Volume 49 · Issue 11 · 2013

To investigate the impact factors and clinical significance of standardized perioperative antibiotic application on nosocomial infection and drug-resistant bacteria strains in eye hospital.

It was a retrospective series case study.The inpatients underwent ophthalmologic operation of one year before standardized application (from Sep.2009 to Aug.2010) and one year after standardized application (from Sep.2010 to Aug.2011) in Tianjin Eye Hospital were selected and the incidence rate of nosocomial infection and types of drug-resistant strains in these two years were analyzed.

From Sep.2009 to Aug.2010,the prophylactic antibiotics application rate for typeⅠincisional surgeries was 80.29% (12937/16 111),the nosocomial infection rate was 0.011% (2/17 563).From Sep.2010 to Aug.2011,the same values were 44.50% (7968/17 905) and 0.005% (1/19 441).There was a significant decrease of prophylactic antibiotics application comparing these two years (χ²=4587.78,P<0.05).However,there was no significant difference in nosocomial infection rate (χ²=0.44,P>0.05).Average antibiotics application rate for inpatient (typeⅠ-Ⅳincisional surgeries) was 76.69% (13 469/17 563) from Sep.2009 to Aug.2010,and 49.40% (9604/ 19 441) from Sep.2010 to Aug.2011.There was a significant decrease over these two years (χ²=2927.19,P<0.05).The results of isolation and cultivation of bacteria in these two years showed that staphylococcus epidermidis predominated in gram-positive bacteria,pseudomonas aeruginosa predominated in gram-negative bacteria.Drug resistance rate of staphylococcus was 42.86% (33/77) from Sep.2009 to Aug.2010 and 39.19% (39/74) from Sep.2010 to Aug.2011.Drug resistance rate of pseudomonas aeruginosa was 2/11 from Sep.2009 to Aug.2010 and 2/13 from Sep.2010 to Aug.2011.There were no significant differences in drug resistance rate of staphylococcus and pseudomonas aeruginosa between these two years (χ²=0.09,P>0.05,χ²=0.03,P>0.05).

By standardizing the perioperative antibiotics application in eye hospital,the rate of systemic administration of antibiotics declined gradually.The Choices and the administrative mode of antibiotics were more rational than before.In the meanwhile,the rate of nosocomial infection and drug-resistance did not increase.Therefore,avoiding the drug abuse ensured the medical safety,which was worthy of further study. (Chin J Ophthalmol,2013,49:1002-1005)

To Explore the feasibility of rhesus monkey vascular endothelial cell (RMVEC) transplantation to substitute the allogeneic corneal endothelial cells (CEC),through observe the morphologic and functional change of the vascular endothelial cell which was transplanted to the inner surface of cornea without Descemet's membrane.

It was an experimental study.The rhesus monkey vascular endothelial cell was cultivated to proliferation and marked by Brd U in vitro.The experimented monkeys are divided into 2 groups:experimental group (6 monkeys),control group (3 monkey).In experimental group: the cultured RMVEC,marked by Brd U,were transplanted onto the posterior surface of rhesus monkey cornea without Descemet's membrane though centrifugal sedimentation,then sew back the corneal graft.In control group: detach the corneal Descemet's Membrane of rhesus monkey but without cultured RMVEC transplantation.Corneal transparence of every monkey was frequently observed postoperation.On 30,60,90 postoperative days,corneal graft were respectively detached to observe the distribution,appearance and ultrastructures morphological structure of RMVEC on the inner surface of cornea,by pathological section,anti Brd U monoclonal antibody immunohistochemistry,scanning electronic microscope (SEM) and transmission election microscopy (TEM).

Corneal transparency: In the experimental observation period (three months),the corneal graft of experimental group had better transparency than control group and without corneal neovascularization and bullous keratopathy.Pathological section: A layer of cells with Brd U staining positive was found on the posterior surface of cornea in experimental group,indicated the cells are RMVEC.And no cell-like structure was found in control group.SEM: Experimental group showed that RMVEC with irregular shape uniformly distributed on the inner surface of cornea and growing well,a small amount of white blood cells can be seen between RMVEC,and part of cellular debris exist in the trabecular meshwork.Control group showed a fiber material without RMVEC.TEM:The cultured RMVEC and which in posterior surface of cornea was irregular oblateness,a large number of desmosomes link were been seen between RMVEC.Abundant organelles and characteristic WPBs appear in cytoplasm,which suggest the characteristics and vitality of vascular endothelial cells in vivo,and no cell structure in the control group.

