Cataract surgery is not only a surgery for vision resuming, but also a kind of refractive surgery. Besides improving the design of intraocular lens, perfecting the technique of surgery and examining far and near visual acuity, we should stress the objective evaluation including contrast sensitivity, glare sensitivity, accommodate ability, binocular function and wavefront aberation for better visual results.

BACKGROUND: The phakic intraocular lens implantation has advantages of reversibility and accommodative capability, which is a promising refractive operation. Posterior chamber phakic intraocular lens implantation is a developing method for the correction of extreme myopia. OBJECTIVE: To evaluate the efficacy, safety and stability of posterior chamber phakic intraocular lens implantation for the correction of extreme myopia. METHODS: This study included 18 eyes of 11 patients whose received posterior chamber phakic intraocular lens implantation at Shierming Eye Hospital from March 2006 to January 2009, including 4 males (7 eyes) and 7 females (11 eyes). All patients were followed-up 3-6 months, mean 5.3 months. The refraction, intraocular pressure, contrast sensitivity, glare sensitivity, endothelial cell morphometry, as well as lens opacities were observed. RESULTS AND CONCLUSION: After operation, naked visions of the 18 eyes were better than or equal to preoperative corrective vision, and the astigmatism was relieved obviously. The naked contrast sensitivity and glare sensitivity was better than that before the operation. The anterior chamber depth, intraocular pressure and corneal endothelium counting before and after the operation had no significant difference. No serious complication was detected during the follow-up. The vision decent at night and dazzling sensation occurred in 2 cases. Shot-term observation shows that implanting intraocular lens in posterior chamber to correct high myopia is safe, stable and predictable. This operation is a promising method for correcting high myopia.

Epidermal growth factor (EGF) is a multifunctional growth factor,which is widely expressed in most ocular tissues including cornea,retina and sclera.It may regulate the growth and proliferation of various ocular cells with the interaction of epidermal growth factor receptor in vitro or in vivo.This article reviews the role of EGF in pathological and physiological processes of ocular diseases,including corneal injury,retinal proliferative diseases,myopia,pterygium,glaucoma,cataract,and eye tumors.

High myopia is a common blinding eye disease with high specificity and population genetic heterogeneity.It has emerged as a major public health concern,which is often accompanied by many severe associated comorbidities,including retinal detachment,cataract and glaucoma.While rarely effective treatment Is found so far.This article reviews recent advances in understanding genetic mechanism of high myopia,such as mode of inheritance,MYP locus and candidate genes.

To foster interdisciplinary talents with the highly fusion of clinical skills and the capacity for scientific research, a preliminary exploration of teaching for the cultivation of scientific innovation ability was carried out for clinical postgraduate students. In the cultivation of clinical post-graduate students' innovation consciousness and innovative spirit, we focused on the transformation of attaching more importance to the clinical skills than to the capacity for scientific research to establish the foundation of the competitive compound talents. Then in the early stage of medical project writing, basic knowledge learning and exchange, we stressed clinical postgraduate students' solid grasp of basic knowledge of medical science to consolidate the way of enhancing the scientific research ability. Furthermore , under the guidance of the second research supervisors allocated by the department , we strengthened the clinical postgraduate students' writing of scientific research project bid and pro-fessional paper to promote the organic combination of the clinical practice and scientific research innovation and enhance their scientific research ability.

