Background The test for visual acuity is the conventional standard for evaluating visual quality.However,there is little correlation between visual acuity and visual disability.Therefore,other clinical observations such as contrast sensitivity or straylight have been used in the clinical assessment of visual quality after cataract surgery.Objective This study was to examine the change in the amount of straylight in cataractous eyes and to evaluate the correlation of the types of cataract with visual quality.Methods A non-randomized case-controlled study was designed.Eighty eyes of 40 patients with age-related cataract were enrolled in this study,including 22 eyes with hard nucleus cataract,19 eyes with cortical cataract,23 eyes with mixed cataract and 16 eyes with posterior subcapsular cataract diagnosed based on the criteria from Lens Opacities Classification System Ⅲ(LOCS Ⅲ).The values for straylight and best corrected visual acuity (BCVA) were measured with the C-quant straylight meter and Snellen chart,respectively.The differences in the straylight values among the different types of cataract were analyzed,and the correlation of the straylight value with age or BCVA was assessed.Forty eyes of 40 age-matched normal people served as controls.Results Examination was completed in sixty-two eyes of 31 patients in the cataract group at a completion rate of 77.5％,and all the subjects in the control group finished the examination at a rate of 100％.The mean straylight value was (2.06±0.88) log in the cataract group and (1.96±0.42) log in the control group,showing a significant difference between them (t =3.251,P＜0.01).The respective mean C-quant measurements for hard nucleus cataract,cortical cataract,nuclear-cortical cataract and posterior subcapsular cataract patients were (1.96±0.42) log,(1.91 ±0.16) log,(2.05 ±0.19) log and (2.48 ±0.66) log,respectively,with a significant difference among these four groups (F =2.156,P =0.019).The highest straylight value was detected in the posterior subcapsular cataract group.The straylight value was enlarged with the increase of age with a regression equation of Y=0.0010X+ 1.025 in the hard nucleus cataract group (r =0.455,P ＜ 0.05).In addition,the negative linear correlation was found between the straylight value and BCVA in both the hard nucleus cataract group and cortical cataract group (r=-0.590,-0.697,P＜0.01).However,no correlation was found in the mixed cataract group and posterior subcapsular cataract group (r =-0.240,-0.235,P＞0.05).Conclusions The C-quant straylight meter can objectively reflect the visual function for hard nucleus and cortical cataractous eye.Posterior subcapsular cataract produces straylight and exerts a great influence on visual quality due to early glare sensation,so it should be benefit to perform surgery earlier.

Ojective To investigate the relationship between the serum adiponectin concentration and insulin resistance in patients with obesity and diabetic patients. Methods Fasting serum adiponectin concentration was measured by RIA in 19 normal subjects, 23 obese subjects, 31 diabetic patients without obesity and 26 diabetic patients with obesity. Results There was no significant difference in serum adiponectin concentration between nomal and obese subjects, and between type 2 diabetics without obesity and type 2 diabetics with obesity . The serum adiponectin concentrations was significantly higher in type 2 diabetics without or with obesity than that in nomal and obese subjects. There was significant difference in serum adiponectin concentration between female and male subjects. Body mass index (BMI), waist circumference(WC), waist-hip ratio (WHR), body fat percentage (BF%), fasting plasma glucose (FPG), insulin sensitivity index (ISI), triglyceride (TG) and high density lipoprotein-C (HDL-C) were significantly correlated with serum adiponectin concentration. A stepwise mulitiple linear regression analysis showed that HDL-C, FPG, WC, BF% entered the regression equation. Conclusion Serum adiponection level was associated with sex, obesity, type 2 diabetes mellitus and insulin resistance.

