目的:探讨血府逐瘀汤辅助治疗玻璃体积血的临床效果.方法:抽取本院2018年1月—2019年1月接收治疗的84例玻璃体积血患者为观察对象,入院时随机的分为对照组(42例)和观察组(42例).对照组给予常规治疗,观察组在对照组基础上另辨证予血府逐瘀汤加减治疗.对两组玻璃体积血吸收、疗效和生活质量进行比较.结果:观察组玻璃体积血吸收率明显比对照组高,组间数据差异具有统计学意义(P<0.05);观察组总有效率高于对照组,且各项生活质量评分也均高于对照组,差异具有统计学意义(P<0.05).结论:血府逐瘀汤辅助治疗玻璃体积血疗效显著,吸收率高,缩短病程,减轻患者痛苦,值得临床推广使用.

目的 探讨治疗后段眼球内金属异物的不同手术方式和临床疗效.方法 回顾性分析我院2016年1月至2018年12月收治后段眼球内金属异物82例(82只眼).观察分析治疗后段眼球内金属异物的不同手术方式和治疗结果,及外伤性视网膜脱离的相关因素、治疗效果等.结果 52例患者行一期23G玻璃体切除手术,异物取出成功率100％,30例患者行外路巩膜切开磁吸取异物手术,异物取出成功率90.00％,两组间比较差异有统计学意义(P<0.05).两组患者术后视力较术前视力均有提高,差异有统计学意义(P<0.05).两组视力改善率:内路组76.92％、外路组63.33％,内路组视力改善情况优于外路组.视网膜脱离26例,发生率31.71％,其发生与异物大小、损伤区域密切相关(P<0.05),所有视网膜脱离患者在8 h内行玻璃体切除手术,均成功复位.结论 23G玻璃体切除手术治疗后段眼球内金属异物手术成功率高、视力改善率高,并在治疗外伤性视网膜脱离等方面疗效显著,值得推广.

AIM: To explore the influencing factors and coping strategies of adverse reaction after retinal laser photocoagulation.METHODS: Retrospective analysis of 1 165 cases of adverse reactions in patients with retinal laser photocoagulation in our hospital.RESULTS: The present study included 50 patients with adverse reactions in 1 165 patients(4.29%), including 13 patients with nausea and vomiting(1.12%), 21 patients with dizziness, chest tightness, cold sweat(1.80%), 4 cases with yawning and drowsiness(0.34%), 12 cases with syncope(1.03%), and no death. There was no difference in the incidence of adverse reactions between men and women(3.68% vs 5.14%, χ2=1.474, P=0.225); there was a difference in the incidence of adverse reactions among patients of different ages(χ2=48.817, P<0.05)and under 40. The incidence of adverse reactions was higher than that of patients aged 40 and older, and the incidence of adverse reactions in men under 40 was significantly lower than that in women(8.46% vs 18.60%, χ2=6.094, P=0.014). The adverse reactions of patients with different fundus diseases were different.CONCLUSION: The incidence and degree of postoperative adverse reactions in patients with fundus diseases treated by retinal laser photocoagulation are different, so we should understand the history and mental state of the patients in detail before operation, and prepare the patients with high risk factors and possible serious reactions in time to ensure the safety of the patients.

AIM: To evaluate the clinical effects of using technetium-99 methylene diphosphonate(99Tc-MDP)with methylprednisolone to treat thyroid-associated ophthalmopathy(TAO). METHODS: We retrieved from 9 databases, from their foundation to March 2019, including Pubmed, the Cochrane Library, EMbase, ClinicalTrial.gov, Web of Science, CNKl, VIP database, China Biology Medicine disc, Wanfang database and collected the randomized controlled trail(RCT)of 99Tc-MDP combined with methylprednisolone for treatment of TAO. According to inclusion and exclusion criteria, two researchers retrieved the literature independently, extracted data and evaluate methodological quality. Meta analysis was performed by Review Manager 5.3 software.RESULTS: A total of 8 RCTs were identified with 644 patients. There was significant difference in the overall clinical effective rate between 99Tc-MDP combined with methylprednisolone and methylprednisolone alone(RR=1.14, 95% CI: 1.03-1.26, P=0.01). Significant difierence was found in the effective rate of proptosis between intravenous injection of 99Tc-MDP with methyprednisone and methyprednisone only(RR=1.28, 95% CI: 1.16-1.41, P<0.00001). Meanwhile, great improvement was seen in diplopia(RR=1.64, 95% CI: 1.04-2.58, P=0.03), but there was no significant difference in disturbance of ocular dyskinesia(P=0.37).CONCLUSION: Applying 99Tc-MDP combined with methylprednisolone is better than methylprednisolone alone for TAO with less adverse reaction, which appears to be an effective treatment for TAO.

