Abstract:AIM: To investigate the distribution of conjunctival lymphatic vessels in New Zealand white rabbits and its relationship with age.

METHODS: Subconjunctival trypan blue was injected in four quadrants(nasal, superior, temporal, and inferior)and recorded videos. The number of lymphatic outflow pathways arising from the blebs was counted. The difference in the number of lymphatic outflow pathways across the quadrants of each group was tested by single-factor analysis of variance. Paired t-test was used to compare the differences in the number of lymphatic outflow pathways in the same rabbit quadrants across different ages.

RESULTS: In New Zealand white rabbits, thick annular lymphatic vessels were mainly distributed near the limbus part of the conjunctiva. The single collecting lymphatic vessels were primarily distributed in the peripheral parts. Although the lymphatic vessels of juvenile rabbits have fewer branches, the number of lymphatic vessels in the different quadrants was no significant difference in each group(all P>0.05)and was no difference between the two age groups(all P >0.05).

CONCLUSION:The lymphatic vessels were abundant in rabbit conjunctiva. The number of lymphatic vessels in each quadrant and between two age groups had no significant difference.

Abstract:AIM: To evaluate the effect of vitrectomy with inverted internal limiting membrane(ILM)flap technique and air tamponade in high myopic eyes with macular hole retinal detachment(MHRD).

METHODS: A retrospective, noncomparative study of high myopia patients with MHRD was conducted. In all cases, triamcinolone acetonide was used to visualize the vitreous during vitrectomy. After ILM was inverted, a venous blood clot was placed on the inverted ILM flap and air was used as tamponade. Macular hole closure rate, retinal reattachment rate, and postoperative best-corrected visual acuity(BCVA)were assessed after the surgery.

RESULTS: Twenty-four eyes of 24 high myopia patients with MHRD were included in this study. The patients were followed up for at least 6mo, averaging 13.58±7.00mo. At last follow up,macular hole(MH)was closed in 21 eyes(88%)and retina was reattached in 20 eyes(83%). Seventeen eyes(71%)had both complete MH closure and retinal reattachment. Three eyes(13%)had complete reattached retina with unclosed MH, while 4 eyes(17%)had persistent subretinal fluid with closed MH. No additional pars plana vitrectomy(PPV)was performed. BCVA(LogMAR)was significantly improved at last follow up(0.65±0.34 vs 1.36±0.49, P<0.001). An improvement in BCVA of 2 or more lines was achieved in 12 eyes(50%).

CONCLUSION:Vitrectomy combined with inverted ILM flap, autologous blood transplantation and air tamponate is an effective treatment for MHRD in myopic eyes.

Abstract:AIM: To investigate the effect and mechanism of curcumin on inhibiting choroidal neovascularization(CNV)in vitro.

METHODS: Human retinal pigment epithelial(ARPE-19)cells chemical hypoxia model was established by cobalt chloride(CoCl₂). CCK-8 method was used to detect the effect of curcumin on the activity of ARPE-19 cells induced by CoCl₂. RT-qPCR and Western blot were used to detect the expression of AKT, HIF-1α, VEGF mRNA and protein in ARPE-19 cells hypoxia model induced by CoCl₂. Cell scratch test, transwell chamber migration test, transwell chamber invasion test and matrigel matrix hose lumen formation test were used to observe the effects of conditioned medium of curcumin in ARPE-19 cells on the proliferation, migration, invasion and lumen formation of human umbilical vein endothelial cells(HUVEC)in non-contact condition.

RESULTS:Chemical hypoxia model of ARPE-19 cells can successfully establish by CoCl₂ at 100μmol/L. CoCl₂ at the final concentration of 100μmol/L can promote the expression of AKT, HIF-1α and VEGF mRNA and p-AKT, HIF-1α and VEGF protein in ARPE-19 cells. Curcumin at the final concentration of 100μmol/L can reduce the expression of AKT, HIF-1α and VEGF mRNA in ARPE-19 hypoxia model. Curcumin at the final concentration of 100μmol/L can reduce the expression of AKT, HIF -1α and VEGF proteins in ARPE-19 hypoxia model. The conditioned medium of low(6.25μmol/L), medium(25μmol/L)and high dose(100μmol/L)curcumin in ARPE-19 cells can significantly inhibit the level migration of HUVEC. The conditioned medium in high dose group can significantly inhibit the vertical migration and cell invasion of HUVEC. The conditioned medium of middle and high dose curcumin in ARPE-19 cells can inhibit the lumen formation of HUVEC.

CONCLUSION:Curcumin at 100μmol/L can protect ARPE-19 cells from hypoxia induced by CoCl₂. Curcumin can inhibit the formation of blood vessels at the cellular level.

Abstract:AIM:To investigate the dynamic expression characteristics of interleukin-10(IL-10)after implantation of glaucoma drainage material, and to reveal the role of IL-10 on scarring formation.

METHODS:Totally 75 New Zealand white rabbits were randomly divided into three groups, which were implanted with different types of material-Polymethyl methacrylate coated Parylene C(PMMA group), silicone together with injection of Mitomycin C(MMC)(silicon-MMC group)and silicone(silicone group). Aqueous humor were collected at 1, 3d, 1, 2, 3, 4 and 8wk after operation and enzyme-linked immunosorbent assay(ELISA)were utilized to detect the expression of IL-10 in the aqueous humor. The connective tissue surrounding the material were collected at 1, 2, 3, 4 and 8wk postoperatively. Hematoxylin-eosin(HE)staining was applied to evaluate the proliferation of fibroblasts and the infiltration of inflammatory cells. The protein expression and mRNA of IL-10 in the connective tissue were detected by immunohistochemistry and real-time PCR.

RESULTS:Compared with PMMA and silicon-MMC group, silicone group showed significantly increased proliferation of fibroblasts and infiltration of inflammatory cells according to the HE staining result. The result of ELISA showed the expression of IL-10 in the aqueous humor increased significantly at the early stage after surgery, and then decreased gradually,the highest appeared on the third day after operation,and in silicone group there was higher than the other two groups in the early stage postoperatively(1d-3wk)(all P<0.05), and there was no significant difference in the late stages(4-8wk). The protein expression and mRNA of IL-10 in connective tissue were the highest in the first week after operation, decreased gradually at 2-3wk after operation, and increased again at 4-8wk after operation by immunohistochemistry and real-time PCR. And the expression was higher in silicone group than in the other two groups at each time point(all P<0.05). Furthermore, there was a positive correlation between the expression of IL-10 protein and the proliferation of fibroblasts in the late stages(4-8wk).

CONCLUSION: After implantation of glaucoma drainage material, the process of IL-10 increased first, then decreased gradually, and increased again 4wk later, thus IL-10 may be a potential target for inhibiting the scar formation.

Abstract:AIM:To provide a clinical reference for the design of personalized surgical parameters for cataract, swept source optic coherence tomography angiography(SS-OCTA)was applied to comparatively study the blood flow of the macular area before operation in patients with different intraocular pressure during cataract surgery.

