The treatment of malignant glaucoma is still difficult because of its poor prognosis.However, prognosis could be improved greatly with an understanding of its mechanism and the development of modem vitrectomy and intraocular lens (IOL) techniques. Now, the poor prognosis of malignant glaucoma is mainly due to problems associated with early diagnosis and improper treatment.In order to improve the diagnosis and treatment of the disease, we must pay attention to some easily confused questions in the clinic. This paper discusses such topics as intraocular pressure (IOP) criteria and ultrasound biomicroscopy (UBM) value in diagnosis, and how to do vitrectomy and use IOL in therapy, etc.

Objective To assess the compliance in glaucoma patients with topical medication and to explore the influential factors of it, in order to design better therapeutic scheme for patients.Methods In this investigative survey of topical medication compliance in glaucoma patients, 120out-patients were selected and a self-designed questionnaire was used. According to the standard recommended by Morisky of evaluating the compliance in glaucoma patients, all the data obtained were analyzed by the SAS 9.1.3 software using a logistic regression analysis. Results Glaucoma patients with topical medication compliance account for 63.9％ of all the patients investigated.Patients' age, incoming level, frequency and method of medication and doctors's notify were correlated with the topical medication compliance in glaucoma patients (x2=18.752, 17.783, 13.530, 9.022,14.831, P＜0.05). Conclusion There is a good topical medication compliance in these glaucoma patients investigated. Patients over 60 years old, over 600 yuan monthly incomings, using eyedrop 3times in a day, correct method and notified by doctors have good topical medication compliance.Simple and reasonable therapeutic scheme, more education of knowledge regard to glaucoma, can improve the topical medication compliance in glaucoma patients.

Objective To evaluate visual function and visual quality objectively using visual field analysis after the implantation of two different intraocular lenses (IOL). Methods This was a prospective case control study. The subjects who accepted phacoemulsification and IOL implantation were divided into 2 groups (group A and group B) based on the type of IOL implanted. Patients in group A (19 cases, 21 eyes) were implanted with AcrySof IQ (SN60WF) aspheric lenses. Patients in group B (17 cases, 21 eyes) were implanted with Sensar AR40e spherical lenses. Twelve subjects (21 eyes) from an age-matched normal population were selected as the normal control group (group C).All patients underwent visual acuity and visual field testing 1 month after surgery, and mean deviation (MD), pattern standard deviation (PSD) and the MD value of the different regions were compared for the 3 groups. The data were analyzed with an independent samples t test and an one-way ANOVA. Results Postoperative uncorrected visual acuity was ≥4.7 for all in A and B group. There were no significant differences between the 2 groups. The visual field outcomes showed MD for group A, B and C were (-4.37±2.29), (-4.57±2.74) and (-1.86±0.56)dB, and PSD were (2.51±1.35),(2.63±0.94) and (1.92±0.63)dB, respectively. There were no significant differences between group A and B when MD, PSD and the MD value of the different regions were compared. But statistically significant differences were found for MD, PSD and the MD value of the different regions in comparisons between group C and the other 2 groups (P＜0.01). Conclusion After IOL implantation，visual acuity improve significantly, but the light sensitivity of the retina generally decrease. The patients implanted with SN60WF aspheric IOL do not have better sensitivity than those who implanted with Sensar AR40e spherical IOL.

