AIM: To discuss the efficacy of different surgical methods in treating traumatic lens dislocation.METHODS:Totally 39 cases with traumatic lens dislocation who underwent surgery treatment were analyzed retrospectively from October 2011 to September 2012. According to different positions and degrees of the lens dislocation, different surgical managements were performed: intracapsular lens extraction, phacoemulsification, lens extraction through incision of orbiculus ciliaris. Meanwhile, the cases were associated with homologous operations according to different conditions, such as vitreo-retinal operations, anti-glaucoma operations. RESULTS: All dislocated or subluxated lenses were removed completely, 32 eyes(82%)of postoperative visual acuity were improved, no significant complications were observed. CONCLUSION: The surgical treatment method of traumatic lens dislocation should be chosen according to the location, the extent, and the presence of complications of the dislocated lens.Vitrectomy and lensectomy or lens extraction are the most efficient treatments for patients of lens dislocation. Reasonable choice of surgical approach or combined surgery is the key point of treating traumatic lens dislocation.

AIM: To explore the effects of oral acyclovir combined with sodium hyaluronate and fluorometholone eye drops on the treatment of herpes zoster keratitis. METHODS:Forty patients with ocular herpes zoster were divided into two groups, 20 cases in the observation group, 20 cases in the control group. Observation group was treated with 200mg oral acyclovir for 5 times a day and sodium hyaluronate eye drops for 4 times a day. When stromal keratitis, disciform keratitis or corneal endotheliitis occurred, fluorometholone was used for 4 times a day. The control group was treated with ganciclovir ophthalmic gel for 4 times a day. The efficacy of two groups was observed, patients were followed up for 3-4wk. RESULTS:The observation group of local pain and photophobia in remission time and corneal damage healing time were better than control group, and there were significant differences(P<0.05). There was efficient comparison, but no statistically significant difference.CONCLUSION: Effects of oral acyclovir combined with sodium hyaluronate and fluorometholone eye drops on the treatment of herpes zoster keratitis are satisfactory.

AIM: To observe the clinical effect of phacoemulsification and intraocular lens implantation combined with goniosynechialysis in the treatment of cataract and angle-closure glaucoma. To provide a reliable method for the treatment of cataract patients with angle-closure glaucoma. METHODS: A retrospective analysis included clinical data of 95 patients(112 eyes)with cataract and angle-closure glaucoma which came from our hospital from Jan 2010 to Oct 2011. The patients were treated with phacoemulsification and intraocular lens implantation combined with goniosynechialysis. The clinical effect was compared between before and after treatment. The following clinical parameters were tested before and after treatment: visual acuity, intraocular pressure(IOP), anterior chamber depth, angle changes, and incidence of complications. Pair t test was used to analyze the measurement data.RESULTS: The postoperative IOP of these patients was significantly lower than the preoperative at 1wk; 1, 6mo. There was significant difference between before and after treatment concerning visual acuity, anterior chamber depth, and angle changes(P<0.05). At different periods after treatment, all parameters of patients showed no significant differences. Comparison of the efficacy of before and after operation, chamber angle examination: all the subjects'(112 eyes)angle completely open after operation; the visual acuity, IOP, anterior chamber depth were 0.14±0.18, 34.5±6.5mmHg, 1.51±0.27mm respectively at pre-operation; after operation of 1wk; 1, 6mo, the visual acuity were 0.61±0.14, 0.61±0.2, 0.60±0.151 respectively; at 1wk; 1, 6mo of postoperation, the IOP were 13.1±3.7, 12.8±3.9, 12.9±4.3mmHg, and anterior chamber depth were 2.49±0.31, 2.45±0.39, 2.46±0.43mm. There were statistical differences at pre- and post-operation. Shallow anterior chamber, intraocular hypertension rate, and anterior chamber inflammation were treated efficiently and timely.CONCLUSION: Phacoemulsification and intraocular lens implantation combined with goniosynechialysis in the treatment of cataract patients with angle-closure glaucoma can significantly improve visual acuity and reduce early complications of operation. It's safe, effective and convenient. The method of operation can be widely used.

AIM: To analyze the clinical effects of small-incision extracapsular cataract extraction with intraocular lens implantation for the treatment of cataract.METHODS:Totally 642 cases 676 eyes of cataract were treated by small-incision extracapsular cataract extraction with intraocular lens implantation. Complication during and after operations and postoperative visual acuity was observed.RESULTS:Visual acuity of 670 eyes was ≥0.05 and off-blindness rate was 99.11%, and there was 627 eyes ≥0.3 and the off-disability rate was 92.75% after 1mo. Rupture of posterior capsule during surgery occurred in 24 eyes. Fifty-four eyes were corneal edema, and anterior chamber exudation were 26 eyes, and 23 eyes were hypertension after operation. CONCLUSION: There are a little complications during and after operation for cataract treated by small-incision extracapsular cataract extraction with intraocular lens implantation. Patients have good recovery after operation. This operation does not need high-standard equipments and is suitable in the sight restoration project.

AIM: To investigate the clinical curative effects and value of small incision cataract extraction in the treatment of acute angle-closure glaucoma and cataract.METHODS: A total of 60 cases of acute angle-closure glaucoma with cataract patients in our hospital from May 2012 to November 2013 were selected as the study objects, and randomly divided into Group A, B and C, each group contained 20 cases(eyes). Group A were given anti-glaucoma surgery, Group B were given glaucoma and cataract surgery, while Group C were given simple small incision cataract extraction and intraocular lens implantation. The IOP, anterior chamber depth, anterior chamber angle, papilledema C / D ratio change, and corrected visual acuity, complications, hospital stay, cost-effectiveness and the learning curve and other indicators before and after the treatment of these three groups were compared. RESULTS: Three groups of patients on admission and there was no significant difference in IOP after treatment(P>0.05); through different surgical methods, IOP of group C was significantly better than that in group A and group B(P<0.05); after surgery, the difference of patients with correction change in visual acuity between group A and group B was not significant(P>0.05), while group C was significantly better in group A and group B(P<0.05); compared the complications of group A and group B, there was no significant difference(P>0.05), group C had significantly less complications than group A and group B(P<0.05). CONCLUSION: The small incision cataract surgery for acute angle-closure glaucoma has faster recovery, a small wound, a significant effect and fewer complications. It can effectively improve the cure rate of the disease and improve patient quality of life. Medical equipment is not expensive, the learning curve is short, the cost is low, and it is worthy of clinical use.

AIM: To investigate the long-term outcomes after surgery for intermittent exotropia \〖X(T)\〗, constant exotropia with a previously intermittent history and constant exotropia without a previously intermittent history. METHODS: Totally 137 patients with intermittent exotropia or constant exotropia who had underwent surgery were analyzed retrospectively. They were assigned into three groups: group 1, seventy-four patients with X(T); group 2, thirty-eight constant exotropia patients with a previously intermittent history; group 3, twenty-five constant exotropia patients without a previously intermittent history. The surgical outcomes in the ocular deviation and the recovery of stereoacuity were compared separately among the three groups. The average follow-up time was 2.2 years. RESULTS: The successful alignment rates were 78%(group 1), 68%(group 2), 64%(group 3), respectively(group 1 vs group 2, P=0.249; group 1 vs group 3, P=0.153; group 2 vs group 3, P=0.716). Fifty-seven patients(77%)in group 1, five patients(13%)in group 2 and one patient(4%)in group 3 achieved binocularity after surgery(group 1 vs group 2, P<0.001; group 1 vs group 3, P<0.001; group 2 vs group 3, P=0.440). The number of patients who achieved gross stereopsis in group 1, group 2 and group 3 were 66(89%), 27(71%), 8(32%)(group 1 vs group 2, P=0.015; group 1 vs group 3, P<0.001; group 2 vs group 3, P=0.002). Twenty-nine patients(56%)in group 1, 5 patients(24%)in group 2, 1 patients(7%)in group 3 achieved distance stereoacuity(group 1 vs group 2, P=0.013; group 1 vs group 3, P=0.001; group 2 vs group 3, P=0.366). CONCLUSION: Patients with constant exotropia who had a intermittent history have a better surgical result compared with those without a intermittence period in gross stereopsis, but a worse postoperative sensory outcome than patients with X(T)in binocular vision, gross stereopsis, and distant stereoacuity. Constant exotropia patients with a period of X(T)may have missed the optimal timing for treatment, early surgery can optimize the postoperative sensory results.

