AIM: To evaluate anatomic foveal configuration changes in fellow eyes of patients with idiopathic macular hole using spectral-domain optical coherence tomography(SD-OCT). METHODS: Fifty eyes of fifty patients were studied and divided in two groups: group 1=25 patients with idiopathic macular hole and group 2=25 healthy individuals(control group). SD-OCT cross line scans were obtained using RTVue 100(Optovue, Inc., Fremont, CA, USA). The widest foveal B-scan was selected on each patient. Bi-dimensional foveal configuration was measured in mm2 using caliper tool. RESULTS:The mean foveal configuration in group 1 was 0.1590.03mm2 and in group 2 was 0.079±0.01mm2. The difference between the two groups was statistically significantly(P<0.001). In group 1, one patient developed a macular hole in the fellow eye. CONCLUSION: Fellow eyes of patients with idiopathic macular hole tend to have an enlarged foveal configuration when compared to healthy subjects. Our finding combined with other vitreomacular risk factors may play a role in idiopathic macular hole formation.

AIM: To evaluate the repeatability of ocular biometrical measurements obtained from the optical low-coherence reflectometry(Lenstar LS900® version 1.10), as well as its agreement with the partial coherence interferometry(IOL Master® 500 version 7.1)in Chinese school-aged children. METHODS: A prospective comparison of ocular biometrical measurements made by the Lenstar and IOL Master was performed on right eye of each participant. The intraobserver repeatability of Lenstar was assessed by coefficient of variation(CV). Agreement was analyzed using Bland-Altman plots. RESULTS: The mean age of the 110 subjects(range 6-15y)was 10.9±2.0y, and 54.5% were female. The Lenstar yielded repeatable measurements, with the smallest CV was obtained for axial length(AL)(CV<0.1%). The Lenstar produced a greater mean value for AL(23.90±1.28 vs 23.88±1.27mm, P<0.001), anterior chamber depth(ACD)(3.62±0.26 vs 3.58±0.25mm, P<0.001), and the steepest corneal radius of curvature(CR2)(7.58±0.27 vs 7.56±0.27mm, P<0.001)than IOL Master. The 95% limits of agreement(LoA)between the two instruments were -0.025 to 0.053mm for AL, -0.047 to 0.057mm for the flattest corneal radius of curvature(CR1), -0.057 to 0.102mm for CR2, and -0.083 to 0.152mm for ACD. CONCLUSIONS: The Lenstar yielded excellent repeatability results of AL, ACD, and corneal curvature measurements, which were interchangeable with the IOL Master measurements in school-aged children.

AIM:To investigate the effect of high glucose on the redox system of the cultured rat lenses in vitro, and evaluate the effect of thioltransferase(TTase)against oxidative stress in diabetic cataract. METHODS: Lenses were incubated with different concentrations of glucose: control group(5.5mmol/L), high glucose groups(35.5, 65.5, 95.5mmol/L)and mannitol control group for 7d. Following incubation, the lenses were evaluated daily using a dissecting microscope. After 7d of incubation, lenses were homogenized in lysis buffer and processed for measurement the activity of TTase, catalase(CAT), superoxide dismutase(SOD)and the specific value of GSSG/T-GSH. RESULTS: The lenses treated with high glucose exhibited mistlike opacity in the early stages, while the lenses of control group remained relatively transparent. With the rise of the concentration of high glucose, the activity of TTase increased and the maximum appeared in 35.5mmol/L group(1.743±0.20mU/mg protein, P<0.01). No changes were observed in the mannitol control group(P>0.05). The specific value of GSSG/T-GSH of lenses with high glucose groups increased compared with the control groups, there were 2.89, 2.57 and 2.42 times to the normal control group(P<0.05). There was no significant difference between each group treated with high glucose, and the difference was also no significant between the mannitol group and the control group. Compared with the control group, the activities of CAT and SOD decreased in the high glucose treatment groups, the activities of SOD were 0.71, 0.52 and 0.49 times to the normal control group(P<0.05), and the activities of CAT were 0.47,0.56 and 0.50 times to the normal control group(P<0.05). There was no significantly different between each group treated with high glucose. CONCLUSION: The antioxidant system of the lens was activated by the high glucose following the increased activity of TTase, the specific value of GSSG/T-GSH, and the decreased activities of CAT and SOD. The gradually decreased oxidation resistance in the lens may contribute to the development of diabetic cataract.

AIM: To investigate the morphological changes and the expression of hypoxia-inducible factor-1 alpha(HIF-1α)subunit during embryonic development of rat lens and explore the role of HIF-1α in lens development process. METHODS: Thirty clean pregnant Wistar rats were divided into 6 embryon groups,10-d, 12-d, 14-d, 16-d, 18-d and 20-d embryo. Two embryons were randomized obtained from every pregnant rat. One of the eyeball samples that were parallel to sagittal axis of optic nerve were cut into serial sections, used HE staining and examined by light microscope. Expression of HIF-1α protein in lens was detected by immunohistochemistry. The positive expression of HIF-1α mRNA of the other eyeball samples was detected by real-time PCR.RESULTS:In the 10th d of embryo(E10), the formation of lens vesicle were recognized under the light microscope. In the 12th d of embryo(E12), the anteriorly situated cells and posteriorly situated cells have already differentiated. The anteriorly situated cells were epithelium. In the 14th d of embryo(E14), primary fibers which came from posteriorly situated cells were examined. In the 16th d of embryo(E16), the lens epithelium undergoes extensive proliferation, and enlongate into the secondary fibers. In the 20th d of embryo(E20), the lens was maturation. By immunohistochemistry staining, the HIF-1α was highly expressed in the lens embryonic development. The expression was gradually promoting from E10 to E16, then reducing. The lens epithelium expressed more HIF-1α than fibers. The highest mean density was at E16, the lowest at E20. The difference was significant among of the 6 groups(P<0.0001). The E10 group was combined with the E12 group, the E14 group was combined with the E16 group, showing no significant difference(P>0.05). The other groups were compared with each other, finding significant difference(P<0.05). By the real-time PCR, HIF-1α mRNA was highly expressed in the lens development, and was different at different time. The expression of HIF-1α mRNA was increasing from E10 to E16, then descending at E18 and E20. The expression of HIF-1α mRNA was the highest at E16, the lowest at E20. The difference was significant among of the 6 groups(P<0.0001). The E10 group was combined with the E12 group, showing no significant difference(P>0.05). The other groups were compared with each other, finding significant difference(P<0.05). CONCLUSION:The lens of Wistar rats differentiate from the E10 when the vesicle formed through the embryo phase. The lens is basic mature before birth. The HIF-1α in the lens embryonic development is highly expressed and changeful. The varies of HIF-1α expression is depend upon rat embryo development indicating that HIF-1α might participate in the process of development of rat lens.

AIM:To evaluate the effect of phagocytic load on apoptosis of cultured aged bovine retinal pigment epithelium(RPE)cells.METHODS: The third generation of cultured aged bovine RPE cells was cultured respectively with culture medium, containing 200μg/mL photoreceptor outer segment(POS)and 400μg/mL POS. Then the apoptosis rates of RPE cells after 24, 48 and 96h were detected with flow cytometry instrument(AnnexinⅤ/PI double staining).RESULTS: In blank control group, the apoptosis rates were very low at different time. After RPE cells were cultured with culture medium containing 200μg/mL POS for 24h, the apoptosis rate including early apoptosis and late apoptosis was 1.73%. As time going, the apoptosis rate increased rapidly and reached 65.92% after 96h. After RPE cells were cultured with culture medium containing 400μg/mL POS for 24h, the apoptosis rate was 4.02%. And it reached 91.34% significantly after 96h.CONCLUSION: Phagocytic loads can induce the apoptosis of RPE depending the time and dose.

