AIM: To observe the clinical effect of transparent corneal incision phacoemulsification in cataract patients who had undergone different kinds of glaucoma filtration surgeries.METHODS: Totally 43 cases(50 eyes), in which 23 patients with primary angle-closure glaucoma(group A, 26 eyes)and 20 patients with primary open angle glaucoma(group B, 24 eyes), all had undergone glaucoma filtration surgery for more than 6 months. Visual acuity, intraocular pressure, slit lamp, gonioscope, corneal endothelial cell counts, etc., were done before surgery.And transparent corneal incision phacoemulsification combined with artificial lens implantation operation were preformed, postoperative follow-up of 3 to 12 months, visual acuity, intraocular pressure, corneal endothelial cell counts and vision field, etc. were observed and recorded.RESULTS: The visual acuity of 50 eyes(100%)increased with different degree postoperatively, 41 eyes(82%)with postoperative visual acuity ≥0.3; average preoperative intraocular pressure: group A 18.08±5.08mmHg(1mmHg=0.133kpa), group B 14.48±3.52mmHg; Postoperative follow-up average intraocular pressure: group A 13.65±3.51mmHg, group B 14.28±3.41 mmHg, intraocular pressure changed significantly pre and post-operation in group A(P<0.05), there was no significant difference between pre and post-operation in group B(P>0.05); Postoperative intraocular pressure of 1 eye in group A and 3 eyes in group B rose within three days post-operation, the intraocular pressure fluctuated between 21-33mmHg, with drug therapy and drug withdral when intraocular pressure epistrophy; Intraocular pressure was stable in the follow-up process.Corneal endothelial cell density: pre-operation group A was 2 293.57±352.24(cells/mm2), group B 2 658.14±458.69(cells/mm2), post- operation group A 2 175.95±379.16(cells/mm2), group B 2 442.97±477.30(cells/mm2), cell loss rate: 5.13% in group A, and 8.10% in group B. Postoperative visual acuity was related to vision field damage in patients, the more visual field damage, the longer the duration. CONCLUSION: Visual function restore is stable in transparent corneal incision phacoemulsification in cataract patients who underwent glaucoma filtration surgeries; the intraocular pressure can be controlled effectively, and can further reduce the intraocular pressure of angle-closure glaucoma. Preoperative comprehensive evaluation of the affected eye and appropriate technique selection are benefit to the improvement of operation effect and the reduction of complications.

AIM:To compare and evaluate the efficiency and safety of ozil torsional mode coaxial microphacoemulsification and conventional phacoemulsification in hard nuclear cataract.METHODS: It was a prospective and randomized clinical trial. A total of 209 eyes(209 cases)with grade 4 nuclear cataract were randomly assigned into either ozil torsional mode coaxial or conventional group(104 eyes)to undergo microphaco. Best-corrected visual acuity(BCVA), intraocular pressure(IOP), central anterior chamber depth(ACD), endothelial cell count(ECC)before operation and cumulative dissipated energy(CDE), esstimated fluied used(EFU)in operation and complications were recorded. BCVA, IOP, ACD and ECC at 1 day, 1 week, 1 month after operation were compared and statistically analyzed. RESULTS: The values of BCVA, IOP, ACD and ECC of experimental group were lower than those of conventional group before operation, there was no statistically significant differences(P>0.05). The values of CDE and EFU in ozil torsional mode coaxial group were less than that in the conventional group. The differences among two groups had statistical significance(P<0.05). The BCVA after the operation were improved in both groups, the ozil torsional mode coaxial group were better than the conventional group with the differences of BCVA≥0.3 at 1 day after operation(P=0.11). The ECC at 1 month after operation of two groups was obviously reduced(15%-30%)with a statistically significant difference in the degree of reduction.(P<0.05). CONCLUSION: The anterior chamber stability was better in ozil torsional mode coaxial microphacoemulsification for hard nuclear cataract, with a significant reduction in the ultrasonic energy and the phaco time. The method can reduce the amount of fluid used in operation, with less ECC loss after operation, which can promote the rapid recovery of vision.

AIM: To describe and compare ocular surface changes in type 2 diabetes patients treated either oral antidiabetic drugs(OAD)or insulin. METHODS: Forty eyes of twenty patients treated with OAD, 40 eyes of 20 patients treated with insulin and 10 non-diabetic controls seen at the Ministry of Health Ankara Educational and Research Hospital were studied. All subjects underwent routine ophthalmic examinations, Schirmer test, tear film break-up time analysis and conjunctival impression cytology analysis. Patients in three groups were compared for tear function parameters, goblet cell density and squamous metaplasia grade. The relation between status of retinopathy and ocular surface disorders were noted. RESULTS: The tear film break-up time values were significantly lower at patients treated with OAD(P<0.05). Goblet cell density and squamous metaplasia grade were similar at all groups. The median grade was grade 1 in which epithelial cells are slightly larger, more polygonal, have eosinophilic staining cytoplasm and goblet cells are decreased in number. Status of retinopathy did not seem to relate with ocular surface disorders. CONCLUSION: Precorneal tear film stability is found to be worse in patients treated with OAD whereas impression cytology analysis is similar in all groups.

AIM: To observe the expression of bone morphogenetic protein 7(BMP-7)during corneal wound healing in rats, and to discuss the effects of BMP-7 on corneal wound healing. METHODS: Totally 42 male Wistar rats were divided into seven groups, six rats in each group and one of the groups as control group. The experimental groups were made into cornea model by needle puncture at their corneas of right eyes. The corneas were surgically removed at six different time points(6h, 1d, 3d, 5d, 7d, 14d)after operation. The localization and expression of BMP-7 was determined by immunohistochemical methods and computer image analysis. RESULTS: The expression of BMP-7 of experimental groups gradually rose on the 1st day and 3rd day in the injured corneal epithelium after operation and significant difference(P< 0.05). Then it decreased gradually on the 5th day. And it reached the normal level on the 14th day.CONCLUSION: BMP-7 is expressed in cornea of rats and may play a negative role on corneal wound healing after injury.

AIM: To observe the predictability of corneal flap creation with the VisuMax femtosecond laser and preliminarily analyze the factors correlated to the thickness and diameter of the flap. METHODS: This retrospective case series study included 300 eyes of 150 consecutive patients. The eyes were assigned to two groups according to intended flap thickness, 100μm(204 eyes)and 110μm(96 eyes), which created with the VisuMax femtosecond laser. Intended flap diameters were 7.9mm and 8.3mm. Difference analysis of flap diameter and intended diameter as well as flap thickness and intended thickness were made. The data were analyzed with SPSS to sum up a multiple stepwise regression formula that could express their quantitative relationship. RESULTS: The 100μm flap group had an average flap thickness of 103.11±4.07μm, while for the 110μm group the average flap thickness was 113.35±5.71μm. The difference between right and left eyes was not statistically significant(t100μm =-0.901, t 110μm=-0.490; P>0.05). Corneal flap thickness was not related to flap diameter(r=0.003, 0.018; P>0.05), preoperative patient age(r=0.022, 0.050; P>0.05), corneal thickness(r=0.051, 0.101; P>0.05), keratometric value K(r=-0.048, -0.136; P>0.05)or intraocular pressure(r=-0.113, 0.047; P>0.05). Preoperative corneal keratometric value K was positively correlated with corneal flap diameter(r=0.359, 0.532; P=0.01, 0.007<0.05). CONCLUSION:The LASIK flap creation with the VisuMax femtosecond laser has relatively good predictability. There is no influencing factor for flap thickness.

AIM: To explore the clinical value of quantitative determination of aqueous flare in patients with uveitis by FM-600 laser flare cell meter(LFCM). METHODS:According to clinical manifestation, 129 patients(171 eyes)with uveitis were divided into 3 groups in our hospital from July 2009 to July 2010: 87 cases(87 eyes)in anterior uveitis group, 10 cases(20 eyes)in intermediate uveitis group, 32 cases(64 eyes)in posterior uveitis group. The other 50 cases(100 normal eyes)were in the control group. Flare in patients with uveitis at different stages was graded and measured by LFCM(FM-600)and slit-lamp microscope. RESULTS: Flare of grade 1+, 2+, 3+ and 4+ were noted in 48, 35, 2 and 2 eyes in anterior uveitis patients, respectively. LFCM examination revealed that the mean flare values in anterior uveitis eyes with flare of grade 1+ and 2+ were 28.6±6.7pc/ms and 144.3±28.1pc/ms, and 5.1±1.8pc/ms in the control group. In patients with flare of grade 3+ and 4+, LFCM readings were unreliable because of increased background noise. The differences between the two groups were statistically significant(P<0.05). There was significant correlation between slit lamp examination and LFCM measurement for flare of grade 1+ and 2+(r=0.901, P<0.01). Flare of grade 1+ and 2+ were noted in 10 and 10 eyes in intermediate uveitis patients, respectively. LFCM examination revealed that the mean flare values were 31.7±5.0pc/ms and 130.7±12.9pc/ms, and 5.1±1.8pc/ms in the control group. The differences between the two groups were statistically significant(P<0.05). There was significant correlation between slit lamp examination and LFCM measurement for flare of grade 1+ and 2+(r=0.867, P<0.01). Flare of grade 0 was noted in 64 eyes in posterior uveitis patients. LFCM examination revealed that the mean flare value was 9.8±3.1pc/ms which was higher than that in the control group(P<0.05).CONCLUSION:LFCM(FM-600)is able to evaluate precisely the mild and moderate breakdown of blood aqueous barrier in uveitis, therefore it provides an important parameter for the determination of inflammatory response in anterior segment and the clinical treatment of uveitis.

AIM: To evaluate the effects of sanxuemingmu capsule combined with compound anisoine in the ocular ischemic disease.METHODS: We divided our patient into two groups according to their blood-activating and stasis-dissolving drug using history at first, then divided them into observation/positive/negative control subgroups according to random case-control method. The clinical key data and advert effects after 3 cycles of treatment were obtained by visual acuity/visual field and color Doppler.RESULTS: The index of general effects/visual acuity/the general visual acuity loss/the artery/vein perfusion time of fundus fluorescein angiography(FFA)and color Doppler index(CDI)together with the advert effects rate of cardiovascular system of the observation groups were significantly better than those of the contrast groups.CONCLUSION: The combination of sanxuemingmu capsule with anisoine is effective in the ocular ischemic diseases and can lessen the cardiovascular advert effect rate of ocular ischemic diseases suffer while this administration method is more benefit in cases without blood-activating and stasis-dissolving drug using history than cases with drug using cases.

