Volume 51 · Issue 04 · 2015

Cataract is the major cause of blindness in China. After efforts of generations, there were tremendous progresses in cataract diagnosis and treatment. With the popularity of microincision cataract surgery, the rise of femtosecond laser-assisted cataract surgery, and the application of advanced intraocular lens, cataract surgery has been gradually changed from visual rehabilitation to refractive surgery. But there are still some problems such as the lower surgery coverage, the large discrepancy of the diagnosis and treatment between urban and rural areas, and the imperfect treatment standard. In future work, cataract study group combining with other ophthalmic institutes will continue to find and solve problems for upgrading the overall level of cataract treatments in China. (Chin J O phthalmol,2015,51:241-244)

In recent years, the cataract surgery has been transformed from simple visual recovery surgery to refractive laser-assisted cataract surgery. Femtosecond laser-assisted cataract surgery just holds the promise and is the product of this certain tendency. Initial clinical studies have claimed that it provides superior outcomes with higher accuracy, predictability, safety and also it can efficiently reduce ocular manipulation and minimize injury to surrounding tissue. However, complications including severe ones associated with different periods of the surgery still can not be avoided as a learning curve exists and the unique characteristics of the devices and patients may further add to this condition, which should be emphasized. With the development of the techniques, optimization of certain parameters and popularization of the devices, it is important to choose clinical eligible patients and fully recognize as well as timely prevent those possible complications during femtosecond laser-assisted cataract surgery, which may be necessary for the healthy development of this innovative technique. (Chin J Ophthalmol, 2015, 51:245-248)

China is one of the countries with the most extensive development of laser corneal refractive surgery. In order to further standardize the clinical application of laser corneal refractive surgery and ensure the quality and safety of medical care, the expert members of the Keratology Group of Ophthalmology Branch of Chinese Medical Association reached the following consensus in combination with the actual situation in China.

pigment dispersion syndrome (PDS) is a group of syndromes in which a large number of pigment particles in the pigment epithelium layer on the posterior surface of the iris are shed and deposited in the anterior segment of the eye due to the contact and friction between the posterior fovea of the iris in the middle periphery and the suspensory ligament of the lens. Pigment particles circulate with the aqueous humor and can be deposited on the posterior cornea, the anterior surface of the iris, the anterior and posterior surfaces of the lens, the suspensory ligament of the lens, and the angular crypts, especially the trabecular meshwork. Excessive pigment particles deposited in the trabecular meshwork can cause increased aqueous outflow resistance, increased intraocular pressure, and glaucoma, that is, pigmented glaucoma, which is the natural outcome of pigment dissemination syndrome and the cause of blindness.

Posterior chamber IOL ciliary sulcus fixation is the most commonly used IOL implantation method without capsule support in clinic^[1,2]。 Because most cases without capsule are caused by ocular trauma or surgery, the individual differences of surgical cases undergoing posterior chamber IOL ciliary sulcus fixation are large. So far, there is a lack of large sample, multi-center, randomized and controlled studies. However, its clinical application time in ophthalmology is longer, the indication range is wide, and the clinical effect is positive. Compared with iris fixation anterior chamber IOL, ophthalmologists have a larger audience and richer clinical experience. Therefore, posterior chamber IOL ciliary sulcus fixation technology has greater advantages in the current ophthalmology clinical practice.

At this stage of the development of cataract surgery, IOL intracapsular implantation is recognized as the safest and most effective implantation method. However, there are many cases where the posterior chamber IOL cannot be implanted in the capsular bag, such as lens dislocation caused by various reasons, including ocular trauma and surgery, and the complete or most missing lens capsule. How to safely and effectively correct the refractive error of aphakic eyes without capsule support, minimize the surgical injury and improve the visual quality is an urgent problem for ophthalmologists. In addition to wearing glasses or contact lenses, the main methods at present are to implant iris clamping IOL or ciliary sulcus suture to fix posterior chamber IOL.

