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Objective: To evaluate the efficacy of 0.05% cyclosporine A eye drops combined with vitamin A palmitate eye gel in the treatment of dry eye associated with meibomian gland dysfunction (MGD). Methods: A single-center, prospective, randomized, parallel controlled trial design was used to include patients diagnosed with MGD-associated dry eye. The patients were randomly divided into three groups and administered with medications binocularly for 12 weeks. The CsA+VA group was given 0.05% cyclosporine A eye drops twice a day and vitamin A palmitate eye gel three times a day. The CsA+HA group was given 0.05% cyclosporine A eye drops twice a day and 0.1% sodium hyaluronate eye drops three times a day. The HA group was given 0.1% sodium hyaluronate eye drops 3 times a day. The OSDI score, tear meniscus height, fluorescein tear break-up time, Schirmer Ⅰ test (without anesthesia), tear film lipid layer thickness, meibomian gland morphology and function examination, and corneal fluorescein sodium staining score were evaluated at baseline, 4, 8, and 12 weeks after the initiation of the treatment, respectively. Results: A total of 120 patients with MGD-related dry eye met the enrollment criteria, but 10 patients were lost to follow-up; 110 patients were finally included for observation, including 36 patients in the CsA+VA group, 38 in the CsA+HA group and 36 in the HA group. The OSDI score, tear meniscus height, fluorescein tear break-up time and meibomian gland secretion of the 3 groups were significantly improved. At the 12th week of the treatment, the differences of the CsA+VA group [25.45±15.11, (0.30±0.13) mm, (3.72±1.40) s, (5.03±2.52) points] and the CsA+HA group [26.98±16.89, (0.27±0.10) mm, (4.34±1.76) s, (5.11±2.39) points] from the HA group [24.57±11.26, (0.24±0.06) mm, (3.18±1.11) s, (9.11±3.34) points] were statistically significant ( P <0.05). Compared with the CsA+HA group [(68.39±26.66) nm], the tear film lipid layer thickness in the CsA+VA group [(72.61±23.65) nm] was significantly increased ( P <0.05). In the CsA+VA group, the meibomian gland secretion characters and discharge capacity among patients with severe abnormalities [(6.28±2.59) and (5.89±2.77) points at the 12th week of treatment], moderate abnormalities [(4.27±2.02) and (4.64±2.02) points at the 12th week of treatment] and mild abnormalities [(2.80±0.84) and (2.60±0.55) points at the 12th week of treatment] were significantly different ( P <0.05). Conclusion: 0.05% cyclosporine A combined with vitamin A palmitate can significantly improve the symptoms and signs of patients with MGD-related dry eye, especially the tear film lipid layer thickness and the meibomian gland secretion characters and discharge capacity in severe cases.

Objective: To evaluate the effectiveness and safety of 0.05% cyclosporine A and 0.1% tacrolimus eye drops in treating severe dry eye associated with chronic graft-versus-host disease (cGVHD). Methods: This non-randomized concurrent control trial enrolled 83 eyes from 83 patients with cGVHD-associated severe dry eye. The treatment had two phases. During the initial shock treatment period (0-3 months), 44 patients received 0.05% cyclosporine A eye drops (4 times/day; group A) and 39 patients received 0.1% tacrolimus eye drops (twice/day; group B) alongside basic treatment. In the maintenance treatment period (3-6 months), both groups used 0.05% cyclosporine A eye drops (twice/day) and sodium hyaluronate. Examinations were conducted at 1, 3, and 6 months after treatment initiation, assessing the Ocular Surface Disease Index (OSDI), corneal fluorescein staining (CFS) score, and fluorescein tear break-up time (BUT) for efficacy. visual acuity and intraocular pressure (IOP) were evaluated for safety, and patients' post-medication irritation symptoms were recorded. Results: The study included 52 males and 31 females, aged (28.57±15.67) years. After 1 month of treatment, the CFS score in group A significantly decreased from 10.0 (6.0, 14.0) to 5.0 (3.0, 8.5) ( P <0.001). in group B, the CFS score also significantly decreased from 10.0 (6.0, 15.0) to 6.0 (2.0, 10.0), and the BUT increased from 2.0 (1.0, 2.0) s to 2.0 (1.8, 3.3) s ( P <0.001). No significant OSDI decrease was observed in either group. No significant differences were found in OSDI, CFS score, and BUT between the two groups. After 3 months, group A showed significant improvement in OSDI, CFS score, and BUT ( P <0.05), while group B only demonstrated significant CFS score decrease ( P <0.05). OSDI was significantly lower in group A than group B ( P <0.05). No significant differences were noted in CFS score and BUT between groups. After 6 months, OSDI, CFS score, and BUT were 18.9 (9.3, 34.2), 7.0 (3.0, 8.5), and 2.0 (1.0, 3.0) s in group A, and 10.9 (3.6, 35.4), 5.5 (2.8, 10.0), and 2.0 (1.0, 10.0) s in group B. In both groups, CFS scores significantly decreased and BUT increased ( P <0.05). Visual acuity improved significantly in group A at 1, 3, and 6 months ( P <0.05), while no significant changes were seen in group B. Irritation symptoms were transient and self-resolving in both groups. Conclusions: Both 0.05% cyclosporine A and 0.1% tacrolimus eye drops, when combined with local glucocorticoids, exhibited significant anti-inflammatory effects, effectively and safely treating severe dry eye in cGVHD patients. Although the onset of 0.05% cyclosporine A was slower than 0.1% tacrolimus, it offered more stable long-term effects and better symptom improvement.