BackgroundBigbag intraocular lens (IOL),due to its special conducive design to support vitreous and retina after cataract surgery in high myopia,and ensure the visualization of peripheral retinal,is closely concerned.But whether its concave design has the advantage in reducing aberrations on the basis of stability or not is worth to be studied.ObjectiveThis study was to evaluate the high order aberrations(HOA) of phacoemulsification and the Bigbag IOL implantation in patients with myopia and cataract.MethodsA retrospective case-observational study was designed.Total 39 eyes of 39 cases with cataract and high myopia were enrolled in this study.The patients were divided into Bigbag IOL group and AR40e IOL group.Phaco-chop technique and IOL implantation were performed in April to June,2010 in Tianjin Eye Hospital.Two months after surgery,the operated eyes were clinical examined and the aberrations were detected including Root-Mean-Square (RMS),coma,spherical and Trefoil.Postoperative RMS values of HOA components of the whole and interior optic with iTrace were compared.Results The operation was smoothly with the correct IOL position after two months.No complication was found.Under the 4.5 mm pupil diameters,the whole ocular HOA RMS values and coma were significantly different between Bigbag IOL group and AR40e IOL group( t =-3.296 、-3.322,P＜0.05 ),but no significant differences were seen in spherical and Trefoil aberrations ( t =- 1.256、- 0.573,P＞ 0.05 ).Regarding to the interior optic with iTrace aberration,only the coma showed the significant difference between Bigbag IOL group and A R40e IOL group( t =-2.004,P＜0.05 ),and there were no significant differences in RMS,spherical and Trefoil aberrations( t=-1.073、0.380、0.288,P＞0.05 ).ConclusionsThe Bigbag IOL,a design for high myopia,is safe and effective after implant for the high myopia with cataract.It offers more exact obligate degree and better visual quality.The chief total and interior HOA components difference between groups is coma aberration.

Background Aberrant proliferation of residual lens epithelial cells (LECs) is one of main causes of posterior capsular opacification (PCO).Researches indicated that Wnt3a signaling pathway promote proliferation of epithelial cells,but its effect on LECs is still unclear. Objective The present study was to investigate the effects of Wnt3a on proliferation of human LECs and its mechanism and to provide a new gene target in the prevention and treatment of PCO. Methods Human LECs line (SRA01/04 cells ) was cultured and then incubated to 6-well plate at the density of 4×105/well.A human Wnt3a cDNA expressing vector targeted human LECs was constructed to increase the Wnt3a expression in SRA01/04 cells,and pcDNA3-HA expression vector was used as the control group.The expression of Wnt3a was identified by Western blot assay after transfected.The growth and proliferation of SRA01/04 cells were detected by MTT and flow cytometry (FCM).The expressions of β-catenin,cyclin D1 and c-myc in the cells were detected by Western blot assay.β-Catenin expression was localized using immunofluorescence assay,and the expression and localization of proliferating cell nuclear antigen ( PCNA ) were analyzed by immunocytochemistry for the exploration of the active mechanism of Wnt3a to proliferation of LECs.Results Human Wnt3a cDNA expression vector was designed successfully and transiently transfected to SRA01/04 cells,and Wnt3a/SRA01/04 cells and pcDNA3-HA/SRA01/04 cells were obtained.The expression of Wnt3a was verified in the Wnt3a transfected group compared with the control group.MTT indicated that the cell proliferating rate was significantly different between the Wnt3a transfected group and the control group ( Fgroup =15.235,P =0.005 ;Ftime =369.677,P =0.000),and that in various time points after transfected was significantly different (t =20.843,P=0.001 ;t =26.214,P＜0.001 ;t=25.177,P=0.001 ;t =35.516,P＜0.001 ;t =615.056,P＜0.001 ).The proportion of SRA01/04 cells in G1 phase was 51.74％ in the Wnt3a cDNA transfected group,with a significantly decrease in comparison with 79.44％ of the control group.However,the proportion of SRA01/04 cells in S phase in the Wnt3a cDNA transfected group was higher than that of the control group (36.23％ versus 12.34％ ).The positive expression rate of PCNA protein in SRA01/04 was (47.00％ ±7.58％ ) in the Wnt3a cDNA transfected group and ( 16.00％ ±3.61％ ) in the control group with a significant difference between them (t =8.256,P＜0.01 ).After 48 hours of transfection of the Wnt3a cDNA,the expression amount of β-catenin proteins was higher and the immunofluorescence was stronger in cell nucleus,and the expressions of cyclin D1 and c-myc proteins were elevated in Wnt3a/SRA01/04 cells. Conclusions The overexpression of Wnt3a activates the Wnt/β-catenin signaling pathway and downregulates the expression of a subset of target genes,including cyclin D1 and c-myc,which plays an important role in promoting the proliferation of human LECs.

