AIM: To evaluate the clinical efficacy of cataract extraction and intraocular lens implantation in patients with senile cataract and hematologic disease. METHODS: Forty patients(58 eyes)with senile cataract and hematologic disease underwent cataract extraction and intraocular lens implantation. Preoperative assessment included blood coagulation testing, leukocyte classification, and bone marrow examination. Appropriate preoperative treatments were administered to patients with senile cataract and thrombocytopenia, leukopenia, anemia, and/or pancytopenia(identified through blood testing). Thirty patients with senile cataract and normal routine bloodwork findings, with ages similar to those of patients in the study group, were randomly recruited as a control group. Postoperative corrected visual acuity and intraoperative and postoperative complications were recorded. The causes of hematologic disease in patients in the study group were recorded. Blood clotting data were compared between groups using t-tests. RESULTS: Plasma prothrombin time and activated partial thromboplastin time did not differ significantly between the study and control groups(P=0.379 and P=0.945, respectively). Surgery improved corrected visual acuity in all patients(>0.4 in 56 \〖96.55%\〗 eyes). No postoperative infection, bleeding or fever occurred. The etiology of hematological disease was unknown in some patients; most patients had diabetes mellitus, hypertension, cirrhosis, and/or kidney disease. CONCLUSION: With adequate perioperative treatment, patients with senile cataract and hematological disease can safely undergo cataract operation and intraocular lens implantation, with good outcomes.

AIM:To observe buddleja officinalis total flavonoids' effect on the basal tear secretion amount, tear film stability, lacrimal gland histomorphology and serum testosterone level of castrated male rat model with xeroma, to study the mechanism of rat xeroma caused by buddleja officinalis total flavones' anti-sex hormones disorders.MEATHODS: A total of 150 Wistar male rats of 1 month old, weighted about 200g, were randomly divided into 5 groups with 30 rats in each group with A representing normal group; B representing sham operation group; C representing surgery control group; D representing group treated with androgen; E representing group treated with buddleja officinalis total flavonoids. For the groups C, D, E, the bilateral testicle and epididymis were excised; For group B, scrota were incised without removal of the testicles, as the sham operation group; For group A, nothing was done. One week after modeling when the wound was to be healed, drug was given to each group. Respectively at the 1st month, 3rd, and 5th months after treatment, 10 rats were randomly selected in each group, to receive Schirmer I test, tear breakup time measurement. Blood serum testosterone levels were tested in the fifth month. RESUITS: For groups D and E, the Schirmer I test measurements were significantly higher than that of group C(P<0.05), tear film breakup time was significantly longer than that of group C(P<0.05). Serum testosterone levels in groups C and E were significantly lower than that in groups A, B, D(P<0.01). CONCLUSION: Decreased androgen levels can lead to xeroma, and removal of bilateral testes and epididymis can successfully establish the animal models of xeroma in rats caused by decreased androgen levels. Buddleja officinalis total flavonoids have androgenic effect, which produces the similar treatment effect of xeroma with testosterone propionate. Buddleja officinalis total flavonoids may become a new treatment for xeroma.

AIM: To investigate the expression of HPV-DNA in retinoblastoma tumor samples in China, and to provide preliminary evidence for the role of HPV in sporadic retinoblastoma(RB).METHODS: Fresh tumor tissues from 22 children with sporadic RB were collected to detect the presence of HPV-DNA using polymerase chain reaction(PCR)and MY09/11 primers.RESULTS: HPV-DNA was present in 7/22(32%)RB tumors. All the positive cases were sporadic unilateral RB(4 cases were male, 3 cases were female). Two bilateral RB cases were negative for HPV-DNA.CONCLUSION: The presence of HPV in RB tumors can be a pathogenic factor for sporadic RB. But its role and mechanism in carcinogenesis needs further research.

AIM: To observe the change law of the ratio of CD4+ CD25+ regulatory T cell in the peripheral blood of the patients with Graves' ophthalmopathy by detecting the ratio of this cell.METHODS: This experimental study selected 53 GO patients without exophthalmos, 51 GO patients with exophthalmos, and 51 healthy people were collected. The ratio of CD4+CD25+ T cell in peripheral blood was determined by flow cytometry. RESULTS: The ratio of CD4+CD25+ T cell in GO patients without exophthalmos was lower than that in healthy group(P<0.01). The ratio of CD4+CD25+ T cell in GO patients with exophthalmos was far lower than that in healthy group(P<0.01). Compared with the group of GO patients without exophthalmos, the ratio of CD4+ CD25+ T cell of GO patients with exophthalmos was also much lower(P<0.01). CONCLUSION: The ratio of CD4+ CD25+ T cell in the GO patients decreases and there is autoimmune disorder in patients of this disease. Perhaps this is an important mechanism causing immune suppression damage, which provides a new clue for immunological treatment.

AIM: To observe the clinical effect of Buddleja officinalis and Xueshuangtong capsule treating the mild and moderate simple diabetic retinopathy(sDR). METHODS: Based on the strict control of blood glucose and blood pressure, eighty patients(160 eyes)with mild and moderate sDR were randomized into two groups equally: Buddleja officinalis(15g,tid)and Xueshuangtong capsule administered to group A and only Xueshuangtong capsule administered to group B. They are taken before meals half an hour. The vision, funduscopy, FFA, fundus photography and traditional chinese medcine symptoms(TCMS)were evalutated before and after treatment in 7d,42 d respectively.RESULTS: There were no significant difference between two groups in terms of patients' gender, age, DM course, visual acuity, course of disease and TCM syndrome.(χ 2 sex=0.472, P>0.05; tage=1.742,tDM condition=0.716,tvision=0.662,tDR degree=1.276,tDR condition=0.562,t TCMS=0.616,P >0.05); Follow up for 42d on average after treatment the effective rate of fundus lesions of group A was 56%and the total effective rate was 82%,while the effective rate of group B was 32% and the total effective rate was 66%. The result showed that the curative effect of group A was better than that of group B. There were statistically significant difference for the effective rate between the two groups(χ2=8.025, P<0.05). The effective rate of TCMS in group A was 50%, and total effective rate was 80%, while group B shows a 24% effective rate and 62% total effective ratet.The result showed that the curative effect of group A was significantly better than that of group B(χ 2=5.980,P<0.05). CONCLUSION: Buddleja officinalis and Xueshuangtong capsule can improve the vision of patients with the mild and moderate sDR patients, the fundus lesions and the TCMS.

AIM: To investigate the effects of ginkgo biloba extract(EGb 761)on laser-induced choroidal neovascularization(CNV)in rats.METHODS: Totally 60 BN rats were randomly divided into 4 groups: normal control group, model group, experimental group, physiological saline group with 15 in each group. All CNV models were made by krypton laser. Rats in experimental group were intraperitoneally injected with 0.35% EGb761(100mg/kg)every day after laser exposure until they were sacrificed. Rats in physiological saline group were intraperitoneally injected physiological saline every day after laser exposure until they were sacrificed. Fundus fluorescein angiography(FFA)was performed on every rat on the 7th day, 14th day and the 21st day after laser exposure, then the rats were sacrificed immediately. The eyes were enucleated and processed for histopathologic examination.RESULTS: There was no choroidal fluorescein leakage staining in normal rats. There were obviously less choroidal fluorescein leakage points in experimental groups than that in the corresponding model groups(P<0.05), the difference had statistical significance. The structures of the retina and choroid were preserved better in experimental group than that in the model group. CONCLUSION: EGb761 len inhibit the formation of laser-induced CNV in rats. The longer the time, the better curative effect.

AIM: Using monoclonal antibodies indirectly immunofluorescence to detect the changes of CD4 and CD8 T lymphocytes in the different time points in corneal tissue after corneal transplantation. METHODS: Normal rabbit cornea, axillary lymph node tissue were taken. Get corneal tissue at one week, two weeks after ostrich-rabbit heterogeneous corneal transplantation, fixed by formaldehyde, conventional paraffin embedding sectioning dewaxing after water, gastric enzyme digestion method for antigen repair, use mouse anti rabbit CD4, CD8 monoclonal antibody and fluorescent tagging sheep anti mouse IgG for immunohistochemical assay, and observe the expression of CD4+, CD8+T lymphocytes in the cornea tissue in fluorescence microscope.RESULTS: The expression of CD4+, CD8+T cells in the cornea tissue was negative one week after the ostrich-rabbit heterologous cornea transplantation, CD4 T lymphocytes showed strong positive expression after the second week, CD8 was negative. CONCLUSION: Indirect immunofluorescence method can be used for determination of related antigen expression in local corneal tissue after heterologous corneal transplantation, and it can lay the foundation for the studies of heterogeneous cornea transplantation rejection mechanism and postoperative drug screening.