AIM: To compare corneal curvature and astigmatism values identified with OPD - Scan Ⅲ, lOL Master, Pentacam and KR - 8900 in cataract patients and to evaluate the consistencies and differences. METHODS: In this prospective clinical trial, 45 cataract patients (86 eyes), received treatment at the Department of Ophthalmology in our hospital from April 2017 to June 2017, underwent corneal parameters measurements with four instruments: OPD-Scan Ⅲ, Pentacam, IOL Master, and KR-8900. Measurements included corneal curvature (K1, K2, Km) and astigmatism parameters. The results were assessed using the paired samples t tests, Pearson coefficient,and Biand-Aitman plots. RESULTS: The difference of K1value measured by OPD-ScanⅢ and IOL Master was significant (P<0.001). Significant differences were also found in K2and Km values between OPD - Scan Ⅲ and Pentacam or IOL Master(P<0.05),while others had noncomparable results (P>0 05). All biometry measurements revealed good liner correlation (r=0.408-0.980, P<0.001). The Biand-Aitman showed that the corneal curvature and astigmatism vectors examined by OPD-Scan Ⅲ and Aii other devices had non-comparable results,except for the comparison of K1, K2and Kmmeasured by OPD-Scan Ⅲand KR-8900.CONCLUSION: OPD-Scan Ⅲ and KR-8900 can be interchangeable for the measurements of corneal curvature, while the others are not directly interchangeable. The astigmatic results obtained from OPD-Scan Ⅲ are not completely interchangeable with KR-8900,IOL Master or Pentacam.

目的 探讨将经巩膜二极管激光睫状体光凝术(TDCP)作为某些闭角型青光眼首选手术方式的效果及利弊.方法 回顾性病例分析.收集我院眼科住院治疗的闭角型青光眼例99例(103只眼).患者既往无眼部手术史,以二极管激光经巩膜睫状体光凝术作为降眼压的首选手术方式.分析将睫状体光凝术作为首选手术方式的原因,术后随访眼压、视力、记录术中术后并发症以及后续治疗情况.结果 将睫状体光凝术作为首选手术方式的主要原因是术前眼压控制不良,其中67例(69只眼)为原发性急性闭角型青光眼持续性高眼压,22例(24只眼)为原发性慢性闭角型青光眼,其余10例(10只眼)为继发性闭角型青光眼.光凝前眼压(49.1±12.4)mmHg,光凝后1周时(14.7±7.0)mmHg,末次随访时(21.0±13.1)mmHg,眼压变化差异有显著统计学意义(F=276.027,P<0.001).光凝前后不同时间点视力变化眼数分布的比较差异无统计学意义(χ2=5.927,P=0.821).1例光凝后发生眼球萎缩.12例光凝后再行降眼压手术,占11.8％.结论 经巩膜睫状体光凝术对于眼压控制不良的闭角型青光眼,可作为首选手术方式,降眼压效果确切且对视力影响小,并发症少,安全可靠.

Objective To compare the results of Cotia visual electrophysiological system examination between patients of primary open-angle glaucoma (POAG) and cortical cataract, and to evaluate the value of Cotia in diagnosis of POAG.Methods 18 cases of 29 eyes confirmed as POAG, 22 cases of 35 eyes with cortical cataract were examined by Cotia.Inclusion criteria: corrected visual acuity was ≥0.1.It could be combined with mild cortical cataract in POAG group.All fundus could be seen and there were no other fundus diseases in both groups.Isolated-check model of Cotia was applied and signal to noise ratio (SNR) was recorded in all patients.If SNR<1, it was judged as abnormal, conversely, it was normal.The value of SNR was compared between two groups by SPSS.Results There were 24 eyes which's SNR was <1 in POAG group (82.76%) and there were 17 eyes in cataract group (48.57%),x2=8.051,P=0.005.The sensitivity, specificity and accuracy were 82.76%, 51.43% and 65.63% for POAG,respectively.Conclusion The percentage of abnormal SNR is higher in POAG than in cortical cataract examed by isolated-check model of Cotia.It applies a new method for the diagnosis of POAG.

