AIM: We compared polymerase chain reaction (PCR) to cell culture isolation for the laboratory diagnosis of ocular herpes simplex virus (HSV) disease.METHODS: Laboratory and medical records of consecutive patients were reviewed for results of (1) HSV PCR testing, (2) HSV cell culture isolation, and (3) clinical diagnosis. PCR results were statistically compared to cell culture isolation and patients initially diagnosed for ocular HSV infection.RESULTS: Of 581 cases submitted for laboratory testing,520 were PCR negative, cell culture negative (89.6％); 0 was PCR negative, cell culture positive (0％); 27 were PCR positive, cell culture negative (4.6％); and 34 were PCR positive, cell culture positive (5. 8％). PCR tested more positive than cell culture isolation (McNemar's, P=0.0001 ). Of 47 HSV PCR positive cases with complete medical records, 19 were cell culture negative for HSV and 28 were cell culture positive for HSV. Fourteen of 19 cell culture negative cases (74％) (Without PCR, 5 cases of HSV would be missed) and 25 of the 28 cell culture positive cases (89％) ( Laboratory testing was necessary for diagnosing 3 cases) were clinically diagnosed with HSV at the initial examination.CONCLUSION: PCR was a more definitive test for diagnosingHSVocularinfectionthancellculture isolation. Cell culture isolation alone can miss an atypical presentation of HSV ocular infection.

AIM:To report a rare case of medullary thyroid carcinoma (MTC) with iridocorneal angle metastasis.METHODS:A 28-year-old woman,a known case of sporadic MTC was referred to our hospital due to left eye mass involving iridiocorneal angle.Several months' later retinal evaluation revealed retinal involvement with some patches.RESULTS:After palliative laser photocoagulation ablation of the choroidal and angle lesions no signs of recurrence or any new lesion was detected.CONCLUSION:As we know this is the first report of MTC with iridocorneal angle metastasis in the literature.

penetrating keratoplasty was done.Isolated stromal graft rejection was noticed 3 weeks after penetrating keratoplasty,which was confirmed on histopathology.Repeat penetrating keratoplasty 6 months later also had same fate.Diagnosis and management of isolated stromal graft rejection is a very challenging situation.

To describe a modified simple iris suture for pupillary dilation technique during vitrectomy in cases with a miotic pupil.Four translimbal incisions were created with a sharp straight blade at 1:30,10:30,4:30,and 7:30 o'clock,respectively.The straight needle of 10-0 polypropylene suture and a Sinskey IOL hook was used to displace the pupillary margin toward the limbus.In 3 cases,four sutures caused a 6-mm to 9-mm square-shaped pupil,and the pupil was allowed to return to a smaller size at the end of the operation.It is simple and may reduce postoperative complications.

A 60 years old female with a 4 years history of recovered non-Hodgkin's lymphoma(NHL) complained about vision Ioss on her right eye. There were floating cells in the anterior chamber and the vitreous cavity; and choroidal infiltration was detected on her right eye as a relapse of lymphoma. Some weeks later a magnetic resonance imaging of the brain revealed also an intracranial tumor and systemic chemotherapy started. Intraocular infiltration is an extremely rare form of relapse of NHL.

AIM: To observe the clinical effect of amniotic membrane transplantation and penetrating keratoplasty in the treatment of atheromatous corneal ulcer.
METHODS: Thirteen patients ( 13 eyes ) diagnosed atheromatous corneal ulcer from February 2009 to May 2014 in our hospital were retrospectively analyzed. Surgical treatment including amniotic membrane transplantation and penetrating keratoplasty were used to deal the patients with no effects of drugs. All patients were followed up for 4mo to 2a ( mean 8mo ) after surgery. Visual acuity, healing and recipient of ulcer were examined.
RESULTS:There patients were treated conservatively with corneal ulcer slowly healing, healing time was 14~35 ( 21±12. 1 ) d. Seven cases were treated with amniotic membrane transplantation, 2 cases were treated with penetrating keratoplasty, 1 case of corneal ulcer perforation and lost light perception received enucleation of eyeball. Corneal ulcer were cured in patients performed amniotic membrane transplantation and penetrating keratoplasty. All patients had no recurrence during the follow-up period.
CONCLUSION:Atheromatous corneal ulcer is difficult to be cured by conservative treatment. Most patients need operation treatment. Amniotic membrane transplantation and penetrating keratoplasty can be performed to deal with atheromatous corneal ulcer and abtain satisfactory effect. But amniotic membrane transplantation is relatively simple and easy, and it is suitable for promotion in primary hospitals.

