Volume 48 · Issue 05 · 2012

Domestic corneal refractive surgery is embarking on a steady development stage,and following the introduction of femto-second laser,which will open up a new era of corneal surgery.Facing new historical opportunity and challenge,it is vital for scientifical and healthy performance of the surgery both concerning on the improvement of visual quality and preventing the occurrence of complications.Only under a harmony and healthy environment,we will achieve the win-win situation between doctors and patients and sustainable development of corneal refractive surgery in the future.

It is very important to avoid inadequate patients to perform excimer laser keratectomy in order to prevent from surgical complications.The ametropic eyes with corneal guttata is considered very carefully whether to perform excimer laser corneal ablation or not,especially for the patient with corneal guttata companied by Fuchs endothelial dystrophy family history is contraindicated to perform laser corneal refractive surgery.

Objective To observe the predictability of corneal flap creation with the FEMTO LDV femtosecond laser and analyze preliminarily the factors correlating to the thickness and diameter of the flap.Methods It was a study of serial cases.260 eyes of 130 consecutive patients were treated with the FEMTO LDV.The eyes were assigned to two groups according to intended flap thickness,110 μm (208eyes) and 90μm (52 eyes).Intended flap diameter varied from 8.5 to 9.5 mm.Difference analysis of flap diameter and intended diameter as well as flap thickness and intended thickness were made.The data was analyzed with SPSS to sum up a multiple stepwise regression formula that could express their quantitative relationship.Results The 90 μm flap group had a average flap thickness of (95.12 ±7.65)μm,while for the 110 μm group the average flap thickness was (104.81 ±t 3.09 )μm.The difference between right and left eyes was not statistically significant ( t110 μm =- 1.223,t90 μm =- 1.343,P ＞ 0.05 ).Corneal flap thickness was inversely correlated with flap diameter ( r110 μm =- 0.143,r90μm =- 0.315,P ＜ 0.05 ),but was not related to preoperative patient age,corneal thickness,keratometric value K or intraocular pressure (r110μm =-0.160,0.054,-0.011,-0.363; r90:=0.024,0.074,-0.212,-0.434,all P＞0.05).Corneal flap diameter was positively correlated with preoperative corneal keratometric value K and thickness ( P ＜0.001,P ＜0.05).Multiple stepwise regression analysis showed flap diameter was an influencing factor for flap thickness.Preoperative corneal keratometric value K and thickness were influencing factors for flap diameter. Conclusions The LASIK flap creation with the FEMTO LDV laser has relatively good predictability.Flap diameter is an influencing factor for flap thickness.

Objective The microbial culturing results were analysed from samples of the microkeratome blade and sponges in laser in situ keratomileusis (LASIK) procedures as for chossing the rational antiotic eye drops for preventing infectious keratitis.Method In this prospective study, 106microkeratome blades and 212 sponges were cultured in routine LASIK procedure,at Excimer laser center in Henan Eye Institute During March to April 2009.Positive cultures were then sent for routine sensitivities and the results were analysed.Results 8 of the 106 blades were culturing positive,the positive rate was 7.55％.Each four positive cultures were in male and female patients.There was no statistical difference with gender(P =1.000).23 of the 212 sponges cultures were positive.The positive rate was 10.38％.All positive cultures grew Staphylococcus epidermidis.Twelve sponge positive cultures were in right eye and 11 were in left eye.There was no statistical difference between the right eye and left eye( P =0.825).All of the 31 positive cultures were sensitive to gatifloxacin. The sensitivity of gatifloxacin, tobramycin,levofloxacin,ofloxacin,and ciprofloxacin were 100.00％,96.77％ ( 30/31 ),93.55％ ( 29/31 ),90.32％(28/31) and 74.20％ (23/31) respectively.All the patients have no infectious keratitis followed-up more then 6 monthes.Conclusion There could be positive cultures from samples of the microkeratome blade and sponges in routine LASIK procedures but no patients with positive cultures developed postoperative infectious keratitis.The main positive bacteria was Staphylococcus epidermidise.They are sensitive to third and the fourth-generation fluoroquinolones and tobomycin antibiotics. Pre and post-operative supply of sensitive antibiotics can prevent post-operative infection.

