AIM: To investigate the efficacy and safety of perfluorocarbon liquid(PFCL)as a short term postoperative tamponade for treating retinal detachment associated with giant retinal tears.METHODS: Data was retrieved from the medical charts of patients who underwent vitrectomy from January 1998 to December 2010 at a single medical center. Success rates of retinal reattachment, visual outcome, and postoperative complications were compared between procedures with and without PFCL. RESULTS: At the end of surgery, all retinas were attached in the 22 eyes(21 patients)treated with PFCL and in the 14 eyes(14 patients)not treated with PFCL as temporary tamponade. Final reattachment rates were 81.8% and 42.9%, respectively(P<0.05). Four eyes(18.2%)in the study group compared to 7 eyes(50%)in the control group developed severe proliferative vitreoretinopathy with persistent retinal detachment. Visual acuity was 6/12 or better in 73.3% of the study group and 26.7% of the control group, P<0.05. Visual acuity improved in 50.0% of patients in the study group and 14.3% in the control group. Visual acuity worsened in 22.7% of the patients in the study group and 57.1% in the control group(P=0.054).CONCLUSION: Perfluorocarbon liquid appears safe and effective as a short term postoperative tamponade in the management of retinal detachment from giant retinal tears and in the prevention of proliferative vitreoretinopathy.

AIM: To investigate the potential association between serum sialic acid and diabetic retinopathy and its several grades.METHODS: We studied the level of serum sialic acid in 70 patients. Thirty control vs 40 type 1 diabetics and with different levels of diabetic retinopathy as well. RESULTS:We found higher levels of serum sialic acid level in diabetics compared to control subjects(95.95±9.5 vs 45.05±19.91mmoL/L, P=0.0001). We also observed a progressive rise in its concentration as the level of diabetic retinopathy increased(P<0.05)but the correlation was weak. Serum sialic acid level correlated positively with blood glucose level(r=0.67, P=0.0001).CONCLUSION: Increase in serum sialic acid levels seems to be related to the stage of the retinopathy and may help us to determine the extent of retinopathy in type 1 diabetic patients. But we think that we need more detailed studies to get a more precise conclusion.

AIM: To investigate extent and nature of visual pathways involvement in children with acute viral encephalitis. METHODS: Thirty patients(age 5-12 years)with acute viral encephalitis underwent visual evoked potentials(VEP)investigation within 12 days from the appearance of the first signs of disease. Latency and amplitude of P100 peak were compared with normative data and between patients with varicella and tick-borne encephalitis. RESULTS: There were no significant differences between children with these two forms of encephalitis. In the whole group in 40% of the cases signs of the visual cortex dysfunction(P100 amplitude lowering)and mild slowing of the conductivity along the visual pathways(P100 latency lengthening)were seen. In 3% of the cases retrobulbar optic neuritis was diagnosed. CONCLUSION:The results indicate that visual pathway have good endurance to the viral encephalitis anatomically, but functionally visual cortex is quite vulnerable towards general disturbances caused by this kind of illness.

AIM: To investigate the angiogenesis effect and mechanism of ginsenoside Rg3 on human retinal capillary endothelial cells(HRCECs)cultured in normal and high glucose conditions. METHODS: We cultured HRCEC both in normal and high glucose conditions. Each condition we treated the cells with 0.1mmoL/L ginsenoside Rg3 and 0.5mmoL/L ginsenoside Rg3. The effect of ginsenoside Rg3 on HRCEC proliferation was tested by methylthiazoletrazolium(MTT)assay 24h, 48h and 72h after the treatment; The effect of cell migration was tested by transwell; The effect of tube formation was tested by Matrigel; Western-Blot and real-time quantitative RT-PCR were used to detect the expression of vascular endothelial growth factor(VEGF)protein and mRNA. Data were statistically analyzed by ANOVA method. RESULTS: Ginsenoside Rg3 could inhibit proliferation, migration and tube formation of HRCEC in both conditions, depending on the concentration and time. Ginsenoside Rg3 could decrease the expression of VEGF mRNA and protein in both conditions. CONCLUSION: Ginsenoside Rg3 could inhibit VEGF expression, thus suppress the proliferation, migration, and tube formation of HRCEC in normal and high glucose conditions.

AIM: TO investigate the effects of tranilast on proliferation of cultured human retinal pigment epithelial(RPE)cells in vitro.METHODS: To treate them with different concentrations of tranilast 0(control group), 12.5, 25, 50, 100mg/L after culturing human retinal pigment epithelial cells(hRPE-19 cell line)3-5 generations. And then to observe cell morphology under inverted microscope combined with HE staining, identify the cell by keratin CK18. Detecting inhibition rate by MTT colorimetric method after the cells were treated with different concentrations of tranilast for 12h, 24h, 48h. The RPE cells were cultured with different concentrations of tranilast for 24h, then to measure the transforming growth factor β1(TGF-β1)and platelet-derived growth factor receptor A protein(PDGFR-A)expressing by Western-Blot and immunohistochemical method. RESULTS: The cell inhibition rate increased with the increase of concentration at the same time point(P<0.05). It shows a statistically significant difference. TGF-β1 protein expression is in cell plasma and PDGFR-A protein in the cell membrane and cytoplasm, the expression of their amount was lowered with the increase of concentration of tranilast(P<0.05). It shows a statistically significant difference.CONCLUSION: Tranilast could inhibit RPE proliferation, and it may be connected with the decreased TGF-β1 and PDGFR-A protein expression.

AIM:To evaluate the long-term effect of laser in situ keratomileusis(LASIK)in the treatment of myopia. METHODS:A retrospective analysis of the uncorrected visual acuity(UCVA), refractive diopters, corneal curvature, central corneal thickness and postoperative complications were performed for the people who has accepted the operation for at least 8 years. The patients were divided into three groups according to their degree of preoperative myopia: -1.00～-6.00D of 92 eyes were in group A; -6.25～-10.00D of 68 eyes in group B; ≥-10.00D of 27 eyes in group C. RESULTS: More than 8 years after the operation, the UCVA≥1.0 were 73.9%, 52.9% and 22.2% and the refractive diopters were -0.21±0.06D, -0.54±0.12D, -2.33±0.36D in each group. The residual refractive error within ±1.00D was 83.4% and within ±0.50D was 59.4%. There were significant differences between group A and group B/C(P<0.05). More than 8 years after LASIK compared with that one year after the operation, the refractive regression more than 1.00D accounted for 9.09%. CONCLUSION: LASIK for the treatment of myopia is safe, effective, predictable and stable. Especially for the low to moderate myopia patients who can obtain more satisfactory treatment effect.

AIM: To compare therapeutic effect of three different patterns of laser in situ keratomileusis: standard laser in situ keratomileusis(S-LASIK), aspheric ablation laser in situ keratomileusis(A-LASIK), and tissue-saving laser in situ keratomileusis(T-LASIK). METHODS: Retrospective Case Series. From February 2001 to October 2012, 66 patients(112 eyes), who received laser in situ keratomileusis in our hospital and were followed up for more than 6 months, were analyzed retrospectively. The surgery was underwent with 217z excimer laser of Bausch & Lomb and with the 110μm corneal flap made by OUP90 of Moria company. According to diopter, corneal thickness and pupil diameter in dark, different surgical patterns were adopted, and thus the patients were divided into three groups: S-LASIK(n=36), A-LASIK(n=40)and T-LASIK(n=36). The preoperative nocturnal visual satisfaction, nocturnal visual satisfaction in 6 months after the operation, UCVA, BSCVA, spherical equivalent(SE), K value measured by Orbscan II anterior eye segment analysis system, thinnest corneal thickness(TCT)and high-order aberration analysis(C7, C8, C12, RMSh)at 5mm pupil diameter were noted. Changes and relevance of these testing indexes were observed and analyzed preoperatively and postoperatively.RESULTS: According to the research on nocturnal visual satisfaction in 6 months after surgery, A-LASIK group showed better outcome than S-LASIK group and T-LASIK group. In the same period, SE less than ±0.5D in three groups accounted for 96.43%. RMSh, C7 and C12 in three groups all increased postoperatively(P<0.05). These differences were of statistical significance. In the three groups, the measured ablation depth, compared with estimated ablation depth, increased 14.94±29.81μm, 11.2±10.94μm, 5.83±17.09μm respectively and the ablated depth per unit area and per unit diopter was 0.85±0.27μm/(D·mm2), 0.72±0.08μm/(D·mm2), 0.59±0.09μm/(D·mm2)respectively(P<0.05). T-LASIK and A-LASIK saved 30.59% and 15.29% of corneal tissue compared to S-LASIK. CONCLUSION: S-LASIK, A-LASIK and T-LASIK can correct myopia and astigmatism effectively. RMSh, C7 and C12 in three groups have all increased postoperatively. The nocturnal visual satisfaction of A-LASIK group is superior to the other two groups, which may be associated with the less change in aberration. Compared with S-LASIK, both A-LASIK and T-LASIK are effective in saving corneal tissue. Ensuring the effect of clinical correction, meanwhile, group T-LASIK reduced the corneal thickness correction to reduce the changes of corneal blomechanics as much as possible.

