AIM: To observe the effect of traditional Chinese medicine(TCM)of bushenhuoxue on primary visual cortex(PVC)brain-derived neurotrophic factor(BDNF)in rat model of chronic elevated intraocular pressure(EIOP), and explore the mechanism of it initially. METHODS: The rat model of chronic EIOP was established by unilaterally cauterizing 3 episcleral veins, then 30 rats were divided into 3 groups randomly: control group, model group, and treatment group. After given drugs or normal saline for 8 weeks, the rats were put to death. The effect of intraocular pressure(IOP), expression of BDNF and ultrastructure of neuron cell in the PVC was observed. RESULTS: Unilaterally cauterizing episcleral veins increased IOP of the rat model obviously, there was significant difference compared with pre-operation(P0.01). Semi-quantitative pathological analysis on PVC showed that BDNF of total area in the model group was(82438±2597.39)S/µm2,mean optical density was(1155.9±123.14), integrated optical density was(12915±673.28), compared with the control group {total area was(132370±7588.47)S/µm2, mean optical density was(5365±379.65), integrated optical density was(35102±2648.5)}, there were statistical differences(all P0.05),there was statistical difference in BDNF of total area between model group and treatment group{(108980±9126.77)S/µm2, P0.05}, significant difference in mean optical density between the model group and treatment group(3220.4±413.67, P0.05), statistical difference in integrated optical density between the model group and treatment group(23821±3431.68, P0.05). CONCLUSION: TCM of bushenhuoxue can repair the PVC damage in the rat model of chronic EIOP by enhancing expression of BDNF, improving ultrastructure of neuron cell.

AIM:To explore cataract surgery complication of the anterior chamber injection 0.1mL dexamethasone for uveitis complicated cataract patients. METHODS: The experimental group was injected 0.1mL dexamethasone to anterior chamber at the end of phacoemulsification(Phaco)+intraocular lens(IOL)implantation, while the control group did not. And the different postoperative inflammation between them was observed. RESULTS: The differences of visual acuity between the two groups on the first two days after operation were statistically significant(P0.05). The postoperative corneal edema and anterior chamber flare between the two groups in the first day were different(P0.05). And the percentage of the experimental group postoperative visual acuity improved was higher than that of the control group. CONCLUSION: It can reduce short-term postoperative inflammation, improve visual acuity earlier and do not impact the short-term postoperative intraocular pressure that uveitis complicated cataract was injected 0.1mL dexamethasone to anterior chamber at the end of Phaco+IOL.

AIM: To know the change of the retina and optic nerve for proliferative diabetic retinopathy(PDR)patients after silicone oil influxing, who have been performed with silicone oil influxing following vitrectomy, recover the functions of their retina and optic nerve, and to gain an insight into the safety of such operation. METHODS: Totally 30 patients, who were confirmed as PDR and performed with vitrectomy operation and silicone oil influxing during June 2010 to December 2011, were chosen as treat group; and 30 cases, who were performed with vitrectomy and C3F8 influxing due to suffering from PDR, were chosen as control group. The patients in the two groups were observed for their intraocular pressure(IOP), best-corrected visual acuity(BCVA), after surgery colored fundus photography, perimetry, etc. to examine and evaluate the retinal functions. RESULTS: Among the 30 cases in observation group, 15 eyes were found pale optic nerve, 9 eyes were found with faint colored optic nerve, and 15 eyes were found with local blood vessel occlusion in the retina. Among the 30 cases in the control group, the gas was entirely absorbed after three months postoperation, 3 eyes were found with faint colored optic nerve, and no one was found with paint optic nerve and local blood vessel occlusion in the retina. Visual acuity: By comparing the visual acuity of the patients preoperation and postoperation in the latest follow-up visit, the visual acuity of the patient postoperation in the silicone oil influxing group is improved by 23 eyes than that preoperation, reduced by 8 eyes than that preoperation, while the visual acuity of 10 eyes keeps unchanged. postoperation in the C3F8 group, the visual acuity is improved by 33 eyes, reduced by 3 eyes(8.33%, P0.05), which is of statistical significance. Using Goldmann tenometer to compare the average of the cases seven days postoperation and in the follow-up visit, the pressure in the silicone oil influxing group was 15.07±0.85mmHg, and that in the C3F8 group was 17.84±1.86 mmHg. The change postoperation was of significance difference(P0.05). The pressure in one week's following visit was of no statistical significance. Visual field: among the 60 cases who were performed with vitrectomy due to suffering from PDR, the visual field examination of 26 cases three months after the operation was made. It was found that, their visual field was tubular change. CONCLUSION:Diabetic patients with silicone oil filling 3 months after surgery to remove the silicone oil found in some patients, color fades or pale optic local vascular occlusion of the retina, the white sheath, proliferating like change, As a result, the visual acuity and visual field of the patients showed impairment to different extent. Therefore, after they are operated with vitrectomy due to suffering from PDR, the silicone oil should be released as early as possible, depending on retinal restore so as to avoid impairment of optic nerve and retina.