Objective To detect the accommodative convergence to accommodation (AC/A) ratios measured respectively by objective and subjective methods.The differences and its relative factors were explored.Methods Forty young volunteers were measured by eye tracker to get the amount of convergence when fixating at the target at 100cm,50 cm,33 cm and 25 cm and were measured by infrared auto-refractor to get corresponding accommodative responses.AC/A ratio based on these two measurements were compared with the calculated and the gradient AC/A ratio from Von Graefe tests.Results Mean value of stimulated AC/A ratio measured by eye tracker was higher than the calculated and gradient AC/A ratio by Von Graefe method ( P =0.003,0.001 ).There are statistic correlation ( r =0.871,P =0.000 ) and difference ( P =0.000) between stimulated AC/A ratio and response AC/A ratios both measured by eye tracker,and the difference trends to be greater with the higher AC/A ratio.Conclusion The objective AC/A ratio is usually higher than the clinical subjective measurement because of more proximal effect.The response AC/A ratio measured objectively may reveal realistically the mutual effect and relationship between accommodation and convergence and it seems to be more credible to be the monitor parameter on progression of myopia in clinics.

Objectives To evaluate the contrast visual acuity(CVA) in Chinese normal adults and to study the effects of different contrast levels between the optotypes and background,age and sex on the CVA.Methods It was a cross-sectional study.Three hundreds and fifty-three normal adults with age from 20 to 70 years were selected as the normal adults( naked visual acuity equal or more than 0.8,and equivalent sphere diopter - 1.00 - + 1.00 DS,astigmatic diopter - 0.75 - + 0.75 DC ).After conducting eye and refractive examination,all examinee were received the CVA measurements in the different coutrast levels between the optotypes and background ( 100％,25％,10％ and 5％ ) in the dark room by the multifunction visual acuity chart. SPSS 18.0 software package was used for one-way ANOVA( analysis of variance),Spearman correlation and paired t test.Results In the normal adults,CVA significantly decreased by the decrease of the contrast level between optotypes and background( FOD =1317.21,P ＜0.01 ;FOS =991.09,P ＜0.01 ; FOU =1223.87,P ＜ 0.01 ).In the same contrast level between optotypes and background,CVA significantly decreased by aging( F100％CVAoD =10.86,P =0.000;F25％CVAOD =11.54,P =0.000;F10％CVAOD =7.63,P =0.000;F5％CVAOD =4.88,P =0.001 ;F100％CVAOS =15.26,P =0.000;F25％CVAOs =16.93,P =0.000;F10％CVAOS =8.33,P =0.000;F5％CVAOS =4.08,P =0.003;F100％CVAOU =11.87,P=0.000;F25％CVAOU =15.08,P=0.000;F10％CVAOU =11.71,P =0.000;F5％CVAOU =9.51,P =0.000).CVA in the high contrast was similar between male and female,however,there was a significantly difference in CVA in the low contrast between male and female( F100％CVAOD =0.341,P =0.560;F25％CVAOD =0.434,P =0.510;F10％CVAOD =5.615,P =0.018 ; F5％CVAOD =9.492,P =0.002 ; F100％CVAOS =0.212,P =0.645 ; F25％CVAOS =0.132,P =0.716;F10％CVAOS =4.588,P =0.033 ; F5％CVAOS =4.812,P =0.029 ; F100％CVAOU =0.775,P =0.379 ; F25％CVAOU =1.043,P =0.308;F10％CVAOU =8.555,P =0.004;F5％CVAOU =5.630,P =0.018).A significantly correlation could be seen between the visual acuity of ETDRS and 100％ CVA( rOD =0.632,rOS =0.536,roU =0.456,all P ＜0.01 ).The 100％ CVA was higher than the visual acuity of ETDRS( tOD =20.70,tOS =17.25,tOU =23.47,all P ＜0.01 ).Conclusions Age and the different contrast levels between optotypes and background significantly affect CVA.In the low contrast between optotypes and background,CVA in the female is better than in male.