Primary open angle glaucoma is a chronic and progressive optic neuropathy. It can lead to serious damage of visual impairment, and it is an important eye disease of blindness. Multifocal electroretinogram is a new way to measure visual electrophysiology. It can measure electroretinogram of the whole visual field of many small parts in a relatively short period of time, and it can reflect the function of regional retina. It has an extremely important value for early diagnosis of primary open angle glaucoma. The research advances on multifocal electroretinogram in diagnosing primary open angle glaucoma were summarized in this paper.

Pterygium is one of the common ocular surface diseases, characterized by local subconjunctival fibrovascular proliferation invading the cornea, not only influences facial beauty, but affects visual acuity and causes ocular dyskinesia. Surgical removal is the main treatment option. However, the recurrence rate is high(20%-40%). Many explanations are put forward by scientists, but the mechanism of pterygium still remains unclear. It is of great importance to study the pathogenesis of pterygium so as to prevent its occurrence and development. In this paper, we make a review about the domestic and international studies of the inhibition of apoptosis, matrix metalloproteinase, oxidative stress and immunity in pterygium.

AIM: To measure the expression of stromal cell derived factor-1(SDF-1)and vascular endothelial growth factor(VEGF)in retina of diabetic rats model at the different stage and explore the inhibitory effect of AMD3100 on the expression of SDF-1 and VEGF mRNA by RT-PCR and Western-Blot test.METHODS: RT-PCR and Western-Blot tests were carried out. In RT-PCR test, 60 adult SD rats were divided into normal group, antagonist group, and diabetes group. After diabetic rat model was induced using streptozotocin and antagonist group and diabetic group were injected intravitreously and postocularly with AMD3100 and PBS respectively. All rats were killed and the retina was extracted. after 1,3,5 months and the HE stain of paraffin sections was used and the expression of SDF-1 and VEGF mRNA were measured with RT-PCR. In Western-Blot test, 18 rats were divided into normal group, diabetes group and four antagonist groups which were using different concentration of AMD3100, and killed after 3 months.RESULTS: SDF-1 and VEGF mRNA were expressed in normal group, antagonist group and diabetes group. At the same age group(1, 3 and 5 months)and among the normal group, antagonist group and diabetes group, the difference of expression of SDF-1 and VEGF mRNA were significant. The expressions in diabetic group were always highest and antagonist group lower than diabetic group. The expression of SDF-1 and VEGF mRNA was increased significantly with the extension of disease. The HE Stain of paraffin sections showed DM group had more cell nucleus which protruded internal limited membranes than normal control group and antagonist group. The Western-Blot test showed in 4 antagonist groups the SDF -1 and VEGF protein expression levels gradually decreased with the increases of SDF-1 antagonist AMD3100 concentration, the difference was significant. When intravitreous injected concentration of AMD3100 increased over 10μg/μL, the expression of SDF-1 and VEGF protein did not change, the difference was not statistically significantCONCLUSION: With the progression of diabetic retinopathy, the expression of VEGF and SDF-1 mRNA in the retinal tissue of diabetic rats increased. The antagonist AMD3100 could reduce the expression of SDF-l, VEGF and inhibit the development of new blood vessels. In a certain concentration range, this inhibitory effect of AMD3100 was dose-dependent.

AIM: To evaluate the clinical efficacy of lamellar keratoplasty combined with anterior chamber injections in the treatment of fungal corneal ulcer.METHODS:Patients who are diagnosed with fungal corneal ulcer and treated with layer corneal transplantation were in control group. Those with fungal corneal ulcer that treated with lamellar keratoplasty in experimental group, as well as they were injected with 0.1mL fluconazole(0.05mL 2g/L fluconazole +0.05mL normal saline)into the anterior chamber for three times during operation, at the 3rd day and 10th day after operations.RESULTS: The recurrence rate was 11% in control group, while no recurrence for experimental group in a 3- to 6-month follow-up observation.CONCLUSION: The combination of anterior chamber injection into lamellar keratoplasty is an efficient approach to cure fungal corneal ulcer, and shows low recurrence rate.

AIM: To investigate and analyze corneal edge ulcer training results, pathogenic bacteria distribution and drug resistance status of fungal keratitis.METHODS:Corneal edge ulcer of 68 fungal keratitis patients who were treated in our hospital from January 1, 2011 to December 31, 2012 was collected. They were sent to isolate culture, identification and drug sensitive test. The culture and drug sensitive test results, and pathological changes of corneal tissue were summarized.RESULTS:Fifty strains of fungi strains were checked out from 68 corneal edge ulcer, most of them were sickle bacteria genus. The resistant rate of natamycin, fluconazole, amphotericin and itraconazole was 26%, 46%, 54% and 60%, respectively.CONCLUSION: The most pathogenic bacteria were sickle bacteria genera, the resistance of amphotericin and itraconazole is higher, while that of itraconazole is lower.

AIM: To investigate the perioperative prophylactic utilization of antibiotics in phacoemulsification and intraocular lens implantation patients in ophthalmology department of our hospital.METHODS: A total of 1 156 cases underwent phacoemulsification and intraocular lens implantation from November, 2009 to November, 2012 in our hospital was included. Category of antibiotics, administration time point, medication time, wound healing were analyzed statistically and the rationality of above indexes was evaluated.RESULTS: All 1 156 cases received prophylactic antimicrobials by local application in the perioperative period(100%). The utilization rate of the antibacterials systematically of 1 156 patients was 166(14.36%); The utilization rate of the antibacterials systematically in patients with two systemic infection risk factors was 72.09%; The utilization rate of the antibacterials systematically in patients with three or more systemic infection risk factors was 100%. All incisions were healed well with no postoperative infections.CONCLUSION: The perioperative prophylactic utilization of antibiotics in phacoemulsification and intraocular lens implantation patients was meeting the standard of the ministry of health. In addition, the ministry of health organization was advised to formulate the clinical guidelines on perioperative prophylactic utilization of antibiotics in eye operation.

AIM: To observe the effect of IL-10 modified immature dendritic cells(imDC)for providing theoretical and practical basis for anti-rejection of corneal transplantation.METHODS: Eighteen Wistar rats were used as donors and 36 SD rats were used ad recipients. The recipient was injected by tail with donor IL-10-treated imDC or with untreated imDC. The rats were randomly assigned to three groups, 12 in control group received nopretreatment, 12 in imDC group were injected with imDC(2×106)3d before surgery, and 12 in IL-10-imDC group were injected with IL-10-imDC(2×106)3d before surgery. The survival time of corneal allografts in three groups were observed. The expression of NF-κB was detected by histopathological examination 14d postoperative.RESULTS: The mean survival time was merely 10.17±2.16d, 19.83±2.25d and 27.57±1.72d respectively in control, imDC and IL-10-imDC groups. There was significantly difference among three groups(P<0.01). Corneas in groups B and C had fewer infiltrating cells, corneal thickness almost normal, and stroma arrangement in order, the center of the grafts showed no inflammatory cellular infiltration. NF-κB cells strongly expressed in control group(P<0.05), and there was no significant difference between groups B and C(P>0.05).CONCLUSION: IL-10 can restrained DC from mature. Derivatives from donor imDC can markedly prolong the survival time of corneal allografts. NF-κB may play a potential role in the development of corneal graft rejection.

AIM: To evaluate the effect of trabecular filtration surgery combined with scleral interlayer filled with silicon rubber for refractory glaucoma and its complications.METHODS: A total of 32 cases(32 eyes)of refractory glaucoma underwent trabecular filtration surgery combined with sclera interlayer filled silicone piece, namely trabeculectomy combined silicon rubber filled in sclera between layers was as experimental group. Twenty-one cases(21 eyes)treated by simple trabecular filtration surgery were as control group. Reducing effect of intraocular pressure(IOP)and complications of two groups were observed after operation.RESULTS: Postoperative follow-up was 6-24 months. The mean IOP was 14.36±5.2mmHg(1mmHg=0.133kPa)in experimental group and 23.36±9.3mmHg in control group after operation. IOP of three eyes(9.4%)in experimental group and 5 eyes(23.8%)in control group was over 30mmHg. There was no serious complications and rejection correlated with silicone piece during the follow-up period.CONCLUSION:Silicone piece filled between sclera layer is an effective method for refractory glaucoma, and can effectively reduce IOP. Due to its economic, convenient, especially can replace expensive imported drainage plant figure treatment of refractory glaucoma in our country the grass-roots hospital, it should be widely applied.

