Volume 48 · Issue 04 · 2012

Intraoperative floppy-iris syndrome (IFIS) is one of the common complications during the cataract surgery.Recently,international ophthalmologists has obtained progresses on the recognize of IFIS risk factors such as the use of systemic adrenergic α1-antagonist tamsulosin and the safety remedy measures.At the same time,domestic ophthalmologists pay little attention to the IFIS and know little on the diagnosis and treatment of IFIS.This syndrome is associated with a high rate of cataract surgical complications and affects the success rate of surgery. We must pay attention to the IFIS risk factors, make thorough preparations before the surgery and take measures during the operation for the high risk patients.

Coaxial small-incision phacoemulsification has become the most performed and widely accepted cataract surgery in the world. With the development of phaco technique and advances in surgery skills,ophthalmologists pay more and more attention to micro-incision phacoemulsification.Clinically,there are a number of debates focusing on efficiency and safety of micro-incision phacoemulsification.By analyzing the chnical and laboratory studies at home and abroad,we believe that micro-incision phacoemulsification is safe,efficient and economic.Therefore,it will be a new trend of cataract surgery. In order to support our view and to improve ophthalmologists' understanding about micro-incision phacoemulsification and ultimately strengthen their clinical performance,we primarily introduce the history,features and effects of microincision phacoemulsification in this paper.

Objective To compare the optical performance and stability of different kinds of aspheric IOLs.Methods It was a retrospective case series study.Five different kinds of aspheric IOLs were implanted into 130 eyes after cataract operation,including hydrophilic acrylic IOLs (AO,Bausch&Lomb),25 eyes; hydrophilic acrylic IOLs (20H,Rayner),20 eyes; 3-piece hydrophilic acrylic IOLs (PY60AD,HOYA),30 eyes ; acrylic IOLs (ZC,B00,AMO),25 eyes ; and 3-piece hydrophobic acrylic IOLs (Tecnis 9003,ZA9003,30 eyes).Straylight on the retina was measured with C-quant. IOLs tilt and decentration were measured using Scheimpflug system (Pentacam,Oculus) and image-analysis was performed by Imagepro plus 6.0 software. Difference among groups was evaluated by analysis of variance ( ANOVA). The relationship between straylight parameters and age,best corrected visual acuity (BCVA),inner HOA and MTF (HOA,high order aberration; MTF,Modulation Transfer Function) at different spatial frequencies was evaluated by Pearson correlation analysis. Results The mean C-quant measurements for AO,920H,PY60AD,ZCB00 and ZA9003 groups were 1.33 ± 0.69,1.43 ± 0.57,1.56 ± 0.43,1.61 ± 0.56 and 1.71 ± 0.72,respectively,which showed no statistically significant differences (F =0.593;P =0.669).The straylight values in AO and 920H groups were significantly lower than that of ZCB00 and ZA9003 groups (t =2.159,3.271 and 2.286; P =0.045,0.013,and 0.046).The mean IOL decentration and tilt measurements in the 5 different groups showed no statistically significant differences (F =4.016,3.985;P =0.056,0.064).Conclusions There are no significant difference in straylight between 5 different types of aspheric IOL implanted within the lens capsules.All of them show satisfy stability.One-piece design and hydrophilic material IOLs provide better optical performance than that of 3-piece 2-point haptic design.

Objective To evaluate the visual outcome of + 3.00 D aspheric intraocular lens (IOL) implantation and compare it with the previous +4.00 D aspheric AcrySof ReSTOR multifocal IOL.Method It was a case-control study. Sixty patients (120 eyes) from the Tianjin Medical University Eye Center between Jan.2009 and Dec.2010 were enrolled into two groups. Twenty patients were assigned to each group respectively. Parameters analyzed included contrast sensitivity, distance uncorrected and bestcorrected visual acuity,distance corrected near visual acuity,intermediate visual acuity (60 cm) under bright light condition (100 cd/m2) and dim light condition (6 cd/m2),through-focus measurement,spectacle independence survey 6 months after second-eye surgery.Independent-samples t tests were used to statistically analyze.Results In the + 3.00D ReSTOR group,LogMAR visual acuity in bright (dim) light was 0.10 (0.24),0.24 (0.41 ),0.14 (0.41) at distant,intermediate and near distance,respectively.While in the +4.00 D ReSTOR group,it was 0.09 (0.23),0.42 (0.48),0.15 (0.36),respectively.There was significant difference at intermediate vision between these two groups ( P =0.001 ).The best near distance was approximately 7 cm out in the + 3.00 D IOL group. The percentages of patients not wore glasses for daily activities in + 3.00 D and + 4.00 D ReSTOR groups were 76％ (23/30) and 73％(22/30),respectively.No significant visual interference problems were noted in both groups. Conclusion The + 3.00 D aspheric AcrySof ReSTOR IOL achieves a more satisfactory intermediate distance vision when compared with the + 4.00 D aspheric IOL.