Objective To seek safe,effective,economical,simple treatment conjunctivochalasis surgical methods,optimize treatment,evaluation conjunctivochalasis surgical treatment. Methods A prospective randomized control study,60 patients (60 eyes) conjunctivochalasis surgery patients were randomly divided into two groups,one line of bipolar coagulation therapy,another group of crescent conjunctival resection. Ater comparing the two surgical methods ocular surface disease index ( OSDI )points,the degree of relaxation conjunctiva,tear meniscus height,BUT,surgical complications,the operation time to evaluate the two kinds of surgical methods of clinical efficacy.Results Bipolar coagulation therapy with crescent conjunctival resection in 8 weeks after the OSDI points,loose conjunctiva residual points,tear meniscus,BUT the difference was not statistically significant.8 weeks after bipolar coagulation complications points lower than the crescent conjunctival resection is low,the difference was statistically significant ( t =4.67,P =0.029 ) ; bipolar coagulation operating time ( 9.53 ± 3.15 ) min crescent than conjunctival resection time ( 18.59 ± 7.68 ) min short,the difference was statistically significant ( t =13.26,P ＞ 0.01 ).Conclusions Conjunctivochalasis line bipolar coagulation and removal of loose conjunctiva crescent with considerable effect,bipolar coagulation was significantly shorter operative time,a significant reduction in postoperative complications,surgical procedures easier.

Objective To investigate the clinicopathological significance of expression of insulinlike growth factor-1 receptor (IGF-1R) and its association with the expression of p-AKT Thr308 in uveal melanoma.Methods Experimental study.Twenty-four patients with uveal melanoma were included from January 2000 to December 2008.The levels of IGF-1R and p-AKT Thr308 were detected by immunohistochemical methods,and their association with clinicopathological parameters including localization of tumor,tumor size,largest tumor diameters,cell type,necrosis,degree of pigmentation,lymphocyte infiltration,mitosis rate,scleral invasion and liver metastasis were statistically analyzed.The relationship of expression of IGF-1 R with clinicalpathological parameters or with the expression of p-AKT Thr308 was analyzed by chi-square test.Results The positive rate of expression of IGF-1R in 24 cases of uveal melanoma was 75％.The expression of IGF-1 R were associated with the largest tumor diameters,degree of pigmentation,liver metastasis and lymphocyte infiltration( x2 =15.569,P =0.016;x2 =11.348,P =0.010;x2 =8.738,P =0.033 ; x2 =8.362,P =0.039 ).The positive rate of expression of p-AKT Thr308 was 58％.The expression of IGF-1R and p-AKT Thr308 was positively correlated ( x2 =17.108,P =0.009 ).Conclusion IGF-1R plays a role in the development of uveal melanoma which may be induced by activation in P13 K/AKT pathway.

Objective To investigate the effects of hydrogen peroxide ( H2 O2 ) on the barrier function and expression of tight junction protein in human retinal pigment epithelium (RPE) cells.Methods Experimental study.The human RPE cell line (D407) were cultured and treated with ( H2O2 treated group) or without H2O2 ( normal control group).The effect of H2O2 on cell viability of RPE cells was determined by MTT test.After treated with low concentration of H202 for 24 h to 72 h,transepithelial electrical resistance (TER) of confluent RPE cells was measured by epithelial voltmeter.The permeability of RPE cells to sodium fluorescein was measured.The expressions of the occludin and claudin-1 to -4 were determined by real-time polymerase chain reaction and Western blot analysis.t-text and one-way ANOVA were used to assess statistical significance btween H2O2 treated and normal coutrol groups.Results H2O2 at 0.2 mmol/Lshowed no decrease of cell viability of D407 cells,and this concentration was selected for the present study.The TER of D407 cells gradually increased,peaking at day 8 and then remained stable for 1 week.As compared to the control group,a reduction in the TER was first evident after 3 hours of treatment.Continuous culturing of cells for longer periods further reduced the TER,with a maximum effect after 24 hours of treatment and was maintained to 72 hours (24 h:11.86 ± 1.19 vs.24.13 ± 1.26,t =12.260,P =0.000;72 h:11.56 ± 1.47 vs.24.33 ± 1.52,t =10.460,P =0.000 ).At any time point after adding sodium fluorescein,the permeability values of cells after treated with H2O2 for 24 hours were significantly higher than those of cells without H2O2 treatment (20min:25％ ±3％ vs.12％ ±4％,t =-4.50,P =0.011 ;40 min:36％ ±4％ vs.16％ ±5％,t =-5.41,P =0.006;60 min:51％ ±5％ vs.29％ ±6％,t =-4.88,P =0.008 ).The expression of mRNA and protein in claudin-1,-3,and -4 were all downregulated in D407 cells treated with H2O2,whereas the expression of claudin-2 was upregulated ( claudin-1 mRNA:0.98 ± 0.18vs.0.28 ±0.12,t =5.60,P =0.005,claudin-1 protein,48 ± 10 vs.100 ± 12,t =5.77,P =0.004;claudin-3mRNA:0.37 ±0.12 vs.1.03 ±0.15,t =5.95,P =0.004;claudin-3 protein:63 ± 13 vs.100 ± 15,t =3.23,P=0.032;claudin-4 mRNA:0.38 ±0.11 vs.0.99 ±0.17,t =5.22,P=0.002,claudin-4 protein,57 ± 12vs.100 ± 13,t =4.21,P =0.014 ).However,the expression of these occludins did not differ bettween cells treated with and without H2O2(mRNA:1.30 ±0.21 vs.1.02 ±0.16,t=- 1.84,P =0.140;protein:109 ±15 vs.100 ± 14,t =-0.76,P =0.490 ).Conclusion Oxidative stress causes increase in the paracellular permeability of RPE cells in vitro,which may depends on the changes in expression of certain transmembrane proteins associated with the tight junction.