AIM: To analyze the clinical effect of perioperative intervention in proliferative diabetic retinopathy(PDR)patients. METHODS: Totally 52 cases of eye diabetic retinopathy with medical records and follow-up materials were retrospectively analyzed from May 2009 to December 2011, male 15 cases, female 25 cases, age 31 - 78 years old, all patients underwent preoperative visual acuity, intraocular pressure, slit lamp microscope, slit lamp microscope eye fundus examination, B ultrasonic, corneal endothelial mirror etc. After 1 week, 2 weeks, 1 month, 2, 3, 6 months follow-up, the patients were observed the vision, intraocular pressure, artificial crystal, fundus, perioperative observation of patients with blood glucose, blood pressure, systemic, adverse events, and so on. Implementation of all patients perioperative interventions. According to the patients with diabetes related systemic complications diagnosis rating, each complication was recorded as 1 point, no complication 0. Operation method for vitrectomy + full retinal photocoagulation, merger macular edema and macular front wall line macular inside boundary film stripping, who do the same period with cataract phacoemulsification, stage I or implant implantation of artificial crystal, according to the intraoperative situation intraocular filling long-term gas/oil/song amine Ned; During the operation, the conventional for ecg monitoring, appear obvious blood pressure fluctuation in anesthesia physician care descending controlled decompression. RESULTS: Forty cases of 52 eyes of diabetic retinopathy in patients with type I 5 cases, eyes surgery of 12 patients(30%), each eye around 14 cases(35%), PDR stage IV 15 eyes(28.8%), V stage 16 eyes(30.7%), VI period 21 eyes(40.3%). Preoperative sight is lower than 0.02 and eyes(73.1%), 0.02 - 0.1 7(13.5%)eye, 0.1 - 0.3 5 eyes(9.6%), more than 0.3 2 eyes(3.8%). In the follow-up of sight is lower than 0.02 17 eyes(32.7%), 0.02 - 0.1 9 eyes(32.7%), 0.1 - 0.3 14 eyes(32.7%), 0.3 above 12 eyes(23.1%). One surgery cured 47 eyes(90.4%), reoperation five eyes(9.6%), early postoperative mild vitreous hemorrhage again five eyes(9.6%), late again vitreous hemorrhage along with neovascular glaucoma 1 eyes(1.9%), infectious endophthalmitis 1 eye(1.9%). The material in our hospital medicine diagnosed with complications of patients for 17 cases(42.5%), no complications of 23 cases(57.5%), the score of 0 points 23 cases, 1 points, nine cases(22.5%), 2 points, four(10%), 3 points in 3 patients(7.5%), 4 points 1 cases(2.5%). During the operation, the implementation of controlled decompression five eyes(9.6%). All patients perioperative blood glucose, blood pressure and body were stable, no adverse events. CONCLUSION: The perioperative intervention can significantly reduce the diabetes patients with systemic complications and adverse events, but the cost of patient care increased; Stable blood sugar, blood pressure and appropriate drug therapy can reduce the incidence of early vitreous hemorrhage again. Vitreous surgery or joint operation treatment is an effective means of PDR, surgical indications and timely grasp the surgical treatment of the patients with visual function is the key to save the residual of visual function.

AIM: To investigate the success rate and relevant factors for probing and irrigation in children with congenital nasolacrimal duct obstruction(CNDO). METHODS: A total of 261 eyes from 235 children were treated surgically with probing due to CNDO between 2005 and 2011. Patients were classified into three groups with respect to age. Group 1(12-24 months), group 2(24-48 months)and group 3(48-120 months)consisted of 131, 82 and 48 eyes respectively. Probing was performed for upper and lower punctum under general anesthesia. Postoperative control visits were performed on 1st day, 1st and 2nd weeks, 1st and 3rd months. Success rate and correlation with age were analyzed using Mann Whitney U and Chi-square tests. RESULTS: The mean age for the 235 patients(122 females, 113 males)was 27.6±10.7(12-120)months. The rates of success after one probing in groups 1, 2 and 3 were 90.1%, 85.4% and 47.6% respectively and the procedure was significantly more successful in groups 1 and 2(P0.05). Probing was repeated in 53(20.3%)patients and rates of success in groups 1, 2 and 3 were 61.5%, 58.3% and 25.0% respectively. CONCLUSION: Probing is an effective treatment for CNDO especially in children 2 years of age. Rate of success decreases with advancing age, but second probing and application both through upper and lower canaliculi are measures that may improve the outcome.

AIM: To explore the correlated factors which may affect the therapeutic effect of amblyopic children. METHODS:The therapeutic effect of 120 amblyopic children was retrospectively analyzed, then the relation between multivariate factors and the therapeutic effect with the logistic regression model was analysed. RESULTS: The average curative time of the 120 amblyopic children were 22.15±6.20 months, 81 cases was basically cured, and 20 cases improved, after single element analysis there were 5 factors affecting the curative effect, multivariate logistic regression analysis showed that the independent risk factors were the older age of the child, parents lack of the knowledge of the amblyopia, the poor guidance of the teacher and the deficiency of the indoor illumination, OR=3.601, 3.366, 2.690, 2.563. CONCLUSION: The independent risk factors which affect the curative effect are older age, parents lack of the knowledge of the amblyopia, the poor guidance of the teacher and the deficiency of the indoor illumination. For this we should take actions to enhance the level of the therapeutic effect.

AIM:To study normal value of corneal thickness in healthy subjects in different age groups with Fourier-domain optical coherence tomography(FD-OCT). METHODS:Total 420 eyes of 210 healthy volunteers were analyzed. These were divided into three groups: young group(YG, n=70, 140 eyes, 18 to 40 years old), medium group(MG, n=70, 140 eyes, 41 to 60 years old), old group(OG, n=70, 140 eyes, more 61 years old). Corneal thickness in central zone and inner-ring and outer-ring zones were measured by using FD-OCT. RESULTS:The thinnest zone was 527.19±1.72µm in central cornea zone, and the thickest zone was 582.42±2.50µm in superior in outer zone. Differences of corneal thickness were not significant in different measured zones(P>0.05). Average values of corneal thickness made by FD-OCT was better consistent and highly correlated for three groups(right eye: YG-MG: r=0.949, MG-OG: r=0.924,YG-OG: r=0.981. left eye: YG-MG: r=0.996, MG-OG: r=0.901, YG-OG: r=0.876). CONCLUSION: Measurement of cornea thickness by FD-OCT is more reproducible, reliable and convenient, and may better represent actual cornea thickness.

AIM: To investigate diabetic choroidal hemodynamics in order to provide valuable theories for preventing and treating diabetic retinopathy(DR)and make compensation for the ocular disease of diabetes mellitus(DM). METHODS: Color Doppler flow imaging(CDFI)was used to quantitate peak systolic velocity(PSV), end diastolic velocity(EDV)and resistence index(RI)of the ophthalmic artery(OA), the temporal posterior ciliary artery(PCA1), and nasal posterior ciliary artery(PCA2), in the control group(15 patients)and 45 DM patients. Statistic software was used to analysis the hemodynamic parameters. RESULTS: elative to the control, the EDV, PSV and RI have changed in non-diabetic retinopathy(NDR), non- proliferative diabetic retinopathy(NPDR)and proliferative diabetic retinopathy(PDR), and the differences are more evident according to the severity of DR. CONCLUSION: We conserved the choroidal circulatory properties of DM. CDFI is very valuable to evaluate the hemodynamic changes in diabetic eyes, and has important significance in the early impression of diabetic choroidopathy.

