AIM: To screen mutations in the ABCB 6 gene in a Chinese family with autosomal dominant coloboma.METHODS: Recently ABCB 6 mutations have been reported to be associated with isolated coloboma. We collected 5 mL of blood samples from members of a Chinese family with coloboma and 100 normal controls. Mutations in ABCB 6 were determined by sequencing polymerase chain reaction(PCR)products. RESULTS: We identified a novel mutation(c.1380c>a)in the Chinese family. The mutation co-segregated with the disease phenotype in the patients, while it was not detected in other relatives or in the 100 normal controls.CONCLUSION:Our results expand the spectrum of ABCB 6 mutations causing ocular coloboma, and further confirm the role of ABCB 6 in the pathogenesis of ocular coloboma.

AIM: To study the pattern/distribution of retinal vascular diseases in the hilly terrain of Himachal Pradesh(altitude ranging from 500-4500m above sea level).METHODS: It is a retro/prospective study of patients with retinal diseases attending the general ophthalmology clinic of a tertiary care facility at Shimla from August 2008 to April 2013. Out of 5600 subjects, 4323 were taken as a sample. The data were taken from the hospital records and thereafter analyzed to determine their age, sex distribution and diagnosis. All patients underwent visual acuity, refraction, slit lamp examination and fundus evaluation. The diagnosis was confirmed from fundus clinic records and evaluation of fundus photographic records retro/prospectively. The photographs were taken on the fundus camera(Kowa Fundus Camera VX-10)and fundus fluorescein angiography done where ever indicated.RESULTS:Out of the 4323 patients, there were more males 2563(59.29%)than females 1760(40.71%)with retinal diseases. Out of the 525(12.14%)diabetic retinopathy(DR)subjects, mild non-proliferative diabetic retinopathy was present in 133(3.08%), moderate non-proliferative diabetic retinopathy in 156(3.60%), severe non-proliferative diabetic retinopathy in 120(2.78%)and proliferative diabetic retinopathy in 116(2.68%)subjects. Amongst the 393(9.10%)subjects of hypertensive retinopathy, hypertensive retinopathy-grade 1(was present in 130(3.01%), hypertensive retinopathy-grade 2 in 111(2.57%), hypertensive retinopathy-grade 3 in 131(3.03%)and hypertensive retinopathy-grade 4 in 21(0.49%)subjects. Of all the 660(15.27%)subjects of other retinal vascular disorders, branch retinal vein occlusion(BRVO)was present in 229(5.30%), central retinal vein occlusion(CRVO)in 55(1.27%), hemi central vein occlusion in 8(0.19%), central retinal artery occlusion(CRAO)in 20(0.46%), branch retinal artery occlusion in 4(0.09%), ocular ischaemic syndrome in 1(0.02%), retinopathy of prematurity in 9(0.21%), retinal artery macroaneurysm in 5(0.12%), juxtafoveal telangiectasia in 6(0.14%), anaemic retinopathy in 16(0.37%), leukemic retinopathy in 10(0.23%), preretinal haemorrhage in 52(1.20%), Coats disease in 8(0.19%), cilioretinal artery occlusion in 1(0.02%), Eales disease in 10(0.23%), vasculitis in 17(0.39%)and clinically significant macular edema in 209(4.83%)subjects.CONCLUSION: DR was the most common retinal vascular disorder. Retinal disorders appear to be a major public health problem in India. The present study shall help us in planning the management of such disorders in the hilly state of Himachal Pradesh to reduce the visual morbidity arising out of such disorders.

AIM: To report refractive error findings and other eye abnormalities in preschool children population in Greater Area Jakarta using the Plusoptix pediatric autorefractor A09.METHODS: Cross sectional study of preschool age children with mean age 4.46(range 2-6 years old)of 3 preschools in 3 municipalities in Greater Area Jakarta(South Tangerang, Bekasi and West Jakarta)were screened for refractive errors and other eye abnormalities.RESULTS: Totally 166 children, consisting of 51.2%(n=85)male and 48.8%(n=81)female were screened. Using the Arthur modification criteria for vision screening referral, 15.67%(n=26)were given recommendations for further comprehensive ophthalmology examination. From those given recommendations, 2 had high hyperopia, 14 had significant astigmatism, 6 had combined hyperopia/astigmatism, 1 had anisometropia, 1 unable to measure, 2 had other ocular conditions(congenital ptosis and severe ecchymosis and subconjunctival bleeding due to chronic cough).CONCLUSION: The finding of amblyopia risk factors in using Plusoptix A09 was 15.67% in this study.This percentage should warrant healthcare providers in Indonesia, where the importance of preschool vision screening is not widely acknowledged, especially for the risk of irreversible amblyopia.

AIM:To study the relationship between JAK-STAT pathway and epithelial-mesenchymal transition in human lens epithelial cells. Meanwhile, the function of AG490 as a JAK inhibitor was also demonstrated in this article.METHODS:Human lens epithelial cells SRA01/04(LECs)were treated by low concentration of glucose(5.5mmol/L). High concentration of glucose(30.5mmol/L)was used to treat the cells in order to form the high glucose model. According to adding AG490 or not, cells were divided into the control group and the experimental group, appropriate concentration 10μmol/L and 50μmol/L of AG490 were chosen and acting time of 6, 12, 24, 48h were selected. Effect of AG490 on cell migration was measured by wound healing test. The expression of TGF-β1, FN, α-SMA mRNA were examined by RT-PCR.RESULTS:With the prolonged acting time(6, 12, 24 and 48h), cell activity increased in the HG group, as well as more expression of TGF-β1, FN, α-SMA mRNA were detected compared to the LG group(P<0.05). In AG490 group, the cell migration activity and expression of TGF-β1, FN, α-SMA mRNA decreased compared to the HG group(P<0.05).CONCLUSION:JAK-STAT pathway takes part in high glucose-induced epithelial-mesenchymal transition in human lens epithelial cells. The mechanism is that it impacts the transcriptional expression of TGF-β1 and extracellular matrix. AG490, a JAK inhibitor, inhibits high glucose-induced epithelial-mesenchymal transition in human lens epithelial cells, And the inhibition enhances with the increasing concentration of AG490.

AIM: To evaluate the expression of transcriptional factor Islet-1 in retina in experimental retinal neovascularization induced by oxygen. METHODS: The murine retinal neovascularization were induced by hyperoxia exposure.The morphological observation of retinal neovascularization was performed using angiography by fluorescein dextran injection under the fluorescence microscope, and the new blood vessels were quantified after 5d in room air(17-day-old)by counting the vascular epithelial cell nuclei protruding into viteous cavity using HE stain. Realtime PCR and Western blot were used to examine retinal Islet-1 level in postnatal 7,12, 14,17 and 26d respectively.RESULTS: A lots of new blood vessels were demonstrated in the mouse retina in hyperoxic group by fluorescein angiography and histological method. Moreover, no significant difference was found in retinal Islet-1 level in postnatal 7d between hyperoxic group and control group, but was significantly higher in postnatal 12, 14 and 17d mice compared with control mice. However, mice at postnatal 26d, expression of Islet-1 in retina decreased to normal level. CONCLUSION: In processing mouse model of retinal neovascularization, sustained hypoxia retinal tissue induce retinal neovascularization by increas the expression of transcription factor Islet-1.

AIM: To explore the expression and significance of cysteine-rich 61(CCN1/Cyr61)in oxygen-induced retinal neovascularization(RNV)of mice and study the inhibition effect of CCN1 specific siRNA on RNV.METHODS: Two hundred healthy C57BL/6J mice were chosen and randomly divided into control group, hyperxia group, hyperxia control group and CCN1 treated group, with 50 mice in each group. The hyperxia control group was treated with vector plasmids by intravitreal injection. The CCN1 treated group received CCN1 siRNA recombinant plasmids by intravitreal injection. Adenosine diphosphate-ase(ADPase)stained retina flat-mounts was performed to assess the retinal vascular profiles, HE staining was applied to count the number of vascular endothelial cell nuclei breaking through the internal limiting membrane, protein and mRNA level expression of CCN1 were measured by immunohistochemistry, Western blot and RT-PCR. RESULTS: There were large nonperfusion area and a large number of vascular endothelial cell nuclei breaking through the internal limiting membrane(25.25±1.26; 23.12±1.16)in the hyperxia group and the hyperxia control group. Regions of nonperfusion and vascular endothelial cell nuclei(8.47±1.15)were decreased in the CCN1 treated group compared to the hyperxia group and the hyperxia control group. Compared with the control group, there were high protein and mRNA expression of CCN1 in the hyperxia group and the hyperxia control group. The expression of CCN1 protein and mRNA were decreased in the CCN1 treated group compared with the hyperxia group and hyperxia control group(all P<0.05).CONCLUSION: The abnormal expression of CCN1 has close relation with RNV. The development of RNV can be markedly inhibited by RNA interference targeting CCN1, which, we believe, will provide new molecular targets and a rationale for clinical developing new strategy for ROP therapy.