METHODS: Prospective randomized controlled study. A total of 61 patients(77 eyes)who underwent cataract surgery in Sichuan Provincial People's Hospital from January to April 2021 were collected and divided into group A(37 eyes)and group B(40 eyes)for the study using a random number table. Group A and group B received the height of 75 and 90cm perfusion bottles with intraoperative,corresponding to 55.5 and 66.6mmHg intraoperative mean intraocular pressure,respectively. All patients were examined with SS-OCTA in macula area before and 1,7 and 30d after surgery, except routine ophthalmologic examination, the macular retinal thickness, the perfusion area and vessel density of the radial perioptic capillary plexus(RPCP)layer, superficial vascular plexus(SVP)layer, intermediate vascular plexus(IVP)layer and deep vascular plexus(DVP)layer were observed.

RESULTS: There were no significant differences in the best corrected visual acuity(BCVA), intraocular pressure, foveal avascular zone(FAZ), macular retinal thickness, perfusion area and vascular density between the two groups at each time point before and after surgery(all P>0.05),but there were differences in time(all P<0.05). In both groups, BCVA improved significantly from preoperative values at all time points after surgery, intraocular pressure and FAZ decreased compared with preoperative values(all P<0.05), and macular retinal thickness, perfusion area in all layers, and blood flow density were increased compared with preoperative values.

CONCLUSION:The macular retinal thickness, blood flow density and perfusion area of all layers increased,and the FAZ area decreased after cataract surgery, which may help to promote the recovery of visual acuity after surgery. At different intraocular pressures of 55.5 and 66.6mmHg intraoperatively, there was no significant difference in the patients'postoperative fundus blood flow changes, therefore, intraocular pressure can be flexibly selected during the operation to provide patients with personalized surgical design.

Abstract:AIM: To explore the efficacy of intravitreal injection of ranibizumab and conbercept in the treatment of exudative age-related macular degeneration(ARMD), and analyze the effects on best corrected visual acuity(BCVA), central retinal thickness(CRT)and complications of patients.

METHODS: The clinical data of 60 patients(60 eyes)with exudative ARMD in the hospital between January 2017 and January 2020 were collected for retrospective analysis. According to different treatment drugs, they were divided into intravitreal injection of ranibizumab group(30 eyes)and intravitreal injection of conbercept group(30 eyes). The BCVA, CRT, choroidal neovascularization changes and occurrence of complications were compared between the two groups before treatment and 1, 2 and 3mo after treatment.

RESULTS: After 1, 2 and 3mo treatment, the BCVA(LogMAR)of patients in the two groups was better than that before treatment(P<0.05). The CRT was lower than that before treatment(P<0.05), and the CRT at 1, 2 and 3mo after treatment in intravitreal injection of conbercept group was lower than that in intravitreal injection of ranibizumab group(P<0.05). There were no significant differences in the recovery of choroidal neovascularization and the occurrence of complications between the two groups(P>0.05).

CONCLUSION: Both intravitreal injection of ranibizumab and conbercept can achieve a good efficacy in the treatment of exudative ARMD, and there was no significant difference in the improvement of visual acuity between them. However, conbercept has obvious advantages in reducing CRT in the treatment of exudative ARMD.

Abstract:Keratoconus(KC)is a progressive disease characterized by gradual corneal thinning and ectasia, resulting in irregular astigmatism, myopia, and mild to severe visual impairment. Although the pathogenesis of KC is still unclear, twin studies and family-based studies have identified that the occurrence of KC is closely related to genetic factors. First-degree relatives of KC patients including their parents, siblings and offspring are very important for the family aggregation analysis and polygenic analysis of diseases. This review summarized the current situation of clinical and genetic research about first-degree relatives of KC patients, hoping to deepen the understanding of clinical manifestations and genetic characteristics of first-degree relatives of KC, and to provide new ideas for exploring the role of genetic and environmental factors in the pathogenesis of KC.

Abstract:Night-wear aspheric orthokeratology lens(refers to OK lens)is used to correct vision while sleeping at night, which is one of the few ways to prevent myopic children from wearing glasses during the day, so often recommended as the first choice in clinical practice for the myopic population of 8-16 years old. The main effect of OK lens is producing reasonable compression on the surface of the eye to reduce the curvature of the cornea. At present, as a recognized non-surgical method for the treatment of juvenile myopia, the lens material and the optometry level of OK lens have been continuously innovated and upgraded. Meanwhile,because OK lens directly cover the ocular surface, so long-term wearing definitely affects the ocular surface microenvironment, including meibomian glands, tear film, conjunctiva, cornea, ocular surface microorganisms and so on, and even causes the imbalance of these ocular surface microenvironments, thereby leading to the occurrence and development of ocular surface diseases. In order to expect clinicians to give comprehensive consideration when wearing OK lens for teenagers and increase the safety and effectiveness of wearing OK lens, this article analyzed the effects of wearing OK lens on ocular surface meibomian gland morphology, tear film morphology and function, conjunctival microcirculation, corneal cell morphology, ocular surface microorganisms and other factors.

Abstract:Familial exudative vitreoretinopathy(FEVR)is a severe clinically and genetically heterogeneous retinal disease which characterized by abnormal development of the peripheral retinal vessels. FEVR presents many clinical phenotypes, the main and typical feature is retinal folds. There are various inheritance modes with high genetic heterogeneity of FEVR including autosomal recessive, X-recessive, autosomal dominant recessive, and other scattered inheritance modes. So far, nine FEVR pathogenic genes have been reported: NDP, FZD4, LRP5, CTNNA1, TSPAN12, ZNF408, KIF11, CTNNB1, and JAG1 genes. These genes are mainly involved in signaling pathways such as Wnt, Notch, and Norrin-β-catenin. This article reviews the above nine FEVR pathogenic genes and their signaling pathways.

Abstract:Targeted retinal photocoagulation(TRP)refers to targeted photocoagulation of the non-perfusion areas(NPA)of the retina, which can greatly reduce the risk of complications of panretinal photocoagulation(PRP). Ultra-wide field fluorescein angiography(UWFFA)can clearly show NPA of the far peripheral retina, which is conducive to precise positioning and implementation of TRP therapy. At present, the safety of short-term TRP treatment programs for proliferative diabetic retinopathy(PDR)is reasonable, but the long-term efficacy is still uncertain. In the future, TRP may become an early treatment option for some PDR patients, by delaying PRP to maintain the visual acuity and central field of vision. Anti-vascular endothelial growth factor(VEGF)drugs are currently the first-line drugs for diabetic macular edema(DME), for which with retinal neovascularization(NV)or poor compliance, combined TRP therapy may be considered. The ischemic index(ISI)is used to quantitatively analyze NPA of the retina under the vision of UWFFA, which is expected to become an important index in the future to guide the selection of clinical TRP treatment options.

Abstract:Diabetes is a disease that leads primarily to microvascular damage. In recent years, with the improvement of living standards, the number of diabetes patients has been increasing. The latest data is shown that about 9.3%(463 million people)globally have diabetes. Diabetic retinopathy is a leading cause of visual impairment and blindness among the working-age population. What have been progressively recognized in recent years is hyperglycemia can also lead to tear film instability, corneal nerve dysfunction, corneal sensitivity decreased, and tear osmolarity increased. The etiology and mechanisms of ocular surface dysfunction caused by diabetes are diverse and complex, including hyperglycemia destabilizing the tear film, disturbances in connectivity between dendritic cells and neurons, and inflammatory cytokines inducing damage to the lacrimal glands, leading to impaired tear secretion. This article is intended to review recent progress and mechanisms in diabetic dry eye and the general conditions of patients that ophthalmologists should consider during the diagnosis and treatment of the diabetic dry eye.

