AIM: To explore the expression of insulin-like growth factor-1(IGF-1)in extraocular muscle and serum of children with normal eye position and strabismus, in order to further understand the correlation between pathogenesis of strabismus and IGF-1. METHODS: Children were divided into 3 groups according to the position of eye and the type of strabismus as follow: concomitant esotropia group(67 cases), concomitant exotropia group(129 cases)and normal eye position group(23 cases). For each group of the children, the extraocular muscle were cut out and frozen for detecting the expression pattern of IGF-1 by means of immunohistochemistry and Western-blot. We also used ELISA to measure the serum level of IGF-1. RESULTS:(1)Result detected by immunohistochemistry: IGF-1 was expressed mainly in the cytoplasm of extraocular muscle cells, small amount of IGF-1 was expressed in the extracellular matrix. The expression of IGF-1 in extraocular muscle of normal eye position group was significantly more than that of concomitant esotropia group and concomitant exotropia group(P<0.05).(2)Result detected by Western blot: compared with concomitant esotropia group and concomitant exotropia group,the expression of IGF-1 in normal eye position group was significantly increased(P<0.05).(3)The difference of serum level of IGF-1 among normal eye position group, concomitant esotropia group and concomitant exotropia group was not statistically significant(P>0.05). CONCLUSION: The occurrence of simple abnormal eye position such as concomitant esotropia and concomitant exotropia in children may has few association with the level of IGF-1 in serum, but be associated with the expression of IGF-1 in extraocular muscle. It suggests that injecting IGF-1 into extraocular muscle may be a potiential application for curing strabismus.

AIM: To evaluate the effect of inhibition of 99Tc-MDP on experimental corneal neovascularization in rats.METHODS: Chemical cauterization of the cornea was performed by touching alkali. Twenty-four healthy SD rats were divided randomly into two equal groups: experimental group underwent i.p. injection of 99Tc-MDP everyday until 14th day after alkali burn. Control group underwent i.p. injection of normal saline as control. Rats were examined for detection of the first signs of neovascularization. 21 days later, lengths of neovascular and total corneal neovascularization area were assessed.RESULTS: The time of neovascularization in experimental group was 6.25±1.93 days, the control group was 5.83±1.86 days, and there was no statistically significant difference(P=0.30). The lengths of neovascular were 1.74±0.33mm and 2.82±0.25mm in two groups and the difference was statistically significant. The total neovascularization area was 17.3±3.26mm2, 24.8±5.10mm2 respectively and the difference between the two groups was statistically significant(P<0.01). CONCLUSION: 99Tc-MDP has a significant effect on inhibition of alkali burn-induced corneal neovascularization.

AIM: To compare the clinical effect of phacoemulsification cataract extraction and intraocular lens implantation combined with trabeculectomy, and goniosynechialysis in the treatment of cataract and angle-closure glaucoma. The results provided a reliable method for the treatment of cataract patients with angle-closure glaucoma. METHODS: Seventy-eight patients(106 eyes)with cataract and angle-closure glaucoma were randomly divided into two groups. Group A contained 40 patients(56 eyes)which were treated by using phacoemulsification cataract extraction and intraocular lens implantation combined with trabeculectomy. Group B included 38 patients(50 eyes)which were treated with phacoemulsification cataract extraction and intraocular lens implantation combined with goniosynechialysis. The clinical effect was compared between the two groups. The following clinical parameters were tested before and after treatment: visual acuity, intraocular pressure, anterior chamber depth, and incidence of complications. RESULTS: The operations of the two groups were all smooth. There was significant difference between before and after treatment concerning visual acuity, intraocular pressure, anterior chamber depth, angle changes(P<0.05). Comparison of the efficacy of the two groups after operations: 49 eyes angle completely open in group A, 44 eyes angle completely open in group B. No significant statistical difference was found between the two groups. Preoperative anterior chamber depth: group A was 1.73±0.42mm and group B was 1.78±0.39mm; anterior chamber depth after operation: group A was 3.25±0.36mm, group B was 2.91±0.53mm. There was significant difference between the two groups. Occurrence of complications in group A was significantly higher than that of group B.CONCLUSION: Phacoemulsification cataract extraction and intraocular lens implantation combined with goniosynechialysis in the treatment of cataract patients with angle-closure glaucoma can significantly improve visual acuity, effectively control intraocular pressure, and reduce early complications of operation. The method of operation is simple, and can be widely used.

AIM: To study the effect of amniotic membrane(AM)suspension on corneal neovascularization(CNV)and ultrastructure in corneal alkali burn, and to explore the best concentration of AM for the clinical treatment.METHODS: Forty eyes from 40 Sprague-Dawley male rats were used. After alkali injuries at central corneal using 1mol/L NaOH,the control group(Group A)received topical PBS four times a day. The rest groups(Group B, C, D)received topical AM suspension with different concentration(240, 400, 560μg/mL). Using slit lamp biomicroscopy, CNV were evaluated and scored. Tissue ultrastructure changes of cornea were analyzed by corneal confocal microscope.RESULTS:The area of CNV were statistically different at each time point between group C and group A, B(all P<0.05). CNV were reduced as AM concentrations increased, while there were no significant differences between group C and group D. Inflammatory cells in corneal were reduced in group AM-treated groups.CONCLUSION: AM suspension leads to significant reduce in CNV with increasing AM concentrations. However, when the concentration reached 400μg/mL, the effects on restraining CNV cannot be enhanced by concentration. This effect may be elicited in part through the inhibiting of inflammatory cells.

AIM: To study the effect of exogenous IL-10 transfection to dendritic cells(DC)of rat on expression of IL-4 and IFN- γ in aqueous humor after corneal transplantation. METHODS: Cells of 8-DC, GFP-DC and IL-10-GFP-DC were prepared. Totally 55 SD rats were randomly selected 6(6 eyes), as a negative control group, the rest were randomly divided into 4 groups: positive control group, injected of 1mL PBS by receptor tail vein 3 days before surgery, and 8-DC group, GFP-DC group, IL-10-GFP-DC group, respectively, injected of 1mL cell suspension(8-DC, GFP-DC and IL-10-GFP-DC)have been prepared by receptor tail vein 3 days before surgery. Wistar rats as donor, keratoplasty was performed. The rats corneal graft status was examined after operation, and ELISA method was used to detect the expression of IL-4, IFN- γ in aqueous humor at the fourteenth day after operation. RESULTS: The survival time of corneal graft in group IL-10-GFP-DC was significantly prolonged. Expression of IL-4 in group IL-10-GFP-DC cytokines was higher than that in other groups, while the expression of IFN- γ was lower than other groups, the difference was statistically significant. CONCLUSION: Exogenous IL-10 gene transfection to immature dendritic cells could inhibit corneal allograft rejection, and induce the formation of immune tolerance. The disturbance over the expression of cytokines IL-4, IFN- γ in aqueous humor is one of the mechanisms for the induction of immune tolerance in corneal transplantation.

AIM: To explore the changes of macrophage migration inhibitory factor(MIF), interleukin 1(IL-1β), tumor necrosis factor-alpha(TNF-α)levels in the botulium toxin B-induced murine dry eye model.METHODS: The rats were randomly divided into two groups, 20 mice received injection of botulium toxin B(0.1mL), and 10 mice were injected physiological saline(0.1mL). Schirmer I test, corneal fluorescein staining and the levels of MIF, IL-6,TNF-α were performed before and 3, 7, 28, 42 days after injection. The levels of MIF, IL-6, TNF-α were detected by enzyme-linked immunosorbent assay(ELISA).RESULTS: The tear production was significantly decreased at 4 points and the corneal fluorescein staining increased at 5 points in BTX-B-injected mice compared with control mice. In the BTX-B-injected mice, the level of IL-1β increased significantly at the 3 days and 1, 4, 6 week, and the level of MIF in lacrimal gland increased significantly since the 4th week compared with control mice. The level of TNF-α has no difference between the two groups.CONCLUSION: Injection botulium toxin B can successfully established the mice model of dry eye. This model has the characteristic changes of the expression of inflammatory factors, which is an ideal animal model for dry eye experiment.

AIM: To observe the change of lens antioxidant enzyme activity after glaucoma trabecular resection. METHODS: Thirty-two eyes of sixteen New-Zealand rabbits(2.2-2.4kg)were divided into two groups. The left eyes of rabbits underwent standard glaucoma trabecular resection were treatment group, and the normal right eyes served as controls. Transparency of lenses was monitored by a slit-lamp biomicroscopy before and after glaucoma trabecular resection. The morphology of lens cells was observed under the light microscope.The activities of Na+-K+-ATPase,catalase(CAT), glutathion peroxidase(GSH-px), glutathione reductase(GR), superoxide dismutase(SOD)and content of malondialdehyde(MDA)in lenses were detected six months after trabecular resection. RESULTS: Lenses were clear in both treatment group and normal control group during the six months after operation. The morphology and structure of lens cells were normal under the light microscope in both operation group and normal group. The activity of lens cells antioxidant enzyme activity were significantly decreased in operation group compared with control group, Na+-K+-ATPase declined by 20.97%, CAT declined by 16.36%, SOD declined by 4.46%, GR declined by 4.85%, GSH-px declined by 10.02%, and MDA increased by 16.31%. CONCLUSION: Glaucoma trabecular resection can induce the change of Na+-K+-ATPase, CAT, GSH-px, GR, SOD and MDA in lens of rabbit. Glaucoma filtration surgery for the occurrence of cataract development mechanism has important guiding significance.