Rhesus monkey endothelial cells can growth on the posterior surface of cornea without Descemet's membrane.The cultured cells,with similar ultrastructure to RMVEC in vivo,can play a role of barrier to keep the corneal dehydration and transparency to some extent. (Chin J Ophthalmol,2013,49:1006-1013)

To study the effect of chloride channel on proliferation induced by basicfibroblast growth factor (bFGF) in human lens epithelial cells HLE B-3 (LEC).

HLE B-3 cells at Logarithmic growth phase were incubated in the 6 or 96 well plate overnight and the proliferation was induced by 10μg/L b FGF.The cells were divided into b FGF group treated with b FGF and the blank control group with the regular cells culture.LEC were treated with different concentrations of chloride channel inhibitors:5-nitro-2-[3-henylpro-pylamino] benzoic acid (NPPB) at 50,100,150μmol/L and 4,4'-2 diisothiocyanostilbene-2,2'-disulfonic acid (DIDS) at 10,50,100μmol/L with b FGF or without bFGF in 10% serum for 24,48,72 hours.The cell viability and the drug toxicity were detected by CCK-8 colorimetric assay.The expression of proliferating cell nuclear antigen (Ki-67) of LEC treated with NPPB or DIDS were observed by immunocytochemistry staining assay.The phase change of cell cycle was examined by flow cytometry.Each experiment group and control group were compared using two-way ANOVA,further pairwise comparisons using LSD-t test or by the Independent-Samples t test.

10μg/L bFGF induced LEC proliferation and the values of A stage were gradually declined with the increase of chloride channel inhibitos'concentrations and time at 24 hours,48 hours and 72 hours (b FGF+ NPPB group:Ftime=305.28,Fconcentrations=18.76,P=0.000;bFGF+ DIDS group:Ftime=94.44,Fconcentrations=24.42,P=0.000).Different concentrations of chloride channel inhibitor reduced the values of a stage with 10μg/L b FGF in a doseand time-dependent manner.The expression of Ki-67 was significantly lowered compared with the b FGF group (b FGF+ NPPB group: 18.32%±1.23%,F=580.3,P=0.000;bFGF+ DIDS group: 11.21%±1.02%,F=507.4,P=0.000),when 150μmol/L NPPB and 100μmol/L DIDS with 10μg/ L bFGF were added at 48 hours.After 150μmol/L NPPB and 100μmol/L DIDS treatment at the 48th hour,the rate of G₁stage was significantly increased (F=390.754,P=0.000),where as that of S stage decreased significantly (F=166.240,P=0.000).

These results indicate that chloride channel inhibitors play an important role in modulating the proliferation cycle of LEC treated with bFGF by limiting the cell at cycle S/G₁stage from dividing into S stage. (Chin J Ophthalmol,2013,49:1014-1019)

This study is to investigate the effect of the combination of the olfactory ensheathing cells (OEC) transplantation and intravitreous injection of ciliary neurotrophic factor (CNTF) on the retinal ganglial cells' (RGC) apoptosis and axonals' reparation and regeneration.

In this study,the supraorbital margin exposure of the optic nerves was used to establish adult SD rats' optic nerve inhausted injury model as control group.Then the purified OECs were injected into the optic nerve sheaths,and CNTF was injected into the vitreous body simultaneously.The rats were divided into control group,CNTF group,OECs group,and OEC+ CNTF combined group.At 4 weeks postoperatively,a cholera toxin B subunit (CTB) anterograde tracing technique and fluorescence (FG) biotinylated dextran amine (BDA) retrograde tracing technique were adopted to evaluate the survival of RGC and the regeneration of optic nerve axons.The number of survival neurons of the same vision field and the density of neurons were evaluated by analysis of variance.

At the one and three quadrant distance between optic disc 2 mm spot,the number of the RGC in the control group was significantly (F=633.38,P<0.01) decreased compared with the normal group (46.00±1.42,34.80±1.34,25.00±1.61,15.40±2.30).The survived RGC in OEC group was significantly more than that in CNTF group,while the combined treatment with CNTF and OEC had strongest repair effect.The neuron axon density showed a statistically significant difference in the average optical density value at distance between foramen opticum 2 mm spot (OEC+ CNTF: 3.18±0.26,OEC:2.96±0.28,CNTF: 2.83±0.37,and control: 2.75±0.12,respectively,F=17.66,P<0.01).