Objective To evaluate the mid-long term stability and safety of posterior chamber phakic intraocular lens (ICL) implantation for the correction of extreme myopia. Methods This retrospective study included 993 eyes of 498 patients received ICL implantation from June 1996 to December 2008.Multivariate analysis and variance analysis were used to evaluate the stability of the results and to identify risk factors of the complications. Results Successful implantation was achieved in all patients.Spherical equivalent(SE) was (16.23 ±4.12,mean ±SD) D before the operation and ( -0.92 ± 1.22) D at the last examination. Intraocular pressure was (13.58 ± 2.93) mm Hg( 1 mm Hg =0.133 kPa)preoperatively which was ( 13.90 ± 3.01 ) mm Hg at the last examination. There was no statistical significance in follow-up( t =0.44 ～1.30,P ＞ 0.05 ).Endothelial cell density was (2858.21 ± 395.13 )/mm2 before the operation and (2567.19 ± 423.45 ) /mm2 at last examination.Pupillary block glaucoma occurred in 2 eyes (0.2％ ) at two hours and 1 eye (0.1％ ) at one month after the operation.Three eyes developed anterior cataracts between 6 months to 1 year after ICL implantation and another 2 eyes subcapsular opacification at semi-peripheral regions occurred 4 years after the operation,and was not related with age,SE and vaults (F=2.42,1.98,0.81,P＞0.05). Macular puckers were found in 5 eyes (0.5％) 1 year postoperatively,including 2 eyes developed choroidal neovascularization and received PDT,best corrected visual acuity lost more than 2 lines.Retinal detachment occurred in 2 eyes at 1.5 years after the operation.Acute iritis happened in 1 eye (0.1％ ) and chronic iritis in 1 eye (0.1％ ) which combined with slight pupil distortion and elevation of intraocular pressure.Iris stroma atrophy and pupil distortion were found in 2 eyes (0.2％ ).Conclusion Correction of high myopia by ICL implantation is a safe procedure and the results are stable.

Objective To investigate the effects of Wnt3a on epithelial-mesenchymal transition (EMT) in human lens epithelial cells and its molecular mechanisms.Methods Experimental research.The Wnt3a expression vector was designed and transiently transfected into SRA0104 cells and the PcDNA-HA expression vector was transfected into the controls.The expression of Wnt3a was detected by western blot analysis.The expression of β-catenin was detected by western blot analysis and the location of β-catenin was detected by immuneofluorescence assay.The expression of E-cadherin protein as epithetlial biomarker and fibronectin protein as mesenchymal biomarker was detected by Western blot analysis. The mobility of SRA0104 cells was assessed by scratch assay and transwell assay in vitro. Statistical significance was determined by Student's t-test. Results The Wnt3a/SRA/01/04 cells were obtained by transfection of wnt3a cDNA expression vector in SRA01/04 cells and the pcDNA3-HA/SRA01/04 cells were used as the controls.The Wnt3a cDNA expression vector triggered β-catenin as a transcriptional activator accumulated and traslocated into the nucleous,which induced the decreasing expression of E-cadherin proteins and increasing expression of fibronectin protein,and resulted in EMT in lens epithelial cells. Wound healing assay in vitro showed that the migration distance of Wnt3a/SRA01/04 cells was ( 0.36 ± 0.02 ) mm at 24 hours after scratch,significantly increased as compared to the control cells (t =21.98,P ＜0.01 ).After 48 hours of incubation in transwell migration assay,the number of migratory cells across polycarbonate membrane in Wnt3a/SRA01/04 cells was 92.25 ± 10.34,which was much more than the control cells (t =10.40,P ＜ 0.01 ). The mobility and migration of Wnt3a/SRA01/04 cells was increased. Conclusion Wnt3a activates Wnt/β-catenin signaling pathway,induces EMT in lens epithelial cells and then increases mobility and migration of lens epithelial cells.

