Objective:To investigate influencing factors of persistent diplopia after orbital floor blowout fracture reconstruction surgery.Methods:A case control study was conducted.Data of 146 eyes of 146 orbital floor blowout fracture patients with diplopia occurring 1 day after operation were collected in Henan Eye Hospital from July 2011 to July 2020.The patients were divided into two groups, persistent diplopia group (14 cases 14 eyes) and disappeared diplopia group (132 cases 132 eyes), according to the persistence of diplopia in the follow-up.Differences in sex, right or left eye, age, preoperative course of disease, preoperative intraorbital soft tissue hernia, operation methods, operation approach, postoperative eyeball rotation exercise compliance, the number of eyes with postoperative inferior rectus muscle damage level were compared between the two groups to select factors with P<0.05 for multifactor logistic regression analysis.This study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2021[15]). Results:All eyes were successfully operated and no complications such as infection or dislocation of the orbital implant occurred in any of the eyes during the postoperative follow-up period.There were statistically significant differences in age, preoperative course of disease, preoperative intraorbital soft tissue hernia, operation methods, postoperative eyeball rotation exercise compliance and postoperative inferior rectus muscle injury between the two groups ( χ 2=9.443, P=0.002; χ 2=29.041, P<0.001; H=53.943, P<0.001; H=34.583, P<0.001; χ 2=46.041, P<0.001; H=101.438, P<0.001). The multiple logistic regression analysis indicated that the long preoperative course of disease ( OR=8.678, 95% CI=1.013-74.304, P=0.031), preoperative intraorbital soft tissue hernia (Severe: OR=32.963, 95% CI=7.647-142.084, P<0.001.Moderate: OR=11.852, 95% CI=2.679-52.436, P=0.001), and postoperative inferior rectus muscle injury (Severe: OR=511.000, 95% CI=42.815-6 110.808, P<0.001.Moderate: OR=132.000, 95% CI=12.442-1 400.458, P<0.001) were independent risk factors for postoperative persistent diplopia.Advanced operation methods (Individualized shaped titanium mesh method: OR=0.020, 95% CI=0.002-0.127, P<0.001.Manufacturers prefabricated titanium mesh method: OR=0.031, 95% CI=0.004-0.257, P=0.001), and the postoperative eyeball rotation exercise ( OR=0.015, 95% CI=0.001-0.197, P<0.001) were independent protective factors for postoperative persistent diplopia. Conclusions:Severe preoperative intraorbital soft tissue hernia and postoperative inferior rectus muscle injury are the main risk factors for persistent postoperative diplopia after orbital floor blowout fracture repair surgery.Shortening the preoperative course of disease, improving the operation methods, and enhancing postoperative ocular functional exercises may reduce the incidence of postoperative persistent diplopia.

Objective:To evaluate the clinical efficacy of the modified computer-assisted orbitonasal reconstruction by the auther for recurrent orbital and paranasal sinus mucocele.Methods:The clinical data of 45 cases of recurrent orbitonasal sinus mucocele treated by modified computer-assisted orbitonasal reconstruction from Jul. 2008 to Jan.2018 in Henan Province People’s Hospital were analyzed re-trospectively. The efficacy was observed. The follow-up time was 25-44 months.Results:The postoperative vision(BCVA, logMAR) was better than preoperative vision( t=7.665, P<0.05) and postoperative exophthalmus was lower than that before operation in all cases( t=8.871, P<0.05). The examination of computed tomography scan indicated that all of the 45 cases had the unobstructed passageway of endonasal drainage without recurrence of paranasal sinus mucocele, meanwhile without any adverse effects such as infection, foreign body rejection and so on. The computed tomography scan also showed that all the 45 cases had excellent recovery of the orbitonasal anatomical structure, and with the location of eyeball and function of ocular motility restoring to normal condition gradually. Conclusion:Modified computer-assisted orbitonasal reconstruction is a comparatively better method for the treatment of recurrent orbital paranasal sinus mucocele.