AIM: To research surgery effect and complications of transscleral suture fixation intraocular lens(IOL)assisted with endoscope or with the traditional method. METHODS: Thirty cases need IOL implantation without sufficient posterior lens capsule membrane support were chosen. These patients were divided into two groups randomly and every group had 15 patients. Group A underwent surgery of transscleral suture fixation IOL with the traditional method. Group B had surgery of transscleral suture fixation IOL assisted with endoscope. The surgical complications and postoperative effect were regularly observed and analyzed. RESULTS: All patients were successfully completed surgery. The mean naked visual acuity(NVA)of group A was 0.26±0.14(from 0.1 to 0.6)one month after operation. The mean NVA of group B was 0.37±0.16(from 0.15 to 0.8). The postoperative NVA of two group patients was improved different degree than preoperative NVA. The differences of postoperative NVA between the two groups had statistical significance(t=2.351, P<0.05). The mean best-corrected visual acuity(BCVA)of group A and group B were 0.45±0.13(from 0.3 to 0.6)and 0.47±0.14(from 0.3 to 0.8)one month after operation. The differences of postoperative BCVA between the two groups had statistical significance(t=1.327, P>0.05). Group A appeared more complications included 3 cases of corneal edema, 3 cases of uveitis, 4 cases of anterior chamber hemorrhage, 2 cases of vitreous hemorrhage, 3 cases of IOL deviation or tilted, 1 case of the peripheral iris anterior adhesion, 2 cases of elevated intraocular pressure. Group B appeared only a few minor complications including 5 cases of corneal edema, 2 cases of uveitis. CONCLUSION: With the help of endoscope for transscleral suture fixation IOL can ensure sutures fixed position is located in the ciliary sulcus, surgery complications decrease significantly and surgical effect is better compared with the traditional method.

AIM: To evaluate the efficacy and safety of Latanoprost/Timolol fixed combinations(LTFC)in treatment of refractory glaucoma following vitrectomy in short period.METHODS: In the present study, 42 eyes of 38 refractory glaucoma patients who had received vitrectomy were carried out. The patients were randomly divided into two groups after a 2-week washout period for previous antiglaucoma medication. Patients in group 1 underwent a 6-week treatment with LTFC and those in group 2 were treated with Latanoprost/Timolol unfixed combinations(LTuFC)for 6 weeks. The IOP, visual field, and mRNFL were measured after the washout period as the baseline, and after 6 weeks of therapy. Eye condition and adverse reactions were observed. RESULTS: The mean baseline IOPs of groups 1 and 2 were respectively 37.90±3.74mmHg and 37.57±3.23mmHg. After 6 weeks, the mean IOPs were respectively 30.10±4.90mmHg and 30.62±4.62mmHg, indicating a significant reduction from the baseline(t=12.16, t=13.78, P<0.01). No difference was observed in the IOP reduction between LTFC and LTuFC(20.54%±7.88%, 18.23%±7.03%, t=0.75, P>0.05). IOP reduction was 24.87%(20 eyes), 17.46%(15 eyes), and 9.65%(7 eyes)respectively among those with open-angle glaucoma, with partially open-angle glaucoma, and with closed-angle glaucoma. The eye drops didn't have effects on the vision field and mRNFL(all P>0.05), and their main adverse reactions were eye irritation and mild hyperemia.CONCLUSION: In refractory glaucoma, especially in open-angle or partially-open-angle glaucoma, LTFC, administered after vitrectomy, helps to reduce IOP with desirable safetly and tolerance.

AIM: To evaluate the effect of sharp-edged capsule tension ring(CTR)on posterior capsule opacification(PCO). METHODS: Twenty eyes of New Zealand white rabbits were randomly divided into two groups. After phacoemulsification, the experimental group was implanted with CTR and Crane OV-55C intraocular lens(IOL), and the control group was implanted with Crane OV-55C IOL only. Complications and PCO were observed by slit lamp microscope. Three months after surgery, light microscope and transmission electron microscope examinations were performed. RESULTS: There was no statistically significant difference between the experimental group and the control group about PCO and Soemmering's ring formation(P>0.05). Pathological evaluations revealed lens epithelial cells(LECs)accumulated at the equatorial capsule forming a large Soemmering's ring and abundant LECs were migrated onto the posterior capsule forming a thick layer in both experimental group and the control group. CONCLUSION: Sharp-edged CTR fail to retard PCO formation and development in rabbits and it is nessessary to improve it.

AIM: To observe the clinical effect of double-frequency 532nm laser on retinal hole in 62 cases 68 eyes with high myopia >-6.00D.METHODS: Totally 68 consecutive eyes diagnosed of retinal hole associated with high myopia >-6.00D accepted double-frequency 532nm laser therapies. The situation of retinal hole and the occurrence rate of retinal detachment were observed. RESULTS: After the follow up of 6-24 mouths, 65 retinal holes were closed successfully among 68 cases(96%), and 3 cases(4%)got retinal detachment and undergone, underwent vitreous retinal surgery finally. CONCLUSION: Double-frequency 532nm laser is a safe, effective tool in treatment of retinal hole associated with high myopia >-6.00D.

AIM: To analyze the cause and management of shallow anterior chamber after glaucoma surgery.METHODS: The cause and management of shallow anterior chamber after glaucoma surgery on 298 cases(462 eyes)were analyzed retrospectively.RESULTS: In 298 cases(462 eyes), 99 eyes(21.4%)had shallow anterior chamber. In 358 eyes treated with trabeculectomy, 77 eyes(21.5%)had shallow anterior chamber. In 85 eyes treated with trabeculectomy+MMC(mitomycin C), 20 eyes(23.5%)had shallow anterior chamber. In 19 eyes treated with trabeculectomy combined with cataract phacoemulsification and intraocular lens implantation, 2 eyes(10.53%)had shallow anterior chamber. Shallow anterior chamber appeared at 1 day to 5 days postoperatively. Forty-two eyes(42.4%)were with excessive filtering, 6 eyes(6.1%)with malignant glaucoma, 29 eyes(29.3%)with choroidal detachment, 2 eyes(2.0%)with malignant glaucoma complicated by choroidal detachment. Of 99 eyes with shallow anterior chamber, anterior chamber of 79 eyes recovered treated by nonsurgical methods, 20 eyes treated by operation.CONCLUSION: The common cause of shallow anterior chamber after glaucoma surgery was preoperative high intraocular pressure, inflammation, excessive filtering, conjunctival flap flushing and choroidal detachment. Most cases can be managed with nonsurgical methods. Surgical interference should be taken if necessary.

AIM:To investigate the reasons of the barriers to free cataract surgery in suburban area of one city in middle China. METHODS: From 2008 to 2009, in Sight Rehabilitation Programme of Cataract in suburban district of one city in middle China, all visually significant cataract patients screened were questioned about why he/she did not accept free cataract surgery. The answers were recorded and analyzed. RESULTS: Of 892 screened patients, only 387 patients(43.39%)wanted a free cataract surgery at first. At last 490 patients(54.93%)accepted free surgery. The main reasons for patients who did not accept free surgery include: be afraid of surgery and wanting other treatments(193, 21.64%), thinking the eyesight was enough for daily life(148, 16.59%), worrying about that the result would not be good as those paid for surgery(147, 16.48%), and other reasons(17, 1.91%).CONCLUSION: The reasons of the barriers to free cataract surgery include patients' ignorance, surgery outcome of patients around, and working mode of designated surgical hospital.

AIM: To evaluate the clinical effect of photocoagulation with 532nm frequency-doubled laser in patients with retinal hole.METHODS: Seventy-two cases(78 eyes)with retinal holes were treated with 532nm frequency-doubled laser. All the eyes were divided according to the quadrants of location of retinal holes and the size of retinal hole and existence of local retinal detachment accompanying retinal holes. Statistical analysis was made on these data.RESULTS: 1)The retinal holes were located in the upper quadrants of retina in 44 eyes and there were also retinal holes located in the lower quadrants of retina in 31 eyes(there were 3 eyes with retinal holes both located in the upper and lower quadrants of retina, which were not included in control group). The difference of photocoagulation effect between the two groups was statistically significant. 2)The retinal holes diameter ≤2 papilla diameter(PD)were present in 37 eyes, the holes diameter of retina >2PD were seen in 41 eyes, the difference of photocoagulation effect between the two groups was statistically significant. 3)Retinal holes without local retinal detachment were observed in 45 eyes, retinal holes with local retinal detachment were seen in 33 eyes, the difference of photocoagulation effect between the two groups was statistically significant.CONCLUSION:Photocoagulation with 532nm frequency-doubled laser is effective and safe to treat retinal holes. The effect is better in patients with retinal holes in the upper quadrants and with the retinal holes diameter ≤2PD and without local retinal detachment.

Cataract with high myopia is research priority associated with the large amount of high myopia patients. The unaided visual acuity and the best-corrected visual acuity are partial for the visual acuity of the patients with cataract. The mechanism and clinical significance of modern visual function measurements associated with cataract and high myopia, including accommodation and convergence, stereoscopic vision, contrast sensitivity, have been introduced. These measurements could be of great value in early diagnosis of cataract, assessment of surgical indication, customized intraocular lens(IOL)selection and evaluation of visual performance after IOL implantation. They could also be helpful to the analysis of postoperative impaired visual function and its management. Having an adequate understanding of the contents and significance of visual function was helpful to the improvement of cataract surgery techniques and postoperative visual acuity.

As a routine measure to prevent intraocular inflammation, rinsing conjunctival sac with povidone-iodine(PVP-I)has been increasingly adopted in cataract surgery. It can effectively reduce the complications of cataract surgery, including endophthalmitis and corneal complications. However, PVP-I itself has certain side effects. Therefore, to achieve the best bactericidal effect and to avoid eye injury, it is necessary to find out the optimal treatment duration and concentration. This article offers a review on the latest researches worldwide in this field.

