To compare the effect of suction on the retinal superficial vascular networks's flow density, macular retinal thickness, and retinal nerve fiber layer thickness during small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) surgery using optical coherence tomagraphy angiography (OCTA). Methods: This was prospective, non-randomized, controlled study. From November 2017 to March 2018, 45 patients with a binocular spherical equivalent (SE) <-6.00 Dwere treated at the same refractive surgery center of Beijing Tongren Hospital. The study included 22 patients (22 eyes) who had undergone FS-LASIK and 23 patients (23 eyes) who had undergone SMILE surgery, and the SE was -8.10±1.20 D, and -7.34±1.90 D, respectively. Besides the routine examinations, all patients were examined with OCTA by the same operator. OCTA was performed at 1 week, 1 month and 3 months after surgery. Repeated measures analysis of variance and independent sample t-tests were used to analyze and compare the collected data from the two surgical groups. Results: All patients had uncorrected and best corrected visual acuity assessed preoperatively. The FS-LASIK and SMILE groups had SE values of 0.14±0.82 D and -0.23±0.56 D, respectively, at 3 months postoperatively. The difference was not statistically significant (t=1.696, P=0.098). There were no significant differences in the preoperative retinal superficial vascular networks's flow density, macular retinal thickness, and retinal nerve fiber layer thickness between the FS-LASIK group and SMILE group (all P>0.05), and there were no statistical differences between the follow-up times at 1 week, 1 month and 3 months after surgery in each group (all P>0.05). Conclusions: The suction during SMILE and FS-LASIK surgery has no effect on the microstructural parameters of the fundus in high myopic eyes. It is safe and feasible to choose either surgical methods for high myopia.

preoperative BCVA (LogMAR) -0.02±0.07 (t=8.714, P<0.001). The prevalence of spherical equivalent (SE) within ±0.50 was 94%; the residual astigmatism was 0.40±0.17 D. At 3 months, postoperative coma and OSI decreased compared with preoperative levels, and the MTF cutoff increased compared with preoperative levels. The difference was statistically significant (t=1.757, -2.935, 4.243, P<0.05). The UCVA, coma and MTF of the moderate and high astigmatism group and the low astigmatism group had improved at 3 months after surgery, and there was no significant difference between the two groups. Conclusions: FS-LASIK guided by corneal topography can effectively improve the visual quality of myopic astigmatism patients.

To investigate the visual and refractive outcomes in patients with super high myopia after thin-flap femtosecond laser assisted LASIK (FS-LASIK) combined Triple-A profile. Methods: In this prospective non-randomized case-controlled study, patients were enrolled from January to July 2016 at Affiliated Hospital of Nanjing University of Chinese Medicine, were divided into high myopia group (96 eyes of 48 patients) and super high myopia group (88 eyes of 44 patients). All patients were treated with FS-LASIK combined Triple-A profile. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE) and high order aberration were measured preoperatively and 1 day, 1 week, and 1, 3 and 6 months postoperatively. Data were analyzed using repeated measurs ANOVA and generalized estimating equation. Results: At 1, 3 and 6 months after surgery, there was no significantdifference between the two groups in the ratio of UCVA that was better than or equal to preoperative BCVA (P>0.05). At postoperative 6 months, there was no significant difference in the efficacy and safety index between the two groups (P>0.05). There was a hyperopic shift in the two groups after surgery. The shift was more significant in the super high myopia group in the early stage after surgery. The SE of the two groups tended to be stable after 3 months postoperatively. The changes in total corneal high order aberrations, spherical aberration and horizontal coma were significantly different in time and group, but there was no significant difference in vertical corneal aberration. Conclusions: The postoperative results indicate that using the Triple-A ablation profile of the MEL 90 excimer laser associated with thin-flaps is a safe, efficient, and predictable method to correct super high myopia.

To assess the impact of the pre-diagnostic use of corticosteroid on the prognosis of visual outcomes and treatment methods of fungal keratitis. Methods: This was a retrospective consecutive case cohort study. Two hundred and eleven eyes of 211 patients diagnosed with fungal keratitis from December 2014 to December 2015 in Shandong Eye Hospital were analyzed. Thirty-six eyes of 36 patients with a history of corticosteroid use before the diagnosis was the corticosteroid group. The remaining 175 eyes of 175 patients with no use of corticosteroid before or during the treatment was the control group. Patients' demographics, clinical findings, management details, changes after the antifungal therapy, and corrected distance visual acuity 2 months after the cure were recorded. Independent samples t test and chi-square test The fungal onset time of the corticosteroid group was 14.5±10.1 days, which was significantly shorter than that of the control group, 20.6±22.5 days (t=2.657, P=0.008). The mean diameter of corneal lesions was 6.3±2.4 mm in the corticosteroid group, which was significantly larger than that of the control group 4.8±2.1 mm (t=3.683, P<0.001). The positive rate of a corneal scrape was 97.2% in the corticosteroid group and 90.6% in the control group, with no significant difference between the groups (χ2 =1.633, P=0.201). Only 1 case (2.8%) in the corticosteroid group was cured by antifungal drugs, which was significantly lower than that of the control group, with 34 cases (19.4%) (χ2 =5.983, P=0.014). Penetrating keratoplasty was performed in 22 cases (61.1%) in the corticosteroid group, a proportion that was significantly higher than that in the control group, with 55 cases (31.4%) (χ2 =11.351, P=0.001). A corrected distance visual acuity of less than 0.3 after antifungal therapy was recorded in 32 cases (88.9%) in the corticosteroid group, a proportion which was significantly higher than in the control group, 110 cases (62.8%) (χ2 =9.194, P=0.002). Conclusions: Corticosteroid use before a diagnosis of fungal keratitis can increase the range of lesions, while antifungal drugs seem to be less effective, which increases the probability of penetrating keratoplasty and a poorer outcome. were used for statistical analysis. Results: The demographic data were matched between the two groups.