Objective To study the effects of transpupillary thermotherapy (TTT) on circumscribed choroidal hemangiomas (CCH). Methods It was a retrospective cases series study.One hundred and fourteen cases( 114 eyes ) in out-patient department were enrolled in the study with 80 male cases and 34 female cases.The age ranged from 16 to 71 yrs with an average at 44 years.Single eye was affected in all cases.Indirect ophthalmoscope,fundus fluorescein angiography ( FFA),ultrasound (B) were used for the examination.Treatment was delivered via slit lamp by using an 810 nm diode laser (Irises) with spots or composed spots (larger tumor) covering the whole tumor.If the tumor was located or partly located in the fovea,laser spot should be avoided in the fovea and papillo-macular bundle. The laser power should be lesser ( light gray color) in parafovea area.Routine laser spot ( gray-white color) was used in perifovea area.A width of 200 μm out of disk border should not be placed by laser spot in paradisk tumor cases.Results The visual acuity(VA)≥0.5 of pre-and post-treatment was 17 eyes( 14.9％ ) and 27 eyes (23.7％),respectively.Pre-treatment,the retinal detachment extended in the inferior part in 27 cases (23.7％) except on the tumor surface.The tumor was located at macular area in 67 cases (58.8％),around the disc in 35 cases (30.7％ ),at the temporal arcuate in 12 cases ( 10.5％ ).In our cases,VA maintenance with fluid absorption was noted in 76 cases (66.7％ ) after the treatment. VA improvement with fluid absorption in 28 case (24.6％ ).Both VA maintenance and improvement ( rate of efficiency) with fluid absorption were 91.2％.Fluid non-absorption or VA decline was regarded as unsuccessful in 10 cases (8.8％).The average thickness of 32 cases tumor pre- and post-treatment was (3.90 ± 1.15 )mm and ( 2.41 ± 1.30) mm.Twenty seven cases were followed up for ≥ 1 year (mean 22.8 months) with rate of efficiency at 81.5％. The complications (9 eyes,7.9％ ) contained minor macular hemorrhage in 2 eyes,macular pucker in 3 eyes,macular edema and cystoid macular edema in 2 eyes,retinal branch occlusion in 1 eye,and arcuate scotoma in 1 eye.Conclusions The treatment of TTT on CCH,whether the tumor located around-disc or in foveal area with exudative fluid could get successful in the majority of cases.TTT is one of the treatments worth doing owing to fewer complications,less expenses and easy-doing with definite and persistent effect.

Objective To compare the sensitivity of Pentacam and Orbscan Ⅱ and to analyze the morphology characteristic of topography in normal eyes and different stages of keratoconus,to provide the basis for early screening of keratoconus suspects. Methods One hundred and ninety six normal eyes,50 eyes with keratoconus suspect and 73 eyes with clinical keratoconus were enrolled.The changes of corneal anterior/posterior curvature,best fitting sphere (BFS).Inferior-Superior value ( I-S ) ( 3 mm and 5 mm),classification of elevation maps and corneal thickness were measured. Results There were significant differences including posterior curvature,anterior/posterior BFS,elevation value and corneal thickness in normal eyes between the data measured by these two different instruments,values obtained by Pentacam were less than those by Orbscan.Concerning the elevation maps pattern,the progressively decreasing pattern was dominant in Pentacam with normal eyes and keratocomus suspects,with the progressively increasing pattern accounting for 14.4％ (28/196) and 20.0％ (10/50) respectively in anterior surface,and 2.0％ (41/96)and 26.0％ (13/50) in posterior surface.The progressively increasing pattern was in dominant with clinical keratoconus,accounting for 91.7％ (67/73) and 94.5％ (69/73) respectively in anterior and posterior surface.Progressively increasing pattern in Orbscan was presented in 80.4％ ( 165/196 ) normal eyes and suspected or clinical stage keratoconus.As to the receiver-operating-characteristic (ROC) curves and cutoff value,Orbscan I-S value (3 mm and 5 mm) of anterior and posterior surface was sensitive for the diagnosis of keratoconus suspects,with the cutoff value of anterior and posterior 5 mm I-S at 1.15 D and 0.65 D,respectively.In addition to the sensitivity of I-S values in Pentacam,the elevation value of anterior and posterior surface also displayed important diagnostic meaning. The cutoff of anterior,posterior elevation values was 4.5 μm and 7.5 μm,respectively. Conclusions Numerous measured indicators revealed obviously difference between the two instruments in normal eyes,with slightly smaller values in Pentacam.In addition to I-S values,pattern changes and elevation values in elevation map of Pentacam represent remarkable advantages for the screening of keratoconus suspects. There is an incremental risk of corneal ectasia in the increasing pattern of elevation map.