AIM: To observe the clinical effect of super quantity of binocular medialrectus in treating large angle concomitant esotropia.METHODS: Eighty-one patients with large angle concomitant esotropia were analyzed retrospectively. According to the operation method, they had been divided into observation group(large recession of rectus muscle)and control group(normal recession of rectus muscle). The number of muscle were evaluated, eye's position and involution function in a week and a year after operation were also evaluated.RESULTS:Forty-three cases in observation group had binocular medial rectus treatment, while 5 cases had binocular medial rectus+monocular medial rectus muscle resection treatment. Six cases in control group had the surgical treatment of bilateral medial rectus recession, 21 cases had binocular medial rectus+monocular medial rectus muscle resection and 6 cases with binocular medial rectus+bilateral lateral rectus shortening. The difference of the muscles' numbers of two groups in operation had statistical significance(χ2=41.72, P<0.01). One week after the operation, eye position of observation group was -2△～+12△, the average was +6.52△±3.23△, while that of control group was -3△～+10△, the average was +5.38±2.46△. The difference of two groups had no statistical significance(t=1.45, P=0.08). One year after operation, eye positions of observation group and control group were -5△～+10△(average: +4.57△±2.71△)and -5△～+8△(average: +3.92△±2.15△). The difference of two group had no statistical significance(t=1.23, P=0.10). One week after the operation, 14 cases of observation group and 6 cases of control group's involution function were limited. One year after operation, 5 cases of observation group and 2 cases of control group's involution function were limited. The differences of two group had no statistical significance(χ2=1.27, P>0.05; χ2=0.47, P>0.05).CONCLUSION: Super quantity of medial rectus recession in treating large angle concomitant esotropia can reduce the muscle's number, but it has no obvious influence on eyeball's involution function.

The refractive status of peripheral retina, also called peripheral refraction, is the abnormal refraction in the peripheral visual field which has a certain off-axis and off-fixation angle over 30°. Animal experiments and human studies suggest that the refractive status of peripheral retina has a close relationship with myopia. Peripheral relatively hyperopia diopter can influence the myopic degree. People in different ages with the refractive status of relatively hyperopic are risk factors for myopia onset, and may be one of risk factors for myopia progression. Peripheral myopic defocus might prevent axial elongation, so as to control the myopia progression, and promote the visual acuity. This article aims to summarize the recent findings about the influence of peripheral refraction on the onset, progression and control of myopia and its relationship with eye shape, accommodation, and heritability.

AIM: To observe the clinical features of paralytic strabismus and analyze its etiology.METHODS: Eighty-nine cases(97 eyes)were diagnosed with paralytic strabismus and recruited in this study in the Department of Ophthalmology, the Fourth Affiliated Hospital, China Medical University between July 2008 and February 2013. The clinical data were recorded including the general and ophthalmic history, symptom, visual acuity, fundus, pupil, eyelid, visual field, eye movement, synoptophore, acting countervail head, ultrasound of eyeball and ocular muscle, color Doppler ultrasonography of the carotid artery, orbital computed tomography(CT), brain magnetic resonance imaging(MRI), blood biochemistry and immunologic tests.RESULTS: The medical history disclosed that among these cases, hypertension in 36 cases, diabetic mellitus in 28 cases, hyperlipidemia in 19 cases, heart diseases in 17 cases, ischemic cerebrovascular disease in 12 cases and hyperthyroidism in 3 cases. Symptoms included vertigo in 47 cases and binocular temporal amaurosis in 36 cases. The horizontal restriction was manifested in 38 cases 45 eyes, vertical restriction in 42 cases with 42 eyes, and horizontal-and-vertical restriction in 9 cases with 10 eyes. CONCLUSION: Brain vascular ischemic disease is one of the top reasons causing paralytic strabismus. Systemic disease history was found in a high proportion of the cases. It is of great essence to detect the life-threatening ischemia of vertebrobasilar artery system and take priority for treatment.

AIM: To investigate the difference of central corneal thickness(CCT)measured by Lenstar LS900, OrbscahⅡ system and ultrasonic pachmetry, and to evaluate the correlation and consistency of the results for providing a theoretical basis for clinical application.METHODS: The mean value of CCT in 70 eyes of 35 patients measured three times by Lenstar LS900, OrbscahⅡ system and ultrasonic pachmetry underwent statistical analysis. The difference of CCT was compared, and the correlation and consistency of three measurements were analyzed to provide theoretical basis for clinical application. CCT values measured by different methods were analyzed with randomized block variance analysis. LSD-t test was used for pairwise comparison between groups. The correlation of three measurement methods were analyzed by linear correlation analysis, and Bland-Altman was used to analyze the consistency.RESULTS: The mean CCT values measured by Lenstar LS900, OrbscanⅡ and ultrasonic pachmetry were 542.75±40.06, 528.74±39.59, 538.54±40.93μm, respectively. The mean difference of CCT measurement was 4.21±8.78μm between Lenstar LS900 and ultrasonic pachmetry, 14.01±13.39μm between Lenstar LS900 and Orbscan Ⅱ, 9.8±10.57μm between ultrasonic pachmetry and Orbscan Ⅱ. The difference was statistically significant(P<0.05). Three measurements were highly correlated(P>0.05): There was positive correlation between CCT with Lenstar LS900 and ultrasonic pachmetry(r=0.977, 0.944; P<0.05). The analysis method of Bland-Altman: 95% consistent interval of upper and lower value was -13.0～21.4μm between Lenstar LS900 and ultrasonic pachmetry, 1.4% points outside the limits of agreement of 95%, 95% consistent interval of upper and lower value was -30.5～10.9μm between OrbscanⅡ and ultrasonic pachmetry, 7.1% points outside the limits of agreement of 95% consistent interval. CONCLUSION: There are excellent correlation among Lenstar LS900, Orbscan Ⅱ and ultrasonic pachmetry. Lenstar LS900 can be used as CCT non-contact measurement tool.

AIM: To study the effect and safety of applying mitomycin C(MMC)in laser subepithelion keratomileusis(LASEK)surgery of middle or high myopia to prevent the formation of haze under corneal epithelium. METHODS: Totally 120 patients(240 eyes)for LASEK surgery were selected randomly, the right eyes were set as test group, and the left eyes as control group. The eyes in control group underwent general LASEK, while for the test group, a filter paper with 0.2g/L MMC solution was covered on the corneal stroma bed after the laser ablation. The postoperative symptom, epithelial flap, recorrected visual acuity, haze formation were investigated.RESULTS: There was no statistical difference of ocular irritation symptom and corneal epithelium healing time between the two groups. For the test group the grade 0 haze was found in 105 eyes(87.5%)by 1 month, in 80 eyes(66.7%)by 3 months, in 96 eyes(80.0%)by 6 months, while for the control group in 62 eyes(51.7%)by 1 month, in 39 eyes(32.5%)by 3 months, in 68 eyes(56.7%)by 6 months, there was statistically significance. Uncorrected visions were more than 1.0 in 91 eyes(75.8%)for the test group, while in 51 eyes(42.5%)for the control group in 6 months after operation, there was statistically significance(P<0.05).CONCLUSION: The application of 0.2g/L MMC during LASEK for treatment of middle or high myopia was a safe and effective treatment. It could reduce the formation of haze.

AIM: To observe the changes of visual functional status at different diopter degrees and to research the correlatively objective sensitive indications among diopter degrees, visual function and morphological damage at early stage in high myopia.METHODS: Low vision course(LVC)in vision center, macular course(M2, C08, TG2), the index that can reflect the state of visual function in visual electrophysiology system were used to make qualitative and quantitative observation, including single cones-electroretinogram(ERG), 30Hz flicker ERG, P-VEP, 1, 2 rings at first kernel response of multifocal ERGRESULTS: Vision light sensitivity was decreased with the increase of diopter. P-VEP in visual electrophysiology, single cones cells, b wave of 30Hz flicker ERG, amplitude density of 1 and 2 rings, b wave in 1 ring, and latencies of a, b wave in 2 ring were all decreased(P<0.05). The results of stepwise multiple regression analysis indicated that diopter value had negative correlation with axial and single cone b-wave latency, and had positive correlation with P-VEP amplitude.CONCLUSION: Vision, visual electrophysiology amplitude can detect the effect of different diopter on retinal function at early stage.

AIM: To investigate the expressions time and the position of VEGF and PEDF in the retina and choroid of diabetic rats and compare them with the expressions in the normal rats. METHODS: Healthy male Wistar rats were selected and randomly divided into diabetic group and normal group(M0). Type 1 diabetes rat model was induced by being injected of large-dose streptozotocinum(STZ)into abdominal cavity. The retina and choroid of rats was obtained to detect the VEGF and PEDF expressions by immunohistochemistry at 1st(M1), 2nd(M2), 3rd(M3), 5th(M5)month after diabetes induction. RESULTS:VEGF expression in retina and choroid of rats had no obvious difference between M1and M0. M2 VEGF expression in choroid was positive(33.3%), while in retina was not significantly different with M0. M3 VEGF expression in choroid was positive(55.6%), and in inner nuclear layer and ganglion cells layer of retina was positive(33.3%). M5 VEGF expression in choroid was and the whole retina positive(88.9%). PEDF expression in retina of rats had no obvious difference between normal group and M1, M2 group, and there was no PEDF expression detected in choroid of all the groups. In M3 and M5 group, PEDF expression in retina was lower than M0, the expression gradually weakened with the extension of the course(P<0.05), and there was also no PEDF expression detected in choroid of all the groups. The ratio of VEGF/PEDF gradually increased with the extended duration of diabetes, and there was significant difference compared with M0(P<0.01)CONCLUSION: The expression of VEGF and PEDF in retina of rats was related with the diabetes course, VEGF expression in retina and choroid was increased, while PEDF expression was gradually decreased in the course. There was no PEDF expression in choroid, it might because the experimental model was not in proliferative stage.

AIM: To explore and compare the effects of trabeculectomy, mitomycin C(MMC)trabeculectomy and sclera pool trabeculectomy on life quality of patients with glaucoma. METHODS: Totally, 60 patients(60 eyes)with glaucoma were divided into group A, B and C equally and randomly. Twenty patients(20 eyes)in group A received treatment of traditional trabeculectomy; Twenty patients(20 eyes)in group B received MMC trabeculectomy; while twenty patients(20 eyes)in group C received sclera pool trabeculectomy. One-year follow study was proposed, Chinese version low vision quality of life questionnaire(CLVQOL)and self- assessment score were used to evaluate effects of surgeries on life quality of patients. RESULTS: Compared with group A, scoring of CLVQOL increased significantly in group B and C, and more significantly in group C(distant vision, movement, sensitization and fine work)when compared with group B(P<0.05). Compared with group A, scoring of self assessment increased significantly in group B and C, more significantly in group C(vision self scoring and subjective brightness scoring)when compared with group B(P<0.05). CONCLUSION: The improvement effect of sclera pool trabeculectomy on life quality of patient with glaucoma is better than traditional and MMC trabeculectomy.

