Volume 52 · Issue 02 · 2016

Femtosecond laser-assisted cataract surgery (FLACS) is a novel technology and the biggest revolution in the field of cataract in the latest several years. However, increasing large-scale population randomized controlled trials (RCT) have demonstrated that FLACS does not provide significant advantages over conventional phacoemulsification cataract surgery (CPCS) for common cataract patients. Furthermore, the cost and space requirement of the femtosecond equipment are another two limitations for the universal application of FSL in cataract surgery. However, FLACS may be beneficial for complex cataract situations, such as lens dislocation, zonular laxity, traumatic cataract, low preoperative endothelial cell values, and significant corneal astigmatism. With the progress of science and technology, FLACS can be expected to achieve integration with phacoemulsification systems, and equipment costs can be reduced, making it more widely used in clinical practice in the future. (Chin J Ophthalmol, 2016, 52: 81-84)

Accompany with dramatically growth of large-scale biological databases (such as human genome sequence), improvement of life science and development of international clinical trials, science offers great potential for improving health care through precision medicine. As a hot topic recently, precision medicine might launch a revolution of the methodology in medical research. How to achieve precision medicine in clinical ophthalmology by means of biological data mining is a challenge for ophthalmologist-scientists. The best approach for advanced individual medicine is to buildup the digital ophthalmology, which includes human eye biobank, national biological databases network, clinical department, basic research lab, and international clinical trial center. The system of digital ophthalmology could explore the methods for ophthalmology research, integrate the source of eye biologic databases, promote international cooperation, and thus eventually supply the opportunity for translational medicine. (Chin J Ophthalmol, 2016, 52: 85-88)

Femtosecond laser-assisted cataract surgery (FLACS) is known as an innovative new technology. Compared with traditional surgical approach, FLACS is more accurate, more predictable and less energy used. However, in the current stage of development, there still may be intraoperative and postoperative complications, or even serious complications. FLACS has obvious advantages in certain surgical steps, but there are still clear disadvantages, so it still cannot completely replace the traditional phacoemulsification surgery. (Chin J Ophthalmol, 2016, 52: 89-92)

To evaluate the effect of phacoemulsification on intraocular pressure (IOP) in filtered eyes with primary angle closure glaucoma (PACG).

In this retrospective case series, 47 eyes from 47 PACG patients who previously had trabeculectomy were consecutively enrolled. All patients had visually significant cataracts and phacoemulsification was performed at least 3 months after trabeculectomy. The IOPs were recorded preoperatively, 1 day, 1 week, 2 weeks, 1 month, 3 months, 6 months, 12 months and 24 months after surgery. The best correct visual acuity (BCVA) , the number of glaucoma medications and the filtered bleb grade were recorded preoperatively and 24 months after phacoemulsification. IOP and BCVA before and after phacoemulsification were compared by studentt test. The frequences of antiglaucoma medicine, bled grade and IOP control before and after phacoemulsification were compared by Mann-Whitney Test. Linear regression analysis, Pearson and Spearman were performed to assess the correlation between IOP change and other variants.

IOP was decreased significantly from (18.7±6.7) mmHg (1 mmHg=0.133 kPa) at baseline to 16.4±2.0 mmHg at final follow-up (t=2.54,P=0.015) . The median number of glaucoma medications was significantly decreased (P<0.01) at 2 years postoperatively. The magnitude of IOP reduction was significantly correlated with preoperative IOP (r=0.95, P<0.01). BCVA (LogMAR) was improved significantly at month 24 (t=5.62,P<0.01). Filtered bleb decreased insignificantly at 2 years postoperatively (P=0.113). Complete success, qualified success and failure rates in terms of IOP were 61.7%, 27.7% and 10.6% before surgery , 89.4%, 8.5%, 2.1% at 2 years postoperatively. In 29 patients with preoperative IOP≤21 mmHg, mean IOP increased insignificantly from (14.5±4.0) mmHg to (15.5 ± 2.3) (P=0.195) at 2 years. In the 18 patients with preoperative IOP> 21 mmHg, mean IOP decreased from (25.3 ± 4.4) mmHg preoperatively to (17.8 ± 2.4) mmHg (P<0.01).