Objective To evaluate protective effects of L-carnitine on corneal and conjunctival epithelium of mouse dry eye model induced by hyperosmolar saline.Methods Sixty female BALB/c mice at the age of 6-8 weeks were randomly divided into three groups (20 in each):Hyperosmolar saline group (HO),Hyperosmolar and Isosmotic saline group (HO + IO),as well as Hyperosmolar saline and 1％L-carnitinegroup (HO + 1％ LCA).The HO group was treated with 500 mOsmol/L sodium chloride solution;the HO + IO group with 308 mOsmol/L sodium chloride solution first and 500 mOsmol/L sodium chloride solution 30 minutes later; and the HO + 1％ LCA group with 1％ L-carnitine eye drop first and 500 mOsmol/L sodium chloride solution 30 minutes later. Alternately,5 times a day for 28 days. Corneal fluorescein staining,corneal epithelial hematoxylin-eosin staining and thickness measurement,conjunctival epithelial periodic acid-schiff reagent staining and goblet cell counting were conducted on 0,7th,14th and 28th days,respectively.On 28th day,corneal surface was inspected by scaning electron microscopy and tear osmolarity was measured.Results In HO or HO + IO group,compared with HO + 1％ LCA group,the number of goblet cells was reduced,the score of corneal fluorescein staining and corneal epithelial thickness was elevated:on 7th day,there was difference noticed in the corneal epithelial thickness [ ( 27.7 ± 1.1 ),(26.5 ±1.4),(25.1 ± 1.0) μm,P＜0.01 ] and the number of goblet cell [ (11.9 ±1.1),(12.1 ±0.9),( 13.3 ± 0.9),P ＜ 0.01 ] in 3 groups; on 14th day,there was evident change in the corneal flurescein staining area[ ( 3.2 ± 0.9),(2.9 ± 0.7),( 1.7 ± 0.8),x2 =11.465,P ＜ 0.01 ] in 3 groups.On 28th day,Increased tear osmolarity and lowered microvilli on cornea were examined in HO [ (327.37 ±4.20)mOsmoL/ L] or HO + IO [ (324.36 ± 5.72) mOsmol/L] group compared with HO + 1％ LCA [ ( 308.29 ± 5.72 )mOsmol/L] group (P ＜ 0.01 ).Conclusion L-carnitine had protective effect on corneal and conjunctival epithelium of mouse dry eye model induced by hyperosmolar saline,and should be studied further.

Objective To study the development of lymphatic vessels after keratoplasty and to explore the molecular mechanisms of corneal lymphangiogenesis in transplanted corneas. Methods Experimental research.The development of corneal lymphangiogenesis was examined by LYVE-1immunohistochemistry and whole mount immunofluorescence 1,3,7,10,14,30 and 60 days after corneal transplantation, then lymphatic vessels counting (LVC)was evaluated. The expression of vascular endothelial growth factor-C (VEGF-C) in transplanted corneas was examined by immunohistochemistry,enzyme-linked immunosorbent assay (ELISA), and real time-PCR at same time. In addition, the inflammatory index (IF) was recorded at each time point.The association of VEGF-C and IF with LVC in transplanted corneas was examined. Analysis of the significance of differences between two groups was performed using paired Student's t-test. Pearson's analysis was used to analyze the correlation between VEGF-C,IF and LVC.Results Corneal lymphangiogenesis occurred in the stroma with LVC ( 1.8 ± 0.3)on Day 3,then developed and reached the peak with LVC (9.1 ± 1.5) on Day 14 after corneal transplantation.Both VEGF-C protein and mRNA up-regulated dramatically in rat transplanted corneas.The immunoreactivity reached the peak on the 3rd day and the 14th day after keratoplasty.Compared with the expression of VEGF-C mRNA ( 1.62 ± 0.08 copies/g) on Day 3,the expression of VEGF-C mRNA (2.48 ±0.03 copies/g) significantly increased 14 days after the transplantation ( t =4.296,P =0.02 ).LVC was strongly and positively correlated with IF ( r =0.55,P =0.003 ) and the expression of VEGF-C mRNA ( r =0.51,P =0.003 ). Conclusions Corneal lymphangiogenesis correlates closely with corneal inflammation.The increased expression of VEGF-C in the cornea may be one of the important molecular mechanisms in the occurrence of corneal lymphangiogenesis after keratoplasty.