AIM: To compare changes of anterior capsular opening size between complicated and simple cataract patients who underwent phacoemulsification and foldable IOL implantation.METHODS:Patients complicated with high myopia, primary angle-closure glaucoma(PACG), diabetic cataract and simple cataract(control group)were selected, 25 case in each group. All patients accepted phacoemulsification by the doctor with operation experience of more than 5 000 cases, and the same 1-piece hydrophilic acrylic IOL was implanted without any complicated happened. The measured value about anterior capsular area by Image-pro plus 6.0 was greater than 23mm2. Every patient was checked regularly through dilated pupil, take photos by slit-lamp camera and area was measured after operation 1 week, 1 month, 3 and 6 months, then to record the biological changes about anterior capsular in 4 groups.RESULTS: The average anterior capsular area in 4 groups 1 week after operation had no difference(P>0.05); No difference was found between simple and complicated high myopia group 6 months after operation(P>0.05). Capsule contraction was observed in complicated POAG group 3 months after operation and in diabetes mellitus group 6 months postoperatively, the average anterior capsular area become smaller than 1 week postoperatively(P<0.05). CONCLUSION: Cataract patients who complicated PACG or diabetes mellitus maybe the high-risk groups, capsule contraction will be happened 1 month after operation. For high-risk groups, we should prolong the follow-up time, enrich the observation data, and provide the clinical basis for reasonable and preventive intervention.

AIM: To evaluate the efficiency of 532nm laser photocoagulation in treating diabetic retinopathy.METHODS: Totally 96 eyes in 48 diabetic cases, including 54 eyes with preproliferative diabetic retinopathy(PPDR), 42 eyes with proliferative retinopathy(PDR)(20 eyes with high-risk PDR, 22 eyes with non-high-risk PDR), and 21 eyes with macular edema, were treated with 532nm laser photocoagulation. According to DR stage and severity, the patients had received the treatment of subpanretinal photocoagulation(Sub-PRP), standard panretinal photocoagulation(S-PRP), extra panretinal photocoagulation(E-PRP), local photocoagulation and grid pattern photocoagulation. All cases were followed-up for 3 months to 4 years, and visual acuity and retinopathy changes were observed. Further photocoagulation was performed when necessary.RESULTS: Visual acuity was improved or maintained in 45 eyes(83%)in the group of PPDR, 18 eyes(82%)in the group of non-high-risk PDR, 12 eyes(60%)in the group of high-risk PDR. As to the retinopathy development, edema, exudation and bleeding absorption in the retina, as well as partial or entire vanishment to retinal neovascularization, were considered as effective outcome. The effective data were 50 eyes(93%)in the group of PPDR, 19 eyes(86%)in the group of non-high-risk PDR, 13 eyes(65%)in the group of high-risk PDR.CONCLUSION: In treating diabetic retinopathy, 532nm laser photocoagulation is effective and safe. Better effect can be achieved in early stage. Early discovery and treatment, attention to photocoagulation methods and skills, regular follow-ups and timely supplement of photocoagulation, are the key points for improving the effect of retinal photocoagulation.

AIM: To study the effects of estrogen on the expression of matrix metalloproteinases-1(MMP-1)and tissue inhibitor of matrix metalloproteinase-1(TIMP-1)in lacrimal gland of ovariectomized rat. METHODS:A total of 60 female rats were examined for the expression of MMP-1 and TIMP-1 protein in lacrimal gland through SⅠt measurement together with Western- blot and RT-PCR methods.RESULTS:There was significant reduction in SⅠt and increase in the protein expression of MMP1, TIMP1 and mRNA after ovariectomy conducted on rats(P<0.05). After estrogen treatment, there was significant reduction in SⅠt and increase in the expression of MMP1, TIMP1 and mRNA as compared with before treatment(P<0.05).CONCLUSION: Estrogen must be applied cautiously to treat xerophthalmia following menopause because estrogen can up regulate the expressions of MMP-1 and TIMP-1 and can aggravate the decrease of lacrimal secretion.

AIM: To explore the relationship between retinal thickness changes in different macular sections and decrease of visual function in myopia after laser in situ keratomileusis(LASIK).METHODS: The retinal thickness in different macular sections of patients after LASIK was measured by Cirrus high spectral domain optical coherence tomography(HD-OCT). The contrast sensitivity function(CSF)was measured by OPTEC 6500. The results were analyzed by correlation analysis.RESULTS: The retinal thickness in different macular sections outside fovea was positively correlated with the CSF of different spatial frequencies.CONCLUSION: The decreased CSF of different spatial frequencies results from the changes of retinal thickness at different macular regions outside fovea.

AIM: To evaluate the efficiency of 532nm laser photocoagulation in treating diabetic retinopathy.METHODS: Totally 96 eyes in 48 diabetic cases, including 54 eyes with preproliferative diabetic retinopathy(PPDR), 42 eyes with proliferative retinopathy(PDR)(20 eyes with high-risk PDR, 22 eyes with non-high-risk PDR), and 21 eyes with macular edema, were treated with 532nm laser photocoagulation. According to DR stage and severity, the patients had received the treatment of subpanretinal photocoagulation(Sub-PRP), standard panretinal photocoagulation(S-PRP), extra panretinal photocoagulation(E-PRP), local photocoagulation and grid pattern photocoagulation. All cases were followed-up for 3 months to 4 years, and visual acuity and retinopathy changes were observed. Further photocoagulation was performed when necessary.RESULTS: Visual acuity was improved or maintained in 45 eyes(83%)in the group of PPDR, 18 eyes(82%)in the group of non-high-risk PDR, 12 eyes(60%)in the group of high-risk PDR. As to the retinopathy development, edema, exudation and bleeding absorption in the retina, as well as partial or entire vanishment to retinal neovascularization, were considered as effective outcome. The effective data were 50 eyes(93%)in the group of PPDR, 19 eyes(86%)in the group of non-high-risk PDR, 13 eyes(65%)in the group of high-risk PDR.CONCLUSION: In treating diabetic retinopathy, 532nm laser photocoagulation is effective and safe. Better effect can be achieved in early stage. Early discovery and treatment, attention to photocoagulation methods and skills, regular follow-ups and timely supplement of photocoagulation, are the key points for improving the effect of retinal photocoagulation.

AIM: To study the correlation between visual display terminal(VDT)exposure time and ocular symptoms.METHODS: By use of questionnaire, a survey was carried out in 1218 undergraduate students from 3 universities in Zhuhai to find out their VDT exposure time and their eye symptoms. VDT exposure time at different grades and ocular symptom scores in different exposure intensity crowd were compared, the relationship between VDT exposure time and ocular symptoms were investigated.RESULTS: On average, VDT exposure time in all students of the three universities was 3.72±2.17h, the mean exposure time increased with grade. And the ocular symptoms scores increased with exposure time, VDT has a positive correlation with VDT exposure time.CONCLUSION: Long-time exposure to VDT is harmful to visual health, eye health education should be strengthened to avoid or reduce the health damages caused by VDT exposure.

AIM: To analyze the progress in ophthalmic epidemiology and prevention of blindness research between 2001-2010 through bibliometric approach.METHODS: This research used Chinese Science Citation Database(CSCD)for statistical sources, and retrieved ophthalmic epidemiology and prevention of blindness literatures during 2001-2010. The data were analyzed by bibliometric statistical methods.RESULTS: Within the CSCD statistics, there were 179 ophthalmic epidemiology and prevention of blindness literatures which had a linear upward trend. “Chinese Journal of Ophthalmology” and “International Eye Science” were the largest number of published journal literatures. Professor Zhao Jialiang has reported most literatures in all experts, whose publication “Prevalence of glaucoma and normal intraocular pressure among adults aged 50 years or above in Shunyi county of Beijing” in 2002 as the single most frequently cited paper, blindness and low vision study were in the most research, diabetic retinopathy in fundus study occupied a large proportion of epidemiological studies.CONCLUSION:Ophthalmic epidemiology and prevention of blindness research has become a focus of eye scientific research.

AIM: To explore the application feasibility of problem-based learning(PBL)teaching mode in ophthalmology class in medical colleges of China.METHODS: Totally 157 students of class 2009 in Yangtze University majoring in clinical medicine were surveyed by questionnaires.RESULTS: The survey showed that 77.9% of students thought that traditional teaching methods of ophthalmology classes were quite satisfying. 82.8% of them considered it necessary to introduce the new teaching mode. 83.4% of them would choose PBL teaching mode between the traditional teaching mode and PBL teaching mode. 56.6% of them thought that PBL teaching mode was conducive to students' self-learning ability. The subjective and objective conditions made the exploration of PBL teaching modes feasible. However, there were disadvantages of PBL teaching mode. 73.1% of students thought the school teaching facilities were not enough, 78.6% of students thought that only part of the content of ophthalmology teaching was suitable for using PBL teaching mode.CONCLUSION: PBL teaching mode should be continuously explored and studied in the future ophthalmology teaching, in order to create suitable for China's national conditions of ophthalmology teaching mode.

AIM: To assess the vision-related life quality of patients with thyroid associated-ophthalmopathy(TAO)accompanied by intraocular hypertension and to analyze the relevant factors. METHODS: Altogether, 90 TAO patients with intraocular pressure(TAO group)and 90 normal persons(control group)were involved in the investigation. With vision function(VF)questionnaire, their visual perception, peripheral vision, sensory adaptation and depth perception were assessed. With quality of life(QOL)questionnaire, their self-care ability, mobility, social and mental status were assessed. For each group, the total score of VF/QOL and scores of each scale were calculated.RESULTS: The average total score of VF/QOL in the TAO group was(89.93±8.9, 92.89±5.91)points, which was significantly lower than that in control group(98.18±4.06, 99.21±1.87)points(P<0.01). Except peripheral vision(Z=-0.65, P=0.52), the scores of any other scales in VF in the TAO group were significantly lower than those in control group(P<0.01). Scores of all scales in QOL in the TAO group were remarkably lower than those in control group(P<0.05). In the multiple linear regression analysis, the VF scores were significantly correlated with “NO SPECS'' classification and psychological factors instead of ocular hypertension, age and course of disease, while the scores of QOL were correlated with education background. CONCLUSION:The VF/QOL in patients with TAO and ocular hypertension is lower, the VF scores were significantly correlated with “NO SPECS” classification instead of ocular hypertension. Intraocular pressure does not affect the vision-related QOL of patients with TAO. The “NO SPECS” classification only affects the scores of VF rather than those of QOL.