AIM:To investigate the changes of retinal histology and oxidative stress in diabetic retinopathy and its reversal by pyruvate in diabetic rats. METHODS:Eighty Wistar rats were divided into 3 groups: control group(20 rats), model group(30 rats)and treatment group(30 rats). After streptozotocin(STZ)induced diabetes mellitus in the model group and the treatment group, the treatment group received 2% pyruvate in diet and drinking. The changes of body weight and blood glucose were observed and the changes of glutathione peroxidase(GSH-PX), malonie dialdehyde(MDA), and Na+-K+-ATPase levels of retinal tissue and retinal ultrastructure were investigated in three groups at 12wk after occurrence of diabetes. RESULTS:Compared with control group, the body weight of the model group were significantly decreased, the activities of GSH-PX and ATP in the retina of diabetic rats were significantly lower, the MDA was signigicantly higher and significant changes occurred in retinal ultrastructure. Compared with model group, the blood glucose of the treatment group had no significant changes. However, the activities of GSH and ATP in the retina of diabetic rats were higher, the MDA was lower and the retinal ultrastructure was comparatively mild. CONCLUSION:Pyruvate can alleviate oxidatie stress reaction, improve the energy metabolism of retina, and delay the development of retinopathy.

AIM: To study the effects of different concentrations of Coix seed oil on human retinal capillary endothelial cells(HRCECs)proliferation and vascular endothelial growth factor(VEGF)expression in high glucose environment.METHODS: HRCECs extracted from human fresher eyeball and cultured in vitro, and ultimately used in the experiment were the growth of 3rd～4th cells, the experimental were divided into blank control group, low glucose control group, high glucose control group, high glucose +(50μL/mL, 100μL/mL, 200μL/mL)different concentrations Coix seed oil group. Detecting the multiplication of HRCECs by MTT, the immunocytochemical method was employed to detect the each group HRCECs of VEGF expression.RESULTS:MTT assay results showed that: different concentrations of coix seed oil acted at HRCECs for 48h, inhibition of cell proliferation was significant difference compared with high glucose control group(P<0.05). Within 48h showed concentration dependence. There was no statistical difference between the low glucose group and high glucose control group(P>0.05). Immunocytochemical assay showed that: 50μL/mL, 100μL/mL, 200μL/mL Coix seed oil acted at HRCECs 48h, the expression of VEGF decreased significantly compared with the high glucose control group(P<0.05), and in a dose-dependent manner. However, in high glucose control group, the expression of VEGF was obvious higher than that of low glucose control group(P<0.05).CONCLUSION:Coix seed oil can inhibit the HRCECs proliferation and suppress the VEGF expression in high glucose environment.

AIM: To construct recombination eukaryotic expression plasmid of human thyrotropin receptor extracellular domain encapsulated with cationic liposomes. METHODS:We amplified the target gene of shuttle vector PHMCMVTSHR289, conjugated the target gene and eukaryotic expression plasmid pcDNA3.1+, and accredited whether pcDNA3.1+/TSHR289 was connected or not by enzymatic digestion and sequencing. Cationic liposomes encapsulated the recombination plasmid pcDNA3.1+/TSHR289.RESULTS: Recombination plasmid pcDNA3.1+/TSHR289 digested with enzyme HindIII and the fragment through 0.8% gel electrophoresis showed 512bp strip. Recombination plasmid pcDNA3.1+/TSHR289 were found synonymous mutation through forward(AAC to AAT)and reverse sequencing(GCG to GCT). The volume ratio of cationic liposomes and recombinant plasmid was 3:1. CONCLUSION: It is successful to construct the recombination plasmid pcDNA3.1+/TSHR289 by accredit it through enzymatic digestion and sequencing.

AIM:To provide a proper assessment of the clinical use of orthokeratology by observing and analyzing the ocular biometric changes of the eyes and the stereopsis of the myopia.METHODS:Sixty eyes from 30 myopia(from 8 to 17 years old)were fitted with orthokeratology. Stereopsis, visual acuity, near visual acuity, central corneal thickness, anterior chamber depth, average anterior corneal refractive power(K value), and intraocular pressure were measured before the orthokeratology treatment and 3mo after it. Refraction was expressed as spherical equivalent(SE), and the subjects were divided into 3 groups according to refraction: low myopia group(SE<-3.00D), moderate myopia group(-3.00D≤SE<-6.00D), and high myopia group(SE≥-6.00D).RESULTS: All subjects had significant improvements in visual acuity and near visual acuity 3mo after the orthokeratology treatment(P<0.01). In the comparisons of any pair of the groups, there was no significant difference in the near visual acuity(P>0.05). Three months after the orthokeratology treatment, Naked eye near stereoacuity values of all subjects were decreased(P<0.01). There was no significant difference in the comparisons of the differences of stereopsis between any pair of the groups(P>0.05). There was significant correlation in stereopsis and anisometropia(Pearson coefficient r=0.778, P<0.01). And with greater anisometropia, the stereopsis was higher. All subjects had significantly lower K values than before 3mo after the orthokeratology treatment(P<0.01). There was no significant difference in central corneal thickness, anterior chamber depth, and intraocular pressure(P>0.05).CONCLUSION: Orthokeratology could lower K value in a short time and change the corneal curvature to correct myopia, to improve visual acuity and near visual acuity. It also has an influence on improving stereopsis. There are no obviously changes in patients' central corneal thickness, anterior chamber depth or intraocular pressure after the orthokeratology treatment, making it a safe and effective treatment for adolescent.

AIM: To investigate the effect of cyclosporine A(CsA)on the phosphatidylinositol-3 kinase(PI-3k)pathway during procession of proliferation in epithelial cells of rabbit lens, and provide treatment strategies for after cataract on the basis of experiment. METHODS: Sixty eyes of 30 healthy white rabbits were operated by lens cortex removal in cataract surgery, and 30 right eyes were divided in treatment group and the other 30 eyes were divided in control group. From the first postoperative day, the control group eyes were dropped with normal saline 6 times each day, and the treatment group eyes were dropped with 1% CsA 6 times each day. Six rabbits were selected randomly and killed on the day before dropping and 1, 2wk, 1 and 2mo of postoperative day respectively. The lens of those killed rabbits were removed by surgery. The strategies of immunohistochemistry and mount in situ hybridization were used to detect the content of proliferating cell nuclear antigen(PCNA), gene of phosphate and tension homology deleted on chromsome ten(PTEN)mRNA, Ser473-R, respectively. RESULTS: The expression of PCNA and Ser473-R were both down-regulate after operation in treatment group and control group, and the PCNA levels were significantly lower among treatment group than those in control group on 1wk(0.690±0.035 vs 0.785±0.015, t=6.099, P<0.01)and 2wk(0.571±0.038 vs 0.670±0.037, t=4.585, P<0.01). In addition, the levels of Ser473-R were significantly lower among treatment group than those in control group on 1wk(0.374±0.031 vs 0.435±0.030, t=3.486, P=0.006)and 2wk(0.220±0.022 vs 0.251±0.020, t=2.516, P=0.031). However, the expression levels of PTEN mRNA were continually increased 1wk～1mo after operation, in which the expression levels of PTEN mRNA were significantly higher among treatment group than those in control group on 1wk(0.302±0.027 vs 0.255±0.038, t=2.474, P=0.033). CONCLUSION: 1% CsA could inhibit the proliferation of epithelial cells in lens of rabbits with after cataract through preventing PI-3k pathway.