AIM: To detect expression of N-methyl-D-aspartate receptor-1-subunit(NMDAR1)in visual cortex of monocular deprivation rats during sensitive period and compare with that of normal group, to explore the site of NMDAR1 action in improving visual acuity and its molecular mechanism. METHODS: Sixty 14-day-old healthy SD rats were randomly divided into 4 groups including normal group, monocular deprivation(MD)group, normal saline(NS)group, levodopa(LD)group, 15 rats for each. All the rats except those in the normal group were performed monocular deprivation surgery to establish monocular deprivation animal models and were raised in normal sunlight to 45-day-old. Rats in the MD group and normal group were killed and then marked by immunohistochemical and immune protein printing, respectively. The expression of NMDAR1 in visual cortex of these two groups were measured by quantitative real time PCR method. LD and NS groups were administered with levodopa(40mg/kg)and normal saline for 28d. The expression of NMDAR1 was examined with the same method.RESULTS:NMDAR1 expression in visual cortex of MD group was lower than that in normal group. NMDAR1 expression in visual cortex of LD group was higher than that in NS group.CONCLUSION: NMDAR1 is associated with the plasticity of visual development. Levodopa may revert the reduction of expression of NMDAR1 caused by monocular deprivation. This mechanism may be related with NMDAR1 capacity of improving visual function whose site of action may lie in the parts of the visual cortex.

AIM: To observe pathological changes of blood glucose, the retina and pancreatic tissue after establishing rats diabetic retinopathy(DR)model, and preliminary evaluate of Shuangdanmingmu capsule on the improvement of retina and pancreas tissue structure. METHODS: DR rats were fed with Shuangdanmingmu capsule. Then the blood glucose and glycated hemoglobin were determined. Immunohitochemical staining was used to observe the expression of structure of retino and pancreas.RESULTS: Compared with the control group, the blood glucose and glycates hemoglobin in Shuangdanmingmu group were decreased after 2mo of treatment(P<0.01). The layers tissue of retina was less edema and gradually arranged in Shuangdanmingmu group. The structure of pancreas was clear basically. Fat cells, infiltrati on of lymphocytes and fibrosis hyperplasia appeared in the interacinar and interlobular connective tissue. Some acinar and islet cells of fatty rat pancreatic tissue had fatty or vesicular degeneration.CONCLUSION: Shuangdanmingmu capsule can decrease blood glucose and glycates hemoglobin in DR rats effectively and improve the ultrastructure of retina and pancreas tissue.

AIM: To observe retinal ultrastructural features and retinal cell apoptosis of defocus induced myopia in guinea pigs. METHODS: Thirty guinea pigs(3-wk old)were received -10.00D rigid contact lenses(RGP)on the right eye and without wearing glasses on the left eye. Diopter change with cycloplegic retinoscopy, ultrastructural features of the retina with transmission electron microscopy were observed, the apoptosis of retinal cell by TUNEL immunofluorescence staining after 3wk were detected.RESULTS: Eye diopter difference was 3.28±0.21D in the right eye and 1.55±0.23D in the left eye before and after induction. There was significantly statistical difference(P<0.01); Retinal ultrastructural features were showed with transmission electron microscopy(TEM)the retinal disk membranes edema, some shedding, mitochondrial swelling and deformation, small amount of vacuolar changes in the inner and outer nuclear layer cells. Some characteristics of apoptosis were also be seen such as cell membrane irregular contractions, irregular nuclear chromatin aggregation. The incidence of retinal cell apoptosis was(2.42±1.24)% in the right eye and(0.29±0.08)% in the left eye after induction. There was significantly statistical difference(P<0.01). CONCLUSION: Accompanied by abnormal apoptosis of retinal cells during the formation of defocus-induced myopia in guinea pigs.

AIM: To observe the structure changes of retina and determine the expression of TGF-β2 in retina model. At the same time to clarify the function of TGF-β2 in form deprivation myopia model. METHODS: A facemask was worn on the right eyes of guinea pigs to develop form deprivation myopia. Before and after experiment, refraction was measured using retinoscope, and ocular axial was determined by A-scan ultrasonography. Morphologic alternations of the retina were observed by light microsope. The expression of TGF-β2 in the retina was determined by immunohistochemistry.RESULTS:Retina of myopic eyes became thinner, and inner nuclear layer of retina had few layers, nuclear of outer nuclear layer became smaller and circular, at the same time, they arranged in disorder. The immunohistochemisty results showed that expression of TGF-β2 in model eyes was lower than that in control eyes(P<0.05).CONCLUSION: Covering eyes with facemasks is effective, simple and convenient in making myopic model. The retina of the model eye appeares degeneration. TGF-β2 plays an important role in the course of development in form deprivation myopia.

AIM:To investigate the effect of trichostatin A(TSA)on cell proliferation and the expressions of histone deacetylase 1(HDAC1)and HDAC2 in cultured human Tenon capsule fibroblast(HTF).METHODS: Human Tenon capsule fibroblasts were cultured in vitro after glaucoma filtration surgery. The third to sixth passage of cell were treated by 600nmol/L TSA or none. Cell viability measured by MTT assay after 1, 2 and 3d respectively. The expressions of HDAC1 and HDAC2 were analyzed by Western blot 2d after TSA treatment.RESULTS: Compared to the control, cell viability decreased significantly after treatment with TSA at 1d(P<0.05), presented time-dependent manner. The expression of HDAC1 and HDAC2 significantly reduced in TSA-treated HTF compared with control cells at 2d after TSA treatment. CONCLUSION: TSA inhibits the proliferation of Tenon capsule fibroblast by inhibiting the expression of HDAC1 and HDAC2, and reduces subconjunctival scar formation.

AIM: To study the expression of hypoxia-inducible factor(HIF)and Pax6 in pterygium and investigate the relationship between expression of HIF and Pax6 in pterygium.METHODS:Thirty-five patients with pterygium who underwent simple excision and 10 cases of normal conjunctival tissues were enrolled in this study. Immunofluorescence was performed in pterygia tissue and normal conjunctiva, detecting the expression of HIF-1α and Pax6.RESULTS: The positive expression rate of HIF-1α was 66%(23/35)and 10%(1/10)in pterygia tissue and normal conjunctiva, respectively. The difference of expression between pterygia tissue and normal conjunctiva was statistically significant(P<0.05). Expression of Pax6 was full-thickness nuclear in normal conjunctiva; however, expression of Pax6 decreased and even was negative in pterygium. The difference of expression in two groups was statistically significant(P<0.05).CONCLUSION: HIF-1α is highly expressed in pterygium, suggesting that it may be involved in the occurrence and development of pterygium. Pax6 gene downregulated in pterygium epithelial cells, suggesting that epithelial cells are squamous metaplasia.

AIM: To analyze the the ability of optical coherence tomography(OCT)in diagnosis of primary glaucoma through evidence-based medicine,the application of a variety of evaluation and statistical analysis model, provide a reasonable selection of reference to clinicians diagnose glaucoma diagnostic method.METHODS: The method according to Cochrane systematic reviews, systematic and comprehensive literature was searched PubMed, Web of Science, Medalink, CNKI, CBM, Wanfang Data. Collect all OCT relevant diagnostic test, the quality assessment of diagnostic accuracy studies(QUADAS)items were used to assess the quality of the included studies. The Meta-Disc software was used to analyze the data.RESULTS: A total of 16 trials were included, The results of Meta-analyses showed that the summary sensitivity, specificity and 95% CI were 0.86(0.84～0.88), 0.90(0.88～0.92). The SROC area under curve(AUC)was for 0.9517.CONCLUSION: OCT for diagnosis of primary glaucoma has higher sensitivity and specific degree, has great value in clinical application.

AIM:To compare the recurrence rates between primary pterygium excision with limbal epithelial autograft transplantation and amniotic membrane transplantation. METHODS: There were 99 patients(103 eyes)with primary pterygium. These patients were randomly divided into two groups, group A received limbal epithelial autograft transplantation combined with pterygium excision(n=54)and group B received amniotic membrane transplantation(n=49). All patients were followed up with 1a. Breaking-up time(BUT)of tear film and recurrence rates were observed. RESULTS: One year after surgery, in the limbal epithelial autograft transplantation group, 4 eyes(7.4%)had recurrence pterygium, in the amniotic membrane transplantation group, 11 eyes(22.5%)had recurrence pterygium, The recurrence rates of the two surgical methods were significantly different(P<0.05). No statistically significant difference was observed between the two groups regarding postoperative tear film BUT(P>0.05). CONCLUSION: Limbal epithelial autograft transplantation combined with pterygium excision is superior to amniotic membrane transplantation in terms of recurrence rates.