AIM: To evaluate the efficacy and clinical significance ofglycosylated hemoglobin(HbAlc)determination on diabetic cataract surgery.METHODS: Totally 105 patients with diabetes(120 monocular)undergone phacoemulsification in our hospital from March 2012 to March 2013 were enrolled into the observation group(glycosylated hemoglobin determination group, HbA1c <6.5%). One hundred and eleven patients received diabetic cataract phacoemulsification surgery(126 monocular)in our hospital from January 2011 to March 2012 were reviewed as control group(blood glucose group, blood glucose <6.4mmL/L). Both of the groups were performed phacoemulsification with IOL intraocular lens implantation. Postoperative anterior segment inflammatory response(TASS), visual acuity and intensity of use of antibiotics(DDD)of the two groups' were compared during the following-up.RESULTS:Glycated hemoglobin determination group: the mean visual acuity recovery was 0.72, the incidence of TASS was 83.3%, and DDD was 45.5. Blood glucose group: those were 0.498, 93.7%, and 88.6. The difference of incidence, degree and occurrence time of TASS(SAS 15.0 software analysis)and the degree of visual recovery between the two groups were statistically significant(P<0.05). The values of DDD were significantly different(P<0.01).CONCLUSION:Glycosylated hemoglobin determination is the gold standard to measure blood sugar preoperation and has important significance for choosing the right time for diabetic cataract surgery. TASS was significantly reduced in the patients with preoperative standard glycosylated hemoglobin, the visual acuity of them improved significantly, and DDD values were significantly lower.

AIM:To observe the effect of platelet-derived growth factor receptor-α antisense oligonucleotide(PDGFR-α ASODN)on the proliferation of rabbit lens epithelial cells N/N1003A in vitro and investigate its mechanism. METHODS: PDGFR-α ASODN was transfected into N/N1003A cells with LipofectamineTM 2000. The proliferations of the transfected cells were analyzed by MTT assay and the expressions of PDGFR-α mRNA were detected by RT-PCR. Phase microscope and transmission electron microscope were used to observe the changes of cell morphology and ultramicrostructure. Flow cytometry was applied to detect the changes of cell cycle and apoptosis rate. RESULTS: After N/N1003A cells were treated by PDGFR-α ASODN, the proliferations of the cells were significantly inhibited(P<0.05), and the expression levels of PDGFR-α mRNA were notablely lowered(P<0.05)in a dose-dependent manner, respectively. The cells in the experimental group showed typical features of apoptosis under the transmission electron microscope and the rates of cell apoptosis were markedly higher(P<0.05). The analysis of cell cycle indicated that the cells were arrested in G1 phase. CONCLUSION: PDGFR-α ASODN can silence PDGFR-α gene expression in rabbit lens epithelial cells, inhibit cell proliferation, and induce cell apoptosis, which provides the experimental basis for the application of PDGFR-α ASODN to prevent the formation of posterior capsular opacification.

AIM: To discuss the security of small incision cataract extraction and intraocular lens implantation in cataract treatment, and to analyze intraoperative and postoperative complications and promote corresponding management.METHODS: The surgery,extracapsular cataract extraction with small incision and intraocular lens implantation, was performed on 1 232 eyes with cataract. And complications were reviewed.RESULTS: In the surgery: there were 19 eyes(1.54%)with irisprolapse, 4 eyes(0.32%)with iridodialysis, 62 eyes(5.03%)with ruptured posterior lens capsule, 4 eyes(0.32%)with detachment of post elastic layer. After the surgery: there were 56 eyes(4.54%)with corneal endothelial edema, 62 eyes(5.03%)with temporary intraocular hypertension, 2 eyes(0.16%)with acute endophthalmitis, 42 eyes(3.41%)with uveitic reaction, 5 eyes(0.41%)with hyphema, 1 eye with retinal detachment, 28 eyes(2.27%)with residual cortex.CONCLUSION:Extracapsular cataract extraction with small incision and intraocular lens implantation is a safe, simple, and effective operation. However, various complications may occur due to nonproficiency and inadequate experience. Consequently, in order to achieve approving surgical outcome, operative skills should be mastered proficiently, and complications should be managed appropriately.

AIM: To evaluate clinical effect of phacoemulsification combined with anterior vitrectomy for uveitis complicated cataract.METHODS: Totally 20 patients(24 eyes)with uveitis who had phacomeulsifacation and anterior vitrectomy between March 2010 and October 2012 were reviewed retrospectively. All patients were implanted intraocular lens.RESULTS: The follow-up varied from 6 to 12 months. The visual acuity improved in 23 eyes(96%). There was iris hemorrhage in 6 eyes(25%)of operation.Postoperative complications were anterior chamber inflammation in 2 eyes(8%), a transient elevation of intraocular pressure in 1 eye(4%).CONCLUSION: Phacoemulsification combined with anterior vitrectomy is an effective method in the treatment of uveitis complicated cataract, which can contribute to the control of inflammation, improve the visual function, reduce complications.

AIM:To evaluate best corrected visual acuity(BCVA)and contrast sensitivity(CS)under mesopic condition with no glare in patients following implantation of three different kinds of aspheric acrylic monofocal intraocular lens(IOLs).METHODS: Seventy-seven cases(90 eyes)of age-related cataract patients were selected, who were undergone phacoemulsification and intraocular lens(IOL)implantation in our hospital during December 2011 to November 2012. Preoperatively, the patients were randomly divided into three groups: 30 eyes(25 cases)were implanted with hydrophobic yellow-tinted acrylic(HOYA)IOLs in group 1; 30 eyes(28 cases)with hydrophilic acrylic IOLs(Rayner)in group 2; 30 eyes(24 cases)with hydrophilic acrylic surface heparin processing IOLs(XO)in group 3. All eyes were evaluated at 1 month and 3 months postoperatively. The BCVA and CS under mesopic condition without glare were measured and underwent statistical analysis.RESULTS: There was neither statistically significant difference in the BCVA(P>0.05), nor statistically significant difference in CS results(after standardization of contrast sensitivity value: lgCS)(P>0.05)between groups under mesopic condition, but the lgCS of the HOYA group decreased slightly. CONCLUSION: There were not marked differences of BCVA and CS between groups of patients at the follow-up intervals of 1 month and 3 months under mesopic condition. The blue-filter type artificial lens may protect the retina, thus, it is advisable to implant yellow-tinted filter blue artificial lens, especially for patients who are children or young persons.

AIM: To evaluate the clinical significance and technique of intraocular lens implantation in the condition of vitreous cavity filled with gas. METHODS: Clinical data of 36 patients(36 eyes)who received intraocular lens implantation in the condition of vitreous cavity filled with gas was retrospectively studied. The postoperative follow-up period was for 3-12 months, averaged in 5.6 months. RESULTS: Postoperative visual activity improved 2-6 lines compared with preoperative best corrected visual activity in all eyes. No severe complication occurred. CONCLUSION: Assisted with noncontact panoramic viewing systems, it is easier to observe peripheral retinal clearly for photocoagulation in aphakia with gas filled vitreous cavity. Intraocular lens implantation in the condition of vitreous cavity filled with gas is easier, without unnecessary duplication operation. The surgery is safe and effective without too much difficulty.

Surgery is the most important management for glaucoma patients, and in order to reduce complications and increase the surgical effect, there are some new surgical manners appearing continuously. Aqueous reduction surgery has developed from transscleral cyclophotocoagulation to an endoscopic cyclophotocoagulation. Regarding the external filtering surgery approach, traditionally represented by trabeculectomy, there is the evolution of newer procedures, such as those using Ex-Press mini-shunts and Fugo blade transciliary filtration. Internal filtering surgery includes excimer laser trabeculotomy, the use of iStents or the Trabectome procedure, canaloplasty, and gold shunt implantation.We critically review recent advances in glaucoma surgery.

AIM: To investigate the clinical effect of corneal layer plate removal with Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis.METHODS: There were 168 cases suffered keratomycosis that the focus located shallow of the cornea and was not obvious to drug, who registered in our hospital from March 2005 to June 2010. In surgery we removed plate layer to cormea clear, the region was greater than focus for 0.5mm,then we injected fluconazole which is 2g/L density in corneal stroma to make the edema area greater than Removal of area for 0.5mm. At last we took pedicle conjunctival flap to cover the plant bed by continuous suture. Postoperative day use drug to drop eye and to observe that whether recurrent of the keratomycosis and how was the edema degrade, the blood supply of conjunctival graft pieces, how about the stimulating signs of the surgery eye, the vision.RESULTS: The improvement rate was 96.2% after surgery for seven days and the cure rate was 95.5% after surgery for one months. We found in 157 eyes accepted trigeminy surgery there were 6 eyes recurrence and the recurrence rate was 3.8%. The mean time of corneal stromal edema faded away was 13.4 hours. After surgery for one month there were 39 eyes(24.8%)whose vision removed than preoperative, there were 91 eyes(58.0%)whose vision were same as preoperative and there were 27 eyes(17.2%)whose vision lower than preoperative. In these operations the loss ratio of corneal endothelium was from 0%-8%, the mean was 2.9%. The irritative symptoms postoperative were mild for 87%, moderate for 10% and severe for 3%. By this surgery the mean length of stay was 7.3 days so the mean hospitalization expenses only were 2160 RMB. Three months after surgery, 4 cases were slight corneal ectasia.CONCLUSION: This operation combined corneal layer plate removal, Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis which was in early-to-mid was affordable and curative effect. So which could be used in some district which shortage the cornea donor.

AIM:To observe the effect of phacoemulsification combined with goniosynechialysis for angle-closure glaucoma and cataract.METHODS: Fifty-five patients(55 eyes)with angle-closure glaucoma combined with cataract were analyzed retrospectively, including male 25 cases(25 eyes)and female 30 cases(30 eyes), aging from 52 to 82 years old(mean age: 70.6±1.2 years). All patients were treated with phacoemulsification combined with goniosynechialysis. The intraocular pressure, visual acuity, central anterior chamber depth and the change of anterior chamber angle were observed and recorded. The time of following-up was 6 months. RESULTS:After 6 months' follow-up, the mean postoperative intraocular pressure was 14.3±4.1mmHg, which significantly decreased compared with that of preoperative(22.4±3.1mmHg, P<0.05). The mean postoperative central anterior chamber depth was 3.04±0.34mm, which significantly increased compared with that of preoperative(1.49±0.31mm, P<0.05). Visual acuity was increased in all patients. The range of angle closure ≤180°in 36 patients preoperative were widened postoperative.CONCLUSION: The treatment of cataract with primary angle-closure glaucoma by phacoemulsification combined with goniosynechialysis is safe and effective.