AIM: To evaluate the efficacy of vitreoretinal surgery in the treatment of X-linked retinoschisis(XLRS)and its complications. METHODS: A retrospective study was made on all the XLRS patients with severe complications after operation in this hospital. All the 25 patients(31 eyes)present with macular abnormalities with/without peripheral retina split bypreoperative OCT examination. Among the 31 eyes, there were 7 eyes with vitreous hemorrhage, 8 eyes with retinal detachment and vitreous hemorrhage, and 16 eyes with rhegmatogenous retinal detachment. All the 31 eyes were divided into 2 groups: group A included 15 eyes which underwent photocoagulation before the surgery, while the other 16 eyes in group B didn't perform photocoagulation before the surgery. All the patients underwent a pars plana vitrectomy without lensectomy associated with internal limiting membrane peeling. Photocoagulation was done to the retinal holes and degeneration areas in group A. Gas or silicone oil was filled in group B after retinal photocoagulation treatment. Three years later, analysis was made on the results of the visual acuity, postoperative anatomical and functional outcome in these 2 groups. Statistical analysis was made on the results of average visual acuity before and after operation by SPSS software method, the difference was statistically significant(P<0.05). The differences of changes of visual acuity in two groups were statistically significant by one-way analysis of variance method. RESULTS: Postoperative anatomical and functional outcome were satisfied at the last visit. A total of 23 eyes'(74.2%)visual acuity were improved with the mean visual acuity increasing from 0.13±0.08 to 0.24±0.16, the difference was statistically significant(t=-5.354,P=0.000). The average visual acuity in group A was improved from 0.11±0.08 to 0.22±0.15 after operation(t=-4.391, P=0.000). While the average visual acuity in group B increased from 0.14±0.08 to 0.26±0.15(t=-4.488, P=0.000). The visual changes in two groups were statistical significance. But when compared the average changes of visual acuity before and after operation between two groups, F=4.055, P=0.069, there was no statistical significance. During the following-up period, the complications were found in three eyes, among which two eyes presented with proliferative vitroretinopathy and traction retinal detachment 10 and 12 months after surgery, and one eye presented with cataract 3 months after surgery. Two eyes belonged to group A while the third eye pertain to group B. After reoperation, all the three eyes have good prognosis and retinoschisis didn't worsen.CONCLUSION: Vitreoretinal surgery can be applied to the treatment of X-linked congenital retinoschisis and its complication, effectively preventing the deterioration of schisis cavity and contributing to the improvement and stabilization of visual acuity and resuming the anatomic structure of retina.

AIM:To investigate the effects of transforming growth factor-β1(TGF-β1)on gene expression of main components of Smads family including Smad3, Smad4 and Smad7 in orbital fibroblasts(OF)of fibrosis extraocular muscle with thyroid -associated ophthalmopathy(TAO). METHODS: OF were treated with 5μg/L TGF-β1 at different time points(0min, 15min, 30min,1h, 2h and 4h), and real-time quantitative RT-PCR was performed to observe the effects of TGF-β1 on the expression of Smad3, Smad4 and Smad7 mRNA.RESULTS: The expression of Smad3 mRNA was 10.71 times to that of control group at 15min and 25.07 times at 1h(P<0.01); Smad4 mRNA was 1.54 times to that of control group at 15min and 15.99 times at 1h(P<0.01); Smad7 mRNA was 3.21 times to that of control group at 30min and 14.66 times at 4h(P<0.01).CONCLUSION: TGF-β1 up-regulate the expression of Smad3, Smad4, Smad7 mRNA in OF in a time dependent fashion, TGF-β1/Smad pathway may play an important role in the pathogenesis of extraocular muscle fibrosis with TAO.

AIM: To make a retrospective analysis of the clinical data of modified trabeculectomy in treating glaucoma surgery with high elevated intraocular pressure retrospectively and evaluate the effect of modified trabeculectomy.METHODS:One hundred acute angle-closure glaucoma patients(100 eyes)with persistent high intraocular pressure were divided into treatment group(45 eyes)and control group(55 eyes). Patients in treatment group was treated with by trabeculectomy, while those in control group received modified trabeculectomy. The modified measures include stellate ganglion block preoperative, topical anesthesia and local anesthesia with 20g/L lidocaine cotton-piece, to make scleral flap with sclerotome, to release aqueous humor outflow slowly after paracentesis of anterior chamber, and using mydriatic and cycloplegic during and after surgery.RESULTS: The incidence of operation complicationin control group was lower than that in treatment group. The differences were statistically significant(P<0.05). The intraocular pressure of control group was lower than that of treatment group after 3 months follow-up. The differences were statistically significant(t=9.1535, P<0.05). The average hospitalization days and the expenses in the hospital of the control group were lower than that of the treatment group. The differences were statistically significant(t=39.8010, P<0.01; t=11.3219, P<0.01).CONCLUSION: The modified trabeculectomy applied in the treatment of glaucoma with persistent high intraocular pressure can not only save the visual function of connection part to a certain extent, but also reduce the incidence of serious complications. It can obtain better intraocular pressure, shorten the average hospitalization days, decrease the expenses and increase patients satisfaction.

AIM: To investigate the related risk factors of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(DM)in residents of community in our local area and provide a clinical evidence for prevention and treatment for the complication of DM. METHODS: The residents who lived in our local community with type 2 DM and hospitalized were studied. The stages of DR and duration of DM, blood pressure, level of blood glucose, blood lipids and other factors were analyzed statistically.RESULTS: Fifty-three patients(30.1%)were found with DR in 176 cases. The risk factors included the diabetic duration and glycosylated hemoglobin(all P<0.05). Age, systolic blood pressure, diastolic blood pressure, fasting blood glucose, 2-hour postprandial blood glucose, serum cholesterol, triglycerides, high dense lipoprotein, low dense lipoprotein, alanine aminotransferase, aspartate aminotransferase, creatinine, blood urea nitrogen were not risk factors of DR(all P>0.05). CONCLUSION: Diabetic duration and glycosylated hemoglobin are the risk factors of DR.

AIM: To investigate the progress, prevention and cure effect of diabetic retinopathy(DR)during pregnancy.METHODS: Eighty-four gravidas were enrolled in this prospective study. The patients were divided into three groups, group A consisting of 28 gravidas with gestational diabetic mellitus(GDM)with DR, group B consisting of 28 gravidas with GDM alone, and group C consisting of 28 normal gravidas. The best corrected visual acuity(BCVA)and glycosylated hemoglobin(HbA1c)were determined and fundus photography was performed at 6, 9 months of pregnancy and 6 months after parturition respectively. RESULTS: During pregnancy, the morbidity of GDM and DR was respectively 5.6% and 16.7%; the progress rate of gestational DR was 39.3%. At 9 months of pregnancy, the mean BCVA of group A was significantly poorer than that of group B or C(P<0.05)while there was no significant difference in BCVA between group B and C(P>0.05). The BCVA of group A at 9 months of pregnancy was poorer than that at 6 months of pregnancy or 6 months after parturition. At all times, the mean level of HbAlc of group A were significantly higher than that of group B or C(P<0.05). CONCLUSION: DR progressing during pregnancy may be related to the increased HbAlc level, so close monitoring and control of blood glucose may help to reduce the visual impairment among DM gravidas.

AIM: To evaluate the efficacy of prophylactic vitrectomy for acute retinal necrosis syndrome(ARNS).METHODS: Twenty-six patients(33 eyes)were retrospectively included in this study. The eyes were divided into 2 groups by treatment, including routine treatment, which consisted of antiviral medication and vitrectomy after retinal detachment(RD)(n=20), and prophylactic vitrectomy, which consisted of antiviral medication and vitrectomy for the prevention of RD performed during the active inflammatory phase(n=13). The follow-up period ranged from 6 to 48 months. RESULTS: In the routine treatment group, retinal detachment occurred in 11 eyes(55%), 4 eyes(20%)developed ocular atrophy, 3 eyes(15%)achieved increased visual acuity. In the prophylactic vitrectomy group, RD occurred in 1 eyes(8%), 5 eyes(38%)achieved increased visual acuity. There was lower incident of retinal detachment in the prophylactic vitrectomy group than that in the routine treatment group(P<0.05). CONCLUSION: Prophylactic vitrectomy can prevent RD and improve the prognosis of ARNS.

AIM: To investigate the long-term clinical manifestations of Array multifocal intraocular lens implantation.METHODS: Of 33 cases with phacoemulsification cataract operation, 19 cases(25 eyes)underwent implantation of multifocal intraocular lens(experimental group), 14 cases(20 eyes)implanted monofocal intraocular lens(control group). Postoperative far visual acuity, intermidiate visual acuity, near visual acuity, stereo vision, off glass rate under different distances was observed.RESULTS: The near uncorrected visual acuity ≥0.5 in experimental group were 17 eyes(68%, 17/25), and that in control group were 6 eyes(30%, 6/20), there was significant difference between two groups(P<0.05). The far uncorrected visual acuity ≥0.5 in experimental group were 23 eyes(92%, 23/25), and that in control group were 20 eyes(100%, 20/20), there was significant difference between two groups(P>0.05). Intermediate visual acuity: 40cm: scores of experimental group were 54.64±10.80, scores of control group were 47.05±6.39, there was significant difference between two groups(P<0.05). 63cm: scores of experimental group were 50.36±10.32, scores of control group were 46.50±8.32, there was no significant differences between two groups(P>0.05). 100cm: scores were 43.44±8.08 and 42.05±6.63 in experimental group and control group, with no significant difference(P>0.05). Stereo vision: 6 cases of experimental group underwent bilateral operation, stereo acuity of 6 cases was ≤60″, 6 cases of control group underwent bilateral operation, 1 case stereoacuity was ≤60″, there was significant difference between two groups(P<0.05). Wear glasses rate when reading newspaper: 6 cases of the 19 cases in experimental group need glasses, 11 cases of the 14 cases in control group need glasses, there was significant difference between two groups(P<0.05).CONCLUSION: Array multifocal intraocular lens offered good vision in postoperation, provided good stereo vision for operators, reduced the rely on glasses postoperation, improved the quality of life for patients.