AIM: To describe the application and evaluate the effects of internal limiting membrane(ILM)peeling in patients underwent primary vitrcetomy for complicated proliferative vitreoretinopathy(PVR). METHODS: Totally 48 cases with serious PVR underwent vitrectomy were enrolled in this study. All these cases were divided into two groups: 23 cases in group A underwent vitrectomy with ILM peeling; 25 cases in group B underwent vitrectomy without ILM peeling. All patients underwent successful primary vitrectomy using silicone oil. After regular referral, silicone oil was removed, the retina reattached successfully. The results of slit lamp, optical coherence tomography(OCT), best corrected logarithm of minimal angle of resolution(logMAR)visual acuity pre and post operation and secondary epimacular membrane formation were observed and contrasted. Independent sample t-test, paired sample t-test, Pearson Chi-square test and Fisher's Exact test were used to analyze the significance of results with a P value ≤0.05 interpreted as statistically significance. RESULTS: Secondary epimacular membrane formation was found in one eye in group A, and seven eyes in group B after vitrectomy, the difference was significant. Central macular thickness was 188.36±45.53μm in group A, and 220.42±53.15μm in group B after the removal of silicone oil, the difference was significant. Macular edema was comparatively mild in group with ILM peeling. Image of macular morphology in OCT was more similar to the normal in group A. The final logMAR visual acuity was 1.38±0.60 in group A and 1.61±0.51 in group B, the difference was not significant between these two groups.CONCLUSION: ILM peeling may prevent the formation of secondary epiretinal membrane, is conducive to the recovery of retinal structure. This technology can be used in vitrectomy for PVR.

AIM: To compare changes in visual quality and the corneal flap after LASIK surgery with femtosecond laser and microkeratome.METHODS: The study enrolled 80 patients who received LASIK surgery from March 2009 to March 2012 in our hospital. Among them, femtosecond laser was used for 35 patients and microkeratome was used in the other 40 patients, The two groups were compared with each other in postoperative visual quality and the corneal flap.RESULTS: Visual quality: the two surgical procedures both had significant predictability, efficacy and safety, and there was no significant difference between the two groups in postoperative visual aberrations and contrast sensitivity(P>0.05); Corneal flap: There was no significant difference between the two groups in corneal thickness at the same horizontal points(P>0.05). CONCLUSION: LASIK surgeries with femtosecond laser and microkeratome, both produce good outcome of vision and the difference in the postoperative corneal flap thickness between the two techniques is not significantly different.

The health of ocular surface is maintained by the ocular surface(cornea and conjunctiva, accessory lacrimal gland and meibomian gland), the main lacrimal gland and the lachrymal function units between them, any damage in which can lead to the failure of integrity and normal function of tear film. With the development of medical science, more and more eye surgeries are operated to treat eye diseases. However, preoperative anesthetic applications, operation process, preservatives in the eye drops may lead to tear film instability and/or abnormal manifestation on eye surface which may cause dry eyes.

Adipose-derived stem cells(ADSCs)are multipotent population of cells with multipotential differentiation capability, which can differentiate into mesoderm including adipocyte osteoblasts and chondroblasts in specific conditions, even the endoderm cells like hepatocyte and and ectoderm cells like neurocyte. Besides, ADSC has many advantages like easy access and light damage to selected area, which enables it to become a hotspot in tissue repair area. This paper made a classified summary on the biological characteristics of corneal epithelium and its application in research to offer beneficial hints to the research of ADSC application in ophthalmology.

AIM: To explore the meaning of the level of D-dimer(D-D), fibrinogen(Fib)and fibrin degradation products(FDP)in serum for eye malignant tumor diagnosis and evaluation. METHODS: Sixty-seven patients with eye malignant tumor(malignant tumor group)in our hospital were selected,among which, 44 as malignant tumor without metastasis group, 23 as malignant tumor with metastasis group; 46 patients were selected with eye benign tumor(benign tumor group)during the same time period; 30 healthy people visited our hospital for regular physical examination was elected simultaneously as the healthy control group. The level of D-D, Fib and FDP were detected in serum.RESULTS: The D-D, Fib and FDP level in eye malignant tumor group was significantly higher than those in either the eye benign tumor group or the healthy control group(P<0.01), malignant tumor with metastasis group had the significant higher level of D-D, Fib and FDP than those of malignant tumor without metastasis group(P<0.05). There was no significant difference statistically between the eye benign tumor group and healthy control group of the serum level of D-D, Fib and FDP(P>0.05). There was significant difference of D-D level distribution among each group(P<0.05). CONCLUSION: To detect the level of D-D, Fib and FDP in serum can help with differentiation the tumor from benign to malignancy, analysis the progression of tumor and prognosis.

AIM: To compare the clinical effect and characteristics of lens loop extracting nucleus method, water irrigation and nucleus fragmentation within anterior chamber in small incision cataract surgery with non-phacoemulsification. METHODS:There were 324 cases(324 eyes)with senile cataract randomly divided into three groups, by the lens loop extracting nucleus method(group A), water irrigation(group B)and nucleus fragmentation within anterior chamber(group C), to complete the process of nucleus division. The time of nuclear removal, complication during operation, the degree of edema of corneal endothelium on the first day after the surgery and visual acuity after surgery were observed and recorded.RESULTS:The average extracting nucleus time was 45s in lens loop(group A); 34s in water irrigation(group B)and 65s in manual fragmentation(group C).The differences of average time are statistically significant(P<0.05), and the complications in lens loop and manual fragmentation mainly are iris trauma and posterior capsular rupture; the complication in the water irrigation is hyphema. Regarding corneal edema from 0 to 1degree, the difference between group A and group B, group B and group C were statistically significant(P<0.05). The difference between group A and group C had no statistical significance(P>0.05).Regarding the visual acuity on the first day after surgery, the difference between group A and group C, group B and group C were statistically significant(P<0.05), The visual acuity on the 7th day after surgery: the difference between group B and group C were statistically significant(P<0.05). In terms of the visual acuity on 1 momth after surgery: three groups have no statistically significant difference(P>0.05).CONCLUSION:Manual fragmentation has obvious advantages in removing nuclear above Ⅳ grade; The water irrigation method has fewer complications with low incidence of corner edema, which is more preferable in removing the nuclear below Ⅳ grade.

AIM: To study the correlation of operation age, axial length and lens thickness in cataract eyes.METHODS: A total of 319 patients(393 eyes)were divided into non-high myopia cataract group(198 patients, 237 eyes)and high myopia cataract group(121 patients, 156 eyes)according to the axial length. Axial length and lens thickness were measured with A-mode ultrasound biometry.RESULTS: There were statistical difference in operation age(t=3.614, P=0.000), lens thickness(t=-3.081, P=0.002)between the non-high myopia cataract group and high myopia cataract group. The operation age of high myopia cataract group was younger than that of non-high myopia cataract group. The lens thickness in high myopia cataract group was thicker than that in non-high myopia cataract group. There was no significant correlation between age and axial length in the non-high myopia cataract group(r=-0.081, P=0.214). Age and lens thickness had positive correlation in the non-high myopia cataract group(r=0.178, P=0.006). Axial length and lens thickness had no significant correlation in the non-high myopia cataract group(r=-0.050, P=0.442). There was a negative correlation between age and lens thickness in the high myopia cataract group(r=-0.211, P=0.008). Age and lens thickness had no significant correlation in the high myopia cataract group(r=0.078, P=0.332). Axial length and lens thickness had positive correlation in the high myopia cataract group(r=0.207, P=0.010).CONCLUSION: For the non-high myopia cataract patients, the cataract aggravate as the age increase. The operation age will not change as the axial length change. For the high myopia cataract patients, the cataract will not aggravate as the age increase, and the longer of the axial length, the younger of the operation age.

AIM: To observe the clinical effects of the sutureless intraocular suspended implantation of foldable three-piece acrylic aspheric posterior chamber lens(Tecnis)through clear corneal incision.METHODS: A total of 21 patients(24 eyes)with non or unintact capsule that underwent the intraocular suspended implantation of foldable three-piece acrylic aspheric posterior chamber lens(Tecnis)through clear corneal incision were observed and compared clinically to evaluate the clinical effects of this operative method. The observation and comparison were made on the parameters including visual acuity, intraocular reaction and lens situation by ultrasound biomicrography(UBM)before and after the operation.RESULTS:A 3-12 months(6.5 months on average)follow up shows significant improvement(P<0.01)of both the uncorrected and corrected visual acuity of 24 eyes. The corrected postoperative visual acuity were 1.0-1.5(8 eyes, 33.3%), 0.5-0.9(13 eyes, 54.2%)and 0.1-0.4(3 eyes, 12.5%), respectively. There was no statistical difference in the distance from the plane of artificial lens body to corneal endothelium, and the distance from ciliary process to corneal endothelia(P>0.05)in UBM photos after operations. All of 24 eyes were successfully conducted intraocular lens implantation without serious, intraocular infections or inflammations, no complications like cyclodialysis or retinal detachment. Only a few cases present temporary increase of intraocular pressure.CONCLUSION: The sutureless intraocular suspended implantation of foldable three-piece acrylic aspheric posterior chamber lens(Tecnis)through 3.0-6.0mm clear corneal incision is an advisable remedy for capsule rupture failure during phaco-emulsification and an advisable operation for the dislocation of crystalline lens resulted from trauma or congenital cataract. The procedure can improve visual acuity safely and effectively without obvious complications. Its long-term effect needs long-term follow-up observation.