Abstract:Ocular toxocariasis(OT)is an ocular parasitic disease involving ocular tissue infection by the ascarid-omatidae nematode. OT is usually caused by toxocara canis or toxocara cati. Susceptible population are more likely to be affected by their own hygiene, the frequency of exposure to dogs and cats, and the consumption of food or water contaminated with toxocariasis larvae. Most cases have been reported worldwide in children, but cases in adults have also been reported in recent years, which may be due to the lack of systematic induction and summary of its diagnosis, treatment and prognosis. In this paper, the four clinical manifestations of OT, advanced noninvasive diagnostic techniques, and laboratory immunological tests were sorted out and supplemented by reviewing domestic and international literature. Meanwhile, this paper introduced the treatment progress of OT in recent years, such as the combination of anthelmintic and hormone, and the application of intravitreal injection and vitreous surgery. It is expected that clinicians should pay more attention to this disease, improve the accuracy of early diagnosis of toxocariasis and protect patients' vision.

Abstract:Myopia refers to the refraction state in front of macular fovea when the external parallel light falls through the refractive system of the eye. Myopia has seriously affected the healthy growth of teenagers,so that prevention and control of myopia have become a hot issue of social concern. Studies generally agreed that myopia has a close relationship with choroid changes, and the choroid thickness shows a gradual thinning trend with the increase of diopter and ocular axis. Evidence-based medical studies have proved that effective methods for myopia prevention and control(orthokeratology, defocus lens, atropine eye drops, illumination, posterior scleral reinforcement, etc.)showed choroid thickening effect, suggesting that choroid thickening is a protective factor for myopia control. In order to provide a reference for the change of choroid thickness as an evaluation index of myopia prevention and control efficacy, this paper reviews the effect of current effective methods of myopia prevention and control on choroid thickness.

Abstract:Ocular diseases in human immunodeficiency virus(HIV)infected patients have attracted increasing attention due to their impact on quality of life. As HIV treatment continues to improve, opportunistic eye infections are decreasing, while HIV-associated retinopathy is becoming a growing concern. HIV-associated retinopathy, including a series of structural changes in the retina and optic nerves(thinning of the nerve fiber layer, changing in blood vessels), has been found to cause decreased visual sensitivity, visual field defect, color vision disorder. However, the pathogenesis of HIV-associated neuroretinal disorder has not been fully clarified, and the existing findings may be related to direct destruction of retinal optic nerve tissue by HIV virus, chronic inflammation, and destruction of the blood-retina barrier. Understanding the pathological characteristics and possible mechanisms of HIV-associated neuroretinal disorder is expected to provide new ideas and approaches for the treatment of the disease and improve the quality of life of HIV-infected patients.

Abstract:Refractory macular hole(MH)mainly includes large MH, high myopia MH, persistent MH, recurrent MH, and traumatic MH. Compared with ordinary MH, the closure rate in patients with refractory MH through conventional vitrectomy combined with internal limiting membrane(ILM)peeling is greatly reduced. Currently, the ILM flap technique has gradually been applied for the treatment of refractory MH and achieved higher MH closure rate and better visual function recovery. The ILM flap technique has many variations, including the difference of size, shape, number, and method in which the flaps put on the MH, but each has its own advantages, disadvantages and application limitations. So far, there is no recognized standard procedure for the treatment of refractory MH. This paper reviewed the surgical methods and therapeutic effects of ILM flap technique appeared in domestic and foreign literature, which is aimed to provide a reference for the selection of clinical procedures for refractory MH by new ILM flap technique needs to be explored in the future.

Abstract:Congenital lacrimal duct disease is caused by congenital dysplasia of nasolacrimal system, which usually involving bone, mucous membrane or membranous structure. It can be divided into upper lacrimal duct system and lower lacrimal duct system or both. Its clinical manifestations are mostly epiphora, or it can be combined with pyorrhea. In recent years, more and more studies are devoted to the diagnosis and treatment of congenital lacrimal duct disease, but the views of all parties are different. Therefore, in order to obtain better serve the clinical, this article reviews the latest diagnosis and treatment progress of congenital lacrimal duct disease.

Abstract:AIM: To evaluate the clinical effects and safety of Loratadine combined with Diclofenac sodium eye drops in the treatment of allergic conjunctivitis by system review.

METHODS:Using “Loratadine” “Diclofenac sodium” and “allergic conjunctivitis” as keywords, a randomized controlled trial of Loratadine combined with diclofenac sodium in the treatment of allergic conjunctivitis was searched in Embase, Cochrane library, Pubmed, CNKI, Wanfang database, VIP and SionMed. The retrieval time is from the establishment of the database to July 2021. The risk bias tool provided by the Cochrane cooperation scale was used to assess the risk bias of included studies of RCTs. The publication bias of the included studies was assessed by the Egger's test. Meta-analysis of clinical efficiency, incidence of adverse effects, ocular itch score, and discharge score were using RevMan 5.3. Descriptive analysis were performed on the results with high heterogeneity.

RESULTS:A total of 19 articles were included, all of which were Chinese literatures, including 1 931 patients(2 044 eyes). The control group was treated with Loratadine, and the experimental group was treated with Loratadine combined with Diclofenac sodium eye drops. The Meta-analysis showed that the clinical effect of experimental group was better than control group(OR=4.43, 95%CI:3.26-6.03,P<0.00001).The incidence of adverse reaction was lower than control group(OR=0.32, 95%CI:0.2-0.52,P<0.00001). The Score of ocular itching(MD=-0.36, 95%CI:-0.39 to -0.33,P<0.00001)and discharge(MD=-0.24,95%CI: -0.31 to -0.18,P<0.00001)in experimental group was lower than control group. All the studies on hyperemia and edema of conjunctiva, conjunctival papilla or follicle proliferation and foreign body sensation in patients with allergic conjunctivitis showed that the experimental group could significantly reduce the above symptoms(all P<0.05). Egger's test was performed on the total effective rate, the incidence of adverse reaction. The results showed that there was publication bias in the total effective. Trim and fill method showed that the publication bias did not affect the results.

CONCLUSION: On the basis of the oral Loratadine, combined with Diclofenac sodium eye drops has a certain clinical efficacy in the treatment of allergic conjunctivitis, which can improve the clinical symptoms such as ocular itching, foreign body sensation, hyperemia and edema of conjunctiva, and the incidence of adverse reactions is low, which can provide evidence-based basis for the drug treatment of allergic conjunctivitis in the future. However, due to the low intensity of the included research evidence, more multicenter, randomized double-blind clinical trials are needed in the future, so that to improve the evidence intensity.

Abstract:AIM: To systematically evaluate the changes of hemodynamics, astigmatism and cytokines between travoprost and timolol in the treatment of primary open angle glaucoma(POAG)in Chinese adults.

METHODS:Randomized controlled trials(RCTs)and cohort studies comparing the related efficacy of travoprost and timolol for POAG were retrieved from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure(CNKI), Chinese Biomedical Literature Database(CBM), VIP database and Wanfang database. The search time was from January 1, 2015 to December 31, 2020. The literatures were screened according to the inclusion and exclusion criteria. After quality evaluation by Cochrane tools for RCTs and NOS scores for cohort studies, Review Manager 5.4 software was used for Meta-analyses to generate weighed-mean-difference(WMD)as effect size contrasting the efficacy of travoprost and timolol for the peak systolic velocity(PSV), the end diastolic velocity(EDV)and the resistance index(RI)of the central retinal artery(CRA)and the posterior ciliary artery(PCA), astigmatism, the plasma endothelin-1(ET-1), the serum matrix metalloproteinase(MMP), the tissue inhibitor of metalloproteinase-2(TIMP-2)of the aqueous humor and the serum TIMP-2.

