Purpose:Comparison of topical vs general aneasthesia for strabismus surgery.Methods:Preoperative patients (aged 6～12 years) were divided into two study groups:the topical aneasthesia group (n=22),and the general aneasthesia group (n=21).The study groups were compared on the following measures:analgesic effect,surgical correction effect,eye-heart reflex,preoperative preparation time.and operation time,using t-tests or X2tests where appropriate.Results:Compared with the general aneasthesia group,the topical aneasthesia group gained better surgical correction results(P＜0.05),had a lower rate of eye-heart reflex (P＜0.05),and had a shorter preoperative preparation time (P＜0.001).No significant difference was observed between the groups in terms of the analgesic effect or operation time (P＞0.05).Conclusion:Topical aneasthesia represents a safe and effective alternative to general aneasthesia for strabismus surgery in children.

Purpose:To investigate the efficacy of progressive addition lenses on the treatment of ametropia and loss of accomodation after the single eye's IOL implantation.Methods:Eighty four patients undergoing IOL implantation in single eyes were prescribed with progressive addition lenses for ametropia correction and regularly followed up to observe subsequent correction effect.Results:Among these 84 patients,72 could comfortably adapt to the use of progressive addition lenses to improve visual acuity and accomondation,while the remaining 12 patients failed to accomodate the usage of progressive addition lenses.Conclusion:Wearing progressive addition lenses acts as a relatively feasible approach to improve visual acuity and alleviate disorders of accomodation for patients who underwent IOL implantation in single eyes.The patients should be prescribed with progressive lenses under professional instructions and guidance.

Purpose:To study the effect of intravitreal injections of triamcinolone acetonide (TA) for the treatment of macular edema secondary to central retinal vein occlusion (CRVO)in a sample of Chinese patients from Shaanxi province.Methods:The 50 eyes from 50 patients were separated into three TA treatment groups:17 patients were given 4 mg/0.1ml,19 patients were given 8 mg/0.2 ml,and 14 patients were given 16 mg/0.4 ml.Patients were followed up for 12 months.Foveal thickness,intraocular pressure (IOP),and best-corrected visual acuity (BCVA) were measured.Results:Macular edema responded well both anatomically and functionally to the TA injections.After the initial intravitreal injection,macular edema recurred at 2-4 months in the low-dose group (4 mg),at 3-5 months in the medium-dose group (8 mg),and at 6-9 months in the high-dose group (16 mg).No significant difference in BCVA or in foveal thickness were observed between the first intravitreal injection and the re-injection.There was no increase in IOP after re-injection of 16 mg TA,if the patient did not have an elevated IOP after the initial intravitreal injection of 4/8 mg TA.Conclusion:A low dosage of TA (4 mg) administered via intravitreal injection might be useful as an initial treatment for macular edema secondary to CRVO.A higher dosage of TA (16mg) can be used if there is no IOP elevation with the initial TA injection.

Purpose:To evaluate the efficacy and safety of using coreoplasty,and an iris-supported Artisan intraocular lens (IOL),for mydriasis and aphakic correction in post-traumatic vitrectomized eyes.Methods:A total of 17 aphakic patients were admitted between April 2009 and April 2010 to the ophthalmologic department of Xiamen Eye Centre.All eyes had previously received lens removal and vitrectomy.After the retina stabilized and corrected visual acuity improved,the iris was sutured.The Artisan IOL was fixated onto the iris surface.Patients were followed-up at one day,one week,one month and three months postoperatively.The following outcomes were assessed:symptoms of photophobia and glare,uncorrected visual acuity (UCVA),best-corrected visual acuity (BCVA),intraocular pressure (IOP),endothelial cell density (ECD).The diameter of pupil and the anterior chamber depth (ACD)were measured by the anterior segment optical coherence tomography (OCT).Results:Artisan IOLs were successfully implanted in all aphakic eyes.Postoperatively,improvement was observed in photophobia and glare symptoms.UCVA was enhanced in all patients (six eyes had better UCVA postoperatively than BCVA preoperatively).However,there were no significant changes in IOP.Mean loss of ECD was 336.06/mm2.Mean postoperative pupil diameter was 3.67±0.41 mm,compared with 5.67±0.57 mm preoperatively(P＜0.05).Mean ACD was reduced by 0.88 mm (3.38±0.33 mm preoperatively vs 2.50±0.35 mm postoperatively,P＜0.05).Conclusion:Surgery that combined coreoplasty and Artisan IOL implantation was a safe and effective treatment for correcting aphakia and mydriasis in post-traumatic vitrectomized eyes.