AIM: To describe the expression of hypoxia-inducible factor-1α(HIF-1α)and erythropoietin(EPO)in rats' corneal and evaluate its potential effect on corneal neovascularization(CNV)growth. METHODS: The young SD rats(3mo)was chosen and randomly divided into 2 groups, which were experimental group and normal control group. CNV model was established by alkali burn, and the length and area of CNV was observed everyday after operation by slit lamp. After that, the expression of HIF-1α and EPO was measured by SABC and RT-PCR methods at 1, 3, 5, 7, and 14d after alkali burn. The data was analyzed by SPSS 20.0. RESULTS: The area of CNV was increasing at 1, 3, 5, 7, and 14d after alkali burn, and the peak point appear at 7d. The growth speed was decreased after 14d. SABC method told us that no HIF-1α and very tiny amount EPO was detected at normal rats' corneal. The expression of the two factors increased at 1d after alkali burn in corneal epithelium and endoderm. The results of RT-PCR showed that a few amounts of HIF-1α and EPO mRNA were detected at normal group. The expression of the two factors was increased at 3d after alkali burn, and the peak value was found at 7d, however, it was decreased at 14d. Statistical difference was found at different time(P<0.05). CONCLUSION: HIF-1α and EPO is closely related to CNV.

As one of the serious complications of diabetes, diabetic retinopathy(DR)has become a main eye disease which causes blindness. The occurrence and development of DR is related to many factors. The pathogenesis is complicated, and the mechanism has not been clear. Early data suggest that the occurrence and development of DR has relations with many factors such as blood sugar level, diabetes duration and the environment. Among the factors, mitochondrial dysfunction and oxidative stress is the important mechanisms of DR and has become research focus in recent years. Consequences of mitochondrial dysfunction within cells include elevation of the rate of reactive oxygen species(ROS)production due to damage of electron transport chain proteins, mitochondrial DNA(mtDNA)damage, and loss of metabolic capacity. Clear understanding on the mechanism of mitochondrial functional change under high sugar level and oxidative stress response in the occurrence and development of DR is of great significance on prevention and cure of DR. In this article, the development of mitochondrial metabolism and oxidative stress of DR is reviewed.

On the anatomy, posterior vitreous cortexneighbors with retina, the relationship of vitreous and retinal is both independent and closely linked. Under pathological condition, changes in the vitreous provides a good environment for occurrence and development of a number of vitreoretinal diseases, which indicates that vitreous plays a crucial role in many vitreoretinal diseases occurrence and growth. Elimination of vitreous change in disease, is an issue of great concern of the ophthalmic industry in recent years. Based on the description of vitreous and vitreoretinal interface structure, changes in the vitreous and retinal adhesion mechanisms and interfaces retinal disease risk factors and the impact on the retinal disease were discussed, And the posterior vitreous detachment impact on the vitreoretinal interface disease, the testing methods and its importance were described in this article.

Traumatic optic nerve injury(TON)is caused by direct or indirect optic nerve trauma, which is one of a serious complication of craniocerebral trauma. Its prognosis poor and usually bring permanent vision damage. At present, optic nerve injury and regeneration is hot in neurobiology research. To build an ideal experimental animal model is extremely important in research and development in the treatment of optic nerve injury. In this article, we review the methods of making rat models of traumatic optic neuropathy, clinical similarities, advantages and disadvantages of among these models, to provide reference for more experimental study.

AIM:To compare the effect of different incision in corneal astigmatism after phacoemulsification. METHODS: Totally 88 cases(122 eyes)with pure cataract were randomly divided into two groups. Forty cases(60 eyes)were clarity corneal incision in group A, and 48 cases(62 eyes)were sclera tunnel incision in group B. Mean corneal astigmatism, surgically induced astigmatism(SIA), uncorrected visual acuity(UCVA)and best correct vision acuity(BCVA)were observed in pre- and post-operation at 1d; 1wk; 1mo.RESULTS: The mean astigmatism had statistically significant difference between two groups at 1d; 1wk; 1mo after operation(P<0.05). The SIA had statistically significant difference at 1d(P<0.05); The SIA had no statistically significant difference between two groups at 1mo after operation(P>0.05). UCVA≥0.5 and BCVA≥0.8 had statistically significant difference at 1d; 1wk(P<0.05). There had no statistically significant difference at 1mo after operation(P>0.05).CONCLUSION: Phacoemulsification with scleral tunnel incision remove combined intraocular lens(IOL)implantation has small changes to corneal astigmatism. By selecting personalized corneal incision according to the corneal topography might be more beneficial.

AIM:To observe the clinical efficacy of two types of scleral-fixated posterior chamber intraocular lens(IOL)combined intra-capsule lens extraction to treat cataract dislocation.METHODS: After intra-capsule lens extraction of dislocated cataract, two types of IOL were used as scleral-fixated posterior chamber IOL. First group was with four seal loops, the second group was with two open loops. All 21 patients(23 eyes)took the examination of the best corrected visual acuity, intraocular pressure, fundus, and IOL decentration using camera system attached to slit-lamp ophthalmoscope and IOL tilted using ultrasound biomicroscopy(UBM)at 6mo after surgery. RESULTS: After 6mo, all patients had improved eye sight. There was significant difference in the mean IOL decentration between the two groups(0.57mm vs 0.79mm, P<0.05). There was significant difference in the mean IOL tilted degree between the two groups(6° vs 11°, P<0.05).CONCLUSION: IOL with four loops are more appropriate as scleral-fixated posterior chamber IOL with less tiltness and dicentration.

AIM: To study the relationship of retinal associated lesions and postoperative visual acuity of cataract phacoemulsification. METHODS:From February 2013 to February 2014, 120 cases with given cataract phacoemulsification were divided into observation group and control group. Cases in observation group were with of retinal associated lesions, those in control group were without retinal associated lesions. The best corrected visual acuity, ision acuity, visual evoked potential, intraocular pressure were compared between two groups. RESULTS:Two weeks after surgery, visual acuity in observation group was higher than those of before therapy. Visual acuity recovery rate of observation group was significantly slower than that of control group; best corrected vision, visual acuity in observation group was significantly lower than that in control group; observation group's amplitude(12.01±4.50μV)was significantly lower than control group, incubation period(114.29±11.32ms)was significantly higher than control group; After 6, 12, 24h, intraocular pressure(23.64±4.28, 24.12±5.13 and 18.28±3.22mmHg)were significantly higher than control group. CONCLUSION: Retinal associated lesions can lead to visual evoked potential change, elevated IOP, affect postoperative visual recovery level.

AIM: To investigate and evaluate the prevalence of xerophthalmia among aerospace science and technology staff and its influencing factors for the eye health guidance.METHODS: The staff underwent physical examination in our examination center from September 2013 to June 2014 were preliminary screened, and those patients with symptoms of dry eye were investigated with questionnaires and diagnosed by basic lacrimal secretion test(Schirmer I), breakup time of tear film(BUT)test and fluorescein(FL)staining test.RESULTS:There were 606 complaints of dry eye symptoms of the 1 000 premiers, distributed in random(60.6%), and 432 employees were diagnosed(43.2%). The positive rate of dry eye was 71.3%. The causes of xerophthalmia, besides of gender, age, also include a variety of factors such as air-conditioner, heating, video terminals, sleep time, etc. CONCLUSION: Dry eye, an epidemic disease, has a variety of symptoms and complex etiology, the main causes of aerospace science and technology staff with dry eye is working environment and some local factors. We can give appropriate health guidance according to the different factors. Meanwhile the relevant series of dry eye screening should also be taken as a routine examination in ophthalmic examination.

AIM: To find out the weaknesses of the cultivation of the Chinese ophthalmology physicians and the gap between Chinese and the international ophthalmology physicians, so that provide the advice on the future cultivation of the Chinese ophthalmology physicians. METHODS: The passrate of the 2013 ICO examinations taken by worldwide examiners by common statistical methods was analyzed. RESULTS:The results indicated that the test scores of Chinese candidates' were lower than that of the international average level, there was a obvious gap existed between Chinese and other countries' ophthalmology physicians. It showed that Chinese candidates were not quite adaptable to this examination, basic science and clinical level needed to be improved. CONCLUSION: It may shows that the effects on the mid-anaphase of our country's ophthalmology residency training are not so good, which area we should pay more attentions.