AIM: To explore clinical effect and influence factors of upper eyelid blepharoplasty combined with levator aponeurosis plication in general anesthesia for mild congenital ptosis in children.METHODS: According to relevant data before operation 40 eyes of 37 cases of children with mild congenital ptosis were treated with upper eyelid blepharoplasty combined with levator aponeurosis plication in general anesthesia. The clinical data were recorded and analyzed, the effect was evaluated.RESULTS: In the 40 eyes of 37 cases, the satisfactory rate was 78%(31 eyes), 5 eyes(12%)were under-corrected, 1 eye(2%)was over corrected, 3 eyes(8%)were return to back.CONCLUSION: The effect is affirmative that upper eyelid blepharoplasty combined with levator aponeurosis plication in general anesthesia treated the mild congenital ptosis in children, it is one of main methods for treating mild congenial ptosis in children.

AIM: To explore the expression and clinical significance of chemotactic factor receptor-3(CXCR3)of female patients conjunctival with dry eye at perimenopause. METHODS: Thirty dry eye case(60 eyes)in the patient at perimenopause of the First Affiliated Hospital of Xinjiang Medical University and thirty dry eye cases(60 eyes)in patient at non-perimenopause were selected. The conjunctival epithelial cells at perimenopause and non-perimenopause in dry eye cases were obtained by impression cytology methods, and then immersed into the centrifugal tube with corresponding number respectively and the expression of CXCR3 in conjunctival epithelium of at perimenopause and non-perimenopause in dry eye cases were detected by flow cytometry. RESULTS: The break-up time(BUT)and Schirmer Ⅰ test result of perimenopause was significantly lower than those of non-perimenopause(F=4.076, 5.023; P<0.05). Positive expression rate of CXCR3 at non-perimenopause in dry eye cases was more obvious than that at perimenopause in dry eye syndrome cases(P<0.01). Expression rate of CXCR3 in dry eye cases was negatively correlated with BUT and Schirmer Ⅰ test(r=-0.753, r=-0.684; P<0.05). However, it was non-related with corneal fluorescence staining(P>0.05).CONCLUSION: CXCR3 plays an inflammatory mediators role in dry eye mechanism and its expression level reflects the progress of dry eye at perimenopause.

AIM: To analyze the clinical manifestations and etiological factors of high myopia in 320 cases. METHODS:A total of 320 patients(640 eyes)with high myopia treated in Ningxia Eye Hospital from January 2011 to November 2012 were studied. All of them underwent thorough eye examination and relevant environmental factors were recorded. The following data were analyzed, including gender, ethnicity, age of onset, refractive error, axial length, best corrected visual acuity(BCVA), educational level and living environment. RESULTS: Bilateral high myopia was present in 320 patients(130 men and 190 women; 250 being of Han nationality and 70 of Hui nationality)with a mean age of 42.65±16.51 years(range: 3-80 years); the male to female ratio was 1:1.5. The age of onset was lower than 20 years in 237 patients, higher than 21 yeas in 83 patients, the difference was statistically significant(P<0.001). There was no significant difference between diopter and educational level(P>0.05). The patients with BCVA higher than 0.3 increased with diopter increased, while BCVA lower than 0.8 and between 0.4～0.7 reduced. Refraction was significantly negatively correlated with BCVA(r=-0.196, P<0.05)and positive correlated with axial length(r=0.681, P<0.05). CONCLUSION: In the study, patients with high myopia tend to have early onset, low educational level, and spacious living environment. Such results indicate that the genetic factors may be the main cause of high myopia in this group. The higher the degree of myopia was, the worse BCVA and the longer AL would be.

AIM: To investigate the effect of improved irrigation for hyphema in the treatment of severe contusion hyphema.METHODS: Totally 106 patients with severe contusion hyphema underwent viscoelastican and irrigation for hyphema through tunnel incision with urokinas. RESULTS: The hyphema was clear in all patients but 2 cases were rebleeding. The surgery method was superior to the conventional operation in the aspects of vision, intra-ocular pressure and complication.CONCLUSION:Improved irrigation for hyphema could be extended, the operating methods is simple, safe and effective.

AIM: To analyze the higher-order aberrations of anterior corneal surface in patients with subclinical keratoconus.METHODS: Forty-three eyes with the diagnosis of subclinical keratoconus(KCS group, mean age 25.32±4.18 years)and 60 normal eyes(control group, mean age 24.63±4.82 years)were included in this study. Corneal higher-order aberrations in each eye were measured by OPD Scan ARK-10000. Root mean square(RMS)values were calculated for total higher-order aberrations(HOAs), total coma(TC), total trefoil(TT)and total spherical aberration(TS)in 3mm and 6mm central area. The aberrometric parameters were respectively compared between two groups by Student's t-test.RESULTS: In 3mm central area, the RMS of corneal HOAs, TC, TT and TS were 0.424±0.175μm, 0.113±0.068μm, 0.262±0.132μm, 0.016±0.010μm respectively in KCS group, while those in control group were 0.310±0.093μm, 0.070±0.038μm, 0.244±0.106μm, 0.019±0.016μm respectively, the differences were statistically significant in HOAs and TC(t=3.896, 3.748; P=0.000, 0.000), except for TT and TS(t=0.740, 1.169; P=0.231, 0.124). In 6mm central area, the RMS of corneal HOAs, TC, TT and TS were 0.987±0.292μm, 0.642±0.260μm, 0.487±0.208μm, 0.292±0.145μm respectively in KCS group, while that in control group were 0.587±0.146μm, 0.252±0.113μm, 0.337±0.182μm, 0.271±0.065μm respectively, the differences were statistically significant in HOAs, TC and TT(t=8.273, 9.231, 3.800; P=0.000, 0.000, 0.000), except for TS(t=0.888, P=0.191).CONCLUSION: The corneal higher-order aberration, especially TC, is significantly higher in subclinical keratoconic eyes than in normal eyes. It may be a potential diagnostic tool for subclinical keratoconus.

AIM: To study the cause of endophthalmitis and the effect of vitrectomy on endophthalmitis.METHODS: We retrospectively analyzed records of 16 cases(16 eyes)of endophthalmitis from January 2010 to December 2012, 13 males, 3 females. The patients' ages ranged from 42 to 82 years old(mean 60 years). Five patients received evisceration therapy, all the other patients underwent pars plana vitrectomy. RESULTS: Endophthalmitis was diagnosed as resulting from eye injuries in 8 eyes, endogenous endophthalmitis in 2 eyes, cataract surgery in 2 eyes, glaucoma surgery in 2 eyes, keratitis in 1 eye, hypermature stage cataract phacoanathylactic endophthalmitis in 1 eye. The postoperative visual acuities of 8 patients increased in various degrees. Six patients(55%)were out of blindness(visual acuity >0.05). CONCLUSION: Eye injury is the most common cause of endophthalmitis, and vitrectomy can recover the visual function of the patients to different levels.

After mammalian peripheral nerve injury, axons can regenerate very long distance. In certain conditions, the central nervous system can also partially regenerate after damage. Nogo has been proved to be one of the myelin-associated inhibitors, after central nerve injury increased Nogo release, enhanced Nogo expression, start-up process of apoptosis, leading to neuronal death. In this paper, we summed up the mechanism of action of Nogo from Nogo-A, Nogo-66, soluble NgR fragments, RhoA enzyme and Rho-A/Rho kinase signaling pathway, calcium ion aspects, and discussed its application prospect in nerve regeneration after optic nerve injury.

AIM: To explore the development process of when posterior vitreous detachments(PVDs)after coaxial micro-incision phacoemulsification and aspiration combined with foldable intraocular lens implantation.METHODS: Clinical data of 917 patients with cataract were collected after coaxial microincision phacoemulsification and aspiration combined with foldable intraocular lens implantation. The 917 operating eyes forms observation group and the 917 corresponding normal eyes serve as control group. All patients underwent a comprehensive ocular examination before surgery. The vitreous and retinal condition was tested by B-scan ultrasonography and biomicroscope with a 90-diopter(D)preset lens after 1 week and 1, 3, 6, and 12 months postoperatively. RESULTS: The incident rate of eyes in the observation group that developed PVD after operation were 8(0.9%), 31(3.4%), 53(5.8%), 78(8.5%), 129(14.1%)within 1 week and 1, 3, 6, 12 months, respectively. Ten(7.8%)of the 129 eyes in which PVD developed during the one year follow-up period had new retinal breaks with or without a retinal detachment; One(0.1%)of the 788 eyes in which a PVD did not developed during the follow-up period had new retinal tear with or without a retinal detachment; these percentages were statistically significant(P=0.009). Eight(14.8%)of 54 eyes with lattice degeneration and 2(2.7%)of 75 eyes without lattice degeneration had retinal tears associated with a PVD; the difference was statistically significant(P=0.004).CONCLUSION: Development of PVDs seems to accelerate after coaxial microincision phacoemulsification and linearly accumulated for 1 year postoperatively. Approximately 7.8% of eyes with a PVD had retinal tears. Compared with patients having no lattice degeneration, Patients' eyes with lattice degeneration had a 5.5-fold higher risk of developing retinal breaks associated with a PVD. This indicates long-term follow-up is necessary after phacoemulsification is performed.

Application of surgical assistive devices can effectively improve surgical safety, reduce surgical complications, and improve the quality of vision in patients with cataract surgery. Capsular tension ring and iris hook are the most important of surgical assistive devices in the cataract surgery, they have been used widely in recent years. Their development in material and design, alone or in combination in cataract surgery are reviewed in this paper.