Phacoemulsification reduces IOP and the number of glaucoma medications in previously filtered PACG eyes. The IOP remained normal in normal tension eyes after phacoemulsification in filtered PACG eyes but decreased significantly in hypertensive eyes.(Chin J Ophthalmol, 2016, 52: 104-109)

To investigate the safety and efficacy of cyclosporine A sustained release from modified intraocular lens for preventing posterior capsular opacification (PCO) in rabbit eyes.

Forty-five New Zealand albino rabbits undergoing phacoemulsification in their right eyes were randomly and equally divided into three groups. Group A had implanted original IOL, group B had implanted PLGA-IOL(IOL coated with polylactide-glycoli acid), and group C had implanted CsA-PLGA-IOL (CsA loaded PLGA-IOL). All the 45 eyes were examined by a slit-lamp microscope. The intraocular pressures were recorded. Anterior chamber flare and aqueous humor cells were graded at different time point after surgery. The concentrations of CsA in the aqueous humor and blood were determined by high performance liquid chromatography. Anterior segment tissue was histologically examined. Wet posterior capsules were weighed. PCO was graded 6 months later.

The mean concentrations of CsA in group C at 2 h,1 d,3 d,7 d,14 d,30 d,60 d after operation were (11.47±2.42) mg/L, (10.30±2.15) mg/L, (6.71±1.45) mg/L, (4.81±1.16) mg/L, (6.11±0.84) mg/L, (2.53±0.77) mg/L, (0.86±0.28) mg/L. The concentrations of CsA in blood were undetectable. During the early days after operation, the reactions of the anterior chamber in group A and B were more severe than group C. The initial appearance of PCO in group C was much later than in the other two groups, and the grade of PCO in group C was much lower than the other two groups. The mean weights of wet posterior capsules in group A(312.86±52.91) mg and B(310.64±62.42) mg were much heavier than that of group C(56.93 ± 24.24) mg. Histological observation showed that there was remarkably less accumulation of lens materials on the posterior capsules in group C than in the other two groups. No toxic actions were found in intraocular tissues in group C.

Our study suggested that Cyclosporin A modified intraocular lens could effectively and safely prevent the formation and development of posterior capsular opacification in rabbit eyes for a relatively long term.(Chin J Ophthalmol, 2016, 52: 110-116)

To evaluate the diagnostic value and treatment guidance of lacrimal magnetic resonance hydrography (LMRH) and lacrimal endoscopy examination in lacrimal duct obstruction.

A retrospective analysis of clinical and imaging data of 59 patients with epiphora who had LMRH examination in Tongji Hospital during June 2013 and January 2014. Multiplanar reconstruction (MPR) and maximum intensity projection (MIP) were used to process the three dimensions T₂-weighted images (T₂WI). The size of lacrimal sac, lacrimal mucosal lesions and the obstructed plane of nasolacrimal duct were observed. The lacrimal irrigation results were used as gold standard. The sensitivity, specificity, accuracy of LMRH in diagnosis of lacrimal duct obstructive diseases and the consistency between the two methods were analyzed. In addition, 22 cases had lacrimal endoscopy examination in less than half month after MRD. The results of lacrimal endoscopy were compared with LMRH images. The treatment method was made according to the results of LMRH and lacrimal endoscopy.