AIM:To observe the changes of corneal endothelium after phacoemulsification cataract surgery in different types of cataract patients. METHODS: Randomly selected age-related cataract, diabetic cataract and cataract of high myopia 30 eyes of 30 cases, respectively, in our hospital. All patients underwent phacoemulsification combined with intraocular lens implantation, corneal endothelial density and the percentage of hexagonal cells were measured by corneal endothelial cell instrument without touching before surgery and one week after surgery. RESULTS: The difference of the preoperative corneal endothelial cell density and the percentage of hexagonal cells among three groups were not statistically significant(P>0.05). One week after surgery, the cell density in three groups were respectively 2 496.86±298.96/mm2, 2 379.51±375.13/mm2, 2 425.38±312.68/mm2, the percentage of hexagonal cells were respectively(46.20±12.03)%,(43.44±13.99)%,(44.35±8.13)%. Both the cell density and the percentage of hexagonal cells one week after surgery were lower than those before operation. There were significant difference in three groups(P<0.05). Both the measurements in diabetic cataract group and cataract of high myopia group after surgery were lower than those in age-related cataract group, the cell density and the percentage of hexagonal cells in diabetic cataract group were lower obviously compared with those in age-related cataract group and the difference was significant(P<0.05).CONCLUSION: The tolerance of corneal endothelial cell to phacoemulsification cataract surgery is lower in cataract with diabetes and high myopia. Corneal endothelium should be assessed preoperatively and protected intraoperatively.

AIM: To evaluate the early diagnosis of sub-clinic stage of diabetic retinopathy.METHODS: This was cross sectional study,multifocal retina electroretinogram(mf-ERG), contrast sensitivity(CS)and central retinal artery color Doppler examination were recorded from 30 cases(30 eyes)matched control subjects, 35 cases(35 eyes)with type 2 diabetes mellitus(DM)without diabetic retinopathy(NDR)and 38 cases(38 eyes)with non-prolifera tive diabetic retinopathy(NPDR). One-way ANOVA and SNK-q test were used for data analysis.RESULTS: P1 response density of NDR patients were found decrease, N1 implicit time were delayed. Which were related with the degree of retinopathy(P<0.05); CS of NDR patients were found significant in middle and high frequency(P<0.05), NPDR patients were found significant in full frequency(P<0.05); Central retinal artery(CRA)blood flow in the control groups and NDR groups were not found statistically significant(P>0.05), The differences between normal group, NDR group and NPDR group were found statistically significant(P<0.05).CONCLUSION: mf-ERG and CS are sensitive indexes for early evaluation of visual function in patients with diabetes mellitus, with development of the disease, CRA blood flow also appears to decline.

AIM: To measure the retinal electrical activities in patients with diabetic retinopathy(DR)by applying multifocal electroretinogram(mf-ERG)and evaluate the degree of visual damage at different stages of DRMETHODS: Thirty cases(30 eyes)aged 50～70 years old, excluding other diseases, were as normal group, and 99 cases(99 eyes )diagnosed with type 2 diabetes were as experiment group. The cases received mf-ERG examination in the standard state, respectively. The results were statistically analyzedRESULTS: For DR patients with early and background stage, the reaction density of mf-ERG P1 wave decreased as the disease worsened, significantly reduced in non-proliferating stage and decreased more significantly in the background of the stage Ⅲ. This showed that in the macula, electrical activity had weakened before the retina without visual or morphological changes, and with the development of the disease, the electrical activity decreased more obviously. CONCLUSION: mf-ERG can evaluate the severity of DR, especially suit in the early and background period of DR.

AIM: To observe the effects of the coelomic cavity injection of triamcinolone acetonide(TA)combined with laser photocoagulation on patients with retinal vein occlusion. METHODS: Fifty-six patients of retinal obstruction with macular edema were accepted from January 2010 to December 2012 in our hospital. All patients received iodized lecithin and Xueshuantong. And, patients with central retinal vein occlusion(CRVO), hemi-central retinal vein occlusion(hemi-CRVO)and branch retinal vein occlusion(BRVO)treated by TA combined with laser photocoagulation, respectively. Follow-up period was of at least 6moRESULTS: After the treatment of 1,3 and 6mo, the central foveal thickness was reduced significantly(P<0.05). After followed up 6-12mo, the total effective rate of CRVO, Hemi-CRVO and BRVO patients was 83%～95% and all the patients had no significant adverse reactions. CONCLUSION: Basing on the traditional treatment, TA combined with laser photocoagulation is more effective in the treatment of retinal vein occlusion and is worthy of clinical usage.

AIM: To explore the clinical significances and changes of related parameters of corneal endothelial cell in keratouveitis patients before and after treatment.METHODS:Fifty-two keratouveitis patients(52 eyes)diagnosed and treated in our hospital from October 2012 to December 2013 were collected. Before and after treatment, the related parameters of corneal endothelial cell in all patients were measured with non-contact corneal specular microscope and these parameters were statistically analyzed. RESULTS: Compared with the normal group, obvious endothelial cell edema and great variation was observed in diseased group. The shorter duration of treatment, the better the recovery of endothelial cells and the fewer cells lose. Conversely, the longer the healing of normal hexagonal cell ratio was smaller, the larger the coefficient of variation. Before and after treatment, the differences of each parameter were statistical significance(P<0.05).CONCLUSION: The functional recovery of corneal endothelial cell has directly relation with disease times.

AIM: To compare the different formulas in intraocular lens(IOL)power calculations on high myopia after LASIK with cataract patients who received the phacoemulsification and intraocular lens implantation(Phaco+IOL). METHODS: This was a retrospective study. Data from 102 eyes of 61 cataract patients with high myopia, who received Phaco+IOL after LASIK, were collected. Patients were divided into three groups by formulas in IOL power calculations before surgery: Holladay group(11 cases, 21 eyes), Haigis-L group(30 cases, 47 eyes)and SRK-T group(20 cases, 34 eyes). The ratios of equivalent IOL power after LASIK were predicted and the accuracy of their predictions were compared 3mo after surgery. It was an index of reliability of the formulas outcomes.RESULTS:The ratios of equivalent IOL power after LASIK using the Holladay, Haigis-L and SRK-T formulas were 0.86±0.41D, 0.43±0.30D and 1.27±0.58D, respectively. There was no significant difference between Holladay group and SRK-T group(t=-0.271, P=0.625>0.05). However, significant difference was found between Haigis-L group and Holladay group(t=2.249, P=0.047<0.05), Haigis-L group and SRK-T group(t=6.012, P=0.031<0.05).CONCLUSION: The Haigis-L formula is more accurate than the SRK-T and Holladay formulas in predicting IOL power for cataract patients with high myopia after LASIK.

AIM:To explore the clinical outcome of trabeculectomy with mitomycin C(MMC)on glaucoma. METHODS: A total of 57 patients(95 eyes)of primary glaucoma were randomly divided into two groups, 31 patients(54 eyes)in trabeculectomy with MMC(T+MMC)group, which received trabeculectomy with 0.2mg/mL MMC in surgical sites, and 26 patients(41 eyes)in trabeculectomy(T)group. The anterior chamber, bleb, intraocular pressure(IOP)and complications were observed. The post-operative follow-up periods ranged between 4 and 6mo.RESULTS: The mean IOP was 11.24±3.73mmHg on 1d in group T+MMC. There was the significant difference compared with preoperative IOP(P<0.01), while no difference with the group T(P>0.05). At final follow-up, the IOP was significantly different between group T+MMC and group T(16.15±3.62mmHg vs 18.79±5.27mmHg, P<0.05). The rate of bleb formation was 94.44% and 80.48% in group T+MMC and T, respectively(P<0.01). The postoperative complications were seldom, hyphema and corneal edema, and were cured finally.CONCLUSION: Trabeculectomy with MMC for glaucoma can effectively reduce postoperative scar formation of the filtration passage and lower the IOP to a target level with fewer complications.

AIM: To understand the prognostic factors of myopic rhegmatogenous retinal detachment(RRD)surgery, and provide guidance for clinical treatment.METHODS: This retrospective study included 288 myopic RRD eyes(excluding trauma, aphakia, congenital diseases, tractional and exudative retinal detachment)from April 2007 to April 2014 in our department. The surgical anatomic reduction situation was statistically recorded, the effects of hole's size, retinal detachment duration on sight restoration and surgery success rate were analyzedRESULTS:The statistical results showed that 245 eyes(85.1%)healed after their first operation, about 95.1% cases finally healed after their second or third operation. The degree of myopia and aging factor influenced the RRD operation: the higher degree and the older age were, the lower success rates were(P<0.05). Through surgery, postoperative visual acuity was significantly better than the preoperative ones(P<0.01). A higher degree of myopia RRD led to poor visual acuity(P<0.01). Postoperative visual acuity of 152 eyes(52.9%)were improved, of which 106 eyes' visual acuity was 0.05 or more.CONCLUSION: Surgery is an effective means of treating myopic RRD. The older patients have lower success rates. A higher degree of myopia led lower reset rate after retinal detachment surgery and poor postoperative visual acuity. When treat myopic RRD, we should pay attention to the recovery of visual function.

