Volume 46 · Issue 08 · 2010

At present, the aspherical intraocular lens (IOL) has gradually become a general IOL after the cataract surgery. All aspherical IOL are different in the amount of aberration, the material and the structure design. Therefore, the clinicians should understand the characteristics of various aspherical IOL, know which kind of patients can benefit from the implantation of an asperical IOL, how to select a correct aspherical IOL as well as how to take advantage of aspherical IOL, etc. Patients can obtain a better vision after the implantation of asperical IOL only if they receive a correct selection of asperical IOL.

The phakic intraocular lens implantation (PIOL) is a promising surgical method for the correction of myopia. It offers better visual quality as well as more stable and predictable refraction after the surgery. It must be recognized that the design of such intraocular lens has not been perfect, and the implanted PIOL would affect the structures surrounding it. The surgeon should pay close attention to the indications of different PIOLs and the specification of the operation. It is necessary to have a long-term postoperative follow-up for the reduction of the incidence of various complications.

：Objective To evaluatethe visual performance after implantation of the Tecnis ZM900 multifocal intraocular lens(IOL) ( TMF) and the Restor SA60D3 multifocal IOL (Restor). Methods In a prospectivestudy, TMF or Restor was implanted randomly in 73 patients (90 eyes) . The followingparameters were assessed 3 months after surgery: refraction, uncorrected and bestcorrected visual acuities (VA) for distance, intermediate, near and different contrastlevels, reading ability, pupil size, wave-front error, defocus curve and position of IOLPatient satisfaction (overall satisfaction, spectacle independence, photic phenomena) wasassessed by a questionnaire. The chi-square test was applied to compare categoricalvariables and Mann-Whitney U test was used to compare the measured data. Results Theuncorrected, best corrected and/or distance-corrected VA for distance, intermediate, nearand different contrast levels did not show statistically significant differences betweenthe two groups (P > 0. 05 ). Near reading acuity and reading speed were better in TMFunder low-light conditions (Z= -2.579, P=0.009; Z = -5.244, P=0.000). The curve of defocusshowed that TMF had significantly better intermediate distance (at 50 cm) (Z = -5.300, P =0.000) and worse near distance (from 25 to 28 cm) than those of Restor (Z= -3.745, P = 0.000; Z= -5. 691, P=0. 000). Measurements under pupil diameter at 3. 0 mm and 5. 0 mm,ocular and intraocularZ (4, 0) were significantly lower (Z = -8.175, P = 0.000; Z= -5.210,P=0.000andZ = -4.453, P=0.000; Z= -3.790, P = 0.000) , the values of PSF Strehl Ratio andMTF AreaRatio A/D were significantly higher (Z = - 3. 047, P = 0. 002; Z = - 3. 672, P =0. 008 and Z = - 2. 038, P = 0.042; Z = -2.579, P =0.009) in TMF than those in Restor. Onthe questionnaire, there was no difference of overall satisfaction, spectacle independenceand photic phenomena (P > 0.05 ). Conclusions Implantation of the TMF and Restor offersexcellent distant and near VA. Restor had better near VA than that of TMF based on thecurve of depth, TMF had better VA at 50 cm-distance. Reading speed is faster in TMF.Compared to spherical Restor, TMF provides a better quality of vision due to a negativespherical aberration.