AIM: To study the changes of corneal curvature after the operation of pterygium excision with transplantation and pterygium excision with limbal stem cell transplantation. METHODS:Patients with pterygium were selected. They were divided into 2 groups in random: simple pterygium excision was performed in group A; pterygium excision with limbal stem cell transplantation was performed in group B. The results of visual acuity, astigmatism, corneal curvature and central anterior chamber depth were tested between pre-surgery, post-surgery 15 day and post-surgery 1 month. RESULTS:Visual acuity seemed to be mostly unaffected up to a height of 2.5mm. Naked visual acuity of post-surgery was better than that of pre-surgery. Corneal horizontal curvature on post-surgery was statistically and significantly improved. Corneal vertical curvature: group A, the corneal vertical curvature of post-surgery was higher than that of pre-surgery(P0.05); 15 days postoperatively, the vertical curvature of group B had no statistical difference with that of pre-surgery(P And gt;0.05), and 1 month postoperatively, the vertical curvature was higher than that of pre-surgery and post-surgery 15 days(P0.05). Corneal mean curvature on post-surgery was statistically and significantly better than that of pre-surgery. CONCLUSION: The patient's naked eye visual acuity is improved after pterygium surgery; the horizontal diameter line curvature of the cornea is ascended, but the vertical diameter line curvature of the cornea did not change significantly.

AIM: To evaluate effect of polyethylene glycol eye drops combined with basic fiberoblast growth factor(bFGF)eye drops on dry eye. METHODS: Fifty-one patients(102 eyes)with dry eye were divided into treating group and control group randomly. Both eyes of one were compared by each other. The eyes of treating group were treated by polyethylene glycol eye drops combined with bFGF eye drops 4 times each day for 1 month. The 2 drops were dropped 5 to 10 minutes apart each time. The eyes of control group were treated by polyethylene glycol eye drops 4 times each day for 1month. Schirmer ? test, break-up time(BUT), corneal fluorescein staining and improvement of symptoms were observed before treatment and after treatment in the two groups. RESULTS: There was significant difference intear film break-up time(BUT), corneal fluorescein staining and symptoms between before and after the treatment of both groups(P0.05). There was also significant difference in BUT, corneal fluorescein staining and symptoms between the two groups after the treatment(P0.05). There was no significant difference in Schirmer ? test between all time-point of the two groups(P>0.05). CONCLUSION: Polyethylene glycol eye drops combined with bFGF has obviously effect on dry eye.

AIM: To investigate if insulin can promote retinal pigment epithelial(RPE)cell proliferation and the secretion of transforming growth factor ß2(TGF-ß2). METHODS: Human RPE cells were exposed to different concentrations insulin at different times(0 to 48 hours). We used the MTS method to test the proliferation of RPE cells. And we used the ELISA method to text the secretion of TGF-ß2 of RPE cells in various cases, and the Real-time PCR method to test the expressions of TGF-ß2 mRNA. RESULTS: The MTS results showed that after 12 hours exposure of insulin RPE cells proliferated significantly(P0.05). ELISA results showed that insulin can significantly promote the secretion of TGF-ß2 of RPE cells, and this process was independent of time and dose. And Real-time PCR results showed that 24 hours after the stimulation of insulin, TGF-ß2 mRNA increased significantly(P0.01), and 10×103U/mL insulin group, TGF-ß2 mRNA expression were significantly higher than the 0.1× 103U/mL insulin group(P0.01). CONCLUSION: RPE cells are important intraocular sources of TGF-ß2, and insulin can promote the proliferation of RPE cells and the secretion of TGF-ß2 to promote myopia.

Choroidal hemangioma(CH)is a benign vascular tumor that occurred in the fundus posterior pole. Although it is a benign tumor, exudation from the lesion can lead to retinal detachment and other complications that make visual loss for patients. CH can occur as a circumscribed choroidal hemangioma(CCH), generally without systemic associations, or as a diffuse choroidal hemangioma(DCH)that is often associated variations of Sturge-weber syndrome(SWS). The management of CH has included laser photocoagulation, radiation therapy, transpupillary thermotherapy(TTT), photodynamic therapy(PDT). This article aims to introduce the current situation and the latest progress of the various therapies, to explore the most safe and effective method for the treatment of CH.

AIM: To assess and compare the results of 2.2mm microincision coaxial cataract surgery(MCCS)phacoemulsification with the conventional 3.0mm MCCS in hard nuclear cataracts. METHODS: Totally 132 eyes with hard cataract(? level and above)were randomized to two groups: 2.2mm MCCS(group 1:60 eyes)and 3.0mm MCCS(group 2:72 eyes). All patients underwent standard phacoemulsification and intraocular lens implantation surgery by one experienced surgeon. The average ultrasound power(AVE)was recorded during the operation. The incidences of capsule rupture and postoperative corneal edema were compared.Visual acuity, surgically induced astigmatism(SIA)and the descent rate of endothelial cell density were compared at intervals of 1 day, 1 month and 3 months after surgery. Statistic analysis was taken by Student's t test and Chi square test. RESULTS: There was no significant difference on the incidences of capsule rupture, postoperative corneal edema and AVE(P> 0.05)between the two groups(3.3%, 10.0%, 65.09±20.15)and(4.2%, 11.1%, 69.13±15.44). One day after the surgery, the 2.2mm MCCS group showed better uncorrected visual acuity as compared to the 3.0mm MCCS group(P 0.05). There were no significant differences on best-corrected visual acuity on 1 month and 3 months after the surgery. There was no significant difference on the descent rate of endothelial cell density(16.54%±10.20%, 17.69%±10.65%)3 months after the surgery. One day, 1 month and 3 months after the surgery, SIA was 0.77±0.31,0.66±0.29, 0.52±0.25D in the 2.2mm MCCS group, and 1.41±0.73,0.98±0.61D,0.82±0.35D in the 3.0mm MCCS group, respectively. The differences were statistically significant. CONCLUSION: The operative safety of the 2.2mm MCCS group were the same as 3.0mm MCCS group with the hard nuclear cataracts. The 2.2mm MCCS phacoemulsification could significantly reduce SIA and get better earlier visual rehabilitation.