Objective To investigate the activity of glycogen synthase kinase-3β (GSK3β) on retinal ganglion cells (RGCs) under pressure, and the effect of GSK3β on the survival of RGCs.Methods This was an experimental study. Rat RGCs were mixed cultured in vitro and then divided into RGCs control group, RGCs pressure only group (60 mmHg of pressure cultivated for 24 hours),RGCs pressure group treated with 10 mmol/L lithium chloride (Licl, inhibitor of GSK3β) and RGCs pressure group treated with 20 mmol/L lithium chloride. Phospho-Ser9-GSK3β (pS9-GSK3β) was observed by immunocytochemical staining. Meanwhile, MTT method test optical density (OD) value to reflect the activity of RGCs of each group. The data for all groups were analyzed by an one-way ANOVA. Results Compared to the RGCs control group [mean optic density (MOD) was 0.085±0.023], the pressure only group expressed less pS9-GSK3β (0.057±0.012). However, both Licl treated groups, expressed more pS9-GSK3β (0.081±0.016 and 0.099±0.024) than the pressure only group.Meanwhile, as the concentration of Licl increased, the higher levels pS9-GSK3β were expressed. Moreover, MTT results showed that the difference of OD value in four groups had statistical significance (F=14.539, P＜0.05). OD value of pressure only group (0.109±0.016) was significantly lower than control group (0.135±).015) (P＜0.05), and RGCs viability was reduced. Compared to the OD value of the 20 mmol/L Licl treated group (0.159±0.014), the pressure only group showed lower OD value (P＜0.05), and the viability of RGCs increased. Conclusion The reduction of pS9-GSK3β in RGCs under pressure prompts GSK3β to be activated, so the viability of RGCs is lower than that of normal RGCs.However, Licl, as the inhibitor of GSK3β, maybe have the ability to protect RGCs from apoptosis.

Objective To evaluate the clinical characteristics of younger patients with primary angle-closure glaucoma (PACG). Methods Retrospective case control study. Twelve patients (22 eyes) aged 40 or younger with a confirmed diagnosis of PACG from January 2006 to July 2010 were investigated. At the time of the initial diagnosis, all patients were in the middle or late stageand did not feel significant pain. Eighteen eyes underwent surgical treatment. Full ophthalmic examinations were performed. They were compared to 217 older patients (236 eyes) with PACG who underwent trabeculectomy during the same period. The clinical characteristics, including clinical presentations,surgical results and complications were evaluated. Data were analyzed with a paired t test and a chi-square test. Results The mean age of the younger patients with PACG was (32.8±5.7)years.The majority of them were female (75％). The mean axial length was (21.1±1.9)mm. Plateau iris was the most common underlying etiology (91％), and only 1 case (2 eyes) was pupillary block. The mean follow-up period was (24.8±6.3)months. There was an (11.6±5.2)mmHg reduction in the final postoperative intraocular pressure (IOP) compared to preoperative IOP (t=6.456, P＜0.01). The main postoperative complications included shallow anterior chambers (44％) and malignant glaucoma (17％). The mean age of the older patients with PACG was (60.2±7.1)years. The majority of them were females (81％). The mean axial length was (21.5±2.7)mm. Pupillary block (81％) was the most common underlying etiology,and 19％ patients were Plateau iris. The differences of plateau iris and pupillary block were significant (x2=56.446, 14.303, P＜0.01). The incidence of postoperative shallow anterior chamber and postoperative malignant glaucoma was 10％ and 6％, respectively. There was a statistically significant difference in the incidence of postoperative shallow anterior chamber when younger patients were compared to older patients with PACG (x2=14.091, P＜0.01). Conclusion The younger PACG patients cannot b