Objective To evaluate the visual quality in patients implanted with aspheric diffractive multifocal intraocular lens. Methods Prospective nonrandomized controlled study. One hundred cataract eyes in 50 patients were included. Patients received AcrySof IQ ReSTOR IOL (SN6AD3) or AcrySof IQ IOL (SN60WF) implantation. The follow up period was 6 months. The mean of unconnected distance visual acuity ( UCDVA) , best corrected distance visual acuity ( BCDVA), unconnected near visual acuity (UCNVA), best distance-corrected near visual acuity (BCNVA) and intermediate unconrrected visual acuity in patients with SN6AD3 and SN60WF was compared preoperatively and postoperatively in all patients. Photopic and mesopic contrast sensitivity function with and without glare were tested at 6 months after operation. Aberrations were recorded postoperatively. Subjective outcomes were assessed by VF-14 questionnaire. The chi-square test was applied to compare categorical variables and the paired-samples t test was used to compare the measure data. Results Postoperatively, there were no significant differences between groups in spherical equivalent (SE) (t=0.233, P = 0.876), UCDVA (t = 1.018, P=0.265) or BCNVA (t = 0. 679, P = 0. 501). The BCDVA in the monofocal IOL group was better than that in the multifocal IOL group (t = 2. 388, P = 0. 021). UCNVA improved remarkably after the implantation of multifocal IOL (t = 11. 311 ,P =0.000). The intermediate UCVA in the monofocal IOL eyes was butter than that in the multifocal IOL at 60 cm(t =2.414,P=0.020). The total aberration (F = 5. 169,P =0. 041), total low grade (F =4.973,P =0.036) and total high grade total aberrations (F =4.640,P = 0.048) were higher in the multifocal IOL group. There was no difference between these two groups in the defocus ( F = 0.862, P=0.358), astigmatism(F=3.893, P=0.052), spherical aberration(F = 1.743, P=0.055), coma(F＝2. 724, P = 0. 105) and trefoil ( F = 3. 014, P = 0. 109). Contrast sensitivity in eyes with multifocal IOL was lower than that in eyes with monofocal IOL, especially under mesopic conditions without glare at 6 c/d (t =2.16,P=0.041) at 3 c/d (t =2.329,P=0.029) and 6 c/d under mesopic conditions with glare (t = 2.087, P =0.048). Most patients were satisfied with their IOL implantation. Percentage of patients wearing spectacle for distance vision were less than 4% in all groups. Percentage in patients wearing spectacle for near vision in SN60WF and SN6AD3 groups was 60% and 16% , respectively. Percentage of overall spectacle wear was 64% and 24% in patients wearing SN60WF and SN6AD3, respectively. On the questionnaire, patients in multifocal IOL group complained with double vision, trouble in night vision and halo; while patients in monofocal IOL group noted more about near blur. Conclusion Compared with monofocal lenses, multifocal IOL provide greater depth of focus so that better near vision, higher percentage of spectacle independence and satisfactory visual function, are obtained but the contrast sensitivity decreases slightly.

Objective To evaluate the visual acuity and subjective satisfaction of different aged monocular cataract patients who were implanted with ReSTOR multifocal intraocular lens ( MIOL). Methods Prospective comparative study; the objects are 24 cases of monocular cataract patients who consecutively received phacoemulsification and implantation of ReSTOR MIOL. The patients were divided into two groups by age; the presbyopic group has 17 cases with age≥45 years, the non-presbyopic group has 7 cases with ages<45 years. Research parameters; unconnected and corrected distance (4m), intermediate (80 cm, 60 cm), and near visual acuity; contrast sensitivity (CS); and questionnaire survey. All data were statistically analyzed with rank sum test. Results Among presbyopia patients, the near vision of the eyes implanted with ReSTOR MIOL is better than that of the contralateral eyes with clear lens (Z =2. 864, Z = 2. 911 ;P = 0. 004) , whereas the distance and intermediate vision and the CS results show no significant differences compared to that of contralateral eyes with clear lens (Z =0.183—1. 417 ,P =0. 855-0.156) ; the subjective satisfactions are 7 to 10 points with 70. 6% (12/17) patients scoring higher than 9 points; and the spectacle-independent rate among presbyopia patients is 58.8% (10/17). In non-presbyopic group, the near and intermediate visions of ReSTOR MIOL implanted eyes are lower than that of the contralateral eyes with clear lens (Z=2.197-2. 371 ;P =0.028—0.018) ; CS results of MIOL implanted eyes are also generally lower than that of the contralateral eyes, and the difference between CSs of bilateral eyes under night glare mode (3 cd/m2 4-28 Lux) with low spatial frequency (1.5 c/d) is statistically significant (Z = 1.997,P =0.046) ; the subjective satisfactions are 6 to 9 points with 14. 3% (1/7) patients scoring higher than 9 points; the spectacle-independent rate of both eyes is 85.7% (6/7). Conclusions The monocular cataract patients with presbyopia are suitable for implantation of ReSTOR MIOL, because their near visual acuity of ReSTOR MIOL implanted eyes is better than that of the contralateral clear lens eyes with higher subjective satisfaction and without decrease in distance and intermediate visions and CS. For non-presbyopic young patients with monocular cataracts, the near and intermediate visions of MIOL implanted eyes are lower than that of the contralateral clear lens eyes and with lower subjective satisfaction ( compared to that of presbyopic patients), though the distance visions are similar. Therefore, although ReSTOR MIOL can be implanted in non-presbyopic group, a more detailed preoperative communication with these patients is needed.