AIM: To study the lacrimial pump functions and tear proteins of patients with functional Epiphora.METHODS: One hundred cases(200 eyes)with functional epiphora and 20 cases(40 eyes)of nonfunctional controls were recruited and under routine ophthalmic examinations, including Schirmer I test, Schirmer I test while pressing the lacrimal sac, tear film break-up time(BUT). Enzyme linked immunosorbent assay(ELISA)was used to detect main tear proteins, and the results were compared with control group. RESULTS: Compared the result of the Schirmer I test on the normal subjects while pressing the lacrimal sac with that of releasing the lacrimal sac, the difference was significant(t=-4.008, P<0.05). While the result on the functional epiphora group showed no significant difference(t=-0. 811, P>0.05). The mean BUT was significantly shorter than that in the normal subjects(t=-5.382, P<0.01). The concentrations of lactoferrin and albumin in the functional epiphora group decreased significantly(P<0.05), and the concentrations of Lactoferrin and secretory IgA didn't show significant(P>0.05).CONCLUSION: The damage of lacrimal pump function plays a great role in the functional epiphora and the tear proteins of functional epiphora patients changed.

AIM: To evaluate preoperative and postoperative the characteristics of microperimetry in patients who underwent macular surgery for idiopathic macular hole(IMH). METHODS: Fifty eyes of 50 patients with IMH were included in the study. Patients underwent pars plana vitrectomy and peeling of the internal limiting membrane(ILM). ILM visualization was improved by using triamcinolone acetonide(TA group)or indocyanine green dye(ICG group). Macular hole closure and retinal function was assessed preoperatively and postoperatively over a period of 6mo by spectral-domain optical coherence tomography examination, best corrected visual acuity(BCVA)and MP-1 microperimetry.RESULTS: Macular hole closure was achieved in 76%, Hole was not closed but calm in 16%, 8% was not closed in TA group and those in ICG group were 72%, 16% and 12% respectively, detected by optical coherence tomography(OCT). At 6mo, visual acuity improved in both groups(P<0.05), and there were no statistically significant differences of BCVA between groups. Mean macular sensitivity within the central 20° increased in both groups, and TA group's mean macular sensitivity was better than ICG group's. CONCLUSION: Vitrectomy and ILM peeling assisted with either TA or infracyanine green staining improves visual acuity and mean macular sensitivity at 6mo in patients affected by IMH. Macular microperimetry could be used to evaluation visual function changes of macular after surgery.

AIM:To summarize the pathology, B-scan ultrasound and CDI manifest of orbital neurinoma. Try to analyze the connection between the different amounts of cystic degeneration and vascular distribution and the findings in ultrasound and CDI imaging.METHODS: A retrospective analysis was performed on 44 cases with orbital neurinoma treated during January 2001 to December 2008, including 44 cases of pathological sections and B-scan ultrasound pictures, and 42 cases of CDI pictures. The connection between them were compared. RESULTS: The incidence of cystic changes in Antoni type A was the highest, mixed type followed, Antoni type B at least, which was statistical significance(P<0.05). Antoni type B had more blood vessel structures, mixed type followed, Antoni type A at least, which was not statistical significance. The coincidence rate between the cystic changes and nonuniform echo in ultrosonography was 50.0%. On the other hand, between the non-cystic changes and uniform echo, the coincidence rate was 69.3%. On CDI, 83.0% of Antoni type B and 59.2% of Antoni type A can be detected blood current with no statistical significance. CDI showed compliance rate of 100% between blood flow and pathology, with statistical significance. CONCLUSION: Mixed type is the most common type in orbital neurinoma. Cystic changes are more common in Antoni type A, while blood vessel structures are more common in Antoni type B. Ultrasonography can demonstrate the site, configuration and characteristics of the tumors, which is coincidence with the cystic changes and the blood vessels.

AIM: To analyze the occurrence and influencing factors of retinopathy in prematurity. METHODS: Totally, 103 premature infants born in Ningbo Women and Children's Hospital Department of Ophthalmology from May 2012 to May 2013 were selected as the research objects. The incidence and risk factors of screening for ROP were checked. RESULTS: The positive rate of preterm infants was 11.7%. Logistic multivariate regression analysis results showed that the gestational age, birth weight, oxygen concentration, mechanical ventilation, oxygen time, anemia, intracranial hemorrhage were the risk factors of ROP(P<0.05). CONCLUSION: Low birth weight of premature infants and oxygen concentration factors has significant relationship with the occurrence of ROP.

AIM: To investigate the related factors of the retinal hemorrhage in high-risk infants.METHODS: RetCam Ⅱdevice was used to examine the ocular fundus in 1 463 cases of high-risk infants in our hospital from October 2012 to April 2014.RESULTS: In 1 463 cases of high-risk infants, retinal hemorrhage was found in 381 infants(26.04%).In 556 cases of full-term newborns, retinal hemorrhage in 82 cases accounted for 14.75%. 181 cases of 907 premature infants were retinal hemorrhage, accounting for 19.96%. From self factor, neonatal asphyxia, neonatal hypoxic ischemic encephalopathy and intracranial hemorrhage had high incidence in retinal hemorrhage. From the maternal factors, pregnancy induced hypertension syndrome have a high incidence of retinal hemorrhage. CONCLUSION: The incidence of retinal hemorrhage in high risk infant was 26.04%.Neonatal asphyxia, neonatal hypoxic ischemic encephalopathy, intracranial hemorrhage and pregnancy induced hypertension syndrome may play roles of risk factor in retinal hemorrhage of high-risk infants.

AIM: To observe the effect of the treatment to the perfluorodecalin residue on macular subretinal by internal limiting membrane(ILM)peeling combined with 38G casing needle.METHODS: Twenty-nine cases(29 eyes)of retinal reattachment and with perfluorodecalin residual on the macular subretinal, selected in Xiamen Eye Center from January 2008 to October 2013, were divided into group A(14 cases, 14 eyes)and group B(15 cases, 15 eyes)randomly. In group A, after removal of silicone oil, perfluorodecalin liquids at the macular subretinal directly were aspirated by 38G casing needle. In group B, after removal of silicone oil, ILM was dyed and peeled completely to the range of 4PD approximately. Then the perfluorodecalin liquids at the macular subretinal were aspirated by 38G casing needle. All cases of both groups were filled with filtered air. After 1wk, the case with macular hole found by OCT was exchanged by air-fluid and filled with 16% C3F8. The best corrected visual acuity(BCVA)of two groups of patients was observed after 4, 8, 24wk. OCT was reviewed to observe whether there were perfluorodecalin residue on the macular subretinal, formation of macular hole and macular morphological changes, retinal detachment.RESULTS: BCVA was improved in both groups after 4, 8, 24wk. And the value of BCVA improvedin group B was better than that in group A(P<0.05). There were 7 cases(50%)with macular hole in group A and 1 case(7%)with macular hole in group B at 24wk after operation. In both groups, there were no perfluorodecalin residual on the macular and retinal detachment at 24wk after surgery.CONCLUSION: ILM peeling combined with 38G casing needle can aspirate completely the perfluorodecalin residual on macular. There were not caused macular hole and retinal detachment. This method is an safe, effective and minimally invasive surgical technique to protect the macular function.

AIM: To accurately measure the implicit time and amplitude of a-, b-wave from flash electroretinogram(ERG)through filtering technology, eliminate oscillatory potentials interference. METHODS: Full-field ERGs were recorded in 30 eyes of 15 physical check-ups, measured the implicit time and amplitude of a-, b-wave, when the passband was set at 0.6～300Hz and 0.6～70Hz, and correlation was performed among those results by paired t-test.RESULTS: When the passband was set at 0.6～70Hz, a-, b-wave had a single peak, compared with the passband was set at 0.6～300Hz, the implicit time of a-, b-wave was prolonged, amplitude was decreased(P<0.01). CONCLUSION: A passband of 0.6～70Hz was the best choice to obtain smooth a- and b-waves from the original ERG, It could accurately measure the implicit time and amplitude of a-, b-wave.