To investigate the effects of vitrectomy combined with internal limiting membrane (ILM) peeling indiabetic macular edema (DME). Methods: In this retrospective clinical study, 33 eyes of 31 patients with DME confirmed preoperatively or intraoperatively by optical coherence tomography (OCT) were included. All patients underwent vitrectomy for dense vitreous hemorrhages due to diabetic retinopathy or proliferative diabetic retinopathy between June 2014 and January 2017 at the Eye Hospital,Wenzhou Medical University. A total of 16 patients (18 eyes) with vitrectomy and ILM peeling were in the ILM-removed group, 15 eyes of 15 patients with vitrectomy only were in the control group. All the surgeries were performed by the same surgeon. All subjects underwent OCT examination at 1 month and 3 months postoperatively. The central macular thickness (CMT) and visual outcomes between the two groups were analyzed relative to each other. The data were analyzed by repeated measures analysis and t-tests. Results: Before the therapy, and at one and three months after therapy, the total difference of best corrected visual acuity (BCVA) between the two groups was statistically significant (F=15.93, P<0.001). The BCVA in the ILM-removed group was higher than the control group at one month after therapy (t=2.55, P=0.02). However, there was no significant difference between the two groups in terms of BCVA at three months after therapy (t=0.82, P=0.42). Before the therapy, and at one and three months after therapy, the total difference of CMT between the two groups was not statistically significant (F=2.85, P=0.065). At both one month and three months after therapy, the CMT in the ILM-removed group was lower than the control group (t=2.24, P=0.03; t=3.79, P=0.001). At 1 month postoperatively, the subjects of effectiveness (a decrease in CMT by at least 20%), ineffectiveness (a change in CMT by <20%) and deterioration (an increase in CMT by more than 20%) were 8, 6 and 4 respectively, while the subjects were 11, 5 and 2 respectively at 3 months after therapy. There was no significant difference from the control group (Z=-1.687, P=0.092) at one month after therapy, but there was a significant difference at three months after therapy (Z=-2.177, P=0.029). Conclusions: The removal of ILM contributes to the resolution of nontractional DME at an early stage after therapy.

To evaluate the effect of vitrectomy and internal limiting membrane peeling with air tamponade for the treatment of idiopathic macular hole (MH). Methods: A retrospective study was performed on 32 eyes of 32 patients with idiopathic macular hole in our hospital from January 2017 to January 2018. There were 9 males (9 eyes) and 23 females (23 eyes), with amean age of 60.7±12.2 years (range from 47~78 years). Pars plana vitrectomy with internal limiting membrane peeling was performed, followed by fluidair exchange. According to the results of OCT scanning in the first postoperative follow-up, all patients were divided into two groups: MH closed ornot closed. The preoperative and postoperative best corrected visual acuity (BCVA) and diameter of the MH were compared between the two groups, using a Wilcoxontest and independent sample t test. The MH closure rate, the continuity of the external limiting membranes and photoreceptors were compared using a chi square test. Results: At the last follow-up, the LogMAR BCVA was 0.40 (0.30, 0.73), which was significantly higher than the preoperative BCVA 0.80 (0.70, 1.00) (Z=-3.439, P<0.001). Early postoperative OCT scansshowed that 24 macular holeswere closed, while the macular holes in the other 8 eyes were not closed sofluid-air exchange was performed again. The macular holeswereclosed in all 8 patients one month after the second treatment or the last follow-up. Sixteen patients hadcontinuous external limiting membrane (ELM) but none with a continuous external zone (EZ) in the OCT scansone month after the operation. However, 18 patients showed continuous ELM and 6 showed continuous EZ at the last follow-up. According to whether MH was closed or not at the first postoperative OCT scanning, all patients were divided into two groups. The mean pre-surgical diameter of the MH of the unclosed group was 532±104 um, which was significantly larger than that of the closed group (352±180 μm)(t=-2.656, P=0.013). The continuity of the ELM of the MH closed group was higher than the unclosed group at one month after the operation and at the last follow-up (P<0.05). The patients with continuous EZ at the last follow-up were all in the closed group, while the EZs in the unclosed group were discontinuous. There was a statistically significant difference between the two groups (χ2 =3.89, P=0.048). Conclusions: The results of this study indicate that vitrectomy combined with ILM peeling and air tamponade for the treatment of idiopathic macular hole has a good result. However, for those macular holes with more than a 400 um diameter, a second fluid-air exchange is needed. Early closure of the MH suggests a better prognosis after surgery.