Objective To compare the difference of surgically induced astigmatism (SIA) between femtosecond laser-assisted and manual clear corneal incisions for cataract surgery.Methods Nonrandom control study.Sixty right eyes were recruited which excluding ocular surface diseases,eye injuries or surgical history.Femtosecond laser-assisted cataract surgery was performed in 28 patients (28 eyes of femtosecond laser group) and conventional phacoemulsification using a disposable keratome was performed in 32 patients (32 eyes of manual group).The main incision located at 135°,which was a 2.8-mm clear corneal incision.All operations were completed by one surgeon and intraocular lens were implanted successfully.Both magnitude and direction of comea astigmatism were measured by IOL Master before and 3 months after surgery.Log on to calculate each eye's SIA.The value of corneal astigmatism and SIA were accounted and compared between two groups.Results The preoperative corneal astigmatism was (0.882±0.583)D in femtosecond laser group and (0.947±0.800)D in manual group (t =-0.355,P =0.724).The corneal astigmatism one month after operation was (0.930±0.613)D and (1.082±0.740)D respectively (t =-0.860,P =0.393).The SIA was (0.435±0.183)D and (0.428±0.197)D respectively (t =0.153,P =0.879).There were no significant differences between two groups.Conclusions Compared to manual clear corneal incisions,the value of SIA shows no significant different in femtosecond laser-assisted cataract surgery.

Objective To compare the clinical curative effect of iris localization and Kappa Angle correction on femtosecond LASIK surgery.Methods Prospective randomized controlled study.Matching t test was used on two groups of postoperative 1 month visual acuity,contrast sensitivity respectively and preoperative best corrected visual acuity,best corrected vision wear glasses measuring contrast sensitivity.Two independent sample t test and nonparametric test were used on between the two groups of postoperative 1 month visual acuity,contrast sensitivity compared with preoperative best corrected visual acuity,best corrected vision wear glasses contrast sensitivity increased value and Pentacam measurement of cutting off center value pairs.Two groups of postoperative 1 month visual acuity,contrast sensitivity increased value with Pentacam measurement of cutting off center value,postoperative residual spherical mirror,1 enticular mirror and cylindrical mirror axis for correlation analysis.Results Two groups of postoperative 1 month visual acuity,contrast sensitivity and preoperative best corrected visual acuity,best corrected vision wear glasses measuring contrastsensitivity difference was statistically significant.Between the two groups of postoperative 1 month visual acuity,contrast sensitivity and Pentacam measurement of cutting off center value differences had no statistical significance.Conclusions The two kinds of operation method can effectively avoid cutting off center of LASIK,get better than that of preoperative vision and contrast sensitivity.Two kinds of operation method postoperative visual acuity,contrast sensitivity increase value and cutting off center has no difference.

Objective To compare the Kappa Angle consistency measuring using Pentacam front section analyzer and Topolyzer corneal topography instrument.Methods Prospective controlled study.All 29 patients with refractive error (57 eyes) from the Department of Ophthalmology in Quanzhou #180 Hospital were received femtosecond laser refractive surgery from June 2015 to August 2015 were measured Kappa Angle using Pentacam and Topolyzer,and applied Topolyzer iris location model to acquire image and imported EX500 excimer laser iris location cutting pattern to generate Kappa Angle by the same inspectors respectively.The consistency was evaluated by using three methods of Kappa Angle (vertical level X and Y values) Intraclass correlation coefficient and Bland-Altman analysis method.Results Intraclass correlation coefficient analysis of three sets of X and Y values was uniform.X 95％ LoA1 of group 2 was-0.14 ～ 0.09;Group 1 and 3 was-0.15 ～ 0.12;Group 2 and group 3 was-0.10 ～ 0.11.Y value 95％ LoA of group 1 and group 2 was-0.14 ～ 0.03;Group 1 and group 3 was-0.17 ～ 0.08;Group 2 and group 3 was-0.10 ～ 0.11 by Bland-Altman analysis method.Conclusions The three methods of measuring results are consistent,can substitute,correct and supplement each other.Pentacam front section analyzer and Topolyzer corneal topography can obtain accurate Kappa Angle data.