AIM: To research the neuroprotective effects of lomerizine(LOM)on retinal ganglion cells(RGCs)in the diet-induced obese C57BL/6J mice. METHODS: Fifty-four mice were randomly divided into two groups which were fed a high-fat diet for 19wk. One group mice were lavaged LOM by the dosage of 80mg/kg daily at the same time. The obese mice were selected and divided into diet-induced obesity(DIO)group, diet-induced obesity and lomerizine(DIO+LOM)group. The mice in the control(CON)group were fed a basal diet. The ultrastructural changes of RGCs were detected by transmission electron microscope. The cellular apoptosis was detected by TUNEL. The laser scanning confocal microscope was used to measure intracellular calcium ion concentration. RESULTS: Compared with the CON group, the RGCs in DIO group showed smaller and condensation of nuclear chromatin and increased electron density of the cytoplasm, whereas the changes in DIO+LOM mice were obviously diminished. TUNEL staining showed that the number of apoptosis cells in the ganglion cell layer(GCL)increased in DIO group and the percentage of apoptotic cells was much higher than that in the CON groups(P<0.01). The DIO+LOM group mice showed fewer apoptosis cells and the percentage of apoptotic cells in this group were significantly decreased than the DIO mice(P<0.05). The Laser scanning confocal microscope detection showed Ca2+ staining intensity of RGCs in DIO group increased and its staining intensity ratio was significantly higher than in CON group(P<0.01), the Ca2+ staining intensity and its staining intensity ratio in DIO+LOM group were significantly decreased than the DIO group(P<0.01). CONCLUSION: Lomerizine has neuroprotective effects on damage of retinal ganglion cells in diet-induced obesity mice, which may be related to the attenuation of intracellular Ca2+ overload.

AIM:To observe whether progesterone has a protective effect on retinal neural cells by establishing the acute high intraocular pressure model and intervening with progesterone.METHODS: Totally 140 Wistar rats were randomly divided into normal control group(group A)20, high intraocular pressure control group(group B)60 and high intraocular pressure progesterone treatment group(group C)60. The acute high intraocular pressure models were made by saline anterior chamber perfusion. Group C were treated with intraperitoneal injection of progesterone 4.0mg/Kg immediately after intraocular pressure restored, and after 6, 24h and every other day were treated with subcutaneous injection. Group B were injected with equivalent saline at the same time. At the 1, 3, 7d after ocular hypertension, the retinas of rats in each group were obtained respectively. Retinas pathological changes were observed in samples hemetoxylin and eosin staining. The protein expression of Caspase-3 was measured with immunohistochemistry and Western blot. Apoptosis in retinal nerve cells were tested with TUNEL technique. Statistical analysis was performed in each group.RESULTS: The rats retina of group B and group C were edema, but the degree in group C was lower than that in group B. In relative quantitative detection of immunohistochemistry and Western blot, expression of Caspase-3 was lower than group B. Substantial expression of Caspase-3 protein lay in cell nucleus and cytoplasm. The level of Caspase-3 in group B was higher than in group C. The positive cells were mainly in inner nucleus layer and ganglion cell layer. The level on the first day after high intraocular pressure was the highest, then gradually decreased along with the passage of time. Apoptosis tested with TUNEL technique, positive cells could be observed in group B and group C, which in inner nucleus layer and ganglion cell layer. But the number in group B was significantly more than group C. CONCLUSION: Progesterone has nerve protection functions on retinal acute high intraocular pressure injury in rats.

AIM: To investigate the neuroprotection of lomerizine(LOM)on retinal ganglion cells(RGCs)in early diabetic rats and their mechanism.METHODS: Adult male Spraque - Dawley(SD)rats were randomly divided into control(CON), diabetes mellitus(DM), lomerizine(LOM)group, and each group had 40 rats. Diabetes rat model was induced by Streptozotocin(STZ)of intraperitoneal injection of 60 mg/kg of disposable. In LOM group, after model was established, rats were lavaged LOM by the dosage of 60mg/kg daily, the CON group and DM group were given the same dosage sodium chloride. In 4th, 8th, 12th wk, RGCs' apoptosis were detected by HE, TUNEL, transmission electron microscope, and TUNEL and laser confocal microscope detection was used to test the calcium ion concentration.RESULTS: Morphological observation: with the extension of the DM, RGCs decreased gradually and appeared disordered arrangement of cells. In DM group, different stages of apoptosis were observed by transmission electron microscope and got worse gradually with its extension. In LOM group, compared with DM group in the same period, RGCs apoptosis signs diminished gradually at 8th and 12th wk. TUNEL detection: no apoptotic RGCs was observed in CON group. In DM group, few TUNEL positive RGCs were seen at 4th wk, and became more and more gradually. The apoptosis index was significantly higher in DM group compared with CON group in same time and there was statistical significance(P<0.01). In LOM group at 8th and 12th wk, compared with DM group in the same period, the numbers of TUNEL positive RGCs decreased. The apoptosis index was significantly lower in LOM group compared with DM group in the same period(P<0.01). Calcium ion concentration detection by laser confocal microscope: compared with CON group in same time points, at 8th and 12th week, DM group's calcium fluorescent staining intensity of RGCs markedly elevated and had significant differences.(P<0.01). In LOM group, at 8th and 12th wk, calcium fluorescent staining intensity of RGCs markedly decreased and had statistical significance(P<0.01).CONCLUSION: The LOM played a protective role for RGCs in early stage of diabetic rats.

AIM: To demonstrate that ultraviolet A(UVA)induces osmolytes accumulation in retinal pigment epithelial(RPE)cells.METHODS: Under different experimental conditions such as UVA exposure, hyperosmotic stress condition and hypoosmotic stress condition, RPE cells were cultured for different time periods. The betaine /γ-amino- n-butyric acid(GABA)transporter, the sodium-dependent myoinositol transporter and the taurine transporter(TAUT)mRNA were measured by quantitative PCR. The radioactive labeled osmolytes were measured to evaluate the level of osmolytes transportation. RESULTS: This study demonstrated that RPE expressed mRNA specific for the betaine/GABA transporter, for the sodium-dependent myoinositol transporter and for the TAUT. In comparison to norm osmotic(300mosmol/L)controls, a 3-5-fold induction of mRNA expression for the betaine/GABA transporter, the sodium-dependent myoinositol transporter and the TAUT was observed within 6-24h after hyperosmotic exposure(400mosmol/L). Expression of osmolyte transporters was associated with an increased uptake of radioactive labeled osmolytes. Conversely, hypoosmotic(200mosmol/L)stimulation induced significant efflux of these osmolytes. UVA significantly stimulated osmolyte uptake. Increased osmolyte uptake was associated with upregulation of mRNA steady-state levels for osmolyte transporters in irradiated cells.CONCLUSION: UVA induces osmolyte uptake in RPE. It is similar reaction to hyperosmotic stress. This suggests that osmolyte uptake response by UVA may be important to maintain homeostasis.

AIM: To discuss the functional significance of purine receptor P2X7 in retinal capillary pericytes rats.METHODS: The TUNEL test was applied to observe the survival rate of normal retinal capillary pericytes and diabetic retinal capillary pericytes which were affected by P2X7 agonist BzATP and antagonist OxATP in microscopy. RESULTS: Activation of P2X7 receptors caused occurence of apoptosis in retinal capillary pericytes. Compared with normal retinal capillary pericytes, when they were at the same concentration or time, the diabetic retinal capillary pericytes caused much more apoptosis than normal retinal capillary pericytes. The antagonist OxATP could significantly reduce the toxic effects activated by BzATP, and then increased the livability of retinal capillary pericytes. CONCLUSION:The activity of P2X7 receptor plays a regulatory role on RPC apoptosis.

AIM: To research the feature of normal SD rat and retinal cone dysfunction(RCD)rat electroretinogram(ERG)under different color stimulation and to explore its possible diagnostic value. METHODS: Six male SD rats and six RCD rats were used, all of which were mature rats. They were stimulated by red, white, blue and green light and the ERG was recorded. The wavelength of red, green and blue light were 625nm, 525nm and 470nm respectively and the white light was mixed by three color light.RESULTS: The response of ERG in normal SD rat under green and blue light stimulation were stronger than under red and white stimulation. The dark-adapted ERG of RCD rat responsed to color stimulation was similar to the ERG of normal SD rat, but the amplitude under each color stimulation was lower than that of normal SD rat. Light-adapted ERG response was hardly detected waveform.CONCLUSION: Rat is sensitive to blue and green light, which can be used as a suggested light stimulation in the ERG recording. The ERG of RCD rat is not specific for color stimulation, and at present we could not use color ERG as a diagnostic indicator.

AIM: To investigate the safety and therapeutic effectiveness of phakic iris-claw intraocular lens implantation for correction of high myopia with clear corneal incision. METHODS: Implantation of phakic iris-claw intraocular lens through clear corneal incision was performed on 28 eyes of 20 high myopic patients under topical anaesthesia. Intraoperative and postoperative complications, visual acuity, intraocular pressure, refractive diopter, corneal endothelium, the stable of intraocular lens and the turbid level of lens were observed. RESULTS: All cases were smoothly implanted iris-claw intraocular lens. No complications were found during the operation. The uncorrected visual acuity of post-operation was better than the best corrected visual acuity of pre-operation. The follow-up time lasted for 6mo, and the intraocular lens in all the eyes were basically in the normal position without tilting and obvious deviation. No serious complications such as cataract, uveitis, cystoid macular edema, retinal detachment were seen in all cases. CONCLUSION: On the basis of having adept microsurgery technology, phakic iris-claw intraocular lens implantation is predictable and stable, and post-operation visual acuity is satisfying with few complications. It is a safe and effective way to treat high myopia.