Objective: To investigate the changes in the types of anti-glaucoma eye drops and daily treatment costs in 2021 compared with 2006 in China. Methods: The information of the main anti-glaucoma eye drops in 2021 was obtained from the database of Yaozhi.com. The daily cost of each eye drop was calculated by recording the number of drops in a single bottle and pricing in the national market, and the corresponding information of anti-glaucoma eye drops collected in 2006 was compared. Based on the income of Chinese residents in 2006 and 2021, the proportion of the daily cost of anti-glaucoma eye drops in the annual income of residents was analyzed. Results There were 32 kinds of anti-glaucoma eye drops in 2021, and the daily cost was 0.34 to 16.00 yuan. The daily cost is 0.34 to 6.77 yuan after removing the single-dose package. The number of drugs in 2021 was significantly higher than that in 2006 (16). In 2021, prostaglandins accounted for the highest proportion of 31.25%. There was a significant increase in the number of generic drugs, fixed formulations and preservative-free single-dose packages. In 2021, the price of imported drugs was significantly reduced, with the daily cost falling by 29.28% to 53.78% compared with 2006. In 2021, the daily cost of the most expensive drugs accounted for 12.32% and 30.85% of the daily income of urban and rural residents, respectively (5.21% and 13.05% after removing single-dose packaged drugs), which were significantly lower than 37.46% and 122.79% in 2006. Conclusions Compared with 2006, the variety of anti-glaucoma eye drops increased significantly in 2021, and the daily treatment cost and the proportion of daily income were significantly reduced.

Glaucoma is a chronic progressive sight-threatening eye disease, so most patients need long-term or even lifelong medications. The ocular surface diseases caused by the use of topical glaucoma medications seriously affect the treatment compliance, the quality of life, and the treatment effects. In order to standardize the diagnosis and treatment of topical glaucoma medications-related ocular surface diseases, to improve the ocular surface health of patients and to effectively control the progress of glaucoma, the Glaucoma Group of Ophthalmology Branch of Chinese Medical Association has formulated this consensus after serious consideration and discussion. This evidence-based consensus puts forward suggestions on the characteristics, occurrence mechanism, risk factors, diagnosis, treatment, prevention and follow-up of ocular surface diseases associated with topical glaucoma medications.

Objective: To compare the clinical efficacy of thumb-tack needle and sodium hyaluronate eye drops for dry eye., Methods: A total of 60 patients with dry eye were randomly divided into a thumb-tack needle group and a western medication group, 30 cases in each group. Based on Biaoben Genjie theory, thumb-tack needle was applied at Zhiyin (BL 67), Lidui (ST 45), Fuyang (BL 59), Yanglao (SI 6), Jingming (BL 1) and Cuanzhu (BL 2) in the thumb-tack needle group, 2 times a week. In the western medication group, 0.1% sodium hyaluronate eye drops were applied, 3 times a day. Both groups were treated for 4 weeks. Before and after treatment, TCM symptom score, tear film break-up time (BUT), SchirmerⅠtest (SⅠT), corneal fluorescein sodium staining (FL) score and 36-item short form health survey (SF-36) score were observed, and the clinical efficacy was evaluated in the two groups., Results: After treatment, the total scores and each item score of TCM symptom in the two groups were decreased compared with before treatment ( P <0.05); except for score of visual fatigue and photophobia, the total score and each item score of TCM symptom in the thumb-tack needle group were lower than the western medication group ( P <0.05). After treatment, the BUT, SⅠT and SF-36 scores were increased and the FL scores were decreased in the two groups ( P <0.05); the BUT, SⅠT and SF-36 score were higher than the western medication group ( P <0.05), and the FL score was lower than the western medication group ( P <0.05) in the thumb-tack needle group. The total effective rate in the thumb-tack needle group was 93.3% (28/30), which was higher than 80.0% (24/30) in the western medication group ( P <0.05)., Conclusion: Thumb-tack needle based on Biaoben Genjie theory could effectively relieve clinical symptoms of dry eye patients, prolong tear film break-up time, increase tear secretion, improve tear film function and quality of life, and its curative effect is better than sodium hyaluronate eye drops.