Objective To introduce a method calculating surgically induced astigmatism (SIA) and discuss the influence of incision location.Methods Retrospective case analysis of 31 eyes were recruited which undergoing emulsification and excluding ocular surface diseases,eye injuries or surgical history.The main incision was located at 135 which was a 2.8ram clear cornea incision.All operations were done by one surgeon and intraocular lens were implanted successfully.Both magnitude and direction of cornea astigmatism were measured by IOL Master before and 3 months after surgery.The cornea power and axial was recorded.Log on www.doctor-hill.com to download free SIA calculator.It was compared the influence of different incision location to SIA.Results Among the 31 eyes,16 eyes were operated in temporal superior incision on the right eyes and the rest 15 eyes were in the nasal superior incision on the left eyes.The SIA of the right eyes was (0.36±0.19)D,while the SIA of the left eyes was (0.43±0.27)D.There were significant differences between the fight and left eyes (P ＜0.05).Conclusions It's easy to measure SIA.The individual SIA should be applied because the default of 0.5D is not accurate.The SIA in temporal superior incision on the right eyes is smaller than in nasal superior incision on the left eyes.

AIM: To discuss the application of anterior segment optic coherence tomography(AS-OCT)in the diagnosis of corneal ulcer.METHODS: The cross linear scan was used in 88 patients(88 eyes)with corneal lesion by AS-OCT to gather the image data, observe the pathological changed tissue by measuring all layers for patients with initial inspection, providing important visual images and data for treatments. All the patients were followed up for 2mo. RESULTS: Clear images with structure of all layers were obtained. It can provide the intuitive image data and scan the same position and show the changes during the treatment. CONCLUSION: AS-OCT can discover the important condition immediately. It also can monitor course of disease dynamically, provide the intuitive image data for clinical treatment.

目的:评估玻璃体腔填充C3F8气体在复杂性开放性眼外伤Ⅰ期救治中应用的安全性及有效性.方法:选取2012-01/2014-12复杂性开放性眼外伤患者54例54眼,满足以下条件:眼球复杂性开放性外伤,累及角巩膜,眼内容多量流失,眼内出血严重,眼压低.对以上患者行清创缝合及眼前段/眼内灌洗,玻璃体腔注入适量C3F8气体,术后观察1 ～2wk,根据病情行Ⅱ期手术.结果:所有患者Ⅱ期行玻璃体手术时玻璃体腔仍见不等量气体填充,眼压正常41眼,13眼眼压偏低;角膜不同程度水肿,无角膜血染;玻璃体大部分丢失,积血少;54眼均有视网膜裂孔形成,可见不同程度脉络膜视网膜脱离.所有患者行玻璃体切割+硅油填充术,术后矫正视力提高32眼(59％),矫正视力不变17眼(31％),矫正视力下降5眼(9％).结论:玻璃体腔填充C3F8气体在复杂性开放性眼外伤Ⅰ期救治应用安全有效,对止血、维持眼压、预防角膜血染及预防视网膜大范围脱离后粘连等有一定效果,为Ⅱ期手术创造条件.