Objective To evaluate the efficacy of the Ritleng lacrimal intubation system in the treatment of congenital nasolacrimal duct obstruction (CNLDO) after failed probing and to analyze the effect of various factors that affected the recovery rate.Methods Retrospective noncomparative case series.The outcome of 616 cases (eyes) of silicone intubation with the Ritleng lacrimal intubation system,performed between Feb.2008 and Oct.2009 on 546 children with CNLDO ( aged from 3 to 156 months with an average at 11 months) from Beijing Children's Hospital,was retrospectively reviewed.The follow-up period varied from 4 to 17 months (average 11 months).The effects of age,treatment history,and the type of obstruction on the recovery rate were evaluated and the complications such as epistaxis,lacrimal duct edema or silicone tube prolapse were recorded.The statistics analysis included Pearson correlation coefficient and independentsamples t-test.Results The overall recovery rate was 88％ (544/616 cases).In the five sub-groups based on the age,6 - 12 month,12 -24 month,24 -36 month,36 -48 month and older than 48 month age,the recovery rate was 96％ (94/98) ; 94％ (244/260) ; 87％ (104/119) ; 77％ (58/75) and 69％ (44/64),respectively ( R =-0.98,P =0.003).According to the times of previous probing,there were three groups,once,twice,and more than twice,the recovery rate was 95％ (291/304); 89％ (163/184) and 70％( 90/128 ),respectively ( R =- 0.99,P =0.050 ).In the simple membranous obstruction group and the complex obstruction group,the recovery rate was 92％ (343/374) and 83％ (201/242),respectively (P = 0.000).Complications included laceration of lachrymal point (8 eyes,1％ ) and false passage formation (14 eyes,2％ ).The silicone tube prolapsed in 18 eyes (3％).Conclusions The Ritleng lacrimal intubation system is an easy,effective and non-traumatic procedure for the treatment of CNLDO children after failed probing.Age of the patients,times of previous probing and type of obstruction influence the recovery rate.

Objective To investigate the clinical manifestation,management and prognosis of optic neuritis combined with viral hepatitis.Methods Retrospective study case series.Clinical data from twenty patients with optic neuritis combined with hepatitis who were hospitalized in Beijing Tongren Hospital neural eye wart from September 2003 to June 2010 were collected,the clinical characteristics and visual field changes in the group of patients were summarized,and comparison between the vision before and after treatment was made by the Wingerchuk vision classification.Results Among the twenty patients,eighteen patients had chronic hepatitis B and two patients had chronic hepatitis C.Thirteen (65％) patient were monocular,sixteen( 80％ ) patients were single-phase course.Twenty-seven eyes were affected.Disc edema was very common which was found in 14 eyes(52％ ),severe vision impairment ( Best corrected visual acuity worse than 20/200) were recorded in 19 eyes (70％).Lower altitudinal visual field impairment was more common which was found in 10 eyes (50％).All patients were followed for 3 months after steroid therapy,complete visual recovery or significant improvement was seen in only 3 eyes (1 1％ ) or 4 eyes (15％).Minor improvement was seen in 12 eyes (44％),while 8 eyes (30％) had no improvement.Conclusions In this study,optic neuritis combined with hepatitis usually showed severe visual impairment.Although the vision of some patients could completely recover after steroid therapy,most of the patients had poor recovery.Combination of steroid and anti-viral therapy should be considered in the management of optic neuritis combined with hepatitis.