To compare the optical quality after two different types (aspheric and spheric) of toric intraocular lens implantation.

The study was a prospective study. One hundred eyes of 89 patients with regular corneal astigmatism (range 1.00 D to 3.00 D) underwent implantation of toric intraocular lens in the Tianjin Medical University Eye Hospital from May 2012 to June 2013, including 50 eyes of 44 patients implanted Acrysof IQ Toric IOL(SN6AT) (aspheric group) and 50 eyes of 45 patients implanted Acrysof Toric IOL(SN60TT) (spheric group). Mean age was 73.7 years ±6.6 and mean astigmatism was 1.68±0.51D. Main outcomes of two groups evaluated at 3-months of follow-up, included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), residual refractive cylinder and IOL rotation. Contrast sensitivity testing was performed under photopic, mesopic and mesopic with glare conditions using the CSV-1000E charts. Ocular higher order aberrations, including total higher order aberrations and spherical aberration, were measured at optical zone of 3.0 and 5.0 mm using iTrace aberrometer. Objective optical quality was measured using optical quality analysis system(OQAS), included MTF cutoff, OSI, Strehl ratio, OV100%, OV20% and OV9%. The Student t test was performed for data with normal distribution. The Mann-Whitney U test was performed for data with no normal distribution.

Postoperatively, the mean UDVA of aspheric and spheric group were 0.19±0.11 and 0.21±0.11 LogMAR respectively; the mean CDVA were 0.08±0.09 and 0.10±0.10 LogMAR respectively; the mean residual refractive cylinder were 0.50±0.30D and 0.59±0.32D respectively; the mean absolute misalignment were 3.74±1.88 degrees and 3.84±1.68 degrees respectively. No statistically significant differences were noted between groups in mean UDVA, CDVA, residual refractive cylinder and absolute misalignment(U=1135.50, P=0.414; U=1118.52, P=0.342; U=1035, P=0.128 and t=0.28, P=0.780, respectively). Aspheric group performed better than spheric group under mesopic and mesopic glare conditions at moderate and high spatial frequency. Mean ocular spherical aberration of aspheric group at 3.0 mm pupil was significantly less than spheric group and mean total higher order aberrations and spherical aberration of aspheric group at 5.0 mm pupil were less than spheric group (t=3.49, P=0.003; t=6.46, P<0.001 andU=0.00, P<0.001, respectively). The mean MTFcutoff of aspheric and spheric group were(23.207±5.409) cpd and (25.01±5.46) cpd, the mean OSI were 1.69±0.7 and 1.65±0.77, the mean Strehl ratio were 0.14±0.04 and 0.16±0.04, the mean OV100% were 0.77±0.18 and 0.83±0.18, the mean OV20%were 0.77±0.18 and 0.79±0.21, and the mean OV9% were 0.75±0.20 and 0.78±0.17. No statistically significant differences were noted between groups in mean MTFcutoff, OSI, Strehl ratio, OV100%, OV20% and OV9%(t=0.26, P=0.795; t=1.66, P= 0.100; t=1.92, P=0.057; t=1.72, P=0.089; t=0.39, P=0.693 and t=0.98, P=0.328, respectively).

Both aspheric and spheric toric IOL implantation were an effective and safe method to correct corneal astigmatism during cataract surgery. Moreover, aspheric toric IOL performed better optical quality than spheric toric IOL.(Chin J Ophthalmol,2015,51:263-269)