RESULTS:Totally 8 RCTs and 4 retrospective cohort studies were included with 1 192 patients.Meta-analysis showed that:compared with timolol group, the travoprost group had greater effect on increasing the PSV(WMD=2.40, 95%CI: 2.12-2.68, P<0.00001; WMD=3.76, 95%CI: 3.30-4.22, P<0.00001)and the EDV(WMD=0.81, 95%CI: 0.70-0.91, P<0.00001; WMD=0.90, 95%CI: 0.72-1.09, P<0.00001)of the CRA and the PCA as well as on decreasing the RI(WMD=-0.07, 95%CI: -0.10 to -0.04, P<0.00001; WMD=-0.07, 95%CI: -0.08 to -0.05, P<0.00001)of the CRA and the PCA; Travoprost was more effective in decreasing astigmatism(WMD=-1.34, 95%CI: -1.62 to -1.06, P<0.00001); Compared with timolol, travoprost could significantly decrease the plasma ET-1(WMD=-5.14, 95%CI: -7.08 to -3.20, P<0.00001)and the serum MMP(WMD=-12.48, 95%CI: -24.27 to -0.69, P=0.04), while no statistically significant differences were found in the TIMP-2 of the aqueous humor(WMD=-1.40, 95%CI: -5.51-2.71, P=0.51)and the serum TIMP-2(WMD=1.69, 95%CI: -30.03-33.41, P=0.92).

CONCLUSION:Compared with timolol, travoprost was more effective in improving hemodynamic indexes and decreasing astigmatism in the treatment of POAG.

Abstract:AIM: To explore the risk factors of xerophthalmia after cataract surgery in patients with type 2 diabetes mellitus, and to construct a risk prediction model.

METHODS: A total of 212 patients(212 eyes)with type 2 diabetes who underwent cataract surgery in our hospital from April 2019 to April 2021 were selected. The patients were divided into dry eye group(43 cases, 43 eyes)and non-xerophthalmia eye(169 cases, 169 eyes). The general data, laboratory examination index and quality of life score of the two groups were compared; multivariate Logistic regression analysis was used to analyze the risk factors of postoperative xerophthalmia; constructed a line chart prediction model and evaluated its prediction accuracy.

RESULTS: There were significant differences in the history of keratoconjunctival disease, pterygium, meibomian gland dysfunction, lens nucleus hardness, disease cognition, postoperative anxiety, postoperative depression, surgical incision, medication compliance, and the levels of interleukin-1β(IL-1β), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and HbA1c at 1wk after operation between the two groups(P<0.05). The results of multivariate Logistic regression analysis showed that postoperative anxiety, postoperative depression, 3.0mm of surgical incision, IL-1β>31.26ng/mL, IL-6>29.42ng/mL, TNF-α>77.68ng/mL and HbA1c≥6.50% were risk factors for postoperative xerophthalmia(P<0.05). The calibration curve and standard curve of the nomogram prediction model were fit well, and the prediction probabilities were mostly distributed around 0 and 1, with high accuracy.The visual function evaluation, environmental trigger factors, ocular discomfort symptoms and ocular surface disease index(OSDI)score in the dry eye group was significantly higher than those in the non-xerophthalmia group(P<0.05).

CONCLUSION: Surgical incision, postoperative anxiety, depression, medication compliance, serum inflammatory factors and HbA1c are all related to xerophthalmia after cataract surgery in patients with type 2 diabetes. Early identification of risk factors and timely intervention are helpful to reduce the incidence of postoperative xerophthalmia and improve the quality of life.

Abstract:AIM: To evaluate the efficacy of EX-PRESS drainage device implantation combined with phacoemulsification for chronic primary angle-closure glaucoma(CPACG)with cataract and compare with trabeculectomy combined with phacoemulsification.

METHODS: A retrospective case control design was used in this study. The patients underwent combined operation of glaucoma and cataract in the ophthalmology department of our hospital from January 1^st, 2017 to January 1^st, 2019 were collected and divided into two groups according to different operation methods. The study group(13 cases, 16 eyes)was treated with EX-PRESS drainage device implantation combined with phacoemulsification and intraocular lens implantation. The control group(16 cases, 20 eyes)was treated with trabeculectomy combined with phacoemulsification and intraocular lens implantation. The best corrected visual acuity(BCVA)and intraocular pressure(IOP)at 1wk, 1, 3, 6mo after surgery, central anterior chamber depth(ACD)at before surgery, 1, 6mo after surgery, central corneal endothelial cell count, the duration of operation, length of hospital stays after surgery were compared between the two groups.

RESULTS:The demography was matched between the two groups(all P >0.05). The number of eyes with visual improvement was significantly raised 6mo after treatment in study group(Z=-2.066,P=0.039). There were no significant differences in BCVA between two groups 6mo after treatment(Z=-0.319,P=0.765). The IOP of study group at 1wk, 1, 3 and 6mo was significantly lower than that before operation(all P<0.001). There were no significant differences in IOP between the two groups(F=0.003, P=0.956). The anterior chamber significantly deepened at 1 and 6mo after operation in two groups respectively(all P<0.001). There were no significant differences in ACD and central corneal endothelial cells count between two groups(all P>0.05). The duration of operation was 26.1±4.5min in study group and 31.5±5.1min in control group, which showed significant differences(t=-3.307, P=0.002). The length of stays after surgery was 7.2±1.6d in study group and 7.7±1.5d in control group, and there was no significant difference between the two groups(t=-0.880, P=0.388). One eye EX-PRESS touched the iris in study group. Since the IOP was normal, it didn't receive therapy. In control group, the anterior chamber of 2 eyes was 2 degrees shallow after surgery, which recovered in 1wk by pupil dilation and pressurized bandage. At 6mo point after operation, one eye in each group was treated with one IOP drop to maintain normal IOP. In control group, one case received EX-PRESS drainage device implantation again 12mo later for recurrent glaucoma, another case underwent ciliary body photocoagulation 8mo later.

CONCLUSION: EX-PRESS drainage device combined with phacoemulsification is effective in improving visual acuity and controlling IOP for CPACG, and it takes shorten operation time compared with trabeculectomy combined with phacoemulsification.

Abstract:AIM:To evaluate the effect of keratometry on the calculation accuracy of intraocular lens(IOL)diopter in patients with normal axial cataract.

METHODS:Totally 157 cases(157 eyes)with age related cataract were collected in Kaifeng Central Hospital from June 2020 to June 2021. Patients were divided into 3 groups according to keratometry: group A(53 eyes)(K<42D), group B(55 eyes)(42D≤K≤46D), group C(49 eyes)(K>46D). The IOL diopter was calculated by SRK/T, Hoffer Q, Holladay 2, Haigis, Kane and Barrett Ⅱ formulas respectively. Subjective optometry was performed after 1mo operation. The average refractive prediction error(RPE)and mean absolute error(MAE)were calculated, and their differences were compared and analyzed.