Background The study on influences of gender,age and axial length (AL) on lens thickness (LT) and anterior chamber depth (ACD) in normal population is still lack in China.Objective This study was to measure LT and ACD in normal subjects and discuss their changes with age,gender and AL.Methods AL,ACD and LT were measured on 866 eyes of 433 normal population with Lenstar LS900 in Tianjin Eye Hospital from March through December in 2013,including 390 eyes in 195 males and 476 eyes of 238 females.ACD/AL,LT/AL and (ACD+LT)/AL were calculated after measurement.The subjects were grouped to the 10-20 years group,21-30 years group,31-40 years group,41-50 years group,51-60 years group and ≥61 years group based on age,or the 22 mm≤AL＜24 mm group,24 mm≤AL＜26 mm group and AL≥26 mm based on AL,and the measured parameters were compared and analyzed among the groups.Oral informed consent was obtained from each subject or child contutor prior to any medical examination.Results AL,ACD and LT values were (24.41±1.37),(2.89±0.42) and (4.05±0.52) mm in the males,and those in the females were (23.83±1.31),(2.72±0.40) and (4.20±0.44) mm,showing significant differences between them (t=6.278,6.102,-4.595,all at P=0.000).No significant differences were found in ACD,LT,ACD/AL,LT/AL and (ACD+LT)/AL values between the right eyes and the left eyes (t=-0.713,0.186,-0.754,0.296,-0.168,all at P＞0.05).As the increase of the AL,ACD was remarkable deepened but LT was declined,with the considerable difference among the 22 mm ≤ AL＜24 mm group,24 mm ≤ AL＜ 26 mm group and AL ≥ 26 mm group (F =176.640,94.569,both at P =0.000).ACD value was higher,but LT value was lower in the 24 mm≤AL＜26 mm group or AL≥26.00 mm group than that in the 22 mm≤AL＜24 mm group (all at P＜0.05).ACD value was gradually reduced,while LT value was elevated with aging,with significant differences among the different age groups (F =104.531,373.225,all at P =0.000).Significant correlations were found between age and ACD,LT or (ACD + LT)/AL,with the regression equations of ACD (mm) =-0.015 × age + 3.434 (F =-22.979,P =0.000);LT (mm) =0.024 × age + 3.122 (F =44.856,P =0.000),LT/AL =0.001 × age + 0.122 (F=37.982,P=0.000),(ACD+LT)/AL=0.001×age+0.259 (F=22.451,P=0.000).Conclusions Compared with normal females,males have thinner LT and deeper ACD.In the normal eyes,longer AL is,thinner LT is and the deeper ACD is.LT thickens and ACD deepens with aging.

Background Phacoemulsification with IOL implantation can reduce the light scattering caused by cataract,but many patients with IOLs implantation complained of glare or blurred vision.IOLs from different materials will affect IOL refractive index (RI) and optical design,which affect the value of scattered light of IOLs implantation.Objective This study was to analyze the effect of IOL materials on optical quality in pseudophakic eyes with optical quality analysis system (OQAS).Methods The clinical data of 95 eyes from 65 patients with age-related cataract who received phacoemulcification with IOL implantation in Tianjin Eye Hospital from March to Octomber were retropectively analyzed.Three types of lOL,including AR40e,Acrysof SA60 AT and Rayner 620H,were implanted in 32 eyes,30 eyes and 33 eyes,respectively.The visual quality indexes were detected and evaluated using OQAS,including uncorrected distance visual acuity (UCDVA,LogMAR),objective scatter index (OSI),modulation transfer function cut off (MTF cut off),strehl ratio (SR),Profile width at 50％ point scatter function (PSF),Profile width at 10％ PSF and contrast visual acuity under the 100％,20％,9％ contrasts.Results The UCDVA was ≥ 0.3 in the eyes of AR40e group,SA60AT group and 620H group 1 month after surgery.No significant difference was found in the best corrected distance visual acuity (BCDVA,LogMAR) among three groups (F =1.362,P =0.246).The OSI was 1.72±1.11,1.89±1.07 and 2.13±1.13 in the AR40e group,SA60AT group and 620H group,with a significant difference among the groups (F =3.638,P =0.045),and the OSI was significantly lower in the AR40e group than that in the SA60AT group or 620H group (both at P＜0.05).No considerable difference in MTF cut off among the groups (F =2.401,P =0.192).The SR value was significantly elevated and the PSF at both 50％ and 10％ was declined in the AR40e group compared with the SA60AT group and 620H group (all at P＜0.05).A significant difference was found in 9％ contrast visual acuity among the three groups (F=3.866,P=0.038),and 9％ contrast visual acuity was better in the AR40e group than that in the SA60At group or the 620H group (both at P＜ 0.05).Negative correlations were found betwee OSI and BCDVA in the AR40e group,SA60AT group and 620H group (r=-0.275,P=0.041;r=-0.287,P=0.042;r=-0.233,P=0.037).Conclusions OQAS can evaluate optical quality of cataract patients after opeartion objectively.Material and RI of IOL have a great effect on visual quality after phacoemulcification with IOL implantation,especially under the low contrast environment.The operated eyes implanted hydrophobic acrylic IOLs with a lower RI can get better optical quality in comparison with the eyes implanted hydrophilic IOLs.