Objective:To investigate the protective effect of a modified orbital decompression on postoperative eye position in thyroid-associated ophthalmopathy (TAO).Methods:A cohort study was performed.One hundred and thirty-six eyes of 96 TAO patients who received orbital decompression in Henan Eye Hospital from July 2008 to July 2018 were enrolled.The patients were divided into two groups according to different operation methods.A depressed bone window was made in the region of orbital apex in the modified orbital decompression group with 100 eyes of 70 patients.A depressed bone window was made in the middle and anterior region of orbit in the traditional orbital decompression group with 36 eyes of 26 patients.The best corrected visual acuity, palpebral fissure, eyeball exophthalmos, strabismus, eyeball position、CT image and postoperative complications were compared.This study was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2020[07]), and written informed consent was obtained from each subject before surgery.Results:Strabismus was improved in 14 eyes of 10 patients, unchanged in 75 eyes of 52 patients and slightly aggravated in 11 eyes of 8 patients after operation in the modified orbital decompression group.In the traditional orbital decompression group, strabismus was slightly aggravated in 6 eyes of 4 patients, seriously aggravated in 30 eyes of 22 patients after surgery. In the modified orbital decompression group, the eyeball displacement was unchanged in 91 eyes of 64 patients, slightly aggravated in 9 eyes of 6 patients after surgery in the traditional orbital decompression group, the eyeball displacement was slightly aggravated in 15 eyes of 10 patients, seriously aggravated in 21 eyes of 16 patients after surgery.Significant differences were found in the number of eyes with different degree of strabismus and eyeball displacement between the two groups ( Z=-9.634, -10.278, both at P<0.01). The postoperative eyeball exophthalmos values were (14.36±2.03)mm and (14.36±1.03)mm in the modified orbital decompression group and the traditional orbital decompression group, respectively, which were significantly lower than preoperative (20.47±1.92)mm and (20.28±2.03)mm (both at P<0.05). CT imaging showed that the bone window was clear in orbital apex and the compression of optic nerve was relieved postoperatively in the modified orbital decompression group, and the bone window was in anterior part of the orbit and the orbital apex was still crowded in the traditional orbital decompression group.No severe complication was seen during the fellow-up duration in the two groups. Conclusions:Compared with traditional orbital decompression, the modified orbital decompression surgery can reduce the risks of strabismus and eyeball displacement, showing an obvious protective effect on eye position.

Objective To investigate the methods of establishing animal model of regeneration of optic nerves after section injury. Methods A experimental study. Sixty-four Wistar healthy rats were divided into 3 groups randomly: normal group of 4 rats, no treatment was given; control group of 20 rats, the optic nerve of rats was completely sectioned and appositionally sutured; experimental group of 40 rats, received the same dispose with control group and traumatic cataract were formed artificially. After killing animals, the entire visual pathways were observed under blue light by low power fluorescence microscope. Results The rhodamine-B-isothiocyanate fluorescence was stopped by optic nerve blockage in control group with no axon regeneration. The obvious regeneration of optic nerve was observed in experimental group and rhodamine-B-isothiocyanate fluorescence was penetrated the optic nerve blockage. Conclusion It is a better animal model of optic nerves regeneration for the sectioned optic nerves of rats with traumatic cataract. Key words: Injury, optic nerve; Regeneration; Model, animal

