AIM:To evaluate visual outcomes and visual function in nonamblyopic adults with myopic anisometropia treated with small incision lenticule extraction(SMILE).METHODS:Prospective comparative cohort study. The consecutive patients who underwent SMILE for the treatment of myopia or myopic astigmatism at Zhongshan Ophthalmic Center(Guangzhou, China)between October 2015 and January 2016 were included. They were divided into two groups based on the bilateral difference of a spherical equivalent(SE)refraction ≥1.50 D: the anisometropic myopia group(interocular SE difference ≥1.50 D)and non-anisometropic myopia group(interocular SE difference<1.50 D). Refractive status, uncorrected and corrected distance visual acuity(UDVA and CDVA), and visual function parameters including fusional vergence amplitude, stereoacuity and horizontal phoria were measured preoperatively and at 1 wk,1,3 and 6 mo after surgery.RESULTS:A total of 49 cases(98 eyes)were included in the study, and 19 cases(38 eyes)in the anisometropic group, including 11 males and 8 females, with a mean age of 25.4±6.2 y, and 30 cases(60 eyes)in the non-anisometropic myopia group, including 19 males and 11 females, with a mean age of 26.8±4.6 y. The CDVA of the non-anisometropia group was significantly better than that of the anisometropia group 6 mo postoperatively(P=0.036). However, the safety and efficacy indexes of the two groups did not show significant differences. The fusional vergence(break point and recovery point)of the anisometropia group decreased(P=0.005 and P=0.03)and was significantly lower than that in the non-anisometropia group at 6 mo post operatively(P=0.029 and P=0.046). Both groups showed a significant improvement in distance and near stereopsis at 1, 3 and 6 mo in comparison with the preoperative baseline and 1 wk postoperatively(all P<0.05). No clinically significant change in the amount of ocular alignment in terms of distance and near deviation postoperatively in either groups.CONCLUSION: SMILE is a predictable, effective, and safe method for correcting myopic anisometropia in adults without amblyopia. Although the fusional vergence amplitudes changed, stereopsis can be improved after surgery.

Objective:To understand the real experience of occlusion therapy in caregivers for children with congenital cataract, and provide reference for visual rehabilitation of children with congenital cataract after surgery.Methods:This article adopts a qualitative research method, using the purposive sampling method, a total of 14 caregivers of children with congenital cataracts who visited Guangzhou Women and Children's Medical Center of Guangzhou Medical University from October 2022 to April 2023 were selected, and a semi-structured interview was conducted using phenomenological research methods. Transcription, coding, analysis and theme extraction of interview data was conduceted using Colaizzi 7-step analysis method.Results:A total of three themes and seven sub themes were extracted, namely emotional experience (obvious sense of shame and positive development), difficulties in responding (difficulties in initial occlusion therapy, lack of effective coping methods and impaired confidence in treatment) and lack of support from others (lack of professional support and lack of family support) .Conclusions:Caregivers of children with congenital cataract have obvious stigma, difficulties in occlusion therapy and lack effective coping styles and support from others. Medical staff should pay attention to the psychology of the caregivers, build a standard postoperative visual function rehabilitation program, make reasonable use of health education means, help them establish positive treatment beliefs, improve medical professional support and promote family support.

Objective:To investigate the differences in ametropia among school-age children and between Han and Uygur ethnic groups in the main urban area of Kashgar, and to understand the epidemiological characteristics of myopia among children in Kashgar.Methods:A cross-sectional study was conducted.Random stratified sampling method was used to select the first to third grade students from 6 primary schools in the main urban areas of Kashgar, Xinjiang, from April to June 2018.Visual acuity was examined by the international standard visual acuity chart and refraction was detected by the automatic computer refractometer without cycloplegia.The subjects were classified into low vision (uncorrected visual acuity<0.8 in either eye), hyperopia≥2.00 D, myopia≥-1.00 D, astigmatism≥1.00 D and anisometropia≥1.00 D according to examination results.The percentage of different refraction states and percentage of different ethnic groups among myopic students in the three grades were analyzed.The study protocol was approved by an Ethics Committee of The First People's Hospital in Kashgar ([2021] QSY No.81).Results:A total of 6 108 students were enrolled, among which, there were 3 119 males and 2 989 females, 3 395 Uygur and 2 713 Han people, 2 016 first grade, 2 155 second grade and 1 937 third grade students.The detection rate of low vision was 13.5% (825/6 108) in the whole, 21.5% (584/2 713) in the Han people and 7.1% (241/3 395) in the Uygur people, 8.8% (176/2 016) in the first grade, 11.8% (254/2 155) in the second grade and 20.4% (395/1 937) in the third grade.The detection rate of myopia was 9.9% (606/6 108) in the whole, 17.6% (477/2 713) in the Han people and 3.8% (129/3 395) in the Uygur people, 4.4% (89/2 016) in the first grade, 8.1% (174/2 155) in the second grade and 17.7% (343/1 937) in the third grade.There were significant differences in percentage of low vision, myopia, astigmatism and anisometropia among different grades and between the two nationalities (all at P<0.001), and no significant difference in the percentage of hyperopia was found (P>0.05).Conclusions:The percentage of visual abnormalities and myopia in the first to third grade children in Kashgar is lower than the national average, but the percentage is gradually increasing with age.The percentage of visual abnormalities and myopia among Han pupils is close to the national average, and far higher than that of Uygur pupils.