Objective To analyze the variation of expression of proline-rich tyrosine kinase 2 (Pyk2) in the oxygen-induced retinal neovascularization mice model.Methods Experimental study.One hundred and forty-four C57BL/6J mice were divided equally into the hyperoxia group and the control group.In the hyperoxia group,72 mice (7-day-old) were exposed to (75 ± 2)％ oxygen for 5 days and then moved to room air; in the control group,72 mice were simply raised in room air.These mice were sacrificed on the 12th,14th,17th days and their eyeballs were collected for the preparation of pathological section,retina fiat mounting and RNA extraction.The expression of Pyk2 and vascular endothelial growth factor (VEGF)mRNA in the retina were measured by real-time PCR.ANOVA was used in conjunction with SNK-q test to assess statistical significance at different time within groups ; t-test was used to assess statistical significance between two groups at the same time point.Results Pathological sections showed that there were many endothelial cell nucleus and vascular buds on the 14th day (15.36 ±3.69) and 17th day (29.63 ±4.69) in hyperoxia group.There was significant difference between the control group (0.97 ± 1.00,0.83 ± 0.79 ) and hyperoxia group ( t14 d =- 20.629,P14 d =0.000 ; t17d =- 33.814,P17 d =0.000 ).Retina flat mounting showed that on the 12th day,hyperoxia group showed vascular occlusion,vasoconstriction and large nonperfusion areas,neovascularization appeared and reached the peak on the 17th day.Real-time PCR showed that on the 12th day in hyperoxia group,Pyk2 mRNA (0.05 ±0.03) and VEGF mRNA (0.10 ±0.06) were lower ( Pyk2:t =15.706,P =0.000 ; VEGF:t =15.911,P =0.000 ).However,on the 14 th day and the 17th day,Pyk2 mRNA ( 1.11 ± 0.22,1.68 ± 0.30) and VEGF mRNA (2.10 ± 0.41,4.85 ± 0.46) increased significantly ( Pyk2:t14 d =- 3.376,P14 d =0.007 ; t17 d =- 7.358,P17 d =0.000 ; VEGF,t14 d =- 6.904,P14d =0.000;t17d =- 19.667,P17d =0.000).Conclusion Comparing to the control group,expression of Pyk2 in retinal tissue increases on the 14th day and 17th day in the hyperoxia group,indicating that the expression of Pvk2 is correlated with neovascularization.

Objective To observe the inhibition of neovascularation in the oxygen-induced retinopathy (OIR) mice by a stromal cell-derived factor 1 (SDF-1) antagonist.Methods Experimental study.Fifty-eight 7-day-old C57BL/6 mice were divided into 3 groups randomly,the control group (n =17),the test group (n =17) and the medication group(n =24).According to the dosage of AMD3100,the medication group (n =24) were divided into low dose group,high dose group,low dose control group,and high dose control group (each group n =6).Each group (19-day-old) was sacrificed to perform ADPase staining,paraffin sections and immunohistochemical staining ( anti-VEGF and anti-SDF-1 ). The average positive staining area percentage (APSAP) was measured as the outcomes and processed with the Students' t-test. Results Real-time PCR showed expression of both VEGF mRNA (0.080 ± 0.022 vs.0.123 ±0.032) and SDF-1 mRNA (0.731 ±0.099 vs.0.544 ±0.108) in retinas from the control group and test group,respectively.The expression of these factors in the test group was significantly higher (t =2.488,P =0.038 ; t =2.864,P =0.021 ).The number of neovascular endothelial nuclear that broke through the retinal internal limiting membrane in the paraffin section in the high dose group and the low dose group was significantly less than that in the self-control group ( t =- 9.507,P =0.000 ; t =- 10.761,P =0.000).The appearance of ADPase staining sections in the medication group was more similar to the simple control group than that of the test group. Immumohistochemical staining sections showed that VEGF and SDF-1 expressed in neuroepithelial cells in each group. APSAP in the high dose group and the low dose group was significantly lower than that in the self-control group ( VEGF:t =- 7.249,P =0.000 ; t =-9.02,P=0.000; SDF-1:t=-5.246,P=0.000; t=-5.216,P=0.000).Conclusion These results indicate that AMD3100 block the SDF-1 receptor to reduce the effect of SDF-1,decrease the production of VEGF protein and inhibite neovascularization.