AIM: To investigate the correlative factors of corneal horizontal diameter(CHD)and anterior chamber depth(ACD)and discuss the affecting factors of anterior chamber volume(ACV).METHODS: A total of 241 cases(482 eyes)of myopia aged 6-47 years were collected on randomly. There were 124(248 eyes)male subjects and 117(234 eyes)female subjects. CHD and ACD were measured with the Orbscan ⅡZ system, and each measurement was repeated three times. SPSS 17.0 software was used to analyze the correlation data. Mathematical model was set up to research anterior chamber volume. RESULTS: The average of CHD is(11.69±0.51)mm, with diameter of(11.74±0.49)mm in male and(11.64±0.53)mm in female.The average of ACD was(3.04±0.30)mm, with depth of(3.07±0.30)mm in male and(3.02±0.29)in female. Differences in gender of CHD and ACD were significant in the t-test for independent samples(t= -2.265, -1.971; P=0.024, 0.05), these size of male were both larger than that of female. Through person correlation analysis, a negative correlation was found between CHD and age, ACD and age(r= -0.260,-0.246; P=0, 0); a positive correlation was found between CHD and ACD(r=0.297; P=0), the regression equation between CHD and ACD in myopia population was Y=1.025+0.173X(F=46.440,P=0, R2=0.088), where Y represents ACD and X represents CHD. CONCLUSION: There are statistically significant difference between male and female in CHD, ACD and ACV. The size of these in male is larger than in female. The CHD is positively correlated with the ACD, and CHD, ACD and ACV are negatively correlated with age and are not associated with the degree of myopia.

AIM: To evaluate the efficacy of photodynamic therapy(PDT)with one third-dose verteporfin for treating acute central serous chorioretinopathy(CSC).METHODS: Twenty-two eyes of 22 patients diagnosed with acute CSC from May 2010 to May 2011 received single session of PDT with one third dose(2mg/m2)verteporfin. All eyes were imaged by optical coherence tomography(OCT)preoperative and 1 week, 2, 4 weeks and 3 months after PDT. The resolution of subretinal fluid(SRF)was observed. Fundus fluorescein angiography(FFA)and indocyanine green angiography(ICGA)were applied preoperative and 4 weeks after PDT to evaluate the reliability and effectiveness of PDT.RESULTS: Twenty-two eyes presented serous neuroepitheial detachment in OCT image and showed fluorescence leakage or smokestack phenomenon in FFA, and revealed dilated and tortuous choroidal vessels with diffuse hyperpermeability in ICGA pictures. After one week, OCT showed that SRF was reduced in 7 eyes. The SRF was completely resolute in 11 eyes after 2 weeks. Four weeks after PDT, 22 eyes had complete resolution of SRF and disappear of fluorescein leakage in FFA. The dilated and tortuous choroidal vessels improved in 15 eyes and remained the same in 7 eyes by ICGA. The mean BCVA was 0.5 at baseline and 0.9 at 3 weeks. None of the patients developed any systemic adverse event associated with the operation in the follow-up period.CONCLUSION: PDT with one third dose verteporfin is effective and safe in treating acute CSC.

AIM: To investigate the clinical effect of photodynamic therapy(PDT)combined with Traditional Chinese medicine Sanqi Panax Notoginseng therapy for age-related macular degeneration(AMD)and choroidal neovascularization(CNV). METHODS: Seventeen patients(17 eyes)with AMD and CNV were diagnosed by visual acuity, ocular pressure, fundus fluorescein angiography(FFA), idocyanine green angiography(ICGA)and optic coherence tomography(OCT), and male 7 cases, female 10 cases, age 53-72 years old. PDT was performed using the recommended standard procedure. The patients were treated with PDT for 5 days, and Sanqi Panax Notoginseng 500mg injection by intravenous drip for 10 days, once a day, 15 days as one course. One month, 3, 6 months of follow-up after treatment. RESULTS: Of 17 patients after 6 months treatment, visual acuity improved in 8 cases(47%, 8/17), remained stable in 6 cases(35%), and decreased in 3 cases(18%); and 12 cases(71%)with CNV closure and leakage stopped completely, 5 cases(29%)with most of the CNV's closure, 1 patient experienced blurred vision. CONCLUSION: The results show that PDT combined with traditional Chinese medicine Sanqi Panax Notoginseng in treatment of ADM-CNV is simple and has reliable effect, it can be used in clinical application.

AIM: To observe the characteristics of fundus images and fluorescin angiography(FFA)in diabetic retinopathy(DR)combined with retinal vein occlusion(RVO). METHODS: The clinical data of FFA and other related information of 118 patients(129 eyes)who were diagnosed as DR combined with RVO were retrospectively analyzed.RESULTS: In the 118 cases of DR combined with RVO, only 11 patients were involved with both eyes. Central retinal vein occlusion(CRVO)was the most predominant(66 eyes, 51.2%), followed by temporal upper branch RVO(58 eyes, 45.0%), other branch RVO(5 eyes, 3.9%). FFA results showed that extensive hemorrhage was seen at the vein occlusion area, and disc and fovea of macula was involved with fluorescein leakage. At the same time, they covered DR change of this eye. The opposite eye had DR changes at different degrees. CONCLUSION: The clinical and fundus changes of DR combined with RVO are of many characteristics and should be distinguished with single DR or RVO.

AIM: To investigate the effect of heparin treatment on capsular tension ring(CTR)in the prevention of after-cataract postoperative patients with Marfan syndrome and subluxation of lens.METHODS: Totally 34 cases(56 eyes)were divided randomly into experimental and control groups. Preoperative heparin 12500 units was added to 500mL Ringer's infusion, and CTR was dealt with heparin stock solution soak for 20 minutes in experimental group; there was no any drugs in the control group's solution, and CTR was not dealt with heparin. Postoperative IOP, anterior chamber reaction, corneal edema, IOL position, posterior capsular opacification were observed.RESULTS: There was statistically significant difference in the posterior capsular opacification between the heparin group(13.3%)and the contral group no-heparin(69.2%)(P<0.01). In addition, anterior chamber reaction of the experimental group was significantly lighter than the control group. However, no significant differences were found between the two groups in IOP and corneal edema.CONCLUSION: The present results indicate that there is the preventive effect on posterior capsular opacification by CTR soaked in heparin in postoperative patients with Marfan syndrome and subluxation of lens, thus contributing to the recovery of visual function.

AIM: To observe and analyze on the incidence rate and causes of complications after anintravitreal injection of bevacizumab. METHODS: Totally, 207 cases(207 eyes)with wet age-related macular degeneration were selected randomly. All cases were treated with intravitreal injections of bevacizumab(1.5mg/0.06mL)and asked for chief complaints at 1 day, 1 week, 4, 12 weeks after operation, and also examined for routine visual acuity(best corrected visual acuity, BCVA), non-contact tonometer, slit lamp microscope and indirect ophthalmoscope etc.RESULTS: Among 207 cases(207 eyes), visual acuity improved efficiency was 90.8% 12 weeks after treatment, foreign body sensation was found in 7 cases(3.4%), eyelid skin pruritus in 1 case(0.5%), conjunctival congestion in 6 cases(2.9%), subconjunctival hemorrhage in 1 case(0.5%), post-operative intraocular pressure elevation in 2 cases(1.0%). CONCLUSION: The intravitreal injection of bevacizumab is effective with fewer complications. We propose to carry out a further randomized multicenter and larger-sample clinical research and further draw up the clinical application criterion of bevacizumab.

Cataract can be defined as any opacity of the crystalline lens. Congenital cataract is particularly serious because it has the potential for inhibiting visual development, resulting in permanent blindness. Approximately half congenital cataract is inherited, either in isolation or as part of a syndrome of ocular or systemic anomalies. Advances in genetic technology and analytical algorithms have greatly accelerated elucidation of the genetic contribution to cataractogenesis. Currently, more than thirty specific genes and hundreds of loci have been identified by linkage analysis or mutational screening. In this paper, research progresses of these disease-causing genes were reviewed.

AIM: To observe the clinical significance of travoprost for prevention of high intraocular pressure(IOP)within 24 hours after diabetic retinopathy(DR)vitrectomy.METHODS: A total of 102 patients(102 eyes)with DR who underwent vitrectomy and related literatures were analyzed and compared. All patients were randomly assigned to group A(vitrectomy combined with intravitreal silicone oil, C3F8or balanced salt solution tamponade group, 51 patients 51 eyes)or group B(surgical therapy is the same as the group A, while instilling one drop of 0.04g/L travoprost eyedrops in the inferior cul-de-sac about 60 minutes before the surgery, 51 patients 51 eyes). The changes of IOP, best-corrected visual acuity(BCVA)and ophthalmoscope observations within 24 hours respectively before and after the surgery were counted and analyzed.RESULTS: The mean IOP of each group within 24 hours after the surgery was higher than the contralateral eyes(t=2.17 and 2.09, P<0.05)and the mean IOP within 24 hours before the surgery(t=2.41 and 2.28, P<0.05). The incidence of high IOP(the high IOP was defined as mean IOP≥25mmHg)and decreased BCVA in group A transcended group B(χ2=4.86 and 3.99,P<0.05). Meanwhile, the mean BCVA of group A within 24 hours after the surgery was slightly worse than that of group B(t=1.43, P>0.05).CONCLUSION: The preliminary result in our scrutiny showed that the preoperative treatment of 0.04g/L travoprost eyedrops was well tolerated with the significant reduction in the incidence of high IOP and decrease in BCVA within 24 hours after DR vitrectomy. It has clinical significance about the prevention of visual impairment owing to high IOP within 24 hours after DR vitrectomy.