AIM: To investigate the effect of micropulse diode laser photocoagulation on central serous choroidretinopathy(CSC). METHODS: Twelve patients diagnosed with CSC by fluorescein angiography(FFA)and optic coherence tomography(OCT)examination were treated with micropulse diode laser photocoagulation. The data of visual acuity testing, ophthalmic examination, color photographs, FFA and OCT before photocoagulation and 1 week, 2 weeks, 1 month, 3 months after it were used to evaluate the effects of micropulse diode laser photocoagulation. RESULTS: All patients' self-conscious symptom and visual acuity improved differently. Nine and eleven eyes leakage point disappeared after micropulse diode laser photocoagulation in 2 weeks and one month in FFA. Nine and eleven eyes of subretinal effusion in OCT were absorbed after laser photocoagulation in 2 weeks and one month. All cases' leakage point and subretinal effusion disappeared after 3 months. The window defect in FFA did not occur in all laser treated eyes. CONCLUSION: The micropulse diode laser photocoagulation could shorten the course of CSC, improve the patient's visual acuity and reduce the complications.

In recent years, the small-incision cataract extirpation andintraocular lens implantation has become more and more mature, which has satisfactorily improved the cataract patients' postoperative vision, but because of the artificial lens is lack of accommodation, patients still need to wear glasses for postoperative near or far visual. Multifocal intraocular lens has provided a full-distance visual for cataract patients, but the visual quality problems appear. With the elevation of demands for life, the research and development of accommodating intraocular lens also goes deeper. This paper will review the research progress of accommodating intraocular lens in clinical application.

Non-arteritic anterior ischemic optic neuropathy(NAION)is clinical common presentation of acute ischemic and anoxic damage to the optic nerve. The condition is caused by the blood circulation disorder of the optic nerve head supplied by the short posterior ciliary arteries. NAION is the most common ischemic optic neuropathy(ION). Now the related risk pathogenic factors of NAION in the population of plateau regions are reviewed simply.

Dislocation of intraocular lens(IOL)is one complication of cataract extraction and posterior chamber IOL implantation. The reasons for IOL dislocation include incompletion of lens capsule cut, unevenness of capsulorhexis, break of zonules and/or posterior capsule, remain of lens cortex, capsule contraction, drag of exudate and organize strap, after cataract, trauma, etc. And the treatments for IOL dislocation include simple IOL reposition, capsular tension ring(CTR)implantation, anterior chamber IOL implantation, suspensory IOL implantation, IOL dislodgment, vitrectomy, etc.

AIM: To study the influence of phacoemulsification on five sites of corneal endothelium of senile cataract in patients after anti-glaucoma surgery. METHODS: Patients with cataract after anti-glaucoma surgery were selected, and the surgery of phacoemulsification was performed by a same skilled surgeon, The superior, inferior, central, nasal, temporal endothelium cells were observed with a non-contact endothelium scope on pre-operation and seventh day, first month, third month and sixth month of post-operation. RESULTS: After operation, there were obvious differences of corneal endothelium of every sites between two groups(P0.01). CONCLUSION: Endothelium cells of senile cataract in patients after anti-glaucoma surgery are easier to be damaged in the phacoemulsification, so preoperative evaluation, surgery manner and postoperative treatment are very important.

AIM: To study the cause of high-risk neonatal retinal hemorrhage risk and analyze its related factors. METHODS: After the first 72 hours of the birth, the newborns in the pediatrics were examined for fundus used the wide area digital fundus imaging system(RetCam ?). RESULTS: Among 123 newborns, 19 neonates had retinal hemorrhage, and the incidence of retinal hemorrhage in newborns was 12.2%. Among 49 newborns who were came through spontaneous delivery, 18(29.6%)neonates had retinal hemorrhage, while 1(0.7%)neonate from 74 who were born by caesarean section suffered from retinal hemorrhage. The difference was statistically significant.(?2=34.763 P=0.000). Logistic regression equation analysis tip: The risk factors of retinal hemorrhage were eutocia, premature delivery and intracranial hemorrhage. CONCLUSION: The important relevant factors of high-risk neonatal retinal hemorrhage are eutocia and associated with intracranial hemorrhage.

AIM:To investigate the efficacy of intravitreal lucentis combined laser photocoagulation treatment on macular edema. METHODS: Ninety –eight patients(136 eyes)with macular edema diagnosed by ocular-fundus examination, fundus fluorescein angiography(FFA). Sixty-eight eyes of them were treated with intravitreal lucentis combined laser photocoagulation and sixty-eight eyes only laser photocoagulation. The follow-up time was 1 month, 3, 6 months. Visual acuity and FFA were measured. RESULTS: Among patients with intravitreal lucentis combined laser photocoagulation, visual acuity in 51 eyes(75.0%)was improved in 2 lines or more and 10 eyes(14.7%)remained no change, 7 eyes(10.3%)deceresed. Edema in 59 eyes(86.8%)reduced after treament. Among patients with laser photocoagulation, visual acuity in 12 eyes(17.6%)was improved in 2 lines or more and 42 eyes(61.8%)remained no change, 14 eyes(20.6%)deceresed. Edema in 21 eyes(30.9%)reduced after treatment. CONCLUSION: The result of intravitreal lucentis acetonide combined laser photocoagulation treatment for macular edemae is better than those of only using laser photocoagulation.

AIM: To investigate the surgical approaches of immediate eyelid reconstruction after the operation of malignant tumors of eyelids, and evaluate the clinical effect. METHODS: From January 2010 to October 2011, 11 cases of malignant tumor of eyelid underwent the eyelid reconstruction with local or free flap grafting and hard palate mucosa autotransplantation. Of 11 cases, there were 3 males and 8 females, aging from 38 to 77 years. The defect was caused by basal cell carcinoma of eyelid in 6 cases, by carcinoma of meibomian glands in 4 cases and by squamous cell carcinoma of eyelid in 1 case, including 4 cases of complete eyelid defect and 7 cases of 1/2-2/3 eyelid defect. RESULTS: The appearance and function of the eyelid in all cases were satisfactory. No tumor recurrence was observed in all cases during the follow up period of 6 to 24 months. CONCLUSION: The eyelid reconstruction with local or free flap grafting and hard palate mucosa autotransplantation is an easy and effective method after resection of malignant eyelid tumors.