A 57-year-old female was hospitalized in the Department of Ophthalmology of the Armed Police General Hospital on June 9, 2010 due to tearing in her left eye for more than 10 years and pus for more than 7 months. The patient developed tearing in her left eye without obvious trigger 10 years ago, accompanied by itchy eye, blurred vision, red eye, eye swelling and pain, and no redness, swelling and pain in the medial canthus of her left eye. She had been irrigated in the local eye hospital: it was not unobstructed. After local application of eye drops, the symptoms did not improve, and no other treatment was given. She was usually in good health, and denied that she had systemic diseases such as hypertension, diabetes and heart disease, and denied that she had a history of similar diseases and family genetic diseases in her family. Routine ophthalmological examination was performed. Left eye: a large amount of purulent secretion reflux could be seen when pressing the lacrimal sac area, and a secondary lacrimal point could be seen in the mons of lacrima (Figure 1). Slit lamp microscopy showed that the size and shape of the secondary lacrimal point were similar to the normal lacrimal point. Irrigation of the lacrimal duct: needles were inserted from the upper and lower lacrimal points, and soft resistance was encountered at 7 mm distance from the lacrimal point, which could not be broken through and could not reach the medial bone wall of the lacrimal sac. The irrigation fluid flushed up and down. The yellow-white purulent secretion reflux can be seen, and small yellow granules can be seen in the pus.

Ocular trauma is one of the main diseases causing terminal eye at present, among which blunt contusion occupies the highest proportion of ocular trauma, ranging from 46.3% to 51.0% [1-4], blunt contusion causes anterior chamber and vitreous hemorrhage the most common, 23.1% and 15.6% respectively; However, the formation of retinal fold after severe eye contusion and laceration is relatively rare. In November 2009, our hospital treated a patient with giant retinal fold after severe eye contusion and laceration. The clinical manifestations, fundus changes (Figure 1) and treatment results are analyzed and reported as follows.

Case 1: A 66-year-old male was diagnosed as "choroidal hemangioma" due to transient foreign body sensation in both eyes in October 2009. A choroidal mass was accidentally discovered in an external hospital due to transient foreign body sensation in both eyes. After examination by fundus fluorescence angiography (FFA), ocular B-ultrasound and orbital MRI, he was diagnosed as "choroidal hemangioma" and was diagnosed as "choroidal hemangioma in left eye". After multiple laser photocoagulation treatment, the size of the mass remained unchanged, and he was followed up regularly. Until March 2011, orbital MRI was re-examined, which showed that "the lesion was larger than October 2009 with bleeding". For further diagnosis and treatment, he went to our hospital in March 2011. The patient denied systemic medical history and family disease history. Physical examination: The patient's left forehead, upper and lower eyelid area skin had blue-melanin deposition (Figure 1A). Eye examination: The visual acuity was checked by the international standard visual acuity chart. The naked eye visual acuity of both eyes was 0.6 in the right eye and 0.8 in the left eye, and the best corrected visual acuity was 1.0. The right eye did not

The patient, a 31-year-old male, came to the clinic due to "sudden double vision in both eyes for 2 weeks". Two weeks ago, the patient found double vision in both eyes after waking up in the morning, without vertigo, headache and obvious numbness and weakness in the limbs. He had a history of cold 4 weeks before the onset of the disease. Physical examination: clear consciousness and fluent speech. Both pupils were equal size and round, with a diameter of 3 mm, and sensitive light response. Eye position: original orthogonal position, eye movement: upward rotation of both eyes was obviously limited, and downward rotation was mildly limited (Figure 1), but the vertical vestibular reflex (VOR) was preserved; Vergence spasm; There were no abnormalities in the other directions of eye movement.Bilateral upper eyelid retraction, the upper eyelid margin was located 0.5 mm above the upper limb.The right nasolabial fold was slightly shallow,the tongue extension was to the right,the muscle strength and muscle tone of the limbs were normal, the tendon reflex of the limbs was symmetrical, the pathological signs were negative, the bilateral sensory examination was symmetrical, and the co-taxic movement was not abnormal.At the 5th day of onset, the cranial magnetic resonance (MRI) showed that the left thalamus was long T1 and long T2 signal (Figure 2A), and the enhancement was not obvious, and the DWI was high.