AIM: To monitor long-term changes of matrix metalloproteinase-2(MMP-2)in human tears fluid after laser in situ keratomileusis(LASIK). METHODS: Thirty-two myopia cases(64 eyes)underwent uneventful LASIK were enrolled in the study. Tear fluid were collected and MMP-2 expression was analyzed by Western-bolt assay preoperatively and postoperatively on 15d, at 1, 3mo, and 1a. RESULTS: LASIK increased the concentration of MMP-2 in human tear fluid. At 15d postoperatively, the magnitude of MMP-2 was 1.4 times that of preoperative, thereafter subsided, but didn't return to preoperative level by 3mo(P<0.05). Up to 1a after surgery, the concentration of MMP-2 almost recovered(P>0.05). CONCLUSION: MMP-2 is significantly expressed in human tear fluid after LASIK, then subsided with time, but didn't return to preoperative level by 3mo and almost recovered up to 1a, indicating wound healing of LASIK would continue up at least 3mo after surgery and almost recovered 1a postoperatively.

AIM: To evaluate the applicability and the development of the normal visual acuity from age 3 to 3.5 years using Lea Symbols and HOTV charts.METHODS: It was a survey research study. Totally, 133 preschoolers(266 eyes)between 3 to 4.5 years old recruited from two kid-gardens in Guangzhou were tested with both the Lea Symbols chart and the HOTV chart. Outcome measures were monocular logarithm of the minimum angle of resolution(logMAR)visual acuity and inter-eye acuity difference in logMAR units for each test. RESULTS: The testability rates of the two charts were high(96.24% vs 92.48%, respectively), but difference was not statistically significant(P>0.05). The difference between the two kind of monocular vision was not statistically significant(the right eye: t=0.517, P=0.606; the left eye: t=-0.618, P=0.538). There was no significant difference between different eye(Lea Symbols chart: t=0.638, P=0.525; HOTV chart: t=-0.897, P=0.372). The visual acuities of the boys were better than those of the girls, but the difference was not statistically significant(P>0.05). The results which came from visual acuities with the two charts for the corresponding age groups(3-year-old group, 3.5-year-old group, 4-year-old group, 4.5-year-old group)indicated that the visual acuities of the preschoolers were improving with increasing age, but the difference among the visual acuities with the Lea Symbols chart was not statistically significant(the right eye: F=2.662, P=0.052; the left eye: F=1.850, P=0.143). However the difference among the visual acuities with the HOTV chart was statistically significant(the right eye: F=4.518, P=0.005; the left eye: F=3.893, P=0.011).CONCLUSION: Both Lea Symbols and HOTV chars are accepted and appropriate for preschool vision screening from 3 to 4.5 years old. The monocular visual acuity of preschoolers from age 3 to 4.5 years could be assessed was similar using the two charts. There is no correlation between visual acuity and different eye. There is no statistical difference between the genders. The results further demonstrate that the preschoolers whose age reached three years old have the ability to accept the Subjective vision checks. Also the development of the normal visual acuity is faster in the early stage.

Diabetic retinopathy(DR)is one of the common and serious complications of diabetes, which also the main causes of visual impairment in patients with diabetes, and its incidence has been increasing. With the in-depth study of the pathogenesis of DR, through the control of risk factors including blood glucose, blood pressure and lipid, as well as the application of a variety of drugs, the prevention and cure of DR achieved a certain effect. In this paper, we make a review of the present status and progress in recent years on the DR control risk factors and drug intervention.

Diabetic retinopathy(DR)is one of the common and serious complications of diabetes, which also the main causes of visual impairment in patients with diabetes, and its incidence has been increasing. With the in-depth study of the pathogenesis of DR, through the control of risk factors including blood glucose, blood pressure and lipid, as well as the application of a variety of drugs, the prevention and cure of DR achieved a certain effect. In this paper, we make a review of the present status and progress in recent years on the DR control risk factors and drug intervention.

Corneal newborn lymphatic vessels construct the afferent arc of corneal immunological reaction, which play important role in immune response. The corneal transplantation rejection rate rises due to the emergence of new lymphatic vessel which breaks the immunologic mechanism. With the founding of specific marker of lymphatic endothelial cells and research advancing of growth factor of lymphatic vessels, the mechanism, therapy and prevention of corneal immunological rejection reaction of corneal lymphatic vessel have been studied intensively. The graft survival rate has been greatly improved through inhibiting newborn lymphatic vessel.

Intraocular lens(IOL)often has different degrees of tilt, decentration and rotation in the eye. The deflection of IOL is an important factor to impact on the visual quality of the patients with cataract surgeries. Vision was commonly used to evaluate visual quality before. In recent years, some new methods are also introduced to evaluate visual quality, such as optical aberration, modulation transfer function(MTF)and subjective visual perception. They show that the IOL deflection will cause decreases in eyesight and MTF, cause increase in aberration, lead to ametropia and so on. Therefore, a better evaluation of the effects of IOL deflection on visual quality, has significance for IOL selection, positioning and cataract individualized treatment.

AIM: To establish the frequency, associations and risk factors for age-related macular degeneration(AMD)in hospital population.METHODS: In this hospital based study, 589 subjects above 60 years of age were screened randomly for AMD. Participants underwent ocular evaluation and were interviewed for lifestyle variables and dietary intake of carotenoids by structured food frequency questionnaire. AMD was defined according to the international classifications and grading system.RESULTS:Either form of AMD was detected in 48 participants. AMD was significant among diabetes, diabetic retinopathy, body mass index, heavy cigarette smokers and alcoholics(P<0.05). Dietary lutein/zeaxanthin(L/Z)and β-carotene intake were associated with the reduction in risk for AMD(P<0.05).CONCLUSION: Higher dietary intake of carotenoids, especially L/Z, is associated with lower risk for AMD. Risk of AMD is prevalent among subjects with diabetes. Cessation of smoking and alcohol may reduce the risk of AMD in this population.

AIM:To determine the changes of regional macular retinal thickness(RT)with spectral domain optical coherence tomography(SD-OCT)after successful pars plana vitrectomy(PPV)surgery with inner limiting membrane(ILM)peeling in patients with idiopathic macular hole.METHODS:A non-randomized retrospective case study on 17 patients(17 eyes)who were hospitalized between March 1, 2011 and June 30, 2013. All 17 eyes had been diagnosed with idiopathic macular hole and thereafter underwent 25G-PPV surgeries performed by the same surgeon with ILM peeling and short-term gas tamponade. In the 6mo-plus follow-up after surgery, these eyes were found to have successful closure in the macular hole. The macular RT of the nine areas in the Early Treatment Diabetic Retinopathy Study was measured by SD-OCT. All patients were applied by SD-OCT with linear scan of the macular. At least four examinations on the operated eye were conducted in contrast to the other normal eye: before the surgery, 3～5wk after the surgery(stage A), 2～3mo after the surgery(stage B), and >6mo after the surgery(stage C).RESULTS:In stage A, the macular RT of operated eyes in the areas of C, IS, II, IN, OS, OI, ON(263.00±39.48, 313.92±18.35, 311.00±18.02, 335.67±19.91, 280.83±33.74, 269.92±23.32, 307.00±28.40)were significantly thicker than the corresponding areas of the normal fellow eyes(220.51±23.94, 292.08±21.93, 282.50±20.30, 288.33±20.76, 251.25±17.60, 247.75±21.48, 265.17±24.76μm)(P<0.01)with the exception of the IT(291.58±18.97, 280.33±20.82μm)and OT(250.83±21.21, 242.08±24.02μm)(P>0.01). In Stage B, the macular RT in the areas of II, IN, OS(335.67±19.20,319.75±19.20, 273.50±16.89μm)were significantly thicker than the corresponding areas of the normal fellow eyes(286.33±20.46, 293.42±17.64, 252.50±16.32μm)(P<0.01). However, the macular RT of the operated eyes in the areas of C, IS, IT, OI and OT had no statistically significant difference compared with the corresponding areas of the normal fellow eyes(P> 0.01). In Stage C, the macular RT of operated eyes with the areas of IN(321.17±19.71μm)were significantly thicker than the corresponding areas of the normal fellow eyes(296.25±19.57μm)(P<0.01). Meanwhile the other areas of the operated eyes were not significantly different from the normal fellow eyes(P>0.01). Moreover, the macular RT of operated eyes in the areas of ON, IT(307.00±28.40,291.58±18.97μm)in stage A significantly decreased compared to that of the corresponding areas in stage C(276.08±32.39, 278.75±10.19μm)(P<0.01).CONCLUSION: SD-OCT is a convenient tool for the observation of macular regional changes after macular hole surgery. Macular RT had persistent changes after vitrectomy on eyes with macular hole by SD-OCT. ILM peeling may have caused microstructural changes in wide areas of the macular region after PPV surgery. More support and evidence were provided to the further study of the long-term observation for the structural and function of macular after macular hole surgery.