Objective: To observe the effect of Lingnan fire needling combined with artificial tears in the treatment of xerophthalmia., Methods: A total of 86 xerophthalmia patients were equally and randomly divided into treatment group and control group. The patients of both groups were received treatment with 0.1% sodium hyaluronate eye drops in their eyes 3 times a day, one drop in each eye. In addition, the patients of treatment group also treated by Lingnan fire needling on bilateral Shaoze (SI1), Neichengqi and beside lacrimal puncta once a week. The treatment was conducted for 4 consecutive weeks. Before and after 4 weeks of treatment, the clinical efficacy, visual acuity, intraocular pressure, ocular symptom score, OSDI score, fluorescence staining （FL） score, schemer I, tear menisci height, tear film break-up time (BUT) and eye redness index were recorded and evaluated., Results: After the treatment, self-comparison showed that the symptom score, OSDI score, FL score and eye redness index were significantly decreased ( P <0.05), and BUT was notably increased in both groups ( P <0.05) in comparison with their own pre-treatment. The tear menisci height in the treatment group was higher than that before the treatment ( P <0.05). Comparison between the two groups showed that the symptom score, OSDI score and eye redness index were obviously lower in the treatment group than in the control group ( P <0.05), whereas the BUT and tear menisci height were evidently higher ( P <0.05). The total effective rate of the treatment group was 84.88% (73/86), better than 76.74% (66/86) of the control group ( P <0.05)., Conclusion: Lingnan fire needling combined with 0.1% sodium hyaluronate eye drops is more effective than simple sodium hyaluronate eye drops for xerophthalmia patients, with significant curative effect and no adverse reactions.

Dry eye is the most common ocular surface disease, the core pathogenesis of which is ocular surface inflammation. Anti-inflammation is one of the important clinical treatments of dry eye. Since the definitely immunosuppressive effect, topical ophthalmic cyclosporine A (CsA) has been used in dry eye for many years. A large number of studies have been published in recent years, including its therapeutic effects, indications and applications. This article will introduce the mechanism of ophthalmic CsA, summarize its clinical treatment effects in dry eyes of different countries, different causes, and different severity. Meanwhile we will analyze the pros and cons and the applied prospects of ophthalmic CsA with various forms, and generalize the indications, treatment suggestions and safety of CsA used in dry eye, in order to provide references for the clinical applications. (Chin J Ophthalmol, 2020, 56:787-795) .

Objective: To investigate the effect of deproteinized calf blood extract eye drops on early postoperative recovery in primary pterygium patients. Methods: This is a prospective randomized controlled study. Patients diagnosed with primary pterygium in single eye at affiliated Xiamen Eye Center of Xiamen University during March 2016 to May 2016 were enrolled. After Pterygium excision with autologous conjunctival transplantation, patients were randomly assigned into four groups by a random number table, treated with anti-inflammaroty drugs only (control group) or combined with the following agents: deproteinized calf blood extract eye drops (DCBE group), carboxymethylcellulose sodium eye drops (CMC group), and recombinant human epidermal growth factor eye drops (rEGF group). Short-form McGill pain questionnaire, slit lamp and corneal fluorescein sodium staining, non-contact intraocular pressure, uncorrected visual acuity (UCVA) and best corrected visual acquity (BCVA) as well as redness score of bulbar conjunctiva were performed before surgery (d0) and on day 1 (d1), day 2 (d2), day 3 (d3), day 7 (d7) and day 14 (d14) after surgery. Results: One hundred and fourteen patients including 43 males and 71 females, aged (48.9±12.5) years, were eventually included in this study. The McGill scores gradually decreased after surgery in all groups. On d2, the McGill score in DCBE group, control group, CMC group and rEGF group was (1.42±0.67), (2.21±0.88), (1.93±1.08) and (1.77±1.18), respectively; On d3, the score was (1.32±0.54), (1.93±0.72), (1.79±0.87) and (1.52±0.77), respectively. On d2 and d3, statistical difference was recorded among groups (d2, F= 3.43, P= 0.019; d3, F= 4.047, P= 0.009), and the McGill score of DCBE group was significantly lower than that of CMC group (d2, P= 0.047, d3, P= 0.017). On d2, the percentage of corneal epithelium defect in DCBE group, control group, CMC group and rEGF group was 8.6%±1.9%, 11.7%±1.7%, 11.5%±1.9% and 10.4%±1.8%, respectively; On d3, the percentage was 4.5%±2.2%, 9.2%±2.4%, 7.4%±2.5% and 5.9%±2.3%, respectively. On d2 and d3, statistical difference of corneal epithelium defect percentage was recorded among groups (d2, F= 17.17, P< 0.001; d3, F= 21.4, P< 0.001). On d2, the percentage of corneal epithelium defect in DCBE group was significantly lower than the other three groups ( P< 0.01); On d3, the percentage of corneal epithelium defect in DCBE group was significantly lower than control group and CMC group ( P< 0.001), while no difference was found between DCBE group and rEGF group ( P> 0.05). However, no statistical differences were recorded in the number of patients with vision improvement among the groups ( P> 0.05). The intraocular pressure remained stable. No differences in the conjunctival redness score were found among the groups after surgery ( P> 0.05). Conclusion: Our data demonstrated the efficacy of deproteinized calf blood extract eye drops on the postoperative management in patients with primary patients, with faster pain relief and promoted epithelium recovery. (Chin J Ophthalmol, 2019, 55:134-140) .