Background Accurate measurement of corneal refractive parameters plays an important role in the diagnosis of eye diseases,design of refractive surgery and calculation of intraocular lens (IOL) power.Ophtha TOP is a new IOL calculator,so it is necessary to evaluate the repeatability and accuracy of Ophtha TOP in measuring corneal refractive parameters.Objective This study was to evaluate the repeatability of Ophtha TOP in measuring corneal refractive status in normal eyes and determine the agreement of the measuring outcomes between Ophtha TOP and Pentacam in pre-surgery cataract eyes.Methods A reliability evaluation method of diagnosis test was performed from September 2013 to October 2014.Sixty eyes of healthy volunteers aged (30.83 ±8.66) years old were examined in Tianjin Eye Hospital with Ophtha TOP for more than 5 times to evaluate the stability in measuring corneal refractive parameters.Corneal refractive parameters were measured by both Ophtha TOP and Pentacam for more than twice in 30 pre-surgery cataract eyes to assess the agreement with Pentacam.Keratometry and astigmatism parameters were recorded,including the flattest meridian (Kf),steepest meridian (Ks),mean keratometry (Km) and the astigmatism at J0 and J45.Intra-class correlation coefficients (ICC),repeatability (2.77Sw) and coefficient of variation (CoVs) were used to assess the stability of Ophtha TOP,and Bland-Altman graphs were adopted to value the consistency of measuring outcomes between Ophtha TOP and Pentacam.This study complied with Helsinki declaration,and written informed consent was obtained from each patient prior to any medical examination.Results The ICC of Ks,Kf,Km,J0 and J45 by Ophtha TOP were all ≥0.90,and 2.77Sw were all ≤0.36,The CoVs of Kf,Ks,Km by Ophtha TOP were all ≤0.30.The measuring values of Kf,Ks and Km were significantly higher in the Ophtha TOP than those in the Pentacam,with the mean differences (0.18±0.28) D,(0.24±0.29) D and (0.21± 0.26) D,respectively(t =3.48,4.50,4.49,all at P=0.00).The mean difference of the J0 was (0.07±0.21) D and that of the J45 was (-0.02±0.18)D between Ophtha TOP and Pentacam,showing insignificant differences between them (both at P＞0.05).Bland-Altman graphs revealed that the 95％ limit of agreement (LoA) of Kf,Ks and Km between the two methods was-0.37 D to 0.73 D,-0.33 D to 0.81 D and-0.30 D to 0.72 D,respectively,and that of J0 and J45 was-0.34 D to 0.48 D and-0.37 D to 0.33 D,respectively.Conclusions Ophtha TOP shows an excellent repeatability.Compared with Pentacam,Ophtha TOP presents a good consistence for measurement of the corneal astigmatism and moderate consistence for corneal curvature.