AIM: To evaluate the clinical feasibility of using a new optical coherence interferometry(IOL-Master), comparing with traditional ultrasonic biometry and manual keratometry in the accuracy and characteristics for intraocular lens calculation of high myopia.METHODS: The measurement of axial length was performed in 60 eyes(30 eyes for each group)with senile cataract of high myopia(≥-6.00D)using IOL-Master and ultrasonic biometry. The measurement of corneal power(K)was also performed in the patient using IOL-Master and manual keratometry preoperatively. Phacoemulsification and foldable lens implantation were done on the patients. IOL power calculation was carried out according to the SRK/T formula on the basis of the group-related data. Best corrected visual acuity, refraction, contrast sensitivity and wave front aberration root mean square(RMS)were re-tested after 3 months postoperatively.RESULTS: Significant difference between the two methods in axial length measurement which was 29.81±1.53mm by ultrasound and 29.63±1.81mm by IOL-Master(P=0.001). And in corneal power measurement which was 43.22±1.67K by manual keratometry and 44.27±1.39K by IOL-Master(P=0.006). There was a significant difference between the two groups(P=0.001). 63.0% vs 31.2% had a mean absolute refractive error(MARE)within ±0.50 diopter for the IOL-Master and A-scan groups, respectively(χ2=3.1, P<0.05). The RMS values of 4th order aberration, 4th order spherical aberration and total high order aberration in the IOL-Master group were lower than those in the A-scan group at 6mm pupil diameter 3 months later. CONCLUSION: IOL-Master is a non-contact, accurate, safe and reliable tool for calculating IOL power and it is more accurate on the design of the IOL in the cataract surgery on the high myopia patients.

AIM: To analyze the law and the therapeutic schedule of postoperative intraocular hypertension of posterior vitrectomy combined with intraocular plombage.METHODS: The visual acuity of 198 eyes after posterior vitrectomy combined with intraocular plombagefrom January 2009 to January 2011 in our hospital was monitored. Cases with intraocular hypertension were observed and analyzed.RESULTS: Among the 198 cases, there were 53 cases with early postoperative intraocular hypertension, showing that the incidence was 26.8%. The incidence was similar among DR, rentina vascular diseases, macular hole and rhegmatogenous retinal detachment, with no statistic significance(P>0.05). The incidence rates were also similar between the silicone oil plombage group and inert gas plombage group, with no statistic significance(P>0.05). But the incidence rates were different between the groups with and without cataract extraction and IOL implantation, showing statistic significance(P<0.05).CONCLUSION: The incidence of intraocular hypertension after vitrectomy combined with intraocular plombage has little to do with the protopathy and the filler, but is related with the surgical method. Releasing partial gas or anterior chabeer aqueous humbor fluid is an effective mean to lower IOP.

AIM: To analyze the visual evoked potentials(VEP)of 189 eyes subjected to traumatic injury, and to explore the feasibility and method to applying VEP technology to the evaluation of visual acuity after eye trauma. METHODS: All the objects were volunteers who were grouped according to a random examination with the international standard visual acuity chart. The study determined spatial frequency in stimulation mode, P100 amplitude and latency. Then, the lowest spatial frequency(LSF)was analyzed and its relationship with visual acuity were studied. Finally this study discussed about the way to evaluate visual acuity with VEP and also compared the VEP evaluation results with the visual acuity chart. RESULTS: The LSF of 22', 11', 5', and 3' corresponded respectively to vision of 0.1-0.2, 0.3-0.5, 0.6-1.0, 1.2-1.5. There was a significant difference in P100 amplitude between eyes with different visual acuity, but there was no significant difference in P100 latency between these eyes. The random evaluation results of VEP combined with LSF and P100 amplitude were highly consistent with the results with international standard visual acuity chart. CONCLUSION: It is practicable to evaluate these volunteers' visual acuity with the VEP technology.

AIM: To explore the treatment of neonatal dacryocystitis of different ages and the relationship between caesarean section and neonatal dacryocystitis.METHODS: A total of 260 cases(260 eyes)of children with neonatal dacryocystitis were divided into 1-3 months group, 4-6 months group, 7-12 months group and 13-24 months group, Each group was respectively given the lacrimal sac massage, lacrimal passage irrigation and probing of lacrimal passage method. Curative effect of each method was observed in different groups. Analysis was made to determine whether caesarean section was the cause of neonatal dacryocystitis.RESULTS: The comparison between 1-3 months group and 4-6 months group showed significant difference(χ2=19.89, P<0.05). Lacrimal sac massage was effective for babies under 6 months, particularly in 1-3 months babies. The curative effect of lacrimal passage irrigation in four groups was compared, and there was statistical significance in the difference between the curative effect of each group(χ2=54.95, P<0.05). The difference between the 1-3 months group and 4-6 months group was χ2=0.00003, P>0.05, lacrimal passage irrigation of these two groups showed no significant difference in efficacy. The comparison result between the other two groups showed no significant difference(P<0.05), lacrimal passage irrigation effects are different from each group. The comparison result between 7-12 months group and 13-24 months group was χ2=10.29, P<0.05. Infants born by cesarean section accounted for 85% of all cases. CONCLUSION:Lacrimal sac massage can exert very good therapeutic effects in infants less than 3 months. The curative effects of irrigation of lacrimal passage are quite good in babies under 12 months. Probing of lacrimal passage has a good curative effect in 7-12 months infants, but a poor curative effect in babies over 12 months. Caesarean section is an important cause for neonatal dacryocystitis.

AIM: To investigate a comprehensive treatment for accommodative esotropia.METHODS: Eighty patients with accommodative esotropia were analyzed. All cases wore corrective glasses 7d after mydriasis by 10g/L atropine. The pupils were all comprehensively trained. If the position of the esotropic eyes could not be corrected by spectacles and both eyes had similar visual acuity in one year, surgical intervention was taken to correct the position. Refraction, visual acuity, visual function and strabismus degree change before and after treatment were evaluated.RESULTS: One year after wearing glasses, 50 cases had corrected eye position through correction and 30 cases were partially accommodative esotropia. Ten cases of esotropia degree >+15△ which could not be complete corrected by cure correction got surgical intervention. Seven cases of them got normal eye positions and 3 cases were over corrected 10△-20△. After comprehensive treatment of 3 years, the cure rate of amblyopia was 88.7%.CONCLUSION: The treatment for accommodative esotropia is a comprehensive course. It is necessary to pay attention to eye position correction, but also for the treatment of amblyopia, while paying attention to establish binocular vision.

AIM: To analyze the epidemic status of the poor sight in middle school students in Changsha, and to propose basis for the strategy and measure of preventing poor sight.METHODS: A total of 16 843 students, selected from 12 junior high schools and 12 senior high schools in 6 districts in Changsha city with stratified-cluster sampling method, were brought into the eyesight screening. Light visual chart case was used to test eyesight. Database was established by Epidata 3.20 software and analyzed by SPSS 18.0 statistical software.RESULTS: Poor sight relevance ratio in middle school students in Changsha city was 71.44%, and poor sight relevant ratio in female students(74.47%)was higher than that in male(68.20%), and the difference was statistically significant(χ2=80.79,P<0.01). In general, poor sight relevance ratio was increased with the growth of age. In the same age group, poor sight relevant ratio in female students was higher than that in male. The relevance ratio of mild poor sight, middle poor sight and severe poor sight was 8.64%, 22.35% and 40.44%, respectively. The poor sight relevance ratio in different age groups was discrepant, and the difference was statistically significant(P<0.01).CONCLUSION: It is a social engineering to protect the middle school students' sight, so we should concentrate effort from family, school and social guidance together, and then come into comprehensive measures.

AIM: To explore the treatment effect of puerarin on ophthalmic artery blood velocity and blood rheology in patients with diabetic retinopathy, and provide experience for clinical medication. METHODS: Eighty-six patients with diabetic retinopathy were selected in our hospital from February 2010 to December 2012. They were randomly divided into study group and control group, each group of 43 cases. The two groups were taken blood glucose and symptomatic treatment, while study group were given to puerarin based on the therapy. Recording two groups of patients in hemodynamics and blood rheology in 1 month before and after the treatment, and make a contrast. RESULTS: Before treatment, the two group in blood rheology indexes, was not statistically significant(P>0.05); after treatment, patients in the study group of the hematocrit, the whole blood viscosity at low shear rate, plasma viscosity, whole blood viscosity, erythrocyte aggregation index were lower than those in the control group, the differences were statistically significant(P<0.05). Two groups had no statistically significant differences in the hemodynamic parameters before treatment(P>0.05); after treatment, Peak systolic velocity(PSV)and end diastolic velocity(EDV)in study group were higher than those in the control group, but the resistance index(RI)was lower than that in control group, the difference was statistically significant(P<0.05). CONCLUSION: Puerarin can improve hemodynamics and hemorheology in patients with diabetic retinopathy, and can protect the central retinal artery function.

