Objective To evaluate the therapeutic effects of ultrasound biomicroscopy (UBM) assisted intraocular lens suspension surgery with one loop suturing for residual lens capsule aphakia.Methods Fifty aphakia patients (50 eyes) with residual lens capsular equal or greater than 180 degrees were chosen.The patients were randomly divided into 2 groups and underwent intraocular lens suspension surgery with one loop suturing:Trial group (25 cases,25 eyes) selected suture site according to the preoperative UBM results,and control group (25 cases,25 eyes) selected the suture site according to the clinical experience.The uncorrected visual acuity (UCVA),astigmatism at preoperative and postoperative 1 week,1 month and 3 months were observed,the eccentric and tilt value of the lens were calculated by UBM measurement at 3 month after operation,and the postoperative complications of the two groups were observed.Results UCVA at each time point after operation were higher than that before operation,and gradually increased with time.There was no significant difference between the two groups at 1 week before and after the operation of UCVA (P ＞ 0.05).At 1 month and 3 months after operation,UCVA in trial group were significantly higher than those of control group (all P ＜ 0.05).The astigmatism value at 1 week after operation in two groups was higher than that before operation and gradually decreased with time.The astigmatism value in trial group at 1 month and 3 months after operation had no significant difference with that of preoperative (P ＞ 0.05),while the astigmatism value in control group increased (all P ＜ 0.05).The astigmatism values had no significant difference between the two groups before and 1 week after operation (all P ＞0.05),which were significantly lower in trial group at 1 month and 3 months after operation (all P ＜ 0.05).Three months after surgery,the proportion of lens accurately implanted in the ciliary sulcus was significantly higher than control group (P ＜ 0.01),the eccentric and tilt values of the lens in trial group were significantly less than control group (P ＜ 0.01).No serious complication was observed in all patients.Conclusion UBM assisted intraocular lens suspension surgery with one loop suturing can significantly improve the postoperative visual quality,safety and lens stability,which can be used as a routine preoperative examination of intraocular lens suspension surgery.In addition,UBM provides an alternative method for the calculation of the eccentricity and tile value of the intraocular lens after the implantation of the intraocular lens.

Coats disease,known as the outer exudative retinopathy,is a kind of disease characterized by retinal capillaries expansion and microvascular abnormalities,often accompanied by retinal or subretinal exudation and lipids exudative retinal detachment.Neovascular glaucoma and ocular atrophy often occur in the late time.Coats disease is significant diversity in clinical presentation and morphology.For nearly a century,with the development of understanding of the disease,vireoretinal specialists have a new view on diagnosis and treatment of it.This article reviews the recent progress in the diagnosis and treatment of Coats disease.

The incidence of toxic keratopatby is increasing yearly.Due to the shortage of specific clinical manifestations,the diagnosis and treatment of the disease are relatively difficult,hence toxic keratopathy has received extensive attention of the domestic and abroad scholars.In recent years,with the development of ophthalmic examination technology and progress of instruments,its mechanism,diagnosis and treatment have been newly cognized.These three aspects will be reviewed in this article.

In recent years,there are many studies have reported that a small pupil syndrome appeared during routine phacoemulsification in patients with current or previous use of alpha-1 adrenergic receptor antagonists,with these clinical manifestations:an iris that appears floppy as it billows during normal irrigation and aspiration in the anterior chamber,a tendency for the iris to prolapse and progressive intraoperative miosis during surgery,which called intraoperative floppy iris syndrome This article mainly reviews the mobidity,pathogenesis,clinical features,complications,prophylaxis and treatment of the intraoperative floppy iris syndrome.

Fibrosis is the major cause of corneal scarring.Transforming growth factor-beta (TGF-β) plays a key role in corneal homeostasis and repair.Corneal epithelial basement membrane is thought to be the important barrier of corneal epitheliumstroma interaction.In different stages of corneal wound healing,the isoforms of TGF-β have different temporal and spatial expression.The integrity of basement membrane is a critical factor of these procedures.The temporal and spatial distributions of TGF-β isoforms play the crucial roles in cell migration,proliferation,phenotype changes and deposition of extracellular matrix in corneal wound healing.It is the mechanism of corneal scarring and scar-free healing.This article reviews recent articles to elucidate the biological functions of TGF-β and the temporal and spatial distribution of its isoforms in corneal wound healing.