Objective To report clinical, histopathologic, ultrastructural, and chemical features of extracted hydrogel intraocular lens ( IOL, Bausch and Lomb, H60M) from patients who had visual disturbances caused by postoperative opacification of the lens, and discuss the possible causes of this phenomenon. Methods Four cases (4 eyes) were presented after uneventful phacoemulsification and IOL implantation. Two IOLs were removed from 2 patients (2 eyes) with severe decreased visual acuity. Clinical aspects of patients who had opacification of this IOL were observed. Extracted lenses were stained with alizarin red (special stains for calcium) , examined by scanning electron microscope (SEM) and energy dispersive x-ray spectroscopy ( EDS). Results The extracted lenses showed positive staining for alizarin red, indicating that calcium was present on the surface. SEM disclosed coralliform deposits on the superficial substance of the IOL optic. EDS showed that the presence of calcium and phosphorus mainly in the opacification region. Conclusions The surface of the IOL is subject to opacification as a result of calcium phosphate deposition, thereby limiting the patient's visual outcome, and in some cases necessitating the extraction of the lens. These changes may be relavent to the nature of the materials used for the construction of hydrogel IOLs. This important clinical problem requires further studies.

Objective To study the significance of optic disc tomography and retinal nerve fiber layer ( RNFL) thickness measurement by spectral-domain optical coherence tomography ( OCT) in the diagnosis of glaucoma. Methods It was a noninterventional, observational study. The optic disc topographic parameters and total and regional RNFL thickness were measured by RTVue OCT in 60 normal eyes and 97 glaucomatous eyes. One-way analysis of variance was used to compare the parameters above mentioned between mormal and glaucomatous groups. The area under the receiver operating characteristic curve (AUC) and the sensitivity at 80% specificity were used to assess the ability of each testing parameter in the differentiation between normal and glaucoma eyes. Results There were statistically significant differences in all RTVue OCT measurement parameters ( F = 1. 024, P = 0. 596; F = 36. 519,54. 464, 27.659,36.176,20. 562,63. 833,30. 031,54. 652,98. 146,78. 705,99. 839,43.728, 75. 720,45. 709, 39. 380,33.590,66. 887,78.335,45.485;P=0. 000) except disc area. The average RNFL thickness in normal, early, moderate and advanced glaucomatous eyes was 109.950, 93.313, 80.374 and 65.570 μm, respectively. Among the eight regions around the optic disc, the thickest RNFL was located at the inferotemporal (150. 066 μm) and superotemporal (146. 285 μm) regions in normal eyes, and the superotemporal (108.569, 103.420 and 88.708 (μm in early, moderate and advanced glaucomatous eyes, respectively) and inferotemporal ( 108. 201, 102. 830 and 86. 369 μm in early, moderate and advanced glaucomatous eyes, respectively) regions in glaucomatous eyes. Both in normal and glaucomatous eyes, the thinnest RNFL was located at the nasal and temporal regions, respectively. For optic disc topographic parameters, the highest AUC was vertical cup/disc ratio (AUC =0. 762, 0. 946 and 0. 988 in early, moderate and advanced glaucomatous eyes, respectively), and the sensitivity at 80% specificity was 62. 2% , 76. 5% and 99.2% in early, moderate and advanced glaucomatous eyes, respectively. For RNFL thickness, the highest AUC was superotemporal region RNFL thickness (AUC =0. 915) and the sensitivity at 80% specificity was 89. 5% in early glaucomatous eyes. The highest AUC was inferior average RNFL thickness (AUC = 0.967) and the sensitivity at 80% specificity was 94.1 % in moderate glaucomatous eyes. The highest AUC was average RNFL thickness ( AUC = 0.985) and the sensitivity at 80% specificity was 99.2% in advanced glaucomatous eyes. Among the eight regions around the optic disc, RNFL thickness of region ST (AUC = 0. 915, 0. 926 and 0. 966 in early, moderate and advanced glaucomatous eyes, respectively) achieved the highest AUC. RNFL thicknesses of the nasal and temporal regions showed the lowest AUCs. Conclusions RTVue OCT shows fair discriminating ability in distinguishing normal from glaucomatous eyes. RTVue OCT is a useful equipment for the diagnosis of glaucoma.

