinds of far visual aids and near visual aids were compared in the group of blindness and low vision, respectively.

RESULTS:A total of 86 students(49 blindness and 37 low vision)have improved the distant vision using visual aids(F=110.59, P<0.01). The distant visual acuity in the low vision group was better than the blindness(F=184.06, P<0.01). The main cause of visual impairment was congenital ocular dysplasia in 26 cases(30%). There was no difference in the rate without visual impairment using the 3 kinds of far visual aids in both group of blindness and low vision. There was also no difference in the reading performance rate using the 3 kinds of near visual aids in the blindness, while the effect of electronic aids was significantly better than hand magnifiers and glasses aids in the low vision group(χ²=7.974, 10.571, all P<0.01).

CONCLUSION:The main cause of visual impairment in children is congenital eye diseases, and appropriate visual aids can enhance the rehabilitation effect. The effect of electronic aids was better than hand magnifiers and glasses aids in low vision children.

Abstract:AIM: To investigate the binocular accommodative amplitude(AMP)and accommodative facility(AF), near point of convergence(NPC), accommodative convergence/accomodation ratio(AC/A), positive relative convergence(PRC)of intermittent exotropia(IXT)children, according to the convergence insufficiency type, basic type, divergence excess type, and to compare with the normal children, investigating the differences of regulation and collection function.

METHODS: Totally 40 IXT children were divided into three groups according to the different types of the IXT patients, the convergence insufficiency group(12 children), the basic group(18 children)and the divergence excess group(10 children). And the 20 non-exotropia children were set up as the control group. AMP was measured with improved push-up test, and AF was measured with turning over convex and concave lens test. NPC was measured with push-up test. AC/A ratio were measured with the lens gradient method. PRC was measured with BO prism. The binocular accommodative and convergence function of four groups were compared.

RESULTS: The difference of AMP, AF, NPC, AC/A ratio and PRC among four groups was significant difference(P<0.05), and we did the further pair wise comparisons. AMP of the IXT group was less than the control group, and AMP of the convergence insufficiency group was the least; AF of the convergence insufficiency group was less than the basic group and the control group; NPC of the convergence insufficiency group was the largest; AC/A ratio of the convergence insufficiency group and the basic group was lower than the other two groups; PRC of the IXT group was less than the control group when fixating at near target of 33cm, and the mean of the convergence insufficiency group was the least; PRC of the IXT group was less than the control group when fixating at far target of 6mo(P<0.05).

CONCLUSION: There are differences in the ocular function of accommodation and convergence in different types of IXT children, and the function of the convergence insufficiency IXT is the worst. The binocular accommodative and convergence function of IXT children is worse than non-exotropia children.

Abstract:AIM: To study the effect of intensive online courses on myopia in primary and middle school students with orthokeratology-lens during Corona Virus Disease 2019(COVID-19)epidemic.

METHODS:A total of 77 children in myopia with orthokeratology lens in outpatients from February to August 2020 were included in the study. Take a questionnaire to statistics times spending on online course, school class, playing digital electronic good, outdoor activity, homework, sleeping during the COVID-19 epidemic and school time, and analyze the differences of axial length(AL)variation between the COVID-19 epidemic and school time.

RESULTS:For elementary school students, the time spending on online course and school class were 2.69±1.02h and 4.07±0.78h per day respectively(P<0.001), 6.67±1.82h and 6.31±1.19h per day were spent on short-distance use of eyes during the COVID-19 period and school time, respectively(P<0.001). For middle school students, the time spending on online course and school class were 4.35±1.59h and 6.33±0.66h per day respectively(P<0.001), 9.19±2.46h and 7.85±0.81h per day were spent on short-distance use of eyes(P=0.010)during the COVID-19 period and school time, respectively. For elementary school students, the average increase of right eye AL were 0.15±0.09mm and 0.06±0.06mm(P<0.001), the increase of left eye AL were 0.12±0.16mm and 0.07±0.09mm(P=0.048)during the COVID-19 period and school time, respectively. For middle school students, the average increase of right eye were AL 0.08±0.08mm and 0.05±0.05mm(P=0.242), and the average increase of left eye AL were 0.13±0.09mm and 0.04±0.06mm(P<0.001)during the COVID-19 period and school time, respectively. The results showed that both the time of short-distance use of digital electronic product and totally time on close visual study increased significantly during the epidemic period, the growth of AL was faster than that in school time, and the myopia increased rapidly.

CONCLUSION:During the COVID-19 epidemic, intensive online lessons resulted in the time of short-distance use of digital electronic product increase significantly. Meanwhile, the AL growth accelerates significantly compared with that during school time and finally lead to myopia increased.

Abstract:AIM: To investigate the clinical efficacy and safety of the foldable capsular vitreous body(FCVB)implantation in the treatment of severe ocular trauma and also explore the effect of ciliary body function on the FCVB implantation.

METHODS: This study retrospectively analyzed 10 cases(10 eyes)with severe ocular trauma which had accepted FCVB implantation performed in Affiliated Xiaolan People's Hospital, Southern Medical University from January 2018 to July 2020. Ciliary body function was judged by score which was made by preoperative examination results. The case which scored 5 or less was studied as ciliary failure: 8 eyes scored more than 5, 2 eyes scored 5 or less. Followed up for 1-31mo, the postoperative best corrected visual acuity(BCVA)and intraocular pressure, anterior chamber, retinal reattachment, FCVB condition and adverse reactions were observed.

RESULTS: The operations of 9 eyes with aphakia eyes were successful. Iridodialysis occurred during the operation of 1 eye with lens. Retinal reattachment was found in all 10 eyes, and the position of FCVB in all patients was proper. There was no severe adverse reactions. Comparing the preoperative and postoperative BCVA and intraocular pressure, the difference was not statistically significant(P>0.05). In the group(8 eyes)that ciliary body function scored more than 5, 2 eyes had a supplementary operation individually, 1 eye underwent 2 supplementary operations. In the group(2 eyes)which scored 5 or less, supplementary operations were performed 5 times in 1 eye, only 1 time in the other one case.

CONCLUSION: Implantation of FCVB is a safe option to treat severe ocular trauma. But the postoperative visual acuity cannot be improved. The ciliary body function associates with persistent intraocular hypotension and shallow anterior chamber after FCVB implantation.