Optic nerves damage can be repaired and regenerated by the combined treatment with OEC and CNTF suggesting that CNTF and OEC have synergistic effect on the treatment of optic nerve injury and repair.Transplantation of OECs may genetically modify the secretion of human CNTF and promote optic nerve injury repair. (Chin J Ophthalmol,2013,49:1020-1028)

To establish mouse lens epithelial cell lines with the genotype of Hsf4-/-.

The expended mouse lens epithelial cells,which were generated from P6 Hsf4-deficient mouse lens epithelia,were immortalized with SV40-T-antigen and named MLEC/Hsf4-/-cell.The expression of alpha A-crystallin was immunoblotted.Hsf4b cDNA was reconstituted by transiently transfection.

The SV40-immortalized cells were in adherent growth mode with spindle morphology,pseudopodia,clear nuclear bondary membrane and cytoplasm translucent.Immunoblotting results indicated that the lens biomarker protein alpha A-cryatllin was expressed in MLEC/ Hsf4-/-cells.Reconstitution of Hsf4b into MLEC/Hsf4-/-cells upregulated the expression of Hsp25.

The SV40-immortalized MLEC/Hsf4-/-cells have the lens epithelial characteristics and could be used as a tool for studying the signal transduction in vitro. (Chin J Ophthalmol,2013,49:1029-1031)

To investigate the correlative anterior segment parameters of positive darkroom provocative test in patients with narrow anterior chamber angles.

It was a retrospective case series study.Two hundred and sixty patients[36 males and 224 females,mean age (59.6±9.3) years] with narrow anterior chamber angles underwent darkroom provocative test and UBM scan were analyzed retrospectively.Anterior segment parameters including anterior chamber depth (ACD),pupil diameter (PD),lens vault (LV),peripheral iris thickness (IT),iris convex (IC),anterior chamber angle open distance (AOD),trabecular-meshwork ciliary process angle (TCPA) and the number of appositional angle closure (NPAC) were quantitatively analyzed.Correlative factors of positive results were analysis by both single factor and multiple-factor analysis.

Seventy-one (27.3%) of the 260 patients had positive results in the darkroom provocative test.Males (15 out of 36) had statistically higher positive result rate than females (56 out of 224) (M:41.7% vs.F:25.0%,χ²=4.340,P=0.037).In single factor analysis,male (OR=2.14),AOD (OR=0.98),IT (OR=1.68) and NPAC (OR=2.24) were correlative factors for positive results.In multiple-factor analysis,only IT (OR=1.47) and NPAC (OR=1.70) were independent risk factors of positive results.

Positive darkroom provocative test is correlated to parameters of anterior chamber angle and iris,while IT and NPAC are independent correlative factors in patients with narrow anterior chamber angle. (Chin J Ophthalmol,2013,49:968-972)

To investigate the protective effects of sodium hyaluronate on ocular surface toxicity induced by a prolonged use of benzalkonium chloride-preserved Brimonidine eye drops.

Experimental study.Thirty adult female New Zealand rabbits were divided into three groups with randomized numbers design.Ten rabbits were treated with 0.2% Brimonidine eye drops and PBS (PBS group),the other ten rabbits with 0.2% Brimonidine combined with sodium hyaluronate eye drops (SH group),and control group received no treatment for 60 days.Schirmer test,fluorescein (FL) and Rose Bengal (RB) staining,conjunctival impression cytology specimens collecting were performed on day 0,31,and 61.Apoptosis of conjunctival epithelium was detected by in situ terminal deoxynucleotidyl transferase d UTP nick end labeling (TUNEL) assay on day 61.Conjunctival inflammation was observed by hematoxylin eosin staining.Histomorphological changes of cornea and conjunctiva were observed by light microscopy,and scanning and transmission electron microscopy at day 61.Fluorescein and Rose Bengal scores were analysed by Kruskal-Wallis test.Schirmer scores,goblet cell density and inflammatory cells infiltration were analysed by repeated measures analysis of variance.