To evaluate the clinical effects of Ming Mu-11 (MM-11) in the treatment of stage Ⅰ diabetic retinopathy (DR). Methods: One hundred twenty patients (120 eyes) with stage Ⅰ DR in the AffiliatedHospital of Inner Mongolia University for the Nationalities were selected from July 2016 to March 2017. The 120 eyes with stage Ⅰ DR were divided into two groups: a Mongolian medicine group and a control group (60 eyes each). The control group was treated with calcium dobesilate capsules and the Mongolian medicine group was also treated with MM-11 pills. There were three courses of treatment in total and 28 days in each course. Patients in both groups underwent multifocal electroretinogram (mfERG) and ultra-wide angle fundus photography examinations before and after the treatment. The latencies and amplitudes of the N1 wave and P1 wave were recorded as well as the number of retinal microaneurysms and hemorrhagic spots. Data were analyzed by t-test and Chi-square test. Results: The results of mfERG were as follows. There were significant differences in the amplitude density values of P1 in the R1-R5 regions before and after treatment (tcontrol group=66.86, 18.05, 36.33, 47.43, 30.56, P<0.001; tmongolian medicine group=31.52, 54.56, 101.98, 127.02, 45.74, P<0.001). There were significant differences in the amplitude density value of N1 in the R1-R5 regions before and after treatment (tcontrol group=70.18, 47.02, 78.08, 57.44, 64.51, P<0.001; tmongolian medicine group=46.09, 140.47, 145.14, 50.46, 73.94, P<0.001). Compared to the control group, the amplitude density value differences in the R1-R5 P1 and R1-R3 N1 regions in the Mongolian medicine group were significantly different before and after treatment (tP1=8.96, 23.96, 25.10, 28.80, 13.67, P<0.001; tN1=9.38, 30.34, 52.06, P<0.001). However, there was no significant difference in the amplitude density value in the R4-R5 N1 regions. There was no significant difference in the latency of P1 in the R1-R5 regions before and after treatment. There was no significant difference in the latency of N1 in the R1-R5 regions before and after treatment. The results of fundus color photography were as follows. The difference in microaneurysms and number of bleeding points before and after treatment were statistically significant in the Mongolian medicine group (t=2.08, P=0.042; t=2.07, P=0.043). The effective rates of the eye fundus photography in the Mongolian medicine group and the control group were 88% and 73%, respectively, which were analyzed by a chi-square test. The difference was statistically significant (χ2 =4.36, P=0.037). Conclusions: MM-11 is very effective for treating the damage of retinal functions in stage Ⅰ DR and therefore can be considered as a drug for routine use.

To compare visual performance after bilateral implantation of a bifocal (ReSTOR +3.0 D) or trifocal (AT Lisa tri. 839MP) intraocular lens (IOL). Methods: This prospective clinical study involvedpatients who had cataract surgery that included the bilateral implantation of a bifocal or trifocal IOL from April 2017 to May 2018 at Wuhan Aier Eye Hospital. Fifty-two eyes (26 patients) were implanted with a trifocal IOL (AT Lisa tri. 839MP) as trifocal group and fifty-two eyes (26 patients) with a bifocal IOL (ReSTOR +3.0 D) as bifocal IOL group. The follow-up was 3 months. Near, intermediate, and distance visual acuities, defocus curve, optical quality, including modulation transfer functions and intraocular aberrations, ocular aberrations with 3 mm and 5 mm pupil diameters, National Eye Institute Visual Functioning Questionnaire-14 for Chinese people (VF-14-CN), spectacle independence and patient satisfaction were assessed in all patients. Data were assessed with a Student's t test, Mann-Whitney U test, and Chi-square test. Results: No statistically significant difference was found in distance, near, best corrected distance, distance-corrected intermediate, or distance-corrected near visual acuity between the two groups. Uncorrected intermediate visual acuity was significantly better in the trifocal IOL group (Z=-2.347, P=0.019). In the binocular defocus curve, visual acuity was also significantly better for defocus at -1.0, -3.0, 3.5 and 4.0 diopters (Z=-2.619, -2.452, -2.452, -2.147; P=0.009, 0.014, 0.014, 0.032). No significant difference was found between the two groups for mean postoperative contrast sensitivity function under photopic conditions with or without glare. With a 3 mm or 5 mm pupil diameter, intraocular higher-order aberrations, coma, trefoil and total higher-order aberrations, and trefoil aberrations were significantly lower in the trifocal IOL group (P<0.05). With a 5 mm pupil diameter, intraocular spherical aberrations were significantly lower in the trifocal IOL group (Z=-3.053, P=0.002), but no statistically significant difference was found in modulation transfer function at 3 mm and 5 mm pupil diameters between the two groups. The level of overall satisfaction was similarly high for both groups. Conclusions: Trifocal IOLs can provide significantly better intermediate vision and equivalent distance and near visual performance compared to bifocal IOLs and have the same level of overall satisfaction.