Objective To explore psychological resilience, anxiety, depression, coping styles and social supports status among parents of preterm infants of ophthalmic clinic, and analyze their relationship. Methods A total of 217 parents of preterm infants at ophthalmic clinic of hospital were selected by convenience sampling method and investigated by self- designed general information questionnaire, Connor-Davidson Resilience Scale, Self-rating Anxiety Scale, Self-rating Depression Scale, Social Support Rating Scale, and Simplified Coping Style Questionnaire. Results The total score of psychological resilience was (67.48 ± 14.20) points. The average score of positive coping styles dimension was (1.98±0.50) points, and negative coping style dimension score was (1.19±0.55) points. The social support score was moderate with a total score of (42.75 ± 6.17) points, the anxiety and depression got a total score of (36.77 ± 8.17) points and (39.67 ± 9.02) points respectively. Psychological resilience was negatively correlated with anxiety and depression (r=-0.363--0.242, P<0.01), and was positively correlated with coping styles and the social support (r=0.141-0.312, P<0.05 or 0.01). Multi-factor linear regression analysis showed that depression and social support were the influence factors of psychological resilience(t=-4.376, 2.516, P<0.01 or 0.05). Conclusions The parents of preterm infants are at the poor psychological states. Coping styles and depression are the important factors which affect psychological resilience among parents of preterm infants. Nurses should assess the psychological status of the parents, provide targeted interventions to relieve stress, guide the parents use social support effectively, and improve their psychological state.

Objective To investigate the alterations of dopamine,norepinephrine,cortisol,C-reactive protein (CRP),heart rate (HR),respiratory rate (RR) and mean artery pressure (MAP) before and after the laser photoeoagulation for retinopathy of prematurity (ROP) with topical anesthesia and to provide the guideline for improving its routine management and interventions.Methods Thirty children with ROP who received ROP laser photocoagulation in Guang zhou Women and Children's Medical Center from May to Dec.2012 were selected.The blood of the 30 cases of infants were collected at 4 time points:before laser therapy,the end of laser therapy,1 hour and 24 hours after laser therapy.The concentrations of dopamine,norepinephrine,cortisol and CRP in plasma were measured at each time point with radio immunoassay,and the values of HR,RR and MAP of infants were recorded as well.Results The levels of dopamine,norepinephrine and cortisol at the end and 1 hour after therapy were higher than those in the quiet state before therapy,and the differences were statistically significant (t =6.39,2.55 ; t =7.74,2.91 ; t =8.87,2.15 ; all P ＜ 0.05) ; the levels of CRP at the end of therapy,1 hour and 24 hours after therapy had no statistical difference in comparison with those in quiet state before therapy (t =0.06,0.89,1.16; all P ＞ 0.05) ; the levels of HR and RR at the end of therapy,1 hour and 24 hours after therapy had statistical difference in comparison with those in the quiet state before therapy (t =4.33,3.84,3.38 ; t =6.81,4.42,2.96 ; all P ＜ 0.05).The level of MAP at the end of therapy had statisti cal difference in comparison with that in the quiet state before therapy (t =6.10,P ＜ 0.001).Conclusions Infantswho experieneed ROP laser photocoagulation had stress response.Clinicians should pay more attention to monitoring HR and RR of preterm infants receiving retinal laser photocoagulation under topical anesthesia and take active intrvventions in order to relieve the stress response.

Objective To investigate the clinical efficacy of bleomycinum A5 on different type and site of eye hemangioma in infant. Methods 45 infant cases (23 females and 22 males) of hemangioma of eye were studied from the outpatient deparment of our hospital between 1996 and 2001. The powder of bleomycinum A5 was dissolved in 2 % procaine solution. The mixed liquid was injected uniformly into the mass of hemangioma of eye until it appeared offwhite.Results After the injection, the masses of hemangioma of eye swelled and atrophied subsequently, and the reaction disappeared within 7 days. The appearance of the local tissue turned from red to white. The hardness of it became soft several months after injection. 43 of 45 (95.5 %) patients healed after 2~5 times injection. Conclusions This method is proved effective to different type of hemangioma in infant eye, with minor damage, mild scar formation and good appearance. The side effect includes delay of development in the socket of orbit bone, local tissue necrosis and pigmentation of the skin.