There were significant differences in fluorescein and Rose bengal (H=22.031,15.303,P<0.01) staining among the groups on day 61.Compared with the control group (FL:0,0-1,RB:0,0-1),fluorescein and Rose Bengal scores were significantly (P<0.001) increased in PBS group (FL:1.5,1-2,RB:1,1-2),whereas was significantly (P<0.001) decreased in SH group (FL:0,0-1 RB:1,0-1) when compared to PBS group.There were significant differences in aqueous tear production and goblet cell density (F=7.980,14.545,bothP<0.01) among the groups on day 61.Compared with the control group[ (9.43±0.57) mm,(87.73±2.34/HP) ],Schirmer scores and goblet cell density were significantly (P<0.01) reduced in PBStreated group[ (6.61±0.38) mm,(68.06±3.61) / HP],but significantly (P<0.05) increased in SH-treated group[ (8.75±0.57) mm,(82.31±1.64) /HP] compared with PBS-treated group.The number of inflammatory cells was significant difference (F=56.306,P<0.001) among the groups on day 61.Compared with the control group[ (39.89±2.03) /HP],inflammatory cells infiltration was significantly (P<0.01) increased in both PBS[ (73.18±2.17) /HP]and SH groups[ (48.79±2.64) /HP],however,SH-treated group was significantly lowered when compared with PBS-treated group.In addition,decrease in apoptosis,complete microvilli and cell organelles were found in the corneal and conjunctival epithelial cells in SH-treated group.

Our results demonstrate that topical application of SH reduces the ocular toxicity and protect the ocular surfacein the long term antiglaucomatous medical therapies and may be considered as a vehicles or neutralizing material for future ocular application. (Chin J Ophthalmol,2013,49:973-980)

To investigate the effect of aquaporin4 (AQP4) knock out (KO) on the dysfunction of retinal ganglion cells (RGC) in laser-induced ocular hypertension (OHT) mice.

Experimental study.AQP4 KO mice (n=18,36 eyes) and wide type (WT) mice (n=18,36 eyes) were used.Unilateral OHT was induced by laser photocoagulation in KO and WT mice after anesthesia.A simultaneous recording of PERG was performed by homemade electrodes.Intraocular pressure (IOP) was measured with an IcareLAB rebound tonometer every day at noon before and after surgery.The data was analysised by ANOVA and t test.

In AQP4 KO mice,the mean P50 and P95 amplitudes were significantly (P<0.01) reduced compared with WT mice[P50: KO: (5.53±1.31) vs WT: (8.14±1.24) μvt=5.70 and P95: KO: (7.71±1.89) vs WT: (11.30±2.61) μv,t=3.83,respectively].The latencies of AQP4 KO mice in both P50 and N95 were shorter than those of WT (t=5.70 andt=3.83 respectively,P<0.01).The mean IOP was significantly (P<0.05) increased after photocoagulation in AQP4 KO and WT mice compared with prephotocoagulation[KO post: (14.78±1.80) mm Hg (1 mm Hg=0.133 kPa) vs KO pre- photocoagulation: (6.61±0.90) mm Hg and WT post: (16.44±1.46) mm Hg vs WT prephotocoagulation: (7.31±0.98) mm Hg,respectively] with animals under general anesthesia.IOP was lowered mildly but significantly in KO mice when compare with WT mice (t=3.09,P<0.05) lasting seven days.IOP was gradually decreased to baseline values at day eight in both of KO and WT mice.

Our results indicate that AQP4 null may damage retinal function that can be detected by the measurement of PEGR,a sensitive parameter to reflect the function of RGC. (Chin J Ophthalmol,2013,49:981-986)

To survey the distribution pattern and subject domain knowledge of worldwide glaucoma research based on literatures in Pubmed database.

Literatures on glaucoma published in 2007 to 2011 were identified in Pubmed database.The analytic items of an article include published year,country,language author,and journal.After core mesh terms had been characterized by BICOMS,the co-occurrence matrix was built.Cluster analysis was finished by SPSS 20.0.Then visualized network was drawn using ucinet 6.0.