AIM: To investigate the effectiveness of phacoemulsification with intraocular lens(IOL)implantation combined with trabeculectomy in patients with cataract and angle-closure glaucoma.METHODS: In 36 cases(46 eyes)of angle-closure glaucoma with cataract, phacoemulsification with foldable IOL implantation combined with trabeculectomy was performed. Data of pre- and post-operation, including visual acuity, intraocular pressure, filtering bleb, anterior chamber depth, chamber angle, and funds were all recorded and analyzed in detail.RESULTS: During the follow-up of 3 months to 2 years,visual acuity of 43 eyes(93.5%)got improved, and intraocular pressure in 44 eyes(95.7%)were controlled in normal range(<21mmHg). Mean anterior chamber depth of 35 patients(46 eyes)got deeper from 2.1mm to 3.8mm(average 2.1±0.3mm to 3.8±0.4mm)after operation, with chamber angle opened to some extent. Six eyes(13.0%)got mild to moderate corneal edema, without corneal endothelial decompensation.CONCLUSION: Phacoemulsification with IOL implantation combined with trabeculectomy is an effective and safe surgical technique for patients with angle-closure glaucoma and cataract, with satisfied control of intraocular pressure, deepening of anterior chamber, opening of anterior chamber angle, and improving visual function.

AIM: To investigate the repair efficacy of recombinant human epidermal growth factor on corneal epithelium after corneal foreign body eliminating operation. METHODS: There were 102 patients with corneal foreign body(188 affected eyes)chosen for the study. All patients were divided into treatment group and control group according to the random number table. Both groups received corneal foreign body elimination by slit lamp. Postoperatively, the treatment group was given eye drops containing epidermal growth factor(JinYinShu)combined with tobramycin while the control group was only administrated with tobramycin. Treatment effects were compared 3d after treatment. RESULTS: Three days after treatment, the cure rate in the treatment group(93.7%), was significantly higher than that in the control group(76.6%)(P<0.05). In the treatment group, fluorescein staining was negative in 90.4% of the cases, significantly higher than that in the control group(46.8%)(P<0.01). CONCLUSION: The recombinant human epidermal growth factor is capable of integrating with corneal epithelial cells and endothelial cell receptor, shortening healing time of corneal epithelial wound, thus making it an effective treatment of traumatic corneal epithelial defect.

AIM: To observe and assess the efficacy and safety of conjunctival papilla grinding technique in the treatment of severe vernal keratoconjunctivitis(VKC)with giant conjunctival papilla. METHODS: The prospective and controlled study was performed in 17 patients(24 eyes)with VKC. Eight patients(12 eyes)with giant conjunctival papillae were treated with grinding technique and 9 patients(12 eyes)were performed with conjunctival papillectomy, respectively. A comparison was made on the changes of symptoms including itching, tearing, light sensitivity and grittiness and physical signs of conjunctival papilla and the corneal epithelium before and after surgery.RESULTS:The symptoms and signs in the first week, the second week and the forth week after the operation were obviously improved in the two groups, and differences in these aspects before and after surgery were of statistical significance(P<0.01). However, by grading of the signs of huge conjunctival nipple in the first week, the second week and the forth week after the operation, and conditions of repair of corneal damage in the second postoperative week, the result showed that efficacy of the grinding group was better than that of the surgical removal group(P<0.05).CONCLUSION:Conjunctival nipples grinding operation can make the rough conjunctival wound flat quickly, relieve symptoms, and promote the repair of keratoconjunctival epithelium. And it is an effective, safe, and simple method to treat the severe VKC with huge conjunctival nipples.

AIM: To probe into the clinical value of danshen injection iontophoresis in treatment of vitreous hemorrhage. METHODS: Eighty-eight vitreous hemorrhage patients(88 eyes)were selected from June 2012 to June 2013 in our hospital. The patients were divided into observation group and control group randomly, with 44 cases(44 eyes)in each group. The patients in control group were treated with xueshuantong clinical drug treatment. The patients in observation group were treated with danshen injection iontophoresis clinical drug treatment. The clinical treatment and visual recovery situations of the patients in two groups were compared and analyzed. RESULTS: The cure rate and total effective rate of observation group were 75% and 95%. The cure rate and total effective rate of control group were 59% and 77%. There were statistically significant differences(P<0.05). Compared with control group, the rate of patients in observation group with visual acuity between 0.6 to 0.9 was improved significantly, rate of visual acuity less 0.2 was reduced significantly, and the whole blood viscosity, plasma viscosity, hematocrit and fibrinogen were improved significantly, there were statistical significance(P<0.05).CONCLUSION: Danshen injection iontophoresis therapy has positive role in improving clinical outcomes and promoting visual function for patients with vitreous hemorrhage.

AIM: To study the ortho-k lens and frame glasses in patients with juvenile myopia the influence of the accommodative convergence/accommodation(AC/A), further clear the effectiveness of controlling the myopia development and security.METHODS: Randomly select 60 patients to our hospital check-up successfully with ortho-k lens of juvenile myopia patients as experimental group, and 60 cases were randomly selected given frame glasses as control group. we observed two groups of patients before and after refractive correction the changes of AC/A and spherical equivalent. Observation time was 1 month, 3 months, 6 months, 1 year.RESULTS: The AC/A of experimental group worn glasses before and after 1 month, 3 months, 6 months, 1 year were 4.05±2.03, 3.05±1.85, 3.31±1.02, 3.14±1.64 and 3.20±1.55,respectively with statistically significant difference(P<0.05). That of control group, worn glasses before and after 1 month, 3 months, 6 months, 1 year were: 4.12±1.86, 4.09±1.38, 3.58±1.45, 3.84±1.41 and 4.23±2.01, respectivley. Worn glasses after 1 month,6 months, 1 years there were no statistically significant difference(P>0.05). Three months after worn glasses there was significant difference(P<0.05). The two groups had no significant difference before(P>0.05). Wearing glasses after 1 month, 6 months, 12 months, the two groups had significant difference(P<0.05); 3 months after worn glasses there was no statistically significant difference(P>0.05). Spherical equivalent, observation time was 1 year: experimental group spherical equivalent degrees increased by 0.38±0.35DS, the control group spherical equivalent degrees increased by 0.84±0.56DS, the two groups were statistically significant difference(P<0.05).CONCLUSION: Both groups could reduce the AC/A value. The experimental group than the control group was better and faster to improve the relationship between the adjustment and collection. The AC/A value was on the high side after myopic degree growth. The ortho-k lens is an effective lens for the moderate myopia.It can more effectively control the growth of juvenile myopia than frame glasses, which is an effective way to control myopia. The mechanism of improving his visual function remains to be further studied.

AIM: To investigate the state of inpatients with ocular surface diseases combining with anxiety and depression. METHODS: The common information, Hamilton Anxiety Scale, and Hamilton Depression Scale were investigated in 84 inpatients with ocular surface disease, and the causes of anxiety and depression were analyzed. RESULTS: The morbidity of inpatients with anxiety was 50.0%, and with depression was 11.9%. Women were more anxious or depressed than men. Inpatients with ocular surface trauma were with a higher grade of anxiety scale; and in the sub group of cornea degeneration and dystrophy, patients were of a higher grade of anxiety and depression scale. Anxiety presented a positive and strong linear correlation with depression. CONCLUSION: A certain degree of anxiety and depression is combining with inpatients with ocular surface diseases. We should pay attention to this state and give them positive treatment as well.

AIM: To assess the clinical outcomes and safety of toric intraocular lenses(Toric IOL)for the correction of preexisting corneal astigmatism in cataract patients having micro-incision phacoemulsification.METHODS:Fifty-eight patients(69 eyes)with age-related cataract and corneal astigmatism were included in this clinical case series study and had micro-incision phacoemulsification combined with of Acrysof Toric IOL implantation. Preoperative corneal astigmatism was more than 0.75 diopter(D)for all eyes. The postoperative data of visual acuity, corneal astigmatism,and anticipated residual astigmatism were recorded. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), postoperative residual astigmatism and toric lens axis were observed. The postoperative data was collected on the day 1, month 1, 3 and year 1 after operation.RESULTS: At 1 year following surgery, the UCVA rise up to 0.70±0.11 from 0.15±0.06(χ2=86.67, P<0.05)on average, and BCVA from 0.21±0.01 to 0.73±0.20(χ2=82.23, P<0.05)indicating a statistical difference. Mean preoperative figure of corneal astigmatism and anticipated residual astigmatism was 2.25±0.73D and 0.34±0.09D, and corneal astigmatism was 0.51±0.21D one year after operation, indicating a statistical difference between preoperative and postoperative astigmatism(t=12.48, P<0.05). There was no statistical difference among postoperative corneal astigmatism and anticipated residual astigmatism(t=1.69, P>0.05). The D-value of IOL positioning and predict axis was 3.79°±1.21° one year postoperatively. Ninety-six percent of patients had less than 5.00° of rotation, and no operative complication was found. There was no statistical difference in various time quantum in terms of BCVA, residual astigmatism, IOL axial view rotation(P>0.05).CONCLUSION:For cataract patients, micro-incision phacoemulsification combined with Toric IOL can effectively improve visual acuity, rectify preoperative corneal astigmatism with fair stability.