AIM: To discuss the subjective visual sensation of femtosecond lenticule extraction(FLEx)in treatment of moderate and high myopia and myopic astigmatism for 6mo follow-up, compare the efficacy with standard laser in situ keratomileusis(LASIK)and confirm FLEx had more advantages on improving visual quality after surgery.METHODS: In a prospective study 86(172 eyes)moderate and high myopia and myopic astigmatism patients were involved. The myopia degree was -3.00～-10.00D, the astigmatism degree ≤-6.00D. Eighty-six eyes were treated with FLEx in group A, and 86 eyes were treated with LASIK in group B. All patients in the treatment group completed the final 6mo of follow-up. The higher-order aberrations and the uncorrected visual acuity(UCVA)and the best spectacle-corrected visual acuity(BSCVA), objective and manifest refractions, results of slit-lamp examination, the side effects, the corneal flap thickness, intraocular tensionare, corneal topography were noted.RESULTS: All of operations on 172 eyes were successful without severe complications after 6mo follow-up. The total higher order aberration and spherical aberration induced by FLEx were lower than that by LASIK.CONCLUSION:FLEx for high myopia and myopic astigmatism has obvious superiority in the aspect of improving visual quality.

AIM: To investigate the application of small incision non-phacoemulsification to construct 9 o'clock range of auxiliary incision in the primary prevention of blindness. METHODS: Totally, 160 cataract patients(160 eyes)were randomly divided into the observation group(85 cases, 85 eyes)that were constructed 9 o'clock range of auxiliary incision in small incision non-phacoemulsification and the control group(75 cases, 75 eyes)that was operated the traditional manual sutureless in small incision non-phacoemulsification. The operation time of postoperative astigmatism and postoperative visual acuity between the control group and the observation group were compared.RESULTS: There were statistical significance in visual acuity and the operation astigmatism at 1,2wk,1,3mo(P<0.05). CONCLUSION:To control 9 o'clock range of auxiliary incision in small incision non-phacoemulsification reduces the operation of postoperative astigmatism and restore good eyesight at the same time, it has certain practicability and effectiveness.

AIM: To observe the clinical effect of micro-coaxial phacoemulsification combined with intraocular lens implantation in axial high myopia with cataract.METHODS: Fifty-three patients(74 eyes)with axial high myopia and cataract underwent micro-coaxial phacoemulsification combined with intraocular lens implantation between April 2013 and December 2013. The best corrected visual acuity(BCVA)was observed at 1 and 3mo after operation, and the complications were recorded.RESULTS: Compared with the preoperative, BCVA was improved at 1 and 3mo after operation, and the differences were statistically significant(P<0.05). There was no statistically significant difference between 1 and 3mo after operation(P>0.05). There was no incidence of complications, such as retinal detachment, iris damage, pupil deformation, cystoid macular edema, endophthalmitis after operation in all patients.CONCLUSION:Micro-coaxial phacoemulsification combined with intraocular lens implantation is an effective and safe method for axial high myopia with cataract.

AIM: To analyze huge hardcore cataract surgery with the diameter of the circular capsulorhexis size, discuss circular capsulorhexis technique improvement and evaluate the application advantages of anterior capsule continuous curvilinear capsulorrhexis combined with anterior capsule opening radial multi-point cutting surgery in huge hardcore cataract surgery. METHODS: Sixty-nine cases(80 eyes)with huge hardcore cataract, successfully underwent anterior capsule continuous curvilinear capsulorrhexis combined with anterior capsule opening radial multi-point cutting surgery, and delivered nuclear smoothly. RESULTS: Seventy-eight eyes(98%)successfully completed surgery. Two eyes occurred capsular rupture or part of the suspensory ligament rupture caused by squeezing huge hardcore. Intraoperative, nuclear was spun into the anterior chamber by hands, or dragged into the anterior chamber using circle key and delivered. Pupil vitreous was cleaned up, then suspensory intraocular lens was implanted at second stage.CONCLUSION: As the improvement surgery of anterior capsule continuous curvilinear capsulorrhexis combined with anterior capsule opening radial multi-point cutting method is safe and effective in huge hardcore cataract surgery.

AIM: To research and analyze the impact of distraction on cataract surgery operations. METHODS: Twenty randomly selected hospital physicians were divided into lack of experience group(composed of 10 residents)and experienced group(of 10 go further than attending physician and composition). Two physicians were distracted attention and lower case exercises carried 10 times circular capsulorhexis simulated operation, operation time for the two groups, the effect of surgery were observed and compared. RESULTS: The focus group situation experienced operative time was significantly lower than the distraction group,with statistically significant difference(P<0.05); Comparison result of surgery score and completion success rate of the two cases had no significant difference(P>0.05); Operative time of lack of experience focus group was significantly lower than the distraction group, the completion of surgery and surgical score was significantly higher than the success rate of distraction group, difference was statistically significant(P<0.05).CONCLUSION: Cataract surgery operation process, experienced and less experienced intraoperative caught will be distracted affected, the former under the influence of distracted surgical operation time will be extended, but the effect is not affected, the latter operating time and results of operations will be subject to adverse effects.

AIM: To evaluate the correlation between retinal thickness and photopic flash electroretinogram(ERG)parameters(Cone a-wave, Cone b-wave, and 30Hz flicker)in patients with central retinal vein occlusion(CRVO)and macular edema. METHODS: A total of 25 patients(25 CRVO eyes and 25 unaffected fellow eyes)with CRVO underwent the examination of optical coherence tomography(OCT)and photopic falsh ERG. The amplitude and implicit time of the ERG parameters were extracted from the ERG traces. Retinal thicknesses were measured by OCT in nine macular subfields. Then the correlations between ERG parameters and macular morphological parameters were analyzed. RESULTS: The Cone b-wave and 30Hz flicker implicit time were correlated with macular retinal thickness in seven out of nine subfields, excluding the temporal subfields. CONCLUSION: The retinal thickness of the macular edema may be associated with inner retinal function in CRVO patients.

AIM: To detect the macular ganglion cell complex thickness in monocular strabismus amblyopia patients, in order to explore the relationship between the degree of amblyopia and retinal ganglion cell complex thickness, and found out whether there is abnormal macular ganglion cell structure in strabismic amblyopia. METHODS: Using a fourier-domain optical coherence tomography(FD-OCT)instrument iVue®;(Optovue Inc, Fremont, CA), Macular ganglion cell complex(mGCC)thickness was measured and statistical the relation rate with the best vision acuity correction was compared Gman among 26 patients(52 eyes)included in this study. RESULTS: The mean thickness of the mGCC in macular was investigated into three parts: centrial, inner circle(3mm)and outer circle(6mm). The mean thicknesses of mGCC in central, inner and outer circle was 50.74±21.51μm, 101.4±8.51μm, 114.2±9.455μm in the strabismic amblyopia eyes(SAE), and 43.79±11.92μm,92.47±25.01μm, 113.3±12.88μm in the contralateral sound eyes(CSE)respectively. There was no statistically significant difference among the eyes(P>0.05). But the best corrected vision acuity had a good correlation rate between mGcc thicknesses, which was better relative for the lower part than the upper part. CONCLUSION:There is a relationship between the amblyopia vision acuity and the mGCC thickness. Although there has not statistically significant difference of the mGCC thickness compared with the SAE and CSE. To measure the macular center mGCC thickness in clinic may understand the degree of amblyopia.

Long-term use of systemic or topical glucocorticoid can cause posterior subcapsular opacities(PSO), named glucocorticoid-induced cataract(GIC). There are many hypotheses on the pathogenesis of GIC. However, no one has well explained the formation of PSO, which leads to no effective approaches in the prevention and/or treatment. A new opinion is that hormones might affect lens epithelial cells through GR-mediated vimentin changes, which eventually result in the formation of GIC. Therefore, the association between vimentin and lens epithelial cell proliferation and differentiation, maybe a new direction for further studies in the pathogenesis of GIC.