AIM: To investigate the ultrastructure of the basal vitreo- retina interface in enucleated pig eyes after vitreous injection of enzymes. METHODS:Totally 130 eyes were obtained from freshly slaughter pigs and divided into 5 groups. Each group was sub-divided into the 15 minutes group and the 30 minutes group, with 13 eyes in each group. The control group were performed middle vitreous injection of 0.1mL PBS, 200U/mL and 800U/mL hyaluronidase(HA)were injected in groups A and B, 10U/mL and 50U/mL chondroitinase(CA)in groups C and D. After incubation for 15 minutes and 30 minutes, the eye balls were fixed with 4% glutaraldehyde and retina fixative solution. Pathological examination, eosin-hematoxylin staining, scan electron microscopy were taken to evaluate the remaining vitreous on vitreous base, transmission electron microscopy to evaluate retina toxicity. RESULTS:Both of gross appearance and hematoxylin+eosine slice all revealed basal vitreous partially liquefied and degradation. Remarkably decrease was found in basal vitreous than the control group both in the HA 800U/mL group and the CA 50U/mL group when using electron microscopy scanning. Transmission electron microscopy in group B, C and D revealed the remaining vitreous were less than the control group. CONCLUSION: Both CA and HA can cause basal vitreoretinal detachment in enucleated pig eyes. But the HA may cause less damage to the retina.

AIM: To evaluate the clinical values of oral ganciclovir on the treatment of corneal endotheliitis. METHODS:The data of 14 eyes of 14 patients with corneal endotheliitis diagnosed in China Medical University Eye Center from October 2011 to October 2012 were retrospectively analyzed. Oral ganciclovir was orally administered 1.0g 3 times per day for 2-4 weeks, and then by 0.5g 3 times per day for 4 weeks; 1.5g/L ganciclovir ophthalmic gel and 10g/L prednisolone acetate eye drops were adopted in eyes. The symptoms and signs, together with effective rate and cure rate were evaluated before and after the therapy 1 st week, 2nd week,4th week and 8th week respectively. The recurrence was followed up. The score before and after the treatment by Rank-sum test was compared. RESULTS: One week after therapy of oral ganciclovir, the symptoms and signs bettered, the score changed from 19.14±4.57 to 11.43±3.86, then 6.93±2.59 for 2nd week, and 0.29±0.87 for 4th week. Till 8th week, the symptoms and signs of all the patients disappeared completely. The effective rate was 71%, 100%, 100%, 100% after the therapy 1st week, 2nd week, 4th week and 8th week respectively. Compared with the vision of before, 10 cases fully recovered, 3 cases declined mildly, and 1 case significantly reduced. None of the cases recurred during the follow-up time. CONCLUSION: Treating corneal endotheliitis by oral ganciclovir combined with eye drops is effective. Oral ganciclovir could prevent recurrence.

AIM: To discuss the advantages and disadvantages of combined surgery, which consists of posterior segment diseases and anterior segment diseases(cataract, glaucoma, keratonosus), and analyze the hazards that may affect surgery. METHODS: Group A: proliferative diabetic retinopathy(PDR), group B: complicated retinal detachment(RD). For comparison, group A was divided to group A1: vitrectomy; group A2: vitrectomy + cataract extraction; group A3: vitrectomy + cataract extraction + intraocular lens implantation. Group B was divided to group B1: vitrectomy; group B2: vitrectomy + cataract extraction; group B3: vitrectomy + cataract extraction+ intraocular lens implantation. RESULTS: Surgery complications were the main outcome measures: neovascularity secondary glaucoma in group A and surgery recurrence or proliferative vitroretinopathy in group B. The incidence of complication: group A3>A2>A1, A3 was significantly higher than A2 and A1, and it was statistically significant, A2>A1, but it was not statistically significant. The results of group B were the same as group A. CONCLUSION: Combined surgery will not be chosen if it is possible, and intraocular lens should not be implanted at once if the operation was influenced.

AIM:To observe the expression of syndecan-1 on epiretinal membranes obtained from patients with proliferative diabetic retinopathy and retina of diabetic rats. METHODS:SD rats were given intraperitoneal injection of streptozotocin to induce diabetes. Ink perfusion and stretched retina were used to observe the retinal blood vessels. Immunohistochemistry staining was used to detect syndecan-1 protein in the rat retina and epiretinal membranes of proliferative diabetic retinopathy. RESULTS:In the diabetic rats of 9-week, peripheral retinal blood vessels shaped tortuously, capillary network was significantly reduced, and parts of the capillary perfusion was bad. In the control group, strong positive staining of syndecan-1 was detected in the nerve fiber layer and ganglion cells

AIM: To study the effect of vitamin A palmitate eye gel on ocular surface reconstruction after laser in situ keratomileusis(LASIK), and to evaluate the efficacy and safety. METHODS: One hundred and twenty patients(240 eyes)performing LASIK were enrolled in this study. The right and left eyes were randomly divided into experimental group and control group. The experimental group were treated with vitamin A palmitate eye gel for 1 month, four times a day after LASIK, and the same as control group in other treatments. The Schirmer? test, break-up time(BUT)and corneal sensation were detect at preoperation and the postoperative 1st day, 1st month, 3rd month in two groups. RESULTS: There were significant difference in BUT and tear secretion quantity between the experimental group and the control group at the postoperative 1st month and 3rd month(P0.05), which provided evidence that the postoperative BUT and tear secretion quantity of experimental group recover faster than that of the control group. Comparing with control group, the experimental group had no significant difference in corneal sensation at the postoperative 1st day,1st month and 3rd month(P>0.05), which revealed that vitamin A palmitate eye gel had no obvious effect on recovery of corneal sensation after LASIK. During the treatment, there was no adverse drug event occurred. CONCLUSION: Early use of vitamin A palmitate eye gel postoperatively is applicable for ocular surface reconstruction, but has no obvious effect on the regeneration of corneal sensation.

Review of the literature published in studying the relevant tear physiological function, tear discharge and blink, and as we combined with our clinical practice experiences in the lacrimal apparatus disease, we clearly put forward the theory that blink is the power of the basal tear secretion and discharger. The relationship between physiological function of the discharge basal tear and blink was studied; we also put forward the theory that there has no independent neural reflex arc, which has shared with the blink basal tear secretion. In this paper, we put forward the hypothesis that the blink is the power of the front tear film refreshment, formation and discharged. We make clear the concept of blink, classification, and basic neural reflex arc.