AIM: To evaluate the clinical effect of two different surgical treatments for neovascular glaucoma(NVG).METHODS: A total of 30 NVG inpatients(30 eyes)at our hospital from April 2008 to December 2011 were reviewed. Patients were divided into two groups according to the different surgical treatments. In group A, 12 cases(12 eyes)were treated with Ahmed glaucoma valve(AGV)implantation and in group B, 18 cases(18 eyes)were treated with semiconductor diode laser photocoagulation transscleral cyclophotocoagulation(TSCPC). Intraocular pressure, visual acuity and complications were compared between two groups postoperatively.RESULTS: The postoperative IOP was significantly lower in each group(P<0.01). There were statistically significant differences(P<0.05)between AGV implantation group and TSCPC group in IOP 1 week after surgery, but there were no statistically significant difference(P>0.05)in IOP 1 month after surgery. Visual acuity: in group A, the visual acuity was improved in 3 eyes, unchanged in 7 eyes and worsened in 2 eyes.; in group B, the visual acuity was improved in 3 eyes, unchanged in 12 eyes and worsened in 3 eyes. Postoperative complications: in group A, eyeball pain and corneal edema were found in 5 cases(41.7%), shallow anterior chamber in 3 cases(25%), anterior chamber fibroid exudation in 2 cases(16.7%), hyphema in 3 cases(25%); in group B, eyeball pain atearly stage after surgery were found in 10 cases(55.6% ), corneal edema in 11 cases(61.1%), anterior chamber fibroid exudation in 5 cases(27.8%), hyphema in 6 cases(33.3%).CONCLUSION: AGV implantation and TSCPC are both effective surgical treatment methods for NVG. AGV implantation is a filtration surgery, which is relatively safe. TSCPC is more economical and suitable for glaucoma of advanced or absolute stage.

AIM: To investigate the relative factors of the incidence and development of diabetic retinopathy(DR).METHODS: The retinopathy of the 631 patients with type 2 diabetes mellitus(T2DM)was examined by ophthalmoscopy and fundus fluorescein angiography(FFA), and the relative factors which possibly associate with the incidence and development of DR were collected.RESULTS: There were 205 patients with DR, the morbidity rate of DR was 32.5%(95%CI:28.82%-36.15%), the nonproliferative diabetic retinopathy(NPDR)and proliferative diabetic retinopathy(PDR)were 134 cases occupying 21.2%(95%CI: 18.04%-24.44%)and 71 cases occupying 11.3%(95%CI: 8.78%-13.72%)of the patients with DR, respectively. Univariate analysis showed that income, living environment, whether treatment by insulin, combined with diabetic nephropathy(DN), combined with diabetic peripheral neuropathy(DPN), hold on exercise, course of diabetes, fasting plasma glucose(FPG), 2 hours' postprandial plasma glucose(2hPG), glycosylated hemoglobin A1c(HbA1c), systolic blood pressure(SBP), total cholesterol(TC), urinary albumin excretion rate(UAER), serum creatinine(SCr), and blood urea nitrogen(BUN)were significant different among the patients without DR, the patients with NPDR and the patients with PDR(P<0.05 or P<0.01). Multivariate ordinal Logistic regression analysis showed that the incidence and development of DR increased in patients with longer course of diabetes, high HbA1c, high UAER and without exercise, and decreased in patients without DN and DPN(P<0.05 or P<0.01).CONCLUSION: There was a high morbidity rate of DR in patients with patients with type 2 diabetes. The longer course of diabetes, high HbA1c, and without exercise were the independent development factors of DR, whether combined with DN, combined with DPN and UAER were indices for the incidence and development of DR.

AIM: To investigate the influence of various factors on postoperative visual acuity after the retinal detachment(RD)surgery.METHODS: A total of 119 cases(119 eyes)who were admitted with the first diagnosis of RD and recovered after operative treatment were retrospectively analyzed. Among them, 38 cases received scleral buckling operation, and the other 81 cases received vitrectomy and retinal reattachment operation. The onset age of retinal detachment, the affected area, holes, the macular state, the level of proliferative vitreoretinopathy(PVR), visual acuity before and after operation, and retinal reattachment were studied. Chi-square test was used to analyze the differences. Spearman rank correlation was used to test the results of statistical significance. RESULTS: After retinal reattachment, visual acuity was improved in 65 eyes(54.6%), remained unchanged in 34 eyes(28.6%), and decreased in 20 eyes(16.8%). The influences of the onset age, the duration of retinal detachment, the range of retinal detachment, the hole, the macular state, the level of proliferative vitreoretinopathy had significant influence on recovery of visual acuity(P<0.05). Using spearman rank correlation analysis, we found that the preoperative factors associated with postoperative visual acuity included in the descending order of the correlation degree: the level of PVR(rs=-0.493, P=0.000), the range of RD(rs=-0.476, P=0.000), the hole(rs=-0.411, P=0.000), the macular state(rs=-0.360, P=0.000), the duration of RD(rs=-0.334, P=0.000), and the age of the patients(rs=-0.241, P=0.008).CONCLUSION: The level of PVR, the range of retinal detachment, the hole, the macular state, the time of RD and the age of patients are important factors influencing the postoperative vision recovery, with the first three being the most important.

AIM: To investigate the value of mitomycin C(MMC)in chronic angle-closure glaucoma patients with glaucoma and cataract, and to provide reference for the clinical treatment.METHODS: Forty patients with chronic angle-closure glaucoma and cataract patients were randomly divided into the observation group(MMC group)and the control group(NonMMC group). Phacoemulsification and trabeculectomy was used for the treatment. The treatment effects were compared. RESULTS: After treatment, the distance vision(corrected), peripheral anterior chamber depth, intraocular pressure and the number and types of the IOP drug of observation group were all better than those of the control group(all P<0.05). There was no statistically significant difference of the proportion of functional blebs of the two groups(P>0.05). The main complications after the treatment was shallow anterior chamber, in which the observation group was 1 case(5%)and the control group were 2 cases(10%)(P>0.05).CONCLUSION:MMC in chronic angle-closure glaucoma patients with glaucoma and cataract could improve the intraocular pressure, visual acuity and should be recommended for clinical treatment.

AIM: To compare three clinically similar patient groups and a control group in terms of tear function tests, ocular surface staining and conjunctival impression cytology.METHODS: This was a single-centre, prospective, double-blind, randomised and controlled trial. The study includes 20 dry eye patients with Schirmer 1 scores less than 10mm and a tear film break-up time(TBUT)less than 10s, 20 anterior blepharitis patients with drying and crusting of the eyelashes, 20 seasonal allergic conjunctivitis patients with papillary hypertrophy of the upper eyelid tarsal conjunctiva and 20 control group patients. The Schirmer scores, TBUT scores, ocular surface staining(as graded by the Oxford scheme scale), goblet cell density(as observed using impression cytology and metaplasia scores for all patients evaluated by the Nelson grading scheme)were compared.RESULTS: Significant differences were identified between these patient groups and the control group in terms of tear functions tests, ocular surface-staining scores, goblet cell density and metaplasia scores(P<0.001). CONCLUSION: Inflammatory response against these three diseases was demonstrated to cause damage in parallel to the severity of the local inflammation they generate on the ocular surface. We confirmed that this damage has very serious effects, especially on conjunctival goblet cell density and metaplasia. We believe that the degree of this loss in goblet cells is correlated with clinical findings.

AIM: To observe and analyze the curative effect of YAG laser combined with routine medicine in treating delayed anterior fibrinous membrane after intraocular lens implantation.METHODS: A case control study was adopted and 62 cases(62 eyes)were randomly divided into treatment group(31 cases)and control group(31 cases).All the patients had delayed anterior uveitis after intraocular lens(IOL)implantation with IOL anterior fibrinous membrane reached the grade 3 or above. YAG laser combined with routine medicine were used intreatment group, while conventional medical treatment were performed in control group. All the patients were followed-up for 2-3 months. RESULTS: Visual acuity were improved at different levels, anterior fibrinous membrane absorbed and inflammation subsided after treatment in both groups., there were no significant differences of visual acuity and intraocular pressure in both two groups between pre-operation and post- operation(all P>0.05). The cure time of the treatment group(14.6±2.3d)was significantly shorter than that of the control group(20.4±3.4d)(P<0.01). No serious complication was found in both two groups postoperatively. CONCLUSION: The YAG laser combined with routine medicine has a satisfactory curative effect in treating delayed anterior fibrinous membrane after intraocular lens implantation.

AIM:To observe the optical coherence tomography(OCT)images of idiopathic macular hole(IMH)on patients before and after vitrectomy and internal limiting membrane peeling(ILMP)surgery, and to analyze the relationship between the macular hole configuration and the postoperative best corrected visual acuity so as to offer a potential index to effectively predict visual outcome in eyes with idiopathic macular holes. METHODS: A total of 32 consecutive patients of IMH(7 males, 25 females)receiving the operation of PPV and ILMP were performed with routine ophthalmologic and OCT examination before and after the operation. The best-corrected visual acuity(BCVA)in the follow-up period was recorded. The minimum diameter, the base diameter, the hole height before the operation, and the macular retinal thickness before and after the operation were measured respectively by the analytical model of OCT. The correlation between macular hole index(MHI)and BCVA post operation was analyzed using SPSS 13.0.RESULTS: The negative correlation was observed between the post operative BCVA and the minimum diameter and the base diameter before the operation(r=-0.524, -0.610, P<0.01); There were no significant correlation between the post operative BCVA and the hole height and the macular retinal thickness(r=-0.064, 0.003, P>0.05). The positive correlation was observed between the postoperative BCVA and the MHI before operation(r=0.457, P<0.01); The cut-off value of MHI was defined as 0.5 by clinical observation. Postoperative BCVA in the MHI ≥0.5 group was much better than that in the MHI<0.5 group(Mann-Whitney Test, U=30.0, W=135, P<0.01). The postoperative BCVA of patients with IMH was much better than that before the operation.CONCLUSION: The smaller the minimum diameter and the base diameter is, the better the post operative BCVA. The MHI is easy to calculate, and patients of MHI ≥0.5 have a better postoperative BCVA, MHI can be used as clinical evaluation-index for operation selection. The PPV combined with IMLP can effectively treat the IMH based on the OCT result.