Totally 6427 literatures were included,the number of annual articles changed slightly between 2007 and 2011.The United States,England,Germany,Australia,and France together accounted for 77.63% of articles.There were 52 high-frequency subjects and hot topics were clustered into the following 10 categories: (1) Pathology of optic disc and nerve fibers and OCT application,(2) Methods of visual field (VF) and visual function examination,(3) Glaucoma drug medications,(4) Pathology and physiology of primary open angle glaucoma (POAG) including VF and intraocular pressure (IOP),(5) Glaucoma surgery,(6) Gene research related to POAG,(7) Glaucoma disease pathology and animal models,(8) Ocular hypertension (OHT) induced complications and corneal changes,(9) Etiology of congenital glaucoma and complications,(10) Etiology and epidemiology of glaucoma.The visualized domain knowledge mapping was successfully built.The pathology of optic disc and nerve fibers,medications,and surgery were well developed.Study on IOP and visual field was in the core domain,which have an important link to etiology,diagnosis,and therapy.The researches on glaucomatous gene,disease pathology model,congenital glaucoma,etiology and epidemiology were not developed well,which are of great promotion space.

The distribution pattern and subject domain knowledge of worldwide glaucoma research in the recent five years were shown by using bibliometric analysis.Western developed countries play a leading role in the field of glaucoma research,the international influence of related reasearch in China needs to be strengthened. (Chin J Ophthalmol,2013,49:987-992)

To measure and accumulate imaging anatomical data of lacrimal sac and medial canthal artery,and provide the knowledge for clinical diagnosis and therapy of lacrimal diseases.

80 volunteers (80 eyes) who were eliminated the tearing related diseases by ophthalmologist were included.GE Voluson E8 ultrasound diagnostic apparatus with probe of high frequency 5-12 MHz was used,the probe of the three-dimensional ultrasound contacted eyes indirectly.The vertical diameter,anteroposterior diameter,width of lacrimal sac were measured,and vertical distance between top to bottom of lacrimal sac and medial canthus to skin,vertical distance between medial canthal artery and medial canthus to skin were also measured.

The measurement results of adult male subjects of lacrimal sac cavity vertical diameter and anteroposterior diameter and diameter were (13.3±2.0) mm,(6.2±1.1) mm,(5.0±0.9) mm; the measurement results of adult female subjects of lacrimal sac cavity vertical diameter and anteroposterior diameter and diameter were (13.1±2.2) mm,(5.8±1.0) mm,(4.8±0.8) mm,the difference was not statistically significant (t=1.63,1.45,1.41,P>0.05).The measurement results of adult male subjects of lacrimal sac cavity (top,bottom) to the top of the skin surface and medial canthal were (6.5±0.1) mm,(5.9±0.1) mm,(6.8±0.1) mm,(8.8±0.1) mm; the adult female group measurements were (6.1±0.1) mm,(5.7±0.1) mm,(6.2±0.1) mm,(8.6±0.1) mm,the difference was not statistically significant (t=1.30,1.56,1.45,1.63,P>0.05).The measurement results of adult male subjects vertex are angular artery to the skin surface and medial canthal were (7.7±0.1) mm,(8.0±0.0) mm; the adult female group measurements respectively (7.6±0.1) mm,(7.9±0.1) mm,the difference was not statistically significant (t=1.38,1.34,P>0.05).

Lacrimal sac and medial canthal artery can be showed clearly in three-dimensional ultrasound reconstruction,this can provide the guidance for clinical diagnosis and therapy of lacrimal deseases. (Chin J Ophthalmol,2013,49:993-996)

Ten researches that may represent the most advanced glaucoma related studies in China were voted by specialists from Chinese Glaucoma Society.These researches were concentrated in the following fields: the mechanism of glaucomatous optic neuropathy,tudy of the mechanism of elevated intraocular pressure and the regulation of intraocular pressure,Glaucoma gene research,Epidemiology study of glaucoma.Study of the visual pathway impairments of glaucoma.These studies represented the level of our national glaucoma specialists in the international glaucoma field and have become the landmark study of our specialists. (Chin J Ophthalmol,2013,49:1032-1034)

Recent advances on functional magnetic resonance technology have greatly broadened its application in many disciplines including ophthalmic research area.Functional magnetic resonance imaging (f MRI),which combines the anatomical and functional features of the neural system,is a non-invasive,objective and orienting method.Among so many sub-methods,blood oxygenation level dependent MRI reflects the neural activities of visual cortex; diffusion tensor imaging traces nerve fibers; gadolinium-enhanced MRI could access blood-ocular barrier function; manganese enhanced MRI reveals axoplasmic transport and retinotopic projection to sub-cortical nucleus; blood volume MRI could evaluate lamina-specific hemodynamics of ocular wall; while magnetic resonance spectroscopy investigates the molecular metabolism in nerve system.Glaucoma may damage the whole visual pathway,and f MRI would helps us estimate the in vivo fiber integrity and visual functional status quo in glaucoma patients.Here we first review the basic principles of several f MRI techniques and then discuss the applications in research related to glaucoma. (Chin J Ophthalmol,2013,49:1040-1044)