Congenital cataract is a common eye disease which leads to children low vision. Surgery is the main treatment. Because of children's preoperative evaluation, operation, postoperative management is more difficult than adult, the outcome of surgery is not so well. Therefore, we review the relevant congenital cataract surgery researches in recent years in order to discuss the problems and further developments in this area.

Intraocular lens(IOL)implantation is the major method to replace the cataract lens. How to improve the biocompatibility of IOL has been the focus of current research. Major reactions after the IOL implantation include endophthalmitis, corneal endothelial edema, iritis, uveitis, and posterior capsule opacification, etc. At cellular level, macrophages, monocytes, fibroblasts and lens epithelial cells can be detected on the surface of IOL. Their adhesion, proliferation migration, and transformation may be induced by the operation related cytokines released into the aqueous humor. Detailed analysis of cytokines profile after IOL implantation may be beneficial to explore the mechanism of posterior capsule opacification.

Proanthocyanidins is an effective antioxidants and free radical scavenger derived from kinds of plants in nature. It has some advantages that high absorptivity and bioactivity, low toxicity, which contain broad pharmacological functions such as dropping high blood pressure, reducing blood fat, anti-inflammatory, anti-cancer, anti-aging, anti-fatigue and preventing cardiovascular and cerebrovascular diseases. In this paper, we summarized its physicochemical properties, pharmacologic action and the ophthalmological studies which mainly in keratopathy, cataract, glaucoma, uveitis, retinopathy, traumatic optic neuropathy and asthenopia. With the deeper research and more unequivocal in the pharmacological mechanism of proanthocyanidins, it should make the most of its values in medicine. And some more economical and effective drugs are expected to be provided for the clinical ophthalmology in the near future.

AIM: To investigate the operation time, effect and complication of transconjunctival approaches for orbital blowout fractures Medpor reconstruction. METHODS: Twenty-one patients with orbital blowout fractures were performed transconjunctival approaches for orbital blowout fractures Medpor reconstruction from 2010 to 2014. All the patients were divided into the early operation group(12 cases)and the late operation group(9 cases)based on the treatment time and followed up for 3～12mo. The diplopia, exophthalmos, sensory disturbance degree of infraorbital nerve and complications, effectives of the operation were analyzed and compared. RESULTS: The cure rate of diplopia was 76.2%(16/21), 83.3%(10/12)in the early operation group and 66.7%(6/9)in the late operation group with statistical difference(P<0.05). The cure rate of enophthalmos was 81.0%(17/21), 83.3%(10/12)and 77.8%(7/9)in the early and later operation group, without statistical difference(P>0.05).T the cure rate of sensory disturbance degree of infraorbital nerve was 57.1%(12/21), 58.3%(7/12)vs 55.6%(5/9)(P>0.05). No operation complications were observed. CONCLUSION: Medpor reconstruction with transconjunctival approaches is safe, simple and reliable for patients with orbital blowout fractures. Early operation treatment should be performed in two weeks when conservative treatment was not useful.

AIM: To investigate the choice basis of orbital muscle excision and botulinum toxin A injection in the treatment of blepharospasm.METHODS: This retrospective clinical analysis was involved 100 cases with idiopathic blepharospasm. According to the degree of blepharospasm, they were divided into 0-Ⅳ grade, and divided into two groups. Group A included 60 cases(Ⅰ～Ⅲ grade)treated with botulinum toxin A, and 40 cases(>Ⅲ～Ⅳgrade)in group B treated with orbital muscle excision during the period from March 2012 to May 2014 in our hospital. Patients were followed up 3 ～ 24mo.RESULTS: In 60 cases of group A, After treatment, 57 patients were completely corrected with classified grade of 0, 2 patients residue spasm, but its grade was decreased significantly, and 1 case had no effect. Of 40 patients in group B were in grade>Ⅲ～Ⅳ, 25 patients were poor response to botulinum toxin treatment and accompanied with drooping eyebrow and eyelid ptosis symptoms. Thirty patients were completely corrected after injection, 7 residue cases were in grade Ⅰ, 3 cases in grade Ⅱ.CONCLUSION: The correct choice of the treatment for blepharospasm according to the clinical classification can improve the efficacy and safety.

AIM: To observe the clinical effect subconjunctival bevacizumab and triamcinolone acetonide(TA)on corneal neovascularization(CNV)induced by penetrating keratoplasty.METHODS: Nineteen patients(20 eyes)with CNV induced by penetrating keratoplasty after 3mo were selected and were divided into 4 groups randomly: Group A was control group, group B was treated by subconjunctival of bevacizumab(2.5mg, 0.1mL), group C was treated by subconjunctival of bevacizumab(2.5mg, 0.1mL)and TA(4mg, 0.1mL), group D was treated by subconjunctival of TA(4mg, 0.1mL), one time each month, twice.RESULTS: The average follow-up period was 3a. Visual acuity of groups B and C kept stable or increase slightly. CNV and immunologic rejection were lighten(P<0.01), symptomatic of ophthalmalgia and photophobia relief synchronous.CONCLUSION: Treatment of subconjunctival bevacizumab and TA can effectively inhibite CNV and immunologic rejection, also has the therapeutical effect to maintain implant transparence after penetrating keratoplasty.

AIM: To investigate the related factors of the retinal hemorrhage in high-risk infants.METHODS: RetCam Ⅱdevice was used to examine the ocular fundus in 1 463 cases of high-risk infants in our hospital from October 2012 to April 2014.RESULTS: In 1 463 cases of high-risk infants, retinal hemorrhage was found in 381 infants(26.04%).In 556 cases of full-term newborns, retinal hemorrhage in 82 cases accounted for 14.75%. 181 cases of 907 premature infants were retinal hemorrhage, accounting for 19.96%. From self factor, neonatal asphyxia, neonatal hypoxic ischemic encephalopathy and intracranial hemorrhage had high incidence in retinal hemorrhage. From the maternal factors, pregnancy induced hypertension syndrome have a high incidence of retinal hemorrhage. CONCLUSION: The incidence of retinal hemorrhage in high risk infant was 26.04%.Neonatal asphyxia, neonatal hypoxic ischemic encephalopathy, intracranial hemorrhage and pregnancy induced hypertension syndrome may play roles of risk factor in retinal hemorrhage of high-risk infants.

AIM: To investigate the distribution and drug resistance of the pathogenic bacteria in acute bacterial conjunctivitis in Xingtai, and to provide a reliable basis for clinical diagnosis and treatment.METHODS: Secretion specimens were taken from the patients with acute bacterial conjunctivitis in Xingtai Ophthalmic Hospital during January 2010 to December 2012 for bacterial culture. The pathogenic bacteria and drug sensitivity test were analyzed. RESULTS: Of the 186 specimens, 150(80.6%)were positive in culture, in which 127(84.7%)were gram-positive bacteria, the first three species were Staphylococcus epidermidis(42/127, 33.1%), Human staphylococal(15/127, 11.8%), Staphylococcus haemolyticus(6/127, 4.7%). Twenty-three(15.3%)were gram-negative bacteria, the first four species were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Enterobacter cloacae, the percentage of all resistance were 13.0%. Gram-positive strains were 100% sensitive to vancomycin, and were resistance to other antibiotics with different degree. Gram negative bacteria had the highest rate of drug resistance to cefoperazone 87.0%). CONCLUSION:Some opportunistic bacteria including Staphylococcus epidermidis have become the majority of pathogenic bacteria of acute bacterial conjunctivitis in this area. Both gram-positive bacteria and gram-negative bacteria were higher to drug resistance. Early bacterial culture combined with drug sensitivity test is grate significance for clinical diagnosis and reasonable clinical chose of antibiotics.