RESULTS:There were significant difference between RPE of each formula and 0D in groups A and C(P<0.05), and Barrett Ⅱ formula was significantly different with SRK/T, Hoffer Q, Holladay 2 and Haigis formula(P<0.01), but was no significantly different with Kane formula in RPE(P>0.01). There was no significant difference in RPE between group B and 0D(P>0.05). The ratio of Barrett Ⅱ formula in MAE≤0.5D in group A was significantly higher than SRK/T, Hoffer Q, Holladay 2 and Haigis formula(all P<0.01), but there was no significant difference compared with Kane formula(P>0.01). In group B, there was no significant difference among Barrett Ⅱ formula and the other formulas in the ratio of MAE≤0.5D and ≤1.0D(all P >0.01). In group C, the ratio of SRK/T and Hoff Q formula in MAE≤0.5D was lower than Barrett Ⅱ formula(all P<0.01), and there were no significant difference among Barrett Ⅱ formula and the other formulas in the ratio of MAE≤1.0D(P >0.01).

CONCLUSION:If K<42D or K>46D before operation, the commonly used formulas will produce refractive error, but the accuracy of Kane and Barrett Ⅱ formulas are still higher than other formulas.

Abstract:AIM: To analyze ocular wavefront aberrations and scattering parameters changes in patients with meibornian gland dysfunction(MGD)and aqueous deficient dry eye(ADDE), and assess the visual quality of patients with two types of dry eye syndromes.

METHODS:There were 25 patients with MGD, 25 patients with ADDE and 25 healthy controls treated in our hospital from January to October 2018 were included in this study. Ocular surface disease index questionnaire(OSDI)and tear film correlation examination were performed in three groups. The tear film correlation examination included tear break-up time(TBUT), Schirmer test( SⅠt )and cornea fluorescein staining(FL). The root mean square of total high order aberration(HO), comatic aberration(CA), trefoil aberration(TA)and spherical aberration(SA)were recorded with i-Trace visual function analyzer. The scattering values were recorded by the double-pass Optical Quality Analysis System(OQAS Ⅱ), including the modulation transfer function(MTF cutoff ), Strehl ratio(SR)and objective scattering index( OSI ). Three groups of subjects kept their eyes open for 20s, the mean value of OSI was recorded using OQAS Ⅱ tear film analysis program.

RESULTS:The OSDI score in MGD group was significantly higher than that in ADDE group(38.2±5.6 vs 32.2±7.2, P<0.01). The SⅠT score in ADDE group was significantly lower than that in MGD group(1.98±0.92 vs 12.52±6.80mm/5min, P<0.001). The TBUT and FL staining score were lower in MGD group than those in ADDE group(TBUT: 3.27±1.91 vs 6.02±1.05s, FL:3.27±2.18 vs 6.23±2.19, all P<0.001). There was no significant difference in HO, CA, TA and SA between MGD Group and ADDE group(HO: 0.385±0.081 vs 0.344±0.092, CA:0.210±0.062 vs 0.175±0.075, TA:0.107±0.056 vs 0.086±0.042, SA:0.322±0.078 vs 0.273±0.097, HO:t=1.67, P>0.05; CA: t=1.80, P>0.05; TA: t=1.50, P>0.05; SA: t=1.97, P>0.05). There was no statistically significant differences between MGD group and ADDE group with the value of MTF cutoff, SR and OSI(MTF cutoff: 33.28±8.28 vs 37.12±9.53, SR: 0.19±0.06 vs 0.22±0.08, OSI:1.30±0.32 vs 1.12±0.52, MTF cutoff: t=1.52, P>0.05; SR: t=1.50, P>0.05; OSI: t=1.47, P >0.05). In the condition of not blinking, the mean value of OSI in MGD group was significantly higher than that in ADDE group(2.386±0.118 vs 1.554±0.058, P<0.001).

CONCLUSION:In the treatment of symptoms of patients with dry eye, improving the visual quality of patients should also be considered. The visual quality in patients with MGD is more serious than those with ADDE. The OSI related parameters seem to be sensitive indicators indexes to evaluate the dynamic changes of tear film-related visual quality in dry eye patients.

Abstract:AIM: To investigate the curative effect of atropine penalization therapy and occlusion therapy on children with anisometropic amblyopia, and the influence on visual function.

METHODS:This prospective study included 158 children with anisometropic amblyopia who were admitted to the hospital between February 2018 and September 2020. Children enrolled were divided into penalization therapy group(78 cases)and occlusion therapy group(80 cases)by random number table method. Dominant eyes of the penalization therapy group were treated with 1% atropine gel for twice a week, while dominant eyes of the occlusion therapy group were covered for 2h or longer every day. Treatment effect, stereoscopic function and contrast sensitivity were measured after 6mo of treatment. The pattern visual evoked potentials were detected, treatment compliance,and treatment effect were evaluated.

RESULTS:The overall compliance rates of the penalization therapy group and the occlusion therapy group were 96.2% and 73.8%(P<0.05). The overall response rates of the two groups were 79.5% and 73.8%(P>0.05). The overall effective rates of stereoscopic visual function reconstruction in the two groups were 74.4% and 56.3%(P<0.05). After treatment, the contrast sensitivities under 1, 4, 8, 10 and 12c/d were significantly increased in the two groups(all P<0.001). Besides, the contrast sensitivities under 8, 10 and 12c/d in the penalization therapy group were higher than those in the occlusion therapy group(all P<0.05). After treatment, P100 amplitude(μV)of the penalization therapy group was higher than that of the occlusion therapy group(12.96±2.10 vs 11.42±2.53μV,P<0.05), while P100 latency(ms)was lower than that of the occlusion therapy group(105.26±12.41 vs 111.40±11.74ms, P<0.05).

CONCLUSION:For patients with amblyopia, atropine penalization therapy can improve treatment compliance and stereoscopic visual function of patients with amblyopia, and have higher safety.

Abstract:AIM:To determine the prevalence of screening myopia and refractive correction among primary and middle school students aged from 6-18 years in Xuzhou city, Jiangsu Province.

METHODS: A cross-sectional cluster sampling study was designed. The total number of screened students was 63 488 in 70 schools from Xuzhou city in this study from September 2020 to December 2020. After excluding the unqualified data, 58 149 students aged 6-18 years were included to analyse. The prevalence of screening myopia, refractive correction and full correction with the aspect of different ages, genders, regions and degrees of myopia were described.

RESULTS: The overall rate of screening myopia and refractive correction were 49.26% and 31.11%, respectively and both showed an increasing trend with age(P<0.01). Additionally, the degree of myopia also gradually deepened with age. For the two rates, there appeared to be higher for girls than boys(53.70% vs 45.67% for screening myopia and 32.45% vs 29.84% for refractive correction, all P<0.01). However, girls showed a lower rate than boys for full refractive correction(56.60% vs 63.98%, P<0.01), which was 60.23% totally among all the myopic students with refractive correction. The corrective and full refractive correction rate of urban primary and secondary school students are higher than that of townships(46.50% vs 18.33%,62.20% vs 56.07%, all P<0.01).

CONCLUSION:The prevalence of screening myopia among primary and middle school students was not optimistic in Xuzhou city in 2020. The rates of refractive correction and full correction were relatively low among myopic students, possibly because of the progression of myopia.