Objective To observe the possible influence of hypoxia on the expression of regulators of G-protein signaling 5 (RGS5) in human retinal pigment epithelial (RPE) cells. Methods Experimental study. To establish a hypoxia model, human RPE cells were cultured with 200 μmol/L CoCl2. RPE cells were sorted for showing the expressions of RGS5 and vascular endothelial growth factor (VEGF) in the following time frames: 0, 1, 3, 6, 12 and 24 hours. RPE cells were grouped according to treatment protocols: the hypoxia and VEGF inhibitor Bevacizumab groups at 12 and 24 hour time points, treated with concentrations of Bevacizumab at 25, 100 and 250 μ,g/ml. The expression of RGS5 and VEGF and their mRNA was examined by immunofluorescence, Western blot and RT-PCR. All results were statistically evaluated using a student's t test. Results RGS5 protein was mainly found in the cytoplasm of cultured RPE cells in normoxic conditions. The expression of RGS5 protein and mRNA increased in hypoxia conditions. Expression for both of them peaked at 24 hours after hypoxia (0.932±0.104, t=3.106, P=0.011; 0.742±0.083, t=2.852, P=0.017). The highest levels of VEGF protein and mRNA expression occurred at 12 hours (1.022±0.141, t=4.144, P=0.002;0.491±0.063, t=5.707, P＜0.01), and levels were still higher than normal at 24 hours (0.942±0.125,t=3.306, P=0.008; 0.425±0.080, t=3.239, P=0.011). The expression of RGS5 protein and mRNA was inhibited by Bevacizumab in the 100 μg/ml (t=2.953, P=0.014; t=3.009, P=0.013) and 250 μg/ml (t=2.913, P=0.015; t=4.243, P=0.002) groups, following the inhibition of VEGF (t=2.794, P=0.019; t=2.823, P=0.018; t=3.396, P=0.007; t=9.584, P＜0.01). Conclusion The expressions of VEGF increase earlier than RGS5 in hypoxia conditions, and Bevacizumab can effectively inhibit the expression levels of RGS5 and VEGF in human RPE cells. This may suggest RGS5 could be located downstream from the VEGF signaling pathway, and play an important role in regulating RPE-related hypoxic-ischemic ophthalmopathy.

Objective To investigate the effect and mechanism of Complex Xueshuantong on the angiogenesis of rhesus choroid-retina endothelial (RF/6A) cells. Methods This experimental research included 4 parts. ①RF/6A cells in logarithmic growth phase were cultured and divided into blank control group, positive control group (0.20 mg/ml protamine) and Complex Xueshuantong groups at different concentrations (0.39 to 50.00 mg/ml). Vascular endothelial growth factor (VEGF) at terminal concentration of 10 ng/ml was added into all groups. The optic absorptions (A values) of each group were measured 24 hours later. ②RF/6A cells in logarithmic growth phase were cultured in Transwell insert and divided into blank control group, Complex Xueshuantong groups at different concentrations of 3.13, 6.25, 12.50 mg/ml. The number of cells that migrated to under the Transwell membrane was counted after cultured for 24 hours. ③RF/6A cells were divided into blank control group, Complex Xueshuantong groups at different concentrations of 0.39, 0.78, 1.56 mg/ml. The number of full-formed tubes was counted after cultured for 12 hours. ④RF/6A cells were divided into blank control group, positive control group of protamine at terminal concentration of 0.20 mg/ml, and Complex Xueshuantong groups at different concentrations of 1.56, 3.13, 6.25 mg/ml. Western Blot and real-time quantitative RT-PCR were used to detect the expression of VEGF and matrix metalloproteinase 2 (MMP-2) protein and mRNA of RF/6A cells after cultured for 24 hours. Data were statistically analyzed by ANOVA method. Results ①The difference of the A values within groups was statistically significant (F=158.669, P＜0.01). Compared with that of blank control group,the A values of Complex Xueshuantong groups at different concentrations from 0.78 to 25.00 mg/ml were significantly reduced (all P＜0.01), the proliferation of RF/6A cells induced by VEGF was inhibited by Complex Xueshuantong at certain concentrations. ②When the concentrations of Complex Xueshuantong were 0, 3.13, 6.25, and 12