AIM:To observe the effects of compound Xueshuantong on fundus morphology of patients with vein occlusion in retinal branches. METHODS: Eight-five patients(85 eyes)with vein occlusion in retinal branches were selected and divided into two groups. Forty-three patients in experimental group were treated with compound Xueshuantong capsules, while 42 cases in control group with salvia miltiorrhiza. The preoperative and postoperative fundus morphological variations of patients in two groups were compared. RESULTS: The extinction rate of macular edema and effective rate of patients in experimental group were significantly higher than those in control group. Compared with the optimal corrected vision, relative diameter of retinal veins and square of retinal hemorrhage before treatment, there was no significant difference. However, after treatment, the optimal corrected vision of patients in two groups elevated remarkably, and the optimal vision in experimental group was notably higher than that in control group; the relative diameter of retinal veins and relative square of retinal hemorrhage of patients after treatment significantly decreased or lessened in two groups, and relative square of retinal hemorrhage of patients in experimental group was distinctly smaller than that in control group. CONCLUSION: Compound Xueshuantong capsule can effectively promote the vision recovery of patients with vein occlusion in retinal branches, and lessen the square of retinal hemorrhage, with the therapeutic effect superior to salvia miltiorrhiza.

AIM: To observe the effect of cataract extraction and intraocular lens implantation with manual small incision cataract surgery under surface anesthesia in the Primary Hospitals.METHODS: Totally, 372 eyes of 358 cataract cases, in our hospital from January 2010 to March 2013, underwent cataract extraction and intraocular lens implantation with manual small incision cataract surgery under surface anesthesia. Intraoperative pain, postoperative complications and visual acuity were observed.RESULTS: In the process of surgery, patients without pain and being-cooperated were recorded in 342 eyes(91.9%), that occasionally felt slight pain, but within endure and the operation was completed successfully were recorded in 17 eyes(4.6%). There were 13 eyes quit, 8 eyes(2.2%)of them because of the intolerable pain, the other 5 eyes(1.3%)of the ceaseless movement of the eye. The best corrected visual acuity on the 3rd day after operation of 4.0～4.5 were observed in 57 eyes(15.9%), 4.5～4.8 in 213 eyes(59.3%), above 4.8 in 89 eyes(24.8%).CONCLUSION: The cataract extraction and intraocular lens implantation with manual small incision cataract surgery under surface anesthesia can avoid corresponding complications, reduce the operation time obviously and ensure better quality of operation. It's suitable to carry out the prevention and treatment of blindness at the Primary Hospitals.

AIM:To investigate the clinical profiles, visual outcomes and related factors for the patients with nonarteritic anterior ischemic optic neuropathy(NAION). METHODS: From January 2006 to December 2009 in our hospital, 116 consecutive patients(116 eyes)with NAION were retrospectively analyzed. The clinical and fundus fluoresecein angiographic profiles, visual outcomes and related factors of the patients were recorded. The routine managements included controlling systemic diseases, systemic vasodilators, neuroprotection agents or oral corticosteroids. RESULTS: Of 116 cases, 65 were males and 51 were females. The average ages were 56.4±9.8 years. The unilateral onset were 98 cases(84.5%)and the bilateral onset were 18 cases(15.5%). The papillary edemas were seen in all patients and the peripapillary hemorrhages were seen in some patients. The visual field defects were seen in all patients, and the inferior altitudinal defects or nasal inferior defects were common(53.7%). The filling defect or delay was seen in all patients at the early stage of fluorescein fundus angiography and the optic disc staining or diffuse fluorescein leakage at the late stage. After the active treatment for 2-3 months, the papillary edemas were subsided, and the optic nerve were sectoral or diffuse atrophy. The visual fields defects of 87.3% eyes were improved or stable, and 12.7% eyes were residual partial visual defect. The average best-corrected vision of 116 eyes at the initial visit were 0.52±0.21, and the corrected vision at the final visit were 0.68±0.20, the vision were improved after the treatment(t=10.61, P=0.000). Among the 116 patients, 72 cases(62.1%)were with cardiovascular disorders, 52 cases(44.8%)with systemic hypertension and 27 cases(23.3%)with diabetes mellitus. After the logistic regression analysis, the related factors for the lower final visual acuity(0.5 or less)were related to the lower initial vision(0.5 or less), diabetes mellitus history and older ages(over 60 years), there were not related to the gender and systemic hypertension. CONCLUSION: Elderly persons with systemic hypertension or diabetes mellitus were the major risk factors for the pathogenesis of NAION and poor visual prognosis. Corrected diagnosis and proper treatment would improve the optic nerve ischemia, and improve the visual acuity and visual field defects recovery.

AIM: To explore the surgical intervention time in treatment of proliferative diabetic retinopathy(PDR)combined with vitreous hemorrhage. METHODS: Totally, 128 cases(177 eyes)with PDR combined with vitreous hemorrhage were investigated retrospectively. Patients with PDR were divided into Ⅳ group, Ⅴ group and Ⅵ group. Vitrectomy and laser treatment were applied. Surgical complications, anterior chamber inflammation, intraocular pressure 1 week after surgeries and restoration of vision 6 months after surgeries were observed and compared between groups. RESULTS:Vision of all patients restored significantly after surgeries, but more significantly in Ⅳ group(P<0.05); there were no significant differences of surgical complications, anterior chamber inflammation and intraocular pressure 1 week after surgeries in 3 groups(P>0.05). CONCLUSION: Clinical effects could be improved significantly by surgical intervention at Ⅳ stage of PDR without increasing any surgical risks.

AIM:To evaluate the clinical outcomes of macular laser photocoagulation after intravitreal injection of 1.25mg doses of Bevacizumab for diffuse diabetic macular edema(DME).METHODS: Eighty-six eyes of 74 patients with diffuse DME were randomized into 2 groups. In laser group, 48 eyes were subjected to a macular Focal/grid laser photocoagulation 3 weeks after intravitreal injection of 1.25mg doses of Bevacizumab. In control group, 38 eyes underwent only intravitreal injection of 1.25mg doses of Bevacizumab. The changes of visual acuity and central macular thickness of all eyes in both groups preoperatively, 3 and 6 weeks, 3 months postoperatively were recorded. RESULTS:There was no statistical significance on visual acuity before and 3 weeks after treatment, while the differences before and 6weeks and 3 months after treatment were significant. Central macular thicknesses were 395.933±119.784, 292.617±39.131, 302.350±55.272 and 314.200±60.528μm before, and 3,6 weeks, 3 months after injection, respectively in laser group. In control group, those were 398.734±111.764, 301.217±34.231, 312. 120±53.170 and 395.145±108.687μm, respectively. The 2-tailed T test revealed that visual acuity was not significantly different between two groups at baseline and 3 weeks after injection, but were significantly better in laser group at 6 weeks(P=0.02)and 3 months after treatment(P<0.001).CONCLUSION: Intravitreal injection of Bevacizumab combined retinal photocoagulation is more effective to diffuse DME, benefits retinal photocoagulation and improves visual acuity of patients with diabetic macular edema.

Retinal oscillatory potential has been widely applied in diagnosis, condition variety and prognostic of eye disease. It is believed that oscillatory potentials are generated from the inner retina, and can objectively reflect blood circulation in inner retina. Now the applications and prospects of retinal oscillatory potential are briefly introduced, in order to promote the popularity of this technology.

AIM: To provide the basis of security guidance and decreasing the incidence through a general investigation of the mechanical ocular trauma among all the common causes, occasions where getting hurt as well as the characteristics of the high-risk group, and by further analysis and monitoring of the clinical cases and follow-up visit, study the related key factors of influencing the prognosis statistically. METHODS: The data of the 159 cases with mechanical ocular trauma were recorded.RESULTS: We obtained the 159 subjects' ages, genders as well as mechanical ocular trauma characteristic data, such as ocular distributions, the seasons of the injuries occurring, the causes and the occasions of the injuries, the high-risks group and so on. The factors affecting the visual prognosis,univariate analysis showed that the difference between urban and rural areas was a related influencing factor while the consulting hours and the ages of the patients were irrelevant. In the multivariate Logistic regression model of complications that affected the visual prognosis, there were four main factors leading to poor eyesight: endophthalmitis, retinal detachment, luxation or subluxation of the lens, prolapse of vitreous. In the multivariate Logistic regression model of the visual prognosis of mechanical eye injury, there were three factors of concern that corresponded to poor eyesight: the ages less than 10, zonation Ⅲ, grade of injury more than 3. CONCLUSION: The epidemiologic features of the mechanical ocular trauma in our hospital correspond to the reports from other areas. Appropriate medical care can improve the visual prognosis. Factors such as zonation Ⅲ, ages less than 10, grade of injury more than 3, endophthalmitis with the eye injury, prolapse of vitreous, luxation or subluxation of the lens and so on, indicate poor visual prognosis.

AIM: To investigate the changes of retina in amblyopic eye by measuring macular retinal thickness in hyperopicametropic amblyopic patients.METHODS: Optical coherence tomography(OCT)was used to measure the macular retinal thickness value in 17 amblyopic patients(20 eyes)and 14 healthy controls(20 eyes). The result was processed as retinal thickness value and thickness map by computer. The data were analyzed by SPSS 13.0 software package. RESULTS: The retinal thickness of central sector or region in amblyopic eyes were thicker than those in normal eyes(P<0.05), in the inner ring, the difference of nasal quadrant between amblyopic eyes and normal eyes was statistically significant(P<0.05), but there was no significant difference in other three quadrants of the inner ring and in any quadrant of the outer ring between amblyopic eyes and normal eyes(P>0.05). CONCLUSION: The macular retina thickness of the central region is thicker in hyperopic ametropic amblyopic patient. OCT is a noninvasive, noncontact technique that visualizes the retinal structure in vivo, this technique may be used to find the potential initial neural site of the visual deficit in this condition.

Diabetic retinopathy(DR)is one of the most serious complications of diabetes, as the second general blindness disease in the world currently. The development of procedures for prevention and treatment of DR is one of the most important problems that should be solved currently. A lot of researches show that the development of DR is determined by genetics. The current research advance in DR relevant gene is reviewed in this article.