According to the results of lacrimal irrigation, among 78 eyes of 59 patients, 2 eyes were diagnosed as lacrimal canalicular obstruction (2.6%, 2/78), 8 eyes were diagnosed as nasolacrimal duct stenosis (10.3%, 8/78), 24 eyes were diagnosed as nasolacrimal duct obstruction (30.8%, 24/78), 44 eyes were diagnosed as nasolacrimal duct obstruction accompanied with chronic dacryocystitis (56.4%, 44/78). The other 40 eyes were negative controls. LMRH had a high degree of consistency with lacrimal irrigation in diagnosis of lacrimal duct obstructive diseases. The value of Kappa was 0.963 (P= 0.026). The sensitivity of MRD in diagnosis of lacrimal duct obstructive diseases was 97.4%, the specificity was 100%, the accuracy was 98.3%, the positive predictive value was 100% and the negative predictive value was 95.2% . According to 40 eyes of the control group, the mean value of the maximum cross-sectional area of the lacrimal sac was: (10.9 ± 0.4) mm². Twenty-two eyes underwent lacrimal endoscopy examination and the endoscopic findings were consistent with LMRH diagnosis. The lesions in the lacrimal duct displayed more clearly and intuitively than the LMRH, while LMRH had its unique advantages in showing the size of lacrimal sac, the mucosal thickness of lacrimal duct, large foreign bodies and lesions around the lacrimal duct. According to the results of LMRH and lacrimal endoscopy, 2 eyes of canalicular obstruction, 8 eyes of nasolacrimal duct stenosis, 20 eyes of nasolacrimal duct obstruction underwent lacrimal probing and stent implantation. Four eyes of nasolacrimal duct obstruction had drug treatment under lacrimal endoscopy. Thirty-eight eyes of chronic dacryocystitis underwent endonasal dacryocystorhinostomy. The other 6 eyes of chronic dacryocystitis underwent stent removal combined with endonasal dacryocystorhinostomy.

LMRH is a noninvasive and reliable method to examine the lacrimal duct obstruction. It can better display the size of lacrimal sac, lacrimal mucosal thickness and surrounding soft tissues of lacrimal duct. It is also a good complementary method of lacrimal endoscopy and has guiding significance for individualized treatment in patients with lacrimal duct obstruction.(Chin J Ophthalmol, 2016, 52: 117-122)

To determine the success rates and compare the results of balloon catheter dilation and nasolacrimal intubation as treatment for congenital nasolacrimal duct obstruction after failed probing, stratified by category of age and type of obstruction.

It was a prospective, randomized, clinical trial that enrolled 189 children (245 eyes) aged between 6 months to 48 months who had a history of failed nasolacrimal duct probing. All eyes underwent either balloon catheter nasolacrimal duct dilation or nasolacrimal duct intubation randomly. The eyes were divided into 2 age categories: category 1 (6-24 months) and category 2 (>24 months) and into 2 types of obstructions: simple obstruction and complex obstruction. Treatment success was defined as absence of epiphora, mucous discharge, or increased lacrimal lake at the outcome visit 6 months after surgery. Complications were also compared.

In 124 eyes treated with balloon catheter dilatation, 112 were successful (90.3%) comparing with 106 successful eyes (87.6%) in 121 eyes treated with nasolacrimal duct intubation. The risk ratio for success between intubation and balloon dilation was 0.971, and the 95% confidence interval was 0.95-1.22. Within each age category, the success rate varied but did not show significant difference: In those under 24 months, success rate was 89.7% in 97 eyes treated with intubation, and 91.9% in 99 eyes treated with balloon dilation (RR, 0.976; 95% CI, 0.590-0.956). In those above 24 months, success rate was 79.1% in 24 eyes treated with intubation, and 84.0% in 25 eyes treated with balloon dilation (RR, 0.942; 95%CI, 0.813-1.387). In the group of simple obstruction, success rate was 96.5% in 87 eyes treated with intubation, and 93.1% in 88 eyes treated with balloon dilation (RR, 1.036; 95% CI, 0.967-1.105). In the group of complex obstruction, Success rate was 64.7% in 34 eyes treated with intubation, and 86.1% in 36 eyes treated with balloon dilation. The success rate of balloon dilatation showed slightly higher than that of intubation (RR, 0.751; 95% CI, 0.590-0.956). There were 59 eyes showed complications in intubation group, while only 2 eyes in balloon dilation group.

Both balloon catheter dilation and nasolacrimal duct intubation could alleviate the clinical signs of persistent nasolacrimal duct obstruction with a similar percentage of patients. In the complex obstruction group, balloon catheter dilation showed better efficacy than nasolacrimal duct intubation.(Chin J Ophthalmol, 2016, 52:123-128)

To evaluate the safety and effectiveness of femtosecond laser-assisted cataract surgery.