Background Orbital blow-out fracture often results in the abnormalities of appearance and function of eye.Because of the special and complex anatomical structure of orbital cavity,it is difficult to design and manufacture the corresponding orbital implants.The computer-aided designing and manufacturing (CADM) technology provides a new approach to orbital implants.However,the clinical value of this method is still under evaluation.Objective This study was to investigate the application and the therapeutic effect of CADM for orbital blow-out fracture.Methods The clinical data of 74 eyes of 74 patients who received surgery for orbital blow-out fracture from July 2006 to July 2012 in Henan Eye Institute,Henan Eye Hospital were retrospectively analyzed.Fiftyeight patients underwent CADM implanted surgery and 16 patients received non-CADM surgery in the same period with matched age,gender and lateral eyes in both groups.The individualized 3D orbital implants were designed and manufactured by the technology of CADM and then were implanted in the bone defects in the CADM group,while the traditional hydroxyapatite artificial bone or high density porous polyethylene material (Medpor) was utilized in the non-CADM group with a fellow-up duration for 22 to 69 months.The best corrected visual acuity (BCVA),eyeball exophthalmos,ocular position,eye movement,diplopia and postoperative complications were evaluated.Results The preoperative BCVA were 0.71±0.37 and 0.69±0.41,and the postoperative BCVA were 0.74±0.38 and 0.72±0.41 in the CADM group and the non-CADM group,respectively,showing an insignificant intergroup difference (Fgroup =0.043,P=0.837),but a significant variation was found over time (Ftime =13.576,P ＜ 0.01).The BCVA was significantly improved after surgery compared with before surgery in both groups (both at P＜0.05).No significantdifferences were found in the number of eyes with curative and improved diplopia and eye movement disorders between the two groups during the fellow-up duration (Z =-0.298,P =0.766;Z =-0.548,P =0.584).The preoperative eyeball exophthalmos values were (3.93±0.99)mm and (3.88±0.97)mm and the postoperative ones were (0.91 ±0.67)mmand (1.84±0.80) mm in the CADM group and the non-CADM group,respectively,without significant differencebetween the two groups (Fgroup =3.558,P =0.063).However,the eyeball exophthalmos values after operation wereremarkably lower than those before operation in both groups (both at P＜0.05).CT imaging displayed implants fitting well with fracture defect and attached to bone tissue accurately in all of the eyes in the CADM group,but in the nonCADM group,the bulge of implants damaging extraocular muscles or optical nerve was found in 2 eyes.No postoperative complication was seen throughout the fellow-up duration in the CADM group.Conclusions CADM technology for orbital blow-out fracture can reconstruct a 3D bony orbit and effectively repair ocular position and appearance,and furthermore restore eye movement and visual functions.The therapeutic outcome of CADM technology for orbital blow-out fracture is superior to conventional implants.

Background Orbital cavernous hemangiomas (OCH) is a common benign orbital tumor in adult,and accurate localization and diagnosis before operation supports the significant premise for surgical safety and success of tumor extraction.Objective This study was to research the clinical characteristics,preoperative diagnosis,the selection for different surgical approaches,therapeutic effectiveness and complication prevention of OCH.Methods The clinical data of 117 eyes of 117 patients with OCH who received surgery were retrospectively analyzed.The patients received surgery in Henan Eye Institute,Henan Eye Hospital from January 2011 to December 2014 and followed-up for 3 months to 5 years.The visual acuity,exophthalmos,ocular movement,orbital A/B ultrasound,color Doppler image,CT and MRI were examined before and after surgery.Results The primary clinical manifestations of OCH were gradual exophthalmos and impaired vision.The accordance rate of preoperative diagnosis and pathological diagnosis was 100％ in the group of patients.The surgical approachs included conjunctival approach in 52.14％ (61/117),lateral orbitectomy in 30.77％ (36/117),anterior approach in 16.24％ (19/117) and lateral combined with medial approach in 0.85％ (1/117).At the end of followed-up,visual acuity was significantly improved in 30.77％ (36/117),declined in 8.55％ (10/117) and unchanged in 60.68％ (71/117).Temporary complications after surgery were pupil dilatation in 14.53％ (17/117),emorrhoea in 1.71％ (2/117),ocular motility disorders in 16.24％ (19/117) and ptosis in 4.27％ (5/117).The permanent complications after operation were pupil dilatation in 2.56％ (3/117),visual loss in 0.85％ (1/117) and permanent abduction imitation in 0.85％ (1/117).Conclusions Accurate qualitative and site-specific diagnosis and correct choice of surgeries for OCH depend on clinical and iconographical examinations.Suitable surgical approach and operative skill are helpful to the therapeutic outcome and safety of OCH.

Objective To analyse the method and effect of repairing surgery for orbital fracture.Methods Clinical manifestations and treatments of 96 cases of orbital fracture were analyzed retrospectively.Results Postoperative displace,prolapse,infection,rejection or visual decrease were not observed in the 96 cases.Enophthalmos was corrected completely in 94 cases (97.92％) and undercorrected by 1 ～2 mm in 2 cases (2.08％) after surgery.Exophthalmos was corrected by 1.5 ～3.5 mm compared with preoperation.Diplopia was alleviated obviously in 8 case (8.33％) without diplopia in primary eye position,except for the condition of eyeball maximal exercise;and was corrected completely in 85 cases (88.54％);Diplopia was alleviated partially in 3case (3.13％) and after one year the strabismus correction was adopted.Early chemosis after operation was observed in 27cases,and orbital hemorrhage was found in 2 cases.All cases returned to normal situation within 2 weeks.Decreased sensation of infraorbital nerve innervation existed in 11 cases,with returning to normal situation in 3 months in 9 cases and permanent damage in 2 cases.Conclusion The suitable approaches and orbital implants can be selected according to its fracture condition and location to repair the orbital fracture and recover the orbital cavity volume.The curative effect is better in the early phase of orbital fracture than in the late phase.The key points of eliminating diplopia are to release the blocked extraocular muscles,strengthen the early functional exercise of eyeball and prevent re-conglutination of extraocular muscles.