AIM: To evaluate the efficacy of optical coherence tomography(OCT)in highly myopic macular hole after silicone oil tamponade. METHODS: A retrospective analysis of 20 cases of high myopia macular hole with retinal detachment after vitrectomy with silicone oil tamponade was performed. The mean follow-up time was 7 months. OCT examination was given to assess the macular hole closure and retinal reset during the follow-up. Best corrected visual acuity(BCVA)was recorded.RESULTS: There were three kinds of postoperative OCT performance: macular hole closure in 2 eyes(10%), macular hole was not closed but the retinal reattachment in 16 eyes(80%), macular hole was not closed with shallow retinal detachment in 2 eyes(10%). Postoperative BCVA improved compared with that of preoperative. The improvement of visual acuity was closely related to the anatomy reset of macular hole. No serious postoperative complications occurred.CONCLUSION: OCT for macular hole in high myopia silicone oil tamponade postoperative follow-up can confirm the diagnosis of macular hole closure and retinal reset, providing the means of reference for the timing of silicone oil removal.

AIM: To investigate the safe and reliable examination method for neonatal fundus screening.METHODS: Fundus information of 2 836 neonates performed by RetCamⅡ in our hospital from January 1, 2012 to December 31, 2012 were retrospectively analyzed, including 1 625 cases(57.30%)of premature infants which were first examined 1-4 weeks after birth and 1 211 cases(42.70%)of term infants which were first examined within 4 weeks after birth.RESULTS: Totally 454 cases of abnormalfundus were found, including 207 cases(12.74%)of retinopathy of prematurity(ROP), ROPⅠ in 118 cases(57%), ROPⅡ in 58 cases(28.02%), ROPⅢ in 23 cases(11.11%), ROPⅣ in 8 cases(3.86%), no case of ROPV. A total of 247(20.40%)term infants had abnormal fundus, of which 68 cases(27.53%)were developmental or hereditary disease, retinoblastoma in 1 case(0.40%), retinal hemorrhage in 102 cases(41.30%), retinal exudative changes in 68 cases(27.53%), optic atrophy in 5 cases(2.02%)and optic disc edema in 3 cases(1.21%).CONCLUSION: Neonatal fundus diseases were so various and harmful that early screening should be attended to. Premature infants and term infants with high risk are treated as focus group of fundus screening and RetCamII examination is safe and effective.

AIM:To examine the frequency of different types of strabismus and surgical outcomes in Yazd, Iran.METHODS: In this descriptive study, medical records of all strabismus patients aged below 16 years with at least 6 months follow-up were reviewed. Data on surgical outcomes and complications were collected from questionnaires and analyzed statistically. Chi-square for qualititative and Mann-Whitney tests for quantitative variables were used.RESULTS: Six hundred and eighty-five cases of childhood strabismus were identified during an 11-year study period. The following types of strabismus were identified: 307 cases(44.8%)with exotropia, 294(42.9%)with esotropia and 84(12.2%)combined horizontal and vertical cases. The post-operative alignment in 280 cases(73.9%)was normal(range of horizontal deviation < 8 Δ).CONCLUSION: The most common type of strabismus in this study is exotropia. Outcomes of surgery are comparable to those published in the literature. A longer follow-up is needed to further evaluate the results.

AIM: To evaluate the features and clinical outcomes of cataract extraction by phacoemulsification with intraocular lens implantation in primary angle-closure suspect(PACS), primary angle-closure(PAC)and primary angle-closure glaucoma(PACG)with cataract.METHODS:Phacoemulsification with intraocular lens implantation was performed on 86 cases(86 eyes)diagnosed as PACS, PAC and PACG co-existing cataract from January to December 2012. All cases were followed up for 3 months to 1 year. Pre-operative and post-operative visual acuity, intraocular pressure(IOP), gonioscopy, ultrasound biomicroscopy(UBM), visual field and usage of anti-glaucomaous eye drops were recorded.RESULTS:Zonular dialysis existed in 19 eyes(22%). The post-operative visual acuity improved in 84 eyes(98%). The post-operative visual acuity was <0.1 in 7 eyes(8%), 0.1-0.5 in 32 eyes(37%), 0.6-1.0 in 47 eyes(55%). There were 83 eyes(97%)with IOP between 10-15mmHg without any drug at the end of the follow-up period. The central anterior chamber was deepened and the anterior angle opened postoperatively at different extent.CONCLUSION: PACS, PAC and PACG co-existing zonular dialysis is common. Phacoemulsification with IOL implantation can reduce IOP, deepen anterior chamber and open angle.

AIM:To investigate whether complex surgical incision in cataract surgery based on corneal astigmatism axial can reduce preoperative corneal astigmatism.METHODS: Cataract patients 100 cases(100 eyes)with corneal astigmatism more than 1.50D detected by keratometry were collected in this study. Scleral tunnel incision was made as the main incision according to diameter direction of maximum corneal refractive power, meanwhile, an auxiliary incision was performed on the other side of the main incision. Extracapsular cataract extraction with intraocular lens implantation was performed by a small-incision. The preoperative and postoperative(3 days, 1 month, 3, 6, 12 months)corneal astigmatism and uncorrected visual acuity were measured.RESULTS: The preoperative and postoperative(3 days, 1 month, 3, 6, 12 months)average corneal astigmatism were(+2.08±0.666)D,(-1.06±0.75)D,(+0.67±0.71)D,(+1.11±0.77)D,(+1.20±0.88)D and(+1.30±0.68)D, respectively. The preoperative and postoperative(3 days, 1 month, 3, 6, 12 months)average uncorrected visual acuity were 0.30±0.19, 0.55±0.25, 0.69±0.21, 0.66±0.18, 0.65±0.20, 0.60±0.22. CONCLUSION: The use of composite and personalized incision in cataract surgery helps to reduce preoperative corneal astigmatism. Because of the advantage of simple process and low cost, this operation is suitable to popularize in poverty alleviation at the grassroots level.

AIM: To investigate the clinical characteristics and surgical results of vireoretinal diseases in 68 patients with contralateral blindness(solitary eye). METHODS: A total of 68 patients(68 eyes)with contralateral blindness were enrolled in this retrospective consecutive study. The clinical characteristics, surgical procedures and temponade materials chosen, preoperative and postoperative visual acuity, complications and prognosis were analyzed. The follow-up ranged from 4 months to 5 years, with an average of(11.30±9.57)months. At the last follow-up, the surgical effects were evaluated.RESULTS:After operation, visual acuity increased significantly. The number of eyes with vision of 0.05 or better increased from 22 eyes(32.4%)preoperative to 60 eyes(88.2%)postoperative, and that of 0.3 or better from 3 eyes(4.4%)to 37 eyes(54.4%). The best-corrected visual acuity before and after surgery also differed significantly(t=8.986, P<0.01). CONCLUSION: With vitreoretinal surgery, visual impairment or loss due to vitreoretinal diseases can be avoided in most patients with contralateral blindness.

AIM: To evaluate the therapeutic effect of phacoemulsification and intraocular lens implantation on phacolytic glaucoma.METHODS: A survey of the operative complications, visual activity and intraocular pressure was taken, after the cases received the operation of phacoemulsification and intraocular lens implantation for phacolytic glaucoma. RESULTS: The complications of the surgery were slight and easy to control. The intraocular pressure of 17 cases was between 41.7-62.4mmHg before the surgery, and it was 10.7-18.2mmHg after the surgery. Furthermore, the visual activity was light perception(LP)in pre-operation while it was ≥0.5 postoperatively.CONCLUSION: Phacoemulsification and intraocular lens implantation is a safe and effect way for phacolytic glaucoma.

AIM: To evaluate the clinical effect of trabeculectomy combined with amniotic membrane transplantation in the treatment of neovascular glaucoma(NVG). METHODS: Forty-two cases(42 eyes)with NVG were performed trabeculectomy combined with amniotic membrane transplantation. The vision acuity, intraocular pressure(IOP), anterior chamber depth, hyphema, iris neovascularization and filtering bleb after operation were observed. All patients were followed up for 6-12 months. RESULTS: IOP were controlled in less than 21mmHg in 34 cases postopeartively. Symptoms of 6 cases were alleviated, and the IOP were controlled in less than 21mmHg with treatment of carteolol hydrochloride eye drops 6-12 months after operation. CONCLUSION:Trabeculectomy combined with amniotic membrane transplantation is an ideal treatment for NVG.

AIM: To investigate the application effect of continuous quality improvement(CQI)in ophthalmic clinical teaching management.METHODS: Since 2011, we adopted a series of CQI measures to manage clinical teaching, and compared teaching quality assessment contents before and after application of CQI.RESULTS: After application of CQI, students' theory and skills scores, medical writing quality and satisfaction with teaching were significantly improved.CONCLUSION: Application of CQI in management improves the quality of clinical teaching, and should be widely applied.

AIM: To evaluate the effect of surface anesthesia for phacoemulsification using 20g/L lidocaine.METHODS: There were 1 850 patients(2 600 eyes)who underwent phacoemulsification via surface anesthesia using 20g/L lidocaine. The analgesic effect was observed. RESULTS: Totally 93% of 1 850 patients had not any pain during the surgery, a nice analgesic effect was showed, there was no complications duo to anaesthesia. Seven percent of all patients felt swelling pain during surgery but could tolerate. The naked or corrected visual acuity of 89.4% eyes was ≥0.6 one month after surgery.CONCLUSION: Surface anesthesia of using 20g/L lidocaine is safe and painless for phacoemulsification.

AIM:To analyze the reason of canalicular laceration, and to explore the methods and techniques to raise the success rate of lacrimal canaliculi laceration anastomosis. METHODS: Seventy-eight cases(78 eyes)with canalicular underwent lacrimal canaliculi laceration anastomosis through catheter support under microscope at I stage.RESULTS: The operation was successful in all cases. The extubation time was at 3 months after operation. After one-year follow-up, lower lacrimal canaliculi were all unobstructed. CONCLUSION: The causes of canalicular laceration laceration mostly were frustrated laceration. Receiving anastomosis under microscope at I stage was preferred and necessary. Searching nasal stump, implanting epidural catheter and anatomical reduction of the inner canthus were the keys to make the operation successful. Fake tears could also drain tear.