The interventional case series enrolled 314 eyes undergoing cataract surgery in Xiamen Ophthalmic Center between April and December 2013, patients were randomized to femtosecond laser-assisted cataract surgery(153 eyes) and conventional phacoemulsification cataract surgery(161 eyes). The clincic parameters of preoperation, during operation and postoperation were compared and statistically studied. Quantitative data were analyzed using the analysis of variance, independentt tests. Qualitative datawere analyzed using the crosstabs analysis chi-square test or the Fisher's exact test.

The patient's demographics parameters(age, gender, IOP, axial length, mean keratometry, AC depth, Cataract grade) did not differ significantly between groups (P>0.05) . The CDE showing 4.78% (3.18%-8.88%) and EPT showing 14.05 s (10.07-20.85 s) in the laser group were significantly lower than the CDE showing 8.82% (6.01%-19.16%) and EPT showing 23.65 s (18.36-46.96 s) in the conventional group (z=2.30, 2.91; P<0.05) . The relative diameter and circularity in laser-assisted capusulotomies were significantly more accurate (t=2.58, 3.92; P<0.05). The corneal endothelial cell loss showing 73.50 (-69.51-111.03)/mm² was significantly lower in the laser group than the loss of 118.06 (53.55-299.03)/mm² in the conventional group 1 month postoperatively (z=2.44; P<0.05). Postoperative anterial chamber flare was significantly greater in the conventional group at 1 day of 18.81 (13.32-20.23) ph/ms in laser group, 24.51(16.38-32.18)ph/m in conventional group and at 1 month of 13.01(9.23-16.28) ph/ms in laser group, 18.05(12.37-24.97) ph/ms in conventional group than the laser group (z=2.40, 2.31; P<0.05). There were no severe surgical complications for both groups.

The femtosecond laser-assisted cataract surgery was effective and safe. It reduced EPT and CDE during operation, therefore decreased endothelial damage and postoperative anterior chamber inflammation. It also provided more precise and reproducible capsulotomies.(Chin J Ophthalmol, 2016, 52:93-98)

To evaluate the safety and efficacy of the domestic foldable one-piece aspheric intraocular lens (IOL, Model: A1-UV) for the treatment of cataract.

A prospective randomized controlled clinical research were conducted. One hundred and nineteen cases (119 eyes) of cataract patients were randomly assigned to the study group (58 cases) and the control group (61 cases). The study group were implanted with the domestic made aspheric intraocular lens (Model: A1-UV) and the control group were implanted with imported aspheric intraocular lens (Model: SN60WF, Alcon Laboratories, Inc.). The visual acuity and the slit lamp examination were evaluated 1-2 day, 1 week, 1 month, 3 months, 6 months and 1 year postoperatively. In addition, the contrast sensitivity tests were carried out 3 months, 6 months and 1 year postoperatively. Data were analyzed by chi-square test and independentt-test.

100 patients had completed 1 year of follow-up, among which 49 cases were from the study group and 51 cases were from the control group. No severe inflammation or complications associated with intraocular lens were noted in either group within 1 year follow-up. The mean BCDVA, BCNVA, UCDVA, UCNVA(Log MAR) of the study group and the control group were 0.04±0.11, 0.11±0.17, 0.13±0.20, 0.35± 0.19 and 0.07±0.15, 0.15±0.20, 0.18±0.23, 0.41±0.21 at 1 year postoperatively. No statistically significant differences were noted between groups in mean BCDVA, BCNVA, UCDVA, UCNVA (t=-1.39, P=0.166; t=- 1.25, P=0.216; t=-1.06, P=0.292; t=-1.59, P=0.116) at 1 year postoperatively. And there was no significant difference in visual acuity between the two groups (P>0.05) 1-2 day, 1 week, 1 month, 3 months and 6 months postoperatively. The difference of the contrast sensitivity between the two groups was not statistically significant (P>0.05), besides the contrast sensitivity of the study group was significantly better than the control group at 12c/d, 18 c/d under bright light(t=2.18,P=0.031;t=2.67,P=0.009) at 3 months postoperatively. And the mean contrast sensitivity of the study group and the control group at 12c/d, 18 c/d under bright light were 1.31± 0.36, 0.86± 0.41 and 1.15± 0.40, 0.65± 0.44 at 3 months postoperatively.