Objective To evaluate the changes of the corneal surface morphology and corneal aberrations undergoing overnight orthokeratology treatment and to assess the effect of the amount of decentration on corneal aberrations. Methods This was a prospective clinical study. Twenty-two patients with low and moderate myopia [(-2.23±0.74)D] aged (24.4±2.2)years were included and fitted with Ortho-K contact lenses (CL). The center refractive status was measured with an open field infrared refractometer (Grand Seiko 5500); corneal topography and the amount of decentration (including the magnitude and the orientation) were measured with Medmont E-300 Corneal Topographer, corneal topography data were converted into aberrations data by a Matlab software. The measurements were taken in fight eyes, at pre-wear, 7 days and 30 days after orthokeratology. Data were analyzed with a paired t test, an independent samples t test, an one-way ANOVA, or a Pearson correlation analysis. Results The myopia amount of all subjects were significantly reduced after Ortho-K CL wear within the first week. The reduction also happened in central corneal curvature. The average amount of decentration of 1 week was (0.49±0.24)mm, no more significant changes thereafter.The direction of decentration was mainly in the temporal side, followed by the bottom side. Root mean square (RMS) of corneal total higher-order aberrations, third-order aberration, fourth-order aberration were significantly increased compared to before wear and the changes were stabilized after 1 week. Corneal third-order aberrations variation correlated with decentration (r=0.492, P＜0.05); corneal fourth-order aberration variation did not show significant correlation with decentration; the combined coma variation significantly correlated with both orientation and magnitude of decentration (r=0.546, P＜0.05; r=0.710, P＜0.05). Initial higher astigmatism did not induce the greater amount of decentration. Conclusion Myopia amount reduction along with corresponding corneal curvature changes occu

Objective To understand the care and fitting habits of contact lens wearers; to evaluate perceptions about contact lens medical features based on Chinese questionnaires answered by experienced contact lens wearers; to try to develop tangible strategies to enhance the safety and comfort of contact lens wearers based on this information. Methods This study was based on an investigative survey. The survey was conducted in 42 big optical stores located in 6 cities: Shanghai,Beijing, Guangzhou, Shenzhen, Chengdu and Hangzhou. The survey targeted experienced wearers.The questionnaire consisted of 28 questions (6 parts) including: ①basic information and lens fitting history of wearers; ②current lens fitting behavior; ③daily lens care procedure; ④eye check and follow-up visits; ⑤assessment of perceptions about contact lenses; ⑥lens selection factors. Data were analyzed with chi-square tests. Results A total of 504 valid survey forms were collected. This study showed the following findings: ①Females, 439(87.1％) and males, 65(12.9％), age range of 19-42 years with an average age of (27.8±7.3)year. Experience with contact lens wear ranged from 6 months to 12 years,with an average of (6.3±5.2)years; ②6.2％(31/504) of the respondents reported that they slept with their daily wear lenses. The groups of a 2-week and 1-month replacement schedule were significantly more compliant than the groups with replacement schedule was daily, 3-6 month, ＞6 month disposable group (x2=12.32, 57.52, 45.91, P＜0.01). ③73.0％(368/504) washed their hands before handling the lenses, 54.0％(272/504) rubbed and cleaned the lenses, 38.1％(192/504) rinsed them with care solution; ④67.1％(338/504) indicated that they never proactively went for follow-up visits; 50.1％(207/413) and 38.1％(68/180) used an incorrect solution for discomfort and eye disease during the lens wear period; ⑤17.1％(86/504) knew that contact lenses were categorized as a medical device,over 60％ of the respondents had misunderstandings about contact lenses; ⑥63.1％ (318/504) took lens price

Objective To observe the effect of ametropia on the behavioral characteristics of human microsaccadic eye-movements. Methods Prospective case control study. From October 2010 to March 2011, 17 cases of patients with ametropia and 17 subjects without refractive errors were recruited from the outpatient clinic at Tianjin Eye Hospital. The data were grouped according to the refractive state and whether the tested eye was the dominant eye. Seventeen dominant eyes and 17 non-dominant eyes of ametropic subjects without refractive correction were grouped as group ADa and ANa, respectively; 17 dominant eyes and 17 non-dominant eyes of ametropic subjects with refractive correction were grouped as group ADb and ANb, respectively; 17 dominant eyes and 17 non-dominant eyes of normal subjects were grouped as group ND and NN. A high-speed eye-movement recording system was used to monocularly record the fixational eye-movements of subjects' both eyes. A Matlab was used to detect and analyze the microsaccadic components of eye-movement waveforms. The microsaccadic amplitudes, peak velocities, occurrence rates, inter-microsaccadic intervals of all groups were analyzed and compared using Origin 8.0 and Matlab 2008 statistics. One-way analysis of variance (ANOVA) followed by Turkey's post hoc test was used to compare differences between groups. Results There were no significant differences among the mean microsaccadic amplitudes for all groups. However, the variations in mean amplitudes for group ADa (5.42％±0.26％) and ANa (5.48％±0.25％) were larger than those in group ADb, ANb, ND, and NN and the differences were statistically significant (F=38.67, P＜0.01). The mean peak velocities of group ADa [(55.25±2.40)°/s]and ANa [(54.51±1.77)°/s] were slower than group ADb, ANb, ND, and NN (F=311.84, P＜0.01).The mean occurrence rates of groups ADa [(1.56±0.03)Hz] and ANa [(1.57±0.05)Hz] were lower than group ADb, ANb, ND, and NN (F=155.25, P＜0.01). The mean inter-microsaccadic intervals of group ADa [(557.78±23.12)ms] and ANa [(554.87±22.33)