Objective: To observe the early immunological rejection prevention effect of tacrolimus eye drops combined with glucocorticoids on fungal keratitis patients who received penetrating keratoplasty (PKP). Methods: In a retrospective case series study, medical records of fungal keratitis patients who received PKP in Shandong Eye Institute from March 2013 to December 2015 were reviewed. Twenty-six patients (26 eyes) were given tacrolimus eye drops, and 24 patients (24 eyes) were given 1% cyclosporine A eye drops immediately after PKP. Two weeks after PKP, these patients were given low concentration of glucocorticoids if no fungal recurrence was found. Immune rejection, fungal recurrence, intraocular pressure, and drug irritation symptoms were monitored. Data were analyzed by chi-square test and independent t -test. Results: The average follow-up was 7 months (range, 3 to 12 months) postoperatively. The rejection rate was 15.3% in the tacrolimus group and 47.8% in the cyclosporine A group (χ(2)=5.510, P< 0.05). One patient in the tacrolimus group and two patients in the cyclosporine A group suffered fungal recurrence. Two patients in the tacrolimus group and four patients in the cyclosporine A group had secondary glaucoma. The intraocular pressure was controlled. Three patients receiving tacrolimus eye drops and 13 patients receiving cyclosporine A eye drops had mild irritation symptoms. Conclusions: Tacrolimus eye drops combined with low concentration of glucocorticoids can prevent the early immunological rejection after PKP for fungalkeratitis effectively and safely. (Chin J Ophthalmol, 2017, 53:305-310) .

Objective: To study the clinical features, diagnosis and treatment of Thygeson's superficial punctate keratitis (TSPK)., Methods: Twenty-one cases diagnosed as TSPK between June 2010 and July 2013 were retrospectively analyzed, including clinical manifestation, characteristics of morphological changes imaged by laser confocal microscopy, treatment and therapeutic effects., Results: All the 21 cases had the same presentation. Slit lamp examination showed several rough punctate intraepithelial opacities, which were usually slightly above the niveau of the surrounding epithelium. No cases had conjunctival congestions. Eight eyes of five patients with TSPK were imaged with a laser confocal biomicroscope. Clusters of highly reflective dots were revealed in the epithelium. The number of Langerhans cells was greatly increased in the basal cell layer of the focal corneal epithelium and the Bowman's layer in ten eyes affected by TSPK. The density of the subepithelial nerve plexus decreased. Some keratocytes had highly reflective cell bodies of irregular size, orientation, and shape in the anterior stroma in the affected eyes. After treatment with low concentration steroid eye drops and antiviral drugs, punctate opacities in all 21 cases were completely absorbed, leaving no scar, and the cure rate was 100%. But TSPK recurred in four cases. All recurrent cases were cured completely after treatment., Conclusions: Thygeson's superficial punctate keratitis is a kind of chronic recurrent superficial keratitis, without conjunctivitis. Confocal microscopic images have certain specificity, help diagnose and contribute to its pathogenesis research. Local use of low concentration steroid eye drops combined with antiviral drugs is effective for TSPK. Clinicians should pay attention to recurrence of TSPK.

Objective: To confirm the non-inferiority of the IOP-lowering effect of the 0.0015% Tafluprost ophthalmic solution to the 0.005% Latanoprost ophthalmic solution in patients with primary open-angle glaucoma or ocular hypertension.Safety was also compared between two groups., Methods: This study was conducted from August 2008 to December 2009, at five clinical trial sites in China. Patients of this study population was diagnosed with primary open-angle glaucoma or ocular hypertension in both eyes.Subjects were randomized into 0.0015% Tafluprost group or 0.005% Latanoprost group.Intraocular pressure (IOP) measurement by Goldmann applanation tonometer, slit-lamp microscopy, Gonioscopy, Fundascopy, Visual acuity test, Perimetry, Blood pressure and pulse rate, Subjective symptoms were compered between two groups at Week 0, Week 2 and Week 4.For main effectiveness evaluation index adopt the bad effect evaluation, safety evaluation index by Fisher's exact test probability method., Results: The 246 subjects/246 eyes were randomized (Tafluprost group:122 subjects/122 eyes, Latanoprost group:124 subjects/ 124 eyes). Change in the IOP at 17:00 of Week 2 is (8.8 ± 3.8) mmHg and (8.9 ± 4.4) mmHg (1 mmHg = 0.133 kPa) in Tafluprost group and Latanoprost group. Percent change in the IOP at 17:00 of Week 2 is (33.2 ± 12.8)% and (34.4 ± 14.1)% in Tafluprost group and Latanoprost group. Change in the IOP at 17:00 at the end of treatment is (9.8 ± 4.0) mmHg and (9.2 ± 4.1) mmHg in Tafluprost group and Latanoprost group. Percent change in the IOP at 17:00 at the end of treatment is 37.2% ± 13.4% group and 35.7% ± 13.0% in Tafluprost and Latanoprost group.In addition, distribution of subjects with percentage decrease of IOP > 30% was 72.5% in Tafluprost group higher than 63.8% in Latanoprost group. The major adverse reactions were conjunctival hyperemia, eye irritation, eye pain and foreign body sensation. The incidence of adverse reactions is 31.7% in Tafluprost group and 20.8% in Latanoprost group. The inter-group difference had no statistical significance., Conclusion: Efficacy and safety of Tafluprost ophthalmic solution are no less than Latanoprost ophthalmic solution in patients with primary open-angle glaucoma or ocular hypertension.

