Objective To observe the changes of chamber angle after phacoemulsification and goniosynechialysis(Phaco-GSL) for primary angle-closure glaucoma(PACG) with cataract,and evaluate the therapeutic effect of Phaco-GSL on PACG.Methods Fifty patients(50 eyes) with PACG and cataract were treated in our hospital,and peripheral anterior synechiae(PAS) of all their affected eyes was over 180 degrees.By single blind method,they were randomly divided into Phaco-GSL treated group(treatment group) and single phacoemulsification group(control group).The chamber angles were checked with gonioscopy 1 and 3 months after operation,and intraocular pressure(IOP) of 50 eyes was examined 1 week,1 and 3 months after operation.Results ①In group A,the rate that chamber angles reopened were over 180 degrees was 100%,and the chamber angles were wide,trabecular meshwork visible in 5 cases(20%),scleral spur visible in 12 cases(48%) and ciliary band visible in 8 cases(32%).In group B,the chamber angles reopened over 180 degrees were in 12 cases(48%) 1 month after operation and PAS reoccurred in 2 affected eyes.The effect of reopening chamber angle in group A was better than that in group B(P180 degrees can be treated by cataract extraction combined with goniosynechialysis,while trabeculectomy is not necessary.

ObjectiveTo investigate the clinical efficacy of Jin’s eye three-needle acupuncture as main therapy for acquired paralytic strabismus.MethodSeventy patients with acquired paralytic strabismus were randomly allocated to acupuncture and Western medication groups. Both groups of enrolled patients took prednisone,methycobal, vitamin B1and vitamin B12. In addition, theacupuncture group received Jin’s eye three-needle acupuncture as main therapy. The clinical therapeutic effects and adverse reactions were observed after four and eight weeks of treatment.ResultThe total efficacy rate was 75.0% in the acupuncture group and 51.6% in the Western medication group after four weeks of treatment and 90.6% in the acupuncture group and 77.4% in the Western medication group after eight weeks of treatment. There were statistically significant differences between the two groups (P<0.05). Patients in the acupuncture group occasionally had acupuncture syncope and local blood stasis. Both groups had no special discomforts.ConclusionJin’s eye three-needle acupuncture has a quick and definite therapeutic effect on acquired paralytic strabismus.

AIM: To evaluate the efficacy and safety of porcine corneal acellular stromal deep lamellar keratoplasty in the treatment of infectious keratitis.METHODS:Prospective study. A total of 17 patients(17 eyes)with infectious keratitis who failed to receive conservative treatment in our hospital from February 2017 to October 2020 were collected, and porcine corneal acellular stromal deep lamellar keratoplasty was performed using acellular porcine corneal matrix. The postoperative follow-up was 6 mo, and best corrected visual acuity(BCVA), corneal epithelial healing, corneal transparency were observed, and the recurrence of infection and graft rejection were recorded.RESULTS:All patients successfully underwent deep lamellar keratoplasty without intraoperative complications, and there were no cases of loss to follow-up. Postoperative corneal infections were effectively controlled, and BCVA was improved(P<0.05). The complete epithelial coverage of the graft was achieved in 16 eyes by 1 mo postoperatively. Only 1 eye did not achieve complete epithelialization within this period, accompanied by relapse of viral keratitis. However, by 1.5 mo postoperatively, all patients had fully healed epithelium. Corneal edema began to improve 1 month after surgery, with 1 eye with mild turbidity and 16 eyes with severe turbidity. Corneal transparency was stable 3-6 mo after surgery, and 4 eyes were completely transparent, 6 eyes were mildly turbid, 6 eyes were moderately turbid, and 1 eye was severely turbid at 6 mo. During the follow-up period, there were no recurrences of infection, while 1 eye experienced elevated intraocular pressure, which was successfully managed with treatment.CONCLUSION: The acellular porcine corneal stroma deep lamellar keratoplasty for the treatment of infectious keratitis not only effectively controls infection and alleviates corneal irritation symptoms, but also restores corneal anatomy and function. Additionally, it maintains good transparency and improves patients' vision, making it a viable alternative to allogeneic human corneas.