Abstract:AIM: To explore the current situation of myopia among children and adolescents in Mengzi city and the possible influencing factors of myopia.

METHODS: A multi-stage cluster sampling method was used to select students in 7 schools(2 primary schools, 2 junior high schools, 2 high schools, and 1 vocational high school)in Mengzi city, Yunnan Province in October 2019. A total of 1 837 students were selected for questionnaire surveys, and examination of distance visual acuity and noncycloplegic autorefraction. There were 1 622 valid questionnaires were finally collected after checking the integrity and rationality of the questionnaires.

RESULTS: The prevalence of myopia among primary and secondary students in Mengzi city in 2019 was 61.34%. The prevalence of myopia in girls(71.36%)was higher than that in boys(50.45%), and the prevalence of myopia in Han nationality(70.19%)was higher than that in ethnic minorities(57.70%). With the grade growth, the prevalence of myopia showed an upward trend. Multivariate Logistic regression analysis showed that the risk factors of myopia were female(OR=2.308), Han nationality(OR=1.712), higher learning stage(junior high school: OR=1.579, high school: OR=5.538), the time of doing homework daily in the past 1wk(1-<2h: OR=1.456, 2-<3h: OR=1.514, ≥3h: OR=1.901), occasionally or never keep your eyes more than one foot away from a book while reading and writing(OR=1.741), insufficient sleep(OR=1.585), parental myopia(OR=2.191).

CONCLUSION:The prevalence of myopia among primary and middle school students in Mengzi city is at a relatively high level. Female, Han nationality, higher learning stage, the time of doing homework daily in the past 1wk≥1h, occasionally or never keep your eyes more than one foot away from a book while reading and writing, insufficient sleep and parental myopia are all risk factors that can cause myopia.

Abstract:AIM: To evaluate the clinical efficacy of local application of triamcinolone acetonide combined with mouse nerve growth factor in the treatment of infraorbital nerve injury after infraorbital wall fracture.

METHODS: Forty-three patients(43 eyes)with infraorbital wall fractures who underwent infraorbital wall fracture revision from April 2020 to February 2021 at the Affiliated Eye Hospital of Nanchang University were prospectively analyzed. Patients were randomly divided into two groups, in which 20 patients(20 eyes)in the experimental group had gelatin sponges infiltrated with triamcinolone acetonide and mouse nerve growth factor placed on the nerve injury intraoperatively; 23 patients(23 eyes)in the control group had no special treatment intraoperatively. At 6mo postoperative follow-up, the results of quantitative sensory testing(two-point localization, nociception, and touch)were compared between the affected and healthy lower lid areas, and the results were reported in an asymmetry index(AI).

RESULTS: Baseline results showed no significant differences between the two groups in terms of gender, age, time of injury, and preoperative sensory testing between the two groups(all P>0.05). The AI values of two-point localization sensation, tactile sensation, and pain sensation in both groups were higher at 1wk after surgery than before surgery(all P<0.05), and the symptoms of sensory impairment were aggravated, with different degrees of improvement at 1mo after surgery and statistically significant differences in pain sensation at 3mo after surgery(P<0.05), and two-point localization sensation, tactile sensation, and pain sensation were significantly improved at 6mo after surgery than before treatment(all P<0.01). At 1mo after surgery, the differences in two-point localization sensation and pain sensation in the test group were statistically significant compared with the control group(t=-2.082,-2.143; P=0.044, 0.038). At 3mo after surgery, there was a statistically significant difference in nociception in the test group compared to the control group(t=-2.118, P=0.04). At 6mo after surgery, there was no statistically significant difference in quantitative sensory testing between the two groups(P >0.05).

CONCLUSION: Local application of triamcinolone acetonide combined with mouse nerve growth factor for the treatment of infraorbital nerve injury after infraorbital wall fracture was effective in early internal recovery and superior to the group without special intraoperative treatment.

Abstract:AIM: To investigate the efficiency and safety of 3D visualization assisted phacoemulsification combined with intraocular lens(IOL)implantation.

METHODS: Prospective non-randomized controlled clinical study. A total of 100 patients(103 eyes)who underwent phacoemulsification combined with IOL implantation were enrolled in the study. Among them, according to the way of surgery chosen by the participants, 24 cases(25 eyes)were enrolled from January to March 2020(3D-1 group), 24 cases(25 eyes)were enrolled from April to June 2020(3D-2 group), and 52 cases(53 eyes)were enrolled from January to June 2020(binocular microscope group)as the control group. Total operative time, capsulorhexis time, phacoemulsification operation time, cortical aspiration time, IOL implantation time, viscoelastic agent aspiration time, ultrasound time(UST), cumulative dissipated energy(CDE), fluid flow loss, intraoperative and postoperative complications were recorded in the three groups. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure(IOP)and corneal endothelial cell count(CECC)were recorded preoperatively and 1mo postoperatively.

RESULTS: The total operative time, the time of capsulorhysis, the operation time of phacoemulsification, and the time of removing viscoelastic agent between 3D-1 group and control group were statistically significant(all P<0.01). There were no significant differences in the total operation time and each operation step time between the 3D-2 group and the control group(all P>0.05). The differences of UST, liquid flow loss, and CDE between 3D-1 group and the control group were statistically significant(all P<0.05). There were no significant differences between the 3D-2 group and the control group in intraoperative parameters(all P>0.05). There were no statistical significances in UCVA, BCVA, IOP, and CECC among the three groups 1mo after surgery(all P>0.05).

CONCLUSION: Phacoemulsification combined with IOL implantation using 3D visualization technology is safe and feasible. After a certain learning curve period, there is no significant difference in the surgical efficiency compared with traditional binocular surgery.

Abstract:AIM: To analyze the changes of the epiretinal membrane(ERM)stage, macular status and best corrected visual acuity(BCVA, LogMAR)in cataract patients with idiopathic macular epiretinal membrane(IERM)before and after cataract surgery.

METHODS:We conducted a single center retrospective observational case series of patients that underwent sequential cataract and idiopatic ERM surgeries from March 2016 to May 2019 in Anyang Eye Hospital. Full data were obtained for 51 patients(54 eyes).Preoperative and postoperative 1mo ERM stage, central macular edema(CME), central macular thickness(CMT), macular volume(MV), ellipsoid zone disruption, occurrence of neurosensory detachment(NSD)and BCVA were analyzed.

RESULTS:In this group of patients, 5 eyes(9%)had ERM grade 1, 23 eyes(43%)had ERM grade 2, 21 eyes(39%)had ERM grade 3, and 5 eyes(9%)had ERM grade 4 before surgery; ERM graded 1mo after surgery were keeping steady. Compared with before operation(0.45±0.16),there was no significant change in BCVA(0.47±0.17)at 1mo after operation(P>0.05), but the incidence of CME, ellipsoid band interruption and NSD were significantly higher than those before operation(P<0.05).

CONCLUSION: We suggest that phacoemulsification did not significantly accelerate ERM progression and affect BCVA, but patients underwent cataract surgery in the presence of epiretinal membranes need tight follow up to treat and control eventual macular infammatory changes and eventual prompt vitrectomy if BCVA was threatened.

Abstract:AIM:To study the relationship between astigmatism and keratoconus by using Pentacam anterior segment analyzer.