AIM: To have a detailed picture of school-age children's eyesight status, and the main factors that caused their low vision in Zhouqu County of Gannan Tibetan autonomous prefecture of Gansu province. METHODS: The census work of knowing school-age children's eyesight status was implemented through visual inspection, conventional ophthalmic examination, optometry checks, etc. The results were compared with other domestic epidemiological data. RESULTS: Altogether 536 people with low vision were identified through survey and the rate was 21.12%. Among those people, the number of myopia patients accounted for 80.59% and the prevalence rate was 17.02%. Besides, the prevalence rate of presbyopia was 2.05%, amblyopia 2.76%, strabismus 1.02%, ocular trauma 0.95%, and congenital eye disease 0.71%. CONCLUSION: The prevalence rate of low vision was related with several factors such as gender and nationality. The rate increases with age and the myopia is the primary element that causes low vision.

AIM:To explore safety and effectiveness of stratified emulsion splitting technology in highly hard nuclear cataract ultrasonic emulsification. METHODS: Totally 43 cases(47 eyes)of highly hard nuclear cataract was performed cataract extraction combined IOL implantation with stratified emulsion splitting cataract ultrasonic emulsification technology. RESULTS:Postoperative visual acuity 1 day, 1 week and 1 month best-corrected visual acuity =0.5 was accounted for 70.21%, 87.23% and 89.36%. Intraoperative capsule rupture was found in 2 eyes. Corneal mild edema was found in 7 eyes(14.89%)after the first l day post-operation. CONCLUSION:Stratified emulsion splitting technique has a practical application with little tissue damage, low capsular rupture rate and few complications for highly hard nuclear cataract patients and can bring a desirable outcome.

AIM: To observe the clinical effect of 2.5 mm-long hooker using improved pre-chop phacoemulsification method with ozil technique and to discuss the clinic characteristics of this improved surgery method. METHODS: Retrospectively analyzed 247 patients(320 eyes)with ozil phacoemulsification and intraocular lens implantation surgery. The 247 patients were randomly divided into two groups. The two groups were given different chop method during the surgery: improved pre-chop and traditional stop and chop. The improved pre-chop group were canceled water separation steps, the ultra-long chopper were entered into the capsular bag under the rim of continuous circular capsulorhexis, by passed the intraocular lens equator then reversed the hooker upward against the posterior pole of lens and cracked the nuclear into half with the phacoemulsification hand pieces extruding the nuclear from above downward without using energy, then rotated the nuclear and repeated the chop step. The control group used the traditional stop and chop technique. Pre-surgery recording included the best-corrected visual acuity(BCVA)and corneal endothelial cell counting. Average power(AP), real ultrasound phacoemulsification time(U/Time), accumulated energy complex parameter(AECP), BSS perfusion amount and complications were recorded. And the corneal edema and corneal endothelial cell counting were observed at one week post the surgery. RESULTS: Compared the sub-group of two groups with the same hardness of nuclear, the AP, U/Time, AECP and the BSS perfusion amount of the improved pre-phaco group were lower than the stop and chop group(P0.05)with significant difference. Also the lose rate of corneal endothelial cell of the improved pre-phaco group was lower than the stop and chop group(P0.05). CONCLUSION: Using the improved pre-phaco method in the ozil phacoemulsification cataract surgery could raise the energy utilization efficiency, decrease the BBS perfusion amount during the surgery and further lower the injury to the corneal endothelial cell brought by the phacoemulsification surgery.

AIM:To evaluate the quality of life and influence factors in glaucoma patients after trabeculectomy. METHODS:The quality of life of 123 cases of glaucoma after trabeculectomy patients were evaluated with a scale of life quality for diseases with visual impairment. RESULTS:he quality of life scores of glaucoma patients after trabeculectomy were low. The Visual status was the significant factor to the patient's quality of life; The analysis of multiple stepwise linear regression indicated the visual status(ß=-10.139, P=0.000), health education(ß=2.576, P=0.000), number of operations(ß=-3.598, P=0.002)and gender(ß=3.807, P=0.013)are the main influencing factors. CONCLUSION: The scores of quality of life of glaucoma patients after trabeculectomy were low. Therefore, doctors should not only pay attention to the clinical treatment of patients with glaucoma, but also take care of the quality of life according to the patient's occupation, economic status when protecting visual function. It is necessary to give some health education and psychological treatment to improve their quality of life.

AIM: To investigate the advantage of burst mode of phacoemulsification for rural hard nucleus cataract. METHODS: Totally 162 eyes(162 cases)were randomly divided into small incision cataract extraction(SICE)group and burst group. Actual phaco-emulsification(Phaco)power, Phaco time, visual acuity, corneal edema and other complications were recorded. RESULTS: Visual acuity was significant improved in both two groups postoperatively. But the difference between the two groups was statistically significant(P 0.05)and visual acuity recovery was faster in burst group than in SICE group. In comparison of the astigmatism between the burst group and SICE group, the difference was significant(P 0.05)in early stage. The actual Phaco power in burst group was(16.2±5.4)% and Phaco time was(42.8±6.1)s econds. Serious corneal edema occurred more frequently in SICE group(69 eyes)than that in the burst mode group(12 eyes), 6 eyes suffered posterior capsular rupture in SICE group. CONCLUSION: Burst Phaco mode reduced Phaco time and actual Phaco power consumed during phacoemulsification and reduced corneal edema and surgery complications in hard nucleus cataract surgery. It is an effective measure for hard nucleus cataract for better postoperative visual acuity and shorten recovery time.

AIM: To investigate the clinical efficacy of trabeculectomy combined with phacoemulsification and intraocular lens implantation for the treatment of primary chronic angle-closure glaucoma. METHODS: A retrospective analysis was performed on 65 patients(70 eyes)with chronic angle-closure glaucoma and varying degrees of lens opacity admitted to our hospital ophthalmology from February 2011 to February 2012. Patients underwent trabeculectomy combined phacoemulsification and intraocular lens implantation. And after that patients were followed-up for at least 6 months. Postoperative visual acuity, intraocular pressure(IOP), and bleb complications were compared and analyzed. RESULTS: According to the international standard eye chart check, after 3 months follow-up, visual acuity improved 1 line accounted for 80%(56/70); After 6 months follow-up, after vision correction the vision acuity that improved 1 line accounted for 93%(65/70); after 6 months of follow-up, IOP21mmHg, accounted for 89%(62/70); functional blebs accounted for 89%(62/70), fewer postoperative complications. CONCLUSION:Trabeculectomy combined with phacoemulsification and intraocular lens implantation in the treatment of primary chronic angle-closure glaucoma is a safe and effective surgery method and it has a good visual recovery, IOP decrease, and fewer complications.