Objective To summarize clinical characteristics of mechanical ocular injury and to analyze the role of ocular trauma score (OTS) in the estimation of final visual acuity.Methods All cases of ocular trauma admitted to the Department of Ophthalmology from January 2009 to December 2010 were retrospectively reviewed.Data extracted included laterality of the injured eye,gender,age,presenting time,cause,ocular trauma classification,initial and final visual acuity.These injuries were classified by ocular trauma classification system (OTCS). We also used the OTS in evaluating the final visual outcome.Comparisons between groups for discontinuous variables were analyzed using rank-sum test.Rank correlation was used in analysis between initial visual acuity and final visual acuity or between final visual acuity and OTS.Chi-square test was used to analyze variables,such as age,cause,type and visual acuity.Comparison of ages between male and female was analyzed by using t-test.Results Of the 168 eyes,there were 106 open globe injury (OGI) and 62 closed globe injury (CGI).There were 140 males (85.71％) and 22 females ( 14.29％ ).Presenting time median of OGI and CGI was 5 h and 10 h respectively,and there was significant difference between these two different injuries ( Z =- 2.547,P =0.011 ).The high-risk age group was the young age group ( 100 eyes,59.52％ ),vs.the middle age group ( 46 eyes,27.38％ ) and the elder age group (22 eyes,13.10％ ).Occupation-related injury (70 eyes) was the most common cause and mainly resulted in OGI (54/70).Initial and final visual acuities in CGI were better than those of OGI (x2 =37.847,P=0.000; x2 =44.428,P =0.000).Initial visual acuity was correlated with final visual acuity ( r =0.858,P =0.000 ).Final visual acuity was significantly correlated with total score ( r =0.870,P=0.000) and OTS (r =0.869,P=0.000).Conclusions In this group of mechanical ocular trauma patients,male is more common than the female.Main type of injury is OGI and presenting time of OGI is earlier than that of CGI.The high-risk age group is the young.Main cause of injury is occupation-related injury.Initial and final visual acuities in CGI are better than those in OGI.OTS calculated at initial examination may be a useful parameter for the estimation of prognosis.

The patient was a 73-year-old man whose right eye visual acuity decreased for 3 months and came to the Department of Ophthalmology of the First Affiliated Hospital of Jinan University. Ocular examination showed that the right eye visual acuity was 0.05, there was no abnormality in the anterior segment of the eye, a huge circular hole was seen in the peripheral retina above the temporal fundus of the right eye, and the whole retina showed shallow funnel detachment (Quintessence Picture 1).

The patient was a 48-year-old male. He came to Tianjin Eye Hospital on May 5, 2011 because of the increasing mass in the eyebrow arch of the upper eyelid of his left eye. The patient came to Tianjin Eye Hospital on March 26, 1997 because of the gradual increase in the skin mass in the eyebrow arch of the upper eyelid of his left eye for 10 years, and performed resection of the eyebrow arch mass in the outpatient operating room. During the operation, the subcutaneous mass was removed, which was about 3.5 cm ×1.2 cm ×0.7 cm in size, with unclear boundary and cartilage-like texture. The postoperative pathological diagnosis was sclerosing basal cell carcinoma of the skin of the upper eyelid of his left eye (Figure 1). In 2004, the tumor in the eyebrow arch of the upper eyelid of his left eye recurred and continued to grow slowly, but no treatment was performed. Ophthalmological examination: The skin in the eyebrow arch of the upper eyelid of his left eye showed a reddish, depressed scar-like lesion with irregular boundary and spread to the root of the nose, without obvious pain. The lesion area was hard to touch, with slight bulge locally, and no ulcer on the surface skin (Figure 2). CT examination: The eyebrow arch, medial canthus and nasal root of the upper eyelid of his left eye showed an unclear boundary density increase. There was no obvious edema on the left eyelid, and there was a gray-brown mass about 8.0 mm ×6.0mm in the medial canthus of the conjunctiva, the surface was smooth, the cornea and fundus examination were normal, and the lacrimal duct irrigation was smooth. The right eyelid had no obvious mass lesions, and the conjunctiva, cornea and fundus examination were normal. The patient had no history of long-term exposure to sunlight or local radiotherapy.