The safety and efficacy of the domestic made foldable one-piece aspheric intraocular lens (Model: A1-UV) for the treatment of cataract is equivalent to the imported aspheric intraocular lens (Model: SN60WF).(Chin J Ophthalmol, 2016,52: 99-103)

The patient was a 60-year-old male. On January 22, 2013, I went to the Department of Ophthalmology, West China Hospital, Sichuan University due to head trauma caused by a car accident with visual loss of my right eye for more than one year and exophthalmos of my right eye for half a year. Ophthalmic examination: visual acuity 0.12 in the right eye and 1.2 in the left eye; IOP was 21.6 mmHg (1 mmHg =0.133 kPa) in the right eye and 21.0 mmHg in the left eye. Exophthalmos: right eye 18 mm, left eye 13 mm, orbital distance 103 mm. Palpable pulsation in the right eyeball, restricted movement in all directions, swelling of the eyelid, congestion of the bulbar conjunctiva (+ + +), thick and tortuous blood vessels in the bulbar conjunctiva (Figure 1), the cornea is transparent, the remaining anterior segment (-), the border of the optic papilla is clear in the fundus, the retinal vein is tortuous and thick, and the posterior pole omentum is scattered with patchy superficial hemorrhagic foci (Figure 2), left eye (-). Eye B-ultrasound: An oval weakly echoic area was seen behind the right eyeball, with a size of about 14.55 mm ×21.53 mm (Figure 3）。 Ocular CT showed that the right eyeball was slightly protruding forward, the superior vein of the right eye was tortuous, and the diameter of the tube was obviously thickened up to 1.5 cm (Figure 4）。 Preliminary diagnosis: right carotid cavernous fistula (CCF), recommended to neurosurgery. On January 27, 2013, he went to our hospital for digital subtraction angiography (DSA) examination (Figure 5), diagnosed as right internal carotid cavernous fistula; Aneurysm of left internal carotid and ophthalmic artery segments. Interventional embolization of right internal carotid artery cavernous fistula and left internal carotid artery and ophthalmic artery segment aneurysm was performed. Ocular examination 1 week after surgery: visual acuity of right eye 0.4, intraocular pressure 20.4 mmHg, exophthalmos 14 mm. The swelling of the eyelid obviously subsided, the bulbar conjunctiva was congested (+ +), the bulbar conjunctiva was thick and tortuous, the remaining anterior segment (-), the retinal vein was thick and tortuous, and the posterior pole retina was scattered with superficial hemorrhagic foci.

The patient was a 63-year-old male. He was admitted to hospital for examination on June 27, 2013 due to double vision of both eyes for 6 days. On June 18, 2013, the patient developed double vision in both eyes without obvious trigger, with obvious double vision to the left and reduced double vision to the right. At first, the patient did not pay attention to it, but the symptoms have not improved significantly in the past week. He came to see a doctor and was admitted to the hospital with "left eye external rectus paralysis". Eye examination: visual acuity 0.4 for right eye (correction 0.6+), 0.5 for left eye (correction 0.8); Both eyes: the lens was slightly opaque, and no obvious abnormality was seen in the remaining anterior and posterior segments; There was no obvious abnormality in the rotation of the right eyeball in all directions, while the external rotation of the left eye was obviously limited, and there was no obvious abnormality in the rotation in other directions. After admission, skull MRI plain scan showed abnormal signal focus in the slope area (Figure 1), MRI enhancement revealed a patchy abnormal signal in the slope area, with enhancement, suggesting chordoma (Figure 2）。 Later, the patient went to a hospital in Shanghai and was diagnosed with "skull base chordoma". The patient abandoned treatment for personal reasons and was subsequently lost to follow-up.