Objective To investigate the characteristics of fundus autofluorescence (FAF) patterns of drusen in patients with nonexudative age-related macular degeneration ( AMD). Methods It was a retrospective case series study. Spatial distribution and intensity of FAF of 63 cases (78 eyes) with nonexudative AMD were recorded using a confocal scanning laser ophthalmoscopy ( cSLO, Heidelberg Retina Angiograph 2, HRA2, Heidelberg, Germany), the excitation light used was at 488 run (argon laser), emission light at 514 nm (barrier filter) , and fundus field-of-view at 30-degrees. Color fundus photographs were obtained with Kowa Nonmyd 7. Three-dimensional fundus images were captured by spectral domain optical coherence tomography (Topcon, 3D OCT-1000, Japan). Results The FAF changes did not correlate topographically with visible fundus changes and 3D-OCT images in 78 eyes with drusen in nonexudative AMD. The majority of these eyes (68 out of 78) showed abnormal FAF signal of drusen at the posterior pole, which could be classified into seven different patterns according to their different features: minimal, focal confluent, linear, patchy, lace-like, speckled and scattered changes. In the remaining 10 eyes, the small lesions presented in color fundus photos were not detected in FAF examination. Therefore, a homogeneous background signal similar to the normal fundus was obtained by FAF examination. In addition, IS patients exhibited abnormal autofluorescence in both eyes, 13 of them showed asymmetrical FAF changes, indicating that asymmetrical lesions might be presented. Conclusions Various patterns of abnormal FAF can be clearly imaged with HRA2-cSLO in nonexudative AMD, reflecting different stages of this disease. Periodic observation of drusen with FAF examination is of great clinical value in the estimation of occurrence and development of AMD.

Objective To compare clinical results between the laser in situ keratomileusis ( LASIK) surgery and the laser subepithelial keratomileusis (LASEK) surgery as the second operation after an unsuccessful LASIK surgery. Methods Thirty one patients (62 eyes) with refractive regression or under-correction after LASIK operation received the second surgery. Thirty eyes received LASIK surgery (group A) and 32 eyes received LASEK surgery (group B). The follow-up period was one year. The main parameters included visual acuity, refraction, corneal curvature, and the total value of high-aberration. Results The difference in visual acuity in one week postoperation between both group was statistically significant(t=5.21, P<0.01) , the acuity of LASEK group(0.57 ±0. 11) was obviously lower LASIK group(0.79 ±0.21). There is no difference in acuity between both group in 1 month and lyear postop. The difference in uncorrected visual acuity, average spherical equivalent refractive degree, average corneal curvature, and the total value of high - aberration between both group 1 year after operation was statistically not significant. Uncorrected visual acuity ( A group 0.84 ± 0. 15, Bgroup 0. 82 ± 0. 11, t = 0. 60 ) , average spherical equivalent refractive degree(A group -0.34 ±1.15,B group -0.32 ±1.13,t= -0.07),average corneal curvature(A group 37. 87 ±1. 95, B group 38. 47 ±2. 15,t = - 1. 15) ,the total value of high -aberration (A group 0. 45 ±0. 11, B group 0. 48 ± 0. 13, t = - 0. 98). One patient developed epithelium ingrowth after LASIK surgery. One patient suffered from 2 + haze after LASEK surgery. Conclusion Both LASIK and LASEK surgery can obtain satisfactory therapeutic results after an unsuccessful LASIK surgery.

Objective To investigate the differentiation potential of human bone marrow mesenchymal stem cells (hMSC) inducing into epithelial-like cells, even comeal epithelial-like cells, and to discuss the plasticity that make hMSC the seed cells used in comeal tissue engineering. Methods hMSC were isolated and purified by density gradient centrifugation combined with an attachment culture method and passaged in vitro. hMSC were identified by flow cytometry. The passaged hMSC were planted on fresh pig comeal Bowman's membrane. The expression of CK12, ABCG2 and CK19 in hMSC was identified by immunofluorescence staining. We used in vitro method to obtain a multilayer culture of hMSC. When hMSC formed a monolayer, the cells were inserted to Millicell culture and grew into multilauers by using the airlifting cultivation methodology. Four weeks later, after fixed and dehydrated, the hMSC were observed under the light microscope after hemotoxylin and eosin (HE) and immunohistochemistry staining. Results hMSC could be cultured, expanded in vitro, and showed great potential of proliferation. The result of flow cytometry showed that the positive staining percentage was 0.06% for CD45, 0.41% for CD34, 86.43% for CD44, 85.72% for CD29 and 90.72% for CD105. This indicated that hMSC expressed CD44, CD29, CD105 but not CD45 and CD34. After four weeks induction, part of hMSC expressed CK12 and CK19 but not ABCC2. In the in vitro stratification, HE and immunohistochemical staining showed that there were one or two layers epithelial-like cells, even corneal epithelial-like cells after using the air-lifting cultivation. Conclusions This study suggests that hMSC have the potential to differentiate into epithelial cells, even corneal epithelial cells. hMSC could be the option of cells used to reconstruct the comeal epithelium by tissue engineering technology.