AIM:To evaluate the effects and safety of primary phacoemulsification plus intraocular lens implantation for controlled chronic angle-closure glaucoma(CACG)and acute angle-closure glaucoma(AACG). METHODS: Sixty-eyes of 45 cases with CACG or CACG were randomly divided into two groups. Thirty-four eyes in IOL group underwent phacoemulsification plus intraocular lens(IOL)implantation. Twenty-six eyes in laser iridotomy(LI)group included treatment by LI. Intraocular pressure(IOP), numbers of antiglaucoma medications, complications, and corneal endothelial cell counts were examined in each group. RESULTS: In IOL group, IOP was significantly reduced from a preoperative mean of 14.82±4.23mmHg to a 6-month postoperative mean of 10.94±1.24mmHg. However, in LI group, mean preoperative IOP was 15.34±4.13mmHg, and the 6-month postoperative IOP was 14.68±4.77mmHg. There was statistical significance in preoperative and postoperative IOP between two groups(F=36.452, P<0.01). In IOL group, no patient used anti-glaucoma medications 6-month postoperatively, whereas in LI group, mean number of anti-glaucoma medications was 0.24±0.41(P<0.05). There were no significant differences in preoperative and postoperative corneal endothelial cell counts between IOL and LI groups(P>0.05). CONCLUSION: Primary phacoemulsification plus intraocular lens implantation for controlled CACG or AACG seems to be a safe and effective method in reducing IOP. This procedure might become the first treatment of choice for controlled CACG or AACG with cataract.

AIM: To evaluate the efficacy of simultaneous covering of Tenon's capsule and conjunctival flap for perforated corneal ulcer.METHODS: Totally 18 cases of perforated corneal ulcer from different causes were covered by Tenon's capsule and conjunctival flap, respectively. After operation, the healing of corneal ulcer, exposed portions of the cornea, postoperative inflammation, anterior chamber formation and complications such as glaucoma, iris adhesion were observed.RESULTS: Seventeen cases(94%)were healed, the exposed portion of cornea was transparent. No serious infection was encountered, and anterior chamber were formed. Intraocular pressure in 2 cases(11%)of secondary glaucoma was normal under local drug treatment. Iris adhesion was found in 7 cases(39%), evisceration was performed in 1 case(6%)after corneal perforation and staphyloma.CONCLUSION: The above treatment is a safe and practical approach in case of absence of corneal donor.

AIM: To explore the effects and reliability of macular grid photocoagulation before cataract surgery for diabetes patients with diffuse macular edema.METHODS: A total of 30 patients(40 eyes)were enrolled in the study. All the patients were randomly divided into two groups: group A: 20 eyes were treated with macular grid photocoagulation before cataract surgery; group B: 20 eyes were treated with cataract surgery only. RESULTS: The patients treated with macular grid photocoagulation before cataract surgery. Postoperative visual acuity was improved, the edema of macular decreased. The patients treated with cataract surgery only, visual acuity showed no evident change and macular edema remained stable or creased. CONCLUSION: Macular grid photocoagulation before cataract surgery for diabetes patients can improve the outcome and vision of the patients.

AIM: To analyze the main causes and related factors of evisceration in countries of western Africa, and study 127 cases(127 eyes)of the evisceration under an operating microscope.METHODS:The clinical records of 127 patients were analyzed retrospectively and causes and related factors were concluded. All cases of eviscerations were under an operating microscope, and the short and long term complications after operation were observed. RESULTS: The cause of the evisceration was mainly of perforation by corneal ulcer(114 eyes, 89.8%), in which the purulent ulcer(103 eyes, 90.4%),Moorens ulcer(5 eyes, 4.4%)and with vitreous purulence(34 eyes, 29.8%). The secondary cause of the evisceration was the impossibility to repair because of the big tissue defect caused by severe rupture of eyeball and the lost significance of the repair because of the most prolapse of retina and choroid(8 eyes, 6.3%). And the third cause was the complication of corneal staphyloma(5 eyes, 3.9%). The short and long term complications after operation were visible edema of eyelid and conjunctiva(97 eyes, 76.4%)and active bleeding from operating incision(2 eyes, 1.6%), and long term observation had not yet found the sympathetic ophthalmitis or narrow conjunctival sac as complications.CONCLUSION: The corneal infectious disease is common in western Africa and mainly causes by the large perforation with purulent corneal ulcer. The operation under surgery microscope can minimize the laceration and defection of bulbar conjunctiva and efficiently avoid the residual choroid and pigment, which could easily occur under traditional operation of the naked eye.

AIM:To discuss the effect of Nd:YAG laser release incision of posterior capsular membrane ruffles.METHODS: CGP corneal contact preparation was used after surface anesthesia by Alcaine focus on posterior capsular membrane ruffles acutely with aiming light emit Nd:YAG laser. The energy of mono pulse for cutting ruffle was 0.4-1.0mJ. The total energy was 20-30mJ(average 24.00±0.0625mJ).RESULTS: The visual acuity correction was 1.0 in 31 eyes(58%)after the laser release incision, accounting for 0.6-0.8 in 17 eyes(32%), accounting for 0.4-0.5 in 5 eyes(9%).No complication like IOL injury, vitreous hernia, cystoid macular edema, retinal detachment occurred after the treatment.CONCLUSION: Nd:YAG laser release incision of posterior capsular membrane ruffles improve the eyesight. It's simple, reliable safety and curative.

AIM: To observe the clinical security of torsional phacoemulsification for a beginner.METHODS: The clinical data of 200 eyes who accepted torsional phacoemulsification by a beginner from February 2012 to March 2013 were reviewed. The operation complications were analyzed and the postoperative effect was assessed.RESULTS: There was no collapse of the anterior chamber during operation. When the last nuclear was removed the surge occurred mildly. Posterior capsular rupture happened in 8 eyes, 5 eyes' intraocular lens(IOL)implanted in sclera sulcus after anterior vitrectomy, 3 eyes' IOL in bag without vitreous outflow. One eye without continuous curvilinear capsulotomy was transferred to the superior doctor for extracapsular cataract extraction(ECCE). One eye with the loose zonular fiber was implanted a capsular tension ring by the superior doctor. Seven cases need suture because of short sclera tunnel incisions. Uncorrected visual acuity a week after operation: 2 eyes(1%)<0.05, 31 eyes(15.5%)0.05-<0.3, 64 eyes(32%)≥0.3, 103 eyes(51.5%)≥0.5. There was no grade 3 corneal edema. The high intraocular pressure can be controlled by anterior chamber penetration or drugs.CONCLUSION: The technique of torsional phacoemulsification is safe and effective for a beginner.

AIM: To compare the effects of continuous side whipstitch suture and interrupted suture in conjunctival autograft surgery after resection of primary pterygium.METHODS: A comparative, prospective and randomized clinical trial was performed in 48 eyes of 48 patients with primary pterygium. All patients were randomly divided into two groups with 24 eyes of 24 patients in each group. In group A and B, continuous side whipstitch suture and interrupted suture were respectively adopted. The time spent in suture was recorded during surgery. The postoperative ocular discomfort and the time spent in taking out stitches were recorded during the 6-month follow-up. RESULTS: The average surgical time was 14.05±2.30 minutes for group A and 19.34±2.12 minutes for group B(P<0.01). The ocular discomfort scale analysis showed a lower score in the 3rd (1.32±0.60 vs 1.68±0.35, P<0.05), 5th(0.87±0.24 vs 1.26±0.68, P<0.05)postoperative days in group A, compared with group B. The average time of removing stitches was 9.15±3.36 minutes in group A and 12.61±3.89 minutes in group B(P<0.01).CONCLUSION: In the surgical management of primary pterygium, continuous side whipstitch suture can improve the surgical efficiency and decrease the ocular discomfort in the postoperative period. It proves to be an excellent option for conjunctival autograft attachment in primary pterygium surgery.

AIM: To investigate the effect of pterygium excision combined with autologous limbal stem cell transplantation and drug treatment after the operation.METHODS: A total of 980 eyes of 760 cases underwent pterygium excision, the conjunctival graft with stem cells was interrupted sutured in the limbal sclera planting beds and bulbar conjunctiva. One hundred and sixty-two eyes which relapse again were divided into 2 groups, group A: 1g/L mitomycin C+norfloxacin eye drops for 1-3 months; Group B: dexamethasone eye drops and diclofenac sodium eye drops for 1-3 months or more.RESULTS: One hundred and sixty-two eyes which relapse again were divided into the A and B groups use different medication treatment, Group A: 67 eyes(81.7%)were curd, 12 eyes(14.6%)relapse again, 3 eyes(3.7%)recurrence. Group B: 35 eyes(43.8%)were cured, 29 eyes(36.3%)relapse again, 16 eyes(20.0%)recurrence. The recurrence rate of group A was significantly lower than that of group B(P<0.01).CONCLUSION: Pterygium excision combined with limbal stem cell transplantation without rejection, safe and effective, with low recurrence rate, postoperative eye drops is particularly important, which could effectively inhibit and reduce the recurrence rate and significantly improve the therapeutic effect.

AIM: To investigate the clinical characteristics, diagnosis and treatment results of mechanical ocular trauma.METHODS: In recent 4 years, clinical details of 122 cases(122 eyes)with mechanical ocular trauma in our hospital were analyzed retrospectively.RESULTS: In the 122 cases of mechanical ocular trauma, open ocular trauma was in 116 eyes(95.1%), blunt ocular trauma in 6 eyes(4.9%), The ratio of male to female was 6.18:1, mechanical ocular trauma was mostly composed of open contusion which was mainly caused by foreign object. Most of patients had a significant visual improvement at the time of discharge.CONCLUSION:The work and production accidents were major causes of mechanical ocular trauma. The condition of its was complex, with multiple complications and serious consequences, we should strengthen the prevention. To develop and promote timely hospital, Department of Ophthalmology microscopic operation technology and vitreosity operation can save the injured eyesight. Correct treatment can reduce the mechanical ocular trauma complications.

AIM: To analyze the related factors of eye trauma, and provide local epidemiology information. METHODS: Totally 1137 ocular trauma patients who lived in the ophthalmic in-patient department from January 2007 to December 2011 were chosen. The statistic analysis on general characteristic, injuries causes, prognosis and complications was done. RESULTS: The ratio of male to female was 4.77:1. The peak ages were 20-49 years. The major occupational groups are manual workers such as workers and farmers. The top two causes of injury were contusion and perforating injuries. The highest average rate of blindness was from perforating injuries(45.65%). There was no significant differences between adjacent annual in injury causes constitutes(χ2=14.586, P=0.367). Most of the compositions were mixed, and the top three of them were traumatic cataract, hyphema and uveitis.CONCLUSION: In order to reduce ocular trauma blinding rate, we should raise the awareness of the prevention of eye injuries, and provide the timely treatment to ocular trauma patients.