AIM:To evaluate the clinical efficacy of lacrimal dredge under lacrimal endoscope for treating chronic dacryocystitis. METHODS: Sixty patients(64 eyes)with chronic dacryocystitis were examined and treated by lacrimal endoscope combined with full lacrimal intubation. All patients were followed up for 3-6 months postoperatively. RESULTS: Forty-five eyes of 64 eyes were cured, no tears, irrigation of lacrimal passage unobstructed. Thirteen eyes get partly recover, but there were still mild overflow tears, and although lacrimal passages can be flushed, but there were still partly lacrimal duct obstruction. The rest 6 eyes were invalid and still tears, irrigation of lacrimal passage obstructed. The total effective rate was 90.6%. CONCLUSION: The diagnosis and treatment of nasolacrimal duct obstruction under lacrimal endoscope is a safe and effective way.

Age-related macular degeneration(AMD), one of the most common causes of elderly blindness, is a complex disease results from environmental and genetic factors. AMD pathogenesis is associated with chronic oxidative stress, immune and inflammatory damage. We make a simple generalization of oxidative stress and complement in the pathogenesis of AMD in this article.

Vitreous macular interface disease mainly includes vitreomacular traction syndrome, idiopathic macular epiretinal membrane and idiopathic macular hole. Optical coherence tomography(OCT)as a new tool that provides high resolution biopsy cross section image non traumatic imaging inspection, has a unique high resolution, no damage characteristics, and hence clinical widely used, vitreous macular interface for clinical disease diagnosis, differential diagnosis and condition monitoring and quantitative evaluation, treatment options, etc provides important information and reference value. Vitreous macular interface disease in OCT image of anatomical morphology characteristics, improve the clinical on disease occurrence and development of knowledge. We reviewed the advances in the application of OCT in vitreomacular interface disease.

AIM: To investigate the morbidity of dry eye in policeman of Shunde district, and to analyze the related factors and proposed methods of preventing and treating dry eye.METHODS:Totally 650 policemen who came for physical examination in Shunde district recived questionnaire survey. The patients with dye eye disease were finally diagnosed through slit lamp examination, Schirmer test, tear film break-up time(BUT)measurement and keratoconjunctival fluorescent staining. The morbidity among different policemen was further analyzed and stasticed.RESULTS:The results showed that 152 in 650 policemen suffered from dry eye disease, the ratio was 23.4%. Comparied with security police and crimanl police, the ratio in traffic police, patrolman,and back office police was significantly higher. The prevalence was higher when the ages were greater than 40.CONCLUSION: Unsuitable working environment, air contamination are high risk factors of dry eye disease.

AIM: To evaluate the efficacy of various surgical techniques for correcting different types of senile blepharoptosis.METHODS: From June 2008 to October 2011, 150 cases(164 eyes)patients with senile blepharoptosis underwent surgical treatment. Patients with severe blepharoptosis received frontalis muscle flap suspensio, patients with moderate blepharoptosis get levator palpebrae superioris muscle shortening and those with mild blepharoptosis underwent pleating of levator palpebrae superioris.RESULTS: After 3-month to 1-year follow-up, 154(93.9%)eyes get satisfactory results and 10(6.1%)eyes obtained better results.CONCLUSION: In order to achieve the best correction in patients with blepharoptosis, it is important that making objective and careful preoperative examinations, selecting appropriate operation managements according to the levator palpebrae superioris muscle strength, the degrees of blepharoptosis and combined with experience.

AIM: To evaluate the clinical efficacy of pattern scan laser photocoagulation(Pascal)on proliferative diabetic retinopathy(PDR).METHODS: A total of 93 patients with retinopathy(186 eyes)were randomly divided into treatment group(96 eyes of 48 patients)who treated with panretinal photocoagulation(PRP)using Pascal at one time and control group(90 eyes of 45 patients)who treated with PRP using multi-wavelength krypton laser in 4-5 times. The visual acuity, FFA, OCT, visual field will be evaluated of each patient before and after the treatment.RESULTS: The visual acuity findings were stated as below: the overall effective rate of visual acuity in treatment group is 85.4% while it is 82.2% in control group. The overall effective rate in two groups has no significant difference. The retinal sensitivity has no significant decrease in the treatment group while which decreased significantly in the control group.CONCLUSION: The clinical efficacy of Pascal on treating the PDR is better than which of the regular argon laser. The field of vision has no significant narrowed after the Pascal treatment which can efficiently shorten the length of treatment and reduce the pain sensation.

AIM: To evaluate the effect of surgical treatment of Fuchs syndrome complicated with cataract and glaucoma. METHODS: Phacoemulsification and intraocular lens implantation were performed on 16 patients(16 eyes)with Fuchs syndrome complicated with cataract and glaucoma, 2 patients(2 eyes)complicated cataract and glaucoma were treated with phacoemulsification and intraocular lens implantation combined with trabeculectomy. Visual acuities, intraocular pressure and treatment effects were evaluated after treatment.RESULTS: The visual acuities of all eyes improved obviously. Sixteen eyes(88.89%)attained corrected vision above 0.5 three months after operation, 10 eyes with posterior capsule opacification attained corrected vision above 0.5 three months after the YAG laser posterior capsulotomy. Intraocular pressure of 2 eyes with glaucoma dropped to the normal range. CONCLUSION: Phacoemulsification and intraocular lens implantation with trabeculectomy is effective and safe for Fuchs syndrome complicated with cataract and glaucoma. It is one of the ideal surgical treatments without severe complications at present.

AIM: To assess the efficacy of modified silicon tube in treating canalicular laceration. METHODS:Silicon tube of 0.3mm×0.6mm in diameter was used to treat 24 patients with newly occurred lacrimal canaliculi rupture. Other 24 patients treated with regular tube were served as control. The mean follow-up was 1.5 years. RESULTS:Patients treated with modified tube showed good stability. During follow-up, lacrimal passage was clear and tear drainage maintained unobstructed. In control group, irritation occurred before tube drawing, e.g. foreign body sensation, lachrymation, hyperemia, excessive exudates. The rate of complication between modified treatment group and control group was 4.2%(1/24)and 33.3%(8/24), respectively. The difference was statistically significant(P<0.01). The cure rate between the two groups was 91.7%(22/24)and 62.5%(15/24), respectively, after tube drawing(P<0.05).CONCLUSION: Treatment ofcanalicular laceration using modified silicon tube shows good efficacy, favorable patient compliance, thus can be a new effective treatment.

AIM: To observe the effect of traditional medicine to the expression of vascular endothelium growth factor(VEGF), and explore the intervention effect to the pathological myopia with choroidal neovascularization(CNV)through experimental model of lasers -induced CNV in guinea pigs with pathological myopia induced by form deprivation. METHODS: Fifteen of the forty-five 3-week old female guinea pigs were randomly selected as the blank control group, the rest 30 guinea pigs were using facemask to induce high myopia in 4 weeks, then randomly assigned to model group and treatment group, then induced CNV by different wavelength laser. The treatment group gavaged with modified Zhu Jing prescriptions while the control group was gavaged with distill water. 21 days after treatment, histopathologic choroidal flat mounts, HE stain,immunofluorescence stain and immuno- histochemistry for VEGF in the experimental eyes and control eyes were performed.RESULTS:All the 30 guinea pigs were successfully induced high myopia and the axial length of the right eyes were significantly greater than the non-facemask eyes and the eyes of control group. Immunofluorescence stain and immunohistochemistry for VEGF showed that the expression of VEGF of the treatment group was less than the model group. The average optical density(AOD)of the form deprivation eye in the treatment group(0.0589±0.0146)was higher than that in the model group(0.0972±0.0507)(P<0.01).CONCLUSION: Modified Zhu Jing prescriptions has a positive effect to the reduction of the VEGF expression in the CNV with pathological myopia and thus it can inhibit the growth of CNV.

AIM: To observe the clinical effect and recurrence rate of biological amnion transplantation in pterygium operation, and to provide the reference for pterygium diagnosis. METHODS: Fifty-two patients(58 eyes)with pterygium were conducted microscope excision combined with biological amnion transplantation from April, 2010 to September, 2012. The repair time of corneal epithelium and postoperative recurrence rate were recorded. Forty-six patients(53 eyes)receiving excision of pterygium with microscope alone at the same term were selected to make a controlled study. RESULTS: The recurrence rate of patients in research group was significantly lower than that in control group. The proportion of healing cases in research group on the 3rd and 5th days after operation were remarkably higher than that in control group, while that on the 14th day conspicuously lower than that in control group. The mean healing days of patients in research group were markedly shorter than that in control group. In addition, the patient comfort of the research group was significantly higher than that in control group. CONCLUSION: Excision of pterygium with microscope combined with biological amnion transplantation can effectively shorten the postoperative repair time of corneal epithelium, decrease the recurrence rate distinctly, and is more comfortable, so it deserves to be recommended.

AIM: To explore the relations of clinical efficacy and surgical timing of vitrectomy combined with silicone oil tamponade for severe infectious traumatized endophthalmitis.METHODS: Totally 59 patients(59 eyes)with severe infectious traumatized endophthalmitis accepted vitrectomy combined with silicone oil tamponade. Patients were divided into two groups by different surgical timing. Group A accepted operation in 24 hours. Group B accepted operation 24 hours after injury. Retina status during operation, clinical efficacy and best-corrected visual acuity were observed and recorded. RESULTS: The cases of early operation group got lesser retina injury and higher efficacy and better best-corrected visual acuity. CONCLUSION:Vitrectomy combined with silicone oil tamponade is an effective way to cure severe infected traumatized endophthalmitis. Early surgical treatment is the key to achieve better effect.