Background Cataract is the main cause of global blindness,and surgery is the main method for the treatment of cataract,so precise preoperative parameters have an important significance for improving postoperative visual quality.Objective This study was to analyze the difference of lens thickness (LT) measured by immersion A-scan ultrasound versus optical biometry and consistency of these two methods in measuring the LT for different types of cataract eyes,and to investigate whether A-scan ultrasound for the LT measurement needs to correct the ultrasound speed parameter.Methods A reliability evaluation of diagnosis test was designed.The LT was measured on 143 cataract eyes using immersion A-scan ultrasound and Lenstar optical biometry in Tianjin Eye Hospital from September 2013 to May 2014.The eyes were assigned to nuclear cataract group (60 eyes of 50 patients),posterior subcapsular cataract group (40 eyes of 40 patients) and cortical cataract group (43 eyes of 43 patients) based on the types of cataract,and the hardness of nucleus was grade II in 20 eyes of 14 patients,grade Ⅲ in 20 eyes of 17 patients and grade Ⅳ in 20 eyes of 19 patients.The outcomes measured by immersion A-scan ultrasound versus Lenstar optical biometry were compared with paired t test,and the consistency between the two devices was analyzed by Bland-Altman agreement plot.This study complied with Helsinki declaration,and written informed consent was obtained from each patient prior to any examination.Results The mean LT value was (4.85± 0.39) mm from the immersion A-scan ultrasound and (4.74 ±0.37)mm from the Lenstar optical biometry,with a significant difference between the two devices (t =3.020,P =0.004).No significant differences were found in the LT values of the posterior subcapsular cataractous eyes and cortical cataractous eyes between the two devices (t=1.015,P =0.316;t =1.275,P =0.209).The LT values by immersion A-scan ultrasound were significantly higher in grade Ⅱ,Ⅲ and Ⅳ nuclear cataractous eyes than those by Lenstar optical biometry (t=2.175,2.378,2.383,all at P＜0.05).The outcome showed a good consistency in the posterior subcapsular cataractous eyes between the two measuring methods,with the 95％ limitation of agreement (LoA) from-0.21 to 0.18 mm.However,there were poor consistencies between the two measuring methods in the nuclear and cortical cataractous eyes,with the 95％ LoA from-0.64 to 0.43 mm and from-0.50 to 0.41 mm,respectively.Poor consistencies also were seen in grade Ⅱ,Ⅲ,Ⅳ nuclear cataractous eyes between the two measuring methods,and the 95％ LoA were-0.31 to 0.22 mm,-0.32 to 0.24mm and-1.09 to 0.62 mm,respectively.Conclusions There are differences in measuring LT of different types of cataractous eyes between immersion A-scan ultrasound and Lenstar optical biometry.The measuring values are higher by immersion A-scan ultrasound than those by Lenstar optical biometry,suggesting that the measurement of immersion A-scan ultrasound for LT of different types and nuclear hardness of cataractous eyes should correct the ultrasound speed parameters.

· Application of capsular tension ring ( CTR ) in phacoemulsification has become a common method to increase the stability of the capsular bag. CTR can effectively reduce the posterior capsular opacification ( PCO) , prevent intraocular lens ( lOL ) decentration and tilt, not cause lOL degree deviation and aberration increase.ln this review, we summarized the development overview of CTR in phacoemulsification.

Objective To investigate the clinical effect of IFNα combined with mannan peptide in treatment of patients with HBeAg-positive chronic hepatitis B ( CHB ). Methods Eighty HBeAg-positive CHB patients with HBV DNA quantity ranging from 10 to 10 eopies/mL were enrolled and randomized into the treatment group and the control group ( n = 40 for each ). Patients in treatment group were given daily subcutaneous injection of IFNα-2b 5,000,000 U for 52 weeks, and received mannan peptide 10 mg per intravenous injection or 2. 5 mg per intramuscular injection for a total of 2 to 3 treatment courses (12 weeks for each). The control group received only IFNα-2b treatment. Liver function, serum markers of hepatitis B, HBV DNA quantity and blood tests were performed before the treatment and at 2, 4, 8, 16, 26 and 52-week during the treatment; and the adverse effects were recorded. Results The rates for ALT normalization, negative HBsAg, negative HBeAg, HBeAg seroconversion and negative HBV DNA were 91. 8% , 17. 5% , 52. 5% , 27. 5 % and 47. 5% at 52nd week in the treatment group, while those in the control group were 80. 0% , 12. 5% , 30. 0% , 10. 0 % and 25. 0% , respectively. There were significant differences in HBeAg-negative, HBeAg-seroeonversion and HBV DNA-negative rates between two groups (χ2 = 4. 178, 4.021 and 4.381, P < 0. 05 ) , and these indexes in the treatment group were increased to 57. 5% , 30. 0% and 50. 0 respectively at 52nd week after drug withdraw. White blood cells began to be elevated at 4th week and were restored to the normal levels at 8th week in the treatment group, while the count in the control was lower than the normal value even at 52nd week of the treatment with the average of (3.45±1. 18)×109/L. Conclusion Alpha-interferon combined with mannan peptide therapy is effective for patients with HBeAg-positive CHB, which may restore the declined peripheral WBC counts induced by interferon and improve the compliance.