Objective To investigate the cause and treatment for ischemic ophthalmopathy after cataract phacoemulsification.Methods A total of 3000 patients with cataract underwent phacoemulsification were retrospectively analyzed,and 13 patients with ischemic ophthalmopathy.The ischemic optic neuropathy (ION) were in 8 cases,7 cases occurred in age related cataract,1 cases occurred in the dislocation of lens;The central retinal artery occlusion (CRAO) were occurred in 5 cases,1 cases of age-related cataract,2 cases of congenital cataract,2 cases of traumatic cataract.The patients were diagnosed with fundus,visual field and fundus fluorescein angiography respectively,and then were treated with dilation of blood vessels,nutrition nerves and symptomatic treatment.Results The visual acuity in 6 cases with ION after the treatment were improved in different degrees;The visual acuity in 2 cases with CRAO after treatment were improved,3 cases was not recovered.Conclusion Ischemic ophthalmopathy caused by phacoemulsification cataract surgery may be related to the main vascular disease or optic nerve ischemia and hypoxia during operation,and with early detection and treatment,visual acuity can be improved to some extent.

Objeetive To analyze the effect of treatment of rhegmatogenous retinal detachment(RRD) by scleral bucking as well as the relative risk factors affecting the anatomical reattachment and visual recovery.Methods One hundred and fortyeight patients (148 eyes) with RRD treated by sclera buckling surgery in our hospital during January 2012 to January 2016 were retrospectively analyzed.The rate of postoperative retinal anatomic reattachment,the best corrected visual acuity (BCVA) and complications were observed.Logistic regression analysis was performed to analyze the correlative factors affecting the anatomical reattachment and postoperative vision restoration.R~ults Retinal reattachment achieved in 91.9％ after initial surgery and the final success rate for anatomic reattachment was 97.3％ assessed with ophthalmoscope and fundus photography.But these two rates were assessed with the optical coherence tomography (OCT) were 60.1％ and 80.4％ respectively.Single factor Logistic regression analysis showed that retinal detachment was affected by multiple breaks and Grade C1 PVR(all P ＜0.05);Single factor Logistic regression analysis showed that preoperative BCVA,course of disease,retinal detachment range,macular involvement or not had an impact on the postoperative recovery of BCVA (all P ＜ 0.05),preoperative age,refractive status,releasing retinal fluid or not,intravitreal gas injection,combined scleral buckling,and postoperative subretinal fluid,all of these factors had no effect on BCVA recovery after surgery (all P ＞ 0.05).And through multiple factors Logistic regression analysis,preoperative BCVA was an independent risk factor for BCVA recovery after surgery (P ＜ 0.05).Conclusion Scleral bucking is an effective technique for managing RRD,but multiple breaks and Grade C1 PVR are significant risk factors for anatomic.Preoperative BCVA,course of disease,retinal detachment range,macular involvement or not have the impact on the BCVA recovery after scleral buckling,and the preoperative BCVA is the key factor.Early diagnosis and early treatment as well as protecting the preoperative visual acuity can improve prognosis.

Objective To research and evaluate measuring Toric intraocular lens (Toric IOL) alignment by iTrace aberration without mydriasis.Methods Forty-five eyes of 35 patients underwent phacoemulsification in Tianjin Medical University Eye Hospital from June 2015 to February 2016 were enrolled.Follow-up and iTrace aberration examination were performed at postoperative 1 week.The internal optics aberration astigmatism axis was transformed into postoperative Toric IOL alignment.The result and the Toric IOL alignment measured by tradition slitlamp method were compared by linear correlation and difference.Results At postoperative 1 week,the uncorrected distant visual acuity and corrected distant visual acuity were (0.19 ± 0.12)LogMAR and (0.10 ±0.09) LogMAR.The UCVA was 20/40 or better in 42 eyes (93.3％).The mean IOL misalignment measured by slitlamp was (3.13 ± 2.86) degrees (ranged 0-9 degrees) and by the iTrace aberration was (4.44 ± 3.42) degrees(ranged 0-13 degrees),there was statistical significant difference (t =-2.321,P =0.025).The mean difference in the error of the Toric intraocular lens alignment measured by iTrace aberration and the slitlamp was (3.67 ± 3.59) degrees (ranged 0-14 degrees).The results showed that there was less than 5 degrees of difference between the two methods in 32 eyes (71.1％),locate 5 to 10 degrees in 9 eyes (20％),more than 10 degrees in 4 eyes (8.9％).The correlation between the 2 methods showed significant linear relationship (r =0.926,P ＜ 0.01).Conclusion Using iTrace aberration can accurately measure Toric intraocular lens alignment without mydriasis,the result has some reference value.