Purpose To compare the tilt and decentration between a single-piece and a 3-piece aspheric intraocular lens (IOL), and the impact of these factors on the HOAs after phacoemulsification and IOL implanted in capsular bag. Methods It is a prospective randomized clinical trial. According to the table of random number, 72 eyes of 49 patients were divided into 2 groups. One group received a 1-piece aspheric IOL (Tecnis ZCB00, AMO) and a 3-piece aspheric IOL (Tecnis ZA9003, AMO) in the other group. The tilt at 45°, 90°, 135° and180° and decentration of the IOL were obtained using Scheimphlug system (Pentacam, Oculus) and image-analysis 3 months after the surgery. The internal ocular HOA of the IOL were evaluated with iTrace examination. The tilt and decentration of the IOL and the variables of the internal ocular HOAs were compared by independent-samples t test. The effect of tilt and decentration on the HOAs was assessed by Pearson correlation analysis. Results Patients age ranged from 50 to 80 years. The best corrected visual acuity (BCVA) of both group were all not less than 0.5. In 3-piece IOLs group, there was a significant positive correlation between the BCVA and the astigmatism (Z3) (r=0.504, P=0.003;r=0.637, P= 0.000) and a significant negative correlation between the BCVA and the fourth-order astigmatism (Z13) (r=-0.476, P=0.005;r=-0.531, P=0.001) at 3.0 mm and 5.0 mm pupil. The mean tilt at 90° (vertical) and 135°of the 3-piece aspheric IOL group [(0.90±0.78)° and (0.98±0.73)°, respectively] were higher than those in 1-piece aspheric IOL group [(0.50±0.33)° and (0.69±0.41)°, respectively], the differences were statistically significant (t=2.899, P=0.005;t=2.120, P=0.038). At 5.0 mm pupil, the defocus (Z4), astigmatism (Z5), third-order coma(Z8), fourth-order astigmatism (Z11) and fourth-order spherical (Z12) in 3-piece aspheric IOLs group were higher than those in 1-piece aspheric IOL group, the difference were statistically significant (t=2.372, P=0.021;t=2.801, P=0.007;t=3.269, P=0.002;t=3.230, P=0.002;t=3.468, P=0.001). In 3-piece IOL group, a significant positive correlation was found between the mean tilt and the fourth-order astigmatism (Z13) at 3.0 mm and 5.0 mm pupil (r=0.396, P=0.023;r=0.378, P=0.030), and a significant negative correlation was also found between the decentration and the fourth-order astigmatism (Z13) with at 3.0 mm pupil (r=-0.441, P=0.010). Conclusions Both 1-piece and 3-piece IOL designs showed well stability in capsular bag, the former was slightly more stable with better visual quality. There was no significant correlation between the internal ocular HOA and the degrees of IOL tilt and decentration in the 1-piece aspheric IOL group. At different pupil diameters, a significant correlation was found between the decentration and tilt of IOL and fourth-order astigmatism Z (13) in the 3-piece IOL group.(Chin J Ophthalmol,2015,51:270-275)

To investigate the factors that influence the postoperative refractive error in long axial high myopic eyes, and to compare the accuracy of optimized Haigis and SRK/T formulas.

Retrospective study. From May 2008 to December 2010, 137 high myopic eyes (with axial length (AL) greater than or equal to 26mm) of 137 patients, who got cataract surgeries at Eye Hospital of Wenzhou Medical University, were enrolled for this study. The AL, corneal curvature (K), and anterior chamber depth (ACD) were measured by IOL-Master preoperatively. The intraocular lens (IOL) power was determined by optimized Haigis and SRK/T formulas, respectively. The preoperative and postoperative refractions were measured with phoropter. The target refraction after monofocal foldable IOL implantation was between-1.96 D to- 7.39 D depending on the optimized Haigis formula. The mean absolute error (MAE) equals to the absolute difference between the target refraction and the 3 months postoperative actual refraction. One-way analysis of variance was used to analyze the MAE by two formulas to find the difference between each pair of both groups, which the AL groups were as follow: 26 mm≤AL≤28 mm, 28 mm<AL≤30 mm, 30 m<AL≤32 mm, 32 mm<AL≤34 mm and K was grouped into 40.00–42.00 D, 42.01–44.00 D, 44.01–46.00 D and 46.01–48.00 D. Linear correlation, P-P figure of normal distribution test Bland-Altman plot and linear regression were used to compare the accuracy of two IOL power formulas and analyze the correlation between the 3 months postoperative refractive error and the parameters obtained preoperatively.