AIM: To discuss the effect and safety of Ahmed valve implantation in late neovascular glaucoma. METHODS: The Ahmed glaucoma valve were implanted in 41 eyes(41 cases)with late neovascular glaucoma, the follow-up was 12 months on average, intraocular pressure was recorded at 1 day, 1 week, 1 month, 3, 6, 12 months respectively after operation and compared with that before operation, at the same time, the complications and treatment were analyzed.RESULTS: The mean intraocular pressure before operation, 1 day, 1 week, 1 month, 3, 6, 12 months after operation was 59.83±5.53, 19.27±8.19, 19.69±6.86, 20.67±6.73, 21.05±6.93, 21.49±7.42, 22.14±8.08mmHg, the mean intraocular pressure before operation was higher than that after operation and the difference was obvious in statistics. Major complications included hyphema, low intraocular pressure early postoperation, shallow anterior chamber, obstruction of the tube, the plate wrapped or exposed.CONCLUSION: Ahmed valve implantation is an effective method to treatlate neovascular glaucoma.

AIM: To investigate an ideal correction of intraocular lens(IOL)power for sulcus implantation.METHODS: Totally 25 patients(25 eyes)who underwent cataract surgery and IOL sulcus implantation due to posterior capsule rupture from August 2007 to December 2010 were reviewed. All patients were divided into three groups according to A-Scan length(AL): <22mm, 22-25mm and >25mm, and the differences between the actual spherical equivalent(SE)refraction in three months postoperation and that predicted by biometry using the SRK-Ⅱ and SRK-T formula were compared. RESULTS: The mean visual acuity was improved after cataract surgery. The mean visual acuity was 0.49±0.21 in three months postoperation. The predicted SE refraction of IOL in the bag were -0.43±0.34D(AL<22mm), -0.36±0.22D(AL 22-25mm)and -1.16±0.80D(AL>25mm)respectively. The actual SE refraction was -1.25±0.98D(AL<22mm), -1.22±0.82D(AL 22-25mm)and -2.4±1.39D(AL>25mm). There was significant difference(P=0.001)between the predicted and actual SE refraction in the group of AL 22-25mm, and the myopic shift between the predicted and postoperative refraction was 0.8D. There were no significantly differences between another two groups(P=0.148,0.061). CONCLUSION: In order to correct a myopic shift in the case ofsulcus implantation, the IOL power should be adjusted according to the AL. For patients with AL from 22mm to 25mm, the IOL power should be reduced by 0.8D.

AIM: To observe pattern visual evoked potential(P-VEP)of varying degrees hyperopic refractive amblyopic children. METHODS: We did P-VEP examination for the hyperopic refractive children from May 2011 to August 2012. We divided these children into three groups according to different best corrected vision(BCV): better than 0.5 amblyopic group, 0.3-0.5 amblyopic group and lower than 0.3 amblyopic group. Their P100 latency and amplitude were measured and compared with normal children group. RESULTS: The healthy eye's P100 latency was 101.43±6.82ms, P100 amplitude was 11.27±5.38μV. P100 latency delay and P100 amplitude decline in amblyopic group. Better than 0.5 amblyopic group, 110.54±8.47ms, 9.94±5.28μV; 0.3-0.5 amblyopic group 118.76±6.21ms, 8.57±7.21μV; and lower than 0.3 amblyopic group 124.54±7.36ms, 7.49±5.07μV. P100 latency and amplitude have significant different between groups(P<0.05).CONCLUSION: P100 latency delay and P100 amplitude decline in hyperopic refractive amblyopia and the changes are associated with degree of amblyopia.

AIM: To observe the curative effect of early retinal photocoagulation combined with Xuefuzhuyu decoction in treatment of ischemic retinal vein occlusion(RVO). METHODS: Fifty-five patients(55 eyes)with ischemic RVO received early retinal photocoagulation by Zeiss Lumenis 1000 laser machine combined with Xuefuzhuyu decoction. The visual acuity, capillary nonperfusion and neovascularization were detected at 3 months after treatment. RESULTS: Three months after treatment, visual acuity were increased in 23 cases(42%), steady in 30 cases(55%), decreased in 2 cases(4%), the total effective rate was 96%. Retinal non-perfusion area(NPA)disappeared in 38 cases(69%), NPA was less than 5 disc area(DA)in 15 cases(27%)and ≥5DA in 2 cases(4%).CONCLUSION: Early retinal photocoagulation and Xuefuzhuyu decoction is effective and reasonable treatment for ischemic RVO.

AIM: To evaluate the efficacy and safety of nerve growth factor(NGF)on optic nerve anterior ischemic optic neuropathy.METHODS:A total of 343 eyes of 343 patients with anterior ischemic optic neuropathy were treated with mouse NGF by the dosage of 30μg qd and continuous injected for three weeks, at the same time given expanding vascular medicine and neurotrophic agent. Corrected LogMar visual acuity, visual field mean deviation(MD)values and pattern visual evoked potential(P-VEP)were recorded and analyzed. The adverse reactions in the course of treatment were analyzed in order to evaluate the safety of this method. RESULTS: The patient's vision after treatment were significantly increased compared with that before treatment, MD of visual field and P-VEP display incubation period after treatment were significantly lowered compared with that before treatment, the difference were statistically significant(P<0.05). There were 18 cases of adverse events in laboratory indicators in this study, and the incidence rate was 5.25%.CONCLUSION: Mouse nerve growth factor combined with vasodilators and neurotrophin for the treatment of anterior ischemic optic neuropathy had satisfaction efficacy and safety.

AIM: To discuss the application effect of Panel D-15 in flight cadets. METHODS: Totally, 400 cases in China Southern Airlines flight cadets in December 1 to 10, 2012 were enrolled randomly as the test object. Yu's color test book and Panel D-15 test were used to assess the students of color vision. The result of Yu's was expresses as parachromatism, color weakness and normal. The result of Panel D-15 was expresses as normal, small mistake and cross the line. RESULTS: The results of Yu's color test book showed that 386 cases were normal, 4 cases of full color blindness, 5 cases of red-green color blindness, red green weak in 5 cases. The results of Panel D-15 examination showed that 384 cases were normal, 5 cases of small mistake, across the line in 11 cases. CONCLUSION: Panel D-15 can objectively evaluate pilot candidates, can reduce the rate of misdiagnosis, guarantee the quality of recruitment, to ensure flight safety.

AIM: To learn about the current condition about bacteria contamination of aqueous humor during cataract operation.METHODS: Bacterial culture was conducted of the samples of aqueous humor and conjunctival sac collected from 807 patients during cataract operation from December 2010 to December 2012. Then, the bacterial culture results were analyzed. RESULTS: On average, the bacterial culture positive rate was 0.93%, with no significant difference in the positive rates of samples collected at different times. The average bacterial culture positive rate of conjunctival sac was 9.54%, with significant difference between the positive rates before and after the operation(χ2=37.21, P<0.01). Most of the bacteria types in aqueous humor were the same as those in the conjunctival sac, with most frequent strain being staphylococcus epidermidis(60.00% for aqueous humor and 91.56% for the conjunctival sac). During continuous operations, >6 times of patients' aqueous humor and the positive rate of conjunctival sac bacteria culture is significantly greater than that of ≤5 times of patients. The result of the drug sensitive test indicated that most bacteria in aqueous humor and conjunctival sac were sensitive to Cephalosporins while they were highly resistant to penicillin, erythromycin, tetracycline, and Lomefloxacin. CONCLUSION:Because of the bacterial pollution in the water from most of the conjunctival sac, preoperative conjunctival sac aseptic preparation is essential. Because intraoperative conjunctival sac, even real water may have some bacteria, strengthen the local application of antibiotics can effectively prevent postoperative intraocular infection.

AIM: To investigatethe relation between axial length(AL), age and ocular parameters.METHODS: A total of 360 subjects(360 eyes)with emmetropia or myopia were recruited. Refraction, center corneal thickness(CCT), AL, intraocular pressure(IOP)were measured by automatic-refractor, Pachymeter, A-mode ultrasound and non-contact tonometer, respectively. Corneal curvature(CC), anterior chamber depth(ACD)and white-to-white distance(WWD)were measured by Orbscan II. Three dimensional frequency domain coherent optical tomography(3D-OCT)was used to examine the retinal nerve fiber layer thickness(RNFLT). The Pearson correlation coefficient(r)and multiple regression analysis were performed to evaluate the relationship between AL, age and ocular parameters.RESULTS: The average AL was 24.15±1.26mm. With elongation of the AL, spherical equivalent(SE)(r=-0.742,P<0.01), CC(r=-0.395, P<0.01)and RNFLT(r=-0.374, P<0.01)all decreased, while the mean ACD(r=0.411, P<0.01)increased. On the contrary, there was not statistical significan with CCT(r=0.099, P=0.060)and WWD(r=0.061, P=0.252). There was also a significant correlation between AL and age(P=0.001), SE(P<0.001), ACD(P<0.001), CC(P<0.001)in Multiple linear regression analysis.CONCLUSION: In longer eyes, there is a tendency toward myopia, a flatter cornea, a deeper ACD and a thinner RNFLT. Age is an influencing factor for the AL as well.

AIM: To evaluate the effective and complications rate of silicone reverse-intubation in treating chronic dacryocystitis with different extubation time after surgery. METHODS: From December 2009 to December 2012, 56 patients(60 eyes)with chronic dacryocystitis were studied. Silicone tube was placed for 1.5 months(group A)or more than 3 months(group B), and the follow-up was 6 months after extubation. RESULTS: All eyes were successfully placed silicone tube. In group A(32 eyes), all lacrimal passage were unobstructed after extubation, after 6 months of postextubation, 21 eyes were cured(66%), 6 eyes were improved(19%), 5 eyes were failed(16%), the overall successful rate was 84%. In group B(28 eyes), 27 eyes of lacrimal passage were unobstructed after extubation, after 6 months of postextubation, 16 eyes were cured(57%), 5 eyes were improved(18%), 7 eyes were failed(25%), the overall successful rate was 75%. The difference between two groups had not statistically significance(P>0.05). Two eyes in group A and 5 eyes in group B had complications with no statistically significance(P>0.05).CONCLUSION: With the time of silicone tube in lacrimal passages before extubation, 1.5 months or more than 3 months, the effective rate were similar, the granulation tissue proliferation is less in the former group.

