Objective Diabetic patients are often comorbid with dyslipidemia, however, the relationship between high-density lipoprotein cholesterol(HDL-C) and diabetic retinopathy (DR) in the adult diabetic population remains to be fully elucidated.The aim of this study is to evaluate the associations between HDL-C and DR in the United States adults with diabetes.Methods A total of 1708 participants from the National Health and Nutrition Examination Survey (NHANES) 2005-2008 were enrolled in the present study. Fundus images of all study subjects were captured and evaluated using a digital camera and an ophthalmic digital imaging system, and the diagnosis of DR was made by the severity scale of the Early Treatment Diabetic Retinopathy Study (ETDRS).Roche Diagnostics were used to measure serum HDL-C concentration. The relationship of DR with HDL-C was investigated using multivariable logistic regression. The potential non-line correlation was explored with smooth curve fitting approach.Results The fully-adjusted model showed that HDL-C positively correlated with DR(OR:1.69, 95%CI: 1.25-2.31).However, an inverted U-shaped association between them was observed by applying the smooth curve fitted method. The inflection point of HDL-C(1.99mmol/l) was calculated by utilizing the two-piecewise logistic regression model. In the subgroup analysis, the inverted U-shaped nonlinear correlation between HDL-C and DR was also found in female, Non-Hispanic White, and lower age groups.Conclusion Our study revealed an inverted U-shaped positive relationship between HDL-C and DR.The findings may provide us with a more comprehensive understanding of the association between HDL-C and DR.

AIM: To analyze the risk factors of corneal epithelial dysfunction(CED)after pars plana vitrectomy(PPV).METHODS: Clinical data of 235 patients with 235 eyes of PPV from July 2016 to June 2018 in our hospital were retrospectively analyzed. The age, sex and related medical history of the patients(such as ocular lesions and systemic diseases)were collected, and the intraocular fillers, operation time, postoperative intraocular pressure were recorded. Logistic regression was used to analyze the risk factors of CED after PPV.RESULTS: The incidence of CED after PPV was 16.6%(39/235), and the incidence of persistent corneal epithelial lesion was 1.3%(3/235). Logistic regression showed that age, preoperative xerophthalmia, diabetes mellitus, Silicone oil filling, postoperative high intraocular pressure and operation time were risk factors for CED after PPV. The OR values were 1.270, 5.218, 18.598, 4.659, 10.799 and 1.104, respectively.CONCLUSION: Age, preoperative xerophthalmia, diabetes mellitus, silicone oil filling, postoperative high intraocular pressure and operation time are risk factors for CED after PPV.

目的 观察玻璃体切割联合内界膜填塞手术治疗高度近视黄斑裂孔性视网膜脱离的疗效.方法 对2015年5月至2018年1月在我院接受玻璃体切割联合内界膜填塞手术治疗的高度近视黄斑裂孔性视网膜脱离患者18例18眼的临床资料进行回顾性分析,均采用23G玻璃体切割联合内界膜填塞的手术方式,术中根据患者晶状体混浊情况,必要时联合行白内障超声乳化摘出手术.术后随访6个月,观察术眼的最佳矫正视力、黄斑孔闭合、视网膜复位以及并发症发生情况.结果 术后17眼(94.44％)一次手术后视网膜复位,1眼经再次手术后仍存在局限性视网膜脱离,患者未进行再次手术治疗.OCT随访显示,黄斑裂孔Ⅰ类U形愈合3眼(16.67％),Ⅰ类V形愈合9眼(50.00％),Ⅱ类W形愈合5眼(27.78％),未愈合1眼(5.56％).所有患者手术后最佳矫正视力均较术前有不同程度改善,差异有统计学意义(P＜0.05).术后2眼发生一过性眼压升高,1眼术后出现前房房水闪辉,1眼因患者术后俯卧位置不当出现人工晶状体瞳孔区夹持,经治疗后均恢复正常;2眼术后出现晶状体后囊羽毛状混浊.结论 玻璃体切割联合内界膜填塞手术是治疗高度近视黄斑裂孔性视网膜脱离的有效方法,能够有效促进黄斑裂孔的愈合以及视网膜的复位.