AIM: To establish a reference range of retinal nerve fiber layer(RNFL)thickness by optical coherence tomography(OCT)in Chinese teenagers aged from 13 to 18 years old, and investigate its relationship with age, eye side, gender, and ethnic group.METHODS: A total of 402 eyes from 201 normal Chinese aged from 13 to 18 years old were recruited for this study. Optic disk with 3.4mm diameter circle in different global average, quadrant and part-time bit retinal nerve fiber layer thickness(RNFLT)was measured by RNFL thickness average analysis program. Their RNFLT at different part-time bit, quadrant and global average RNFLT around the disc were measured by OCT with 3.4mm diameter circle, using the RNFL thickness average analysis program. The data was analyzed with SPSS statistical 19.0. The influences of several factors(such as age, eye side, gender, and ethnic group)on RNFLT were also analyzed.RESULTS: The global average RNFLT at 13, 14, 15, 16, 17, 18 years old was 108.32±9.42μm, 109.23±9.67μm, 110.36±11.14μm, 111.27±10.21μm, 109.23±9.67μm, 112.11±8.83μm respectively. RNFLT of right eyes was 109.82±8.93μm and of left eyes was 110.33±9.89μm. All of the male's average RNFLT was 110.14±10.02μm, and all of the female's average RNFLT was 109.96±11.22μm. The average RNFLT of Han nationality was 110.22±9.31μm and of non-Han nationality was 109.87±8.65μm. The average RNFLT of all was 110.02±9.87μm, the RNFLT at the superior, nasal, inferior and temporal quadrant was 146.56 ±18.88μm, 76.49±13.28μm, 136.64±16.29μm, 82.01±12.55μm respectively. There was no significant difference in gender, eye side, and ethnic group(all P<0.05), but the difference was significant compared with adult's data of the database. CONCLUSION: This study has established a normal standard reference of RNFLT and its related indexes by OCT in Chinese teenagers aged 13-18 years old. Gender, age, eye side, and ethnic group have no effect on their RNFLT, which has significant difference with adult's data. And for the diagnosis and follow-up of diseases involving in RNFL changes, the adult's data can not be used.

AIM: To compare the efficiency of coaxial micro-incision cataract surgery(MICS)performed by 3 phacoemulsification techniques(phaco-chop, divide-and- conquer and stop-and-chop).METHODS: It was a perspective and randomized clinical trial. Totally 135 patients with age-related cataract were selected randomly and underwent MICS. According to the lens nuclear opacity(NO)of LOCSⅢ grading standards, it can be divided into 3 groups as NO2, NO3 and NO4 group. All groups were randomly subdivided into 3 groups(phaco-chop, divide-and-conquer and stop-and-chop group). The observation target included best-corrected visual acuity(BCVA), central corneal thickness(CCT)and endothelial cell count(ECC)before operation and 1mo postoperation, ultrasound time(UST), cumulative dissipated energy(CDE), estimated fluied used(EFU)in operation and complications.RESULTS:In lens nuclear opacity NO4 coaxial micro-incision phacoemulsification, phaco-chop group showed significantly less UST, CDE and EFU than the divide-and-conquer and stop-and-chop groups(P<0.05)and the ratio of endothelial cell loss was significantly lower in the phaco-chop group than in the divide-and-conquer and stop-and-chop groups 1mo after surgery(P<0.05). However, after 1mo surgery, BCVA and CCT among three chop technique groups in different lens nuclear opacity groups had no significant differences(P>0.05).CONCLUSION: All 3 techniques may be effective for coaxialmicroincision cataract surgery in mild and moderate nuclear opacity cataracts. However, in eyes with severe nuclear opacity cataract, the phaco-chop technique can be more effective for phacoemulsification, and less corneal endothelial damage.

AIM: To evaluatethe clinical efficacy of trabeculectomy combined with amniotic membrane transplantation for refractory glaucoma. METHODS: This study included 29 cases(29 eyes)with developmental refractory glaucoma at such high risks as neovascular,uveitis,aphakia, pseudophakic.Trabeculectomy with amniotic membrane transplantation was performed in 13 cases and trabeculectomy without amniotic membrane transplantation in 16 cases. The outcome measurements included postoperative intraocular pressure(IOP), the used quantity of antiglaucoma medications, the morphologic characteristics of the filtering blebs and complications. All patients were followed for 12mo.RESULTS: Complete success was seen 11/13(84.6%)in study eyes and 10/16(62.5%)in aontrol eyes at 6mo postoperatively(P<0.05), and 10/13(76.9%)in study eyes and 10/16(62.5%)in control eyes at 12mo after surgery, respectively(P<0.05). IOP decreased from 50.3±11.3mmHg and 49.7±10.7mmHg preoperatively in study and control groups to 15.7±1.1mmHg and 19.8±2.3mmHg respectively at 12mo of postoperation(P<0.05). Early postoperative ocular hypotony developed in 3(18.8%)control eyes owing to excessive filtration but none of them in study eyes. Encapsulated bleb occurred in 6(37.5%)control eyes but only in 1(7.7%)study eyes.CONCLUSION: In refractory glaucoma,trabeculectomy combined with amniotic membrane transplantation compared to trabeculectomy without amniotic membrane transplantation has higher success rates, better control of postoperative IOP, and less complication rates.

AIM: To analyze the changes in higher-order aberrations on anterior corneal surface in the early stages(within 1d)after laser in situ keratomileusis(LASIK). METHODS: A prospective study was designed for 200 eyes of 100 patients who had underwent LASIK. A 3D sirius corneal topography system(SIRIUS)was used to collect and measure the root mean square(RMS)of corneal aberrations at the 4mm optical zones of cornea in different time(preoperation and postoperation of 5, 30, 60min; 1d). Data were analyzed using analysis of variance(ANOVA).RESULTS: From 5min to 60min after surgery, the higher-order aberrations(HOA)on the peak area of corneal surface were significantly increased, but all in the second day returned to the preoperative level and the difference was not statistically significant(P>0.05). In each aberrations' the root mean square(RMS)of Z17 was markedly increased to maximum 1126.98%(P<0.01), and the minimal increase of Z12 was 147.92%(P=0.03). Their peaks of higher-order aberrations were different. According to their characteristics, they can be divided into single-peak period, double peak, and platform-type. Compared with postoperative 5min, the average central corneal thickness in the postoperative 30 and 60min increased significantly and recovered until the next day.CONCLUSION: Higher-order aberrations on anterior corneal surface in the early stages after LASIK increase significantly, and return to the preoperative levels within 1d.

AIM: To investigate prevalence of cataract and status surgery of cataract among adults aged 50 years and above in rural, Shaanxi Province, and to evaluate the rate of blindness caused by cataracts and postoperative effects.METHODS: Cluster sampling was used in randomly selection in Shaanxi Province from Jan. to Dec. in 2011, among the 3494 individuals from Liuba county, Huangling county, Lantian county and Baqiao district, 2124 aged 50 years and above received questionnaire survey and eye examination in the study. WHO diagnostic criteria and cataracts diagnostic criteria were used in the evaluation. RESULTS: Of 1912 participated the eye survey and response rate was 90%, the prevalence of cataracts was 36.66%, and the prevalence of cataracts among adults aged 50 years and above was 15.80%, the prevalence of cataracts among adults aged 70 years and above was 68.71%. The prevalence of age-related cataracts increased obviously with aging(P<0.01). The prevalence of bilateral blindness and low vision caused by cataract was 1.99% and 7.17%, respectively. The rate of bilateral blindness and low vision and monocular blindness and low vision was 0.51%, 0.63%, 1.90%, 2.53% respectively, increasing to 4.55%, 5.35%, 16.44%, and 18.81% in those aged 70 years and above. There was statistically significant difference in cataract blindness of different age groups and incidence of low vision, increased obviously with aging(P<0.01). Among 86 eyes with cataract surgery, 58 eyes were given ECCE, and 23 eyes were given PHACO, and 5 eyes were given ICCE. The corrected vision after cataract surgery ≥0.3 occupied 69.09%, 23.64%, 7.27% in ECCE, PHACO and ICCE respectively. The rate of off-disability and off-blindness was 63.95%, 91.86%, respectively.CONCLUSION: Cataract blindness is a serious public health problem in rural, Shaanxi Province. Prevention of blindness in Shaanxi Province has made some achievements, and the prevalence of cataract and visual impairment have decreased to some extent. PHACO has been carried out in rural areas, however, the penetration and surgical techniques of PHACO should be further improved.

Glaucoma is aneurodegenerative disease characterized by loss of retinal ganglion cells and their axons. Recent evidence suggests that intraocular pressure(IOP)is only one of the risk factors for glaucoma, and the disease progression continues in many patients, despite the IOP has been lowered effectively. This review summarized the latest advances in glaucoma neuroprotection, such as the pharmacological approaches, gene therapy, immunomodulators and vaccination, stem cell therapy, bioenergetics, and provided new outlook of neuroprotection therapy for glaucoma.

Nerve growth factor(NGF)is one of the most important active protein acting on the nervous system, it is applicated widely in ophthalmology, the administration route includes systemic drug administration and local drug administration. Compared to systemic drug administration, local drug administration is targeted, it is more effective to achieve the necessary concentration in eyes and it reduces the risk of side effects. Local drug administration has been a common treatment method in eye diseases. With the development of administration route, corresponding pharmacokinetic researches have received the concern. This review provides a reference for the study on ophthalmological administration routes and pharmacokinetics of nerve growth factor.