目的 探讨泪腺上皮性肿瘤的临床表现、影像学特征、诊断方法及治疗原则.方法 对2003年1月至2014年10月在河南省眼科研究所就诊的97例泪腺上皮性肿瘤的临床表现、影像学检查、治疗方法、术后视力、及随访情况等临床资料进行回顾性分析.采用前路开眶11例,常规外侧开眶19例,改良“S”形皮肤切口并外侧开眶67例.结果 97例泪腺上皮性肿瘤中,泪腺多行性腺瘤65例(67.01％),腺样囊性癌16例(16.49％),多形性腺癌12例(12.37％),腺癌2例(2.06％),黏液表皮样癌1例(1.03％),肌上皮瘤1例(1.03％).术后视力提高37例,无变化54例,下降6例.13例出现眼球内陷,早期上睑下垂11例,4例出现外展运动受限、水平复视.术后6个月随访:上睑下垂4例;1例出现永久性外展不足、水平复视.结论 泪腺上皮性肿瘤具有典型的临床表现和特征性的影像学改变,术前通过准确的定位来选择适宜的手术进路,可顺利并完整地切除肿瘤,避免肿瘤复发和出现严重并发症.

Objective To study the histopathological features and injured mechanism of optic nerves transaction of rats.Methods Twenty rats were divided into 2 groups randomly:normal group (n =4),no any interference; sectioned injured group(n =16),the optic nerve was completely sectioned 0.5 mm behind the eyeball.Animals were killed 4 weeks after treatment in both groups.The retinal ganglial cells were observed and counted.The regeneration of optic nerves was traced anterogrately with rhodamine-B.Results The structures of retina were clear in normal group,while that of sectioned injured group turn to thin.The number of peripheral retinal ganglial cells were 53.25 ± 1.96 in normal group and 4.06 ± 1.45 in sectioned injured group.The difference between the two groups was statistically significant (t =89.31,P ＜ 0.01).There were apparent clustered glial scar between the distal and proximal stumps of optic nerves in sectioned injured group,and fluorescence was blocked at the stumps.Conclusion There is no axon regeneration after suturing the sectioned optic nerves of rats.The most important factors that prevent the axon regeneration are the massive lose of retinal ganglial cells and the formation of the glial scars between the distal and proximal stumps of optic nerves.

Objective To observe the toxic effects of intravitreal injection of etoposide on retinal ganglion cells (RGC) in rabbit eyes. Methods Twenty-four healthy rabbits were divided into 8 groups randomly, including one normal group without any treatment, and 7 experimental groups with intravitreal injection of different dosages of etoposide (0.0, 1.5, 15.0, 150.0, 375.0, 750.0, 1500.0 μg). Twelve days after the injection, the animals were killed by air embolism, and the eyeballs were prepared for routine pathological examination with hematoxylin-eosin staining and transmission electron microscopy. Results Four experimental groups (0.0, 1.5, 15.0, 150.0 μg etoposide) had normal retinal structure and normal shape of ganglion cells while other 3 experimental groups with higher dosage of etoposide (375.0, 750.0 and 1500.0 μg) showed thinner and disorganized retina. The number of RGC of the normal group and 0.0, 1.5,15.0, 150.0, 375.0, 750.0, 1500.0 μg groups were 61.6±63.72, 61.83±4.59, 60.00±7.07, 62.00±4.43, 62.67±3.98, 7.33±1.37, 0.00 and 0.00 per 400 X visual field, with statistical difference among groups (F=145.04, P = 0.00). There was no statistical difference between the normal group and 0.0,1.5, 15.0, 150.0 μg groups (F=0.244,P＞0.05). The number of RGC of 375.0 μg group was decreased obviously compared with normal group and 0.0, 1.5, 15.0, 150.0 μg groups with statistical difference (F=145.04, P＜0.05). Conclusion Etoposide has a dosage-dependent toxicity on rabbit RGCs.