Charcot-Marie-Tooth disease is also known as gastrocnemius atrophy. We reported a family of Charcot-Marie-Tooth disease in 1989 [1]. In 2010, blood mtDNA molecular genetic test was performed on 7 members of this family, which showed that the proband was mutated at 14484 locus. The proband was a male, 55 years old. Because of the gradual decline of vision in both eyes, he went to Fuzhou Southeast Eye Hospital for initial diagnosis on October 20, 1986. Ocular examination: the visual acuity was checked by the international standard vision chart, which was 1.2 in the right eye and 0.05 in the left eye. No abnormalities were found in both external eyes and fundus examinations. Central visual field examination: No abnormalities were found in the right eye, and there were dumbbell-shaped dark spots in the left eye. Initial diagnosis: acute retrobulbar optic neuritis in the left eye. One year later, the visual acuity of the patient's right eye dropped to 0.1, but the visual acuity of the left eye did not change. The paracentric comparative dark spot (about 10°) appeared in the right eye, and there was no abnormality in fundus examination. Multifocal visual evoked potential detection in both eyes showed prolonged latency of P100; There are similar lower limb muscle weakness and optic nerve atrophy in the family (Figure 1). In October 2009, the proband was followed up, and the visual acuity of both eyes was 0.06; the pupils of both eyes were moderately dilated, and the response to light was slow; Both eyes had good movement and no nystagmus; The papilla of both eyes was atrophic and pale, and no degeneration or atrophy of the peripheral part of the retina was observed after mydriasis. The medical history was followed up, and it was found that the proband suffered from muscle atrophy of both lower limbs and obvious claudication at the age of 15. Biopsy of gastrocnemius muscle of both lower limbs and electron microscopy were performed, and no abnormal mitochondrial changes were observed.

The child was a 2-year-old male. He went to the Institute of Orbital Diseases of the Armed Police General Hospital for 3 months of left exophthalmos. The child was delivered naturally at full term, healthy in the past, and had no family genetic history. Ophthalmology examination: the left eye visual acuity examination did not cooperate, the eyeball was displaced upward, all directions moved in place, and the exophthalmos measurement did not cooperate. The left eye was more prominent than the right eye by visual inspection. The intraocular pressure was Tn, and the orbital pressure was T +1 by finger test. No obvious abnormalities were found in the right eye examination. Imaging examination: Axial CT showed a circular space under the optic nerve of the left eye, with clear and homogeneous boundaries, and enlarged orbital cavity. MRI showed a clear tumor boundary, with high signal in T1WI image and medium and low signal in T2WI image (Figures 1A and 1B). Peripheral blood, chest X-ray and abdominal B-ultrasound examination showed no obvious abnormalities. Clinical diagnosis: left orbital tumor (hemangioma?). The child underwent left lateral orbitotomy under general anesthesia to remove the intraorbital tumor. During the operation, the tumor was dark red with clear boundary, about 3cm ×3cm ×2cm in size, and the tumor had a capsule, which was cystic. When the capsule was incised, the contents of the capsule looked like dark brown old blood accumulation. Pathological examination: A pile of dark brown broken tissue was found in general examination, with a total volume of about 2.5 cm ×0.5 cm ×0.3 cm (Figure 2);

The patient was a 73-year-old male. He was hospitalized in the Department of Ophthalmology of Peking Union Medical College Hospital on November 9, 2009 due to the discovery of mass in both eyelids (6 months in the right eye and 3 months in the left eye). Six months ago, the patient developed a mass in the right lower eyelid without obvious trigger, which increased progressively, without pain, without loss of vision, accompanied by symptoms of photophobia and tearing. He was diagnosed as conjunctivitis in the right eye in a local hospital. He was treated with oral antibiotics (the specific name of the drug is unknown) without improvement. Three months ago, the mass in the left lower eyelid was discovered, which progressively aggravated, with hoarseness and dysphagia. He lost about 20 kg in the past 2 years. The patient denied systemic medical history, and there was no special genetic history and family history. Systemic physical examination: swollen lymph nodes were palpable in both mandibles, both necks anterior and posterior to the neck, both groins, right trochlea and left clavicle, with a maximum diameter of about 2.5 cm ×2.0 cm, no tenderness, medium texture and partial fusion; The upper abdomen was tough, with suspicious mass palpable, and the boundary was unclear; The visual acuity of the right eye was 0.8, the visual acuity of the left eye was 0.5, the intraocular pressure of the right eye was 11 mm Hg (1 mm Hg =0.133 kPa), and the intraocular pressure of the left eye was 12 mm Hg; The downward movement of both eyeballs did not exceed the midline, and there was no abnormality in the other directions; The lacrimal gland area of both eyes can be palpable with non-smooth mass, moderate hardness; Both lower eyelids were obviously bulged, with a faba bean-sized mass palpable (Figure 1), moderate hardness, and tenderness on the right side (+); The left upper eyelid is drooping, occluding 1/2 of the pupil, the skin of the eyelid is red, slightly swollen, the root of the nose is obvious, and a nodule with unclear boundary can be palpable, and the tenderness is obvious;