Objective: To observe the efficacy of bromfenac sodium eye drops on relieving the irritative symptoms after LASEK surgery., Methods: Sixty-four people who had received LASEK surgery were randomly divided into two groups, observing the right eye for each group. group A was given 0.1% bromfenac sodium eye drops twice a day in three days before surgery and one day after surgery; group B was given 0.5% ketorolac tromethamine (acular) eye drops four times a day in three days before surgery and on day after surgery. In the 1(st), 3(rd), 5(th) and 7(th) day after surgery, irritative symptoms grade, duration of irritation, time for corneal epithelial healing, and uncorrected visual acuity were observed and compared between the two groups., Results: 0.1% no discomfort in group A with bromfenac sodium eye drops was observed while 0.5% ketorolac tromethamine eye drops caused tingling, burning discomfort that lasted for 2-3 seconds in 16 of the 28 subjects (87.5%). No significant difference was observed between the irritation grades of group A and B (Z = -1.625, P = 0.104); the duration of irritative symptom was significantly shorter in group A than that in group B (Z = -2.895, P = 0.004) . No significant difference was observed between the time of healing and visual acuity recovery of the two groups., Conclusion: 0.1% bromfenac sodium eye drops can effectively relieve the post-LASEK irritative symptoms, and it is better tolerated than 0.5% ketorolac tromethamine eye drops.

Background: With the understanding of the immune inflammatory response in the pathogenesis of dry eyes, and the limitations of widely used artificial tears and numerous pharmaceuticals and methods to promote tear secretion, clinicians pay more attention to the therapies that can promote tear secretion actively. Acupuncture treatment for dry eye may meet this requirement., Objective: To observe the clinical efficacy of acupuncture treatment on dry eye and the effects on duration, and to examine the mechanisms of acupuncture in treating patients with dye eyes., Design, Setting, Participants and Interventions: The study was performed at Department of Ophthalmology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine from August 2010 to May 2011. Patients with the primary diagnosis of dry eye were enrolled. Sixty-five patients were randomly divided into treatment group and control group, and were given 3 weeks of acupuncture treatment or artificial tear therapy respectively., Main Outcome Measures: The enzyme-linked immunosorbent assay was used to detect the lactoferrin content of the tears before and after treatment. In order to evaluate the efficacy of the treatment methods, the Schirmer I test and break-up time were also measured., Results: Compared with before treatment, the lactoferrin content in the tears of patients in the treatment group increased, break-up time was prolonged and the result of the Schirmer I test showed improvement after 3 weeks of treatment. The indexes mentioned above did not change in the control group after treatment. There were no significant differences in tear lactoferrin and Schirmer I test between one week after treatment and after 3-week treatment in the treatment group, but break-up time was significantly shortened. The result of Schirmer I test in the treatment group was significantly higher than that in the control group one week after treatment., Conclusion: Acupuncture can increase tear lactoferrin level, extend tear film break-up time and promote tear secretion in patients with dry eye in a time-limited trial. With the end of treatment, the effect decreased.

Objective: To assess the efficacy of acupuncture for glaucoma., Methods: The search was conducted through database to identify randomized controlled trials of acupuncture for glaucoma until September 2010. The quality assessment, data extraction and Meta-analysis were performed by Cochrane Handbook for Systematic Re views of Interventions., Results: Eight articles were included. Meta-analysis showed that acupuncture did not decrease intraocular pressure compared with eye drops [SMD = -0.1 66, 95% CI (-1.45, 0.13)]. However, acupuncture increased the effectiveness rate of treatment for glaucoma [OR = 4.45, 95% CI (1.96,10.09)]. Compared with placebo, acupuncture did not decrease intraocular pressure 20 min after acupuncture (P = 0.13) and 24 hours after acupuncture (P = 0.21). Nonetheless, acupuncture increased the effectiveness rate of treatment for glaucoma [OR = 45.00, 95% CI (9.73, 208.08)]. Compared with acupuncture, quantitative acupuncture manipulation increased the effectiveness rates of treatment for glaucoma [OR = 2.23, 95% CI (1.14, 4.36)]., Conclusion: Acupuncture therapy has potential to increase effectiveness rates of treatment for glaucoma. It lacks reliable evidence to prove that acupuncture decreases intraocular pressure. More trials with high quality are needed to estimate adverse effects and cost effectiveness of acupuncture therapy.

Objective: To assess the preventive effects of early timolol eye drops application in patients after laser in situ keratomileusis (LASIK)., Methods: Sixty patients (60 eyes) were randomly assigned to the treatment group and the control group. Timolol was administered topically twice per day to the treatment group from the second week through the end of the first month. We observed the changes of intraocular pressure (IOP), spherical equivalent correction (SE), stimulated curvature (Simk), anterior chamber depth (ACD) and different value (Diff) both preoperatively and postoperatively, i.e. before and 1 week after LASIK, 1 month and 3 months after LASIK, respectively. All examinations were completed in person. Independent-samples T test, repeated-measures ANOVA, one-way ANOVA were used for statistical comparisons. Significance level was set to α = 0.05., Results: The manifest refraction of treatment group was (-0.07 ± 0.25) D, (0.04 ± 0.21) D and (-0.05 ± 0.12) D, respectively, while the control group was (-0.08 ± 0.22) D, (-0.15 ± 0.17) D and (-0.14 ± 0.18) D, respectively, at 1 week, 1 and 3 months postoperatively. The difference between the two groups was significant (F = 5.68, P < 0.05) regardless of time. The IOP of treatment group was (12.63 ± 2.56) mm Hg (1 mm Hg = 0.133 kPa), (9.70 ± 1.88) mm Hg and (11.41 ± 1.22) mm Hg, respectively, at 1 week, 1 and 3 months postoperatively. The control group did not change significantly throughout follow-period. The changes of treatment group was significant in different periods (F = 34.62, P < 0.01). After surgery, the posterior corneal surface of the treatment group displayed mean forward shift of (35.73 ± 14.55) µm and the control group did (45.80 ± 19.86) µm (t = 2.83, P < 0.05). The stimulated curvature (Simk) and anterior chamber depth (ACD) was not significantly different between the two groups at any postoperative visit., Conclusions: Our prospective study demonstrates that timolol is effective to stabilize the refraction after LASIK. Reduction of IOP and corneal ectasia may play a significant role in preventing myopic regression.