AIM: To investigate the causes of diagnostic errors by analyzing the 15 cases of Vogt-koyanagi-harada(VKH)syndrome.METHODS: Data of 15 cases with VKH syndrome, collected from our out-patient clinic from January 2005 to December 2010, were analyzed retrospectively to find out the causes of diagnostic errors.RESULTS: The misdiagnosis rate was as high as 80% in 15 cases. The common misdiagnosis was conjunctivitis, papillovasculitis, maculopathy, posterior scleritis, glaucoma-iridocyclitis syndrome, serous retinitis, keratitis, and uveitis. Of 15 cases,visual acuity of 5 cases were lower than 0.3 due to not timely and accurate treatment. CONCLUSION: The misdiagnosis of VKH syndrome are related mainly with having not acquired medical history in detail, having not recognized the clinical symptom's features and the general manifestation of the VKH syndrome. The diagnostic ability for the VKH syndrome should be improved urgently.

AIM: To compare the difference in measurements of central corneal thickness(CCT)using A-scan,corneal specular microscopy and Pentacam in keratoconus. METHODS: Between July 2012 and October 2012, the CCT of 31 patients(55 eyes)were measured by A-scan, corneal specular microscopy and Pentacam. The results were analyzed by F-test and Pearson correlation. RESULTS: The values of CCT measured by A-scan(55 eyes), corneal specular microscopy(45 eyes)and Pentacam(52 eyes)were 469.87±57.56, 479.00±42.39, and 487.02±44.64μm, respectively; F-test results showed there were no statistical significant differences between CCT measured by three different instruments(P>0.05). The correlation between the measurements was evaluated using Pearson correlation coefficients. The CCT values by these three instruments were positively related by linear correlation analysis, A-scan and Pentacam measurements(r1=0.758, P<0.01), A-scan and Pentacam(r2=0.949, P<0.01), corneal specular microscopy and Pentacam(r3=0.685, P<0.01).CONCLUSION: There is a high correlation between these three instruments. A-scan and Pentacam are more precise than corneal specular microscopy. Pentacam system can measure the CCT easily, accurately and without any invasion. It is more suitable for people with keratoconus to monitor the every point of cornea and for people to do more deep research.

AIM: To investigate the effects of Huoxuelishuimingmu Granules on corneal edema after phacoemulsification.METHODS: Ninety cases with at least second degree corneal edema the first day after phacoemulsification were randomly divided into the routinely treated group and the Huoxuelishuimingmu Granules intervened group, 45 cases for each group. To the routinely treated group, Tobramycin and Dexamethasone Eye Drops, Compound Tropicamide Eye Drops and Recombinant Bovine Basic Fibroblast Growth Factor Eye Drops were administered in turn during the treatment. While to the Huoxuelishuimingmu Granules intervened group, traditional Chinese medicines with the function of promoting blood circulation, alleviating water retention and removing nebula named Huoxuelishuimingmu Granules were additionally administered. The curative effects and the time taken for vanishment of corneal edema in each group were then observed. One week was counted as a course of treatment and curative effects were calculated after two courses.RESULTS: The Huoxuelishuimingmu Granules intervened group showed a much higher clinical cure rate and took quite shorter time for vanishment of corneal edema compared with the group treated with routine drugs(P<0.05 in both aspects), while no better total effective rate was observed(P>0.05). CONCLUSION: Huoxuelishuimingmu Granules has a preferable clinical effect on corneal edema after phacoemulsification, shortening the duration of corneal edema and restoring the sight of patients in advance.

AIM: To explore the effect of glucocorticoid eye drops in the treatment of epidemic keratoconjunctivitis(EKC)during the immune reaction period.METHODS:Totally, 206 EKC patients(359 eyes)with conjunctival pseudomembranous or(and)the subepithelial corneal infiltrates were selected. The treatment group used glucocorticoid eyes drops in conventional antiviral treatment and the control group only underwent the conventional antiviral therapy. Treatment effects were periodically reviewed and intraocular pressure was monitored.RESULTS: The total effective rates in conjunctive pseudomembranous were 91.4% and 56.9%; and the total effective rates in subepithelial corneal infiltrates were 90.8% and 61.8%. The difference was statistically significant(P<0.05).CONCLUSION: Using glucocorticoid eye drops during the immune reaction period of EKC is a safe and effective, which can prevent pseudomembranous formed and promote the absorbed of the subepithelial corneal infiltrates.

AIM: To observe the combined effect of Sodium hyaluronate eye drops and recombinant bovine basic fibroblast growth factor(bFGF)eye drops on cornea epithelial repair after corneal rust foreign body extraction. METHODS: Alinety-eight cases(98 eyes)of corneal rust foreign body patients were randomly distributed to combined treatment group(49 cases, 49 eyes)and control group(49 cases, 49 eyes). Hyaluronate eye drops, recombinant bFGF eye drops and levofloxacin hydrochloride were applied in combined treatment group after corneal foreign body extraction. Recombinant bFGF eye drops and levofloxacin hydrochloride were applied in control group. Corneal fluorescein stain, cornea epithelial repair and local symptoms were examined thrice weekly for 2 weeks. RESULTS: General effective rate of treatment in combined group reach 96%, significantly higher than that in control group(88%, P<0.05).CONCLUSION: Combined application of sodium hyaluronate eye drops and recombinant bFGF eye drops can prominently improve cornea epithelial repair after corneal lesion with proven effectiveness and safety.

AIM: To observe the operative treatment results on cataract patients with small incision non-phacoemulsification cataract extraction combined with intraocular lens implantation.METHODS: Totally, 166 cases(194 eyes)of cataract patients with small incision non- phacoemulsification cataract extraction combined with intraocular lens implantation were retrospectively analyzed.RESULTS: The best corrected visual acuity of all patients was significantly enhanced. The best corrected visual acuity >0.5 in 152 eyes(78.4%), 0.5-0.1 in 37 eyes(19.0%), lower than 0.1 in 5 eyes(2.6%).CONCLUSION: Small incision non-phacoemulsification cataract extraction combined with intraocular lens implantation has surgery time short, easily to grasp, the incision closed well and no need for suture, complication few, rapid rehabilitation of visual acuity, good outcome and other advantages.

AIM:To study the effect of high-vaccum-chop combined with intermittent-energy-release technique in phacoemulsification for hard nuclear cataract.METHODS: Sixty-eight patients(82 eyes)with age-related cataract were included in our study, all the eyes had hard nucleus classified as Ⅳ or Ⅴ. High-vaccum-chop combined with intermittent-energy-release technique were adopted in phacoemulsification of cataract, and IOL were implanted at the same time. Time of phacoemulsification, corneal transparency after operation and visual outcome were recorded.RESULTS: The mean relative ultrasound power was 25%-60% intraoperative. The time of ultrasound phacoemulsification was 58-105s, mean 85±20s. On the first day after operation, corneal edema classified at grade Ⅰ were seen in 28 eyes,45 eyes with corneal edema classified at grade Ⅱ, and 9 eyes at grade Ⅲ, no eye at grade Ⅳ. Seventy-three eyes with visual acuity ≥0.3 the first day after operation, and 32 eyes with a visual acuity ≥0.5. One week after operation, best corrected visual acuity >0.5 were seen in 78 eyes, and 71 eyes with a visual acuity better than 0.8.CONCLUSION: High-vaccum-chop combined with intermittent-energy-release technique in ultrasonic emulsification instrument with non-burst mode is an effective and convenient way for phacoemulsification of cataract with hard nucleus, and is especially suitable for primary hospitals.

AIM: To evaluate the effect of cataract surgery on life quality in Tibet plateau patients. METHODS: The Scale quality of life-diseases with visual impairment(SQOL-DVI)were completed by the patients before and at least 1 month after surgery. RESULTS: The indicators of the behavior activity, especially the basic life activity and the spirit activity of the patients with the improved vision function were significantly higher than those of the non-surgery patients. CONCLUSION: The life quality of Tibet plateau cataract patientsare is improved significantly because of the improvement of visual function after cataract operation.

AIM: To study the incidence of dry eye among clinic pediatric patients, and to analyze the correlation between pediatric dry eye and age, video display terminals(VDT)and conjunctivitis.METHODS: There were 128 cases of ophthalmology pediatric outpatients(7-13 years)enrolled in this study in an order-statistic manner. Modified ocular surface disease index(OSDI)questionnaire and the tear film breakup time(BUT)were used to evaluate the prevalence of dry eye and severity.RESULTS: The overall prevalence of dry eye in this study was 19.5%, of which 64 cases(15.6%)of children belongs to 7-10 years old group; another 64 cases(23.4%)of children belongs to 11-13 years old group. OSDI averaged 2.15±0.83 in 11-13 years old group, which was higher than that of 7-10 years old group(1.55±0.61). The difference between the two groups was statistically significant(P<0.05). In contrast, BUT averaged 10.05±2.97s in 11-13 years old group, which was shorter than that of 7-10 years old group(12.05±3.25s). The difference between the two groups was statistically significant(P<0.05). Those children who used visual display terminals over 2h every day had dry eye prevalence higher than that of the control group(43.3% vs 12.2%). Similarly, those who suffered from conjunctivitis during the recently three months had dry eye prevalence higher than that of the control group(26.3% vs 8.3%). The differences of OSDI and BUT between groups of each case were statistically significant(P<0.05). CONCLUSION: A considerable number of pediatric patients suffered from dry eye. Growing age, excessive use of visual display terminals and conjunctivitis are important risk factors.