Age-related macular degeneration(AMD), the most common cause of irreversible blindness over 50 years in developed countries, is a degenerative disease occurs with age. The prevalence rate in our country is also increasing by year and the pathogenesis is still undiscovered. In this review, we focus on the associated risk factors reported in recent years, aim to further understand the pathogenesis of AMD.

Retinoblastoma(RB)is the most common intraocular malignancy of children with extremely poor prognosis. MicroRNAs are small non-coding single-stranded RNAs in eukaryotic cells, which regulate the expression of gene by mRNA degradation or translation inhibition. MicroRNAs, acting as oncogenes or tumor suppressor genes, are associated with the occurrence and development of RB directly, which is vital for the early diagnosis and clinical targeted therapy of RB. This review summarized the expression of microRNAs in RB and the related mechanism.

High altitude retinopathy(HAR)refers to the body which can't adapt to the hypobaric hypoxia environment at high altitude leading to retinal diseases, which typically manifested as retinal hemorrhages, optic disc edema and cotton wool spots. With the development of high altitude medicine, HAR become a hot topic of eye research in recent years. New researches show a significantly higher incidence of HAR, and HAR has a close contact with acute mountain sickness, high altitude cerebral edema and high altitude pulmonary edema. A further study in pathogenesis and prevention measures of HAR will promote the prevention of altitude sickness. Traditional Chinese Medicine has achieved good effects in the prevention of altitude sickness, but the effect and mechanism of herbs on HAR has not been reported. Through read and summarize the relevant literatures and reports, the author will give an overview of the research advances on HAR's pathogenesis and application of Traditional Chinese Medicine.

AIM:To evaluate the clinical effects of amniotic membrane transplantation in the treatment of fungal corneal ulcer. METHODS: Fifty cases(50 eyes)of fungal corneal ulcer were included in this study from January 2010 to December 2013. The cases were divided into two groups randomly, the experimental group and the control group. The experimental group was treated by antifungal drugs and amniotic membrane transplantation. The control group was treated only by antifungal drugs. The visual analogue scale(VAS)of the symptoms, the ulcer healing time, the vision and the complications were observed. RESULTS: The symptoms of the experimental group were disappeared more quickly than the control group 1,2wk after treatment, for example Pain(t=6.463, t=10.134; P<0.05), Photophobia(t=5.02, t=7.534; P<0.05), Foreign body sensation(t=3.771, t=7.459; P<0.05). The ulcer healing time of the experimental group were shorter than that of the control group(t=9.524,P<0.05). The vision of the experimental group was got better than that of the control group 1mo later(F=6.414,P<0.05).The complications of the experimental group were fewer than that of the control group(F=29.621, P<0.05). CONCLUSION: Amniotic membrane transplantation is an effective treatment to fungal corneal ulcer.

AIM: To find out the relationship between the pathological changes of medial rectus muscles and the occurrence of concomitant exotropia. METHODS: Thirty cases of concomitant exotropia patients were collected to conduct the plastic surgery for strabismus correction. Medial rectus amputated intraoperative were fixed with 4% formaldehyde and then sent to histologic examination. The organizational structure of extraocular muscles was observed, Hematoxylin-eosin(HE)and Masson staining were conducted under microscope. RESULTS: In the 30 cases, medial rectus muscle fiber presented different sizes, abnormal morphology, number reducing, and the muscle showed varying degrees of fibrosis. After Masson staining, it was found that extraocular muscle fiber content of longer strabismus patients were significantly shorter than that of shorter strabismus patients(P<0.05).CONCLUSION: The occurrence of concomitant exotropia is related with the abnormal structure of extraocular muscles,with higher extent of fibrosis of extra-ocular muscle in the long period of constant concomitant exotropia than in the late-onset concomitant exotropia. That means the fibrosis of medial rectus probably is the reason of concomitant exotropia. The extent of fiber degeneration change of concomitant exotropia increased with the occurrence of it.

AIM: To observe the effect of axial length on color Doppler hemodynamic of nonproliferative diabetic retinopathy(NPDR)eye. METHODS: This is a prospective comparative case series study. The hospitalized patients with diabetic retinopathy from January 2012 to December 2013 in Department of Ophthalmology and Endocrinology of our hospital were included, those with central retinal significant edema, hemorrhage, exudation and significant other fundus lesions were excluded. According to ocular axial length measured by ophthalmologic A/B ultrasound scanner and axial length, the patients were divided into normal axial group(22～<24mm), long axial group(24～<26mm)and super-long axial group(26mm or above). Color Doppler hemodynamic parameters of all patients were measured. Totally, 248 cases(248 eyes)with complete research data were statistically analyzed and were observed the correlation between axial length and eye color Doppler hemodynamics. RESULTS: Compared with normal axial group, OA PSV(cm/s)of long axial group did not change significantly(t=1.362, P=0.20), CRA PSV(cm/s)was high(t=-2.335, P=0.02), PCA PSV(cm/s)was higher(t=2.756, P=0.01), PI(t=-2.371, -2.585, -2.67; P=0.02, 0.01, 0.01)and RI(t= 2.348, 2.462, 2.293; P=0.02, 0.01, 0.03)is relatively lower, there were statistically significant differences(P<0.05). When compared with super-long axial group, ultra long shaft section OA(t=3.290,P=0.00)low, CRA and PCA PSV of normal axial group was higher(t=3.290, -5.520, -4.900; P=0.00, 0.00, 0.00), PI(t=4.970,6.160,5.990; P=0.00, 0.00, 0.00)and RI(t=-4.310, -5.230, -4.390; P=0.00, 0.00, 0.00)was lower, there was statistically significant differences(P<0.005). When compared with long axial group, OA in PSV(cm/s)of super-long axial group was more slower, but with no statistical significance(t=1.967, P=0.07), CRA PSV(cm/s)was lower(t=-2.543, P=0.01), PCA PSV(cm/s)was higher(t=-2.198, P=0.04), PI(t=-2.331,-2.135, -4.191; P=0.03, 0.03, 0.00)and RI(t=2.570, 2.360, 2.490; P=0.01, 0.02,0.01)was relatively lower, there were significant differences(P<0.05). CONCLUSION: There is a clear correlation between axial length in diabetic retinopathy and ocular hemodynamics with color Doppler index.

AIM: To study the model to predict distant vision with diopter and to explore the distant vision standard for civil aviator recruitment in China.METHODS: The data about distant vision and diopter of 1 219 students participating in physical examination of Civil Aviation Flight University of China from 2006 to 2013 were collected. A model of index regression curve with diopter as independent variable and distant vision as dependent variable was established. The predicted value and 95% prediction interval of distant vision to specific diopter were calculated according to the model. The error rate was calculated by formula: error rate= \〖(distant vision predicted value-actual average value)/actual average value\〗×100%.RESULTS: The curve model with diopter to predict distant vision was: y=0.55e0.41x +e(R2=0.968). The average error rate of predicted distant vision was 3.64%. With diopter range \〖0.00,-3.00\〗D, the 95% prediction interval of predicted distant vision \〖0.14, 0.55\〗 didn't completely coincide with the current standard(0.3≤distant vision<0.7).CONCLUSION: The fitting effect of the model is good and can be used to predict reasonable distant vision according to diopter. It is suggested to maintain diopter standard of China's civil aviation recruitment \〖0.00, -3.00\〗D unchanged, and drop the distance vision standard to 0.1.

AIM: To examin college students part of refractive features(corneal curvature, axial length), and understand their impact on college students myopia.METHODS: In 456 college students(912 eyes)with myopia, cycloplegic retinoscopy optometry was used to measure the refractive error, corneal curvature, and axial length. The data were conducted and analyzed.RESULTS: In 456 cases(912 eyes)with myopia, diopter of 524 eyes was less then -3.00DS, accounting for 57.5%, -3.25～-6.00DS was in 265 eyes(29.1%)and 123 eyes were more than -6.25DS, accounting for 13.5%. The mean axial length was significantly different between high myopia and low to moderate myopia(P<0.05). In two different diopter groups with different age, corneal diameter vertical lines, and horizontal diameter of curvature were significantly different(P<0.05).CONCLUSION: Students with low myopia was for most, accounting for 57.5%. The incidence of myopia in girls was more than that in boys. This situation may be related to female puberty earlier than boys. There is no evidence that myopia in students of moderate or low myopia group is due to axial extension. It probably caused by unbalanced curvature of refraction elements and matching disorders. In the high myopia group, myopia mainly dues to axial myopia growth.