Glaucoma is a common cause of visual impairment and irreversible blindness. Medication is important in the management of glaucoma, especially in primary open-angle glaucoma. Combination drug therapy is needed because single drug therapy can not always control the intraocular pressure effectively to a safe level in glaucoma patients with higher baseline intraocular pressure. Traditional unfixed combination therapy of glaucoma may disturb daily life because the frequency of admitting eye-drops is increased, it is less persistence or compliance, and results in the increase of local concentration of preservatives in the eye. The new fixed combination formulations for glaucoma have been developed to be safer, more effect and more compliable. This article reviews the comparative studies of therapeutic effects of anti-glaucoma fixed combination formulation and summarizes features of each formulation, and then prospects the new developing tendency of anti-glaucoma medication.

Objective: To compare the efficacy of latanoprost, travoprost and bimatoprost given in the evening on the 24-hour intraocular pressure (IOP) curve in open-angle glaucoma patients., Methods: It was a case-control study. Patients with primary open-angle glaucoma were selected for the present study. Twenty-one, 22 and 20 patients were treated once daily with latanoprost, travoprost and bimatoprost for 4 weeks, respectively. Before and four weeks after the treatment, IOP was measured by masked evaluators at 8AM, 10AM, noon, 2PM, 4PM, 6PM, 8PM, 10PM, midnight, 2AM, 4AM and 6AM. Repeated measure analysis of variance was used to compare the IOP responses to the drug regimens for the entire circadian curve. Analysis of variance was used to compare the circadian variations of intraocular pressure., Results: The IOPs of all patients in these 3 groups decreased markedly after 4 weeks. The daily average IOP (mean ± standard deviation) in the latanoprost group decreased from (18.9 ± 2.1) mm Hg (1 mm Hg = 0.133 kPa) to (15.3 ± 2.7) mm Hg, and the extent of the decrease was 19.0%. IOP in the travoprost group decreased from (19.1 ± 3.1) mm Hg to (15.3 ± 2.1) mm Hg, with a decrease of 19.4%. IOP in the bimatoprost group decreased from (18.6 ± 1.9) mm Hg to (14.9 ± 1.9) mm Hg, with a decrease of 19.9%. The effectiveness of the treatments did not differ significantly between these three groups (F = 1.501, P = 0.110). The descending percentage compared with circadian variation ranges before treatment in patients with latanoprost, travoprost and bimatoprost was 31.0%, 31.1% and 31.9%, respectively. In comparison of these three groups, the circadian variations of intraocular pressure did not differ significantly (F = 0.286, P = 0.752)., Conclusions: This study demonstrated that latanoprost, travoprost and bimatoprost are all effective in reducing IOP over the 24-hour curve in primary open-angle glaucoma. On the basis of our data, there was no statistically significant difference in the IOP reduction between these three drugs.

Objective: To study the clinical efficacy and safety of the Esculin and Digitalis glycosides Eye Drops used in the patients of ametropic asthenopia., Methods: Multicenter clinical trial. Asthenopia patients were chosen from eleven hospitals cross China from July, 2008 to January, 2009. The experiment was conducted asthenopia patients who used the Esculin and Digitalis glycosides Eye Drops for 4 weeks continuously. Symptoms of asthenopia, UCVA (uncorrected vision acuity), refraction, amplitude of accommodation, accommodative lag, accommodative sensitivity and positive/negative relative accommodation were measured at different time points, such as treated before, 1 week and 4 week in treated after., Results: After the 4-week's use of Esculin and Digitalis glycosides Eye Drops, each subjective symptom of the patients was decreased significantly (F=353.30, P<0.05). In addition, most of the objective exams of accommodation ability were significantly improved, such as UCVA (left eye: F=23.39, P<0.05; right eye: F=15.62, P<0.05), refraction (left eye: F=10.34, P<0.05; right eye: F=17.13, P<0.05), amplitude of accommodation (left eye: F=14.46, P<0.05; right eye: F=8.29, P<0.05; eyes: F=13.86, P<0.05), accommodative lag (F=14.89, P<0.05) and accommodative sensitivity (left eye: F=62.67, P<0.05; right eye: F=68.77, P<0.05; eyes: F=82.74, P<0.05). And no patient appeared any adverse reaction in whole experiment., Conclusions: Esculin and Digitalis glycosides Eye Drops is effective and safety for use in the patients of ametropia asthenopia.