(1) The IOL power is related to AL, K, ACD and preoperative spherical equivalent, the regression formulas isP=118.966-1.860AL-1.255K (F=472.86, P=0.00). (2) In AL groups: No statistical difference of MAE was found between each pair of groups by optimized Haigis (F= 2.73, P=0.06). However, MAE difference were found between group 26 mm≤AL≤28 mm (-0.05±1.04) D and group 30 mm<AL≤32 mm (0.94±1.21) D, group 32 mm<AL≤34 mm (0.84±0.86) D by SRK/T formula (t=-0.99, P=0.00;t=-0.89, P=0.001).In K groups: There was no statistical MAE difference by optimized Haigis or SRK/T formula between each pair of groups (F=0.32, P=0.81;F=0.56, P=0.65). (3) The limits of agreement (mean difference ± 1.96 SD) of refraction difference between two formulas was (-1.6,1.0) D. The preoperative predicted refraction by the two formulas and the 3 months postoperative refractive error showed linear relationship (F=9.35, P=0.00;F= 7.85, P=0.00).

AL was the main factor affecting refractive error after long-axial high myopic eye cataract surgery, followed by K. For preoperative prediction, SRK/T formula and optimized Haigis formula show no difference. In AL subgroups, optimized Haigis formula showed no significant difference in accuracy, comparing with SRK/T formula induced less refractive error in 26–28mm group than in 30–34 mm group. There was no significant difference between SRK/T formula and optimized Haigis formulas in the K subgroups. (Chin J Ophthalmol, 2015, 51:276-281)

To demonstrate the incidence of posterior capsule rupture during the phacoemulsification of cataract and the risk factors of the complication and to find ways to reduce the rate of the complication.

This retrospective chart review comprised cataract phacoemulsification performed from January 1, 2009 to December 31, 2009 with a total of 3 004 cases (3 186 eyes). The incidence of posterior capsule rupture and the risk factors were the main outcomes. The variables of patient age and gender; laterality of surgical eye; pre-operative visual acuity and intraocular pressure; post-operative visual acuity; the nuclear stages, presence of diabetes mellitus, glaucoma, hypertension and other diseases; history of vitrectomy the surgeons were collected and analyzed.

Male(χ²=7.82, P<0.01), pre-operative visual acuity less than 20/200 (HR=2.3, P=0.01) , and the nuclear stage higher than IV (χ²=18.01, P<0.01) all statistically significantly increased in the posterior capsule rupture group (χ²=14.13, P< 0.01). The post-operative visual acuity increased in both groups ( (2.1±1.0) LogMAR to (1.2±0.8) LogMAR,t=7.71 × 10^-11, P<0.01 vs (1.5±0.8) LogMAR to (0.7±0.7) LogMAR,t=1.27×10^-42, P<0.01).

Gender, pre-operative visual acuity, the nuclear stages are all significantly affect the incidence of the posterior capsule rupture. Improving training of surgeons should further reduce the frequency. (Chin J Ophthalmol, 2015, 51: 282-287)

To investigate the impacts of specific serines phosphorylation of αA Crystallin on anti-oxidation and anti-apoptotic ability of human lens epithelial cells (HLEC).

Experimental Study. Using site-directed mutagenesis, serines on specific sites (Ser45, Ser66, Ser122) were replaced respectively by aspartic acid (D) to mimic phosphorylation. Target genes were inserted into pEGFP-C1 plasmid and transfected into HLEC by Lipofectamine^TM 2000. HLEC transfected with blank plasmid and plasmid over-expressing wide-type (WT) αA Crystallin were defined as control group and WT group. After H ₂O₂ induction, Dihydroethidium (DHE) and Annexin V-PE/7AAD staining were used to detect the reactive oxygen species level and apoptotic rate. T-test, Wilcoxon-two sample test, analysis of variance and Kruskal-Wallis test were used for statistical analysis.