目的探讨眼眶爆裂性骨折术中应用Medpor填充治疗的手术效果。方法对2004年1月至2010年12月在河南省眼科研究所收治的51例眼眶爆裂性骨折患者的临床表现和治疗方法进行回顾性分析。眶内壁骨折患者采用内眦皮肤切口入路,眼眶下壁骨折及下壁合并内壁骨折书中采用下睑睫毛下皮肤切口入路,充分暴露眼眶骨折部位,将嵌顿于眼眶骨折处的眼外肌及眶脂肪游离至眶内,骨膜下填充塑形后的Medpor材料。结果 51例患者眼球内陷全部矫正,48例术后复视均有好转,42例眼球活动度完全改善,6例部分改善。结论用Medpor材料行眶壁修补术是治疗眶壁爆裂性骨折的有效方法,术中应充分松解嵌顿的眼外肌;术后早期加强眼外肌功能训练,防治再粘连是消除复视的关键。早期手术疗效优于晚期手术。

眶壁和眶缘的骨折可引起眶内软组织嵌顿在骨折处或疝入到鼻窦内,造成眼球内陷或移位、眼球运动障碍和复视,严重者还可引起眶下神经损伤、感觉丧失、局部麻木等不适[1].若得不到及时治疗,可严重影响视力和面容美观.本研究探讨眼眶骨折的手术时机及治疗效果.

Background A great advance forward in the study of optic nerves regeneration has been obtained recently,and a suitable labeling method of the regenerating axons is the key link of study on optic nerves regeneration.ObjectiveThis study aimed to observe the labelling effectiveness of modified antegradely labelling method of Rhodmine-B-isothiocyanate(RITC) on the regeneration of optic nerves.MethodsFifty-two Wistar rats were divided into three groups randomly.Four normal rats were used as the normal group,and RITC of 4-5μL was injected intravitreously in 24 rats in the only RITC injecting group.The optical nerve was completely cut off and lens was injuried simultaneously to promote the regeneration of optical nerve in 24 rats in lens injuring group.The rats were sacrificed in 1 week,3,5 weeks after experiment respectively and RITC was intravitreously injected to antegradely label the regenerating axons of optic nerves at 3 days prior to the killing of rats.A green excitation light in the conventional antegradely labelling method was modified into the blue one for the observation of the whole optical tracts.The toxicity of RITC to ocular tissue was evaluated by histopathology examination and the transmission electron microscope.The regenerating rates of optic nerves were compared between conventional label method and modified label method.ResultsThe modified antegrade labelling fluorescence of RITC was very clear and easy to recognize in all groups.No any abnormality of ocular tissue was observed based on the clinical ophthalmological examination and histopathological examination and the transmission electron microscope in both conventional and modified label methods in 1 week,3 and 5 weeks after experiment.No significant difference was found in the numbers of RGCs among normal group and different time groups after injection of RITC(F=0.877,P=0.465).The regenerating rates of optic nerve of rats was higher in modified method than the conventional label method in the first week(χ2=6.788,P=0.009),but no obvious difference was seen in the regenerating rate of optic nerve between two methods in the third and fifth week after injection of RITC(χ2=2.667,P=0.220;χ2=1.143,P=0.600) in lens injury group.ConclusionModified antegradely labelling method of optic nerves axons has the dominant advantages in comparison with conventional one.This method is safe in the study of optic nerves regeneration.

Objective To study the effects of injuried lens on the survival of retinal ganglial cells of rat.Methods Forty rats were divided into three groups randomly,normal group(8 rats),simple injuried group(16 rats),and lens injuried group(16 rats).All animals were killed after four weeks.The retinal ganglial cells were observed and counted pathologically.Results The retina was clear in normal group,and thicker in lens injuried group than in simple injuried group.The number of peripheral retinal ganglial cells per high power field was 53.25±1.96 in normal group,4.06±1.45 in simple injuried group,25.00±1.49 in lens injuried group.There was a highly significant statistical difference comparing between every two group(P<0.01).Conclusion The injuried lens can enhance the number of living peripheral retinal ganglial cells,in which the change of injuried lens played an important role.