Erosive corneal ulcer, also known as Mooren ulcer, is a progressive and painful peripheral corneal ulcer that starts from the limbus of the cornea. Pterygium is a common ophthalmic disease in which local bulbar conjunctival fibrovascular tissue shows triangular hyperplasia and invades the cornea. However, the simultaneous occurrence of two diseases is very rare. At present, only two cases have been reported abroad [1-2], but not in China. On July 6, 2011, we diagnosed and treated a patient with erosive corneal ulcer with pterygium in both eyes, and its clinical data are reported as follows.

Peripheral refraction is the eccentric refraction in the peripheral visual field.Recent studies have shown that it has complex relationship with myopic onset and progression.Generally considered,subjects with relative hyperopic peripheral refraction are more likely to have a prolate posterior eye shape,which is a risk factor of myopia; On the other hand,those with relative myopic peripheral refraction are more likely to have an oblate posterior eye shape which is a protective factor of myopia.This paper reviews recent studies about the effects of peripheral refraction on myopic onset and progression and its correlation with posterior eye shape.

Ocular neovascularization is a sight-threatening condition involved in several pathologic ocular disorders such as corneal neovascularization,retinopathy of prematurity,proliferative diabetic retinopathy,age-related macular degeneration,and neovascular glaucoma.Angiostatin,a naturally occurring inhibitor of angiogenesis,was discovered based on its ability to block tumor growth in vivo by inhibiting the formation of new tumor blood vessels. Angiostatin is a proteolytically derived internal fragment of plasminogen and may contain various members of the five plasminogen ‘ Kringle' domains.Angiostatin's molecular mechanism of anti-angiogenesis includes inhibiting endothelial cell proliferation,migration and tubule formation,and also inducing endothelial cells apoptosis.A number of groups have sought to identify the cell surface binding sites for Angiostatin,resulting in many different binding sites proposed for Angiostatin on the surface of endothelial cells.This review will consider the research supporting all of the various reported Angiostatin binding sites.There have been several developments in the quest to elucidate the mechanism of action of Angiostatin and the regulation of its receptor.The purpose of this review is to describe the highlights of research on the mechanism of action of Angiostatin,and then assess the therapeutic value of this peptide.

Preface Except for 5.2.5, 6.2.2, 6.4, 7.2.7, 7.2.8 and 8.2, which are recommended clauses, the rest of this standard are mandatory. This standard is proposed by the Medical Service Standards Professional Committee of the Ministry of Health. This standard is approved by the Ministry of Health of the People's Republic of China. This standard is drafted in accordance with the rules given in GB/T 1.1-2009. The main drafting units of this standard are: Hospital Management Research Institute of the Ministry of Health, Sun Yat-sen University Ophthalmology Center, Beijing Xinli Ophthalmology Center, Peking University Ophthalmology Center, Ophthalmology Center of the Second Affiliated Hospital of Chongqing Medical University, and Eye, Ear, Nose and Throat Hospital affiliated to Fudan University.

rigid gas permeable contact lenses (RGPCL) used in clinic, including rigid gas permeable contact lenses (RGP lenses for short) for correcting refractive errors and orthokeratologylenses (OK lenses or orthokeratologylenses for short) for the purpose of reducing myopia degree, are Class III medical devices stipulated by the national SFDA. The fitting of clinical RGP lenses and orthokeratologylenses should have certain standards and procedures to ensure their effectiveness and safety.