Objective The guinea pig becomes an important model for studies on myopia, but little is known about its visual performance. In this study, grating acuity was measured using a custom-built automated device to track optomotor responses. Methods To record head nystagmus, guinea pigs were individually placed in the center of a rotating drum of 130 cm diameter. The drum was covered inside with square wave gratings of adjustable fundamental spatial frequencies and contrast. The turning movements of the head were tracked using custom-written video software that detected two little white spots painted on a small black piece of cardboard that was attached to the guinea pig' s head. Angular head speed was determined from the positions of the two white spots with respect to each other over time, and the ratio of angular head speed to drum speed was determined (the " gain" ). In 11 guinea pigs of the same age, but with different refractive states ( +9. 7 to -15. OD), responses to spatial frequencies of 0. 6 and 2. 4 cyc/deg were tested. Furthermore, 17 guinea pigs were tested which had similar refractive states but were different in age (1 to 3 months old). Finally, the effects of different grating contrasts were studied (25% , 50% and 100% contrast respectively) and the effects of different stripe luminances ( 10, 30, and 350 cd/m2 respectively). Results The optomotor response could be used to measure vision in one eye only even if both eyes opened. The optomotor gain was affected by refractive error. Younger animals (one month old) had lower optomotor gain than older ones (0. 61 ±0. 2 in one-month, 0. 77 ±0. 13 in two-month and 0. 80 ±0. 11 in three-month old). For a spatial frequency of 0. 6 cyc/deg, the effects of stripe contrast were tested in two months old guinea pigs. At an average stripe luminance of 30 cd/m2, the optomotor gain dropped from 0. 95± 0. 20 at maximal contrast, to 0. 94 ± 0. 16 at 50% contrast, and 0. 70 ± 0.10 at 25% contrast At three different luminances, gains were 0. 81 ± 0. 25 (10 cd/m2), 0. 95 ± 0. 20 (30 cd/m2) , and 0. 80±0.09 (350 cd/m2), measured with gratings of 100% contrast, respectively. Conclusions Myopic guinea pigs have reduced grating acuity compared to hyperopic ones. The optomotor gain increases with age. For a given grating contrast, the highest optomotor gains are obtained at the highest luminance of 30 cd/m2. In summary, spatial vision in guinea pig declines with the magnitude of myopia, and increases with luminance and age.

Objective To observe the role and possible mechanism of regulators of C-protein signaling 5 ( RGS5) in the development of experimental choroidal neovascularization (CNV). Methods It was an experimental study. A total of 88 male Brown Norway ( BN) rats underwent the 532 run photocoagulation to set up the CNV model. Forty of them were sort by time after the photocoagulation as follows: 1 d (n=6), 3 d (n=6), 7 d (n=7) and 14 d (n=21), then 48 of them were divided by treatment factor; intravitreal injection of physiological saline or Avastin. Nineteen of them served as the controls. The expression of RGS5 and VEGF were examined by immunofluorescence, western blot and reverse transcription polymerase chain reaction ( RT-PCR). The thickness and area of CNV were qualified by histopathological sections and choroidal flatmounts. All of the results were analyzed by Student's I-test. Results (1) The expression of RGS5 and VEGF proteins: there was no statistical significance in gray-scale value of RGS5 between 14 d group (0. 899 ±0. 057) and control group (0. 820 ±0.032), although RGS5 expression reached a peak at 14 days (t =2.079,P>0.05). There was statistical significance in gray-scale value of VEGF between 7 d group (0. 600 ± 0. 031) and control group (0. 382 ± 0. 036) , and VEGF expression reached a peak at 7 days (t = 7. 959, P < 0. 01). (2) The expression of RGS5 and VEGF mRNAs: the RGS5 mRNA expression decreased at 1 day (0.763 ±0.035) and 3 days (0.725 ±0.054) in comparison with the control (0.886 ±0.047, t =3.646, 3.888; P<0.05, 0.05), and reached a peak at 14 days after photocoagulation (t = 2.194,P>0.05). There was statistical significance in gray-scale value of VEGF between 7 d group (0. 855 ±0.029) and control group (0. 274 ±0. 039), and VEGF expression reached a peak at 7 days after photocoagulation (( = 20.709, P < 0.01). (3) The changes of thickness and area of CNV: the thickness and area of CNV were significantly decreased (t = 2. 616, 15.179; P < 0. 05, 0.01) after intravitreal injection with Avastin. Conclusions RGS5 and VEGF coexpressed in the area of CNV, and RGS5 expressed later than VEGF. The expression of RGS5 was decreased when CNV was inhibited by anti-VEGF treatment. Therfore, it is possible that RGS5 may be involved in VEGF-regulated CNV formation.