The patient was a 9-year-old female who went to Beijing Tongren Eye Center of Beijing Tongren Hospital affiliated to Capital Medical University for blurred vision since childhood. He had no history of other diseases. Ocular examination showed that the visual acuity was 0.2 in both eyes. The cornea of both eyes was transparent, the anterior chamber was middle-deep, the pupil diameter was about 3~4 mm, and there was light reaction. The residual membrane was visible in the pupil area, which blocked the center of the pupil (Essence Picture 1), and the lens was transparent. Clinical diagnosis: residual membranes of pupils in both eyes; Amblyopia in both eyes.

The patient was a 36-year-old male who came to the Department of Ophthalmology of Yunnan Red Cross Hospital on August 1, 2011 due to the dark shadow fluttering in front of his right eye for 1 week. Ophthalmological examination showed that the visual acuity was 0.8 in the right eye and 1.0 in the left eye; the conjunctiva of both eyes was not congested, the cornea was transparent, the anterior chamber depth was normal, the pupil was round, and the light response was normal; See the essence picture for the fundus of the right eye 1. See the essence picture for fluorescein fundus angiography 2. Diagnosis: Congenital papilla artery loop with preretinal hemorrhage in the right eye.

The patient was a 55-year-old female who came to the ophthalmology department of Xijing Hospital on March 11, 2010 due to blurred vision with night blindness in both eyes for 17 years and visual deformation for half a year. The family history was denied. Ocular examination showed that the visual acuity was 0.1 in the right eye (corrected visual acuity was 0.5) and 0.05 in the left eye (corrected visual acuity was 0.1). The corneas of both eyes were transparent, the pupils were round, and the light response was normal; Mild opacity of the lens; For both fundus, see the essence picture 1. For fluorescein fundus angiography, see the essence picture 2. Optical coherence tomography showed that the thickness of fovea became thinner, the thickness of pigment epithelium-choroidal vascular layer increased, and multiple atrophic plaques were visible. Visual field examination showed that the peripheral visual field of both eyes was seriously damaged, only the central visual field remained. Diagnosis: circumflex choroidal atrophy of both eyes.

lens subluxation is more common in clinic, and phacoemulsification in the state of subluxation often expands the rupture of the suspensory ligament of the corpus during the operation, and if improper treatment, serious complications such as lens dislocation into the vitreous cavity will occur [1]. We used self-made iris hook to fix the corpus capsular bag during the operation, then performed phacoemulsification and implanted an intraocular lens (IOL), and achieved good results, which are reported below.

Micro-incision cataract surgery (MICS) was developed in the last decades,which was derived from the traditional phacoemulsification cataract surgery. MICS consists of mainly two types,bimanual and coaxial micro-incision cataract surgeries,which are classified by the separation of irrigation and aspiration systems or not. According to their obvious advantages in minimum surgery trauma,slight surgically induced astigmatism and rapid postoperative vision recovery, MICS has gradually possessed widespread clinical use. Combined with the development of cold phaco technique and intraocular lens for ultra-small incision,greater achievements have been made to improve the cataract surgery quality. We review the clinical applications of these two types of MICS and the cold phaco technique which supports the former.

Retinal degeneration diseases are a group of severe eye diseases that can lead to blindness.They are characterized by degeneration and apoptosis of photoreceptor cells and still lacking effective therapeutic procedures.Pluripotent stem cells (induced pluripotent stem cells,iPS cells) obtained from somatic cell reprogramming are similar to the embryonic stem cells (embryonic stem cells,ES cells),which have unlimited proliferation,differentiation and memory characteristics.Retinal cells from iPS cells have been used in cell transplantation for the treatment of retinal diseases,for the study of pathogenesis and drug toxicity evaluation in retinal degenerative diseases.This may provide new ideas and novel procedures for the treatment of retinal degenerative diseases in the future.