Objective: To objectively evaluate the therapeutic effect and safety of Runmushu Oral Liquid (RMS) for the treatment of xerophthalmia in postmenopausal women., Methods: Seventy-two postmenopausal women (144 eyes) with xerophthalmia of aqueous tear deficiency type were assigned to two groups. Patients in the treated group were treated with RMS (consisted of prepared and crude rehmannia root, figwort, lilyturf root, dendrobium stem, wolfberry fruit, chrysanthemum and sticktight) orally combining with local applying of Hialid eye drops; while those in the control group were treated with Hialid eye drops alone. Changes of subjective symptoms and objective indices in the two groups were observed and compared before and after 1-month treatment., Results: After 1 month of treatment, the total effective rate was 86.1% (62/72) in the treated group and 66.7% (48/72) in the control group, showing significant difference between them (P < 0.01). Significant differences between groups were also shown in improvements of total scores of subjective symptoms (P < 0.01), scores of tear film break-up time (BUT) and Schirmer I test, these indices in the treated group were better (P < 0.01). However, the improvement of cornea fluorescin staining scores was insignificant different between groups (P > 0.05)., Conclusion: RMS with artificial-tears can alleviate the eye symptoms, prolong the BUT, promote the secretion of tears in treating postmenopausal women xerophthalmia, showing a therapeutic effect superior to that by artificial-tears alone.

Objective: To evaluate the clinical efficacy between protein-free calf blood extract eye drops and recombinant human epidermal growth factor (rhEGF) eye drops for mechanical corneal epithelial defects in human eyes., Methods: A multi-center, randomized and double-blind study with a parallel, positive-control designation was carried out from April to November in 2005 at Department of Ophthalmology, Eye Ear Nose and Throat Hospital of Fudan University, Xinhua Hospital of Shanghai Jiaotong University, the First Hospital of Zhejiang University, the Second Hospital of Zhejiang University and Qingdao Municipal Hospital. 240 patients (240 eyes) with confirmed diagnosis of corneal epithelial defects at that six hospitals were enrolled in this study and were randomly arranged into two groups in average. One group (120 eyes) were treated by 20% protein-free calf blood extract eye drops which was defined as the experimental group while the other (120 eyes) by 5000 IU/ml recombinant human epidermal growth factor (rhEGF) eye drops as the positive control group. The drug was delivered in both groups 4 times per day, one drop each time in the 14 days duration. The symptoms and signs were scored and the safety was evaluated on the pre-delivery day, the third post-delivery day (day 3), day 7 and day 14. The variants in the study were tested for the different efficacy and safety between the two drugs using non-inferiority test, paired t-test, Wilcoxon signed-rank test, chi-square test, continuity correction chi-square test, Fisher's exact probabilities, analysis of variance, Cochran-Mantel-Haenszel chi-square test and so on. The criterion for statistical significance was P < 0.05., Results: There was no significant difference in efficacy between the protein-free calf blood extract group and the recombinant human epidermal growth factor group (day 3: X2 = 1.5677, P = 0.4566, day 7: X2 = 1.7152, P = 0.4242, day 14: X2 = 3.0814, P = 0.2142). The total scores of symptoms and signs in experimental group had a obvious descending (6.009 +/- 3.030) compared with the positive control group with a descending of (5.177 +/- 2.582), which reached the significant level (t = 2.2367, P = 0.0263). Ocular local stimulates and general side effect were not observed within the treatment course. There was no significant difference between the two groups in the comparison of pre- and post-therapy visual acuity. The difference was not significant when comparing the uncomfortable feelings, including eye burning and eye itching (eye burning: day 3: X2 = 0.4394, P = 0.932, day 7: X2 = 1.4710, P = 0.479,day 14: X2 = 2.1875, P= 0.335, and eye itching: day 3: X2 = 2.1045, P = 0.349, day 7: X2 = 2.0192, P = 0.364, day 14: X2= 0.6863, P = 0.407). And the positive control group gave priority to the experimental group in comfortability. A better comfortableness was reported in the protein-free calf blood extract group on the third day post-delivery (X2 = 6.626, P = 0.0100). However, no obvious difference was examined on day 7 and day 14 post-delivery., Conclusion: Protein-free calf blood extract eye drops has confirmed efficacy, good safety, quick effect and better comfortableness.

