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AIM: To investigate the effect of strabismus surgery on tear film and the incidence of dry eye.METHODS: A total of 66 eyes of 58 patients admitted and underwent surgery in our hospital between September 2018 to September 2019 with concomitant strabismus were enrolled. The patients were divided into two groups based on surgical methods: Group 1 included 25 cases(33 eyes)who underwent a single horizontal rectus cut; Group 2 included 33 cases(33 eyes)who underwent both horizontal rectus cut in. The noninvasive tear film break-up time(NIBUT)was examined with sirius anterior analysis system at the time of 1d preoperatively and 3d, 1wk, 2wk and 3wk after operation. In addition, the tear film break-up time(BUT), Schirmer I test(SⅠt)and corneal fluorescein examination were tested. The patients were diagnosed with dry eye in both groups according to the consensus of clinical experts specialized in the diagnosis and treatment of dry eye. RESULTS: There were no statistically significant differences when compared to SⅠt between the two groups before and after surgery(P>0.05). The BUT of group 1 was higher than group 2 at postoperative 3d, 1wk and 2wk(PP>0.05); BUT returned to baseline by 2wk after surgery in group 1 and by 3wk after surgery in group 2. There were no differences between the NIBUT measured by sirius anterior segment analysis system and the BUT measured by traditional method before and after operation(P>0.05). The lowest incidence of dry eye was found at postoperative 2wk and 3wk in group 1(24%, 18%). The lowest incidence of dry eye was found at postoperative 3wk in group 2(15%). Besides, the incidence of dry eye in group 2 was higher than that in group 1 at postoperative 2wk(52% vs 24%, PCONCLUSION: There was no obvious influence on the SⅠt after strabismus surgery; the surgical effect on tear film was mainly reflected in BUT. The fewer muscles operated, the lesser tear film was affected and the tear film was recovered faster. The incidence of dry eye decreased as time went by.

AIM: To compare the objective optical quality of high myopic patients between SMILE and V4c ICL implantation.METHODS: This was a prospective control study. Thirty-eight patients underwent SMILE and thirty-two patients underwent V4c ICL implantation with high myopia were chosen for this study. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and refractive situation were evaluated preoperatively, at 1wk, 1mo, 3mo and 6mo postoperatively. The objective scattering index(OSI), strehl rate(SR)and modulation transfer function(MTF)cut off frequency were measured by the double-pass optical quality system at the same time.RESULTS: No significant difference of spherical equivalent(SE), UCVA and BCVA was found between SMILE group and V4c ICL implantation group at all time points. At 1wk and 1mo after operation, the OSI values of two groups were significantly higher than pre-operation(PPP>0.05).CONCLUSION: Both SMILE and V4c ICL implantation can obtain good visual acuity and objective optical quality.

AIM: To discuss the effect and mechanism of melatonin on diabetic retinopathy in rats and its mechanism.METHODS:Totally 40 healthy male SD rats were choose and randomly divided into 4 groups, normal control group, diabetid group, low dose melatonin group and high dose melatonin group. The changes of retinal structure were observed by hematoxylin-eosin staining(HE staining), ultrastructure of retinal ganglion cells were observed by electron microscopy, superoxide dismutase(SOD)and malondialdehyde(MDA)level in the retina tissue were detected by xanthine oxidase method, and protein expression levels of B cell lymphoma/lewkmia-2(Bcl-2), Bcl-2 associated X protein(Bax)and P53 were detected by Western Blot.RESULTS: HE staining results showed that the rat retina tissue structure of the normal control group was clear, the retinal tissue of diabetes group rats were not clear, the nerve fiber layer was edema, the retina cells of low dose melatonin group were probably distinct, the interlayer cells were arranged neatly, and the inner and outer nuclear layers were slightly disordered, rats retinal structure in high dose melatonin group were further improved than that in low dose melatonin group; Electron microscope results showed that compared with diabetes group, retinal ganglion cells form in melatonin group were improved in different extent; Xanthine oxidase method detected that SOD level in retinal tissue of melatonin group rats were higher than that in diabetic group, the MDA level were lower than that in diabetic group, compared with diabetes group the differences both have statistically significant(PPCONCLUSION: Melatonin could improve the morphological changes of retina in diabetic rats and inhibit diabetic retinopathy to some extent.

AIM:To evaluate the effectiveness of visian implantable collamer lens with central hole(ICL V4c)implantation for the correction of high myopia using the double-pass visual quality analysis system. METHODS: Totally 60 eyes of 30 high myopia patients who underwent ICL V4c implantation were enrolled into this prospective randomized control study. Myopic degree of selected patients was -6.0D to -12.0D, age 18 to 35 years old, best corrected visual acuity(BCVA)≥0.6, preoperative corneal astigmatism acuities ≤1.0D. All patients were taken the temporal side transparent corneal incision. The patients were evaluated postoperatively 1wk, 1 and 3mo respectively. The evaluating items included preoperative BCVA, postoperative uncorrected visual acuity(UCVA), objective scattering index(OSI), and modulation transfer function(MTF)cut off frequency, Strehl ratio(SR), and 100%, 20%, 9% Optical Quality Analysis System(OQAS)Value(OV, contrast visual acuity). All statistical analyses were performed with SPSS19.0 statistical software. Variance analysis of repeated measurement data was employed. RESULTS: The UCVA gradually improved at 1wk, 1 and 3mo after surgery. There was statistical significance compared with the preoperative BCVA(PPCONCLUSION: ICL V4c implantation can effectively correct high myopia range from -6.0D to -12.0D. The postoperative OSI were smaller than the preoperative OSI. The postoperative UCVA were better than the preoperative BCVA. The value of postoperative MTF cut off, SR, and OV value of 100%, 20% and 9% improved.