AIM: To analyze the refractive development in infants, to screen for the high risk group for infant refractive error and to explore the best timing for early intervention of the condition.METHODS:Noncycloplegic refraction data in 7 stages of age(6, 9, 12, 18, 24, 30, and 36 months)were collected with Suresight autorefractor from 2 447 healthy infants(4 894 eyes). The development and distribution of refraction were analyzed.RESULTS:Most of the 4 894 eyes were found to be hyperopic and astigmatic. The mean and standard deviation of sphere, cylinder, and spherical equivalent for seven age groups from 1.5 years as well as reference ranges(P25～P75 and P5～P95)were obtained. Hypermetropic and astigmatic refractive error reduced rapidly with age until the age of 1.5 years old, after which they did not change significantly.CONCLUSION: In infants, spherical lens deviating from P25～P75(D)and cylindrical lens exceeding P75(D)amblyopia are the suspected signs of amblyopia, and spherical lens deviating from P5～P95(D)and cylindrical lens exceeding P95(D)indicate high risk of amblyopia. Intervention of refractive error may start at the age of 1.5 years.

AIM: To analyze the etiology, therapeutic effects,risk of relapse and prognosis of acute anterior uveitis.MEHTODS: Medical history of 215 patients with acute anterior uveitis who underwent treatment in Department of Ophthalmology, People's Hospital of Fenghua was collected, together with results of clinical examinations and auxiliary examinations. The data were studied in terms of therapeutic effects, etiological factors, prognosis and relapse rate. RESULTS: In 85 cases(39.5%), the cause was identified, and among the among the most frequent causes were traumatic or surgical injury, viral infection and glaucomatocyclitic crisis. After treatment, the best corrected visual acuity was no less than 1.0 in 153 cases(71.2%), between 0.5 and 1.0 in 55 cases(25.6%), between 0.3 and 0.5 in 4 cases(1.9%), between 0.05 and 0.3 in 2 cases(0.9%), and less than 0.05 in 1 case(0.5%). During the follow-up of more than 6 months, relapse occurred in 4 cases(1.9%)during 4-6 months, in 7 cases(3.2%)during 7-12 months, in 10 cases(4.7%)during 13-24 months, and in 3 cases(1.4%)during 25-60 months. CONCLUSION: The etiology of acute anterior uveitis is complicated and mostly idiopathic. Vision prognosis is good after treatment, but therelapse rate is high and can cause visual impairment, so better understanding should be gained of its relapse and its prevention and early treatment should be emphasized.

AIM: To investigate the cause and treatment of high intraocular pressure(IOP)after pars plana vitrectomy(PPV).METHODS: Totally, 482 patients(511 eyes)underwent PPV from January 2007 to March 2010, were reviewed to explore the mechanism and treatment of high IOP after PPV. RESULTS: High IOP occurred in 140 patients(141 eyes), the rate of IOP elevation was 27.6%. The rate of IOP elevation was significantly between C3F8 and silicone tamponading(P<0.01). The rate of IOP elevation with sclera buckling was significantly different from that without sclera buckling(P<0.05). The rate of IOP elevation in aphakia was different from phakia(P<0.01). And it was also had significant difference between traumatic and nontraumatic ones(P<0.01). CONCLUSION: The risk factors of IOP elevation include sclera buckling, C3F8 tamponade, aphakia and trauma.

AIM: To explore the specific image of buried optic nerve drusen during optical coherence tomography(OCT)examination. METHODS: A retrospective study was made on 6 patients with buried optic nerve drusen(6 eyes)diagnosed by fundus fluorescein angiography(FFA)and B scan examination. RESULTS: The high fluorescence area of optic disc showed on the FFA image of all 6 patients imaged with the spectral OCT revealed cluster of calcium deposits. These deposits demonstrated specific wide bars with high reflectivity casting shadows underneath and had lacunae appearance. CONCLUSION: Buried optic nerve drusen showed specific image in the spectral OCT examination. Thus, spectral OCT can serve as an assistant examination method with relatively prominent features for diagnosing buried optic nerve drusen. It can help to raise the detection rate of buried optic nerve drusen.

AIM: To compare the effects of small incision extracapsular cataract extraction and phacoemulsification on corneal endothelial cells. METHODS: Eighty-two age-related cataract cases(82 eyes)from March 2011 to October 2011, were randomly divided into two groups: phacoemulsification group(group A)and small incision extracapsular cataract extraction group(group B). Corneal edema after operation and changes in corneal endothelial cells in different stages before and after operation were observed. RESULTS: In both groups,there was significant difference in the data of corneal endothelial cell density before and after operation(P<0.05). Although all the postoperative data of corneal endothelial cell density were lower than the preoperative ones, they had been slightly increasing over time. The mean density of corneal endothelial cell in group A was significantly higher than that in group B at 7d, 1 month and 3 months after operation(P<0.05). In both groups, the average proportion of corneal hexagonal cells at 7d, 1 month and 3 months after operation was obviously lower than that before surgery, with significant difference between the two groups. Postoperative corneal edema was less severe in group A than in group B(P<0.05). CONCLUSION: Phacoemulsification causes less damage to corneal endothelial cells and less postoperative corneal edema than small incision extracapsular cataract extraction.

AIM: To investigate the clinical effects of phacoemulsification combined with goniosynechialysis for treatment of angle-closure glaucoma. METHODS: A total of 86 patients(96 eyes)with angle-closure glaucoma and cataract were enrolled in the study and they were divided into two groups. Group A included patients with anterior goniosynechia closure of 18°-270°(270° included), and group B included patients with anterior goniosynechia closure greater than 270°.The therapeutic effects were observed. RESULTS: Operation was successful in all patients and there was no intraoperative posterior capsule rupture. During the 6-month follow-up, the intraocular pressure and drug use of group A were both less than those of group B(P<0.05); the anterior chamber depth, the distance vision and goniosynechia closure range in Group A were better than those in Group B(P<0.05). Corneal edema was the main complication in both groups(5 cases,5.8% in each group)and all patients were cured after symptoms were properly controlled.CONCLUSION: Phacoemulsification combined with goniosynechialysis was effective for patients with anterior goniosynechia closure of 18°-270°(270° included).

AIM: To evaluatethe laser photocoagulation of different ranges for diabetic retinopathy(DR)prognosis.METHODS: A total of 98 cases(153 eyes)with proliferative diabetic retinopathy treated by laser photocoagulation from November 2010 to November 2012 were enrolled in this study. The eyes were divided into three groups, Group A of 38 eyes(25%)receiving pan-retinal photocoagulation, group B of 55 eyes(36%)receiving quadrant retinal laser photocoagulation and group C 60 eyes(39%)receiving retinal laser photocoagulation only in the ischemic area. Blood glucose, refraction, intraocular pressure and vision were measured preoperatively and postoperatively. And all patients underwent VEP, ERG, fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)examinations before and after operation. Patients were followed up for 3 months. RESULTS: After 3 months, decrease of macular thickness in group A and B was more significant than that in group C(P<0.05); improvement of visual acuity in group B and C(3 or more lines)was more significant than that in group A(P<0.05). CONCLUSION: Quadrant retinal laser photocoagulation can significantly improve retinal hypoxia, prevent retinal neovascularization and protect visual function in macular area.

AIM: To evaluate and compare the accuracy of IOL-Master and A-scan in measuring the axial length of silicone oil-filled eyes, and to explore the clinical value of IOL-Master in calculating intraocular lens diopter of the silicone oil-filled eyes. METHODS: An analysis was made of 30 patients(30 eyes)who received cataract surgery combined with silicone oil removal in our hospital from June 2012 to December 2012. Before the operation and one month afterwards, the axial length was measured by both IOL-Master and A-scan, and all the results were divided into two groups: A-scan group and IOL-Master group. Then we used IOL-Master to calculate the intraocular lens diopter and to estimate the postoperative refraction. Postoperative refraction was measured one month after operation and compared with the preoperative estimates. RESULTS: Before silicon oil removal, there was significant difference between the axial lengths obtained by IOL-Master and those by A-scan, with the former much smaller than the latter. After the operation, there was no significant difference between the axial lengths obtained by the two methods. The axial lengths measured by IOL-Master before and after operation were not significantly different. No significant difference was observed between the postoperative refraction and the preoperative estimates, either.CONCLUSION: IOL-Master is a more preferable method to measure axial length than A-scan. However, in cases where IOL-Master cannot be applied, A-scan together with other methods should be used.

AIM: To evaluatethe efficacy and safety of improved lacrimal excision surgery in patientsMETHODS:A retrospective study of 92 chronic dacryocystitis patients(92 eyes)undergoing common lacrimal excision surgery and improved lacrimal excision surgery from September 2006 to March 2012 was carried out. The patients(36 males, 56 females)with the age of 71-90 years(average 77.20±11.08)were randomly divided into control group(46 eyes)and experimental group(46 eyes). The patients in control group performed common lacrimal excision surgery and those in experimental group received improved lacrimal excision surgery. The efficacy and safety of two groups were analyzed.RESULTS: The duration of improved lacrimal excision surgery(5min)was shorter than that of common lacrimal excision surgery(20min). No serious complications were presented in experimental group.CONCLUSION:With the advantages of lighter trauma, less bleeding, shorter duration and fewer complications, the improved lacrimal excision surgery is effective and safe, especially suitable for the elderly with chronic dacryocystitis, who's at poor body condition, cannot tolerate longer operative time and has larger trauma.