Behcet disease was a chronic and recurrent systemic vasculitis, the etiology and pathogenesis were not fully understood, the infectious agents, autoimmunological mechanisms and genetic factors were involved. The treatment of complicated uveitis was difficult and the visual prognosis was usually poor. The current treatment strategies of Behcet disease included immunosuppressive agents, systemic corticosteroids and biological agents. The combinations of these drugs were the rules.

The patient was a 38-year-old female who went to the Department of Ophthalmology of the First Affiliated Hospital of China Medical University on December 3, 2007 due to right exophthalmos for 7 years and 4 years after right intraorbital mass extraction. The patient underwent right intraorbital mass extraction 7 years ago, and the eyeball exophthalmos again with facial nerve paralysis such as visual loss, right ear hearing loss and ipsilateral angle of mouth distortion for nearly 4 years.

The patient was a 49-year-old female who was admitted to hospital on March 17, 2009, mainly due to the gradual bulge of the upper edge of the right orbit for 5 years. The patient found the bulge of the upper edge of the right orbit in 2004, which gradually aggravated and was not treated. The patient had no history of trauma or primary bone tumor. After admission, there was no abnormality in the general physical examination. Ophthalmological examination: visual acuity: 0.12 in the right eye and 0.6 in the left eye. The upper edge of the right orbit was full, and the bone was bulged, about 5 cm ×5 cm ×3 cm in size. The right eyeball was displaced downward, without obvious restriction of eye movement. The exophthalmos of the right eye was 15 mm, the left eye was 11 mm, and the orbital distance was 95 mm. No abnormalities were found in the outer eyes and fundus of the remaining two eyes. Orbital CT showed that the upper wall of the right orbit occupied a round space, with a CT value of 16.5 Hu. The bone was compressed and thinned, and the intracranial and frontal sinus were not invaded. Preliminary diagnosis: aneurysmal bone cyst in the upper wall of the right orbit.

The patient was a 16-year-old male with small right eye and unable to open since birth.He went to Nanjing Ningyi Eye Center of Drum Tower Hospital affiliated to Nanjing University School of Medicine in July 2008.No obvious abnormalities were found in the whole body examination.Eye examination: the visual acuity in the right eye was no light sensation, and the left eye was 0.5.

A 26-year-old woman suffered from forehead psoriasis for 3 years. On July 15, 2009, she went to a local clinic for subcutaneous injection of triamcinolone acetonide suspension (dose unknown) in the middle of her forehead. After injection, she felt pain in the eyebrow arch and nasal eyelid of her right eye, and lost sight after about 30 minutes, so she went to another hospital for treatment. She was diagnosed as central retinal artery occlusion (local medical conditions were limited, and fluorescein fundus angiography was not done). She was given sublingual nitroglycerin, low-flow oxygen inhalation for 2 h/d, oral acetazolamide to reduce intraocular pressure, vasodilator and fibrinolytic agent, and interventional thrombolytic therapy.

Albinism is a genetic disease caused by the mutation of different genes, which leads to the defect of melanin or melanosome biosynthesis, and thus manifests as the deficiency of skin, eyes, hair and other pigments. Clinically, if the patient only manifests in local eye involvement, and the clinical manifestation is atypical and difficult to distinguish, it is easy for clinicians to misdiagnose it. In 2009, 3 patients with congenital albinism in one family were diagnosed and treated in our hospital. The eyes only showed obvious depigmentation of monocular iris and fundus retina, but no other manifestations such as nystagmus and strabismus. Moreover, the genetic mode did not show the common X-linked recessive mode, but showed the autosomal recessive mode.

Cataract is the most common eye disease causing blindness in humans, which has been mainly treated by surgery, lacking effective prevention and drug treatment.Pathological myopia complicated with cataract is a common kind of cataract in clinic.It occurs earlier and develops faster, but the pathogenesis is not completely understanded.Proteomics, which represents the research center of post-genome era, has opened up a new way for the study of cataract. This study attempts to establish a research system of human lens proteomics, compare the changes of pathological myopia complicated with cataract and normal lens protein profiles, identify related proteins, and lay a foundation for studying the pathogenesis of pathological myopia complicated with cataract and finding effective therapeutic drugs.

