Although phacoemulsification is quite minimally invasive, effective and safe, it can still injure the structure of eyes and cause and/or aggravate posterior vitreous detachment, retinal detachment, macular edema, diabetic vitreoretinopathy, age-related macular degeneration and high myopic retinopathy due to the turbulence of operation and instrument to intraocular tissue, which disturbs the stability of anterior chamber and vitreous body, damages blood-ocular barrier and results in the release of inflammatory cytokines.Ophthalmologists should have a thorough understanding of relevant knowledge to emphasize the operating risk evaluation and management in perioperative period in order to control the energy and operation time of phacoemulsification as much as possible, especially for the patients with serious fundus diseases and systemic diseases.Ophthalmologist should avoid the operating disturbance of intraocular tissue to the utmost extent by reducing the phacoemulsification energy and duration.It is very important for us to realize the management of whole process of cataract surgery "from anterior segment to posterior segment" and "from eye to whole body" so as to further improve the postoperative visual quality and satisfaction of patients.

Corneal astigmatism in patients with cataract is very common,but it could not be accurately corrected during previous cataract surgery,which usually affects the visual quality seriously.The accurate measurement of corneal astigmatism power and meridian before surgery is key to the effective correction of astigmatism during the cataract surgery by either the determination of astigmatic keratotomies or the selection and implantation of toric intraocular lenses (IOL).The combination of IOL Master for sphere,the Pentacam for the total corneal refractive power and VERION Digital Marker for surgical orientation can provide promising refractive examination,treatment and good postoperative outcomes.Preexsisting astigmatism can be corrected during cataract surgery by modifying incision,performing arcuate keratotomy,or implanting a toric IOL.Femtosecond laser arcuate keratotomy combined with phacoemulsification is an effective,safe and precise method for the correction of low to moderate corneal astigmatism power,and it can improve visual acuity in cataract surgery candidates.Further work is required to establish corneal biomechanics numerical simulation and nomography protocol for cataract refractive surgery so as to improve the predictability and accuracy of femtosecond laser-assisted astigmatic keratotomy during refractive cataract surgery.

Objective To investigate the primary eye care and prevention of blindness in rural area of Jiangsu Province.Design Cross-sectional study.Participant 34 townships and 76 villages of 13 national advanced counties of prevention of blindness in Jiangsu province.Method The fellowship,responsibility,workload and equipment for prevention of blindness of above townships and villages were inspected and evaluated.Main Outcome Measure All measures of the primary eye care and prevention of blindness according to the criteria of the Ministry of Health of China.Result All townships and villages had attained or exceeded national indicators in eye care network,duty and equipment respect,and about 50% country doctors have attained or exceeded the demand for diagnosis and treatment of common eye diseases.There were certain problems in statistic table,cataract surgical technique.Conclusion The primary eye care and prevention of blindness in rural advanced counties of prevention of blindness in Jiangsu have basically attained the criteria of the Ministry of Health,but work level remain to be increased further.(Ophthalmol CHN,2006,15:355-358)

Objective To investigate the effect of nerve growth factor (NGF) on recuperate of optic nerve after contusion by clamping in adult rabbits. Methods Sixteen adult rabbits were randomly divided into NGF and the control group with 8 rabbits in each group. After the optic nerve of the right eyes was clamped,tissue engineering nerve containing (0.06 ml) NGF(concentration: 5?10~(-4) g/L, NGF group) and 0.06 ml of PBS (control group) was immediately transplanted into the injured eyes respectively, and 0.02 ml NGF(concentration: 5?10~(-4) g/L, NGF group)and 0.02 ml of PBS (control group) were injected into the vitreous of right eyes respectively. Flash visual evoked potential (FVEP) test was performed on the eyes 1 day, 2 weeks and 8 weeks after the injury. The number of retinal ganglion cells (RGCs) and changes of optic nerves were observed by light microscopy and electron microscopy at the 8th week after contusion,and a computer-image-analysis system was used to count the optic nerve axons. Results The ratio of amplitude of FVEP of the injured and healthy eyes was 0.765?0.150 in NGF group and 0.494?0.108 in the control at the 2th week after injury with a significant difference between the two groups (P

Objective To investigate the clinical characteristics of retinal degeneration (RD) with retinal holes and the therapeutic effect of argon laser therapy. Methods The data of argon laser therapy in 210 RD patients (224 eyes) with retinal holes who underwent the treatment in our department were retrospectively analyzed, which was compared with the data of argon laser therapy in 173 RD patients (198 eyes) without retinal holes. Results In RD patients with retinal holes, 89.7% of the patients were less than 60 years old (53.3% males and 46.7% females). Grid-like degeneration was found in 65.6% of the patients in whom 87.5% had the range of degeneration less than 1 quardrant. There were oval-shaped holes in 60.7% of the patients and accompanied with limited rhegmatogenous retinal detachment (LRRD) in 23.7%. Compared with RD patients without retinal holes, the ratio of patients with the age of≥35 years, cystic degeneration, retinal lengthways small plica, and subjective symptoms was higher in RD patients with retinal holes; while the therapeutic effect of argon laser therapy on patients with LRRD was obviously less than whom without retinal holes (P

Objective To evaluate the rapid diagnosis of bacterial and (or) fungal endophthalmitis by multiplex polymerase chain reaction (MPCR). Methods MPCR was performed to detect the DNA segment of bacteria and (or) fungi from standard strains and 41 samples of intraocular fluid or vitreous from 38 patients (3 with double eyes and 35 with single), and the results were compared with the cultured bacteria and fungi. Results Five hours after detected by MPCR, bacteria and (or) fungi in 34 out of 41 samples (82.9%) from patients were detected,including bacteria in 26,fungi in 6,and both bacteria and fungi in 2. The positive rate of MPCR was obviously higher than the cultured ones( ? 2 =9.60, P