AIM: To study the clinical effect of combined therapy on neonatal dacryocystit of different age groups.METHODS: The clinical data of 148 eyes of 128 cases with neonatal dacryocystitis were divided into three groups: group 1(<3 months), group 2(aged from 3 months to 6 months), group 3(aged from 6 months to 12 months). Group 1 underwent lacrimal sac massage. Group 2 and group 3 step by step underwent lacrimal sac massage or lacrimal duct pressure flush or probing of lacrimal. RESULTS: The cure rate of lacrimal sac massage for group 1 was significantly higher than that for group 2(χ2=26.65,P<0.05); Pressure irrigation for group 2 was more effective than that for group 3(χ2=5.23,P<0.05); Probing of lacrimal passage for group 2 was more effective than that for group 3(χ2=3.90,P<0.05).CONCLUSION: We should choose lacrimal sac massage step by step according to the patient's age, perform lacrimal duct pressure flush, lacrimal duct probing through combined treatment. Lacrimal sac massage seems to be the first treatment for neonatal dacryocystitis patients aged under 3 months. Lacrimal duct pressure flush or probing of lacrimal passage is an effective treatment for neonatal dacryocystitis and the best time for lacrimal duct pressure flush or probing of the lacrimal passage is 3-6 months after birth.

AIM: To evaluate therapeutic effects of dacryocystorhinostomy combined lacrimal laser plasty and silicone intubation implantation for lacrimal duct with multi-point obstruction.METHODS: Thirty-five patients with one or more point obstruction in upper lacrimal duct received lacrimal laser plasty at first. Then, when the obstruction was broken, modified surgery of dacryocystorhinostomy combined silicone intubation implantation in the both lacrimal ductule was performed. Irrigating of the lacrimal passage was made regularly after operation. The silicone tube was extracted in 4 weeks. The follow-up time was 6 months. RESULTS: There were no intraoperation complications and the silicone tube did not fall off after operation. Irrigating test results of lacrimal passage showed 30 out of the 35 eyes(86%)were cured, improved in 3 cases, 2 cases was ineffective. The cure rate was 86% and the efficiency was 94%. CONCLUSION: Dacryocystorhinostomy combined lacrimal laser plasty and silicone intubation implantation is an effective treatment for lacrimal duct with multi-point obstruction, there are less operation complications and higher rate of recanalization of lacrimal passage.

AIM:To investigate the clinical treatment on patients with infectious keratitis by chestnut thorn. METHODS: Retrospective analysis of 28 cases(28 eyes)with infectious keratitis due to chestnut thorn from June 2009 to October 2012. All patients had the clinical manifestations such as local infiltration, edema and ulcer formation. Chestnut thorn located deeply into corneal stroma, but did not penetrate into the anterior chamber. All patients underwent emergency surgery to remove chestnut thorn, of which 14 patients underwent corneal debridement joint multilayer amniotic membrane transplantation as the treatment group, and the other 14 patients refused amniotic membrane transplantation and had the chestnut thorn removed only as the control group. The corneal epithelial healing time, the degree of improvement of visual acuity and the incidence of complications were compared between the two groups after 3 months.RESULTS: The corneal epithelial average healing time of the treatment group was significantly shortened compared with the control group(t=13.6, P<0.05), the visual acuity of the treatment group was improved significantly higher than that in the control group, and the incidence of complications of the treatment group was significantly decreased compared with the control group. CONCLUSION: For the patients with corneal ulcer due to deep chestnut thorn, emergency surgery of corneal debridement joint multilayer amniotic membrane transplantation can promote the repair of the cornea and prevent the occurrence of complications after injury.

AIM: To evaluate the efficacy of sliding transplantation of auto-corneal limbus stem cell combined with mitomycin C(MMC)on pterygium treatment. METHODS: Totally, 79 patients(89 eyes)who received treatment at our hospital were selected. Eighty-nine eyes of 79 patients with pterygium were randomly divided into two groups: 40 patients(45 eyes)in group A underwent sliding limbal autograft transplantation with MMC and 39 patients(44 eyes)in group B underwent simple limbal autograft transplantation. Recurrence rate and complications were observed during the 12-month follow-up.RESULTS: One of 45 eyes(2%)of group A and six of 44 eyes(14%)in group B were recurrent with significant difference(P<0.05). One eye with corneal epithelium damage was observed in group A, it was healed with treatment after 5 days. Photaesthesia, lachrymation and pain were relevantly severe in 4 eyes, and 3 eyes displayed delayed union in conjunctival wounds(12-15 days). In B group, 3 eyes slight edema of grafts, 1 eye was growth of a wound granulation, and 1 eye was relevantly severe in photaesthesia, lachrymation and pain. Complications compared two groups had no significant difference(P>0.05).CONCLUSION: Sliding transplantation of auto-corneal limbus stem cell combined with MMC for pterygium had advantages of lower recurrence rate, rapid recovery and less complications.

AIM:To evaluate the clinical application effect of three-dimensional EH(epoxide acrylate maleic, EAM; hydroxyapatite, HA; mixer of EH)composite artificial template in cranioplasty.METHODS: Spiral cranial CT and CAD three-dimensional reconstruction imaging were done to declinate the shape and contour of skull defect. The bone defect was repaired by the individual EH compound implants in 35 patients with cranial bone defect due to craniectomy from different disease. The patients were followed up for 6-24 months to evaluate the operation effect.RESULTS:Postoperative following-up showed that the looks of the patients receiving EH implants successfully were satisfactory and repairing effects were good. Mild collection of the fluid under the scalp was found in 2 cases and disappeared after suction and pressure dressing. No other frequent complications were observed after cranioplasty.CONCLUSION:Individual prefabricated EH implant is an ideal material of repairing cranial bone because the looks are satisfactory and there are few postoperative complications in the patients with cranial bone defect repaired by the EH implants.

AIM: To evaluate the effects of ultrasonic emulsification operation on 1800 poor patients with cataract.METHODS: From June 2010 to November 2012, free cataract phacoemulsification and IOL implantation were performed for 1800 poor patients of cataract(1800 eyes), and the effects of the operation and complications of age-related cataract were analyzed. RESULTS:A total of 1326 eyes(73.67%)of the operated eyes had age-related cataract. On the first day after the operation, vision was restored in 98.72% and vision was 0.3 or better in 89.52%. Intraoperative complications included posterior capsule rupture in 32 eyes(2.41%), equilibrium liquid reflux in 7 eyes(0.53%), complete rupture of suspensory ligament in 1 eye(0.075%), and partial rupture in 5 eyes(0.38%). Postoperative complications included corneal edema in 103 eyes(7.77%), mild corneal edema in 79 eyes(5.96%), moderate to severe corneal edema in 24 eyes(1.81%), reactive uveitis in 6 eyes(0.45%), transient high intraocular pressure in 9 eyes(0.68%), IOL clamp in 3 eyes(0.23%), and macular edema in 6 eyes(0.45%). Severe complications, such as bullous keratitis, explosive suprachoroidal hemorrhageor and endophthalmitis did not doccurred. CONCLUSION: Ultrasonic phacoemulsification, offered free to poor patients of cataract in China, has various advantages, including remarkable effect, shorter operational time, minimal operational trauma, faster visual restoration and fewer complications.

AIM: To observe and analyze the side effects of fluorescein sodium injection in fundus fluorescein angiography. METHODS:The incidence of side effects and corresponding treatments of 1 759 patients in fundus fluorescein angiography from June 2010 to July 2012 were reviewed and analyzed. RESULTS:Totally, 267 out of 1759(15.17%)patients had side effects, nausea was reported in 181 cases(10.29%), vomiting in 32 cases(1.82%), sneezing in 6 cases(0.34%), itchy skin and rash in 27 cases(1.53%), itchy throat and cough in 8 cases(0.45%), a transient palpitation and chest tightness in 8 cases(0.45%), dizziness, chest tightness, fatigue and cold sweat in 5 cases(0.28%). CONCLUSION: Fluorescein sodium injection can cause the side effects of varying severity, mostly minor side effects. However, indications and contraindications should be strictly controlled and preparation for severe side effects should be ready during treatment to ensure patient safety in case of emergency.

AIM: To observe the efficacy of Qiming granule combined with Dextran and Hypromellose eye drops in treatment of dry eye.METHODS: A randomized, parallel-control approach was adopted, 100 cases of dry eye patients were divided into treatment group and control group equally, observation on the treatment of 3 months. The treatment group was applied Dextran and Hypromellose eye drops combined with oral Qiming granule, simply Dextran and Hypromellose eye drops for control group. Before and after treatment, tear secretion volume, break-up time, corneal fluorescein staining and symptom were observed.RESULTS: After treatment, there was statistical significance for the break-up time, SⅠt and corneal fluorescein staining in both groups when compared with before treatment(P<0.05 or P<0.01). The total clinical effect satisfaction rates were 94% for treatment group and 76% for control group, both with no serious adverse reactions.CONCLUSION: The combined Dextran and Hypromellose eye drops and Qiming granule perform better than Dextran and Hypromellose eye drops only in treatment of dry eye.

AIM: To observe the effect of pressing triple prism in correcting residual compensatory head posture in postoperative congenital nystagrnus children. METHODS: From March 2007 to October 2012, 28 congenital nystagrnus children with residual compensatory head posture after surgery including 19 males and 9 females were admitted to our department. The average age of these children was 8.7 years old, ranging from 4 to 20. All of them were treated by pressing triple prism. Improvement of vision and compensatory head posture were used to evaluate the efficacy during the follow up. RESULTS: Twenty-seven children adhere to follow-up. One child failed to follow-up. 1)Symptoms: most children did not complain visual distortion, dizziness when wearing glasses. Comfort rate was reaching 96%(26/27). 2)Visual improvement: vision rose from(0.5±0.3)to(0.6±0.2)after wearing glasses, however, the difference was not statistically significant(P>0.05). 3)Improvement of compensatory head posture: compensatory head posture was decreased after wearing glasses, from(9.6±2.2)° to(5.7 ± 2.2)° with significantly difference(P<0.05). Among them, 18 children(67%)had almost disappearance of residual compensatory head(<5°), 8(30%)had improvement(5°～10°). The improvement rate was 96%(26/27). CONCLUSION: Pressing triple prism is an effective way to cure residual compensatory head posture after congenital nystagmus surgery.