AIM: To investigate the effect of unilateral hole blunt lacrimal probe for neonatal dacryocystitis topical anesthesia.METHODS: Seventy-five children(86 eyes), among 4-month or 5-year-old, who had dacryocystisis, were treated by dacryocystitis massage for one month. But it was invalid. Then blocking lacrimal passages were flushed under conventional pressure. Later, unilateral hole blunt lacrimal probes was used to make lacrimal passages open under topical anesthesia. After operation, lacrimal passages were flushed three times every two days.RESULTS:Eighty-four cases were cured and no recurrence with only once treatment. Two cases were cured with the second treatment. All cases were without infection and no complications as false passages and lacrimal points were appeared. After 3-month followed up, none of them was relapsed. CONCLUSION:Using unilateral hole blunt lacrimal probe for neonatal dacryocystitis under topical anesthesia is effective.

AIM: To evaluate the effect of polyethylene glycol eye drops on tear film break-up time and symptoms for dry eyes after cataract surgery.METHODS: Eighty patients with dry eyes secondary to cataract surgery who were treated in our hospital from January to August 2013 were randomly divided into group A and group B. Group A was treated with sodium hyaluronate eye drops for one week, and Group B was treated with polyethylene glycol eye drops for one week. The break-up time of tear film was measured and the subjective symptoms were graded before and after the treatment.RESULTS: The tear film break-up time of group A was respectively 3.87±1.12s and 4.21±1.06s before and after the treatment, with no significant difference(P>0.05); it was respectively 3.98±1.04s and 8.98±1.30s with significant difference for group B(P<0.05). The symptom grade of group A was respectively 13.71±2.9 and 7.01±3.11 before and after the treatment with significant difference(P<0.05). It was 12.98±2.54 and 3.98±1.94 with significantly difference for group B(P<0.05). After the treatment, there was a significant difference between group A and group B(P<0.05).CONCLUSION: Polyethylene glycol eye drops can extend tear film break-up time and improve symptoms of dry eyes. It is an effective drug in treatment of dry eyes after cataract surgery.

AIM: To measure the abnormality of the inferior oblique tendon in patients with congenital superior oblique muscle paralysis.METHODS: In this cross-sectional, self-control designed study, the tensity of the inferior oblique tendon of both the paralytic and nonparalytic eye were measured during the operations in 30 patients who were diagnosed with exotropia(including intermittent exotropia and constant exotropia )accompanied with single superior oblique muscle paralysis. The tensity of the tendon was measured as the maximal distance of which the inferior oblique tendon could be lifted from the scleraRESULTS: Inferior oblique had different degrees of thickness, but was tougher and tighter than that of nonparalytic eye. There was a significant difference(P<0.01)in the average tensity of the inferior oblique tendon between the paralytic eyes 6.33±1.35mm and the nonparalytic eyes 7.76±0.81mm.CONCLUSION: The inferior oblique tendon is stronger and less relaxant in the paralytic eyes.

AIM: To evaluate the differences between Haigis-L formula and CH-SRK/T when predicting intraocular lens power after laser in situ keratomileusis(LASIK)surgery for myopia.METHODS: Seventy-two patients(140 eyes, axial length ≤26mm)after LASIK surgery were recruited between October 2012 and February 2013. Participants with other ophthalmic diseases were excluded. Haigis-L and CH-SRK/T formula were used to calculate the intraocular lens power separately after LASIK surgery and the data were analyzed using SPSS 18.0 software.RESULTS: The mean value of Hoyaintraocular lens after LASIK was 22.99±1.38D by Haigis-L formula compared with 19.95±1.69D using CH-SRK/T formula. According to paired t-test, pairs of differential mean are -3.039±1.899D. Wilcoxon signed rank test was used and the sum of ranks was -3.408a(P=0.001). Meanwhile, the mean value of Allergan AR40 intraocular lens was 23.26±1.49D by Haigis-L formula; while the degree of intraocular lens calculated by CH-SRK/T formula was 20.05±1.69D. According to paired t-test, pairs of differential mean are -3.208±1.823D. Wilcoxon signed rank test was used and the sum of ranks was -3.408a(P=0.001).CONCLUSION: After LASIK surgery for myopia, the degree of intraocular lens power measured by CH-SRK/T is lower than that by Haigis-L formula. The degree of intraocular lens power calculated by CH-SRK/T is more likely to be under corrected.

AIM: To analyze the clinical results of predictive refraction after Laser-assisted Subepithelial Keratomileusis(LASEK)in high myopia patients. METHODS: Totally, 80 patients(160 eyes)with high myopia treated by LASEK were divided into two group according to the different corneal thickness and predictive refraction. Forty patients(80 eyes)in reservation group were reserved a certain diopter(-1.00DS). Other 40 patients(80 eyes)in general group were fully corrected. Ocular symptoms, visual acuity, refraction, and intraocular pressure(IOP)was followed up and observed postoperatively and regularly.RESULTS:The postoperative visual acuity after 6 month was all the best in two groups, which appeared a slight decline 1 year and 3 years after surgery. Three years later, uncorrected visual acuity was basically stable. The preoperative refraction in two groups was -8.25±1.23D with an average of -0.75 ± 0.12D fallback. The mean corneal curvature and corneal thickness had no significantly change. IOP after surgery was stable in two groups with no complications as secondary high IOP or glaucoma, etc. The results of corneal topography indicated that keratoconus was not occurred 3 years postoperatively in two groups. Six months and 1 year after surgery, mild haze appeared in both groups which were disappeared 3 years postoperatively.CONCLUSION: On the premise of safe corneal thickness, we predict a certain degrees of myopia after LASEK in high myopia patients. Through preserving more matrix bed thickness, it will achieve the same expected effect and expand the range of correction.

AIM: To compare the postoperative vision performance of multifocal intraocular lens implantation combined with corneal incision to correct astigmatism and that of monofocal intraocular lenses implantation.METHODS: Eighty patients(100 eyes)with age-related cataract and low cornea astigmatism were divided into control group and intervention group. Intervention group received limbal relaxing incisions at the steepest meridian axis during phacoemulsification with temporal corneal incision and implanting multifocal intraocular; the control group only received phacoemulsifieation with temporal corneal incision and implanting monofocal intraocular lenses. Uncorrected distance visual acuity(UCDVA), uncorrected near visual acuity(UCNVA)and cornea astigmatism were observed 1 week, 1 month and 3 months postoperatively. Best corrected near visual acuity(BCNVA), best corrected distance visual acuity(BCDVA), distant corrected near visual acuity(DCNVA), were observed 3 months postoperatively. RESULTS: UCDVA and UCNVA in intervention group were higher than that in control group 1 week, 1 month and 3 months postoperatively while the cornea astigmatism in intervention group was lower than that in control group. BCNVA, BCDVA and DCNVA in both groups showed obvious improvement 3d after the surgery. There was no significant difference between the two groups in UCDVA and UCNVA 1 week, 1 month and 3 months postoperatively and in BCDVA and BCNVA 3 months postoperatively.CONCLUSION:Multifocal intraocular lens implantation combined with transparency cornea relaxing incisions can effectively rectify preoperative cornea astigmatism in cataract patients, and it can provide good visual acuity of entire range, thus to extend the target users of multifocal intraocular lens.

AIM: To observe and describe the clinical manifestations of multiple evanescent white dot syndrome(MEWDS). METHODS:The clinical data of 25 cases diagnosed as MEWDS from January 2003 to November 2012 in our hospital were retrospectively analyzed. A variety of imaging data were analyzed, and the clinical and imaging features of MEWDS were summarized. RESULTS: All patients with mild to moderate myopia, visual field defect in different degree. Fluorescein angiography(FFA MEWDS)showed: the lesions showed round strong fluorescent spot, with time delayed fluorescence intensity, advanced showed strong fluorescence boundary was not clear staining, optic disc fluorescence enhancement, accompanied by a segment of vascular wall staining. Indocyanine green angiography(ICGA)showed: the relative weak fluorescence early posterior interspersed with different size, advanced gradually with clear boundaries of patchy fluorescence. OCT showed: location photoreceptive cells layer thickness, photoreceptor inner segments of irregular/outer segment(IS/OS)layer band local thin or missing, with reflective intensity(abnormal fluorescence foci of the part and angiography in the corresponding), and retinal inner plexiform layer and outer nuclear layer were no obvious abnormalities.CONCLUSION: MEWDS patients with fundus spot like lesions are characteristic in FFA, ICGA, OCT, these features suggest that the lesions were located in the RPE and photoreceptors, these features of MEWDS disease diagnosis and differential diagnosis.

AIM: To investigate the causative factors of low vision after small incision cataract surgery. METHODS: A retrospective study was made of 291 cataract patients(291 eyes)who received small incision cataract surgery combined with intraocular lens implantation from July 2011 to July 2012. Best corrected vision lower than 0.3 was diagnosed as low vision, and its causes were analyzed. RESULTS: After surgery, low vision was diagnosed in 49 eyes. Of these cases, 17(34.7%)were due to surgical complications and 32(65.3%)were due to preoperative conditions, including age-related macular degeneration(8 eyes), diabetic retinopathy(14 eyes), high myopia(6 eyes)and other diseases(4 eyes). CONCLUSION: In our study, presence of diseased conditions before surgery is the most important cause of low vision after small incision cataract surgery. Close examination before surgery can improve the predictability of the surgery.