AIM: To evaluate the effects of 23G vs 20G pars plana vitrectomy ( PPV ) combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation for macular epiretinal membrane with cataract. ·METHODS: Totally 45 eyes of 45 patients with macular epiretinal membrane and cataract were enrolled in this retrospective non-randomized controlled clinical study. All eyes were treated with PPV combined with internal limiting membrane peeling, phacoemulsification and intraocular lens implantation. There were 20 eyes in 23G PPV group, and 25 eyes in 20G PPV group. The best corrected visual acuity ( BCVA ) , intraocular pressure (IOP), counting of corneal endothelial cells ( CEC) and central retinal thickness ( CRT ) were examined before surgery. BCVA results were converted to the logarithm of the minimum angle of resolution ( LogMAR ) visual acuity. All operations were performed by the same doctor. Operation time for vitrectomy and membrane peeling, average ultrasound energy ( AVE) and effective phacoemulsification time ( EPT ) were recorded. BCVA and CRT were observed postoperatively at 30d and 90d, counting of CEC was observed postoperatively at 90d. IOP was observed postoperatively at 1d and 7d. ·RESULTS:The mean operation time for vitrectomy were 12. 57± 1. 35min in 23G group and 17. 30 ± 1. 19min in 20G group. The difference was statistically significant ( t =-12. 488, P<0. 01). There were no statistical significances in operation time for membrane peeling, AVE and EPT between 23G and 20G groups ( t=-0. 68,-1. 186,-0. 737, P=0. 500, 0. 242,0. 465). On 1d after surgery, IOP in 23G group was lower than that in 20G group, the difference was statistically significant (t= -2. 345, P=0. 024). The BCVA and CRT of the two groups both improved after operations. There were no statistically significant differences between two groups in terms of IOP, BCVA, and CRT ( F = 0. 465, 1. 895, 0. 689; P = 0. 499, 0. 176, 0. 411). IOP, BCVA and CRT were significant statistical different in different time-point within each group ( F=291. 245, 103. 06, 665. 402, P<0. 01 ). Different surgical methods of 23G and 20G had interactive effects on IOP with different time points ( F = 13. 245, P<0. 01 ), but different surgeries had no interactive effects on BCVA and CRT with different time points (F=1. 212, 2. 293;P=0. 283, 0. 129). The counting CEC in 23G group was more than that in 20G group postoperatively at 90d, the difference was statistically significant (t=2. 049, P=0. 048). ·CONCLUSION: The 23G PPV combined with internal limiting membrane peeling, phacoemulsification, intraocular lens implantation for macular epiretinal membrane with cataract is effective. Compared with 20G PPV, 23G PPV has advantages in operation time for vitrectomy and counting CEC. But lower IOP is likely in 23G PPV on 1d after surgery

The stability of the intraocular lens ( IOL ) after cataract surgery is composed of decentration, tilt, rotation, and the change of anterior chamber depth. Its stability is an important factor affecting postoperative visual quality. By analyzing the related factors which influence the stability of intraocular lens, improvements can be identified for future cataract operations. The stability of intraocular lens is influenced by many factors: intraocular structure, the size and the symmetry of intraoperative capsulorhexis, the position of the intraocular lens, the material and design of the intraocular lens, etc. In order to improve the patient's vision, cataract surgeries have been experiencing an evolution. IOL material have also been contributing to such innovations.

AIM: To observe the clinical effect of combined cataract and primary open-angle glaucoma underwent phacoemulsification and glaucoma drainage device implantation. ·METHODS: We selected in our hospital from January 2014 to February 2016, 42 cases (42 eyes) with primary open-angle glaucoma with cataract. According to random number table method, all of the patients were randomly divided into two groups, control group and study group. In control group, 21 patients ( 21 eyes ) underwent trabecular resection combined phacoemulsification;in study group patients, 21 patients ( 21 eyes ) , underwent EX-PRESS glaucoma drainage device combined phacoemulsification. Compared parameters included postoperative complications and filtering bleb, visual acuity, intraocular pressure ( IOP ) and other clinical indicators between two groups. ·RESULTS: Preoperative IOP of two groups was no significantly different (P>0. 05). Postoperative IOP at each time point was significantly lower than before treatment (P<0. 05). At 1d, 1 and 4wk after treatment, IOP of the study group was significantly lower than the control group (all P<0. 05); at 12wk after treatment, IOP of the two groups was not significantly different ( P> 0. 05). At 12wk after treatment, surgical success rate of study group was 95%, significantly higher than that of control group 71% (P<0. 05). The postoperative best corrected visual acuity of two groups was no significantly different (P>0. 05). At 12wk after treatment, 21 patients in study group were shown as functional filtering bleb, while in the control group 18 cases was functional filtering bleb. ·CONCLUSION:Using EX-PRESS glaucoma drainage device combined with phacoemulsification in treating cataract with primary open-angle glaucoma is reliable, the curative effect is better than that by trabeculectomy combined with phacoemulsification treatment.

AIM: To evaluate the efficacy and safety of orbital decompression in the treatment of Graves ophthalmopathy. ·METHODS: Totally 55 patients 77 eyes with Graves eye disease were selected in our hospital from February 2011 to February 2016. All eyes underwent orbital decompression, the visual acuity, exophthalmos and complications of the patients were followed up for 6mo. · RESULTS: Postoperatively 6mo, the best corrected visual acuity were 0. 23±0. 09, which were better than that of preoperative 0. 46±0. 07(P<0. 05). Postoperatively 6mo, the degree of exophthalmos of the patients were 16. 20 ± 1. 99mm, which was significantly lower than that preoperative 20. 13±1. 87mm (P<0. 05). Postoperative CAS score was ≤3 points in 56 eyes ( 73%) , significantly increased compared with preoperative 15 eyes (19%), the difference was statistically significant (P<0. 05). There were 50 eyes ( 65%) with color vision disorder before operation;after operation, 42 eyes (55%) had significant improvement in visual impairment, and there was no change in the eye in 8 eyes (10%). Postoperatively 6mo, the average decreased degree of exophthalmos were 3. 87±1. 03mm;5 cases were found postoperative diplopia, new diplopia rate was 10%;followed up for 3mo, diplopia disappeared. ·CONCLUSION:Orbital decompression is an effective method for the treatment of Graves ophthalmopathy, but attention should be paid to postoperative complications such as diplopia.