Because silicone oil's special physical and chemical properties, they are widely used in the vitreous retinal surgery, but the complications have aroused the concern of eye doctors, particularly, the complicated cataract. Nowadays, there are different kinds of surgery for silicone oil filling complicated cataract, but our aim is to choose a method which can be safe, effective and economical. This article reviews the progress in the research of silicone oil filling complicated cataract surgery.

Glaucoma is the second blindness disease in the world, and there are more primary angle closed glaucoma in China. The anatomy changes of the anterior chamber have close relationships with the development of glaucoma. Anterior segment optical coherence tomography(AS-OCT)has the advantages of fast, non-contact, high resolution and accurate quantitative measurement, which provides a kind of important method for finding the pathogenesis of primary angle closed glaucoma, for early diagnosis and treatment of glaucoma, and for the postoperative evaluation of glaucoma.

Diabetic retinopathy(DR)is one of the most serious and commonmicrovascular complications of diabetes,and it is a major cause of blindness all over the world. However, its exact pathogenesis is complicated and not entirely clear. Pigment epithelium-derived factor(PEDF)is a kind of multifunctional protein. Many studies showed that its protective effects were done by antioxidant properties in the DR. This paper summarized the mechanism of protective effect of antioxidant properties of PEDF in DR.

People with high myopia are high risk populations to have primary open angle glaucoma. Clinically, we found that patients with primary open angle glaucoma and high myopia is closely related. So to understand the clinical features of high myopia with primary open angle glaucoma and the importance of early diagnosis, to avoiding missed diagnosis or lower misdiagnosed rate, can help to improve the vigilance and level of early diagnosis of the clinicians. In this paper, high myopia with clinical features of primary open angle glaucoma, and the research progress on the main points of early diagnosis were reviewed.

Tuberculosis(TB)is a chronic infectious disease with high rate of morbidity and mortality world wide, and it is easy to relapse. TB can involve multiple organs, when it infects eye, it can cause lesions in anterior segment, posterior segment and the accessory organs of the eye. The purpose of this paper is to describe the clinical manifestation of intraocular TB, its diagnosis and treatment.

AIM: To evaluate the curative effects of tacrolimus on vernal keratoconjunctivitis(VKC). METHODS: A double-blind, randomized, placebo-controlled trial.Sixteen ambulatory patients from department of ophthalmology in West China Hospital of Sichuan University were randomly divided into drug treatment group and control group. Patients in treatment group were treated with tacrolimus eye drops, and control group with the basic placebo eye drops. Observation period of the trial was 28 days after taking the drops. The signs and symptoms were recorded and marked respectively. Total variation of ocular signs before or after therapy was main therapeutic index but subjective symptoms were the secondary index. RESULTS: Comparison in groups: there were significant differences on the scores of signs and symptoms before and after medication. After the drug treatment group, consciousness of each period symptom score was lower than before the medication, and over time, symptom score gradually reduced, the difference was statistically significant, but the control group after the medication had no statistically significant differences between different periods. Compared between the groups: There were no significant differences of subjective symptoms and signs before and after medication at the first review, but there were statistically significant differences during the other two reviews. Score variation(scores before or after medication)had no significant differences in the first review but had it in the following two times.CONCLUSION:Tacrolimus can be used to improve the signs and symptoms of VKC, especially for the severe patients who are nonresponse to the anti-anaphylaxis drops. Tacrolimus can be quick and excellent to improve the effects, so it can be applied into clinic.

AIM: To observe the effect of 1.8mm coaxial micro-incision cataract phacoemulsification on corneal astigmatism, and compared with the effect of traditional 3.2mm small incision cataract phacoemulsification.METHODS: Totally 160 patients(168 eyes)with age-related cataract were selected, whose age from 50 to 83 years old. Their lens opacities classification was Ⅱ-Ⅴ grade. Two groups were divided randomly and each group included 84 eyes. They performed 1.8mm coaxial micro-incision(micro-vision group)and traditional 3.2mm small incision(control group)of cataract phacoemulsification respectively. After 1d, 1wk, 1mo follow-up, their naked vision and astigmatism changes were recorded. The χ2-test and t-test was used for the statistical analysis.RESULTS: After 1d, 1wk, 1mo of the micro-incision surgery, naked vision ≥0.5 of the patients were 79%, 83% and 94% respectively. In control group, naked vision ≥0.5 were 46%, 64% and 85% respecticvely. There was significant difference between the two groups(P<0.05). The average corneal astigmatism of micro-incision group was 0.75±0.45D on 1d after surgery, and that of the control group was 1.12±0.55D. There were significant difference between two groups(P<0.01). After 1wk and 1mo, the average corneal astigmatism of micro incision group was 0.76±0.40D and 0.65±0.35D, and the average corneal astigmatism of control group was 1.05±0.53D and 0.85±0.43D. The two groups were statistically significant(P<0.05).CONCUSION: The corneal astigmatism of 1.8mm coaxial micro-incision cataract phacoemulsification was smaller than that of the conventional phacoemulsification and visual recovery was also better after surgery.

AIM: To evaluate the clinical therapeutic effects of senile cataract on phacoemulsification and small incision cataract surgery and the influence of corneal endothelium.METHODS: A retrospective analysis was performed in 296 cases of senile cataract in our hospital from Jan. 2009 to Jan. 2013 in the "Cataract extraction project". One hundred and forty cases underwent phacoemulsification treatment, whereas 156 cases received small incision extracapsular cataract extraction. The therapeutic efficacy and effects on corneal endothelial cells of the two groups were compared. RESULTS: After 3d operation, the visual acuity and corneal astigmatism in phacoemulsification group were much better than that in small incision cataract surgery group(P<0.05), and the two groups were statistically significant differences before operation(P<0.05). However, after 1 and 3mo, the acuity, astigmatism and preoperative and postoperative complications had no significant differences(P>0.05). CONCLUSION: Both phacoemulsification and small incision extracapsular cataract extraction are effective methods of treatment of cataract. However, the method of small incision cataract surgery is more economic, and it is valuable in primary hospital and the “Cataract extraction project”.

AIM: To study the clinical effects of chopping with lens loop-pad in the small incision extracapsular cataract surgery with intraocular lens implantation.METHODS:A total of 75 cases(80 eyes), in which loop-pad and chop knife were performed to chop nucleus before implanting intraocular lens. Visual acuity, postoperative astigmatism degree, intraoperative and postoperative complications were observed. The post-operative follow-up periods ranged from 3 to 12mo.RESULTS: The visual acuity was 0.3-0.5 in 37 eyes and 0.6 or better in 21 eyes at 1d, while was respectively in 43 eyes and in 26 eyes at 1mo. Compared with preoperative astigmatism(0.85±0.29D), there were significant difference at postoperative 1wk(1.75±0.55D)(P<0.05), while there were no significant difference at postoperative 1mo(0.92±0.48D)and 3mo(0.89±0.35D)(P>0.05). Intraoperative posterior capsule rupture occurred in 4 eyes, which implantation was successful in 1 eye and 3 eyes was managed viaciliary sulcus. Two eyes had dermatoglyphic pattern edema in corneal endothelium which recovered after about 3d. Two eyes had local patchy opacities which recovered in 2wk. Two eyes had transient high intraocular pressure.CONCLUSION: The surgery is efficient, low cost, easy process and less complications, it is worth to be popularized.

AIM: To observe the therapeutic effect of triple surgery in the treatment of glaucoma with cataract at different stages.METHODS: Totally 31 patients(55 eyes)with glaucoma and cataract were treated with phacoemulsification, lens implantation and trabeculectomy. Preoperation and postoperation of visual acuity, intraocular pressure, filtering bleb and postoperation complications were observed.RESULTS: After 6mo postoperation, the vision was significantly improved. The intraocular pressure was controlled in normal range and filtering bleb was good. There was a little complications after operation.CONCLUSION: Phacoemulsification intraocular lens implantation with anti-glaucoma establishes new aqueous humor outflow. It can effectively decrease intraocular pressure, deepen anterior chamber and improve vision, reduce all kinds of complications after simple glaucoma surgery.

AIM: To research the application effects of trabeculectomy and phaco emulsification in primary angle-closed glaucoma(PACG)with cataract. METHODS: Fifty-one patients aged from 46 years to 82 years with PACG and cataract from 2011-05/2012-05, were selected in our research. 51 patients were all treated with trabeculectomy(TL)and phaco emulsification(PE), meanwhile, they were implanted intraocular lens.RESULTS: The effects of combing treatments in reducing intraocular pressure were better, and postoperative visual acuity results were satisfactory. It can deepen the central anterior chamber depth and all researches had fewer complications, and there was no posterior capsular rupture, retinal detachment and corneal endothelial decompensation and other serious complications in all the research objects. Total surgery success rate reached 97%, and the failure rate was very low. CONCLUSION: Trabeculectomy combined with ultrasonic emulsification treating PACG can get a good result of reducing intraocular pressure, and be good for postoperative visual acuity recovery and correction, and it can deepen anterior chamber depth. The surgical success rate is high, with low complication rates, so the general effects are better. It is worthy of clinical application and wide application.