AIM:To assess the neuroprotective effects of traditional Chinese medicine in the treatment of glaucoma. METHODS:The electronic bibliographic databases were searched,including Medline(1966-01/2011-03), EMbase(1996-2010), Cochrane library, Wanfang database,VIP(1999-2011), CNKI, the radomized controlled trials of TCM treatment compares with Western medicine treatment of the glaucoma were assembled Data were extracted and evaluated by two reciewers independently with a designed extraction formation by Meta-analysis based on the Cochrane net suggestion. RESULTS:A total of 8 theses written in Chinese were retrieved,including 719 patients.The results of Meta-analysis showed the combination therapy of TCM and western therapy significant improves the effect of neuroprotection(P0.01). In order to boost and qualify the curative effects of the aucupuncture, more precise samples should be designed and a multi-research central need to be bulit. however, according to the existing cases, the evidences of the effectiveness are weak due to the limited numbers of samples and the methodological defect. CONCLUSION: The existing evidence supports the combination therapy of TCM and western medicine stronger than the only used of western medicine(P0.01). But owing to the limited studies and few number of TCM treatment for glaucoma's neuroprotection, the large sample andmulticenter random ized controlled trial is still needed to verify the superiority of TCM for neuroproctive effect of glaucoma's teatment.

AIM: To analyze the causes and disposal of posterior capsule rupture of the lens in phacoemulsification for cataract. METHODS: A total of 326 cases(377 eyes)with cataract were selected and underwent phacoemulsification and intraocular lens implantation. The causes of 23 cases(23 eyes)who suffered posterior capsule rupture were analyzed. RESULTS: Posterior capsule rupture occurred in 23 eyes(6.1%)during the operation; 17 cases with visual acuity=0.3(73.9%). CONCLUSION: It is necessary to know the dangerous factors of posterior capsule rupture and avoid the incidence. If noticed early, the complications can be reduced and the visual acuity can be improved as well.

AIM: To dynamically observe the subtle structure changes in the acute central serous chorioretinopathy(ACSC)by optical coherence tomography(OCT).Compare the efficacy of laser, drug and the combined treatment. METHODS: Totally 96 cases(98 eyes)of ACSC were confirmed by FFA and OCT, the differences of subretinal fluid absorption and visual acuity by drug, laser and laser combined with drug therapy were compared. Follow-up time was 2 weeks, 4 weeks and 8 weeks. RESULTS: Between the groups were no statistically significant in the range of retinal detachment before treatment. After 2, 4 and 8 weeks treatment, the range of retinal detachment and cure rates were not statistically significant between the laser group and drug group. Compared to aforementioned two groups, a smaller range of retinal detachment and higher cure rate was found in combined treatment group, the differences were statistically significant. CONCLUSION: The combined treatment of drug and laser can shorten the course of ACSC, improve the cure rate; OCT is noninvasive, simple, intuitive, can sensitively track the healing process of ACSC

AIM:To evaluate the clinical effects of scleral buckling for the early retinal detachment eyes with silicone oil tamponaded. METHODS: This retrospective observation included 26 cases(26 eyes)who had the signs of early retinal detachment after the silicone oil tamponaded under 15 days. All the cases received scleral buckling and were observed with the change of retinal reattachment, visual acuity and intraocular pressure(IOP)for 6-18 months. RESULTS: All 26 cases(26 eyes)had the retinal detachment at the inferior side. The retina of 22 cases(22 eyes)was anatomical attached(92%)after the operation and 4 cases(4 eyes)accepted another time of silicone oil tamponaded. The visual acuity improved in 22 cases(22 eyes), 3 cases(3 eyes)had no change and 1 case(1 eye)decreased. The IOP increased at early period after the operation and became normal after 3 months. CONCLUSION: Scleral buckling is effective for the early retinal detachment eyes with silicone oil tamponaded.

AIM: To investigate the clinical effects of phacoemulsification combined with goniosynechialysis in the management of chronic primary angle-closure glaucoma(CPACG). METHODS:Totally 57 cases(57 eyes)with CPACG and cataract were treated with phacoemulsification combined with goniosynechialysis. Intraocular pressure(IOP), anterior chamber angle, best-corrected visual acuity and central anterior chamber depth were monitored during follow-up for 8-15 months in these eyes. RESULTS: The IOPs of 52 eyes were normal without any medications. The IOPs of 4 eyes were normal with a single antiglaucomatous eye drops. The IOP of 1 eye was normal with two kinds of antiglaucomatous eye drops. The anterior chamber angles became wider and the synechial angle closure were reopened after surgery in all eyes. The best-corrected visual acuity were improved except 1eye with optic atrophy. The postoperative central anterior chamber depth became deep. CONCLUSION: Phacoemulsification combined with goniosynechialysis is able to safely effectively control IOP and also improve the visual acuity of CPACG.

AIM: To investigate the visual quality after phacoemulsification combined with customized implantation of refractive multifocal intraocular lens(Rezoom NXG1 MIOL)and diffractive multifocal intraocular lens(ReSTOR SA60D3 MIOL). METHODS: A prospective, nonrandomized, unmasked clinical trial was performed. Patients with age-related cataract who were to undergo phacoemulsification were divided into two groups: multifocal intraocular lens(MIOL)vs monofocal intraocular lens(SIOL). 10 patients were included in each group. In the group of MIOL, patients got implantation of ReZoom NXGl MIOL in the dominant eye and ReSTOR SA60D3 MIOL in the fellow eye while patients in the group of SIOL got implantation of Sensar AR40e IOL bilaterally. One month postoperatively, distance, mid-range and near visual acuity, contrast sensitivity, focal depth were measured. Satisfaction of visual quality was investigated by questionnaire. RESULTS: One month postoperatively, the patients in the MIOL group were satisfied with distance visual acuity, meanwhile they achieved better mid-range and near visual acuity compared with patients in the SIOL group. Under mesopia condition, SIOL implantation gave better contrast sensitivity in spatial frequency at 3 cpd, and no difference was observed in other spatial frequency, while under photopia condition, no significant difference was observed among all the five types of spatial frequency. The focal depth of MIOL was 5.30D, which was significantly higher than 2.85D of the SIOL. Satisfaction of visual quality of near and mid-range was significantly higher in the MIOL group. CONCLUSION: Customized implantation of intraocular lens after phacoemulsification provides better visual acuity and visual quality postoperatively.