Conjunctiva relaxation is a common age-related eye disease in the elderly [1-2]. With the aging of the population, the number of patients with conjunctiva relaxation will increase day by day. Histopathological studies have shown that elastic fibrosis occurs in the conjunctival tissue of conjunctiva relaxation [3]. Elastic tissue degeneration is a histopathological characteristic of palpebral cleft plaque and pterygium, and it is a sign of photochemical damage caused by ultraviolet light. Some studies have shown that conjunctiva relaxation is also related to the inflammatory reaction on the eye surface [4]. Whether ultraviolet light or inflammatory reaction, or the combination of both or other factors, may be used as stressors to induce stress response in conjunctival cells.

If the topic involved in the thesis is a national or ministerial or provincial fund or key project, the name of the fund project should be indicated with "Fund Project": as a logo at the beginning of the article, and the project number should be indicated in parentheses. The name of the fund project shall be filled in according to the official name stipulated by the relevant departments of the state, and a number of funds shall be listed in turn, separated by ";". All fund projects must be accompanied by copies of certificates.

The Chinese Journal of Ophthalmology was founded on October 1, 1950. It was sponsored by the Chinese Medical Association and edited by the Editorial Committee of the Chinese Journal of Ophthalmology. The editorial committee is composed of nearly 100 well-known ophthalmologists in China. The current editor-in-chief Zhao Kanxing and the editorial director Huang Yibin. The main readers of this journal are ophthalmologists across the country, and it is publicly distributed at home and abroad. China Standard Issue Number: ISSN0412-4081, CN11-2142/R; Postal Code: 2-60;

In order to comply with the development trend of network and digitalization of journals and provide high-quality services for authors and readers, the Journal of Chinese Medical Association has developed a remote manuscript management system. The system is designed according to the business requirements of manuscript processing process, editing and processing specification, manuscript review system and management specification of Chinese Medical Association series magazines. It adopts advanced database and network technology, and has strong data processing and analysis ability. The remote manuscript management system will assist authors, editors,

The exclusive strategic cooperation of "Chinese Medical Association Series Journal Database" reached by Chinese Medical Association and Beijing Wanfang Data Co., Ltd. (hereinafter referred to as Wanfang Data) has been successfully operated for 3 years, and a new round of exclusive cooperation agreement has been renewed at the end of June 2010. The right to disseminate digital information network of 123 medical journals in 24 provinces and municipalities directly under the Central Government under the Chinese Medical Association continues to be exclusively granted to Wanfang Data.

The patient was a 6-month-old female who went to the Department of Ophthalmology of Wuhan University People's Hospital on October 12, 2009 because the pupil of her left eye was whitening for 3 months. Eye examination showed that the cornea of her left eye was mildly edema, the pupil was white and reflecting, and a bulging lesion was seen in the fundus of the eye after the pupil was dilated, and the blood vessels on the lesion were clearly visible. B-ultrasound and CT examination of both eyes showed that the left eye was retinoblastoma, and the nature of the bulging lesion in the right eye was to be investigated. The right eye was photographed under general anesthesia with RetCam Ⅱ digital retinal camera (essence pictures 1 and 2), and the left eye was enucleated. Postoperative histopathological diagnosis: left eye retinoblastoma (well differentiated).

1. Statistical symbols: According to the relevant provisions of GB3358.1982 "Statistical Terms and Symbols", all statistical symbols are printed in italics. Commonly used: (1) The arithmetic mean of the sample is in English lowercase (the median is in M); (2) Standard deviation is lowercase s in English; (3) Standard misuse of English lowercase sx;

digital object identifier (DOI) is a tool for identifying digital information including Internet information. In traditional publications, books, magnetic tapes and CD-ROM have international standard numbers (ISBN, ISSN, ISCN) and their barcodes as the unique identification of publications. These logos allow the publication to be effectively managed and easy for readers to find and utilize. Once the document on the Internet has changed the URL, there is no way to retrieve it. The digital information annotation DOI is a permanent and unique identification number like a barcode for a publication. Over time, some relevant information of digital objects may change (including the physical location of storage), and DOI allows users to directly link to the publisher's database, literature, abstract or even full text from this, and the identification code can directly direct to the publication itself, so that various types of academic information from various sources and different physical addresses at home and abroad can be interlinked and interconnected. DOI is a management system that can be quickly linked to journals worldwide, and the whole system is managed globally and distributed by the International DOI Foundation (IDF).

In order to advocate the majority of ophthalmologists to pay attention to "repairing damaged nerves and promoting vision recovery", Chinese Journal of Ophthalmology of Chinese Medical Association and Eisai (China) Pharmaceutical Co., Ltd. jointly held the 2010 Eisai Ophthalmology Award-winning essay contest.