AIM: To evaluate the application ofoptical coherence tomography(OCT)and retinal nerve fiber layer thickness(RNFL)measured by rapid and repeated methods in the diagnosis of glaucoma repeated significance. METHODS: Stratus OCT were measured in 38 normal subjects and 42 patients with the primary RNFL thickness of open angle glaucoma patients. Rapid and repeated scanning was applied respectively to measure the RNFL thickness of patients with normal and primary open angle glaucoma. The average RNFL thickness's related coefficient and various coefficient of the temporal, upper, lower and nasal region made reproducibility assessment. RESULTS: In normal and primary open angle glaucoma patients, the overall average RNFL thickness and lateral temporal, above, nasal, below RNFL thickness, in which two groups did not show differences; repeated scanning average RNFL thickness was measured in fast scanning scheme around the optic disc, and had higher ICC and lower value of CV, there were significant differences in the temporal region(P=0.042). The temporal, nasal, upper and lower area of the retinal nerve fiber layer thickness of the ICC(CV)values were as follows: fast scan was 0.918(7.2%), 0.831(6.82%), 0.856(5.12%), 0.911(7.19%); repeated scans were 0.927(3.21%), 0.962(5.01%), 0.909(6.02%), 0.869(4.67%), 0.918(6.89%).CONCLUSION: In normal subjects and patients with primary open angle glaucoma, the application of rapid and repeated scanning in measurement of RNFL with OCT thickness has repeated significance, but repeated scanning scheme in the assessment of RNFL thickness is more accurate.

AIM: To analyze features of optical coherence tomography(OCT)in Vogt-Koyanagi-Harada syndrome before and after therapy.METHODS: Thirty-four eyes of 17 patients, which were identified as Vogt-Koyanagi-Harada syndrome, were examined with OCT and fundus photography, after the treatment of steroid therapy, the change of retinal structure were observed after 5, 15, 30d. RESULTS: OCT revealed retinal neuroepithelial edema and serous detachment of retinal neuroepithelia and subretinal septa that divided the subretinal space into several compartments all of cases. After steroid therapy, the retinal edema, serous detachment and subretinal septa were improved, even resolved completely. CONCLUSION: OCT can observe retinal structural change of Vogt-Koyanagi-Harada syndrome before and after therapy, it is vital for diagnosis and treatment evaluation of the disease.

AIM: To investigate the surgical therapeutic effects and complications of 23-gauge(23-G)vitrectomy combined with phacoemulcification for early proliferative diabetic retinopathy(PDR)and vitreous hemorrhage. METHODS: The 23-G micro-invasive vitrectomy combined with phacoemulcification and intraocular lens implantation were done in 48 patients(48 eyes)from Jan. 2011 to Jan. 2013. Best corrected visual acuity was recorded before or after operation 1mo. All patients were followed up for 4-18mo to observe the eye pressure, inflammatory reaction, intraocular lens location, and the changes of fundus conditions. RESULTS: After 1mo operation, best corrected visual acuity improved 43 eyes(90%), the visual acuity of 36 eyes(75%)≥0.12, 15 eyes(31%)≥0.3, visual acuity in preoperation or postoperation was different significantly(P=0.00). There were 6 eyes(13%)with hypotony, 5 eyes(10%)with choroidal detachment, 13 eyes(27%)with inflammation in anterior chamber, 16 eyes(33%)with increased intraocular pressure, and 10 eyes(21%)with vitreous hemorrhage after operation. However, there were no vitreous retinal hyperplastic lesions, retinal detachment, iris rubeosis, and neovascular glaucoma postoperatively. CONCLUSION: The 23-G micro-invasive vitrectomy combined with phacoemulcification and for early proliferative diabetic retinopathy is safe and effective.

AIM: To investigate the surgical therapeutic effects and complications of 23-gauge(23-G)vitrectomy combined with phacoemulcification for early proliferative diabetic retinopathy(PDR)and vitreous hemorrhage. METHODS: The 23-G micro-invasive vitrectomy combined with phacoemulcification and intraocular lens implantation were done in 48 patients(48 eyes)from Jan. 2011 to Jan. 2013. Best corrected visual acuity was recorded before or after operation 1mo. All patients were followed up for 4-18mo to observe the eye pressure, inflammatory reaction, intraocular lens location, and the changes of fundus conditions. RESULTS: After 1mo operation, best corrected visual acuity improved 43 eyes(90%), the visual acuity of 36 eyes(75%)≥0.12, 15 eyes(31%)≥0.3, visual acuity in preoperation or postoperation was different significantly(P=0.00). There were 6 eyes(13%)with hypotony, 5 eyes(10%)with choroidal detachment, 13 eyes(27%)with inflammation in anterior chamber, 16 eyes(33%)with increased intraocular pressure, and 10 eyes(21%)with vitreous hemorrhage after operation. However, there were no vitreous retinal hyperplastic lesions, retinal detachment, iris rubeosis, and neovascular glaucoma postoperatively. CONCLUSION: The 23-G micro-invasive vitrectomy combined with phacoemulcification and for early proliferative diabetic retinopathy is safe and effective.

AIM: To investigate the efficiency and security of compound anisodine injection in the treatment of juxtafoveal central serous chorioretinopathy(CSC). METHODS: Sixty patients(60 eyes)who were diagnosed of juxtafoveal CSC were assigned randomly into 2 groups: 32 cases(32 eyes, therapeutic group)were injected subcutaneously compound anisodine injection for 2mL q.d around superficial temporal arteries in the affected eyes; 28 cases(28 eyes, control group)received only traditional oral medication. Both groups received therapy for 2 to 4 courses of treatment. The main observations were the best corrected visual acuity(BCVA), subjective symptom, visual field, average light sensitivity and optical coherent topography(OCT).RESULTS: There was no significant difference between the therapeutic group and the control group before treatment(P>0.05), but all the outcome measures at 1, 3mo in the treatment group were significantly improved as compared with control group(P<0.05). After 6mo, there were no significant difference between the two groups in all measures(P>0.05). No severe adverse reaction was noted except mild ones such as temporary dry mouth, dizziness and palpitation in a few cases.CONCLUSION: Compound anisodine injection has remarkable effects in the treatment of juxtafoveal CSC. It can shorten the course, improved the visual function and decreased the recurrence rate of CSC.

AIM: To investigate the clinical significance and feature of intraorbital segment course in infraorbital nevrve on computed tomography(CT).METHODS: Using three-dimensional reconstruction and CT, 101 adults with normal orbital bone were measured with the length of infraorbital canal, the vertical distance from infraorbital foramen to infraorbital margin and to median line of skull respectively, and the included angle between infraorbital canal and antetheca of the maxilla. The average had been taken after 5 times measurement to every value. SPSS 17.0 statistical software was used to the process.RESULTS: Measurement results of 101 adults with normal orbital bone were statistically analyzed. The left infraorbital canal lengths of 53 male were 13.21±2.73mm and the right were 12.97±2.63mm; the left infraorbital canal lengths of 48 female were 12.79±2.77mm and the right was 12.72±2.70mm; the left vertical distances from infraorbital foramen to infraorbital margin of 53 male were 9.01±2.21mm and the right were 8.69±1.98mm; the left vertical distance from infraorbital foramen to infraorbital margin of 48 female were 9.33±2.18mm and the right was 9.14±2.34mm; the left vertical distances between infraorbital foramen and median line of skull of 53 male were 33.41±3.01mm and the right were 33.34±3.33mm; the left vertical distance between infraorbital foramen and median line of skull of 48 female were 32.39±4.23mm and the right were 32.33±3.78mm; the left included angle between infraorbital canal and antetheca of the maxilla of 53 male were 81.47°±11.70° and the right were 79.80°±10.38°; the left included angle between infraorbital canal and antetheca of the maxilla of 48 female were 76.04°±14.64° and the right were 76.30°±13.51°. Pair t test was used to compare the left and right side value in male and female, and the same side value in male and female. The results had no statistical differences(P>0.05).CONCLUSION: Through the measure of the infraorbital nerve on CT, it is good for the clinical diagnosis and treatment. In the meanwhile, it can help patients to avoid the unnecessary nerve injury in the operating.

AIM: To explore the causes of vitreous hemorrhage and the clinical efficacy of vitrectomy in vitreous hemorrhage. METHODS:Totally 162 patients(173 eyes)with vitreous hemorrhage who underwent vitrectomy were analyzed.RESULTS: Postoperative diagnosis: in 173 eyes, proliferative diabetic retinopathy 83 eyes(48.0%), branch retinal vein occlusion 24 eyes(13.9%), Eales disease 13 eyes(7.5%), central retinal vein occlusion 10 eyes(5.8%), traumatic vitreous hemorrhage 9 eyes(5.2%), retinal hole 8 eyes(4.6%), retinal detachment 9 eyes(5.2%), proliferative vitreoretinopathy 7 eyes(4.0%), pure vitreous hemorrhage 4 eyes(2.3%), retinal artery aneurysm 2 eyes(1.2%), polypoid choroidal vasculopathy 2 eyes(1.2%), chorioretinitis 1 eye(0.6%), age-related macular degeneration 1 eye(0.6%). Different causes were distributed in different ages, postoperative follow-up 3-15mo, visual acuity after treatment was compared with that before treatment, unchanged 41 eyes(23.7%), improved 115 eyes(66.5%), decreased 17 eyes(9.8%). Compared with the preoperative visual acuity difference was statistically significant(P<0.05). CONCLUSION:Proliferative diabetic retinopathy, retinal vein occlusion and Eales disease are the main causes of vitreous hemorrhage. To some extent, vitrectomy surgery has a little complications and it can improve visual acuity. Vitreous hemorrhage is a safe and effective treatment method.