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AIM: To observe the choroidal thickness in the macular area in affected and unaffected fellow eyes with central serous chorio retinopathy(CSC)and in healthy controls. METHODS: Twenty-six cases with unilateral CSC and controls were recruited in this study. All eyes were divided into three groups: 26 eyes in Group A(affected eyes with CSC), 26 eyes in group B(unaffected fellow eyes)and 26 eyes in group C(right eyes of age and sex matched control). Enhanced depth imaging was obtained by using spectral-domain optical coherence tomography. Subfoveal choroidal thickness and choroidal thickness at 1mm/3mm nasal, temporal, superior and inferior to the fovea were measured. RESULTS: Choroidal thickness was significantly increased in affected eyes with CSC than unaffected fellow eyes(t=5.57, P0.01).The mean subfoveal choroidal thickness(SFCT)was 528.31±91.24µm in group A, 413.71±79.35µm in group B, and 301.31±52.46 in group C. The subfoveal choroid was significantly thicker in group A than Group C(P0.01). SFCT in unaffected fellow eyes were thicker than the controls(P0.01). CONCLUSION:Choroidal thickness is thicker in affected eyes with CSC and also in fellow unaffected eyes, indicating that the choroid blood vessels are high and perfusion state, may be one of the factors of the disease CSC.

AIM: To observe the efficacy of the argon laser photocoagulation treatment of central serous chorioretinopathy(CSC). METHODS: The treatment groups: 18 patients(18 eyes), argon laser photocoagulation and oral jolethin, vitamin B1, inosine and venoruton tablets. Control group: 18 patients(18 eyes), oral lecithin complex iodine, vitamin B1, inosine, venoruton tablets. Foveal thickness and neuroepithelial layer detachment range were measured by optical coherence tomography(OCT)before treatment, after 1 month and 3 months post-operation to compare the decline in value of foveal thickness and neuroepithelial layer detachment range of the two groups. RESULTS: After 1 month of treatment, the decline in value of the center foveal thickness: the value of treatment group was 256±72µm; the value of the control group was 82±57µm, and the difference of the two groups, P 0.05; the decline in value of neuroepithelial layer detachment range: the value of the treatment group was 3 548±168µm, the value of the control group was 1 520±143µm, And the difference of the two groups, P0.05. After three months of treatment, the decline in value of the center foveal thickness: the value of treatment group was 383±75µm, the value of the control group was 312±67 µm, and the difference of the two groups, P0.05; decline in value of neuroepithelial layer detachment range: the value of the treatment group was 4 908±172µm, the value of the control group was 4 211±153µm, and the difference of the two groups, P 0.05. The differences were statistically significant between the treatment and the control groups(two independent samples t-test). CONCLUSION:Argon laser photocoagulation treatment of CSC is an effective treatment method and can significantly shorten the course.

PAX6 gene plays an important role on the embryological development through regulating cell proliferation, migration, differentiation and adhesion. This is supported by the fact that expression of PAX6 is dysregulated in several congenital diseases, especially in eye, nose, nerve system, pancreatic gland and endocrinologic system. In this review a general background of the PAX6 gene was summarized, and we also give a brief introduction of roles on genes up and down stream from PAX6 gene and its genetic mutation within eye development.

AIM: To investigate the effect of anterior chamber puncture combined trabeculectomy in the treatment of high intraocular pressure continued state of acute angle-closure glaucoma. METHODS: Totally 80 cases with angle-closure glaucoma from March 2011 to June 2012 in our hospital were retrospectively analyzed, and 40 cases were given trabeculectomy after anterior chamber decompression(observation group)while 40 cases were received trabeculectomy after drugs decompression(control group). The clinical efficacy was compared between the two groups. RESULTS: The postoperative vision recovery, anterior chamber angle and pupil improvement were better than the control group, and the incidence of complications were less than the control group, the difference was statistically significant(P0.05). CONCLUSION: The efficacy of anterior chamber paracentesis combined with trabeculectomy in the treatment of high intraocular pressure continued state of acute angle-closure glaucoma is effective, and it is a simple surgery with fewer complications, which is worth to actively promote in clinic.

AIM:To elucidate the relation between tissue factor pathway inhibitor-2(TFPI-2)expression and the expression of matrix metalloproteinases(MMPs)in keratocytes. METHODS: Primary culture and subculture of rabbit keratocytes were established in vitro. Plasmid vector pBos-Cite-neo/TFPI-2 was transfected into keratocytes with Lipofectamine 2000. After being selected by G418, three groups of cells including TFPI-2 gene transfected cells K-TFPI-2, empty vector transfected cells K-V and non-transfected cells K-P were screened for TFPI-2 mRNA and protein by reverse transcription-polymerase chain reaction and Western blot analysis, respectively. The activity of MMPs in the three groups of cells was detected by substrate zymography and compared by ANOVA. RESULTS: Expression of mRNA and protein of TFPI-2 was more in the cells of K-TFPI-2 than in the other cells of K-P and K-V with a significant difference(mRNA:0.79±0.02 vs 0.51±0.03 and 0.48±0.02, P=0.000 and P=0.000; Protein:24.5±0.8 vs 15.5±0.5 and 14.9±0.9,P=0.000 and P=0.000). Compared with the two groups of K-P and K-V, the cells of K-TFPI-2 had a significant decreased activity of MMP1(12.3±0.7 vs 16.7±1.2 and 15.9±0.7, P=0.001 and P=0.003)and MMP2(15.4±1.3 vs 18.2±1.1 and 17.8±1.1, P=0.027 and P=0.046). CONCLUSION: It is suggested that the expression of TFPI-2 may strongly inhibit the activity of MMPs in keratocytes in vitro, which provides an experimental basis for curing CNV with gene therapy.

AIM: To analyze the causes and disposal of posterior capsule rupture of the lens in phacoemulsification for cataract. METHODS: A total of 326 cases(377 eyes)with cataract were selected and underwent phacoemulsification and intraocular lens implantation. The causes of 23 cases(23 eyes)who suffered posterior capsule rupture were analyzed. RESULTS: Posterior capsule rupture occurred in 23 eyes(6.1%)during the operation; 17 cases with visual acuity=0.3(73.9%). CONCLUSION: It is necessary to know the dangerous factors of posterior capsule rupture and avoid the incidence. If noticed early, the complications can be reduced and the visual acuity can be improved as well.