Objective To investigate the cataract patients' awareness on the cataract diseases, treatment and major obstacles for patients to seek eye care. Design Prospective cross-sectional study. Participants All 251 patients in Jiangyan county were screened by the group of eye diseases selection in 6 months for cataract treatment performed by prevention blind surgery group. Methods Patients accepted surveys before operation. The patient's awareness questionnaire was developed in Aravind Eye Hospital, India. Main outcome measures Awareness of eye disease, awareness of treatment, obstacles of therapy and false treatment. Results 89.6% of patients were aware of the occurrence of eye disease for more than 1 year. However, it was only 0.12% of patients when they realized that their eye diseases could be treated more than 1 year,the time less than 6 months was 31.9%,and the time less than 1 month was 65.7%. The major obstacles for seeking eye care were still able to see a little, economic reason, no demand for operation, short of belief for the operation, etc. Conclusions It's high necessary and imperative to educate patient the knowledge of eye health and care. Developing economy is the radical measure in a long run to improve the cataract surgical rate (CSR) in our country. Low price service and high quality surgery is the key of improving CSR at present.

Long non-coding RNA (lncRNA) widely exists in living organisms.It,whose length is more than 200 bp,can regulate the genic expression in the epigenetic,transcriptional and post-transcriptional level.Therefore,it can influence cell proliferation,apoptosis,vitality,immune response and oxidative stress.In recent years,the study of lncRNA is developing rapidly in the ophthalmic research,and this article reviews the latest research progress on mechanism of lncRNA in the ophthalmology disease.

Background Peroxisome proliferator-activated receptor gamma (PPARγ) is one of nuclear transcription factors.It plays potential anti-inflammation,anti-fibrogenesis,anti-angiogenesis and neuroprotection roles in human.So the study of its physiological and pathological function in human and animals is still a focus.To understand the distribution of PPARγ in ocular tissues is important for the target treatment of eye diseases.Objective Current study was to investigate the expression of PPARγ in different parts of eye in rodent.Methods Cornea,lens,ciliary,retina and optical nerve were isolated from 6 SPF C57BL/6J mice and 1 SD rat.Western blot assay was used to detect the expressions of PPARγprotein in cornea,lens and retina.Immunohistochemistry was used to locate the distribution of PPARγ protein in cornea,lens,ciliary,retina and optical nerve.Also,the co-expression of PPARγ with glutamine synthetase (GS) (a Müller cell specific marker) and glial fibrillary acidic protein (GFAP)(an astrocyte specific marker) in retina and optic nerve was detected by immunofluorescent double staining.Results Western blot assay showed that PPARγ was expressed in the cornea,lens and retina of the mice.Immunohistochemistry revealed that PPARγ mainly located at corneal epithelium with the strongest staining in the basal cells,but only weak staining was seen in corneal endothelial cells and stroma cells.PPARγ was strongly expressed in epithelial cells and shallow cortex layer of mouse lens.In mouse retina,PPARγ was extensively and richly expressed in retinal ganglion cell layer,inner and outer plexiform layers and inner nuclear layer.In addition,PPARγ was also expressed in the non-pigmented epithelial cells in ciliary body.The co-locations of PPARγexpression with GS in retinal tissue and PPARγ expression with GFAP in optical nerve tissue were found in the mice.Conclusions PPARγis proved to distribute extensively in different ocular tissues.These results offer basis for the target treatment of relevant eye diseases.

Background Cataract was directly associated with the damage to the structure and function of lens epithelial cells (LECs).In those patients who suffer from cataracts,morphologic changes of LECs is the most compelling evidence confirming loss of cellular structure and function of LECs.So,learning about the morphological changes of LECs of the different types of cataracts is very important for study on biological behaviors of LECs in different environments or diseases.Objective This study was to evaluate the morphological and ultrastructural changes of the LECs in different types of cataracts.Methods Anterior capsular member from age-related cataracts,diabetic cataracts and high myopia complicated cataract were obtained during the cataract surgery and 15 pieces for each.Trypan blue and alizarin red (TB-AR) stain,haematoxylin and eosin stain were performed in the samples to assess the viability and morphology of LECs.The ultrastructural change of LECs was observed under the transmission electron microscope.The features of the LECs were compared among the different types of cataract.Results TB-AR stain showed that LECs were polygon in shape with the mosaic arrangement and round cell nucleus,and a few dead cells were seen in the samples age-related cataract.In the diabetic samples,LECs largened from swelling with different sizes.More dead cells were found in the high myopia complicated cataract.Haematoxylin and eosin stain exhibited that the anterior capsular membrane presented a homogeneuous membrane,and monolayer LECs attached firmly anterior capsular membrane in the samples of related cataract.Majority of the cells had the intact structure.However,the interspaces between cells and capsular membrane were found in diabetic cataract.Also,smaller LECs were seen in high myopia complicated cataract with the irregular cell morphology.Under the transmission electron microscope,LECs presented the normal shape,intact intercellular tight junction and well attachment between cells and capsular membrane in the samples of the age-related cataract.In the samples of the diabetic cataract,edema of LECs and large intercellular spaces were seen.In addition,the jogged pump and vacuolar degeneration of cytoplasm were revealed in the high myopia complicated cataract.Conclusions The degeneration,necrosis and apoptosis was a common pathological basis of age-related cataract,diabetic cataract and high myopia complicated cataract.However,the damage of LECs was more serious in diabetic cataract and high myopia complicated cataract than that of agerelated cataract.