Miller-Fisher syndrome (MFS) is an acute, immune-related cranial nerve demyelinating disease. Clinically, ophthalmoplegia, ataxia and loss of tendon reflexes are the classic triad manifestations, often accompanied by increased blood GQ1B antibody. The pupillary sphincter can also be involved in this syndrome, so except for diplopia, ataxia, unstable walking and other symptoms, some patients may be accompanied by tonic pupil or mydriasis and fixation, photophobia, and blurred near vision. Patients with pupillary sphincter paralysis as the first or main symptom often see an ophthalmologist rather than a neurologist department. We report the clinical characteristics of pupillary involvement in 2 patients with MFS syndrome, so as to provide a basis for better interpretation of the pathogenesis and localization diagnosis of MFS syndrome.

患者男性，38岁。因左眼二期后房型IOL植入术后胀痛1个月余，于2008年12月26日来解放军总医院就诊。8年前患者因反复玻璃体积血，于当地医院确诊为双眼视网膜静脉周围炎，先后行右眼视网膜激光光凝治疗1次，左眼3次。左眼第3次激光光凝治疗后视力突然下降至光感，检查发现玻璃体大量积血，给予口服普洛碘胺等药物保守治疗（具体剂量不详），出血逐渐吸收，1年后视力逐渐提高至0.8。4年前再次视力下降，给予同样治疗，疗效欠佳。2年前检查发现左眼并发性白内障，于2008年8月行超声乳化白内障吸除术，术后反复眼压增高，局部滴用降眼压药物眼压多能控制，偶尔需要静脉滴注甘露醇。2008年11月用镜片矫正视力0.3，行IOL植入术，术中具体情况不详。术后视力可达0.2~0.3,但眼压升高至40~50 mmHg（1 mmHg=0.133 kPa），给予降眼压药治疗，球后封闭，眼压仍不能控制，并多次行前房穿刺术，但病情无法控制，转来我院进行进一步诊断和治疗。入院全身检查：右侧颜面部血管瘤，左侧颜面部太田痣（图1），余全身未见异常。眼部检查：裸眼视力：右眼1.0，左眼为眼前10 cm指数，光定位准确；右眼下睑皮肤及上睑缘部可见血管瘤，鼻侧巩膜表面血管呈串珠状，角膜透明，无角膜后沉积物，前房深，房水清，虹膜纹理清，晶状体透明，眼底视乳头界清，色正，杯盘比约0.3，周边部视网膜可见激光斑，未见血管瘤；左眼眼睑皮肤可见太田痣，结膜充血（++），角膜水肿，无KP，前房深，房水清，虹膜纹理欠清，瞳孔大，直径约5 mm，对光反射迟钝，IOL位于后房睫状沟内，其表面可见色素沉积，后囊膜不完整，玻璃体腔可见大量陈旧性积血及色素颗粒，可见玻璃体视网膜牵拉条索，间接眼底镜下视乳头界清，颜色基本正常，杯盘比约0.3，无视网膜脱离；眼压：右眼18 mmHg，左眼47 mmHg。入院诊断：（1）左眼继发性青光眼；（2）左眼IOL眼；（3）双眼Eales病。入院当天急诊予降眼压药物及左眼前房穿刺术，疗效欠佳，完善相关检查及化验后予左眼玻璃体切除术，术中见左眼巩膜表面大片色素沉着，玻璃体腔内陈旧性积血及大量色素颗粒，未见视网膜脱离。术后第1天左眼眼压29 mmHg，予抗炎及马来酸噻吗洛尔滴眼液和布林佐胺滴眼液等药物，10天后眼压逐渐降至21 mmHg，带药出院。术后两周仅用曲伏前列素滴眼液（自备）维持治疗，当地医院复查左眼眼压为16 mmHg。术后1个月复查眼压14 mmHg。之后用药不规律，眼压间断高至22~30 mmHg，术后1年来我院复查：左眼眼压23 mmHg，房角镜检查发现双眼房角更多量色素堆积，予降眼压药物治疗。