目的：评估半导体二极管激光经巩膜睫状体光凝术(TSCPC)联合小梁切除术治疗新生血管性青光眼(NVG)的疗效。方法选择2013年4月至2014年4月间在解放军105医院接受TSCPC联合小梁切除术治疗的NVG患者56例作为观察组，同期接受单纯TSCPC治疗的NVG患者49例作为对照组，比较两组患者的治疗效果及术后眼压、视力、滤过泡及并发症情况。结果观察组患者接受治疗后的成功率为92.86%(52/56)，高于对照组的77.55%(38/49)，术后眼压为(18.72±3.05) mmHg，低于对照组的(36.18±5.93) mmHg，差异均有统计学意义(P<0.05)；观察组患者术后视力0.3~0.5所占比例为55.36%(31/56)，>0.5所占比例为25.0%(14/56)，有效滤过泡比例为76.78%(43/56)，均分别高于对照组患者的42.86%(21/49)、12.25%(6/49)和55.10%(27/49)，差异均有统计学意义(P<0.05)；观察组患者术后并发症发生率为12.50%(7/56)，低于对照组的为42.86%(21/49)，差异有统计学意义(P<0.05)。结论 TSCPC联合小梁切除术是治疗NVG的有效方式，有助于降低眼压、提升视力、降低并发症发生率。

PURPOSE:To determine the effectiveness of different interventions to slow down the progression of myopia in children. METHODS:We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov from inception to August 2014. We selected randomized controlled trials (RCTs) involving interventions for controlling the progression of myopia in children with a treatment duration of at least 1 year for analysis. MAIN OUTCOME MEASURES:The primary outcomes were mean annual change in refraction (diopters/year) and mean annual change in axial length (millimeters/year). RESULTS:Thirty RCTs (involving 5422 eyes) were identified. Network meta-analysis showed that in comparison with placebo or single vision spectacle lenses, high-dose atropine (refraction change: 0.68 [0.52-0.84]; axial length change: -0.21 [-0.28 to -0.16]), moderate-dose atropine (refraction change: 0.53 [0.28-0.77]; axial length change: -0.21 [-0.32 to -0.12]), and low-dose atropine (refraction change: 0.53 [0.21-0.85]; axial length change: -0.15 [-0.25 to -0.05]) markedly slowed myopia progression. Pirenzepine (refraction change: 0.29 [0.05-0.52]; axial length change: -0.09 [-0.17 to -0.01]), orthokeratology (axial length change: -0.15 [-0.22 to -0.08]), and peripheral defocus modifying contact lenses (axial length change: -0.11 [-0.20 to -0.03]) showed moderate effects. Progressive addition spectacle lenses (refraction change: 0.14 [0.02-0.26]; axial length change: -0.04 [-0.09 to -0.01]) showed slight effects. CONCLUSIONS:This network analysis indicates that a range of interventions can significantly reduce myopia progression when compared with single vision spectacle lenses or placebo. In terms of refraction, atropine, pirenzepine, and progressive addition spectacle lenses were effective. In terms of axial length, atropine, orthokeratology, peripheral defocus modifying contact lenses, pirenzepine, and progressive addition spectacle lenses were effective. The most effective interventions were pharmacologic, that is, muscarinic antagonists such as atropine and pirenzepine. Certain specially designed contact lenses, including orthokeratology and peripheral defocus modifying contact lenses, had moderate effects, whereas specially designed spectacle lenses showed minimal effect.

AIM: To anaIyze the refractive state and expIore the epidemioIogic feature of chiIdren with ametropic ambIyopia. METHODS: This study retrospectiveIy anaIyzed 708 chiIdren (1 416 eyes) with ambIyopia from January 2012 to December 2013 in SpeciaI Department of Strabismus and AmbIyopic and Department of Pediatric OphthaImoIogy in our hospitaI, who were diagnosed as ametropic ambIyopia and accepted centraIIy comprehensive training. The refractive state were given epidemioIogic anaIyze. RESULTS:In the 708 cases (1416 eyes), there were 190 eyes with hyperopia (13. 42%),612 eyes with hyperopia astigmatism (43. 22%),18 eyes with myopia(1. 27%),134 eyes with myopia astigmatism ( 9. 46%), 462 eyes with mixed astigmatism ( 32. 63%). The distributions of refractive state in chiIdren at different age were different, and the difference was statisticaIIy significant (P<0. 05). AmbIyopia caused by refrative error were mostIy miId and moderate ( 1276 eyes, 90. 11%), whiIe the hyperopic astigmatism was predominate in chiIdren with severe ambIyopia ( 82 eyes, 5. 79%). The astigmatism was mainIy with the ruIe(1046 eyes, 86. 59%). CONCLUSION: Hyperopia ametropia and mixed astigmatism are the main types of refractive errors in ambIyopia chiIdren. The IeveI of ambIyopia is reIated to refractive state and astigmatism axiaI.