AIM: To analyze the causes and characteristics of 35 patients suffering from oculomotor palsyMETHODS: The outcomes in a series of 35 patients with oculomotor palsy from January, 2009 to December, 2012 in our hospital were retrospectively evaluated. Blood glucose, computed tomography(CT), magnetic resonance imaging(MRI), magnetic resonance angiography(MRA), and digital subtraction angiography(DSA)were underwent to analyze its causes and characteristics.RESULTS: In 35 cases, causes were head injury in 10 patients(29%), intracalvarium inflammation in 8 cases(23%), diabetes in 6 cases(17%), intracranial aneurysm in 4 cases(11%), intracranial neoplasm in 4 cases(11%), cerebral infarction, cerebrovascular hemorrhage and unknown in 1 case(3%), respectively.CONCLUSION: The causes resulting oculomotor palsy were multiplicity, head injury is the most common cause of oculomotor palsy. The other common causes include intracalvarium inflammation and diabetes mellitus. The causes exist some characteristics in different age stages, determine the causes is important extremely for treatment in correct.

AIM: To observe the efficacy of pterygium excision combined with autologous limbal stem cell transplantation for pterygium in Uygur.METHODS: A total of 163 Uighur cases(180 eyes)with pterygium underwent pterygium excision combined with limbal stem cell transplantation. Recurrence rate of pterygium was recorded after surgery.RESULTS: All 163 cases got successfully surgery. And they were followed up for 6-48 months with no pterygium recurrent 12-month after surgery, 1 eye(0.6%), 6 eyes(3.3%)and 9 eyes(5%)recurred at 18, 24 and 48 months, respectively. The total recurrence rate was 8.9%(16/180).CONCLUSION:Pterygium excision combined with autologous limbal stem cell transplantation is an ideal surgical method for pterygium in Uygur, for its fewer complications and low recurrence rate.

AIM: To analyze the causes and evaluate the surgical effect of A-V patterns strabismus.METHODS: Clinical data of 106 caseswith A-V patterns strabismus in our hospital from January 2011 to December 2012 were retrospectively analyzed. Seventy patients with oblique muscle overaction were performed weakening oblique muscle surgery to treat A-V pattern. Twenty-six patients with no abnormality of oblique muscle and superior and inferior rectus muscle, and with >20△ between gaze up 25° and down 25° in V pattern and with >15△ between gaze up 25° and down 25° in A pattern were performed horizontal rectus muscle transposition to half to one muscle tendon. While ten patients with no obvious abnormality of oblique muscle and vertical rectus muscle, and with ≤20△ between gaze up 25° and down 25° in V pattern and with ≤15△ between gaze up 25°and down 25° in A pattern were only performed horizontal rectus muscle surgery.RESULTS: No A-V patterns was defined asnormotopia and A-V patterns >10△ was defined as overcorrection or undercorrection after surgery. In 106 cases, V pattern was corrected in 75 cases, overcorrected in 5 cases, undercorrected in 4 cases. A pattern was corrected in 15 cases, overcorrected in 3 cases, undercorrected in 4 cases. Horizontal strabismus >±10△ was defined as overcorrection or undercorrection after surgery. Eighty-five cases were corrected, 11 cases were undercorrected, and 10 cases were overcorrected.CONCLUSION: A-V patterns strabismus was caused mainly by abnormal extraocular muscle. A-V patterns with abnormal oblique movement were treated by oblique surgery and A-V patterns with normal oblique and vertical rectus movement were treated by horizontal rectus muscle transposition, both which corrected A-V patterns. Patients had good distance and near stereopsis postoperation. Binocular weakening oblique muscle surgery can correct primary ocular position, so surgical design of horizontal deviation about A-V patterns strabismus with abnormal oblique muscle was considered.

AIM: To explore the effect of improved Parks incision combined rectus linear tucking on the treatment of concomitant strabismus.METHODS: In this retrospective case series, 105 patients(157 eyes)with concomitant strabismus from June 2010 to December 2012 were researched. All the patients adopted improved Parks incision combined rectus linear tucking under microscope. The change of strabismus degree before operation and postoperative at 1 week, 1 month, 3 and 6months were analyzed.RESULTS: The data was dealt with SPSS 12.0. The designs were performed using rank test. It had statistical significance. The change of strabismus degree between preoperative and postoperative at 1 week, 1 month, 3 and 6 months were significantly different(P<0.05), after 1 week and 6 months, strabismus degree showed no significant difference(P>0.05). All patients had good effectiveness, without anterior segment ischemia, conjunctiva faulty union and other complications.CONCLUSION: The improved Parks incision combined rectus linear tucking is satisfactory in treating concomitant strabismus. The operation is simple, and it decreases trauma and complications.

AIM: To compare the effect of two surgical methods: lacrimal laser combined with mitomycin-C and lead-type silicone tube implantation and lacrimal laser combined with lead-type silicone tube implantation only, for dacryagogatresia treatment. METHODS: After dacryagogatresia was opened by Nd:YAG laser, 143 cases(150 eyes)in group A underwent lacrimal laser combined with mitomycin-C and lead-type silicone tube implantation. One hundred and forty-three cases(150 eyes)of group B was treated with lacrimal laser combined with lead-type silicone tube implantation only.RESULTS: In group A, 138 eyes(92.0%)was cured, 10(6.7%)was improved, and the total efficiency was 98.7%, 2 was failed. In group B, 107 eyes(71.3%)was cured, 32(21.3%)was improved, and the total efficiency was 92.7%, 11 was failed. Differences of cure rate(χ2=4.15, P<0.05)and total efficiency(χ2=5.00, P<0.05)between two groups had statistical significance. CONCLUSION:lacrimal Laser combined with mitomycin-C and lead-type silicone tube implantation is more effective compared with the method of lacrimal laser combined with lead-type silicone tube implantation only.

AIM: To evaluate the therapeutic efficacy of Nd:YAG laser on lacrimal duct obstruction and the different efficiency of obstruction on different location. METHODS: Totally 920 eyes(840 patients)with no dacryocystitis received Nd:YAG laser treatment, including 134 eyes with lacrimal canaliculus obstruction and 786 eyes with naso-lacrimal duct obstruction. Every case received 4 days' lacimal duct wash by Poly Pred or Tobradex. Patients in two groups were followed up for 3 months.RESULTS:Total efficiency was 76.2%. Efficiency of naso-lacrimal duct obstruction group was 77.2%(607 eyes), which was obviously higher than 70.1%(94 eyes)in lacrimal canaliculus obstruction by one point group.CONCLUSION:Nd:YAG laser can be suggestively applied in treatment on lacrimal duct obstruction, especially can be used in naso-lacrimal duct obstruction due to its simplicity, economy, practicability, less side effect and complication.

AIM: To observe the effect of laser combined with lacrimal duct intubation on the treatment of lacrimal duct obstruction diseases.METHODS:Of 79 patients(96 eyes)with lacrimal duct obstruction diseases, 27 eyes(22 eyes with canaliculi lacrimalis or lacrimal duct shutting and 5 eyes with ductus nasolacrimalis)underwent laser combined lacrimal drainage tube implantation, 69 eyes(27 eyes with ductus nasolacrimalis and 42 eyes with chronic dacryocystitis)received laser combined with nasolacrimal duct stenting. Eye drops included dexamethasone and antibiotic medicine were given in a week after operation. The patients implanted lacrimal drainage tube removed the tube at 3-6 month after operation, the other removed nasolacrimal stenting at 4 weeks after operation, all of patients were followed-up 12 months.RESULTS:Seventy-nine eyes were cured in all of the 96 eyes, 10 eyes were better, 7 eyes were ineffective. All 96 eyes had not been seen pus after being rinsed. Total efficiency was 93% and significant efficiency was 82%.CONCLUSION: Laser combined with different silicone tube implantation according to the different site was a simple and effective way inthe treatment of lacrimal duct obstruction.

AIM: To observe the clinical effect of low power transpupillary thermotherapy(TTT)with retrobulbar injection of triamcinolone acetonide(TA)for central exudative chorioretinopathy(CEC).METHODS: Fourteen eyes with idiopathic choroidal neovascularization were treated with retrobulbar injection of TA and performed by low power TTT after one week. Laser parameters were as follows: spot diameter 0.8-3.0mm, low power 120-360mW, time 60 seconds. By 3 to 12 months of follow-up, visual acuity, ophthalmoscope, fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were used to observe the curative effects.RESULTS: Visual acuity were improved in 5 eyes(36%), remained stable in 8 eyes(57%)and declined in 1 eye(7%)after treatment. The macular hemorrhage and exudation were reduced significantly in 12 eyes. FFA showed that the fluorescein leakage ceased or decreased in 7 eyes, unchanged in 5 eyes, and enlarged in 2 eyes. The macular edema of 12 eyes in OCT was reduced unequally.CONCLUSION: Low power TTT combined with retrobulbar injection of TA shows good therapeutic effect on CEC.

AIM: To compare the efficacy of 577nm micro-pulse laser and drug in the treatment of central serous chorioretinopathy(CSC). METHODS: Forty-five CSC cases(45 eyes), in our hospital from January 1, 2012 to September 31, 2012, were received 577nm micro-pulse laser in laser group. Forty cases(40 eyes)got drug in drug group. The efficacy of two groups was compared.RESULTS: All eyes in laser group were cured at 6 weeks after treatment, which was shorter than that in drug group. CONCLUSION: 577nm micro-pulse laser treatment for CSC is safe and effective, and can reduce the recurrence of CSC.