AIM:To discuss effective ways of scientific treatment of ocular chemical injury by analyzing the effects of moderate to severe acute ocular chemical injury and amniotic membrane transplantation. METHODS:Totally 36 cases(43 eyes)of Ⅱ degrees and above of ocular chemical injuries were collected, and clinical efficacy was observed by analyzing the causes of injury, the degree of injury, visual acuity and complications. RESULTS:The recovery of visual acuity was well in Ⅱ degrees of burns, and the acuity of 55.6% reached over 0.6. The recovery of visual acuity >0.3 in acid burn group was 80.0%, and the recovery of visual acuity >0.3 in alkali burn group was 56.0%. The difference between two groups was statistically significant(P<0.05). The recovery of visual acuity >0.3 in early amniotic membrane transplantation group was 69.7%, and in early no amniotic membrane transplantation group was 50.0%; the difference between two groups was statistically significant(P<0.05). The incidence of serious complications of acid burn group(60.0%)was lower than the alkali burn group(84.0%), and the difference was statistically significant(P<0.05). The incidence of serious complications in early amniotic membrane transplantation group(60.6%)was lower than in early no amniotic membrane transplantation group(40.0%), and the difference was statistically significant(P<0.05). CONCLUSION: Early clinical treatment, and early amniotic membrane transplantation are very important for patients with ocular burn in acute phase to reduce complications and have a better recovery.

AIM:To investigate the changes of the positive relative accommodation in adolescent pseudomyopia with visual training.METHODS: A total of 42 cases(84 eyes)were randomly divided into the visual training group and the control group. Visual acuity, average refraction of two groups 4wk after the training were measured, as well as positive relative accommodation(5m)were checked before the training and repeated 1, 2, 4wk after the training. Correlation analysis were given.RESULTS: There was statistically significant difference in visual acuity 4wk after the training between the two groups(P<0.05). There was no significant difference statistically in average refraction 4wk after the training between the two groups(P>0.05). There was statistically significant difference in positive relative accommodation(5m)1, 2, 4wk after the training between the two groups(P<0.05). There was statistically significant difference in positive relative accommodation(5m)between the before and 4wk after the training in the visual training group(P<0.01). CONCLUSION: Visual training has significant effect on the positive relative accommodation on adolescent pseudomyopia.

AIM: To discuss the change of anterior chamber depth(ACD), lens thickness(LT)and axial length(AL)for following orthokeratology.METHODS:Orthokeratology was performed for 120 patients(120 eyes), and conducted a prospective clinical study. The ultrasound examination results were compared before and after 1a of orthokeratology. RESULTS: The LT value increased by 0.14mm in the group of low and moderate myopia(P<0.01)and 0.05mm in the group of moderate and high myopia, indicating a statistically significant difference. No significant difference was found in ACD value and AL value following orthokeratology(P>0.05). CONCLUSION: Crystalline lens power is changed following orthokeratology. Accommodation factor may be the possible mode of action of orthokeratology in reducing myopic progression.

AIM: To discuss the common problems and treatment countermeasures in dacryocystorhinostomy under nasal endoscope.METHODS: The clinical data of 37 cases(43 eyes)of postoperative dacryocystorhinostomy under nasal endoscope, by using high-frequency electric knife to open the nasal mucosa, hemostasis in surgery, burning fixed lacrimal sac mucosal flap and nasal mucosal flap, methylene blue staining of the lacrimal sac, lacrimal drainage tube implanted and expansion foam support fixed anastomotic methods were reviewed in our hospital from Mar. 2011 to June. 2013. The effects of surgery were observed, and the intraoperative common questions and the treatments were discussed.RESULTS: In the 37 cases(43 eyes), 42 eyes(97.7%)were cured, and 1 eye was improved, and the total efficiency was 100%. All operations were successfully completed without any serious complications during surgery.CONCLUSION: The common complication in dacryocystorhinostomy under nasal endoscope are effectively treated and the success rates of surgery are improved, by using high-frequency electric knife to open the nasal mucosa, hemostasis in surgery, burning fixed lacrimal sac mucosal flap and nasal mucosal flap, methylene blue staining of the lacrimal sac, lacrimal drainage tube implanted and expansion foam support fixed anastomotic methods. These methods are worthy of application and promotion.

AIM: To assess the clinical efficacy of sub-tenon anesthesia using a ropivacaine and lidocaine mixture for strabismus surgery. METHODS: Totally 80 patients with horizontal strabismus who underwent local anaesthesia surgery were randomly divided into test group and control group. All cases received either sub-tenon anesthesia or subconjunctival anesthesia with 7.5g/L ropivacaine and 20g/L lidocaine mixtures randomly. Intraoperative and postoperative pain scores and oculocardiac reflex were assessed. RESULTS: All 80 cases were successful completion of the surgery under local anesthesia. According to visual analogue scale(VAS), excellent 12 cases, good 21 cases, fair 6 cases, poor 1 case in test group and excellent 2 cases, good 25 cases, fair 12 cases, poor 1 case in control group. There was significant difference by rank sum test(P<0.01). The number of ocular rectus muscle and oculocardiac reflex condition during operation: muscular traction in test group was 74, oculocardiac reflex was 26; in control group it was 76 and 48 respectively. The incidence of oculocardiac reflex between the two groups was significant difference by χ2 test(P<0.01). Rank sum test were used in oculocardiac reflection grade of two groups, there was no statistically difference(P>0.05).CONCLUSION: Sub-tenon anesthesia using a 7.5g/L ropivacaine and 20g/L lidocaine mixture proves to be an efficient procedure for strabismus surgery, which is worth popularizing and applying.

High myopia associated with cone dystrophy is relatively rare in clinical practice. Because the two diseases have a certain genetic predisposition, with the disease developed, clinical examination and clinical symptoms have some similarities, one disease diagnosis is easily confused or masked by the other diagnosis, especially in the face of patients with high myopia associated abnormalities, we should carefully screen abnormal visual function of its own or combined cone dystrophy diagnosis. In addition, the development of the disease may mutually reinforce, aggravate the symptoms of each other, which is likely to cause mission or misdiagnosis, or delay the proper treatment. Therefore, it is clinically difficult to correct and comprehensively and timely diagnosis.

Primary open angle glaucoma(POAG)is the main cause of blindness with visual field damage and optic nerve degeneration. In recent years, a lot of researches have been done, showing that genetic factors and gene mutation play an important role in POAG. There are more than 20 related POAG genes. Now we will review the related genes of POAG, especially the well known causative genes of MYOC, OPTN, WDR36, and CAV1/CAV2, in terms of their locations, structures, research progress, et al, and provide a reference for genetic research in primary open-angle glaucoma.

Congenital cataract is one of the important diseases that cause irreversible visual impairment on children. Compared with adult cataract, the surgery of congenital cataract is more complicated and the complications are more severer, especially the postoperative amblyopia often leads to bad prognosis. Therefore, the postoperative treatment is necessary to obtain the better visual outcome. The traditional visual correction methods after surgery include the combined use of spectacles, contact lens, and intraocular lens(IOL), but some problems such as IOL power calculation and IOL implantation time are still controversial. Besides, occlusion therapy and visual training are also essential for preventing amblyopia after cataract surgery. Occlusion in an appropriate dose and course must be mastered, accompanied by visual training. Both of the operative eyes and normal eyes will be able to achieve much better visual acuity and color sensitivity, so that the binocular vision can recover and develop as normal function.

AIM: To study the serum levels of TNF-α, IFN-γ and MCP-1 in patients with Behcet's disease(BD).METHOS: Twenty-five patients with BD as study group and 30 normal volunteers as control group were inclued in the study. Serum levels of TNF-α, IFN-γ and MCP-1 were measured. RESULTS: Serum levels of TNF-α, IFN-γ and MCP-1 were significant higher in active BD patients than in normal controls.CONCLUSION: Our results suggest that serum levels of TNF-α, IFN-γ and MCP-1 abnormally increased in active BD paiteins. The higher expression may play a role in the pathogenesis of BD.

AIM: To observe the safety and efficacy of intravitreal injection of ranibizumab combined with laser photocoagulation for the treatment of macular edema in branch retinal vein occlusion(BRVO).METHODS: According to fundus fluorescein angiography(FFA), 30 eyes of 30 patients with BRVO were randomized into three groups: group 1(10 eyes)received grid laser treatment alone, group 2 received a single dose of intravitreal injection of ranibizumab(0.05mL/0.5mg)followed by grid laser treatment on 7d following injection, while group 3(10 eyes)received three loading doses of intravitreal ranibizumab with 0.05mL/0.5mg for three times. At 1mo interval, grid laser treatment was performed after 7d of the 1st injection. After 6mo follow-up, the best-corrected visual acuity and optical coherence tomography(OCT)and central macular thickness were observed. RESULTS:After 6mo, the visual acuity of patients were improved significantly. There was an average increase of 11 letters, 17 letters and 18 letters in group 1, 2, and 3, respectively, with the average decrease in OCT being 208.7μm, 312.9μm and 326.8μm, respectively, in these groups. Gain in visual acuity more than 3 lines was 1 case(10%)in group 1. There were 3 cases(30%)in group 2 and 4 cases(40%)in group 3.CONCLUSION:Combined therapy is better than laser therapy alone. Single dose of intravitreal ranibizumab with grid laser for macular edema in BRVO seems to be effective.