AIM:To observe, analyze and compare the effect of minimally external surgery under microscopy and traditional external surgery on the treatment of non-complicated rhegmatogenous retinal detachment. METHODS:The clinical data of 53 patients with 53 eyes of non-complicated rhegmatogenous retinal detachment in our hospital was analyzed retrospectively, of which the minimally external retinal detachment surgery under microscopy was performed in 25 patients with 25 eyes of non-complicated rhegmatogenous retinal detachment(the research group), and the traditional external retinal detachment surgery was performed in 28 patients with 28 eyes of non-complicated rhegmatogenous retinal detachment(the control group). All surgeries were performed by the same surgeon, and the clinical efficacy and complications of the two groups were compared and analyzed. RESULTS: In postoperative hole closure, there was no significant difference in the primary rate of reattachment of the retina between the two groups(P>0.05). There was a statistically significant difference in postoperative complications between the two groups(P<0.05). The best corrected visual acuity after surgery was better than that before surgery in both groups. There was no significant difference in the increase of postoperative visual acuity between the two groups(P>0.05). There was a statistically significant difference in operative time between the two groups(P<0.05). CONCLUSION: The effect of minimally external retinal surgery under microscopy and traditional external retinal surgery is similar in the treatment of non-complicated rhegmatogenous retinal detachment, but the minimally external retinal surgery has the advantages of shorter time, less damage and fewer complications.

? AIM: To observe the efficacy and safety of the phacoemulsification combined with goniosynechialysis and the phacoemulsification combined with trabeculectomy for angle-closure glaucoma ( ACG ) with different closure conditions accompanied with cataract.?METHODS:A total of 65 patients (70 eyes) with primary ACG accompanied with cataract were selected from those admitted in our hospital and were given phacoemulsification with goniosynechialysis ( group A, 30 patients with 33 eyes ) and the phacoemulsification with trabeculectomy ( group B, 35 patients with 37 eyes ) according to the conditions of the closed anterior angle, respectively. The two groups of patients were observed for preoperative and postoperative intraocular pressure ( IOP ) , vision, anterior chamber depth, and complications, and were followed up for 6. 5mo (6-8mo) on average.?RESULTS: Mean postoperative IOP in either group A or group B at 1mo after operation was of statistically significant difference, compared with mean preoperative IOP (P<0. 05). Postoperative 1-week vision in each group was of statistically significant difference, compared with preoperative vision (P<0. 05). Postoperative 1-month mean anterior chamber depth in each group was of statistically significant difference, compared with preoperative anterior chamber depth (P<0. 05). There were no significant differences between the two groups on postoperative 1-month mean anterior chamber depth ( P>0. 05) and postoperative complications (P>0. 05).?CONCLUSION: Clinical doctors can choose appropriate treatment according to different conditions of the closed anterior angle in patients with primary angle- closure glaucoma.

Objective?To?investigate?the?change?of?the?tear?film?function?in?allergic?conjunctivitis?and?to?analyzed?the?correlation?with?dry?eye.?Methods?42?patients?(84?eyes)?with?allergic?conjunctivitis?from?January?to?June?in?2013?were?taken?as?the?observation?group?and?42?normal?people?(84?eyes)?were?taken?as?control?group.?Slit?lamp?examination,?tear?film?break-up?time?(break-up?time,?BUT)?examination?corneal?fluorescein?staining?test?(fluorescein,?FL)?and?Schirmer?I?test(SIt)?were?performed?respectively.?There?is?no?significant?difference?between?the?genders?and?the?age.All?the?subjects?were?exclusion?of?systemic?and?other?ocular?disorders.?Results?The?patients?with?allergic?conjunctivitis?have?different?degrees?of?tear?film?abnormalities,?compare?with?control?group?the?SIt,?BUT?and?FL,has?significant?statistically?difference(P<0.05).?Conclusion?The?allergic?conjunctivitis?decrease?the?stability?of?the?tear?film,?and?also?lead?to?dry?eye.