Objective To discuss the correlations between intraocular pressure (IOP) and gender,age,central corneal thickness (CCT) in children aged from 3 to15 years old.Methods A total of 1884 children (773 eyes) aged from 3 to 15 years old were obtained from the department of ophthalmology of the 180th hospital of PLA from June to December in 2013.The results were analyzed retrospectively.IOP were measured by non-contact tonometry (Canon TX-F).CCT were measured by specular microscopy (Topcon SP-3000).And the correlations between IOP and gender,age,CCT were discussed.Results The mean IOP was 14.64±2.95mmHg,and the mean CCT was 521.43± 35.07μm,and the mean age was 9.59±2.71 years old.The female IOP was greater than the male IOP.IOP was correlated with age (R =0.201,P ＜0.01).IOP was correlated with CCT (R =0.322,P ＜0.01).The male CCT was greater than the female CCT.CCT was not correlated with age (R =0.040,P ＞0.05).Conclusions There is direct linear correlation between IOP and CCT,also IOP is correlated with age in schoolchildren aged 3 to 15years old.All factors by synthesis in clinical work should be analyzed.

Objective To explore the efficacy and safety of intravitreal injection of ranibizumab combined with 23G minimally invasive vitrectomy, panretinal photocoagulation, silicone oil in the treatment of neovascular glau-coma. Methods Fifteen patients (15 eyes) with absolute neovascular glaucoma were enrolled in the study, which were treated with intravitreal injection of ranibizumb 1.25 mg/0.05 ml, followed by 23G minimally invasive vitrecto-my and panretinal photocoagulation after a week based on the observation of disappear or decline of anterior chamber angle and the surface of iris neovascularization. All the patients received silicone oil tamponade. Postoperative intraoc-ular pressure (IOP) and ocular situation during the follow-up of 6~12 months were observed. Results The operation was successful in all the patients, with no severe complication occurred. The mean IOP level was (43.87±8.65) mmHg before the operation, (24.56 ± 4.56) mmHg one week after operation, (16.21 ± 3.32) mmHg 6 months after operation, (18.21±5.32) mmHg 12 months after operation, and the levels after operation were significantly lower than that before operation (P<0.01). Twelve eyes had the IOP controlled in the normal range, 2 eyes applied 2 kinds of anti-glauco-ma drugs and had the IOP controlled<21 mmHg, and 1 eye applied anti-glaucoma drug and had the IOP still IOP>21 mmHg. Conclusion Intravitreal injection of ranibizumb combined with 23G minimally invasive vitrectomy, pan-retinal photocoagulation, silicone oil tamponade is a relatively safe, effective method for the treatment of absolute phase of neovascular glaucoma.

Objective To discuss the safety among individual corneal flaps of different thickness created by FS200 femtosecond laser.Methods In a prospective randomized sample controlled clinical study.Patients made all-in-laser refractive surgery in the 180 Hospital of Quanzhou from June 2013 to December 2013 were randomly divided into four groups according to the order of treatment.Each group of one hundred eyes created corneal flaps of four thickness (90,100,110,120μm) by FS200 femtosecond laser.Compared the incidence of intra-and post-operative complications among four groups.Results No statistical differences of age (x2=5.419,P =0.144),sex (x2=0.362,P =0.948),corneal curvature (x2=5.865,P =0.118),corneal thickness (X2=4.783,P =0.188) and patient factors' score (x2=0.007,P =1.000) were found before operation among four groups.There were no difference in the incidence of intra-and post-operative complications among four groups (x2=14.539,P =0.975).Conclusions If the surgeon operates familiarly,the assistant sets up the canal precisely and the patients cooperate well without mild blepharophimosis or deep eye socket,the safety of creating individual corneal flaps of different thickness thinnest to 90μm by FS200 femtosecond laser is uniform.But corneal flap is not the more the better thin.We should weigh the advantages and disadvantages and consider comprehensively to choose reasonably.The blind pursuit of thin flap is unreasonable.