Objective: To observe the effect of FK506 eye-drop combined with keratoplasty on recurrent Mooren's ulcer., Methods: 9 cases (15 eyes) of recurrent Mooren's ulcer were treated with topical FK506 eye-drop combined with keratoplasty. Of the 15 eyes, two of Mooren's ulcer smaller than half circle of the limbus were treated with 0.1% FK506 eye-drop. Among the other 13 eyes of the ulcer larger than half the circle of the limbus, 12 eyes were treated with excision of conjunctiva combined with lamellar keratoplasty. One eye with a central corneal perforation was treated with penetrating keratoplasty. FK506 eye-drop 0.1% was given to the 13 operated eyes after the re-epithelialization of the cornea. The effect of FK506 on recurrent Mooren's ulcer was observed. Measurements of FK506 in surgically resected cornea and conjunctiva, and aqueous humor of the operated eyes were performed using enzyme immunoassay procedure. Twelve cases of recurrent Mooren's ulcer treated with lamellar keratoplasty combined with topical 0.1% dexamethasone eye-drop were taken as control., Results: After application of 0.1% FK506 eye-drop, concentrations of 30 - 350 ng/g of FK506 were found in the cornea and conjunctiva, and no FK506 was measured in the aqueous humor. Nine cases (15 eyes) of recurrent Mooren's ulcer were all cured and no recurrence was observed during the follow-up time of 12 - 17 months. The vision of 5 eyes was improved more than 2 lines after the treatment. Seven eyes of Mooren's ulcer in the control group recurred., Conclusion: 0.1% FK506 eye-drop combined with keratoplasty is an effective treatment for recurrent Mooren's ulcer.

Objective: To evaluate the therapeutic value of latanoprost on glaucoma., Methods: In an open-label fashion, multicenter, randomized control clinical trial, the efficacy and adverse drug reactions of topical application of 0.005% latanoprost once daily were compared with that of 0.5% timolol twice daily for 12 weeks in patients with open-angle glaucoma or ocular hypertension., Results: The study included 128 patients (63 patients in latanoprost group and 65 patients in timolol group) and 117 patients remained at the end of the study (60 cases in latanoprost group and 57 cases in timolol group). Comparing 12 weeks with baseline diurnal intraocular pressure (IOP), the IOP reduction (mean +/- standard deviation) in latanoprost group was (7.5 +/- 0.3) mm Hg (1 mm Hg = 0.133 kPa) (32%, t = 22.73, P < 0.0001) greater than the reduction in timolol group (6.1 +/- 0.3) mm Hg (26%, t = 17.94, P < 0.0001), the difference between the two groups being significant (F = 9.54, P = 0.0026). Two patients treated with timolol and none treated with latanoprost were withdrawn from the study because of inadequate IOP control; 3 patients with latanoprost had foreign body sensation. In latanoprost group, there was one patient whose eyelashes became darker and longer at the last visit (the 12th week). No ocular and systemic adverse events related to the two drugs were found., Conclusion: It is demonstrated that 0.005% latanoprost topically applied once daily is well tolerated and more effective in reducing IOP than 0.5% timolol topically applied twice daily. Thus, latanoprost has the potential to be a new first-line antiglaucoma drug.

Objective: To examine the effects of isoforskolin (isoF) and forskolin (FSK) suspensions administered topically on eyes with ocular hypertension (OHT) and observe the local irritation of the drugs., Methods: The intraocular pressure (IOP) was measured with pneumotonometer in screened spontaneous or water-loading induced OHT rabbits for evaluation of drug effects, and the irritation indices were recorded as well., Results: In screened OHT rabbits, isoF significantly lowered IOP from 0.5 to at least 4.5 h after the administration (P < 0.05, paired t-test vs. contralateral control eyes), with the maximum decreases of 0.25% and 1% isoF reaching 8.1 mm Hg and 7.0 mm Hg (1 mm Hg = 0.133 kPa) at about 1.5 h later, respectively. In water-loaded OHT rabbits, both 0.06%, 0.1%, 0.25%, 1% isoF and 1% FSK concentration-dependently suppressed the increments of IOP (P < 0.05 with the exception of 0.06% isoF) induced by water-loading, and the peak effects of the optimal concentration of 0.25% isoF and 1% FSK were 7.1 and 6.9 mm Hg (difference of IOP between bilateral eyes) respectively. The results also indicated that 0.25% isoF or FSK suspension had basically no irritation, but 1% induced slight irritating responses during the experiment., Conclusion: Both isoF and FSK had suppressing effects on OHT in rabbits with the optimal concentration being 0.25% and 1% respectively; at concentration of 0.25%, topically both drugs had basically no irritation, while 1% of the drugs may induce mild irritating responses.

Objective: To evaluate the regularity of corneal surface and the effect of artificial tears on the corneal surface regularity in dry eye., Methods: The surface regularity index (SRI), surface asymmetry index (SAI), the indices of TMS-1 corneal topography system, and potential visual acuity (PVA) were used to investigate the corneal regularity and corneal vision in 33 normal subjects (64 eyes) and 22 dry eye patients (42 eyes) before and after instillation of artificial tears., Results: The SRI and SAI were significantly elevated and the PVA was remarkably decreased in patients with dry eye compared to that of normal subjects (P < 0.001). The average amount of astigmatism was also significantly increased in dry eye compared to that in normal eyes (P = 0.02). In the patients with dry eye, the SRI and SAI were positively correlated with corneal fluorescein staining scores. The SRI, SAI and astigmatism were significantly reduced, the PVA was improved and the irregular topographic pattern was markedly decreased in the dry eyes after the usage of artificial tears., Conclusion: The dry eye has an irregular corneal surface and the indices of TMS-1, SRI and SAI can be used to objectively diagnose this disorder, evaluate the severity of the dry eye and the effect of artificial tears on it. Artificial tears can smooth the corneal surface and improve the visual acuity in patients with dry eye.