AIM:To explore the operative opportunity and postoperative effects in patients with partially accommodative esotropia.METHODS: Three stages of the binocular visual function and VEP were observed in different ages with 65 cases of partially accommodative esotropia in preoperatively and postoperatively. RESULTS: The difference in binocular visual function between preoperatively and postoperatively was significant(Z=7.253, P=0.000). The difference in binocular visual function with the difference age of operation was significant(H=6.739, P=0.034). The postoperation latencies were shortened and amplitude values were higher than preoperation(Platency=0.029, Pamplitude=0.037).CONCLUSION: The binocular visual function was improved after surgery. The early correction of eye position will benefit to the binocular visual function.

AIM:To observe the clinical effect of vitrectomy for proliferative diabetic retinopathy(PDR).METHODS: The clinical data of 55 cases(65 eyes), underwent vitrectomy, membrane peeling, endolaser photocoagulation and silicone oil or C3F8 injection, were retrospectively studied. During 6 months to 1 year follow-up period, visual acuity, intraocular pressure, retinal conditions and complications were observed.RESULTS: All 65 eyes received vitrectomy, of which silicone oil was tamponaded in 32 eyes, C3F8 was injected in 8 eyes, BBS was filled in 25 eyes. Visual improvement achieved in 42 eyes. Two eyes were manually vision, form count fingers to 0.05 in 18 eyes, >0.05-0.1 in 28 eyes, >0.1-0.3 in 12 eyes and >0.3 in 5 eyes. Retinal hole was occurred in 7 eyes, limitations fibrosis membrane remained in 8 eyes, retinal detachment appeared in 5 eyes, IOP increased in 18 eyes, vitreous hemorrhage relapsed in 12 eyes, 36 eyes received supplemental photocoagulation treatment 1-3 times after operation.CONCLUSION:Vitrectomy combined endophotocoagulation is an effective treatment for PDR. Silicone oil tamponade can limit the hemorrhage.

AIM: To explore the efficacy and safety of hyperbaric oxygen therapy combined with jolethin in treating central serous chorioretinopathy.METHODS: Totally, 100 cases(118 eyes)of central serous chorioretinopathy hospitalized in our hospital from July 2008 to July 2012 were divided into control group and observation group according to random lot method. The control group only received hyperbaric oxygen treatment, and the observation group was given joint treatment with hyperbaric oxygen and iodized lecithin. The clinical outcome, healing condition at different times after treatment, visual acuity before and after treatment, the recurrence rate and adverse reaction were compared. RESULTS:(1)The control group consisted of 60 eyes and 43 eyes showed therapeutic efficacy, and the total effective rate was 71.7%; the observation group consisted of 58 eyes and 51 eyes showed therapeutic efficacy, and the total effective rate was 87.9%, and there was a statistical difference between the two groups(P<0.05);(2)There was a statistical difference in number of recovered eyes 2, 4 weeks and 3 months after treatment(P<0.05, P<0.01);(3)There was a statistical difference in visual acuity comparison between the two groups before and after treatment(P<0.05, P<0.01), and visual acuity after treatment in the observation group was significantly better than that in the control group(P<0.05);(4)After 1-year follow-up, in the control group, the number of eyes with recurrence was 6, and the recurrence rate was 10.0%; in the observation group, the recurrence rate was 0, and the difference was of great statistical significance(P<0.01).(5)There was no significant difference in adverse reaction during the treatment(P> 0.05).CONCLUSION:Hyperbaric oxygen therapy combined with jolethin in treating central serous chorioretinopathy shows significant effect and high safety. It is worth to be promoted and applied in the clinical treatment of central serous chorioretinopathyd.

AIM: To present a method of repairing orbital floor fractures using pre-shaped titanium mesh implants that were formed on templates designed on the basis of computed tomography images by MIMICS.METHODS: Ten patients with simple unilateral inferior orbital wall fracture were included in this study. All patients underwent transconjunctival repair of isolated orbital floor fractures. First, 3D virtual models and then 2D models with fracture areas were created on the basis of computed tomography images using MIMICS software. These 2D models were printed on the papers in real size and then sterilized as templates to shape the titanium mesh and which were then used in the reconstruction of orbital floor defects. Within 3 days after surgery, the orbits were then scanned by spiral CT to evaluate the reconstruction accuracy of preformed titanium mesh implants.RESULTS: CT scans reveal that the preformed titanium mesh implants had great accuracy to reconstruct the orbital floor defects in all patients. Significant improvement resulted in 1 case with respect to diplopia and enophthalmos and total recovery in 9 cases.CONCLUSION: It is clinically viable to build templates by MIMICS, on the basis of CT studies, that can be used to shape the titanium mesh in the repair of orbital floor fractures.

AIM: To explore the correlation of inflammatory cytokine(TNF-α, IL-1β, IL-6)concentrations of patients' tears with chemical burns of the ocular surface and its severity and prognosis.METHODS: Totally, 66 cases(80 eyes)of chemical burns of the ocular surface were divided to 4 degrees according to Roper-Hall classificatory criteria, with 35 cases(44 eyes)of degree I and II, 22 cases(25 eyes)of degree III, 9 cases(11 eyes)of degree IV. The concentration of TNF-α, IL-1β and IL-6 in tears was detected by ELISA, and there were 12 healthy people as control group.RESULTS: The concentration of TNF-α, IL-1β and IL-6 in patients with chemical burns of the ocular surface was higher than control group(P<0.01), among which, degree IV > degree III > degree I and II(P<0.01), and blinding rate in degree IV was higher than that in degree III, I and II(P<0.05). CONCLUSION: The concentration of TNF-α, IL-1β and IL-6 in patients with chemical burns of the ocular surface rises dramatically, with the increase of Roper-Hall classificatory criteria. With the increase of concentration of TNF-α, IL-1β and IL-6, the blinding rate rises. There would be of great significance of inflammatory cytokine concentrations for judging the severity and prognosis of patients with chemical burns of ocular burn.

AIM: To evaluate the effect of Qinpi eye drops combined with Cyclosporin A eye drops in the treatment of dry eye syndrome.METHODS: Totally, 200 patients(400 eyes)with dry eye syndrome were randomly divided into experiment group and control group, 100 cases(200 eyes)for each. The experiment group was treated by Qinpi eye drops combined with Cyclosporin A eye drops four times per day. The control group was treated by 0.5g/L Cyclosporin A eye drops every 30min only four times per day(one drop per time, 1mL≈15 drops). The Schirmer test(SⅠt), tear film break up time(BUT)were compared with before and after 4 weeks' therapy in both groups. The results were analyzed statistically.RESULTS: There were significant differences in SⅠt and BUT 4 weeks later after treatment in both groups(P<0.01)whereas no difference before the treatment(P>0.05). There were significant differences in SⅠt and BUT in experiment group compared with control group after 4 weeks(P<0.01).CONCLUSION: Qinpi eye drops combined with Cyclosporin A eye drops is an effective method for dry eye syndrome.

AIM: To compare the differences of Titmus stereopsis test, random dot by Yan Shaoming and another random-dot which by Jin Guichang on stereopsis inspection in children. METHODS: Near binocular stereoacuity of 81 cases(5-7 years)was examined with three kinds of methods under the same test conditions. The results were analyzed statistically.RESULTS: The results of Yan stereo and Titmus stereopsis had no significant difference(χ2=0.2282, P=0.6329). There were significant differences on both normal stereopsis and abnormal stereopsis results by Jin stereo and the other two methods(χ2=58.1692, P< 0.01). CONCLUSION: The results of Yan's random dot stereogram and Titmus stereopsis test are similar, while large difference is in the Jin stereopsis inspection. In clinical application, Different methods should be used to evaluate stereoscopic vision.

AIM: To investigate the effects of congenital ptosis degree on total astigmatism, corneal astigmatism, intraocular astigmatism and axis length, and to discuss the relation with amblyopia. METHODS: Fifty patients(100 eyes)with congenital ptosis were selected and divided into four groups: 33 eyes in group Ⅰ(normal); 20 eyes in group Ⅱ(mild); 17 eyes in group Ⅲ(moderate); 30 eyes in group Ⅳ(severity). Firstly, they received standardized medical optometry. Absolute value of astigmatism was recorded as total astigmatism. Then, corneal topography was used to measure double eyes for at least 3 times, and the best results were used to record the SimK. Define absolute value of △SimK as corneal astigmatism. Finally, axial length was measured for 5 times by A super-measurement, and take the mean value. Formula: intraocular astigmatism=total astigmatism-corneal astigmatism.RESULTS: There was a significance difference between total astigmatism and cornea astigmatism(P=0.000, 0.002<0.05). Also they were positive correlation with severity of ptosis(Spearman rs=0.514, 0.721,P<0.05), but there was not significance difference in axial orientation, intraocular astigmatism and axial length(all P>0.05). The axial orientation, intraocular astigmatism had no correlation with severity of ptosis.CONCLUSION: The congenital ptosis affects on eye astigmatism through the change of cornea astigmatism, which is related to severity of ptosis, but has no effect on axial length. The rate of amblyopia is higher than normal on congenital ptosisespecially severity. Amblyopia is related to high astigmatism which is moderate astigmatism with rule.