Objective To investigate the recovery of accommodative function in former amblyopes with monocular hyperopic anisometropia who had undergone successful orthoptic therapy.Methods In this cross-sectional study, 55 children with monocular hyperopic anisometropia who were former amblyopes and 50 emmetropes were investigated. A SRW-5500 autorefractor was used to measure accommodative response while the children viewed an E target placed at 50, 33 and 20 cm.Accommodative lags were calculated with formula accommodative demand minus accommodative refraction. Data were analyzed with an independent samples t test, a paired t test and a linear correlation analysis. Results At the 20, 33, 50 cm distance, the accommodative lags of the dominant eyes of the normal group were (0.26±0.31), (0.12±0.02) and (0.10±0.01)D, respectively, while the accommodative lags of the non-dominant eyes were (0.27±0.30), (0.17±0.14), and (0.12±0.01)D, respectively. The accommodative lags of the dominant eyes of the monocular former amblyopes at the 3 distances were (0.40±0.14), (0.29±0.09) and (0.17±0.06)D, respectively, and the accommodative lags of the non-dominant eyes were (1.66±0.47), (1.38±0.34) and (1.16±0.34)D, respectively. There was no significant difference in the accommodative lags of the dominant eyes between the former amblyopic and emmetropic groups at all reading distances. The accommodative lags of the non-dominant eyes in the former amblyopes were greater than those of the fellow eyes at the 3 distances. These overall differences were significant in the amblyopic subjects (t=18.731, 22.764, 21.020, P＜0.01). The standard deviations of accommodative responses for the former amblyopes with monocular hyperopic anisometropia were (0.09±0.04), (0.09±0.02), (0.09±0.02)D, respectively at the 3 distances, while those for the dominant eyes of the former amblyopes were (0.04±0.01), (0.04±0.03), (0.04±0.00)D,respectively. The standard deviations of the former amblyopic eyes were greater than those of the fellow eyes at the corresponding rea

Objective To analyze and investigate the influence of sub-Bowmann's keratomileusis (SBK) on corneal biomechanical properties in high myopia evaluated by the Goldmann correlated intraocular pressure (IOPg), corneal compensated IOP (IOPcc), corneal resistance factor (CRF), corneal hysteresis (CH), TimeIn, TimeOut and their changing values. Methods In this prospective case series study, there were 36 subjects (65 eyes) with high myopia underwent SBK. Their mean age was (22.9±3.6) years (ranged:19 to 34 years) and spherical equivalent was (-8.35±1.21)diopters (D) (range:-6.375 to -12.50 D). The IOPg, IOPcc, CR, CH, TimeIn and TimeOut were obtained with Ocular Response Analyzer (ORA) preoperatively and 1 month postoperatively. The values were analyzed before and after surgery using a paired t test. A multiple regression analysis and Pearson correlation were used to investigate the factors affecting the changing values. Results The mean preoperative values of IOPg, IOPcc, CRF, CH , TimeIn, TimeOut and the difference between TimeOut and TimeIn were (17.5±3.0)mmHg, (17.6±2.9)mmHg, (11.1±1.4)mmHg, (10.5±1.3)mmHg, (8.0±0.4)ms, (18.6±0.2)ms and (10.7±0.4)ms, respectively, and the mean values 1 month postoperative were (12.4±3.5)mmHg,(16.4±3.3)mmHg, (7.0±1.2)mmHg, (7.5±1.0)mmHg, (7.2±0.5)ms, (18.4±0.2)ms and(11.2±0.5)ms,respectively. The differences between preoperative and postoperative status were statistically significant (t=14.2, 3.5, 28.1, 24.9, 17.4, 16.2, -10.7, P＜0.01 for all). There was a trend toward positive correlation between ablation depth (AD) and △ IOPg (r=0.247, P=0.047), as well as between AD and △CRF (r=0.298, P=0.016); but no significant correlations were found between AD and other indices such as △IOPcc, △CH, △TimeIn, △TimeOut and the changing in the difference between TimeOut and TimeIn. Conclusion SBK for high myopia substantially weaken corneal properties and induce some changes in corneal biomechanical singnals, which are related to ablation depth to some extent.