The patient was a female, 45 years old. Because of blurred vision in both eyes since childhood, he went to Tianjin Eye Hospital. There was no other medical history. The whole body examination showed no obvious abnormalities. Eye examination: visual acuity was 0.5 for the right eye and 0.2 for the left eye; The cornea of the right eye is transparent, and the upper part of the pupil area is obscured by the iris residual membrane. After the pupil is dilated, the membranous residual membrane in the central part is adhered to the anterior pole of the lens, and the peripheral filamentous residual membrane is radially connected to the iris ring, and the lower part of the filamentous residual membrane seems to be broken (Essence Picture 1A）； The cornea of the left eye is transparent, and the residual iris almost completely covers the pupil, with small holes in between. After the pupil is dilated, the residual iris is partially adhered to the anterior pole of the lens, and its base is connected to the small iris ring in the shape of a cord (Quintessence Picture 1B）； The pupils of both eyes reacted to light, the lens was transparent, and no obvious abnormalities were found in the vitreous body and fundus examination. Ultrasound biomicroscopy is shown inQuintessence Picture 2。 Clinical diagnosis: congenital residual membranes of pupils in both eyes; Amblyopia in both eyes.

The patient was a 12-year-old girl. Since childhood, both eyes are photophobic with white hair and skin, and he was seen in Changchun Aier Eye Hospital. Eye examination: visual acuity in both eyes was 1.0; IOP was 12 mmHg (1 mmHg =0.133 kPa) in the right eye and 11 mmHg in the left eye; The iris was light gray in both eyes (Quintessence Picture 1), for fundus conditions seeQuintessence Picture 2。 Clinical diagnosis: binocular albinism.

Congenital cataract is the common cause of visual disability in children. Nearly one third of congenital cataract cases may have a related genetic mutation. With the development of molecular genetics, especially gentechnik, more and more genes, such as crystallin genes, membrane protein genes, eytoskeletal protein genes and regulatory protein genes have been confirmed to participate in the process of congenital cataract. Furthermore, crystallin genes account for most of these genes and the crystallin has the highest amount of the whole protein in lens.It has been found that nearly one hundred mutations in crystallin genes are associated with the onset of congenital cataract. Researchers are exploring how these mutations further affect the function of cellular biology and eventually lead to cataract. Although more and more research results gradually reveal the pathogenesis of congenital cataract from the level of gene and protein, the specific pathogenesis is still unclear. The recent progression about inherited congenital cataract related with crysallin genes is summarized in this review. (Chin J Ophthalmol, 2016, 52: 141-149)

Immune reconstitution inflammatory syndrome (IRIS) is a collection of inflammatory disorders associated with paradoxical worsening of preexisting infectious processes or emerging diseases or even dead after the initiation of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV) infected individuals in a period of recovery of immune function. Ocular immune reconstitution inflammatory syndrome is mainly caused by cytomegalovirus which performing a series of ocular inflammation accompanied with the increase of CD4+ T lymphocytes, such as cytomegalovirus retinitis, after HAART. With HAART widely used, the patients of IRIS gradually increased. But the clinical presentations of IRIS were various because of different pathogens. This review summarized the clinical manifestations, risk factors, diagnosis and treatment of ocular IRIS.(Chin J Ophthalmol, 2016, 51: 150-153)

Ophthalmology Branch of Chinese Medical Association (formerly known as Chinese Ophthalmology Society) is the first and largest ophthalmology academic group in China, with a history of 78 years, and has played a great role in promoting the development of ophthalmology in China. Carefully studying the history of its establishment and development can make more ophthalmologists, especially the younger generation of ophthalmologists, understand the development process of modern ophthalmology in China, the hardships and the joy of success of ophthalmology predecessors, which is conducive to better carrying out and consciously doing a good job in the work of Ophthalmology Branch of Chinese Medical Association in the future, and continue to promote the development of ophthalmology in China.

The first "West Lake International Cataract and Intraocular Lens Summit Forum" sponsored by Zhejiang Medical Doctors Association and jointly organized by Ophthalmologist Branch of Zhejiang Medical Doctors Association and Ophthalmology Center of the Second Affiliated Hospital of Zhejiang University School of Medicine was held in Hangzhou from September 17 to 19, 2015. This forum was attended by more than 70 ophthalmologists, more than 1,500 registered representatives and more than 500 manufacturer representatives from home and abroad.

This issue focuses on the clinical and basic research of cataract and intraocular lens. The responsible editorial committee responsible for the planning, composition and review of this issue is Professor Liu Yizhi.