AIM: To investigate the effect of gap-filling repair for traumatic corneal coloboma with autogenous Tenon capsule.METHODS:Totally, 100 cases with corneal coloboma were studied and divided into two groups randomly(each group n=50). Fifty patients were treated with the repairment of autogenous Tenon capsule as treatment group and 50 patients were treated with the conventional therapy as control group. RESULTS: The effective rate of treatment group(88%)was significantly higher than that of control group(68%)(P<0.05). No complications were found in two groups. CONCLUSION: Gap-filling repair for traumatic corneal coloboma with autogenous Tenon capsule is an effective and promising treatment option for traumatic corneal coloboma.

AIM: To analyze quantitatively the biological characteristics of corneal endothelium in old patients of high myopia with non-contact automatic corneal endothelial microscope.METHODS:A total of 189 old patients(197 eyes)were divided into the high myopia group and the normal control group according to refractive diopter, in which the former 98 cases(103 eyes), the latter 91 cases(94 eyes). The hexagonal cell(6A), the coefficient of variation(CV), the average cell area(AVE), the average cell density(CD)and the central corneal thickness(CCT)were measured by non-contact automatic corneal endothelium. SPSS 14.0 software was used to analyze their percentage. Z-test was used to compare the mean and Chi-square test was used to compare the rate in between. RESULTS: The average cell density in high myopia patients decreased, but there were 14 eyes >3 000/mm2, 11 eyes <2 000/mm2 and 78 eyes in the 2 000～3 000/mm2, there were each 0 eye, 3 eyes and 91 eyes respectively in the normal control group. There was statistically significant difference between high myopia group and control(χ2=19.11, P<0.05). Meanwhile the percentage of the hexagonal cell decreased, the coefficient of variation and the average cell area increased. There was statistically significant difference between high myopia group and control(P<0.05). There was no statistically significant difference in the central corneal thickness between the two groups(P>0.05). CONCLUSION: There will provide a reference valuable for clinical surgeon. Because according to the changes of parameters and morphology of the corneal endothelial cells, we can understand the repair ability, to predict the consequence of the treatment, in order to determine the design and the choice of a surgical.

AIM: To compare corneal epithelial injury by using different surface anesthetics in A ultrasound examination. METHODS: Subjects who accepted A ultrasound examination were randomly divided into three groups: 5g/L tetracaine group(n=50), 20g/L lidocaine group(n=60)and 5g/L Aier Kai genome group(n=60). The patients were instructed to use the surface anesthetics three times in a five minute interval before the A ultrasound examination. Corneal epithelial injury was measured by corneal fluorescein staining. RESULTS: χ2 test results showed the CSF score of three groups had significant difference(P<0.05). The extent of damage to the cornea in the 5g/L Aier Kai genome group was significantly lower compared with the others(P<0.05). CONCLUSION: Varying degrees of damage to the corneal epithelium caused by surface anesthetics and toxic effects of 5g/L Aier Kai genome on the corneal epithelium is minimum.

AIM: To improve quality control of integrative medicine ophthalmology teaching research department continually. METHODS: The background, theoretical basis and procedures of quality control circle(QCC)were introduced. The feasibility of QCC in the quality improvement of integrative medicine ophthalmology teaching research department was analyzed. The QCC pilot activity in integrative medicine ophthalmology teaching research department of our school were reviewed and summarized. The tangible and intangible achievements of QCC activity were analyzed. RESULTS: After QCC's application, the species of teaching method, the number of multimedia, student engagement, student satisfaction, exam scores have improved to some extent, resulting in good tangible outcomes. At the same time, the department team's harmony, problem-solving skills, communication and coordination, responsibility, enthusiasm also improved, resulting in good intangible outcomes.CONCLUSION: The methods of QCC were introduced into the quality control of integrative medicine ophthalmology teaching to improve the quality of this subjects teaching administration comprehensively and strengthen core competitiveness of integrative medicine ophthalmology teaching research department.

AIM: To assess the efficacy differences of probucol and atorvastatin for the treatment of diabetic macular edema.METHODS: By searching the RCT, Pubmed, BMA, EMbase, ASP, The Cochrane Library, EMCC, CBM, CNKI, CECDB, CQVIP, VIP database from January 1999 to January 2014, strict appraisal and data extraction on the quality of the included studies, using Stata/SE version 12.0 software was used for statistical analysis.RESULTS: Eight RCTS, a total of 309 patients, were included, in which 152 cases usingprobucol, 157 cases using atorvastatin. The results showed that compared with atorvastatin group, the number of macular edema patients using probucol with DME was significantly increased\〖OR=1.75, 95%CI=(1.02, 3.01)\〗, after 90d, urinary 8-hydroxy deoxyguanosine significantly decreased \; but system evaluation also showed that: the differences of the two medicines on macular hard exudates were not statistically significant \〖OR=0.80, 95%CI=(0.41, 1.57)\〗, after treatment for 30d, the content of urinary 8-hydroxy deoxyguanosine between two groups had no significant difference\.CONCLUSION: Theprobucol can effectively restrain the production of lipid peroxidation, inhibit the foam cells deposition in the retina, thereby improving the symptoms. Compared with atorvastatin, the treatment of DME using probucol has better clinically effect.

AIM: To investigate the application of optical coherence tomography(OCT)examination to determine the feasibility and clinical value of retinal artery occlusion of this kind of emergency among the eyesight drops suddenly patients awaiting diagnosis due to refractive medium.METHODS:Seventy-eight eyesight drops suddenly and awaiting diagnosis patients accepting OCT inspections and confirmed by fundus fluoresceai angiography(FFA)in our hospital were retrospectively analyzed. With FFA examination as the judging standard and with OCT examination as the evaluation means of inspection, the statistics of OCT sensitivity, specificity and accuracy were counted using the statistical software. The statistics of method sensitivity and the total coincidence rate, specific degrees were counted using statistical software, then to statistically analyze the time difference of two methods from the clinic doctors prescribed checklist to report was given.RESULTS:The sensitivity of OCT examination, specific degrees and the total coincidence rate were very high, 100%, 94.1% and 98.4%, respectively. From the clinic physicians prescribe the checklist to report available, the OCT examination time significantly shorter than the FFA(P=0.000), the difference was statistically significant.CONCLUSION: Clinically to the eyesight drops suddenly patients awaiting diagnosis due to refractive medium, OCT examination should be used first to determine whether for retinal artery obstruction diseases, in order to more quickly treat patients and to win time of rescue vision.

AIM: To analyze dark adaptation time and related factors in the current aircrews, and provide the basis for further development of targeted promotion measures and training.METHODS: TSJ-Ⅰtype aircrew special instrument was used for checking dark adaptation time, while data was analyzed with age, time of flight, aircraft types and flight duties. RESULTS: Dark adaptation time of most aircrews was less than 30s and prolonged by age and flight time(>3 000h), especially in transport aircrew group and mechanic aircrew group. CONCLUSION:The dark adaptation time of aircrews extends by age, meanwhile strength flight and long-term of flying environment have significant effects on dark adaptation. Different machine types and functions of aircrew need appropriate training and protective measures.