The DHE intensity of three phosphorylation groups were 167.53±18.21, 143.54±4.78 and 143.40±30.19, which reduced significantly comparing to control group (274.42±3.71, t=9.963, P=0.001;t=34.961, P<0.01;Z=1.993, P=0.046); The same tendency were found when compared with cell group (WT) over-expressing wide-type αA Crystallin (192.67±1.47, Z=1.964, P=0.049;t=17.887, P<0.01;Z=1.964, P=0.049). After H₂O₂ induction for apoptosis, early apoptotic rates for three phosphorylation groups were 15.08%±0.90%, 16.59%±5.37% and 15.36%±2.62% respectively, which significantly decreased comparing with control group(41.28%±2.70%; t=21.632, P<0.01;t=8.855, t=15.450, P<0.01) and WT group(31.40%±1.64%,t=15.117, P<0.01;t=4.524, P=0.006; t= 8.988, P=0.001). No significant differences were found in both measurements between the three phosphorylation groups(F=1.08, P=0.407; x²=4.345, P=0.114).

The Ser45, Ser66 and Ser122 phosphorylation enhanced the anti-oxidative stress and anti-apoptotic capability of HLEC. (Chin J Ophthalmol, 2015, 51: 288-294)

To analyze the influence of miRNA-184 on epithelial-mesenchymal transition (EMT) of human lens epithelial cells (HLEC) induced by TGF-beta2 in vitro.

Experimental study. Recombinant plasmid of pL/IRES/GFP-miR-184 was constructed and used to produce the lentivirus. The lentivirus was used to transduce the HLEC which was in the process of EMT induced by transforming growth factor-β2 (TGF-β2). The real-time fluorescence quantitative PCR (QRT-PCR) was used to analyze E-cadherin (CDH1) , α-smooth muscle actin (α-SMA) , vimentin (VIM) expression at RNA levels during interval of 0h, 6h and 24h after transduction, in comparison with that of control group. Statistical analysis method was single factor variance analysis.

The expression level of epithelial marker gene CDH1 in the miRNA-184 transduced group maintains relatively stable during 24h interval, while it goes down in the control group. The expression level of mesenchymal cell marker gene VIM, α-SMA in the miRNA-184 transduced group maintain relatively stable, while it goes up in the control group. The results of statistical analysis showed a statistically significant difference between miRNA-184 transduced group and control group( P<0.05). Conclusion miRNA-184 lentivirus-mediated HLEC can inhibit the occurrence of EMT. (Chin J Ophthalmol, 2015, 51: 295-300)

Ten researches that may represent the most advanced cataract related studies in China were reviewed, which were recommended and voted by specialists from Chinese Cataract and Intraocular Lens Society. These researches focused on the following fields: the clinical study of the refractive cataract surgery, the clinical study on the premium intraocular lens, location and function study of the disease-associated genes of congenital cataract, the mechanism and prevention of age-related cataract, the mechanism and prevention of oxidative damage of crystalline lens and so on. These studies represented the level of crystalline lens related disease field in China.(Chin J Ophthalmol,2015,51:301-304)