AIM: To observe the corneal refractive state stability time and changes of corneal refraction after excision of pterygium.METHODS:There were 46 cases(54 eyes), who had undergone excision of pterygium, randomly selected for corneal topography examination operated on the 3rd, 7th, 14th, 30th and 90th day after surgery. And statistic analysis was undertaken.RESULTS:Astigmatism after pterygium excision decreased significantly. Ks value, astigmatism in the 3rd postoperative day compared with that in other observation phases showed differences of statistical significance(P<0.05). Ks value, Kf value, and astigmatism in the 7th days compared with that in other observation phases showed differences of no statistical significance(P>0.05). CONCLUSION: Corneal refractive status is stable in 7 days afterpterygium excision surgery.

AIM: To investigate the characteristics of the refractive state of the youngsters of different ages, and to provide a scientific basis for the prevention and control of juvenile myopia.METHODS: Visual acuity, computer optometry, inserts, anterior segment and fundus were examined in eyes of 37 700 students from some schools in local county. RESULTS: There were statistically significant differences in the subnormal vision rate among different age groups from 7 to 18 years old. There were statistically significant differences in the hyperopia and myopia incidence among different age groups from 7 to 18 years old. CONCLUSION: With the increase of age, adolescents' refractive state is changing. The number of juvenile hyperopia decreases gradually, while the number of juvenile myopia increases gradually. The follow-up observation is needed to protect them from the change of vision and refractive state to make the proper treatment.

AIM: To investigate the methods of treatment and the prognosis of secondary glaucoma.METHODS: Clinical data of 109 admission cases(112 eyes)of secondary glaucoma were retrospectively analyzed. According to the primary diseases, patients were divided into lens-related glaucoma, ocular trauma-related glaucoma, vascular disease glaucoma, inflammatory glaucoma and other related groups. The methods and effect of treatment were evaluated for each group of patients.RESULTS: The intraocular pressure was significantly lower than hospital admission(P<0.05). After a week of treatment, the best corrected visual acuity was increased partially. CONCLUSION:Pathogeny of secondary glaucoma is complex. Treatment should be adopted comprehensive measures. Proper operative option can control intraocular pressure. For the damage of visual function severely, to improve or relieve symptoms is the main objective of their treatment.

AIM: To analyze the effects of epipolis laser in situ keratomileusis(Epi-LASIK)and laser in situ keratomileusis(LASIK)for treatment of myopic astigmatism. METHODS: For treatment of myopic astigmatism, 32 patients(64 eyes)treated by Epi-LASIK and 63 patients(126 eyes)received LASIK. By their degree of astigmatism, the eyes were divided into Group Ⅰ(-0.25～-2.75)DC and Group Ⅱ(-3.0～-5.0)DC. During the 6-month follow-up, the early effects of the two operations were observed and compared in terms of uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), residual astigmatism, corneal healing, intraocular pressure(IOP), corneal topography. RESULTS: In Group Ⅱ, UCVA better than 20/20 was achieved in 87.5% of the eyes subjected to Epi-LASIK and in 63.3% of the eyes subjected to LASIK, with significant difference between them(χ2=4.055, P<0.05); residual astigmatism was -0.41±0.30D for the Epi-LASIK eyes and -0.74±0.36D for the LASIK eyes, with significant difference between them(t=2.672, P<0.05); postoperative corneal astigmatism was 0.63±0.34D for the Epi-LASIK eyes and 0.81±0.52D for the LASIK eyes with significant difference between them(t=2.234, P<0.05). CONCLUSION: For treatment of high astigmatism(≥-3.00D), Epi-LASIK is more effective and predictive than LASIK.

Congenital cataract is an important cause of lifelong visual impairment in children. Its treatment is different from that of senile cataract since visual functions of the affected children are still under development. However, consensus has not be made in surgical management of congenital cataract, especially in the surgical approach,intraocular lens selection and postoperative refractive correction. This study reviews researches on the surgical therapy and its postoperative visual function recovery conducted in recent years.

Due to blood-retinal barrier, drug administration is often limited for the treatment of vitreoretinal disorders. Intravitreal drug injection is an effective method as it can directly deliver drugs to act on vitreous body and retina. However, for chronic and recurrent diseases, injection needs to be repeated frequently to achieve effective drug concentration. Ocular implants, which not only avoid blood-retinal barrier but also extent action time, have become a new treatment for vitreoretinal disorders. Different implants can treat different diseases. Antiviral drug implant can be effective in the treatment of cytomegalovirus retinitis for the acquired immunodeficiency syndrome patients. Steroid implant can be effective in the treatment of chronic inflammatory fundus diseases such as macular edema and noninfectious uveitis. The main side effects were elevated intraocular pressure and cataract formation. Ciliary neurotrophic factor and anti-vascular endothelial growth factor implants may be the effective drugs for the treatment of age-related macular degeneration. This article reviewed the clinical applications of current major intravitreal implants on vitreoretinal disorders.

Security and perfect vision and fewer complications are our goals in cataract surgery, and hard-nucleus cataract surgery is always a difficulty one. Many new studies indicate that micro-incision phacoemulsification in treating hard nucleus cataract is obviously effective. This article reviews the evolution process of hard nuclear cataract surgery, the new progress in the research of artificial intraocular lens for microincision, and analyse advantages and disadvantages of various surgical methods.

AIM: To compare the visual quality of LASIK flap made by femtosecond laser with that by microkeratome.METHODS: Retrospective case series research was undertaken. In 2011, there were 150 cases(300 eyes)underwent LASIK surgery from June to September. The patients were divided into 2 groups: flap made by femtosecond laser was group 1; flap made by microkeratome was group 2, with 75 cases(150 eyes)for each group. All surgeries performed stroma ablation with EC5000CX-Ⅱ(NIDEK CO., LTD)by the same surgeon. Uncorrected visual acuity(UCVA), diopter before operation and one week, one month, three months after the operation were compared between two groups, as well as corresponding data of the best corrected visual acuity, wavefront aberrations, the scotopic and photopic contrast sensitivity. RESULTS: The refractive diopter and uncorrected visual acuity between 2 groups had no significant difference at 1 week,1 month and 3 months after operation. Absolute value of C7, RMS3, RMS6 and RMSh of femtosecond laser group were lower compared with microkeratome group at 1 month after operation(P<0.05). C7 and C14 of femtosecond laser group were also lower at 3 months after operation(P<0.05). At 1 week after operation, the photopic and mesopic contrast sensitivity function in two groups decreased for all spatial frequencies, there were statistical differences compared with which before operation(P<0.05). The scotopic and photopic contrast sensitivity of the first postoperative month was increased compared with that of the first postoperative week. Till the third postoperative month, the contrast sensitivity function in two groups restored to preoperative level. The difference showed no statistic significance. CONCLUSION: LASIK flap made by femtosecond laser can safely and effectively correct myopia and astigmatism. Femtosecond can improve UCVA and visual quality, decrease high order aberration without reducing postoperative contrast sensitivity. Its postoperative outcome is much better than that of LASIK flap made by microkeratome.

AIM:To evaluate microperimetry in treatment of acute pan-uveitis patients before and after glucocorticoid pulse therapy, and to provide evidence for the clinical application of microperimetry.METHODS:Fifty-three patients(106 eyes)with acute pan-uveitis who came to hospital within 5 days of onset were enrolled. The data of visual acuity, best corrected visual acuity, microperimetry images, OCT and flare examination outcome were analyzed before glucocorticoid pulse therapy and 1, 3, 7d, 1 month and 3 months after the therapy. The changes in visual acuity, light sensitivity, cell value of aqueous humor and macular edema were observed. RESULTS: In patients with acute pan-uveitis, inflammation subsided gradually after treatment. Compared with the data before corticosteroid pulse therapy, all the data after the therapy showed significant improvement(P<0.05). Patients' vision at various times after the treatment improved gradually. The thickness of neuroepithelial layer of macular retina improved from(281±61)μm before treatment to(149±43)μm after treatment with significant difference(P=0.000). Flare examination result changed from 213.9±13.8 before treatment to 18.2±2.2 after treatment with significant difference(P=0.000).CONCLUSION:Microperimetry can reveal the changes in visual acuity and light sensitivity before and after the glucocorticoid pulse therapy in patients with acute pan-uveitis, which suggests that microperimetry can serve as an efficient way to observe the development of acute pan-uveitis and its therapeutic effects.