Twenty-six eyes which appeared rejection after allograft penetrating keratoplasty between April 2003 and April 2004 in Shandong Shi'erming Eye Hospital were collected, including 16 males and 10 females, 9 cases were repeated relapsing viral keratitis, 8 cases were traumatic posterior corneal leucoma, 5 cases were corneal decompensation caused by various intraocular surgery, 2 cases were congenital leucoma, and 2 cases had other symptom. The rejection occurred at 2 month to 2.5 years after operation. Among them 19 cases were transferred to our hospital and asked adding traditional Chinese therapy because western medicine was ineffective in other hospital. All cases were received local treatment with hormone and non-steroidal anti-inflammatory eyedrop, some cases applied systemic administration with glucocorticoid, mainly based on eye black immunosuppression decoction, potion daily, twice per day, the average time of medication was 11-42 days. Clinical symptoms were served as observation indexes, results showed that the total effective rate of the 26 cases were 100%. The bulbar conjunctiva hyperemia and edema was reduced, corneal opacity became light, and rejection was complete response in 9 cases, 5 of 19 cases which were transferred to our hospital were exempted from operation, and the average vision was improved three lines. It was found that purging liver and eliminating dampness compound Chinese medicine can rapidly reduce anterior chamber's inflammatory response and backoff corneal neovascularization in clinical practice.

Background Laser assisted in situ keratomileusis (LASIK) for myopia will change corneal asphericity and further affect the quality of vision.However,how operating parameters such as ablation depth and optic zone diameter affect corneal asphericity is still rarely reported.Objective Aim of this study was to investigate the influence of corneal ablation depth and optic zone diameter on corneal asphericity after LASIK for myopia.Methods This prospective study comprised 175 eyes of 89 patients with the spherical equivalent of (-5.93± 1.98)D and the best corrected visual acuity (BCVA) ≥ 1.0.The flap creation with the femtosecond laser combine iris recognize guided LASIK was performed on the patients who were available for the evaluation at postoperative 6 months.Corneal aspherical index (Q value) at the central corneal 6.0 mm were measured with Orbscan IIz-corneal topography before and 6 months after operation.Corneal ablation depth and optic zone diameter were recorded in operation.The changes of visual acuity and spherical equivalent before and after surgery were compared by self-control method,and the correlations between corneal ablation depth or optic zone diameter with alteration of Q value (AQ) after LASIK were assessed using multiple regression analysis.Results The mean spherical power,cylinder diopter and spherical equivalent were (-5.57 ± 1.89) D,(-0.71 ±0.55) D and (-5.93 ± 1.98) D before surgery,and those after surgery were (-0.25 ±0.30),(-0.14±0.22)D and (-0.32±0.37)D,showing significant differences between before and 6 months after LASIK (t=-32.39,-23.91,-35.18,all at P＜0.01).The Q values at the central corneal 6.0 mm were -0.13 ± 0.09 (-0.47-0.08) in preoperation and 1.09 ± 0.54 (0.22-2.51) in postoperation,with a significant increase in postoperation (t=29.37,P＜0.01).Corneal ablation depth was (95±28) μm and optic zone diameter was (6.32±0.26)mm.Ablation depth appeared to be positive correlation with AQ (β =0.803),and optic zone diameter showed a negative correlation with AQ (β =-0.149),with a multiple regression formula AQ =1.517+0.015×ablation depth-0.3 ×optic zone diameter.Conclusions LASIK for myopia increase corneal Q value.The increase of corneal ablation depth and decrease of optic zone diameter contribute to enlargement of corneal Q value.

Autophagy is of highly conserved self degradation under physiological and pathological conditions.Recent studies has been shown that autophagy play the important role in the development of ocular diseases.This article reviews the role of autophagy in the development of ocular diseases,and provides new ideals for clinical treatment of ocular diseases.

Objective To evaluate the effeciency and safety of the implantation of phakic iris-fixated intraocular lens for high myopia.Methods 12 cases(18 eyes)with the mean spherieal equivalent refraction was(-15.12?5.23)diopters of myopia,following up 3~6 months after surgery(averaging 5.1 months)were enrolled.Visual acuity,intraocular pressure,contrast sensitivity,glare sensitivity,corneal endothelium and the stable of intraocular lens and the turbid level of lens were observed.Results A postoperation uncorrected visual acuity of(0.73?0.21)was observed in 18 eyes at 6 months.There was significant difference as compared with preoperation corrected visual acuity of(0.52?0.17)(P