Objective To compare patients' subjective postoperative pain, rate of reepithelialization as well as visual and refractive recovery between custom transepithelial ablation and photorefractive keratectomy (PRK) with mechanical epithelial removal. Methods This prospective non-randomized consecutive case control study was comprised of 30 eyes (group 1) treated with custom transepithelial ablation with a iVIS-Suite 100 Hz laser, with deepithelialization integrated within the excimer laser ablation and 30 eyes (group 2) treated with PRK with a Wavelight Allegretto 400 Hz laser with Amoils brush deepithelialization between March 18, 2009 to October 28, 2009. Postoperative pain and reepithelialization were measured every 24 hours postoperatively until full recovery. Patients' refraction, uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) were measured weekly during the first month postoperatively. An independent samples Wilcoxon rank sum test was used to assess the difference of patients' subjective postoperative pain between the 2 groups, and an independent samples t test was used to assess the difference of the other parameters. Results The mean reepithelialization time was (2.63±0.49)days and (2.93±0.64)days for group 1 and group 2, respectively (t=2.039, P=0.046). Pain score in group 1 was lower than group 2 (Z=-3.535, P＜0.01) 2 days postoperative. Both maximum and average subjective pain scores were lower in group 1 (Z=-2.261, P=0.024; Z=-2.982, P=0.003) 3 days postoperative. The mean UCVA on the third postoperative week was -0.068±0.088 (logMAR) for group 1 and -0.024±0.069(IogMAR) for group 2 (t=2.236, P=0.030). There were no significant differences in postoperative spherical equivalent or BSCVA between the 2 groups. Conclusion Integrated custom transepithelial ablation seems to result in faster reepithelialization and UCVA recovery as well as lower postoperative pain than PRK with mechanical epithelial removal, while the BSCVA and refractive outcomes are comparable.

Objective To assess the characteristics of the ocular biometric parameters and prevalence of refractive errors in junior and senior school children in Deqing County. Methods Investigative survey. There were 1853 students from 6 schools in Deqing County randomly recruited for the study. Their mean age was (14.4±3.1)years; 47.81％ were females and 52.19％ were males.Objective refraction without cycloplegia was obtained with an autorefractor. Axial length (AL), anterior chamber depth (ACD) and corneal curvature (CC) were measured by IOL Master under noncycloplegia.Data were analyzed with an independent samples t test, a paired t test, one-way ANOVA and linear regression. Results The prevalence of myopia and astigmatism of the 1853 students was 82.60％ and 10.50％, respectively. Average spherical equivalent (SE) and cylinder power of right eyes were (-2.38±2.12) and (-0.51±0.49)D, respectively. Mean AL and ACD of right eyes were (24.3±1.2) and (3.6± 0.2)mm, respectively. Average horizontal and vertical CC were (42.78±1.51) and (43.81±1.52)D,respectively. The relationship between anterior segment (AS) and posterior segment (PS) during axial elongation was PS=1.66×AS+14.78. Conclusion The prevalence of myopia is higher in elder students from Deqing County schools, and there is a rapid rise of prevalence of myopia since 9-year-old children. Corneal curvatures significantly correlate to sex, but not to age or refractive state. As the level of myopia increase, ACD becomes deeper and AL elongates, during which posterior segment of eye plays a predominant role.