The patient was a 41-year-old female. The right exophthalmos was significantly aggravated for 3 months, and he went to Xingtai Eye Hospital on April 10, 2013. One and a half years ago, the patient developed right exophthalmos without a clear trigger, and the effect of drug treatment was not good. He went to the local hospital one year ago. Orbital CT examination revealed the right orbital space-occupying lesion, and the right orbital mass biopsy was performed. The pathological diagnosis of right orbital Rosai-Dorfman disease was made in Zhejiang Cancer Hospital. Immunohistochemical staining: S100 (+), CD68 (+), CD79a (-), CD20 (-), Ki67 (+) (partial cells), Epstein-Barr virus encoding small RNA negative in situ hybridization; The pathological consultation of Fudan University Cancer Hospital considered that it was consistent with right orbital Rosai-Dorfman disease. Immunohistochemical staining: S100 (+), CD68 (+), CD1a (-), CD20 (-), CD3 (-); No other special treatment was done, and the patient felt significantly worse in the past 3 months. Admission: The patient was in good general condition and no enlarged lymph nodes were found; The visual acuity of the right eye is 1.0, the exophthalmos is obvious, the internal rotation is slightly limited, the eyelid is swollen, a skin scar about 2 mm long can be seen on the inner side of the lower eyelid 2 mm outside the eyelashes, and a hard mass can be palpable at the inner lower orbital margin, the size is about 2.5 cm ×2.0 cm. The mass is closely connected to the inner and lower wall of the orbit, with poor mobility, and no obvious abnormalities are found in the rest; The visual acuity of the left eye was 1.0, and there was no obvious abnormality in the anterior segment and fundus of the eye; Exophthalmos: right eye 20 mm, left eye 14 mm, orbital distance 92 mm; Orbital pressure: right side T +1, left side Tn; Lacrimal duct irrigation: patent on both sides. Orbital CT examination: the mass in the lower quadrant of the right orbit, the boundary is basically clear, the bone below the inner wall of the orbit is discontinuous, the mass protrudes into the nasal cavity through this place, and the right eyeball protrudes (Figure 1）； Orbital MRI: Right orbital space-occupying lesion, the tumor showed irregular T1 shorter T2 shadow, the boundary was not clear, the tumor protruded into the right ethmoid sinus and nasal cavity, and the enhanced scan showed that the lesion showed obvious contrast enhancement, and the enhanced signal was still uniform; The clinical diagnosis was a space-occupying lesion of the right orbit. On the third day after admission, the right orbital mass was resected under general anesthesia. The right eye mass was found to be located in the inner lower quadrant of the orbit, irregular in shape, tough in texture, and slightly gray-yellow in color (Figure 2), which is closely connected with the periosteum of the orbital wall, and all tumors in the orbit are removed outside the periosteum, and part of the bone in the inner wall of the orbit is destroyed; Because the pathology in the outside hospital showed benign lesions 1 year ago, and the nasal cavity lesions were greatly damaged by intraorbital resection, and may damage the lacrimal duct, resulting in complications such as dacryorrhea, so no treatment was done, and postoperative endoscopic nasal resection was recommended. Postoperative histopathological diagnosis was still considered as right orbital Rosai-Dorfman disease, immunohistochemical staining: S100 (+), CD68 (+), CD1a (-), CD20 (-), CD3 (-) (Figure 3）。 The patient was discharged 1 week after operation and followed up for 4 months. Because there were no obvious symptoms in the nose, the patient did not undergo nasal lesion resection, but there was no recurrence of intraorbital mass.

The patient was a 59-year-old male. He went to Xiamen Eye Center because of redness and pain accompanied by disappearance of vision for 5 h after his left eye was injured. Clinical diagnosis: left eyeball rupture (scleral rupture); Traumatic aphakia and aniris in left eye; traumatic vitreous hemorrhage of left eye; Retinal detachment in the left eye. Scleral debridement and suture were performed in the emergency department. One week later, vitrectomy, heavy water application, gas-liquid exchange, intraocular laser and silicone oil filling were performed. In order to avoid corneal band degeneration caused by long-term contact of silicone oil with corneal endothelium after operation, after filling the vitreous cavity with silicone oil during operation, the scleral incision was closed, the upper and lower bulbar conjunctiva were cut along the corneal limbus, and 3 groups (6) of parallel sutures were made near the ciliary sulcus with 10-0 polypropylene suture, so as to construct a fence structure with 6 sutures. After operation, the surface tension between silicone oil and water was used to intercept silicone oil at the interface between silicone oil and aqueous humor. Postoperative eye examination: visual acuity in the left eye was 1 m index (uncorrectable), intraocular pressure was 18 mmHg (1 mmHg =0.133 kPa), conjunctiva was mixed congested, the cornea was transparent, aqueous humor was visible behind the cornea, the cornea was not contacted with silicone oil, and six vertical sutures were visible in the plane of the ciliary sulcus to form an interface to intercept silicone oil (Quintessence Picture 1), the vitreous cavity is clearly filled with silicone oil, the residual retina in the fundus is in place, and the laser spot is clearly visible. For UBM inspection, seeQuintessence Picture 2。