Objective To study the effects of lens epithelium cells on the regeneration of the optic nerves during the period of lens injury.Methods 144 rats were divided into 5 groups randomly:normal group(n=4),simple injuried group(n=20),Lens injuried group(n=40),uninjuried group(n=40)and preinjuried transplantation group(n=40).Animals are killed after 4 weeks in normal group.The corresponding animals were killed at 1 week,2 week,3 week,4 week and 5 week in other groups.And through the antegrade labelling method of RITC which is injected into vitreous cavity,we can observed the situation of the regeneration of optic nerves.Results There were significant difference statistically between simple injuried group or uninjuried transplantation group and lens injuried group or preinjuried group on incidence,of regenerating after injury of optic nerves.Injuried optic nerves can regenerate a long distance throughout the visual pathway once the regenerating axons penetrating the injuried site of optic nerves.Conclusions Injuried lens which caused cataract greatly promote the regeneration of axons of injuried optic nerves.The change of injuried lens epithelium cells play an important role in process of injuried lens promoting the regenerating of optic nerves.

目的 建立一种稳定的视网膜母细胞瘤(Rb)动物模型.方法 38只新西兰大白兔,根据兔眼前房Rb细胞注入量及免疫抑制因素随机分为10组,除正常组(A组)2只(4只眼)外,其余B～J 9组每组各4只(8只眼),兔眼前房注入Rb细胞后每天观察兔眼前房内Rb肿物的生长情况,30 d后处死动物,行组织病理学及免疫组织化学检查,并分析其成瘤率及维持时间等.结果 C、D、F、G、H、I、J组动物前房内均有不同程度的Rb肿物生长,成瘤率为100%;C组与D、F、G组3组和H、I、J组3组之间前房维持时间比较,差异均有统计学意义(P＜0.05).Rb胞浆神经元特异性烯醇酶(NSE)表达较强,S100表达较弱.结论 兔眼前房内注入Rb细胞的密度大于4×107个/mL时会有不同程度的肿物生长;单独应用环孢素A(CsA)滴眼液、环磷酰胺(CTX),或二者联合应用,均能使兔眼前房内肿物在30 d内稳定生长。

Objective To analyze and study the correlated clinical facters for conservative treatment.Methods To retrospectively analyze the clinical document of 34 cases(35 eyes)of retinoblastoma who adopted conservative treatments from 1996 to 2005.Results For the preliminary diagnosis age、the time of conservafive treatment and the diameter of the tumor there was no statistical difference(P＞0.05)between the two groups for success and failure.For the thickness of the tumor,there was great statistical difference(P＜0.05).For the failure rate of conservative treatment,there was great statistical difierence(P＜0.05)between difierent location for intraocular tumors.Conclusion There iS a certain relationship between the volume,location of the tumors and the effect of the conservative treatments,with higher effect for smaller tumors and peripheral location.It is main factors for failure that tumor is larger and located anteriorly.

Objective Many managements for retinoblastoma(Rb) were reported to be effective in clinic.But the better treating approach is worth studying.The purpose of this study was to explore the effectiveness of intraocular chemotherapy for Rb.MethodsEighty-eight rabbit eyes with Rb of anterior chamber were divided into 11 groups randomly based on tumor size,dose and approach of etoposide and 8 rabbits for each group.Different dose of cyclophosphamide or cyclosporin A was systemically or topically used in different model groups prior to the administration of etoposide.The administering approach of etoposide included subconjunctival injection,intravenous injection and intra-anterior-chamber injection.0.1 mL of normal saline solution was injected into anterior chamber in 8 rabbit eyes with Rb of anterior chamber as control group.After administered of etoposide,the tumor change,ocular manifestations and systemic status were clinically observed every day.The rabbits were killed on the 30th day for histopathological examination under the light microscope.The disappearing rate and control rate of ocular tumor were analyzed.ResultsThe disappearing rate of tumor in intraocular chemotherapy group(intra-anterior-chamber injection) was 100%,but that of subconjunctival injection group and intravenous injection group was 0.Intraocular tumors were controlled to different extent in subconjunctival injection group and intravenous injection group.The tumor disappeared within 30 days and no the metastasis of tumor was found in intraocular chemotherapy group.The treating effectiveness of chemotherapy to tumor was better in the higher dose drug group and smaller tumor group.ConclusionIntra-anterior-chamber injection of etoposide is the better approach to the treatment of anterior chamber Rb in comparison with subconjunctival injection and intravenous injection,but the effect of intraocular chemotherapy can be affected by the size of the intraocular tumor and drug dose.