AIM: To observe the effects of panretinal photocoagulation for diabetic retinopathy in the primary hospital.METHODS: A total of 92 eyes in 55 cases respectively suffering from preproliferative diabetic retinopathy(PPDR), proliferative diabetic retinopathy(PDR)were treated with panretinal photocoagulation. The fundus fluorescein angiography(FFA)and color photograph were taken 3, 6, 12mo after the treatment. For those cases with remaining new vessels and non-perfusion areas, the treatment was complemented with further photocoagulation. The follow-up period was 3-12mo. RESULTS: After treating with panretinal photocoagulation, visual acuity were improved or maintained in 23 eyes(77%)and decreased in 7 eyes(23%)in group of PPDR; Visual acuity were improved or maintained in 44 eyes(71%)and decreased in 18 eyes(29%)in group of PDR. After one time panretinal photocoagulation, for those cases with remaining new vessels and non-perfusion areas, the treatment was complemented with further photocoagulation in 3mo after FFA, the effective rate was 29 eyes(97%)in group of PPDR, 50 eyes(81%)in group of PDR; 13 eyes(14%)developed vitreous hemorrhage, were turned to the superior hospital for vitrectomy. CONCLUSION:Panretinal photocoagulation is obviously effective in the treatment of diabetic retinopathy in the primary hospital.

AIM: To provide the experimental basis for the in vivo study of blood glucose fluctuation injury mechanism, through intraperitoneal injection of glucose to establish blood glucose fluctuation animal models and to simulate blood glucose fluctuation of patients with diabetes.METHODS: Rats were randomly divided into four groups: normal control group(NC), normal fluctuation group(NF), diabetes mellitus group(DM)and diabetes fluctuation group(DF). Diabetic models were induced through intraperitoneal injection of STZ. A certain amount of glucose was injected in the rats of group NF and DF intraperitoneally three times a day after the model was established, thereby causing blood glucose fluctuations. Full-day blood glucose monitoring was conducted once every two weeks to observe the blood glucose fluctuation situation, according to blood glucose levels drawing the “time-blood glucose concentration” curve. The stability of blood glucose was evaluated from four different aspects, through calculating mean blood glucose(MBG), standard deviation blood glucose(SDBG), largest amplitude of glycemic excursions(LAGE)and Sclichtkrull Mz value.RESULTS: The full-day blood glucose of rats in the group NC was in a normal range, and it was stable without fluctuation. The blood glucose of rats in group NF was fluctuated between 5-10mmol/L. The blood glucose of rats in group DM were maintained at higher level(>20mmol/L), without great fluctuation extent and DF with sighificant fluctuation. The blood glucose fluctuation in graoup DF was significant. The blood glucose changes of rats in the group NF and DF were significant and regular. The curve of blood glucose fluctuations was relatively stable. All values of rats in group NF, DM and DF were significantly increased compared with group NC. Group DF was increased more significantly, and the comparison with group NF and DM had significant difference(P<0.01).CONCLUSION: Significant blood glucose fluctuation can be formed through the method of manual intraperitoneal injection of glucose. The method can be used for simulating the blood glucose fluctuation situation of patients with diabetics. This method has the advantages of simple operation, low injury and good repeatability. It can provide experimental basis for in vivo study of blood glucose fluctuation injury mechanism and pathogenesis of diabetic complications.

AIM: To analyze the etiological factors in non-traumatic nonproliferative diabetic retinopathy vitreous hemorrhage.METHODS: The etiological factor in a total of 46 patients(46 eyes)with follow-up records from July 2009 to June 2013 in our department were analyzed retrospectively. RESULTS:Retinal vein occlusion(RVO)was the principal cause(16 eyes, 34.8%), the second were retinal hole or retinal detachment(RH/RD)and exudative age-related macular degeneration(EAMD)(8 eyes, 17.4%), the third was posterior vitreous detachment(PVD)(4 eyes, 8.7%). The other rare causes were retinal macroaneurysm(3 eyes, 6.5%), hypertension(2 eyes, 4.3%), Eales' disease(2 eyes, 4.3%), polypoidal choroidal vaseulopathy(PCV)(1 eye, 2.2%), suprachoroidal hemorrhage(SCH)(1 eye, 2.2%), uveitis(1 eye, 2.2%).CONCLUSION: Retinal vein occlusion, retinal hole or retinal detachment, and exudative age-related macular degeneration are frequent causes of non-traumatic non-proliferative diabetic retinopathy vitreous hemorrhage.

AIM: To observe the effect of the wavefront aberration-guided combining Q-value optimized LASEK(WG-QO-LASEK). METHODS: Retrospective analyzed the pre- and post-operative clinical data of 140 cases(280 eyes)that had gone through WG-QO-LASEK in the department of ophthalmology in our hospital. The observational index was compared in patients' visual acuity of pre- and post-operative and the subjective and objective examination of vision.RESULTS: There were no severe postoperative complications. Totally 132 patients'(264 eyes)uncorrected visual acuity(UCVA)was achieved to the expected correction degree within ±0.5D. Best corrected visual acuity(BCVA)improved one line in 88 eyes(31.4%)and 2 lines in 46 eyes(16.4%). Postoperative scores of NEI-RQL-42 were significantly higher than preoperative ones. After operation, the proportion of higher-order aberrations increased, mainly manifested in spherical aberration and coma, but it did not influence the visual quality obviously. CONCLUSION: WG-QO-LASEK treatment of myopia has good predictability, accuracy and safety.

AIM: To report the clinical manifestation, curative opportunity and effect of congenital cataracts with microcornea.METHODS: The clinical materials of 18 eyes of 11 patients with microcorneas who underwent surgery for congenital cataracts from January 2000 to December 2012 were retrospectively analyzed. Preoperative examination including corneal diameter(<9.5mm), ocular abnormalities and systemic anomalies. The visual acuity and various complications were followed up for 1a.RESULTS: The morphologic types of cataract were family history of congenital cataract(4 cases)among 11 patients. Other preoperative ocular abnormalities included aniridia(6 eyes), nystagmus(18 eyes)and primary vitreous artery residues(1 eye). Totally 11 patients(18 eyes)had been performed the following three different types of operation: 1)extra capsular extraction of cataract(ECCE)was performed in 5 eyes; 2)ECCE for the first step and posterior chamber intraocular lens(PC-IOL)for the second step was performed in 4 eyes; 3)ECCE and PC-IOL was performed in 9 eyes. Visual acuity was achieved after surgery, the best-corrected visual acuity(BCVA)was 0.145±0.0958(0.01-0.20). ECCE intraoperative complication was posterior capsule rupture(1 eye). The main postoperative complications were posterior capsular opacification(10 eyes)and secondary glaucoma(2 eyes).CONCLUSION: The main complication in congenital cataracts with microcornea including aniridia, choroidal defect and nystagmus. IOL implantation can significantly improve visual acuity. Patients should pay attention to prevention corneal injury, posterior capsular rupture and etc. However, adequate management of postoperative complications, especially posterior capsular opacification and glaucoma is required.

AIM: To compare the retinal nerve fiber layer thickness(RNFLT)obtained by optical coherence tomography(OCT)between patients with preclinical diabetic retinopathy(DR)and healthy subjects.METHODS: Forty-eight type 2 diabetic patients and 100 healthy subjects were included in this study. All participants were evaluated for RNFLT by Stratus OCT. In diabetic patients, levels of blood glucose and glycosylated hemoglobin were examined.RESULTS: The mean RNFLT in diabetic patients and healthy subjects was significantly different. The RNFLT of superior quadrant and 5, 11, 12 o'clock sectors had statistically significant differences. The relationship between the RNFLT changes of HbA1C with superior, temporal, and inferior area was recorded at 6mo follow-up.CONCLUSION: This study suggests that theglycemic control affects RNFLT. The mean and superior quadrant peripapillary RNFLT are slightly less in diabetic patients without retinopathy than in healthy subjects.

AIM:To explore the clinical effect of transpupillary thermotherapy(TTT)for the treatment of central serous chorioretinopathy(CSC)with parafoveal leaks.METHODS: Twenty-three eyes from nineteen patients with long-standing CSC and parafoveal leaks(50-200μm around the fovea)who opted for TTT and observation were enrolled in this study. Eighteen of nineteen patients(23 eyes)were male, fourteen of twenty-three eyes were right eyes. The patients' mean age was 44.00±4.973 years(range from 32-52 years). TTT was performed using 810nm infrared diode laser. All patients underwent Snellen visual acuity measurement(converted to LogMAR for analysis)fundus examination, fluorescein angiography(FFA)and optical coherence tomography(OCT). Follow-up was scheduled at 1, 2, 6mo. RESULTS:Following treatment of TTT, complete resolution of neurosensory detachment on OCT and disappearance of leakage on FFA was seen in fourteen eyes(61%), twenty-one eyes(91%)at the 2mo and twenty-three eyes(100%)at the 6mo respectively. A total of 74% had ≥3 lines of improvement after 6mo. Success was defined as resolution of neurosensory on OCT and disappearance of leakage on FFA at the 2mo. Failure was defined as no change at the 6mo and no improvement of visual acuity.CONCLUSION:TTT is safe and effective therapeutic option in patients with CSC and parafoveal leaks. It may improve the visual acuity by shortening the persistent serous elevation of the macula.