AIM: To compare the clinical results of different surgical methods for diabetic antipathy. METHODS: Eighty cases(102 eyes)with diabetic antipathy were selected in our hospital from January 2012 to December 2013. Thirty-eight cases(48 eyes)in group A received joint surgical treatment, 42 cases(54 eyes)in group B took staging of surgical treatment. The clinical effect was observed in both groups.RESULTS: The vision after surgery was improved than that of before surgery in two groups, there were no significant differences(P>0.05). A postoperative complication rate was 16.7% in group A and 22.2% in group B, showed no significant difference(P>0.05). CONCLUSION: Surgery and staging joint surgery are both feasible for diabetic retinopathy patients, can, improve the visionr. Both of them are worthy of clinical application.

AIM:To observe the clinic effect of oral mucosa transplantation in the treatment of severe contracted conjunctival sac after ocular prosthesis implantation.METHODS: Thirty-three cases(33 eyes)with globe disorders and severe contracted conjunctval sac were operated ocular prosthesis implantation firstly, and conjunctival sac plasty using oral mucosa after 6mo. RESULTS: Thirty-one cases were successful, no complications appeared. One case had primary ptosis and 1 case had recurrent conjunctival sac contracture.CONCLUSION: It is recognised that the methods of oral mucosa transplantation in severe contracted conjunctival sac after ocular prosthesis implantation are effective on those cases.

AIM: To investigate the clinical effect of preserved amniotic membrane transplantation in the treatment to conjunctival rupture, dehiscence and socket contracture after hydroxyapatite(HA)orbital implantation. METHODS: In 16 cases of conjunctival rupture and socket contracture after HA orbital implantation, conjunctival tension was release by operation and preserved amniotic membrane was transplanted on conjunctival scleral exposure area.RESULTS: In all cases, conjunctiva healing, completely cover the sclera and conjunctiva socket recover ideal depth after operation in 15 cases, 1 case was fail.CONCLUSION: Preserved amniotic membrane transplantation is an effective method to treat conjunctival dehiscence and keeping the ideal conjunctival socket depth after orbital implantation.

AIM:To compare the functional and cosmetic effects of two different surgical techniques for congenital ptosis. METHODS: The patients were divided into four groups according to the operation method: Patients undertook bilateral fascial suspension surgery as Group A(42 eyes of 21 cases); Patients undertook bilateral levator muscle shortening surgery as Group B(38 eyes of 19 cases); Patients undertook unilateral fascial suspension surgery as Group C(24 eyes of 24 cases); Patients undertook unilateral levator muscle shortening surgery as Group D(29 eyes of 29 cases). Each group patients were followed for postoperative function and appearance effect. RESULTS: 1)Early postoperative of two operation function success rate was up to 100%, the function of levator muscle shortening surgery was 97.01% in the late postoperative, was higher than bilateral fascial suspension surgery(87.88%), with statistical difference in both surgerys(P<0.05). 2)Appearance effect of two kinds of operation method in early postoperative had no statistical difference(P >0.05); In the late postoperative, the mean grades for “Lid Contour” and “Lid Crease” of Group B were better than that of Group A(P<0.01). While the mean grades for “Lid Contour”, “Symmetry of Lid Height” and “Lid Crease” of Group D were similarly better than that of Group C(P<0.01).CONCLUSION: Two kinds of operation method have good effects on the treatment of congenital ptosis. In terms of cosmetic effect, levator muscle shortening surgery is better.

AIM: To study the clinical effect of the application of microscopic pterygium resection combined with different concentration of mitomycin C(MMC).METHODS:A total of 110 cases of pterygium patients(120 eyes)were randomly divided into control group(58 eyes)and observation group(62 eyes)according to the odd and even number method. The control group adopted the pterygium resection combined 0.3mg/mL MMC, and the observation group was given pterygium resection combined 0.2mg/mL MMC. The cure rate and the recurrence rate, eyesight before and after the treatment, two groups of cornea and sclera wound healing situation, the incidence of postoperative complications were compared. RESULTS: The cure rate and recurrence rate of the control group was 84.5% and 15.5% respectively, and the observation group was 93.6% and 6.5% respectively, the differences were statistically significant(P<0.05). There were statistical differences of vision of the two groups before and after treatment(P<0.05), and there were no statistical differences of the two groups between the two groups after treatment(P>0.05). The cornea, sclera, wound healing time of the observation group were less than the control group, and there were statistical differences between the two groups(P<0.05). The incidence of complications was 13.8% in the control group and 3.2% in observation group, with statistically significant difference(P<0.05).CONCLUSION: The application effect of microscopic pterygium resection combined with MMC is remarkable, and the joint of 0.2mg/mL concentration of MMC is more safe and effective, and is worth popularizing in clinical application.

AIM:To evaluate the clinical efficacy of canalicular intubation combined with external dacryocystorhinostomy(ext-DCR)for treatment of chronic dacryocystitis and upper lacrimal duct stenosis.METHODS: Thirty-three patients(33 eyes)with chronic dacryocystitis and upper lacrimal duct stenosis who underwent canalicular intubation combined ext-DCR were retrospective analyzed. The silicon tube was indwelt for 6mo. All cases were re-examined 1wk; 1, 3, 6, 9mo post-operation, flow of tears, pus excretion and lacrimal duct clearance were observed.RESULTS: Clear lacrimal duct ratio was 100% in all cases during 1wk～6mo post-operation; Silicon tube was removed 6mo post-operation, 3mo after tube removal, rechecking reported 32 cases with clear lacrimal duct(97%)and 1 case with resistant duct(3%). Two cases(6%)with minor lacerations, no other complications were observed. CONCLUSION: Canalicular intubation combined ext-DCR is an effective treatment for chronic dacryocystitis and upper lacrimal duct stenosis.

AIM: To investigate the influence of phacoemulsification with different incision on tear film.METHODS: Tear film was monitored in 152 patients(169 eyes)after phacoemulsification. Patients were divided into two groups according to the type of incision: group A(76 patients, 83 eyes)with a 3.2mm corneoscleral limbus incision phacoemulsification and group B(76 patients, 86 eyes )with a sclemtic tunnel incision. Tear break-up time(BUT), cornea fluorescein staining(CFS), lid-parallel conjunctival folds(LIPCOF)and lid-wiper epitheliopathy(LWE )were observed at 3d preoperatively and 1wk, 1, 3 and 6mo postoperatively. The results were analyzed using a Chi-square test and t-test with SPSS 17.0. RESULTS:BUT: The BUT of two groups was obviously shorter at 1wk, 1mo postoperatively, the differences were statistically significant(P<0.05), however, there were no statistically significant at 3, 6mo(P>0.05). CFS score: There was a large increase in CFS at 1wk, 1mo postoperatively, the differences were statistically significant between the two groups(P<0.05), however, there were no statistically significant at 3, 6mo(P>0.05). LIPCOF: There was a large increase in LIPCOF at 1wk, 1 and 3mo postoperatively, the differences were statistically significant between the two groups(P<0.05), however, there were no statistically significant at 6mo(P>0.05). LWE: There was a large increase in tear osmolarity at 1wk, 1mo postoperatively. The differences were statistically significant between the two groups(P<0.05), however, there were no statistically significant differences between the two groups at 3, 6mo(P>0.05).CONCLUSION: The stability of tear film in patients with scleral tunnel incision is much better than in patients with 3.2mm corneoscleral limbus incision phacoemulsification. There is no significant difference between the two groups during later postoperative periods.