AIM: To evaluate the curative efficacy of small incision cataract surgery(SICS)versus phacoemulsification(Phaco).METHODS: A computerized literature search was carried out in Chinese Biomedical Database(CBM), Wanfang Data, VIP and Chinese National Knowledge Infrastructure(CNKI)to collect articles published between 1989-2013 concerning the curative efficacy of SICS versus Phaco. The studies were assessed in terms of clinical case-control criteria. Meta-analysis were performed to assess the visual acuity, the complications rates between SICS and Phaco 90 days after surgery. Treatment effects were measured as risk difference(RD)between SICS and Phaco. Fixed and random effect models were employed to combine results after a heterogeneity test. RESULTS:A total of 8 studies were included in our Meta-analysis. At 90 days postoperative time, there were no significant differences between the two groups at the visual acuity >0.5(P=0.14); and no significant differences on the complications rates of corneal astigmatism, corneal edema, posterior capsular rupture and anterior iris reaction(P>0.05).CONCLUSION: These results suggest that there is no different on the curative effects of SICS and Phaco for cataract.

AIM: To investigate epidemiologic and clinical characteristics, complications, and visual outcomes of post-traumatic intraocular foreign body(IOFB).METHODS: Totally 78 patients with IOFB injury were retrospectively reviewed. Data on age, sex, activity at the time of injury, initial and final visual acuity, complications, surgical methods were recorded. Special attention was paid on risk factors for endophthalmitis.RESULTS: Male adults were the major population affected by IOFBs. Hammering was the most common activities at the time of injury. Explosive injury and posterior segment IOFB had bad final visual outcome. All of anterior segment IOFB was extracted, 93% posterior segment IOFBs was removed. Seven cases of endophthalmitis(9%)were found. Inflammation was controlled by vitrectomy combined with intraocular injection.CONCLUSION: When primary wounds were repaired appropriately and extensive antibiotics administered. Even though advancement in vitreoretinal surgery can reduce the frequency of blindness, further promotion and education on eye protection during work are needed.

AIM:To investigate the extubation time of indwelling epidural catheter in canalicular anastomosis. METHODS: Sixty-two patients(62 eyes)with traumatic lacerations of lacrimal canaliculi underwent canalicular anastomosis were divided into groups A, B, C according to the random number table. All patients received epidural anesthesia catheter canalicular anastomosis, the lacrimal extubation time in group A, B, C were 1 month, 2, 3 months after surgery. The outcomes and surgical complications of patients were compared. RESULTS: After surgery, there were no significant differences between the therapeutic effect of three groups(P>0.05). Compared with groups A and B, the proportion of tears point valgus and canalicular inflammation in group C were much significantly higher(P<0.05). CONCLUSION: One month is the best extubation time for indwelling epidural catheter in canalicular anastomosis. It can not only ensure the therapeutic effect, reduce complications, but also shorten the inconvenience time caused by indwelling catheters.

AIM: To analyze the factors of penetrating ocular injury, and to investigate the prognostic factors and treatment strategies. METHODS: A retrospective analysis of 216 ocular trauma patients(221 eyes), in our hospital from November 2009 to November 2011, was completed. RESULTS: The eyeball atrophy inevitably occurred in 13 eye wounds more than 30mm. Retinal prolapse of the eyes, 78%(35/45)completed vitrectomy, 33%(15/45)were eyeball atrophy. The 51%(20/39)of subchoroidal hemorrhage eyes were eyeball atrophy. Retinal prolapse and subchoroidal hemorrhage increased the risk of ocular atrophy(P<0.05). Scleral rupture of the eyes, 31%(30/96)completed scleral buckling condensation surgery, 51%(112/221)completed the vitrectomy and scleral silicone oil injection surgery. Final, 29%(64/221)eyes were no light perception. It reduced the rate of blindness(P<0.05).CONCLUSION: Serious ocular trauma prognosis related to many factors. The retina prolapse and the subchoroidal hemorrhage were important prognosis testify. A scleral buckling condensation surgery and vitrectomy have a therapeutic effect, and can improve visual function.

AIM: To evaluate the therapeutic effect of modified amnion and lmibal stem cell(LSC)comnined with mitomycin C(MMC)on recurrent pterygium. METHODS: Sixty-two patients(73 eyes)with recurrent pterygium in our hospital during January 2010 and May 2012 were divided into two groups. Thirty patients(35 eyes)in control group were treated with conventional amniotic membrane transplantation and 32 patients(38 eyes)in trial group were treated with modified amnion and LSC comnined with MMC. Postoperative amniotic fit, corneal epithelial healing, ocular surface and recurrence rates were observed in two groups.RESULTS: During the follow-up of 3-6 months(average 5 months), Tear film function were affected at early postoperative stage in control group, but in trial group, it was influenced slightly. Six months after operation, tear film function was recovered. Pterygium was recurrent in 8 eyes(22.9%)in control group and 2 eyes(5.3%)in trail group. CONCLUSION: The method of modified amnion and LSC combined with MMC can achieve a good therapeutic effect with fewer complications in recurrent pterygium treatment.

AIM: To evaluate the ocular manifestation of benign intracranial hypertension(BIH).METHODS: Retrospective case series was taken to study the clinical data of 21 patients(42 eyes)diagnosed with BIH at Xi'an No.4 Hospital from February 2002 to October 2011. Examinations included visual acuity, slit-lamp, fundus, fundus fluorescein angiography(FFA), cerebral angiography and brain imaging tests.RESULTS: Of 21 cases, there were 14 patients(67%)recognized by initial presentation of impaired vision prior to the diagnosis of BIH. Visual acuity: no light perception 1 eye(2%), hand motion to 0.1 in 5 eyes(12%), 0.2-1.0 in 16 eyes(38%), and 20 eyes(48%)above 1.0. The ocular examination revealed exotropia in 1 eye(2%)resulted from abducentparalysis. The fundus examination showed binocular papilledema in 10 cases(48%), monocular papilledema in one case(5%), optic atrophy in 3 eyes of 2 cases(10%), and nothing wrong in 8 cases(38%).CONCLUSION: Ocular manifestation of BIH is usually characterized by impaired vision and papilledema, and optic atrophy occurs at advanced stage. Some patients present with impaired vision at first. The prognosis could be improved if ophthalmologists know ocular characteristics of BIH and give timely and correct diagnosis and treatment.

AIM: To investigate the visual acuity of people over 50 years in ophthalmic clinic and visual impairment before and after refractive correction.METHODS: Totally 149 cases(298 eyes)of refractive error were examined and corrected using autorefractor and retinal optometry. The information of age, sex, economy, income and living standard were collected by questionnaire.RESULTS: Out of 149 cases(298 eyes), 281 eyes(98.6%)had refractive error. 119 eyes(42.3%)had myopia, 94 eyes(33.5%)had hyperopia and 68 eyes(24.2%)had mixed astigmatism. The mean visual acuity was 0.42±0.21 and 0.63±0.32 respectively before and after correction. Corrected visual impairment was in 186 eyes(65.3%). Old age, low education, low income and rural area were risk factors for visual impairment. CONCLUSION: Uncorrected refractive error is an important cause of visual impairment in elderly people. It can be promoted by refractive correction, which may benefit for their living quality.

Pirfenidone is a novel antifibrotic agent that has shown potential in numbers of models and clinical trials. Pirfenidone could inhibit cells proliferation through down-regulating a series of cytokines. Pirfenidone's antifibrotic effect and its safety have been established in organs such as liver, kidney and lung. Current application especially the department of ophthalmology and future researches on Pirfenidone were summarized in this literature.

AIM: To explore the relationship between diabetic macular edema(DME)and diabetic duration with visual acuity.METHODS:The clinical material examination results, diabetic duration and visual acuity on 40 DME patients diagnosed by fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)method were analyzed in this retrospective study. The relationship between various types of DME and above mentioned factors was also analyzed. RESULTS: Among 40 DME patients, 14 eyes(35%)were focal DME, diffuse DME in 20 eyes(50%)and cystoid macular edema in 6 eyes(15%). Significant correlations existed between the visual loss and the types of DME(r=-0.835, P=0.000). There was more damage to the visual acuity of patients with macular cystoid edema than those with focal DME. The diabetic duration was closely related to the types of DME(r=0.472, P=0.002). CONCLUSION: The DME are closely related to diabetic duration and visual acuity.

AIM: To investigate a Chinese autosomal dominant congenital cataract(ADCC)family and to find the relationship between the candidate gene and this pedigree. METHODS: The clinical data and blood samples of the ADCC family were collected.Microsatellite markers were chosen according to 24 known candidate genes of ADCC. Lod scores of microsatellite markers were calculated with Mlink package of linkage software. RESULTS: The phenotype of this family was nuclear cataract. After linkage analyzing,Lod scores of 50 microsatellite markers were less than zero. There was no linkage between the microsatellite markers and this pedigree.CONCLUSION: The related gene of this family is not among the known genes of ADCC maybe there is a new pathogenic gene in this pedigree.

AIM: To evaluate the effects, surgical indications, complications and technique of pneumatic retinopexy(PR)combined with postoperative laser photocoagulation for the emergency treatment of retinal detachment.METHODS: A review of 45 consecutive eyes of 45 patients who underwent PR for uncomplicated rhegmatogenous retinal detachment with superior retinal breaks at 6 o'clock and PVR stage lower than C from September 2011 to June 2012. Laser photocoagulation was performed at 24-48 hours after surgery. Primary and final anatomic outcomes, visual acuity, and adverse events were recorded. RESULTS: The follow-up period was 3-15 months, with the mean of 10 months. The single-procedure reattachment rate was 40 eyes(88.9%). Postoperative subretinal bubble in 2 eyes(4.4%), subretinal fluid was absorded delay in 3 eyes(6.7%). New retinal hole in 5 eyes(11.1%), became tractional detachment of retina in 2 eyes(4.4%), cataract aggravated in 1 eye(2.2%).CONCLUSION: PR with postoperative laser photocoagulation was applied to retinal detachment, which only with superior retinal hole and PVR stage be lower than C. Compared with vitreo-retinal surgery(V-R)and conventional scleral buckling(SB), PR closed retinal hole fleetly after found out rhegmatogenous retinal detachment. The requirements of therapeutic environment and armarium of PR are not so strict.The technique was simple. Treatment cost is cheap. But the single-procedure reattachment rate is low. It must be keep the posture with fidelity and follow up intimately.