In order to promote the scientific and technological journals sponsored by CAST and its affiliated national societies to better serve the independent innovation of science and technology, strengthen the function of academic exchange, promote the implementation of the strategy of fine scientific and technological journals, improve the core competitiveness of scientific and technological journals, and improve the ability of national societies to serve the strategy of rejuvenating the country through science and education and strengthening the country through talents, CAST has organized and implemented the application and evaluation of projects funded by fine scientific and technological journals since 2006. This journal was successively awarded the title of Excellent Science and Technology Journals Project Demonstration Project of China Association for Science and Technology from 2006 to 2010.

Corneal disease is one of the major blinding eye diseases in the world today. Performing corneal transplant surgery is the most effective treatment. In recent years, the technology of corneal transplantation has developed and improved by leaps and bounds. In order to promote the technology of corneal transplantation, help clinicians improve their surgical skills and better serve patients with corneal diseases, "Xie Lixin Corneal Transplantation Collection CD (Part 1)" is specially launched. This series of CDs (3 discs) contains 12 surgical videos, which systematically introduce penetrating keratoplasty surgery,

It is estimated that by 2010, the number of glaucoma patients in the world will exceed 60 million, and the number of blind people will be nearly 10 million. The World Health Organization (WHO) has made the prevention and treatment of primary glaucoma one of the key tasks of blindness prevention. In order to advocate the majority of ophthalmologists to pay attention to the prevention and treatment of glaucoma, Chinese Journal of Ophthalmology of Chinese Medical Association and Alcon (China) Ophthalmic Products Co., Ltd. jointly held the 2010 Alcon "Healthy Intraocular Pressure" Cup prize-winning essay contest.

Glaucoma is one of the main eye diseases causing blindness in China. In recent years, the proportion of primary open-angle glaucoma in primary glaucoma has gradually increased. Studies have shown that up to 75% of glaucoma patients need combination medication, and the compliance of combination medication in glaucoma patients is poor, which is one of the important reasons that leads to further impairment of visual function and even poor blindness in glaucoma patients.

Chinese Journal of Ophthalmology was founded on October 1, 1950. In the course of running the journal for nearly 60 years, there have been many twists and turns. From 1960 to 1964, due to natural disasters in the country and paper difficulties, it was suspended for the first time; From 1966 to 1978, it was forced to cease publication again due to the unrest until it resumed in the autumn of 1978. After more than half a century of ups and downs, several generations of ophthalmologists have paid hard work and sweat, and China Ophthalmology Journal has become the leading fine academic journal in China's ophthalmology community, which represents the national level externally and guides academic development internally.

In recent years, the concept of cataract refractive surgery has penetrated into the clinical diagnosis and treatment of cataract diseases. It is the higher pursuit of cataract surgeons to restore patients' vision like young people. Multifocal intraocular lens has attracted more and more attention of ophthalmologists because of its good clinical application effect.

In order to strengthen the academic exchange of ophthalmology at home and abroad, expand the international vision of domestic ophthalmologists, and promote the integration of domestic ophthalmology with international standards as soon as possible, the Health Express Training Network (www.lxlearn.com) has been specially established. The training network will serve all domestic ophthalmologists in the form of public welfare.

Corneal disease is one of the main eye diseases causing blindness at present. According to statistics, there are more than 7 million blind people in China, of which about 8% are caused by corneal disease. The only hope for blindness caused by corneal disease is corneal transplantation. However, due to the lack of donor corneas, only 8,000 corneal transplantations are performed in China every year, and millions of patients can only pray for light in the dark. Therefore, early intervention for corneal diseases is crucial.

With the continuous progress of surgical technique, equipment and intraocular lens (IOL) design and the continuous improvement of people's requirements for quality of life, cataract surgery has changed from simple vision restoration surgery to refractive surgery to maximize the postoperative visual quality of patients. In order to make patients achieve the perfect visual state of seeing far, close, clear, sharp, natural and true after surgery, various functional IOL have emerged. In order to make these high-end IOL give full play to their unique optical function, besides perfect surgical technology, accurate IOL degree calculation is an important prerequisite.

The 12th National Conference on Cataract and Intraocular Lens, sponsored by the Cataract Group of Ophthalmology Branch of Chinese Medical Association, was held in Hangzhou from April 22 to 25, 2010. More than 550 ophthalmologists from mainland China and Taiwan Province, as well as many ophthalmologists from Japan and Singapore attended the conference. The conference included 52 special lectures, 63 speeches and case discussions, and 39 exhibition panels. The papers were rich in content, reflecting the current research level of cataract and intraocular lens in China.