AIM: To observe the clinical effectiveness and practicality the autologous conjunctiva transplantation with stem cells on edge of cornea for recurrent pterygium.METHODS: Of the 53 recurrent pterygium patients(57 eyes), after all pathological tissues were removed, underwent the autologous conjunctiva transplantation with stem cells on edge of cornea which were locked above conjunctival transplantation of the operated eye.RESULTS: Postopretive follow-up was 1-12 months for all 57 eyes, of which 3 eyes(5%)relapsed. The corneoscleral autolysis was occurred in one eye and surgery treatment was conducted. Corneal wounds were healing and transplantations survived well for the remaining 53 patients without obvious surgical marks. Cure rate was 93%.CONCLUSION: Autologous conjunctiva transplantation with stem cells on edge of cornea for recurrent pterygium can meet the aesthetic requirements of the some patients, with the advantages of obtaining material easily, faster wound healing, lower postoperative recurrence rate, meeting the aesthetic needs of some patients and improving postoperative results. Thus, it is an ideal surgery and is worthy of applying on primary hospital.

AIM: To analyze the epidemiological characteristics of ocular trauma, classify ocular trauma internationally according to OTS standards set by US Association of Ocular Trauma, and to provide objective and accurate information on the severity and prognosis of ocular trauma, guide us to work out the most reasonable diagnostic and therapeutic programs accurately and quickly. METHODS: Statistics of 251 cases(252 eyes)with ocular trauma on basic information( on gender, age, left or right eye, injury time, injury types, vulnerants and complications, etc.), were summarized and converted into OTS categories(on early clinical vision, with or without ocular rupture, endophthalmitis, perforating injury, retinal detachment, merging to relative afferent pupillary defect, etc.). The likelihood of the final visual acuity was calculated according to the OTS data sheet and compared with that in the OTS study. Scores of patients in different ocular trauma level were compared. RESULTS: The likelihood of the final visual acuity of this research showed no significant difference from the final visual acuity calculated according to OTS data sheet(no light perception, light perception/hand motion, 0.005-0.095, 0.1-0.4, ≥0.5). The final visual acuity showed positive correlation significantly to the early visual acuity(r=0.772,P=0.000). The case number of final visual acuity at 0.5 in category-1 of OTS was 0. So was the case number of final visual acuity with no light perception in category-5 of OTS.CONCLUSION: OTS may contribute greatly to initial diagnosis and therapeutic schedule in eye injuries.

Bcl-2 is a proto-oncogene isolated from follicular B cells, and it is closely related to cell apoptosis. In recent years, it has been widely used in experiments to repair central nervous injury, especially the optic nerve injury. In some cases, it is found that Bcl-2 can inhibit cell apoptosis, prolong cell life span, but can not promote cell proliferation. In other cases, it can not prevent apoptosis caused by certain genetic mutations and thus cannot protect the optic nerve.

microRNAs are a class of endogenous non-protein-coding micromolecule RNAs with 22 nucleotides long, and are widely presented in the eukaryotic cells, which play a critical role in a series of life process, including cell proliferation, apoptosis, differentiation, tumorigenesis and individual metabolism. It has become a focus for gene regulation research in recent years. Most of microRNAs are widely expressed in various ocular tissues in the tissue specificity and time specificity mode, and may be closely involved in ocular tissue growth, development, functional regulation and diseases onset. To study the functions of microRNAs in lens development and pathophysiological process is to provide a new idea for further clarifying the mechanisms of lens diseases, exploring the diagnoses and treatments of the diseases.

AIM: To investigate the related factors and treatment of choroidal detachment after glaucoma filtering surgery.METHODS: The clinical data of 42 eyes with choroidal detachment of 457 eyes undergoing glaucoma filtering were retrospectively analyzed. RESULTS: Choroidal detachment occurred at 3-7 days after glaucoma filtering surgery, with mean 4.51±1.14 days. The patient's average age was 65.30±3.50 years. Chroidal detachment was reformed by corticosteroids medicine mydriatic drugs hypertonic agent and all recovered, within 16.50±2.75 days.CONCLUSION: Chroidal detachment is a common complication of glaucoma filtering surgery. The related factors include high intraocular pressure and eyeball congestion before surgery, postoperative low intraocular pressure, diabetes, hypertension and the aged.

AIM: To observe the effect of Zhengyuanyunsheng dripping pills for non-proliferative diabetic macular edema(DME). METHODS: Fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were used in diagnosis of non-proliferation in patients with DME in 40 cases(76 eyes). The cases were randomly assigned to the treatment group(20 cases, 40 eyes)and the control group(20 cases, 36 eyes). The cases in the treatment group were given conventional treatment, and those in the control group received Zhengyuanyunsheng dropping pill. After 3 months, macular retinal thickness and the best vision correction were recorded and compared. RESULTS: Fade rate of macular edema in the control group and the treatment group were 13 eyes(32.5%)and 24 eyes(66.7%), the difference was statistically significant(P<0.05). The best vision correction in treatment group was better than that in the control group(P<0.01). CONCLUSION: The Zhengyuanyunsheng dripping pills has obvious curative effect on macular edema and BCVA for the patients with diabetic retinopathy.

AIM: To investigate the main factors that affecting the positive rate of bacterial culture before the intraocular lens implantation. METHODS:Conjunctival sac specimen form senile patients, who received cataract crystal implantation from December 2010 to December 2012 in our hospital, were collected and cultivated at the following 3 time points: on admission day, after the eye-drops and after the surgical eye preparation. Afterwards, a comparative analysis was made in terms based on of the following factors: age, gender, dominant eye, occupation, days for eye-drops as well as the intervention techniques. RESULTS: Factors such as age, gender, intervention technique were significantly related with the rate of bacterial culture, while factors such as occupation, dominant eye and days for pre-operative eye-drops had few effects on the final results. CONCLUSION: There are both internal factors and external factors affecting the bacterial culture. Inconjunctival sac intervention techniques play a crucial role in the bacterial culture in conjunctival sac, which deserves more attention.

AIM:To explore the outcome and safety of endonasal dacryocystorhinostomy(EN-DCR)with the use of adjunctive mitomycin C(MMC)in nasolacrimal duct obstruction or within dacryocystitis or lacrimal sac abscess. METHODS: Select the 32 cases(38 eyes), noses and lacrimal duct obstruction(or with dacryocystitis, lacrimal sac abscess)in patients with endoscopic nasal bone hole made at the mound, removal of the nasal mucosa, lacrimal bone and a fragment of frontal process of maxilla. cut the lacrimal sac and fully flip flap, 0.1g/L MMC retained tampon in lacrimal anastomotic removed after 48 hours.RESULTS: Postoperative 7 days, 3 and 6 months nasal endoscopy and lacrimal irrigation. Postoperative 7 days, healing 34 eyes, improved in 3 eyes, ineffective 1 eye, treatment improvement rate was 97.4%; postoperative 3 months, cured 32 eyes, improved in 4 eyes, invalid 2 eyes, healing rate was 94.7%; postoperative 6 months, cured 32 eyes, improved in 4 eyes, invalid 2 eyes, treatment improvement rate was 94.7%. All cases did not occur nasal bleeding, orbital complications and postoperative complications.CONCLUSION: Results suggest that EN-DCR with MMC is a safe and successful procedure for the treatment of nasolacrimal duct obstruction or within dacryocystitis or lacrimal sac abscess.

AIM: To investigate the curative effects and advantages of transconjunctival approach operation to treat orbital blowout fracture.METHODS: Totally, 46 cases(46 eyes)with fracture on inner and lower orbit wall were treated with transconjunctival approach operation, and the methods and effects were retrospectively analyzed.RESULTS: All patients had no significant vision loss postoperatively. Among 31 diplopic cases, 12 months after operation, 3 cases existed diplopia with extreme upward and temporal rotation. Among 23 patients with enophthalmos, 3-12 months after operation, 15 patients showed protrusion difference between two eyes less than 2.0mm, and the vision of the operative eye was more than 2.0mm lower than that of the healthy eye in 8 patients. All patients had no visible operative scar and lateral canthus deformity.CONCLUSION: Transconjunctival operation for treating orbital blowout fracture is safe, reliable and simple, with few complications and no facial scar.

AIM:To explore the factors affecting on the making time of LASEK corneal flap. METHODS:A retrospective analysis from August 2009 to August 2012 in our hospital in 320 cases treated by LASEK in myopic patients(640 eyes), the patients were grouped according to age, 18-23 years, 24-29 years, 30- 35 years, and greater than 35 year were divided into 4 groups(A, B, C, D), each group according to whether wearing contact lenses for more than 3 months, divided into 2 subgroups(I, II), the average flap preparation time statistics for each group. RESULTS: Most of the patients in postoperative 2-4h after a foreign body sensation, presented ocular pain. Corneal epithelium was basically healed after about 7days. Visual acuity recovered to the best after 20d. After 6 months, the average visual acuity was 1.23±0.15. Flap preparation time 11-30s, average 18±3.5s. With the increase of age, flap preparation time was significantly prolonged. For those wearing contact lens over 3 months, flap preparation time was significantly longer. There was significant difference(P<0.05)after analyzing the same age as 2 subgroups(I, II). Flap preparation time in male and female patients with the same age had no significantly difference(P>0.05). CONCLUSION: With the increase of age, flap preparation time is significantly prolonged. Long-term wear contact lens is the important factor in the success of production. For those wearing contact lens over 3 months, flap preparation time was significantly longer.