AIM: To assess the impact of diabetes on corneal endothelial cells through the quantitative analysis of corneal endothelial cell morphology for patients with diabetics.METHODS: The corneal thickness and endothelial cell morphology of 360 eyes of 299 cases were detected using full automatic corneal endothelial cell analyzer. The normal control group included 175 eyes of 148 cases, and there were 185 eyes of 151 cases for the patients with diabetes, 110 eyes of 92 cases for the non-proliferating phase group and 75 eyes of 59 cases for the proliferating phase group. The average density of central corneal endothelial cells, proportion of hexagonal cells, coefficient of variation and corneal thickness were compared among groups, and then the statistical analysis was conducted. RESULTS: Compared with the cornea of the normal group, in the diabetes group, the coefficient of variation of corneal endothelial cells and central corneal thickness increased, while the average density of central corneal endothelial cells and proportion of hexagonal cells decreased, showing a significant difference(P<0.05). Compared with the cornea of non-proliferating phase group, in the proliferating phase group, the density of central corneal endothelial cells decreased, the coefficient of variation of corneal endothelial cells increased, while the proportion of hexagonal cells decreased with a significant difference(P<0.05), and the central corneal thickness increased, showing no significant difference(P>0.05).CONCLUSION: Compared with the cornea of normal control group, in the diabetes group, the corneal endothelial cells show abnormal morphology, which aggravates with the severity of lesions, especially for the significant changes in the coefficient of variation and the proportion of hexagonal cells. As a result, the corneal resistance to damage in patients with diabetes will decrease.

[Objective]To study the curative effect of three types of operations for senile glaucoma combined with cataract.[Methods]120 cases(142 eyes) of senile glaucoma combined with cataract were randomly divided into three groups.Group A was given phacoemulsification and foldable intraocular lens implantation,group B received phacoemulsification and foldable intraocular lens implantation combined with trabeculectomy,and group C was treated by phacoemuisification combined with goniosynechialysis.The changes of visual acuity and intraocular pressure before and after operation,and postoperative complications were observed.[Results]Compared with preoperative visual acuity and average intraocular pressure,the visual acuity and average intraocular pressure at 1 week,l months,3 months and 6 months after operation were significantly improved(P<0.05),but the difference among three groups was not significant(P>0.05).There was no severe postoperative complication in three groups.[Conclusion]Phacoemulsification and foldable intraocular lens implantation combined with trabeculectomy,and phacoemuisification combined with goniosynechialysis are effective methods for senile glaucoma combined with cataract,and the curative effect of them has no obvious difference.

·AIM:To investigate the clinical effect of small-incision extracapsular cataract extraction with posterior chamber intraocular lens implantation and trabeculectomy for glaucoma and cataract.·METHODS:Totally 17 patients with glaucoma and cataract underwent the extracapsular cataract extraction with posterior chamber intraocular lens implantation and trabeculectomy,postoperative visual acuity,intraocular pressure and complications were observed.·RESULTS:All the patients were returned to normal intraocular pressure range.Visual acuity was improved in different degrees.Early shallow anterior chamber occurred in 1 eye,and transient corneal edema occurred in 2 eyes.·CONCLUSION:The small-incision glaucoma and cataract surgery is a safe and effective way.·

目的比较翼状胬肉逆行切除联合生物羊膜移植术与单纯翼状胬肉逆行切除的临床疗效。方法分析原发性翼状胬肉85例(94眼)的临床资料,随机分为两组,A组为单纯翼状胬肉逆行切除组38例(42眼)、B组为翼状胬肉逆行切除联合生物羊膜移植术组47例(52眼),比较两组疗效。结果术后随访12～24个月,A组复发10眼(23.8%);B组复发4眼(7.7%),两组比较差异有统计学意义(P<0.05)。结论翼状胬肉逆行切除联合及生物羊膜移植疗效优于单纯逆行切除组。

Objective To observe the effects of orbital implants with reserved scleral flap and with common eye enucleation. Methods Thirty-six patients with eye enucleation randomly adopted either orbital implants with reserved scleral flap or common eye enucleation. The long-term follow-up effects were observed to compare which method was better. Results To compare with common eye enucleation, afterreactions were more slight and better movement of ocular prosthesis was bigger which with reserved scleral flap. Dehiscence of conjunctiva cut happen to one case. No exposure of orbital implants to all cases. Conclusion Compare with common eye enucleation,there are no hurtful to muscle,more slight afterreactions , better movement of ocular prosthesis and fewer complications to orbital implants with reserved scleral flap.