The China Medical Science and Technology Award, established by the Chinese Medical Association, is a science and technology award for the national medical and health industry. The award is awarded to scientific and technological workers and collectives who have made outstanding contributions in scientific discovery, technological invention and promoting scientific and technological progress in the medical field, and is recommended to the National Natural Science Award, National Technological Invention Award and National Science and Technology Progress Award. Seven ophthalmology research projects won the China Medical Science and Technology Award in 2010 and 2011, including 1 first prize, 2 second prizes and 4 third prizes.

With the development of science and technology, cataract surgery technology and equipment, as well as the design and manufacture of intraocular lens (IOL) have made great progress. Cataract extraction and IOL implantation not only make patients see, but also make cataract patients get better visual quality after surgery. In the economically developed countries and regions, cataract extraction is no longer the traditional vision restoration operation, it has gradually changed to refractive surgery.

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 all over the country, and it is publicly distributed at home and abroad. China Standard Issue Number: 1SSN0412-4081, CN11-2142/R; Postal code: 2-60; National map code: M93. "Chinese Journal of Ophthalmology" has always implemented the principles and policies of the Party and the state on health work, implemented the principle of combining theory with practice, popularization and improvement, and reported the major progress and innovative achievements of clinical and scientific research in ophthalmology in China.

In order to improve the printing quality of the journal, this journal has been changed to CTP plate making since 2011. In order to ensure the printing quality of the CTP plate-making screen, this journal makes the following important graves for the published pictures.

The 25th Asia-Pacific Conference on Cataract and Refractive Surgery and the 14th National Conference on Cataract will be held at Shanghai International Convention Center from May 31 to June 3, 2012. This academic conference was sponsored by the Asia-Pacific Association of Cataract and Refractive Surgeons, Chinese Medical Association, Ophthalmology Branch of Chinese Medical Association and Cataract and Intraocular Lens Group of Ophthalmology Branch of Chinese Medical Association. The conference will invite dozens of internationally renowned experts in the field of cataract and refractive surgery at home and abroad to give lectures on the latest progress in the discipline.

According to international practice and the actual situation in China, for papers that meet the following conditions, the Chinese Medical Association series journals allow and accept the republication of relevant papers of the same research in different languages.

In order to safeguard the reputation of the Chinese Medical Association magazine series and the interests of the readers, the Chinese Medical Association magazine hereby declares the treatment of the issue of two submissions of one manuscript and dual use of one manuscript as follows: (1) The manuscripts referred to in this statement refer to the original research report or the main data and charts of the two manuscripts are the same although there may be some differences in the expression of words and the narrative of discussion.

The book "Choroidal Neovascular Diseases", edited by Professor Wang Yusheng, Department of Ophthalmology, Xijing Hospital, Fourth Military Medical University and Institute of Ophthalmology, written by frontline scientific and technical personnel engaged in clinical and basic research of ophthalmology and visual science in Fourth Military Medical University, reviewed by Professor Yan, West China Ophthalmology Center, Sichuan University, and prefaced by Professor Luo Chengren, has been officially published by People's Medical Publishing House. The contents of this book include basic research and clinical diagnosis and treatment of choroidal neovascular diseases, taking into account both advancement and practicality.

Conjunctivalochalasis is a common age-related ocular surface disease in the elderly. With the accelerating aging of the population, the number of people with conjunctiva relaxation will increase day by day. Severe conjunctival relaxation requires surgical treatment. In order to standardize the surgical treatment plan and prevent iatrogenic ocular surface damage, Professor Zhang Xingru combined his more than 10-year research results on surgical treatment of this disease (including key technologies such as indications for surgical treatment, standardized surgical operation, prevention and treatment of surgical complications) with literature and materials to make a CD.

The 12th National Conference on Corneal and Ocular Surface Diseases and the 4th National Conference on Corneal Refractive Surgery will be held in Chengdu from May 24 to 26, 2012. The Keratology Group of the Ophthalmology Branch of the Chinese Medical Association and the Chinese Journal of Ophthalmology, the academic cooperative media of the conference, jointly invited domestic and foreign ophthalmologists, colleagues and ophthalmology business people to attend the conference.

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;

The description format of reference documents in this journal basically implements GB/T7714-2005 "Rules for Description of Reference Documents after Text". Sequential encoding is used to make a record, which is marked with Arabic numerals in the order in which it appears in the text, and the serial numbers are placed in square brackets and arranged at the end of the text. Try to avoid citing abstracts as references. Internal publications, unpublished materials, personal correspondence, etc. should not be cited as literature.