METHODS:Totally 88 patients(93 eyes)with early keratoconus were divided into clinical keratoconus group(43 cases, 46 eyes)and subclinical keratoconus group(45 cases, 47 eyes)according to related standards. Meanwhile, 40 patients(41 eyes)with history of myopia and astigmatism(astigmatism ≥2.0D)were recorded as the control group. The keratoconus index(KI), corneal index of surface variance(ISV)and index of vertical asymmetry(IVA)were determined using Pentacam anterior segment analyzer, and their diagnostic value for keratoconus was analyzed.

RESULTS:The parameters of Pentacam anterior segment analyzer were different among the three groups(P<0.05). Rmin was the highest, and other parameters were the lowest in the control group. Rmin was lower, and other parameters were higher in the clinical keratoconus group than in the subclinical keratoconus group(P<0.05). The area under curve(AUC)values of ISV, KI, IVA, index of highest decentration(IHD), aberration coefficient(ABR), corneal anterior surface maximum keratometry(Kmax), posterior corneal surface elevation(PE), minimun radius of curvature(Rmin)and corneal anterior surface elevation(AE)in the diagnosis of clinical keratoconus were 1, 1, 1, 1, 0.950, 0.919, 0.951, 1 and 0.992, with good sensitivity and specificity. IVA, Rmin, AE, and PE had better sensitivity and specificity in the diagnosis of subclinical keratoconus. The AUC values were 0.927, 0.923, 0.954, and 0.947, respectively.

CONCLUSION:Pentacam anterior segment analysis system has great value in early diagnosis of keratoconus.

Abstract:AIM:To observe the imaging features of optical coherence tomography angiography(OCTA)in the macular hemorrhage of pathologic myopia.

METHODS:Designing a retrospective analysis collected clinical data of 100 patients(108 eyes)diagnosed as macular hemorrhage of pathological myopic in Nanjing Medical University Affiliated Eye Hospital from June 2016 to December 2020. All patients underwent refraction, eye axis,fundus photography, spectral-domain optical coherence tomography(SD-OCT), fundus fluorescein angiography(FFA), indocyanine green angiography(ICGA)and OCTA examination. All patients were divided into macular hemorrhage only with lacquer cracks and macular hemorrhage with choroidal neovascularization(CNV). All patients followed-up for more than 3mo by OCTA.

RESULTS:There were 40 patients(42 eyes)diagnosed as macular hemorrhage only with lacquer cracks, OCTA showed bleed obscured by choroidal capillaries. After hemorrhage was being absorbed, lacquer cracks showed linear or stellate reflection completely in the choroidal capillary layer. B-scan image showed discontinuous retinal pigment epithelium(RPE), thinner choroid and an increased light. Penetrance into deeper tissues. After all macular hemorrhage only with lacquer cracks were absorbed, follow-up mode of OCTA found that 2 eyes(4.8%)without lacquer cracks, 28 eyes(66.7%)were linear and 12 eyes(28.6%)were stellate under the original hemorrhage. Follow-up mode also showed that 8 eyes of 8 patients(19.0%)relapsed macular hemorrhage only with lacquer cracks, and 4 eyes of 4 patients(9.5%)suffered secondary macular hemorrhage with CNV. There were 60 patients(66 eyes)diagnosed as macular hemorrhage with CNV,OCTA showed bleed obscured choroidal capillaries, the outer retinal and choroidal capillary layer also showed the shape of CNV around hemorrhage. B-scan showed CNV breaked through the RPE layer and blood flow signal in it. The area of CNV decreased after anti-vascular endothelial growth factor(VEGF)intravitreal injection treatment. Around all macular hemorrhage with CNV, OCTA found that 48 eyes(72.7%)had lacquer cracks, 28 eyes(42.4%)were linear and 20 eyes(30.3%)were stellate.

CONCLUSION:OCTA has a great significance in the diagnosis of macular hemorrhage of pathological myopia, fast and non-invasive is the biggest advantage. Choroidal capillary layer can clearly observe the shape and location of hemorrhage,lacquer cracks and CNV. The follow-up mode can intuitively comprehend the changes of disease. To some extent, it can replace fundus angiography to directly judge the classification, and time to treat in the clinic.

Abstract:AIM: To investigate the prognostic value of DIP endoscopic scoring system for simultaneous operation of chronic dacryocystitis complicated with sinusitis.

METHODS: From January 2018 to February 2021, 96 patients(96 eyes)with chronic dacryocystitis complicated with sinusitis who underwent nasal endoscopic sinus surgery and dacryocystorhinostomy were enrolled in a prospective single-blind study. Patients were examined by nasal endoscopy and recorded video to get DIP endoscopic score before operation. The patients were followed-up for 6mo, and the curative effect was based on the results of the last follow-up. The receiver operating characteristic curve(ROC curve)was drawn according to DIP endoscopic scoring system and postoperative curative effect, and the value of DIP endoscopic scoring system in predicting the prognosis of nasal endoscopic sinus surgery combined with dacryocystorhinostomy was evaluated. According to the best cutoff value obtained by ROC curve analysis, patients were analyzed in subgroups, and the age and sex constituent ratio of two groups were compared.

RESULTS: Among the 96 eyes with chronic dacryocystitis complicated with sinusitis, 86 eyes(90%)were cured, 4 eyes(4%)were improved, and 6 eyes(6%)were invalid. ROC curve analysis showed that the area under the ROC curve(AUC)of DIP endoscopic score for predicting the curative effect of nasal endoscopic sinus surgery combined with dacryocystorhinostomy was 0.905. When Yoden index reached its peak, the DIP endoscopy score was 16.5 as the best cutoff value. At the same time, the sensitivity was 80.0% and the specificity was 86.0%. In the subgroup analysis, there was no significant difference in age and sex constituent ratio between the two groups(P>0.05); The surgical efficiency of patients with DIP endoscopic score <16.5 was better than the patients with DIP endoscopic score ≥16.5(P<0.05).

CONCLUSION: DIP endoscopic scoring system has a good predictive value for the prognosis of endoscopic of transnasal endoscopic sinus opening combined with dacryocystorhinostomy.

Abstract:AIM: To observe the efficacy of pterygium excision combined with autologous limbal epithelial bulbar conjunctival transplantation in the treatment of patients with pterygium.

METHODS:Prospective controlled study. A total of 102 patients(102 eyes)with pterygium treated in the hospital between October 2015 and October 2019 were selected as study subjects, and they were divided into observation group and control group according to the random number table method, with 51 cases in each group. The control group was treated with pterygium excision combined with amniotic membrane transplantation, and the observation group was given pterygium excision combined with autologous limbal epithelial bulbar conjunctival transplantation. The perioperative indicators(intraoperative blood loss, surgical time, corneal epithelial repair time)and clinical efficacy at 3mo after surgery were compared between the two groups, and the disease recovery-related indicators \〖tear film break-up time(BUT), uncorrected visual acuity(UCVA), Schirmer Ⅰ test(SⅠt), corneal astigmatism degree(CAD)\〗 before and 3mo after surgery, postoperative aesthetic degree and recurrence during follow-up were recorded.