Purpose:To compare melanin-related near-infrared fundus autofluorescence (NIA; excitation 787 nm,emission＞ 800 nm)with lipofuscin-related fundus autofluorescence (FAF; excitation 488 nm,emission ＞ 500 nm) in patients with idiopathic choroidal neovascularization (ICNV).Methods:FAF,NIA,fundus fluorescein angiography (FFA)and indocyanine green angiography (ICGA) were obtained using a confocal scanning laser Ophthalmoscope HRA2 (Heidelberg Retina Angiograph 2) in 18 eyes of 18 patients with ICNV.Results:Eighteen eyes had classic CNV,and autofluorescence imaging showed hypoautofluorescence at the site of CNV.A well-defined hyperautofluorescent ring was detected surrounding the CNV in all 18 eyes with NIA imaging.In our sample,the FAF patterns around the CNV were classified as normal (n=1,5.56％),well-defined hyperautofluorescent ring (n=7,38.89％),or ill-defined hyperautofluorescent ring (n=10,55.56％).Conclusion:The patterns of FAF and NIA indicated different involvement of lipofuscin and melanin in the pathophysiological process of ICNV.Compared to FAF imaging,NIA imaging appears to be a superior noninvasive method for in vivo visualization of retinal pigment epithelium (RPE) abnormalities in ICNV patients.

Purpose:To investigate gender differences in lens thickness (LT) and central anterior chamber depth (ACD) in normal subjects,and to assess age associated changes in these measures.Methods:The anterior chamber depth (ACD),and lens thickness (LT),of 150 normal subjects (150 eyes) was measured by anterior segment optical coherence tomography (ASOCT).Gender differences were assessed by independent ttest,and correlation analysis was used to examine the effect of Results:The mean values of ACD and LT were 2.69±0.32mm and 4.85±0.43 mm,respectively.Women had a significantly lower Mean ACD as compared to men (2.56±0.33 mm vs 2.85±0.29 mm; P ＜ 0.05).No statistically significant difference was found in LT between male and female subjects (P＞0.05).Correlation analysis findings suggest that LT increases with age (r=0.83,P ＜ 0.05),and that ACD decreases with age (r=-0.57,P ＜ 0.05).After controlling for LT,no significant correlation was observed between age and ACD (P＞0.05).Conclusion:The ACD of female subjects was,on average,shallower than that of their male counterparts.Aging was associated with increasing LT,and the observed narrowing of ACD with age,might be partially mediated by the increasing LT.

Purpose:To evaluate the diagnostic performance of the photopic negative response (PhNR) for the detection of primary open-angle glaucoma (POAG).Methods:Fifty-two normal subjects (52 eyes) and 173 POAG patients (173 eyes) were studied.The PhNR was elicited using a white stimuli on a white background.The mean deviation (MD) and pattern standard deviation (PSD) of the visual field were measured using standard automated perimetry (SAP).Spectral domain optical coherence tomography (SDOCT) was used to measure the mean thickness of the retinal nerve fiber layer (RNFL).Results:In the glaucoma group,as compared to the normal group,the amplitudes of a-waves,b-waves and PhNR were significantly smaller (P＜0.001),and the PhNR implicit time was significantly longer (P=0.004).The MD,PSD and mean thickness of the RNFL were significantly correlated with the amplitude of the PhNR (P＜0.001).The area under the receiver operating characteristic curve (AUCs) for the amplitudes of a-waves,b-waves and PhNR were 0.853,0.830 and 0.918,respectively.When the specificity was ≥95％,the sensitivities were 60.4％,54.2％ and 85.4％ respectively.Conclusion:The PhNR amplitude was reduced even when the loss in visual field sensitivity was mild,which suggests that PhNR might be a useful indicator of early glaucoma disease.