The National International Summit Forum on Strabismus and Pediatric Ophthalmology and the Appropriate Technology Study Class on Strabismus and Pediatric Ophthalmology, sponsored by the Strabismus and Pediatric Ophthalmology Group of Ophthalmology Branch of Chinese Medical Association, will be held in Xiamen, Fujian Province from June 7 to 11, 2012. This forum will invite well-known experts at home and abroad to give academic lectures on basic and clinical research on strabismus, amblyopia, childhood optometry, congenital cataract, congenital glaucoma, infantile vitreoretinal diseases, childhood eye trauma, childhood hereditary eye diseases and other childhood eye diseases. Participants will receive Class I CME credits from the Chinese Medical Association.

Sponsored by Tianjin First Central Hospital and co-organized by Xijing Hospital of the Fourth Military Medical University, the 17th Ophthalmology Imaging Ocular Tumor and Orbital Disease Study Class will be held in Xi' an from June 5 to 10, 2012. This workshop aims to improve the application of ophthalmic imaging in the diagnosis and treatment of intraocular diseases, ocular tumors and orbitopathies. The study class is taught by professors such as Song Guoxiang and Sun Fengyuan, famous experts in ophthalmology imaging and orbital diseases in China. The study content covers ophthalmology ultrasound,

Chinese Medical Association is scheduled to hold the 17th National Ophthalmology Academic Conference in Nanjing, Jiangsu Province from August 21 to 25, 2012. This is another large-scale ophthalmology event held in China after the 16th National Ophthalmology Academic Conference of Chinese Medical Association and the 4th Global Chinese Ophthalmology Academic Conference in 2011. It is estimated that 5,000 delegates will attend the meeting, and more than 10,130 famous international and domestic ophthalmologists will give special reports on new technologies, new knowledge and new experiences in ophthalmology development.

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.

The first National Neuroophthalmology Academic Conference sponsored by Chinese Medical Association, Ophthalmology Branch of Chinese Medical Association and Neuroophthalmology Group (in preparation) of Ophthalmology Branch of Chinese Medical Association will be held in Beijing from June 7 to 11, 2012. This conference will invite famous neuro-ophthalmology experts at home and abroad to make special introductions on neuro-ophthalmology diseases in the research fields of diagnostics, genetics, imaging, epidemiology, low vision rehabilitation, etc., and discuss neuro-ophthalmology cases.

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. Jing Chen Jiaqi,

The 90th birthday celebration of Professor Nie Aiguang, a famous ophthalmologist in China, one of the founders of fundus diseases, a predecessor in the diagnosis and treatment of vitreoretinal diseases in Hunan Province, and the symposium on the development trend of ophthalmology was held in the Second Xiangya Hospital of Central South University on the morning of April 7th, 2012. Nearly 300 industry experts, professors, scholars and guests from all over the country attended to congratulate Mr. Nie on his 90th birthday.

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; National map code: M93.

1. Statistical symbols: According to the relevant provisions of GB3358-1982 "Statistical Terms and Symbols", all statistical symbols are printed in italics.

In order to improve the printing quality of the journal, this journal has been changed to CTP plate making since 2011. In order to guarantee the printing quality of the pictures after CTP plate-making, this journal makes the following requirements 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.

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.

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.

Sponsored by the Chinese Medical Association, this journal was founded on October 1, 1950, and is now a monthly magazine. The editorial committee is composed of more than 100 well-known ophthalmologists across the country. Currently Editor-in-Chief Zhao Kanxing, Deputy Editors-in-Chief Wang Ningli, Sun Xinghuai, Yin Zhengqin, He Shouzhi, Yao Ke, Cui Hao, Hui Yannian, Ge Jian, Xie Lixin (Academician of Chinese Academy of Engineering), Li Xiaoxin, and Director of Editorial Department Huang Yibin. For many years, the circulation, influencing factors, total citation frequency and other indicators of this journal have been ranked first among the domestic professional journals.

Shanghai Peace Eye Hospital was established in December 2002, with a building area of 6,600 square meters and 82 beds. It is a modern ophthalmology hospital integrating medical treatment, teaching, scientific research and prevention in Shanghai. It is jointly founded by Xiamen Eye Center Co., Ltd., Shanghai Commercial Investment Venture Capital Co., Ltd., Eye, Ear, Nose and Throat Hospital affiliated to Fudan University and other units. It is a designated hospital of Shanghai medical insurance, the first batch of superior specialty (ophthalmology) hospitals of Shanghai social medical institutions, and a recommended specialty hospital published by Shanghai Science Popularization Press. The hospital offers cataract, glaucoma, vitreoretinopathy, ocular surface and corneal diseases,