Glaucoma is one of the leading causes of blindness,second to cataract.Lowering intraocular pressure is the most effective therapeutic means for this disease,with prostaglandin analogs as the first-line medication.These drugs are efficacious and safe,with well-tolerated local adverse effects.They are also generally regarded to have almost no systemic untoward effect.Nonetheless,with the continuous rise in their popularity,systemic adverse effects caused by topical ocular use of prostaglandins have attracted increasing attention.These adverse effects include digestive,respiratory,and cardiovascular systems,as well as skin and hair.Although the incidence of these adverse effects is low,physicians need to be aware of their occurrence.Research progress of the prostacyclin class IOP-lowering medication side effects are reviewed. (Chin J Ophthalmol,2013,49:1045-1048)

As the most common acute optic neuropathy among individuals who are over 50-year old,nonarteritic anterior ischemic optic neuropathy (NAION) is presumed result from a circulatory insufficiency,or infarct,within the lamina or retrolaminar portion of the optic nerve head that is supplied by the short posterior ciliary arteries.It usually presents with sudden painless unilateral visual loss,characterized visual field defects,relative afferent papillary defect and pallid optic disk edema.The exact etiology of NAION remains elusive.Although numerous risk factors have been proposed,most of them are controversial.We summarized all these risk factors in this review. (Chin J Ophthalmol,2013,49:1049-1051)

Bacterial endophthalmitis is a real rare complication,perhaps the most devastating one,following pars plana vitrectomy.The most common organism responsible for it is coagulasenegative Staphylococcus.Potential predisposing factors of post-vitrectomy endophthalmitis are majorly coming from surgical procedures and compromising of the immune system.Preoperative povidoneiodine preparation received the clinical recommendation for prophylactic interventions.The main choices of bacterial endophthalmitis treatments are intravitreal injection of antibiotics according to etiological diagnoses and vitrectomy. (Chin J Ophthalmol,2013,49:1052-1055)

Promoting the control of primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG) is most important prevention program of blindness in China.PACG has been incorporated into the prevention program of blindness in China based on the population-based screening studies.However,the clinical screening should be strengthened in POAG.The creation of a series of appropriate technologies suitable for glaucoma prevention and management has been achieved in China,especially for PACG.The technologies have been evaluated in the pilot areas and obtained very good results in China.It is recommended to develop new technology suitable for glaucoma management using the following workflow: research,development,and evaluation by large scale hospitals,and then clinical trial in the pilot areas.After a cost-benefit analysis is made,the new technology can be promoted and applied in clinical practice nationwide.We propose to gradually formed a strategical mode of“screening in township hospitals,intervention in county hospitals,and technical support and tackling in provincial hospitals”in order to improve the level of prevention and treatment of glaucoma and reduce the blindness incidence rate caused by glaucoma. (Chin J Ophthalmol,2013,49:961-962)

Ex-Press miniature implant surgery (Ex-Press implantation) is a new alternative anti-glaucoma surgery.It is clinically important to clarify its indications.Ex-Press implantation has been indicated appropriate in primary open-angle glaucoma and should not be used in narrow angleclosure glaucoma and in high risk of failed scarring cases.More evidence-based studies are still needed to convince the pros and cons in other conditions including aphakia or pseudo-phakia glaucoma,secondary open-angle glaucoma and refractory glaucoma. (Chin J Ophthalmol,2013,49:963-964)

Patients with high myopia are at high risk of glaucoma and are difficult to be discovered at early stage in the case of existing glaucoma.Myopic excimer laser corneal refractive surgery changes the structure of the eye,which makes early glaucoma diagnosis more difficult.Furthermore,refractive surgery may aggravate existing condition of glaucoma.To prevent the exacerbation of glaucoma,it is great important to perform the preoperative glaucoma risk assessment.In this paper,we presented the key diagnostic points of glaucoma assessment before and after excimer laser refractive surgery and discussed the postoperative intraocular pressure measurements and its impact on the diagnosis and treatment of glaucoma including characterization of open angle glaucoma and long-term follow up in patients with high myopia. (Chin J Ophthalmol,2013,49:965-967)