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AIM: To observe the application effect of single-pass four-throw pupilloplasty in combined surgery of cataract and glaucoma.METHODS: Twenty eight patients(30 eyes)suffered from acute attack of glaucoma with large pupil and cataract, received cataract phacoemulsification and intraocular lens implantation combined with angle separation or trabeculectomy and single-pass four-throw pupilloplasty in apllication. Preoperative and postoperative visual acuity, pupil diameter and complications were observed, and postoperative visual quality were measured.RESULTS: The visual acuity of 7d after operation was significantly improved without double vision and glare. The preoperative pupil diameter was 5.9+0.25mm, and the postoperative was 4.1±0.13mm(PPCONCLUSION: Single-pass four-throw pupilloplasty is simple, safe and effective. It can obviously eliminate the visual impairment caused by the large pupil after acute glaucoma attack.

AIM: To discuss the curative effect of extra-panretinal photocoagulation on proliferative diabetic retinopathy(PDR)during vitreous operation. METHODS: We conducted a retrospective analysis of 70 diabetic retinopathy patients(70 eyes)who accepted vitreous surgery in our hospital due to vitreous hemorrhage or vitreous retina traction change from March 2011 to March 2013. In follow-up clinics, according to the difference of patient's retinal photo-coagulation range, we divided it into extra-panretinal photocoagulation group(40 patients)and panretinal photocoagulation(30 patients), respectively observed the best corrected visual acuity, intraocular pressure and retinal vessel changes in two groups and made statistical analysis. RESULTS: Through comparing the eye condition, visual acuity after 3mo, intraocular pressure between the two groups patients, the difference had no statistical significance(all of the P>0.05). Comparing the incidence of retinal blood vessel leak, posterior pole exudate, and posterior pole bleeding points in two groups patients, the difference had statistically significant(all of the PP=0.04, 0.02). Comparing the incidence of macular edema in two groups patients after operation, the difference had no statistically significance(P=1.00). Comparing the extinction time of macular edema, the difference had statistically significant(PCONCLUSION: To cure proliferation diabetic retinopathy, adopting the extra-panretinal photocoagulation has a better curative effect than panretinal photocoagulation on curing no-perfusion area of retina, retinal blood vessel leak, prepapillary vascular leak in operation on vitreous. However, the excessive retinal photocoagulation has a clear damage on retina and choroid. Therefore, in the treatment, while covering the retinopathy as far as possible, it is important to master the laser energy and spot number preventing the complications.

AIM: To explored the treatment effects of retinal laser photocoagulation and the applications of color Doppler flow imaging(CDFI)in the diabetic retinopathy.METHODS: We collected 60 patients(120 eyes)with diabetic retinopathy(Ⅲ～Ⅳstage)from February 2013 to February 2014 in Anyang Eye Hospital admitted in fundus disease department. The health control(HC)group of 55 normal people was established simultaneously. Ocular blood flow velocity of the 55 normal people(110 eyes)and the 60 patients(120 eyes)was examined by CDFI of central retinal artery(CRA)and posterior ciliary artery(PCAs)using the PHILIPS HD6. Peak systolic velocity(PSV)was recorded. The examinations of CDFI, electroretinogram(ERG)and the vision were performed in pre-operation, 1,7d, 1, 3 and 6mo postoperatively. RESULTS: Compared the PSV of CRA of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(PPPPP>0.05). Compared the aA and bA of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(PPP>0.05). The vision of 49 cases(98 eyes)was improved 1 to 3 rows, the effective rate was 82%.The vision of 11 cases(22 eyes)remained constant.CONCLUSION: Retinal laser photocoagulation is an effective treatment to diabetic retinopathy patients, which can significantly reduce the peak systolic velocity of the central retinal artery, improve and stabilize the condition, protect visual function in long-term clinical effect. Color doppler flow imaging can observe the changes of ocular vessel flow velocity in diabetic' eyes noninvasively, repeatedly and in real time, providing a basis for clinical treatments.