Background Plasma membrane calcium ATPase 3 (PMCA3) participates in the regulation of Ca2+ level in lens epithelial cells (LECs),which may be associated with the pathogenesis of cataract.It has been proved that ultraviolet B (UVB) is one of causing-factors of cataract.However,the effect of UVB on the expression of PMCA3 in LECs is unclear.Objective This study was to investigate the effects of UVB irradiation on the expression of PMCA3 in human LECs B-3.Methods HLE B-3 cells were cultured and passaged.The cells were exposed to 0,5,10 and 20 mJ · s/cm2 UVB for 0,20,40,80 s,respectively and further cultured for 24,48 and 72 hours.MTT assay was used to detect the cell proliferation rate.JC-1 staining was used to detect the changes of mitochondrial membrane potential (△ψm) in the cells.The intracellular reactive oxygen species (ROS) level was detected by DCFH-DA staining,and cell apoptosis was evaluated using annexin V-FITC/PI staining.In addition,the intracellular calcium ion (Ca2+) concentration in the cells was assayed with Fluo-3/AM staining.The expression levels of PMCA3 mRNA and PMCA protein in the HLE B-3 cells were detected by real-time PCR and Western blot,respectively.Results The survival rates of the cells were significantly reduced with the increase of irradiated intensity of UVB and the lapse of time (Fgroup =72.411,P =0.000 ; Ftime =36.588,P =0.000),and the survival rates of the cells in the 10 mJ · s/cm2 and 20 mJ · s/cm2 UVB for 24 hours were (75.3 ± 2.2) ％ and (48.7 ±4.5) ％,respectively,which were significantly lower than those in the 0 mJ · s/cm2 UVB group ([100.0±0.0] ％) (P=0.001,0.000).The survival rates of the cells in the 5,10,20 mJ · s/cm2 UVB for 48 hours were (84.9± 1.2) ％,(69.3±17.4)％ and (32.8±4.5)％,showing significant declines in comparison with the 0 mJ · s/cm2 UVB group ([100.0±0.0] ％) (P =0.047,0.000,0.000).In 72 hours following 5,10,20 mJ · s/cm2 UVB irradiation,the survival rates of the cells were (55.1 ± 3.0) ％,(42.1 ± 1.9) ％ and (26.1 ±4.7) ％,respectively,with significant differences in comparison with the 0 mJ · s/cm2 UVB group ([100.0 ± 0.0] ％) (P =0.000,0.000,0.000).JC-1staining exhibited the intracellular red fluorescence in the normal cells group.However,in the 5 mJ · s/cm2 UVB group,weak green fluorescence was seen,and the green fluorescence was enhanced in the 10 mJ · s/cm2 and 20 mJ · s/cm2 UVB groups.After irradiated by 5,10 and 20 mJ · s/cm2 UVB,the ROS levels in the cells increased from 0.4％ to 35.8％,51.9％ and 76.7％,respectively.The apoptosis and necrosis rate of the cells was 2.0％ in the 0 mJ · s/cm2 UVB and 4.2％,7.6％,15.1％ in the 5,10,20 mJ · s/cm2 UVB groups,respectively.The Ca2+ level raised by (1.2±0.1) and (1.3±0.1) folds in the 10 and 20 mJ · s/cm2 UVB groups more than that in the 0 mJ · s/cm2 group (P =0.039,0.004).The expression levels of PMCA3 mRNA in the cells were significantly reduced (P=0.001,0.004,0.000),and the expression levels of the PMCA protein were declined in the 5,10 and 20 mJ · s/cm2 UVB groups compared with the 0 mJ · s/cm2 UVB group (P=0.000,0.000,0.001).Conclusions UVB irradiation causes cataract probably through downregulating the expression of PMCA3 in human LECs and inducing apoptosis of LECs in a dose-and time-dependent manner.