Objective To investigate the early changes in tear film after vitreous microsurgery,to compare the postoperative impact of 23-gauge and 25-gauge vitreous microsurgery on tear film.Methods Eighty-six eyes of 86 patients who underwent 23-gauge or 25-gauge vitreous microsurgery monoculady between March 2009 and July 2009 were enrolled in this prospective case series study.The contralateral eyes were regarded as the control group. Among them, 35 eyes each underwent 25- combined 23-gauge surgery (group A), another 35 eyes underwent 25-gauge vitrectomy (group B),and another 16 eyes underwent 23-gauge vitrectomy (group C). Symptoms of discomfort, break-up time (BUT), Schirmer I test (SIT) and corneal fluorescein staining (CFS) were recorded before and after surgery in all patients (86 patients with 172 eyes), and the data from all ophthalmologic examinations were collected. Data were analyzed with a Kruskal-Wallis, a Wilcoxon, an one-way ANOVA and an independent samples t test. Results Nine patients complained of foreign body sensation, burning, or lacrimation with significantly increased SIT (P=0.001) at day 1 and CFS scores (Z=-3.782,P＜0.05) at days 3 postoperatively. Obviously decreased BUT was recorded at day 1 and day 3 postoperatively, BUT recovered significantly 10 days postoperatively (P=0.001). In the subjective scores for symptoms of discomfort and SIT results in the contralateral eyes, no significant changes were found at any follow-up examination, the differences for CFS and BUT were significant 10 days after surgery. Compared to contralateral eyes, all dry eye test values were significantly worse at day 1 and davs 3 postoperatively in the surgical eyes (Z=-5.470, -5.011; t=-4.968, -5.184; t=4.452, 3.963; P＜0.05).CFS values were different at each follow-up examination (Z=-6.229, -5.780, -5.018, -4.379, -2.374,P＜0.05). There were no differences in tear film in both eyes between group A, group B and group C at any follow-up examination. Conclusion The stability of tear film can be affected in the early postop

Objective To record and analyze the changes in the ocular surface and cornea in diabetic patients using a battery of ophthalmic tests and high resolution laser scanning confocal microscopy. Methods Prospective case control study. One hundred and eight patients with type 2 diabetes and 33 normal people (controls) were enrolled in this study. Based on the classification stages of diabetic retinopathy, patients were divided into 2 groups, those 42 patients (59 eyes) with non-diabetic retinopathy (NDR) and 66 patients (86 eyes) with proliferative diabetic retinopathy (PDR). All patients were examined using corneal sensitivity measurements, Schirmer's I test,non-invasive tear film break-up time (BUT), and corneal fluorescein staining. The testing regime also included DR-1 tear film interferometer camera and corneal confocal microscopy examinations.Parameters among groups were analyzed with a one-way ANOVA, a chi-square test and Spearman's rank correlation analysis. Results There was a significant difference between the NDR group (32％ were equal to or greater than grade Ⅲ) and the control group (14％) in the tear film test (P＜0.01). Corneal sensitivity was significantly lower in the PDR group [(33.0±12.4)mm] than in the control group [(47.2±9.7)mm] (P＜0.01). Tear secretion was (11.8±4.2)mm in the PDR group, and (15.2 ±4.3)mm in the control group. The difference between the two groups was statistically significant (P＜0.01). Tear film BUT was significantly shorter in the diabetic group [(7.3±2.5)s] than in the control group [(13.7±4.0)s] (P＜0.01). There was a sgnificant difference between the PDR group (50％ were equal to or gerater than grade Ⅲ) and the control group (14％) in the tear tim test (P＜0.01). Seventy-four percent patients were positive in PDR group in corneal fluorescein staining, much higher than control group (8％) (P＜0.01). Densities of corneal epithelium and corneal nerve fiber were all significantly lower in the PDR group [(4407±480)/mm2, (898±153)μm/field] than in the control group [(4736±313)/mm2, (1231±