Discovery of patients with trinitrotoluene occupational toxic cataract stage I in cataract screening work. The opacity of the lens was observed by slit lamp examination and fundus red light reflection after illumination. It was seen that there were most gray-yellow fine dot-like opacities of different sizes gathered around the lens, which were located in the anterior and posterior cortex of the lens and the adult nucleus, and the transparency of the lens cortex was reduced. Its black-and-white picture resembles the surface of the moon (Quintessence Picture 1）。 (The picture in this article won the Excellent Picture Award of the 9th Topcon Cup Ophthalmology Photo Exhibition of the 19th National Ophthalmology Academic Conference in 2014)

The patient was a 27-year-old male. Because of red eyes, eye swelling and visual acuity decrease for 3 days, he was seen in Beijing Tongren Eye Center. History of eye trauma denied. General physical examination: general condition is good, stature is slender, electrocardiogram examination shows no obvious abnormality. Eye examination: the naked visual acuity of the right eye was 0.2 and the corrected visual acuity was 0.6; The naked visual acuity of the left eye was 0.3 and the corrected visual acuity was 0.7; IOP in both eyes normal; Mild conjunctival hyperemia in both eyes, corneal edema in the central area of the right eye, endothelial folds, and complete dislocation of the lens in the anterior chamber and adherence to the corneal endothelium (Quintessence Picture 1）； Left eye iris tremor, clear aqueous humor, round pupil, presence of light response, incomplete lens dislocation; Fundus examination of both eyes is blurred. The OCT examination of the anterior segment is shown inQuintessence Picture 2。 Clinical diagnosis: Lens dislocation in both eyes (total dislocation in the right eye located in the anterior chamber).

The impact of weightlessness on the eye becomes more and more important with the increase of human space exploration. There is significant elevation in cephalad fluid and ophthalmic vein when individuals are in the state of weightlessness. In this paper, we review adverse effects in weightlessness station, including: retina damage (disc edema, choroidal folds, cotton wool spots, nerve fiber layer thickening), visual function decrease (decreased near vision, decreased ability of acquire and fixate on the target), and intraocular pressure increase. (Chin J Ophthalmol, 2015, 51: 310-313)

Neovascular glaucoma (NVG) is a group of secondary glaucoma which led by a variety of diseases that have anoxia or ischemia to the retina. Some studies have found that the etiology was related to the vascular endothelial growth factor(VEGF). At present, anti-VEGF as a treatment method to NVG, has become an important advance in the field of glaucoma research, which established a new way to improve the prognosis. This review mainly focused on the pathophysiologic basis and clinical research of NVG, fundamental research and applications about four kinds of anti-VEGF agents (Bevacizumab, Ranibizumab, Pegaptanib and Aflibercept) and application of treatment of NVG and anti-scarring in filtering surgery. The review also provided references for the clinical treatment of NVG and improving the success rate of operation. (Chin J Ophthalmol, 2015,51:314-318)

15 September 2014 Professor Yuen Ka-qin (Figure 1) passed away at the age of 95. The bad news came, and the grief was indescribable. Although Professor Yuan left us forever, but this lifelong pursuit of bright old man has left us precious spiritual wealth, her voice and smile will always remain in our hearts.