Objective: To investigate the refractive status of children and adolescents aged 4-18 years in Chengdu, and to analyze the epidemiological characteristics of refractive parameters. Methods: A cross sectional survey was conducted among 82 024 children and adolescents aged 4-18 years in Gaoxin District of Chengdu from August to September 2021. The prevalence of screening myopia, low vision rate, high myopia rate, refractive status and axial development were analyzed. Results: The prevalence of screening myopia in students aged 4-18 years was 40.42%(33 158/82 024). Low myopia was 24.51%(20 108/82 024), moderate myopia was 13.05%(10 703/82 024) and high myopia was 2.86%(2 347/82 024). The prevalence of screening myopia was 1.81% (233/12 848) in kindergarten, 34.44%(17 095/49 644) in primary school, 79.73%(9 738/12 214) in junior high school and 83.25% (6 092/7 318) in senior high school. The rate of visual impairment increased by year from the age of 4, and the rate of myopia increased most rapidly from 6 to 15 years old, the prevalenct of high myopia was compared between adjacent age groups: there were statistical differences between 9-15 years old were more likely to be nearsighted than boys( P <0.035 7). Significant differences in screening myopia between 5- and 7-17 year old groups,and in boys and girls.The median total diopter was 0.40 D at the age of 4 and developed to -2.90 D at the age of 18 . The diopter of girls aged 8-15 years was higher than that of boys, and there was statistical significance( Z=-2.53, -4.09, -5.67, -8.64, -5.56, -4.97, -2.52, -2.14, P <0.05). The axial length gradually increased with age, with the mean value of (22.31±0.59) mm at 4 years old and (24.91±1.00) mm at 18 years old. The mean corneal curvature did not change with age (43.19±1.47)D. Conclusion 6-15 years old is a especially critical period for myopia development. More efforts need to be taken to decrease the prevalence of myopia before 6 years old. Prevention of the development of high myopia should start before the age of 10. The prevalence of myopia in girls is higher than that in boys, more prevention and control of myopia should focus on girls.

AIM:To observe the anti-scarring effects and safety of triamcinolone acetonide(TA)-loaded hydrogel sustained-release sheeting on stab incision glaucoma surgery(SIGS)with “one-step tunnel method” in rabbit eyes.METHODS:A total of 48 healthy New Zealand white rabbits were randomly selected and divided into 4 groups(12 rabbits in each group), trabeculectomy(Trab)group, SIGS group, polyvinyl alcohol hydrogel(PVAH)sheeting was implanted under the conjunctiva flap during SIGS(PVAH group), and hydrogel sustained-release sheeting loaded with TA was implanted under the conjunctiva flap during SIGS(TA/PVAH group). On the 1, 2, 3, and 4 wk after surgery, the intraocular pressure, filtering bubble morphology, anterior chamber reaction, and other complications were observed and recorded in each group. Then animals were euthanized, and the surgery area tissues of right eye were taken for pathological tissue paraffin section. Masson staining, picric acid-Sirius rose red staining, as well as α-smooth muscle actin(α-SMA)and fibroblast growth factor 2(FGF2)immunohistochemistry staining was performed on every section. The infiltration of inflammatory cells, proliferation of fibroblasts and synthesis of type I and type III collagen fibers in local tissues were observed. The average positive area ratio of α-SMA and FGF2 antibody immunohistochemical staining in each group was calculated and compared.RESULTS: The TA/PVAH group maintained diffuse and elevated functional filtering blebs, while flat filtering blebs appeared in Trab, SIGS and PVAH groups at 2 wk after surgery. Functional filtering blebs were present in 1 eye(33%), 2 eyes(67%)in the PVAH and TA/PVAH group at 4 wk after surgery, respectively, while the other filtering blebs were flattened. Masson staining showed that the hydrogels in PVAH and TA/PVAH groups did not degrade at 4 wk after surgery. Compared with the Trab and SIGS groups, the filtration passages were more obvious, with less collagen fiber proliferation. Sirius red staining showed that the expression of type I collagen and type III collagen in the TA/PVAH group was less than that in the Trab group, SIGS group and PVAH group at 4 wk after surgery. Immunohistochemical staining showed that the α-SMA expression in the TA/PVAH group was significantly lower than that in the Trab and SIGS groups at 1 wk after surgery(P<0.01). The α-SMA expression was the highest in the Trab and SIGS groups at 2 wk after surgery, while the α-SMA expression in the PHAP and TA/PVAH groups was significantly lower than that in the first two groups(P<0.01). Compared with the Trab group, the expression of FGF2 in the PVAH and TA/PVAH group was significantly increased at 1, 2, 3 and 4 wk after surgery(P<0.05). Compared with the SIGS group, FGF2 expression in the TA/PVAH group was significantly increased at 4 wk after surgery(P<0.05).CONCLUSION:In SIGS surgery of rabbit eyes, implanting hydrogel sustained-release sheeting loaded with TA under conjunctival flap can effectively inhibit the scarring of the filtering bleb, which may be the interaction of the anti-scar effect of TA and the stent function of hydrogel.