AIM: To observe the image difference of dimensional CT monocular superior oblique palsy form the patient's eyes.METHODS: Clinical cross-sectional study included of 30 cases which clinically diagnosed monocular congenital superior oblique palsy for dimensional CT. CT values were measured at the position of coronal oblique maximum cross-sectional area at patient eyes.RESULTS: Ocular and non-ocular paralysis of superior oblique muscle belly maximum cross-sectional area were 4.52±1.49, 8.80±1.42mm2,respectively. CT values were 11.57±22.88 and 35.13±9.74. Paralysis of eye muscles abdominal oblique maximum cross-sectional area and CT values were significantly less than those of the non-paralyzed eye. The difference had statistical significance.CONCLUSION: The results of dimensional CT scan shows that the CT value of patients with monocular congenital superior oblique palsy superior oblique eye muscle paralysis abdominal cross-sectional area is significantly higher than that of the non-paralyzed eye on the oblique abdominal muscle cross-sectional area.

Adenoid cystic carcinoma(ACC)of lacrimal gland is the most common malignant epithelial lacrimal gland tumor. Excision alone shows unsatisfactory effect, which is easy to relapse and makes poor prognosis. This paper summarizes the clinical treatment for ACC of lacrimal gland, which covers the relevant domestic and international reports in recent years, including improved surgical approach, taking chemotherapy before and after surgery, radiotherapy.etc. Furthermore, treatment strategies for youth patients with ACC of lacrimal gland are reported and the diagnosis and treatment for ACC originated beyond lacrimal gland are analyzed. Above all, we may provide a broader way of thinking for ophthalmological clinicians.

Lacrymation is a common clinical symptom of ophthalmology. In recent years, there been an increasing number of outpatients with symptoms of lacrymation for eye clinics. Both lacrymation and epiphora present tears in clinical manifestation. Epiphora refers to tears at a special pathologic state. However, many ophthalmologists are not clear about the difference between normal lacrymation and epiphora as various reasons can cause tears. This paper mainly reviewed the etiology, mechanism, treatment and prognosis of epiphora as well as the existing problems to be solved.

The cinobufotalin injection was independently developed by China, and this new second category drug has pharmacological effects of regulation of the immune system, inhibition of tumor cell proliferation and anti-hepatitis B virus. It has been widely used to treat malignant tumor advanced stage, chronic hepatitis B, epidemic hemorrhagic fever and clinical treatment of other diseases. In recent years, it is widely used in ophthalmology. Much progress has been made particularly in diseases such as keratitis, pterygium, etc. Exploring ophthalmology new therapeutic approach by the integrated treatment, making use of the advantage of the Traditional Chinese medicine will be the direction of ophthalmic clinical treatment and research in the future.

AIM: To study the effect of platelet derived growth factor ɑ receptor(PDGFR-ɑ)antibody on the rust-induced human retinal pigment epithelial cell(hRPE)proliferation. METHODS: In vitro rust hRPE cells proliferation differentiation model was established. Blank control group, rust group, PDGFR-ɑ antibody(1, 10, 50, and 100μg/mL)treatment group were established. The effect of anti-PDGFR-ɑ antibody on the growth of RPE was determined by MTT colorimetric assay after 0, 12, 24, 48h,and the inhibition rates were calculated accordingly. RESULTS: After adding the anti-PDGFR-ɑ antibody, hRPE cells proliferation activity was decreased at certain concentration as the antibody concentration increased, and 50μg/mL anti-PDGFR-ɑ antibody was the optimum concentration to inhibit hRPE cells proliferation, the inhibitory rate of hRPE was 42.44%.CONCLUSION: The anti-PDGFR-ɑ antibody shows strong inhibitory effect on the growth of cultured hRPE.

AIM: To compare the visual field characteristics of patients with idiopathic demyelinating optic neuritis(IDON), non-arteritic anterior ischemic optic neuropathy(NAION)and papilledema(PE), and analyze their occurrence mechanism.METHODS: It was a retrospective case series study. Visual field data of patients with IDON, NAION, and PE who were treated in Department of Ophthalmology, the Fourth Affiliated Hospital, China Medical University from March 2011 to May 2012 were collected. Ages, gender, best-corrected visual acuities(BCVA), pupil sizes, the visual field testing duration, types of visual field defect, the defect locations, mean deviation(MD)and pattern standard deviation(PSD)of the patients were compared and the reasons of these differences were analyzed by SPSS 12.0.RESULTS: There were 17 cases(20 eyes)with IDON, 21 cases(26 eyes)with NAION, 11 cases(22 eyes)with PE included in this study. All differences from mean age, gender composition, BCVA, pupil size, visual field testing duration, MD and PSD among three groups had statistical significance(P<0.05).CONCLUSION: Although these visual fields of patients with IDON, NAION and PE are complex, they have different features closely related with the pathogenesis of disease. These features can provide important evidence for differential diagnosis among optic nerve diseases.

AIM: To evaluate the effect of polylactic acid membrane(PLA)implantation combined with trabeculectony on primary angle-closed glaucoma.METHODS: Totally, 41 patients(47 eyes)with primary angle-closed glaucoma were randomly divided into 2 groups. PLA implantation combined with trabeculectony was performed for the experimental group while trabeculectony for the control group. Cases were followed up for 6 months postoperatively, with observation and comparative analysis on visual acuity(VA), intraocular pressure(IOP), filtering bleb and anterior chamber depth.RESULTS: In the experimental group,6 months after the surgery, VA was improved to different degrees and IOP reduced greatly. According to comparison between the two groups, the differences were of statistic significance(P<0.05). The rate of functional filtering bleb in the experimental group(88.0%)was much higher than that of the control group(59.1%, P<0.05).CONCLUSION: PLA implantation combined with trabeculectomy for the treatment of primary angle-closed glaucoma is simple, safe and effective.

AIM: To assess the effectiveness and safety of transepithelial photorefractive keratectomy(TransPRK)using the AMARIS laser platform. METHODS: Eighty myopic cases(156 eyes)with or without astigmatism were treated by TransPRK. In all eyes, treatments were planned with Custom Ablation Manager Software and ablations performed with the SCHWIND AMARIS system. Clinical outcomes of visual acuity, manifest refraction, intraocular pressure, and corneal topography were observed and analyzed. The follow-up period was one year.RESULTS: All patients completed the 1-year follow-up. After one-year follow-up, 47 cases(92 eyes, 58.8%)achieved an uncorrected distance visual acuity(UDVA)≥1.0. Twenty cases(40 eyes, 25%)was 0.8 and 13 cases(24 eyes, 16.3%)was 0.6. Sixty-three cases(121 eyes, 78.8%)were close to or above best corrected visual acuity(BCVA). Seventeen cases(34 eyes, 21.2%)were slightly lower than BCVA 1 row or two. Nine cases(18 eyes, 11.3%)got dry eye postoperatively. 16 cases(32 eyes, 20%)complain of glare and poor night vision. CONCLUSION: The results show that TransPRK for myopia with or without astigmatism is safe and effective. The postoperative visual outcomes are stable.

AIM: To investigate the clinic value of combined pars plana lensectomy-vitrectomy in the management of ciliary block glaucoma.METHODS: The post-operative results of 11 hospitalized patients(11 eyes)with ciliary block glaucoma, who were managed by pars plana lensectomy-vitrectomy in our hospital, were retrospectively reviewed.RESULTS: Post-operative ocular tension of all 11 eyes was controlled, and visual acuity was improved in various extent. Ocular tension was stable, and no serious complications were seen after a follow-up of more than 3 months(5 months in average).CONCLUSION: Combined pars plana lensectomy-vitrectomy is one of the effective management of ciliary block glaucoma.

AIM: To estimate the influence of psychological health intervention on the medical compliance and recurrence of glaucoma patients. METHODS: Forty-eight patients with primary angle-closure glaucoma were enrolled and randomly classified into intervention group and control group. Patients in intervention group were treated with common surgery-drug treatment, mental health education and behavior therapy at the same time, and those in control group were treated with common surgery-drug treatment. After 2 years psychological health intervention, the patients were examined to determine their compliance and recurrence rates.RESULTS: The medical compliance of patients in intervention group was higher than that in control group. The recurrence rates of patients in intervention group were lower than that in control group. There were significant difference between two groups(χ2=11.429, P<0.01; χ2=14.667, P<0.01).CONCLUSION: Mental health education and behavior therapy could significantly increase the medical compliance of glaucoma patients and reduce the rates of recurrence.

AIM: To investigate the effect, the catheterization feasibility and complications in canaliculus anastomosis. METHODS: In 67 cases(67 eyes)of inner canthal angle or eyelid laceration of canaliculus anastomosis, the catheterization feasibility, complications, the retention time of catheter as well as extubation more than half a year's presented were studied. RESULTS: In the 67 cases, there were 62 cases underwent successful anastomosis, lachrymal in 3 cases was narrow after extubation, 2 cases were impassability rinsing, lachrymal was unobstructed after YAG laser treatment. CONCLUSION: Injury canaliculus ring immediately before intubation in the law, whether it has epiphora or not, can successfully catheter, and because the catheter retained in the nasal cavity, which can be maintained for a longer time, and does not affect the daily life, work, ensure no pull in repair under the condition of the broken end of the canaliculus, less complications, efficacy.