AIM: To evaluate the clinical therapeutic efficacy of intravitreal ranibizumab injection combined grid laser photocoagulation for macular edema secondary to branch retinal vein occlusion(BRVO). METHODS: Forty-two confirmed cases(42 eyes)with macular edema secondary to BRVO were randomized into 3 groups, each group contained 14 eyes. The ranibizumab group was received intravitreal injection of ranibizumab(0.05mL), the laser group was received grid laser photocoagulation, and the combined group was received a second therapy of grid laser photocoagulation after 1wk of the intravitreal injection of ranibizumab. Recorded the best-corrected visual acuity(BCVA)and the central macular thickness(CMT)preoperative and at 1, 3, 6mo after therapy. RESULTS: The BCVA and the CMT had no differences among three groups pretherapy(P>0.05). While BCVA was much better and CMT was reduced significantly posttherapy than pretherapy in all three groups(P<0.05). The BCVA and CMT in the ranibizumab group were significantly different in every time point(1, 3, 6mo)(P<0.05). The BCVA declined and the CMT was thicker as the time went on. In the laser group and the combined group, BCVA and CMT had little differences in different time point(P>0.05). While the BCVA was better and the CMT was thinner in the combined group than ranibizumab group and laser group at every time point(P<0.05). At 3 and 6mo, the BCVA was better and the CMT was thinner in laser group than Ranibizumab group(P<0.05).CONCLUSION: The intravitreal ranibizumab injection combined grid laser photocoagulation is an effective treatment method for the macular edema secondary to BRVO, it is more effective in improving BCVA than intravitreal ranibizumab or grid laser photocoagulation alone.

AIM: To evaluate the visual quality between femtosecond laser small incision lenticule extraction(SMILE)and femtosecond laser in situ keratomileusis(LASIK)in the treatment of myopia. METHODS: This study comprised 22 eyes(11 patients)underwent SMILE and 43 eyes(23 patients)received LASIK with femtosecond laser to correct myopia and myopic astigmatism. The two groups were recorded bydouble-pass optical quality analysis system(OQAS)at preoperative and postoperative 1mo. The two groups were compared: modulation transfer function cutoff frequency(MTF cutoff), strehl ratio(SR), objective scattering index(OSI). The early visual quality after operation between two groups were analyzed and evaluated.RESULTS: The MTF cutoff after operation one month were 34.835±10.113c/deg(SMILE group)and 38.362±10.623c/deg(LASIK group)(t=0.925, P=0.362). The SR after operation one month were 0.204±0.077(SMILE group)and 0.218±0.072(LASIK group)(t=0.557, P=0.582). The OSI after operation one month were 0.608±0.291(SMILE group)and 0.545±0.405(LASIK group)(t=-0.473, P=0.640). CONCLUSION: The double-pass OQAS tell us that there was not statistically significant between femtosecond laser SMILE and femtosecond LASIK in the treatment of myopia.

AIM: To analyze the bacteriological observation and incidence of bacterial endophthalmitis on meibomian gland massage couple with dilute iodine volts liquid flushing the conjunctival sac before cataract surgery. METHODS: Totally 500 eyes in our hospital outpatient and hospitalization cataract patients were tested with the clinical observation of bacteriology on meibomian gland massage couple with dilute iodine volts liquid flushing the conjunctival sac before cataract surgery. RESULTS: All eyes of cataract which received meibomian gland massage with dilute iodine volts liquid flushing conjunctival sac were carried out randomly the bacteriology training, the sample of conjunctival sac mixture residue fluid had no bacteria growth, no case of cataract patient took place the bacterial endophthalmitis and postoperative anterior chamber of inflammatory reaction. CONCLUSION: Meibomian gland massage makes the meibomian gland secretions and bacteria overflow, flushing conjunctival sac with dilute iodine volts liquid not only can wash conjunctival sac, meibomian gland secretions and bacteria but also can kill bacteria, to ensure the germ-free environment during the eye operation and prevention of bacterial endophthalmitis, which is of great significance to prevention of bacterial endophthalmitis, the method is simple, easy and economic.

AIM: To discuss the clinical efficacy, the safety, the thickness range and operating key points of LASIK personal corneal flap made by FS200 femtosecond laser machine.METHODS: A total of 1 620 eyes of 815 patients underwent LASIK with flaps created by wavelight FS200 femtosecond laser were involved. Corneal flaps thickness in operation was measured, the intraoperative and postoperative complications were observed and summarized.RESULTS: 98.16% the uncorrected visual acuity(UCVA)postoperation 1d and 100% the UCVA postoperation 1wk reached the best corrected visual acuity preoperation or above; 97.55% of spherical equivalent refractions postoperation 1d and 98.16% of spherical equivalent refractions postoperation 1wk were within ±0.50D; 99.39% of spherical equivalent refractions postoperation 1d and 100% of spherical equivalent refractions postoperation 1wk were within ±1.00D; There were difference of corneal flaps thickness between measured value and preset value(P<0.05); 80 eyes of 70 patients had subconjunctival hemorrhage(4.94%), 40 eyes of 40 patients had bubbles under flap(2.47%), 2 eyes of 2 patients had anterior chamber bubbles(0.12%), 40 eyes of 20 patients bleed in canal(2.47%), 2 eyes of 1 patient bleed in corneal margin(0.12%), 3 eyes of 3 patients had flaps with an marginal uncut area(0.19%), 10 eyes of 10 patients had flaps with an irregular and dislocated margin(0.62%), 1 eye of 1 patient had suction loss during the operation(0.06%), 8 eyes of 7 patients postponed operation(0.49%).CONCLUSION: FS200 femtosecond laser is safe, comfortable and little complications in the production of LASIK flaps. If the surgeon operate expertly, patients cooperate well and have healthy cornea epithelium, FS200 femtosecond laser can make ultra-thin corneal flap of 90SymbolmA@m safely.

AIM:To measure the changes of macular retinal nerve fiber layer thickness at different quadrants and macular fovea in diabetic and nondiabetic patients after phacoemulsification. METHODS: This was a retrospective nonrandom clinical comparison study, 90 patients(110 eyes)who underwent phacoemulsification were recruited, nondiabetic patients(32 cases, 40 eyes)were in group A, in diabetic without diabetic retinopathy(28 cases, 35 eyes)were as group B, with non-proliferation diabetic retinopathy(30 cases, 35 eyes)were group C. Macular retinal nerve fiber layer thicknesses were collected by optical coherence tomography on the preoperative day and on postoperative 1st, 14th, 28th d. Statistical analysis of count data measurement data were done separately by the Chi-square test, variance analysis and SNK-q test. RESULTS: The foveal: There was significant increase could be detected among A, B, C(F=18.92, P<0.05), while group C showed significant difference as compared with groups A and B(P<0.05). The quadrant: There was significant increase could be detected among A, B, C(F=13.33, 14.37, 19.02, 16.93, P<0.05). This was not statistically significant of nasal among A, B, C groups(P>0.05). However group C showed significant difference in the superior, the inferior, the temporal as compared with groups A and B(P<0.05).CONCLUSION: Macular retinal nerve fiber layer thickness and macular fovea of patients with diabetic retinopathy were significant increased after phacoemulsification in 4wk, the incidence of macular edema is higher, the time earlier, the duration longer, the poorer visual recovery.

AIM: To explore the efficacy and safety of soft contact lens(SCL)in postoperative of pterygium surgery with limbal conjunctival autograft.METHODS: Pterygium surgery with limbal conjunctival autograft was performed to 38 eyes of 38 patients. After surgery in 19 eyes of 19 patients of group A, SCL was placed on the cornea. In 19 patients(19 eyes)of group B, antibiotic eye ointment was applied and tightly covered with bandage. Follow-up visits were performed on the 24th and 48th hour after the surgery. Re-epithelization time and pain scores were compared.RESULTS: Patients' 24-h pain score was 1 point for 12 cases, 2 point for 7 and 3 point for no one in group A, and 1 point for 6,2 point for 10 and 3 point for 3 in group B. Patients' 48-h pain score was 1 point for 16 cases, 2 point for 3 and 3 point for no one in group A, and 1 point for 10,2 point for 7 and 3 point for 2 in group B. By contrast, Patients' pain scores for both 24-h and 48-h were lower in group A than in group B(P<0.05). The mean re-epithelization times in group A and B were 48±0h and 60.6±12h, respectively. The differences in the pain score and the time of corneal re-epithelization were statistically significant(t=4.43, P<0.01).CONCLUSION: SCL seems effective on reducing post-operative pain and eye stinging, and may accelerate, corneal re-epithelization and maintaining daily activities.