Primary open angle glaucoma(POAG)is one of the eye diseases which can lead to blindness. The early symptom of POAG is unconspicuous, however, it will result in irreversible optic never damage and visual field defect with the disease progress. As an index for diagnosing and evaluating the therapeutic effect of POAG, intraocular pressure(IOP)is simple and important. Clinically, although some treated patients have a target IOP at clinic time, the optic never damage still get worse. Researches indicate that higher nocturnal IOP and 24h IOP variation and lower nocturnal ocular perfusion pressure(OPP)may be the reasons for this phenomenon. The following essay will give an overview of POAG,IOP and OPP according to the relevant literatures so that we can have a better understanding.

AIM:To characterize the circadian fluctuation of intraocular pressure(IOP)and ocular perfusion pressure(OPP)at habitual position in newly diagnosed patients with untreated primary open angle glaucoma(POAG)and to test the feasibility of calculating nocturnal peak IOP from the diurnal mean IOP. METHODS:Nineteen patients(19 eyes)with POAG and eighteen healthy controls(18 eyes)were included and underwent 24-hour monitoring of IOP and blood pressure. At 10:00, 14:00, 18:00 and 22:00 o'clock in the daytime, all the subjects were monitored in sitting position while at 02:00, 05:00 and 07:00 o'clock at night in supine position. For testing the feasibility of calculating nocturnal peak IOP from mean IOP in diurnal supine, all patients still needed to be monitored for IOP in supine position after lying for 5min in the daytime. Measurements were taken in diurnal supine at 2:00, 5:00 and 7:00. OPP was calculated and analyzed. Nocturnal peak IOP was calculated with known formulas and compared with the actual values.RESULTS:The mean IOP and the fluctuation of IOP of POAG group were higher than those of healthy group in 24-hour habitual position(PPPP>0.05). POAG group had higher fluctuation of MOPP than that of healthy group(PP>0.05). CONCLUSION:The peak IOP of habitual position in patients with POAG and healthy people appears in the morning, and POAG group has higher mean IOP and fluctuation of IOP. Nocturnal OPP is lower than diurnal OPP in both groups, and POAG group has larger fluctuation of MOPP. It might be feasible that we could calculate nocturnal peak IOP from the diurnal mean IOP.

AIM: To investigate the influencing factors related to the public awareness of glaucoma in 1 091 people in a health screening center of general hospital in Shenzhen.METHODS: A total of 1 091 people were interviewed in the Health Screening Center of Peking University Shenzhen Hospital using a self-designed questionnaire. Chi-squared test and binary logistic regression were used to analyze the public awareness of glaucoma and the influencing factors and their extents. RESULTS: Influencing factors of the awareness of glaucoma included level of education, monthly income, medical insurance, working experience in healthcare system and myopia(Chi-squared test, PP>0.05). Binary logistic regression was used to analyze the influencing factors of the awareness of glaucoma and it was found that working experience in healthcare system and level of education had statistical significance(PCONCLUSION: People who have working experience in the healthcare system, higher level of education, those who have medical insurance, higher monthly income and myopia have better recognition of the disease. Medical staffs should strengthened the glaucoma knowledge education for the public, especially for those who have lower monthly income, systemic disease, no medical insurance, and the people who have positive personal or family history of glaucoma.

AIM: To evaluate the differences between Haigis-L formula and CH-SRK/T when predicting intraocular lens power after laser in situ keratomileusis(LASIK)surgery for myopia.METHODS: Seventy-two patients(140 eyes, axial length ≤26mm)after LASIK surgery were recruited between October 2012 and February 2013. Participants with other ophthalmic diseases were excluded. Haigis-L and CH-SRK/T formula were used to calculate the intraocular lens power separately after LASIK surgery and the data were analyzed using SPSS 18.0 software.RESULTS: The mean value of Hoyaintraocular lens after LASIK was 22.99±1.38D by Haigis-L formula compared with 19.95±1.69D using CH-SRK/T formula. According to paired t-test, pairs of differential mean are -3.039±1.899D. Wilcoxon signed rank test was used and the sum of ranks was -3.408a(P=0.001). Meanwhile, the mean value of Allergan AR40 intraocular lens was 23.26±1.49D by Haigis-L formula; while the degree of intraocular lens calculated by CH-SRK/T formula was 20.05±1.69D. According to paired t-test, pairs of differential mean are -3.208±1.823D. Wilcoxon signed rank test was used and the sum of ranks was -3.408a(P=0.001).CONCLUSION: After LASIK surgery for myopia, the degree of intraocular lens power measured by CH-SRK/T is lower than that by Haigis-L formula. The degree of intraocular lens power calculated by CH-SRK/T is more likely to be under corrected.