Purpose:To assess the efficacy of vitrectomy combined with intravitreal injection in the treatment of endophthalmitis after phacoemulsification and IOL implantation.Methods:Five patients (5 eyes),who had undergone conventional phacoemulsification combined with IOL implantation at another treatment facility,presented with endophthalmitis.The subjects ranged in age from 41 to 79 years (65.8±0.5years on average),and three were male.All five cases received bacterial culture susceptibility testing.On the basis of the treatment of primary disease,3 cases had anterior chamber irrigation,and posterior vitrectomy followed by intravitreal injection of 1 mg vancomycin plus 2.25 mg ceftazidime.Results:Four out of the five cases of endophthalmitis had a positive bacterial culture testing results (two cases of staphylococcus epidermidis,one case of enterococcus faecalis and one case of head-like staphylococcus),and the remaining case had no bacterial growth.Four cases showed restored visual acuity,clear vitreous cavity,and no retinal detachment or other complications.Conclusion:Management of patients presenting with endophthalmitis subsequent to cataract surgery should include:prompt bacterial culture and drug sensitivity tests,and where appropriate,vitrectomy combined with intravitreal injection of vancomycin.

Purpose:To investigate postoperative inhibition of cell proliferation in animals treated with exogenous p27Kip1 during an experimental glaucoma filtration surgery (GFS) by histological and ultrastructural examinations.Methods:The primer was designed according to p27ip1 gene sequence of GenBank.The p27Kip1-expressing adenovirus-mediated Ad-p27 was constructed according to standard techniques.Gene therapy was performed by subconjunctival delivery of Ad-p27,mitomycin C(MMC) and PBS served as controls.Histological and ultastructural changes at surgical sites were observed for 28 days postoperatively.Results:Histologically,evident cellular proliferation induced by Ad-p27 was observed on day 7,with appreciable filtering cavity.However,thin conjunctival layers were noted,and the number of fibroblasts decreased in the Tenon's capsule on day 14.On day 28,the filtering cavity partially disappeared.The histological features of the animals with MMC delivery were similar to those treated by Ad-p27.In contrast,in the PBS treatment group,thick conjunctival layers were observed,and the number of goblet cells and fibroblasts,increased markedly.The filtering cavity disappeared at postoperative day 21.Twenty eight day postoperatively,ultrastructural findings showed that most conjunctival epithelial cells in the Ad-p27 treatment group were under static state,and that organelles were inactive.The number of goblet cells,and the secretion of mucin,were decreased.The amount of fibroblasts also decreased with partial apoptotic cells.The ultrastructural features presented by rabbits with the MMC delivery resembled those treated with Ad-p27.In the PBS treatment group,the number of conjunctival epithelial cells increased; the amount of goblet cells increased as the secretion of mucin was strengthened,and a substantial amount of fibroblasts were observed with active and productive organelles.Conclusion:Ad-p27 inhibits the proliferation of Tenon's capsule fibroblasts at surgical sites,and suppresses the formation of scars,thereby promoting surgical efficacy.

Purpose:To report on the clinical findings of a case of late opacification of the hydrophobic acrylic intraocular lens (IOLs) in both eyes after cataract surgery.Methods:A 79-year-old man with a history of decreased visual acuity and complaints of glare and blurred vision in both eyes over the past 3 years.He had received an uneventful phacoemulsification combined with posterior chamber IOL implantation for senile cataract in both eyes 13 years ago,and had undergone neodymium:YAG (Nd:YAG) laser posterior capsulotomy on both eyes 6 years ago,for posterior capsular opacification (PCO).The optical portion of the IOLs showed uniform gray haze.Binocular posterior capsular laser holes were clearly noted.Results:IOL exchange was performed by the same surgeon on both eyes,three days apart.Postoperatively,the patient's visual acuity was elevated to 6/12 (OD) and 6/9 (OS) at 6months,and intraocular pressure (IOP) reached 16.8 mmHg (OD) and 18.4 mmHg (OS).Neither glare or blurred vision were observed in either eye.Conclusion:IOL exchange can be used to effectively manage clinically significant optic opacification.