Objective To observe the clinical characteristics and surgical methods of strabismus following external approach for retinal detachment,and explore the common factors related to deviation angles of strabismus.Methods Twenty-five cases of secondary strabismus following external approach for retinal detachment underwent strabismus surgery were recruited,and the follow-up time was from 5 months to 41 months.Ophthalmic examinations were performed before operation.Clinical characteristics of these cases were observed by intraoperative exploration,including preoperative and postoperative eye position and ocular movement (at 1 week and further followup).The preoperative and postoperative deviation angles of strabismus were evaluated according to the times of retinal detachment operation,postoperative BCVA and the surgery procedure of hang-back recession.Results Before strabismus operation,all cases underwent abnormal eye-movements,8 cases suffered from diplopia,and scar adhesions were observed in all involved ocular muscles during operation.Seven cases underwent weakening procedure of extraocular muscle,18 cases underwent weakening procedure plus strengthening procedure.Ten cases underwent hang-back recession among them.At 1 week and the final follow-up,the eyeball in21 cases and 15 cases were in position,4 cases and 9 cases were in undercorrection,5 cases and 7 cases were in limitation,and 2 cases and 1 case were in diplopia.The more operations were performed in retinal detachment,the more scar adhesions were presented,and statistical significance existed with the mean deviation angles before and after operation(in a week) between cases that had one-time and over-one-time of retinal detachment surgery (P =0.01,0.00).No difference of mean deviation angles was found at one week after operation and at follow-ups between the cases with and without hang-back recession (P =0.26,0.63).Conclusion Abnormal eyemovements,diplopia and scar adhesion are the most common clinical characteristics of strabismus following retinal detachment surgery.Times of retinal detachment operation and postoperative BCVA can influence the deviation angles of strabismus,and hang-back recession seems the safe and effective method of strabismus surgery.

Objective To observe the prognosis and correlated factors of cystoid macular edema (CME) secondary to uveitis.Methods A retrospective,noncomparative case series study.The clinical data of 31 uveitis patients with CME were collected from Uveitis & Ocular Immunology Service of Tianjin Medical University Eye Hospital from August 2011 to December 2015.Pre-treatment and post-treatment data were collected,including details of best-corrected visual acuity (BCVA),central macular thickness (CMT),other macular complications,and intraocular pressure (IOP).Results Twenty-seven patients (36 eyes) were analyzed.At the 1 st month after treatment,complete resolution of CME was achieved in 14 eyes (38.9％),BCVA increased from (0.66 ±0.36) LogMAR at baseline to (0.40 ±0.31) LogMAR (P ＜0.001),and CMT decreased from (469.0 ± 99.1) μm at baseline to (368.7 ± 85.9) μm (P ＜ 0.001).At the 3rd month after treatment,complete resolution of CME was found in 19 eyes (52.8％),no significant difference was found in CMT(323.9 ±60.0) μm or BCVA(0.37 ±0.32)LogMAR compared with the 1 st month after treatment (P ＞ 0.05),significant difference was found in CMT(P ＜0.001) or BCVA(P ＜0.001) before the start of treatment.At the 6th month or more after treatment,complete resolution of CME occurred in 25 eyes (69.4％),BCVA(0.32 ± 0.28)LogMAR was significant difference compared with that before the start of treatment(P ＜ 0.05),at the 1st month(P ＜ 0.05),at the 3rd month (P ＜ 0.05).CMT (294.2 ± 81.2) μm was significant difference compared with that before the start of treatment(P ＜0.001),at the 1st month(P ＜0.001),however,no significant difference was compared with that at the 3rd month (P ＞ 0.05).At the 6th month or more after treatment,11 eyes (30.6％) had a persistent macular edema,complicated with macular epiretinal membrane,no significant correlation between the reduction of CMT(185.0 ± 114.2) μm and the improvement of BCVA (0.29 ± 0.21) LogMAR was found (r =0.322,P=0.052),while the improvement of BCVA(0.29 ± 0.21)LogMAR was negatively associated with the duration of CME(8.4 ±9.8)months(r =-0.395,P =0.015).Conclusion Current therapies are effective in curing most of the CME secondary to uveitis.The duration of CME,is correlated with poor final visual acuity,the presence of ERM is an important factor associated with regression of CME.