AIM: To investigate the outcome of wavefront-guided laser in situ keratomileusis(LASIK)with femtosecond laser for correcting high myopiaMETHODS: Thirty-two patients(58 eyes)with high myopia(myopia degree: -6.0～-10.0DS, astigmia degree ≤ -2.0DC)underwent wavefront-guided LASIK using femtosecond laser in Chongqing Aire Eye Hospital from October to December in 2012 were collected as wavefront group, and 28 patients(56 eyes)with high myopia(myopia degree: -6.0～-10.0DS, astigmia degree ≤ -2.0DC)receiving LASIK with femtosecond laser were chosen as control group. These patients were followed up for 6 months. Uncorrected visual acuity(UCVA), refraction, total high order aberrations(HOA), spherical values and coma values between two groups were compared. RESULTS: Six months after the operation, UCVA of all eyes were higher than 0.8. UCVA achieved 1.0 or better, which account for 91.4% of eyes in wavefront group and 87.5% in control group, the difference was not statistically significant(P=0.360). UCVA achieved 1.2 or better in 60.3% of eyes in wavefront group and 57.1% in control group, the difference was not statistically significant(P=0.729). UCVA achieved 1.5 or better in 17.2% of eyes in wavefront group and 12.5% in control group, the difference was not statistically significant(P=0.477). The coma values were lower in wavefront group than that in control group, the difference was statistically significant(P=0.021). There was no statistically significant difference in postoperative UCVA, refractions, total HOA and spherical values between two groups(P>0.05). CONCLUSION: Compared with conventional LASIK with femtosecond laser, although wavefront-guided LASIK with femtosecond laser canreduce the coma values of patients with high myopia, wavefront-guided LASIK with femtosecond laser has no adventage in improving UCVA,correcting refractions, reducing the total HOA, and. spherica values.

AIM: To screen diabetic retinopathy(DR)in diabetes mellitus(DM)patients by non-mydriatic fundus photography, and to investigate the risk factors in DM patients for DR.METHODS:A total of 768 patients with DM type 2 treated in the department of endocrinology in our hospital from November 2010 to December 2011 were enrolled in this study. All patients underwent non-mydriatic fundus photography, and were divided into two groups: non-diabetic retinopathy group(NDR group)and DR group, in accordance with the international clinical staging standard of DR released in 2002. Weight, height, blood pressure and medical history were recorded. Serum levels of fasting plasma glucose(FPG), lipids, glycated hemoglobin(HbA1c)and uric acid(UA)were measured.RESULTS: Totally 317 out of 768 DM patients(41.3%)were diagnosed with DR. The detection rate in women was significantly higher than that in men(45.2% vs 37.6%, P<0.05). Compared with NDR group, DR group had older age, longer course and higher systolic blood pressure(SBP), FPG, Triglycerides(TG), HbA1c and UA level(P<0.05). Dinary logistic regression analysis showed that duration, gender, SBP and HbA1c were independent risk factors of DR in DM patients.CONCLUSION:DR in DM patients is quite common and closely associated with duration, gender, blood pressure and glucose. Non-mydriatic fundus photography is a quite useful method for screening DR.

AIM: To analyze the functions of dendritic cells(DC)from peripheral blood in type 2 diabetes mellitus(T2DM)patients with diabetic retinopathy(DR), and investigate the role of DC in the pathogenesis of DR.METHODS: The subjects were divided into simple T2DM group, T2DM with DR group and normal control group. Flow cytometry was used to analyze classification and number of DC in peripheral blood, and ELISA was used to detect the level of Interleukin -12(IL-12).RESULTS: Compared with the simple T2DM and normal control groups, the number and percentage of myeloid dendritic cells(mDC)in peripheral blood increased significantly in T2DM with DR group(P<0.05). The contents of IL-12 in plasma also increased significantly in T2DM with DR group, while the contents of IL-12 in cultured mDC supernatant and the IL-12 secretion of single mDC reduced significantly(P<0.05). The number and percentage of plasmacytoid dendritic cells(pDC)had no significant difference among the three groups(P>0.05).CONCLUSION: Drift of the mDC/pDC subtype causes Th1/Th2 immune function disorders and promotes the immune inflammatory reaction, which may play an important role in the occurrence and development of DR.

With the development of vitreous surgery technology, patient's expectation of postoperative visual function has been raised. Therefore, the accurate measurement of intraocular lens degree in silicone oil-filled eyes has become an increasingly important factor influencing the prognosis of patients. This article offers a review of the present situation and prospect in this study field.

Retinal vein occlusion(RVO)is the most common, vision-threatening, retinal vascular disease after diabetic retinopathy. RVO has characteristics of the retinal vein dilation and circuity, and retinal hemorrhage, edema and exudation along the vein. If edema occurs in macular area, it will lead to severe decreased central visual acuity. Though the clinical entity of RVO has been known for 100 years, the treatment remains unsatisfied. The advent of glucocorticoid and anti-vascular endothelial growth factor agents has made great progress in the treatment. The article illustrates the mechanism of macular oedema(MO)secondary to RVO. The pharmacological action and advancement of the drugs of glucocorticoid and anti-vascular endothelial growth factor agents are reviewed in this article. The prospects in the treatment of this disease are also mentioned.

AIM: To investigate the epidemiological status of refractive state among school-age children of 5 to 12 years in Chengguan district of Lanzhou city, and to analyze the correlation with axial length(AL), horizontal and vertical corneal refractive power(K1, K2), anterior chamber depth(ACD)and corneal diameter(W-W). METHODS: The value of AL, K1, K2, ACD and W-W of 813 school-age children(1626 eyes)aged 8.46±2.30 years old(5-12 years)were measured by IOL-Master, refractive error was measured by computer refractor. The eyes were divided into 5 groups according to different mean spherical equivalent(SE)diopter: high myopia, moderate myopia, low myopia, emmetropia and hyperopia. The correlation between diopter and different refractive parameters of different ages and different diopter groups were analyzed respectively, the SPSS 19.0 was used for the statistical analysis.RESULTS: There were statistically significant difference(P<0.05)in uncorrected visual acuity and refractive state among the different groups of 5-12 years school-age children, the prevalence of myopia tended to increase with the age. There were statistically significant difference in AL and ACD among the different age groups(P<0.05), AL and ACD increased with the age. There were statistically significant difference in AL among three myopic groups(P<0.05). There were statistically significant difference in ACD between low myopia and moderate myopia, low myopia and high myopia(P<0.05). There were statistically significant difference in corneal refractive power and corneal diameter between low myopia and high myopia, moderate myopia and high myopia(P<0.05). SE was negatively correlated with AL(r=-0.764, P<0.01)and ACD(r=-0.498, P<0.01), but had week correlation with corneal refractive power or corneal diameter.CONCLUSION: The increase of AL plays an important role in the changes of refractive among school-age children of 5-12 years, AL is the main morphological variable related to myopia. Meanwhile, refractive changes may be affected by corneal refractive power(K1, K2), ACD and corneal diameter(W-W). 7-8 years old can be regarded as the main phase from emmetropization to myopization of school-age children.

AIM: To investigate the treatment of transparent crystal in infectious endophthalmitis when vitrectomy, and to compare clinical efficacy of retention and removal transparent crystal.METHODS: Thirty-four patients(34 eyes)were randomly divided into two groups. Retaining transparent crystal group(15 cases):vitrectomy but retained the transparent crystal; Extracting transparent crystal group(19 cases): vitrectomy and removed transparent crystal. The follow-up period was for 6-12 months and clinical efficacy(corrected visual acuity and the eye)of different treatment methods of transparent crystal was analyzed. RESULTS: Retaining transparent crystal group, 14 eyes visual acuity were improved to 93%; Extracting transparent crystal group, 18 eyes visual acuity were improved to 95%. Retaining transparent crystal group, 1 eye endophthalmitis failed to control to 7%; Extracting transparent crystal group, 1 eye endophthalmitis failed to control to 5%. There's no significant difference between the two groups(P>0.05). During the follow-up period, both groups had no recurrence of endophthalmitis.CONCLUSION: There's no significant difference of clinical efficacy in infectious endophthalmitis vitrectomy between retention and removal of transparent crystal.

AIM: To research the vision changes after phacoemulsification for herpes simplex keratitis(HSK)with cataract, and the clinical effect of antiviral drugs in preventing HSK relapse as well.METHODS:Twenty-two cases(22 eyes)with HSK combined cataract were treated by phacoemulsification and intraocular lens implantation, and then randomly divided into two groups. The patients in treatment group received aciclovir tablets and ganciclovir ophthalmic gel, those in control group received ganciclovir ophthalmic gel only. The vision changes after phacoemulsification were observed and the HSK relapse was analyzed.RESULTS: After follow-up of 6 months, the visions of patients in both groups were improved. No relapse of HSK was found in the treatment group, and only one relapse of HSK was found in the control group after 6 months. There were no significant differences in therapy effects. CONCLUSION: Under the protection of antiviral drug, cataract surgery can be applied to patients with HSK recurrence-free more than 6 months, and improve the visions effectively. Ganciclovir ophthalmic gel can effectively prevent the relapse of HSK after cataract surgery.

AIM: To evaluate the clinical effect of modified trabeculectomy for primary angle-close glaucoma.METHODS: The modified trabeculectomy was performed on 114 cases(114 eyes)with primary angle-closure glaucoma. Lamellar sclera incision extended 1mm into clear corneal. Sodium hyaluronate was injected under sleral flap to deepen anterior chamber. Intraocular pressure(IOP), anterior chamber depth, filtering blebs, vision and complications were observed. The follow-up period ranged from 1 to 6 months. RESULTS:Shallow anterior chamber was not occurred postoperatively. IOP was controlled in an ideal range. Functional blebs could form. Postoperative and preoperative visual acuity was significantly different.CONCLUSION: IOP can be controlled effectively and postoperative complications were decreased after performed modified trabeculectomy. Modified trabeculectomy is easy, safe and effective, and has a high successful rate. It's a satisfactory surgery for primary angle-close glaucoma.