AIM:To demonstrate the effect of comprehensive treatments for meibomian gland dysfunctional dry eye. METHODS:Totally, 86 cases(172 eyes)in our hospital, who suffered from meibomian gland dysfunctional dry eye, were measured by BUT, CFS, the machine of infrared meibomian gland function and testing meibomian gland after extrusion. The scores of meibomian gland function missing and secretions were observed, which as a diagnosis, and assessed the effectiveness of treatment, after took comprehensive treatments in different stages(comprehensive treatments including cleaning, hot covering, massaging, TobraDex, Pranoprofen and Lubricant, etc.).RESULTS:All patients were treated and observed for 3wk, in which 46 cases(92 eyes)of cured, 29 cases(58 eyes)effective, 11 cases(22 eyes)ineffective, the total effective rate was 87.2%. After 6wk, 68 cases(136 eyes)of cured, 13 cases(26 eyes)effective, 5 cases(10 eyes)ineffective, the total effective rate was 94.2%, not appeared adverse ocular and systemic reactions in the process of treatment.CONCLUSION: Taken comprehensive treatments for meibomian gland dysfunctional dry eye could effectively shorten the course of the disease, quickly remove meibomian gland tube obstruction, restore the meibomian gland secretion and stable the lipid layer, and could reduce the discomfort of patients with dry eye positively and effectively.

AIM: To investigated the refraction and cycloplegic effects of 0.5g/L tropicamide eye drops in various low myopia age groups, and provide clinical guidelines for proper usage of cyclopegic agent in different population. METHODS: Three low myopia age groups(n=45)were selected, non-cycloplegic and cycloplegic auto-refraction using “Shin-Nippon” auto-refractor were performed at various time point for refractive error. The subjective accommodation amplitudes were also collected at each time point.RESULTS: The accommodation amplitude showed a similar but significant decline between 20～60min after the first cyclopegic drops in all three age groups. However, the decline of accommodation amplitudes were not statistically correlated with the results of “Shin-Nippon”auto-refraction results at different time points. CONCLUSION: The refraction time should be arranged according to the cycloplegic effects of tropicamide. Open-field auto-refractor could reduce the usage of cycloglegice drugs in low myopia groups, even for the youngest.

AIM: To introduce a new color pediatric visual acuity chart and its clinical application.METHODS:The color pediatric visual acuity chart was designed based on principle of visual angle. The optotype on the color chart had graphics. The progression rate of optotype size between 2 lines was 10(10)1/2 and 1.2589. A regular geometric progression of optotype sizes and distribution was employed to arrange 8 lines with 11 optotype on the color chart. The testing distance was 3m. The visual acuity score could be recorded as logarithm of the minimum angle of resolution notation or decimal notation. The reliability of naked distant measurements with this new chart was tested in one eye of 100 children(4 ～6 years old)taking the Chinese national standard logarithm visual acuity chart standard. RESULTS: The color pediatric visual acuity chart and logarithmic chart controls, visual acuity test results that in the two groups had no significant difference(t=1.2671, P>0.05). Two sets of vision data existed positive correlation(r=0.924, P<0.01). Cooperation rate was 100%, the recognition rate was more than 90%.CONCLUSION:Children are easier to accept used new color pediatric visual acuity chart to inspect vision. New chart is reliability and apply to children's vision screening.

AIM: To investigate the refractive status of the preschool children in Xiantao, Hubei Province in order to find out the abnormal refraction error beyond the physiological range. METHODS: In this cross-sectional study, we investigated preschool children in kindergartens and the scattered ones were 12 716(25 432 eyes)ranging from 6mo～6 years old. 1 581 children(3 162 eyes)were diagnosed ametropia by Suresight refractive screening instrument, which were confirmed again after mydriasis optometry. RESULTS: The incidence rate of ametropia in preschool children in Xiantao was 12.4%, and statistics showed no significant difference between boys and girls(P>0.05), but had differences of morbility rate among each age group(P<0.05). With age increasing morbility rate of the refractive error decreased. The simple hyperopia and the compound hyperopia astigmatism were dominant in all refraction error. Professional ophthalmologists diagnosed amblyopia in 261 children(522 eyes), which was 16.5%, among 1 581 abnormal refractive children(3 162 eyes)screened out by Suresight refractive screening instrument. CONCLUSION: The incidence rate of ametropia decreases with age increasing in the preschool children from 6mo～6 years old, which imply preschool children should have mydriasis optometry in order to find out amblyopia and other congenital eye disease.

AIM: To compare the results of 4 methods for measuring angle of exodeviation in the three types of intermittent exotropia, including when looking at indoor distance target of 6m, looking at indoor distance target of 30m, looking at outdoor far distance target, after 1h diagnostic occlusion test. METHODS: Prospective case series study. Sixty-five patients with intermittent exotropia between June 2013 and June 2014 were enrolled in the Department of Ophthalmology, Affiliated Hospital to Qingdao University, included 37 males and 28 females with average age(12.5±6.2)years. All the patients were measured when looking at indoor distance target of 6m, looking at indoor distance target of 30m, looking at outdoor far distance target, after 1h diagnostic occlusion test. Intermittent exotropia was divided into basic type, convergence insufficiency type and divergence excess type, which was based on the different result of between the distance and near measurements. The One-way test was applied to analyze the four methods of measuring angle of exodeviation in the three types of intermittent exotropia. LSD-t test was applied to compare the differences between each two methods in each type.RESULTS: The distance exodeviations tested with looking at indoor distance target of 6m, looking at indoor distance target of 30m, looking at outdoor far distance target, after 1h diagnostic occlusion test were basic type(45.4±21.0, 55.0±15.0, 64.68±17.7, 68.75±16.6PD), convergence insufficiency type(33.3±14.0, 44.9±12.9, 43.6±11.8, 54.6±11.2PD), divergence excess type(55.6±17.4, 66.3±18.8, 76.9±16.4, 78.1±15.6PD). There were obviously differences between each two methods in each type(basic type F=9.649, P=0.00; convergence insufficiency type F=6.886, P=0.001; divergence excess type F=7.989, P=0.00). Compared with looking at indoor distance target of 30m, looking at outdoor far distance target(basic type P=0.044, divergence excess type P=0.048)and after 1h diagnostic occlusion test(basic type P=0.04, divergence excess type P=0.027)had the statistical difference in the basic type and divergence excess type, and there was no obviously difference between looking at outdoor far distance target and after 1h diagnostic occlusion test(basic type P=0.353, divergence excess type P=0.815). Compared with the other three measurements, 1h diagnostic occlusion test can elicit larger angle of deviation in the convergence insufficiency type. CONCLUSION: Both measurement with looking at outdoor far distance target and after 1h diagnostic occlusion test can elicit the larger angle of deviation in the basic type and divergence excess type; The measurement with after 1 hour diagnostic occlusion test can elicit the larger angle of deviation in the convergence insufficiency type.

Patients with early cataract may have normal visual acuity(VA)but complain that they have problems in driving at night, like seeing things through a veil. This phenomenon is defined as disability glare which maybe caused by growing stray light. Patients with intraocular lens following cataract surgery may complain about glare, halos and shadows in visual field, which are also resulted from dysphotopia. Disability glare is the VA loss due to disturbing luminance in visual field. In other words, it's the retinal contrast sensitivity reduction because of the straylight. This article contains the consensus and new progress of disability glare. It provides solutions according to its effect factors and offers clues for further study.

AIM: To establish the frequency, associations and risk factors for age-related macular degeneration(AMD)in hospital population.METHODS: In this hospital based study, 589 subjects above 60 years of age were screened randomly for AMD. Participants underwent ocular evaluation and were interviewed for lifestyle variables and dietary intake of carotenoids by structured food frequency questionnaire. AMD was defined according to the international classifications and grading system.RESULTS:Either form of AMD was detected in 48 participants. AMD was significant among diabetes, diabetic retinopathy, body mass index, heavy cigarette smokers and alcoholics(P<0.05). Dietary lutein/zeaxanthin(L/Z)and β-carotene intake were associated with the reduction in risk for AMD(P<0.05).CONCLUSION: Higher dietary intake of carotenoids, especially L/Z, is associated with lower risk for AMD. Risk of AMD is prevalent among subjects with diabetes. Cessation of smoking and alcohol may reduce the risk of AMD in this population.