Objective To investigate the safety and effectivity of posterior scleral reinforcement surgery combined with strabismus surgery in treating pathological myopia with concomitant exotropia. Methods Thirty-two cases of pathological myopia and concomitant exotropia were analyzed retrospectively. Eighteen cases in a combined-surgery group underwent posterior scleral reinforcement for a variant sclera combined with strabismus surgery (lateral rectus recession alone or combined with medial rectus excision); 14 cases in a two-stage operation group underwent posterior scleral reinforcement and strabismus surgery at different time. The therapeutic effects of the procedures were observed and compared. All cases were followed for 12 to 30 months. Data were analyzed with chi-square test or fisher exact probabilities. Results Eighty-two percent eyes attained stable best corrected visual acuity at 3 months postoperatively (improved or unchanged) in the combined-surgery group, and the same in the two-stage operation group. The difference was not statistically significant.Improvement and recovery of binocular vision: 4 cases in the combined-surgery group and 1 case in the two-stage operation group. The difference was not statistically significant. Eye position: 83％ attained satisfactory cosmetic result (primary eye position was within ±5° or prism angle was within ±10△) in the combined-surgery group, and 86％ in the two-stage operation group. The difference was not statistically significant. Stable refractive error (change≤0.5 D per year): 75％ in the combined-surgery group, and 73％ in the two-stage operation group. The difference was not statistically significant.Ocular axis stability (change≤0.3 mm per year): 75％ in the combined-surgery group, and 77％ in the two-stage operation group. The difference was not statistically significant. Complications: there were no complications such as retinal detachment, anterior segment ischemia, etc. However, different degrees of conjunctival aponeurosis edema and diplopia were common. Conclusi

Objective To evaluate the safety and efficacy of Nd:YAG laser peripheral iridectomy (LPI) in high myopia eyes before phakic posterior chamber intraocular lens (PCIOL)implantation. Methods A retrospective analysis was made of a consecutive series of 76 eyes of 38 patients who underwent LPI before phakic PCIOL implantation. The patients had a mean ages of (29.7±6.3)years (20-46 years). The mean preoperative myopia was (-16.2±18.2)D (-4.5--22.0 D). Nd:YAG laser was applied at two peripheral sites for each eye about 7 days before PCIOL implantation. The iridectomy size, laser energy, laser spots, intraocular pressure (IOP) and inflammatory indicators were measured and recorded. The mean follow-up was (6.2±4.8)months (3-12 months) for complications. Results All 76 eyes were successfully treated with LPI without severe complications. The average energy was (429.6±330.6)mJ. Mean spots for each eye were 142±100. LPI-related transient increased IOP (≥21 mmHg) post PCIOL implantation was 26％ (20/76 eyes) for all treated eyes. There were 6 patients needed systemic ocular hypotensive agents, 5 eyes were underwent paracentesis since the IOP≥45 mmHg. Papillary block glaucoma occurred in 2 patients (3％) which surgical intervention was needed after PCIOL implantation. Conclusion Customized LPI can reduce the risk of papillary block glaucoma and glare after PCIOL implantation.

The treatments for open-angle glaucoma include medication, laser and surgery.Trabeculectomy is still the first choice for its efficacy in controlling intraocular pressure. Good nonfiltering bleb surgeries have been developed recently, and the new surgeries include canaloplasty,trabecular bypass devices, the Glaukos iStent trabecular micro-bypass stent, Eyepass glaucoma implant, Gold Micro-Shunt implant, Trabectome, and excimer laser trabeculotomy ab interno. Other new alternatives such as the Ex-PRESS glaucoma shunt and pneumatic rabeculoplasty have also been developed. This article briefly reviews these new techniques.