AIM: To observe the efficacy of 25G+ vitrectomy surgery for malignant glaucoma after cataract surgery. METHODS: Totally 18 eyes of 18 patients with malignant glaucoma after cataract surgery were analyzed retrospectively from January 2013 to June 2016. The visual acuity was between hand moving to 0.5 before surgery, the intraocular pressure was between 18.3-56.8mmHg before surgery, an average of 35.21±10.43mmHg. The length eye axis was between 19.60-22.46mm, an average of 20.63±0.48mm. The depth of anterior chamber was between 0.98-1.86mm, an average of 1.31±0.22mm. All the patients were performed with 25G+ vitrectomy. The visual acuity, anterior chamber and intraocular pressure were studied after treatment. RESULTS: The patients were followed up for 6-18mo with an average of 9mo. BCVA at the last follow up improved to 0.2-0.8, and there was significant difference compared to that before operation(Pt=7.59, Pt=9.07, PCONCLUSION: The 25G+ vitrectomy is safe and effective for treating malignant glaucoma, controls IOP and reduces complications compared with traditional vitrectomy.

AIM:To observe the effect of intravitreal injection of Ranibizumab at perioperative period of compound trabeculectomy on iris neovascularization, intraocular pressure(IOP)for patients with neovascular glaucoma(NVG).METHODS:Intravitreal injection of ranibizumab, compound trabeculectomy and panretinal photocoagulation were given to 38 patients(38 eyes)with neovascular glaucoma, which could not be controlled by drugs, from January 2013 to January 2014 in Anyang Eye Hospital. Iris neovascularization, IOP and changes of visual acuity were observed before and after treatments. The patients were followed up for 6mo after treatments.RESULTS: Seven days after intravitreal injection, 36 cases(94.74%)had complete regression of iris neovascularization. Two cases(5.26%)had regression of small blood vessels in the iris, a little thick blood vessels were remained. At 1mo after compound trabeculectomy, iris neovascularization in all patients were subsided; at 3mo after treatments, the iris neovascularization in 8 patients(21.05%)were performed again, and accepted intravitreal injection of ranibizumab again. Six months after the first treatments, all patients showed no iris neovascularization. The mean IOP before injection was 42.82±10.29mmHg. At 5d after the drug injection was 39.13±9.71mmHg. Before and after the drug injection, change of IOP was not statistically significant(q=2.65, P>0.05). At 1wk,1,3 and 6mo after compound trabeculectomy, IOP was 10.53±1.81mmHg, 10.11±1.73mmHg, 11.29±2.49mmHg, 12.58±3.01mmHg,which decreased significantly(q=23.15,23.46,22.61,21.68, all Pq=20.51,20.81,19.96,19.04, all PCONCLUSION: Intravitreal injection of ranibizumab at perioperative period of compound trabeculectomy can effectively improve the success rate of the surgeries and reduce risk of complications, and the effect is certainly safe.

AIM:To observe the effect of phacoemulsification on the ocular surface in patients with conjunctivochalasis and cataract. METHODS:Totally, 150 cases(200 eyes)of cataract patients accepted phacoemulsification and intraocular lens implantation form September 2014 to December 2014 in our hospital were retrospectively analyzed. All the cases were divided into two groups, normal group(110 cases with 140 eyes)and conjunctivochalasis group(40 cases with 60 eyes)according to coexisted with conjunctivochalasis or not. Follow up lasted 3～6mo. The breakup time(BUT)of tear film, foreign body sensation, epiphora and conjunctival congestion of two groups were observed before and after operation and statistically analyzed. The time, these factors took to recover to preoperative state were observed too. RESULTS:The differences of the BUT of two groups before and after the operation was statistically significant(t=20.93, 19.16; both P=0.00). The differences of the two groups after operations in terms of ocular foreign body sensation, epiphora and conjunctival congestion had statistical significance(P=0.00). The time these observed factors of two groups took to recover to preoperative state was significantly different(t=17.16, 14.18, 27.41; all P=0.00). CONCLUSION:The ocular surface conditions are significantly worse after phacoemulsification and intraocular lens implantation in cataract patients. Conjunctivochalasis could significantly delay the recovery of ocular surface function after cataract surgery.