AIM: To evaluate the safety and effectiveness of 23G micro-invasion vitrectomy combined surgery for proliferative diabetic retinopathy(PDR). METHODS: Forty cases(40 eyes)with PDR of fibrovascular membrane range >5PD were randomly treated with 20G and 23G vitrectomy combined surgery. The medical records of patients were reviewed, and the visual acuity of postoperation, intraocular pressure, complications in preoperation or postoperation were analyzed.RESULTS:After 1, 3 and 6mo of surgery, the best corrected visual acuity(BCVA)were LogMAR(0.88±0.43),(0.69±0.23),(0.45±0.17)in group 23G, and LogMAR(0.57±0.32),(0.41±0.21),(0.30±0.17)in group 20G. Compared with each other, the differences were not statistically significant. The patients were followed up 6-23mo after surgery. CONCLUSION: 23G vitrectomy issafe and effective for complicated PDR.

AIM: To observe the effect of 23G micro invasive vitrectomy in treating Terson syndrome. METHODS: Six cases(11 eyes)of Terson syndrome with severe vitreous hemorrhage were performed 23G micro invasive vitrectomy since conservative treatment did not show effect on them. Membrane peeling and silicone oil tamponade were applied according to the retinal conditions. We observed the postoperative visual acuity(VA), retina and complications. RESULTS: All the cases had obvious improvement of postoperative VA,in which 8 eyes in 11(73%)was better than 0.5. The postoperative VA of one eye(9%)were less than 0.1 because of pre-existing proliferative vitreoretinal diseases and retinal detachment.CONCLUSION: 23G micro invasive vitrectomy is an effective approach in treating Terson syndrome. Most of the cases indicate good visual outcome. However, the cases with severe proliferation have poor outcome. We recommend performing an early 23G micro invasive vitrectomy for the failure of conservative treatment in Terson syndrome.

AIM: To investigate the prevalence rate and risk factors of diabetic retinopathy(DR)in type 2 diabetes mellitus(T2DM)in Fengyutan community in Shenyang.METHODS: Totally 457 community residents with T2DM were selected in 2011. Ninety-two of these people accepted the reexamination in 2013. Besides, there were 312 residents with T2DM joined in the study in the same year. Basic condition and life style were investigated, and diabetic retinopathy screening were performed. Logistic multiple regression was used to analyze related risk factors.RESULTS: The prevalence of DR were 15.8% and 41.2% in 2011 and 2013 respectively in the community. Compared with NDR group, age, family history of DM, duration of DM, fasting blood-glucose(FBG), 2h post-meal blood glucose(2hPG), hemoglobin A1c(HbA1c), total cholesterol(TC), serum creatinine(Scr), systolic blood pressure(SBP), high- and low-density lipoprotein cholesterol(HDL-C, LDL-C)were statistically significant(P<0.05). The result of logistic regression showed that age, duration of DM, HbA1c, SBP and HDL-C were independent risk factors of DR. There were 31 new sufferers in 92 reexamined patients(33.7%)in 2013 and the main aetiological agent was poor glycemic control. CONCLUSION: The prevalence of DR in Fengyutan community was much higher than the other studies in northern China. It was primarily concerned with long duration of DM, poor glycemic control, inadequate concern with or even neglect of DM and the related oculopathy, hypertension and hyperlipidemia and so on.

AIM: To understand the common conditions of visual impairment in cerebral palsy children, and to provide the basis for early screening of eyes, early diagnosis and treatment, and promote the visual rehabilitation for children with cerebral palsy. METHODS:Two hundred and twenty-three children with cerebral palsy underwent routine ophthalmologic examination, including the position of eye and eyeball movement, indirect ophthalmoscopy or Retcam II fundus examination, mydriasis optometry check and flash-visual evoked potential(F-VEP)examination, and the results were recorded and analyzed. RESULTS: Strabismus,ametropia and changes of F-VEP were the mainly impairments in 223 children with cerebral palsy, and some children also were associated with ocular fundus disease. There were 174 children with different types of strabismus, including 121 children with esotropia, 36 children with exotropia, 15 children with vertical strabismus, and 2 children with nystagmus. There were 129 children(247 eyes)with refractive errors, including 118 eyes with compound hyperopic astigmatism, 51 eyes with simple hyperopia, 33 eyes with mixed astigmatism, 19 eyes with compound myopic astigmatism, 21 eyes with simple hyperopia astigmatism, 4 eyes with simple myopia astigmatism, only 1 eye with simple myopia. The F-VEP of 194 children(381 eyes)were abnormal, and performed as delayed latency and reduced amplitude of P2 wave. In addition, there were 51 children with different types of ocular fundus changes, in which optic nerve atrophy and retinal hemorrhage were the most common. CONCLUSION: Children with cerebral palsy often are associated with different types of visual dysfunction, which seriously affect the visual quality and systemic rehabilitation. Routine eye examination and visual training should be paid attention, which play an important role in the normal development of the visual system and comprehensive rehabilitation of children with cerebral palsy.

AIM: To investigate the differences of the relevant parameters of optic nerve between patients with suspected ocular hypertension and normal people. METHODS: There were 36 eyes of suspected ocular hypertension and 43 normal eyes to test their retinal nerve fiber layer thickness(RNFL), the optic disk parameters, the thickness of macular ganglion cell complex(mGCCT)and visual field index. The analysis and comparison are made on the obtained results.RESULTS: There was significant difference(P<0.01)between the patients with suspected ocular hypertension and normal eyes in average, inferior and superior RNFL thickness, optic disk parameters(rim area, cup volume, average C/D ratio)and the average, inferior, superior thickness of macular ganglion cell complex(P<0.01). There was statistical difference between two groups in nasal RNFL thickness(P<0.05), but there was no statistical difference in temporal RNFL thickness, cup area, mean deviation(MD)and pattern standard deviation(PSD)(P>0.05).CONCLUSION: There is significant difference between normal and suspected ocular hypertension eyes in average, inferior and superior RNFL thickness, optic disk parameters(rim area, cup volume, average C/D ratio)and the average, inferior, superior thickness of mGCCT.

AIM:To investigate the efficacy of adjustable suture on partial accommodative esotropia surgery in children. METHODS: Thirty children with partial accommodative esotropia were treated by the recession of binocular medial rectus combined adjustable suture. The inclusion criteria were medium hypermetropia, and having wear sufficient degree mirror no less than six months, residual nonaccommodative esotropia deviation of +20△ ～ +35△. 3mm to 5mm recession of binocular medial rectus and 1mm to 2mm adjustable suture were kept in surgery. Suture was adjusted on the first day after surgery. The use of adjustable suture after surgery, deviation after surgery and binocular vision function were used to evaluate the efficacy during the follow up. RESULTS: Twenty-two children(73%)were within orthotropia, 6 children deficient correction and 2 children excessive correction. After adjustment, all children(100%)were within orthotropia. Residual strabismus degrees for 33cm and 6m were +5.9△±2.8△, +4.4△±4.3△, +3.8△±3.6△, +2.9△±3.5△, +2.7△±4.1△ and +5.6△±3.2△, +4.0△±3.1△, +3.4△±3.4△, +2.5△±3.4△, +2.3△±3.9△ 1-week, 1-month, 3-month, 6-month, 1-year after surgery respectively, without significant difference(P>0.05). Thirteen children(43%)before surgery and 23 children(77%)after surgery had binocular vision, with significant difference(P<0.05). CONCLUSION: Adjustable suture perform operations can one-off correct partial accommodative esotropia more accurately, decrease the frequency of deficient correction and excessive correction efficiently.

AIM: To analyze the effect of modified trabeculectomy in the treatment of neovascular glaucoma.METHODS: There were 44 cases of neovascular glaucoma enrolled during June 2008 to December 2012. They were randomly divided into experimental group(22 cases)and control group(22 cases). The experimental group were treated with the modified trabeculectomy, and the control group were treated with cyclocryotherapy. Therapeutic effect and complications between two groups were compared. RESULTS: Introocular pressure in both groups were significantly lower after treatment than before treatment(P<0.01), but there was no obvious difference between two groups(P>0.05). The total effective 21 cases(95%)in experimental group was higher than that in the control group 16 cases(73%)and the difference had statistically significance(χ2=7.3789, P<0.05). At the same time, the incidence of complications and severity in control group were significantly higher than that in the experimental group(P<0.05). CONCLUSION: For patients with neovascular glaucoma, modified trabeculectomy can effectively reduce the intraocular pressure, and significantly improve the treatment success rate, as well as reduce the occurrence of adverse reactions. It is a safe and effective method, so modified trabeculectomy should be applied widely in clinical practice.