RESULTS:The corneal epithelial repair time in observation group was shorter than that in control group(4.14±1.35 vs 4.72±1.37d,P<0.05), while the surgical time was longer than that in control group(32.24±6.69 vs 29.67±5.21min,P<0.05), and there was no statistical significance in the intraoperative blood loss between the two groups(P>0.05). At 3mo after surgery, there was no statistical difference in the effective rate of treatment between the two groups(86.3% vs 78.4%, P>0.05). At 3mo after surgery, the BUT, UCVA and SⅠt in the two groups were significantly enhanced compared with those before surgery(all P<0.05), and the UCVA and SⅠt in observation group were higher than those in control group(all P<0.05), but there was no statistical difference in the BUT between the two groups(P>0.05). The CAD in the two groups was significantly lower than that before surgery(P<0.05), but the difference was not significant between the groups(P>0.05). At 3mo after surgery, the scores of dimensions of aesthetic scale for pterygium treatment(ocular recovery, subjective symptoms)were significantly higher in observation group than those in control group(all P<0.05), but there were no statistical differences in the scores of cleanliness of surgical area and congestion between the two groups(all P>0.05). There was no statistically significant difference in recurrence rate between the two groups during follow-up(P>0.05).

CONCLUSION: Pterygium excision combined with autologous limbal epithelial bulbar conjunctival transplantation can effectively treat pterygium and prevent recurrence, and it has faster postoperative recovery and better aesthetic degree compared to pterygium excision combined with amniotic membrane transplantation.

Abstract:AIM:To analyze the efficacy and safety of pterygium resection respectively combined with Ologen collagen matrix implantation and autologous conjunctival flap transplantation.

METHODS:A total of 80 patients(87 eyes)with pterygium admitted to the hospital between January 2017 and January 2020 were selected, and randomly divided into observation group(40 patients, 44 eyes)treated with pterygium resection combined with Ologen collagen matrix implantation and control group(40 patients, 43 eyes)treated with pterygium resection combined with autologous conjunctival flap transplantation. The patients were followed up till 12mo after operation. The best corrected visual acuity, corneal astigmatism, surface asymmetry index(SAI), surface regularity index(SRI), corneal epithelial healing, pterygium recurrence and the incidence of complications were compared between the two groups.

RESULTS:Visual changes of the two groups were similar at 6 and 12mo after operation(P>0.05). Corneal astigmatism, SAI and SRI were reduced in the two groups at 1 and 3mo after operation. The corneal astigmatismat 3mo after operation and SAI, SRI at 1 and 3mo after operation were significantly lower in the observation group than in the control group(all P<0.05). The corneal epithelial healing rate in observation group at 1wk after operation was significantly higher than that in the control group(73% vs 46%, P<0.05), and corneal epithelium of the two groups healed at 2wk after operation. No pterygium recurrence was observed in the two groups within 12mo after operation. The situation of pterygium recurrence was similar in the two groups at 6 and 12mo after operation(P>0.05). There was no significant difference in the incidence of complications between the two groups(7% vs 14%, P>0.05).

CONCLUSION:Both pterygium resection combined with Ologen collagen matrix implantation and pterygium resection combined with autologous conjunctival flap transplantation are effective in the treatment of pterygium, with equivalent safety. However, the former has more advantages in improving corneal astigmatism and regular shape of corneal wound.

Abstract:AIM:To observe the near stereoscopic visual function of adolescents with different degrees of myopic anisometropia after being corrected by spectacles and orthokeratology.

METHODS:In this prospective clinical research,220 patients aged 10-20 years old with myopic anisometropia were recruited between March 2017 and December 2018. All the patients were divided into four groups according to the difference of cycloplegic spherical equivalent refractive(SER)error between the two eyes: group of 76 cases without anisometropia(SER error difference less than 1.00D), group of 60 cases with mild anisometropia(SER error difference of 1.00-<1.75D), group of 51 cases with moderate anisometropia(SER error difference of 2.00-<2.75D), and group of 33 cases with severe anisometropia(SER error difference of 3.00D or more). With regards the different optical correction approaches for myopia, 88 cases were categorized into the orthokeratology group and 132 cases into the spectacle group, the stereoacuity values at 3mo after correction were compared between the orthokeratology group and the spectacle group to see whether statistically significant difference existed.

RESULTS:In the group of spectacle correction, there was significant statistical difference existed between the four sub-groups for the near stereoscopic visual function(P<0.001). In the group of orthokeratology correction, there was no statistical difference existed between the four sub-groups for the near stereoscopic visual function(P=0.765). In both non-anisometropia and mild anisometropia groups, there was no statistical difference between the orthokeratology correction and spectacle correction sub-groups for the near stereoacuity values(P=0.109,P=0.052). However, in the moderate and severe anisometropia groups, orthokeratology group had better near stereoscopic vision than spectacle group(P<0.001).

CONCLUSION: Adolescents with myopic anisometropia corrected by orthokeratology lens were better at near stereoscopic visual function than corrected by spectacles, especially in the moderate and severe anisometropia groups.

Abstract:AIM: To investigate the pathogenic mutations of the OAT gene in a Chinese family affected with gyrate atrophy of choroid and retina(GA)and describe their clinical manifestations.

METHODS: All available family members have underwent detailed ophthalmological examinations. The sequencing results and pathogenic mutations were clarified by whole exome sequencing, bioinformatics analysis and Sanger sequencing.

RESULTS: Based on the clinical manifestations and symptoms, the proband was diagnosed with GA. A missense mutation of c.722C>T(p.P241L)in exon 6 and a nonsense mutation of c.1186C>T(p.R396X)in exon 10 were identified in the OAT gene of the proband, which was a compound heterozygotic mutation. This compound heterozygous mutation showed co-segregation in the family. The heterozygous pathogenic variant of p.R396X was detected in both the proband's father and elder brother, and the heterozygous pathogenic variant of p.P241L was detected in proband's mother. Except for the proband, no other family members have abnormal clinical manifestations.

CONCLUSION: The proband of this family is a compound heterozygous mutation, in which p.P241L is the first reported gene mutation type. This result expands the range of OAT gene variation and is conducive to further understanding the pathogenic factors of GA at the molecular basis level. The discovery and confirmation of the novel mutation type will also help to provide a new basis for the clinical diagnosis and gene therapy of GA.

Abstract:AIM:To analyze the ocular clinical manifestations especially retinopathy of pediatric patients with incontinentia pigmenti(IP).

METHODS: Clinical data of 33 patients diagnosed with IP from January 2014 to December 2018 in Hunan Children's Hospital were retrospectively analyzed. The follow-up was 1a. All the patients underwent ocular examinations and systemic physical examinations. Patients received treatments according to their fundus condition.

RESULTS:Totally 31 female patients and 2 male patients, who aged from 5d-23mo at first visit, with the average age 3.38±5.02mo. There were 14 patients had ocular anomalies, including corneal opacity(1 case, 1 eye), cataract(1 case, 1 eye), exotropia(2 cases, 2 eyes)and retinopathy(14 cases, 23 eyes). In the 14 patients with ocular anomalies, one patient died due to neuropathy, one patient underwent vitrectomy in the right eye and fundus fluorescence angiography(FFA)combined with retinal laser photocoagulation in the left eye, one patient had lensectomy and vitrectomy in the right eye and FFA combined with retinal laser photocoagulation in the left eye during the follow-up. At the last follow-up, one of the 13 surviving patients with ocular anomalies had retinopathy of IP stage 1, while retinal lesions regressed in other patients.

CONCLUSION:The ocular manifestations of IP are diverse, which is identified with retinopathy. Standard ophthalmic fundus screening and regular follow-up are of great significance.