AIM: To establish the frequency, associations and risk factors for age-related macular degeneration(AMD)in hospital population.METHODS: In this hospital based study, 589 subjects above 60 years of age were screened randomly for AMD. Participants underwent ocular evaluation and were interviewed for lifestyle variables and dietary intake of carotenoids by structured food frequency questionnaire. AMD was defined according to the international classifications and grading system.RESULTS:Either form of AMD was detected in 48 participants. AMD was significant among diabetes, diabetic retinopathy, body mass index, heavy cigarette smokers and alcoholics(P<0.05). Dietary lutein/zeaxanthin(L/Z)and β-carotene intake were associated with the reduction in risk for AMD(P<0.05).CONCLUSION: Higher dietary intake of carotenoids, especially L/Z, is associated with lower risk for AMD. Risk of AMD is prevalent among subjects with diabetes. Cessation of smoking and alcohol may reduce the risk of AMD in this population.

AIM: To evaluate the therapeutic effects and safety of femtosecond laser assisted penetrating keratoplasty(FS-PKP).METHODS: In the retrospective case series study, 46 cases(48 eyes)with FS- PKP holds were analyzed. Preoperative best corrected visual acuity(BCVA)was 2.35±1.01(with a standard logarithmic eye chart). Opacities were all from epithelium to endothelium, including keratoconus, keratolukoma and corneal scarring etc. The full-thickness corneal donor-recipient grafts in different diameter and incision kerfangle were made by femtosecond laser in keratoplasty. The patients were treated according to the conventional penetrating keratoplasty after surgery. Evaluation indexes included preoperative and postoperative 1,6,10mo uncorrected visual acuity(UCVA), BCVA, corneal astigmatism(CA)and surgical complications. Forty-three cases(44 eyes)with traditional PKP were as control group. The data of two groups were analyzed by mean comparison of two groups and Chi-square test in SPSS 18.0. RESULTS: All the operations were completed successfully, postoperative visual acuity of all patients had different degrees of increase. Comparison with the postoperative UCVA of traditional PKP surgery, UCVA was 3.48±0.43 and 2.97±1.14 at 1mo after operation, respectively, with statistically significant difference(P=0.009). The UCVA was 3.86±0.25 and 3.74±0.73 at 3mo after operation, respectively; the UCVA was 4.04±0.23 and 3.98±0.29 at 6mo after operation, respectively, with no statistically significant difference(P=0.146, P=0.56). In FS-PKP group, BCVA was better than traditional PKP surgery group, with statistically significant difference(P=0.002). While there had no statistically significant difference between two groups of BCVA at 6, 10mo after operation(P6mo=0.132, P10mo=0.47). The incidence of complication of FS-PKP surgery, such as postoperative astigmatism, postoperative intraocular pressure and postoperative incision dehiscence were significantly lower than the one of traditional PKP surgery(P<0.05).CONCLUSION:Compared with traditional penetrating keratoplasty, FS-PKP provides significantly faster visual recovery in the early postoperative period, and induces significantly less corneal astigmatism and lower incidence of complication. It reflected the clinical superiority of this new technology.

AIM: To investigate the effect of endocapsular phacoemulsification cataract extraction and intraocular lens(IOL)implantation with a 1.8mm or 3.0mm clear corneal incision on total root mean square(RMS)value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film.METHODS:In a prospective study, 156 age-related patients(196 eyes)were randomly distributed into two groups. 1.8mm-group comprised 94 eyes that had a silicone IOL inserted through a 1.8mm sutureless clear corneal incision, while, 3.0mm-group comprised 102 eyes through a 3.0mm clear corneal incision. Postoperatively, the changes in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film at 1wk, 1 and 3mo were determined respectively.RESULTS: In both groups, postoperatively at 1wk,there were statistically significant differences(P<0.05)in the total RMS value of the cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film, while, there were statistically minimal differences(P<0.05)between 1.8mm-group and 3.0mm-group at 1mo, but were not statistically significantly different(P>0.05)between two groups at 3mo postoperative.CONCLUSION:This study confirms that incision size has strong impact on the corneal higher-order aberrations, especially, 3.0mm incision caused significant differences in the total RMS value of cornea, corneal astigmatism, spherical aberration, coma, trefoil and tear film compared with 1.8mm micro-incision, therefore, micro-incision is very beneficial for clinical use in phacoemulsification.

AIM: To assess the correlation between the features of optical coherencetomography(OCT)and fundus fluorescein angiography(FFA)in diabetic macular edema(DEM). METHODS: Totally 70 patients(135 eyes)with diabetic retinopathy(DR)were evaluated by central vision, best corrected visual acuity(BCVA), intraocular pressure, indirect ophthalmoscopy, slit lamp microscope combined +90D front mirror mydriatic fundus examination, mydriatic fundus color photography, OCT, FFA, the correlation between FFA and OCT were analyzed. RESULTS: In mild macular oedema cases, abnormalities in FFA was 56 eyes, abnormalities in OCT was 68 eyes(P=0.0009); FFA showed 12 normal eyes, 10 eyes in OCT were characterized by diffused macular oedema; FFA was performed with cystoid macular oedema, OCT was 46.7% with cystoid type. CONCLUSION: DME is diagnosed by Combination FFA with OCT, OCT is an indispensable tool when following up DME, and it has advantage in early application.

AIM: To study clinical reference value of retinal microvascular changes in patients with cerebral microbleeds(CMBs)and discuss its clinical significance. METHODS:From January 2012 to December 2013, 125 hospitalized patients were collected, including 81 cases were male, 44 cases were female, mean age 76.3±11.2 years old. For all patients, functions of liver and kidney, blood-lipoids, blood sugar and blood biochemical examination were tested, and fundus photography and cerebral MR was done. According to the fundus camera eyes, retinal arteriolar equivalent(RAE), retinal venular equivalent(RVE), retinal vein diameter ratio(AVR)and arteriovenous crossing sign(AVN)were identified, CMBs were classified with cerebral MRI. All the data were processed by SPSS statistical software. RESULTS: The central retinal arteriolar equivalent(CRAE), central retinal venular equivalent(CRVE)and AVR values in the eyes were found no statistical difference(P<0.05). Of CMBs classification, the grade 0 in 75 cases, 1 in 27 cases, 2 in 9 cases and 3 in 14 cases were included. The RVE, AVR and AVN and the different grades of CMBs had statistically significant correlation(P<0.01). The higher CMBs classification, the more obvious retinal microvascular changes were found. In respectively to eliminate risk factors such as age, sex, blood glucose and blood pressure, AVR and AVN were still influencing factors for CMBs classification.COCLUSION: The results show that retinal microvascular changes, especially small retinal vein arteriovenous cross width, and arteriovenous crossing phenomenon, in which CMBs will happen more likely. After sex, age, hypertension and hyperglycemia in patients with traditional cardiovascular risk factors being ruled out, the retinal microvascular changes are still relatively factors of CMB's occurrence.

AIM: To analyze the effect of corneal limbus stem cell transplantation and amniotic membrane transplantation in treatment of recurrent pterygium with symblepharon.METHODS:Totally 80 cases of patients with recurrent pterygium and symblepharon were randomly divided into pterygium resection combined with limbal stem cell transplantation group and pterygium excision with amniotic membrane transplantation group, 40 cases in each group. All patients were followed up for 6mo after the operation, the recurrence rate of pterygium and symblepharon were observed.RESULTS:There were 2 cases of recurrence in the group of corneal limbus stem cell transplantation(5%), 8 cases of recurrence in the group of amniotic membrane transplantation(20%), with statistical difference between two groups(P<0.05).CONCLUSION:Two kinds operation could significantly reduce the recurrence rate of recurrent pterygium, but the corneal limbus stem cell transplantation group has the lower recurrence rate.

AIM: To evaluate the clinic efficacy of protein-free calf blood extract ophthalmic gel on healing children dry eye. METHODS: One hundred patients(50 patients each group)with children dry eye were divided into two groups randomly: control group was dropped 1g/L sodium hyaluronate eye drop four times per day and experimental group was dropped protein-free calf blood extract ophthalmic gel four times per day. Both groups received the depathogeny treatment at the same time. Symptom scores, Schirmer I test values, tear break-up time(BUT), cornea fluorescein staining scores were recorded on the prior treatment and 30d post-treatment, then they were analyzed. RESULTS: There were statistically significant difference(P<0.05)for the comparison in the symptom scores, Schirmer I test values, BUT, cornea fluorescein staining scores of prior treatment and post-treatment in each groups. And there were statistically significant difference(P<0.05)in the same items of post-treatment between the two groups. CONCLUSION: There is a clearly beneficial effect of protein-free calf blood extract ophthalmic gel on healing children dry eye.