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AIM: To evaluate the efficacy of phacoemulsification and intraocular lens implantation combined with goniosynechialysis in the treatment of chronic angle-closure glaucoma.METHODS: Thirty-three patients(35 eyes)with primary chronic angle-closure glaucoma and cataract were enrolled in the Department of Ophthalmology, Xi'an First Hospital from May 2018 to November 2018. The best corrected visual acuity, intraocular pressure, central anterior chamber depth, angle-opening distance at 500μm from the scleral spur, trabecular iris angle, angle closure or adhesion were compared between preoperative and postoperative 6mo.RESULTS: The best corrected visual acuity of 34 eyes(97%)was improved after operation. 27 eyes(77%)did not need any intraocular pressure lowering drugs after operation, and the intraocular pressure was kept below 21mmHg. The average value of anterior chamber depth, angle-opening distance at 500μm from the scleral spur and trabecular iris angle(2.04±0.31mm, 0.132±0.033μm, 15.44°±3.10°)before operation were significantly lower than the postoperative mean values(3.26±0.29mm, 0.407±0.038μm, 34.26°±3.60°). The range of angle closure or adhesion decreased after operation, and the difference was statistically significant. CONCLUSION: Phacoemulsification with intraocular lens implantation and goniosynechialysis is an effective way to treat primary chronic angle-closure glaucoma.

AIM: To explore the difference of dry eyes between children and adults in terms of symptoms and laboratory examinations.METHODS: Patients in 2018-06/2019-02 with the subjective symptoms of dry eye, and served in Xi'an First Hospital, including 52 children clinic cases(52 eyes)and 55 adult patients cases(55 eyes), all the cases were consulted and examined by slit lamp microscope in anterior segment. Both eyes of tear meniscus height(TMH), the first tear film break-up time(BUTf), the average tear film break-up time(BUTave), lipid layer thickness(LLT)and mesangial gland loss rate were measured by a Keratograph 5M non-invasive ocular surface analyzer.RESULTS: In children, patients' TMH(0.15±0.04mm), BUTf(3.22±1.24s), BUTave(4.27±1.67s), and the rate of meibomian gland loss \〖0.00%(0.00%, 5.03%)\〗 were significantly lower than those in the adult group [0.20±0.05mm, 4.36±1.93s, 5.15±1.49s, 9.90%(5.30%, 18.40%), all Pvs 68.58±21.05nm, P>0.05). Both groups of patients had positive correlation sympathise with BUTf and BUTave, with no correlation between LLT and meibomian gland loss rate in children(rs=-0.23,P=0.10), and adult group patients with negative correlation of LLT and meibomian gland loss rate(rs=-0.28,PCONCLUSION: Children's dry eyes and adult dry eyes in the symptoms, clinical manifestations and examination are different. The main symptom is the increase in the number of blinks. The inspection is mainly characterized by a short BUT. With the decrease of TMH, the rate of meibomian gland loss is relatively insignificant.

AIM: To investigate the clinical effects and safety of phacoemulsification combined with different glaucoma surgical procedures for primary angle-closure glaucoma(PACG)coexisted with cataract.METHODS: Thirty-four cases(47 eyes)with PACG coexisted with cataract were divided into group A and group B. Group A was defined as the closed angle of anterior chamber was less than 180°and was treated with phacoemulsification combined with goniosynechialysis. Group B as the closed angle was more than 180° was treated with phacoemulsification combined with trabeculectomy. The follow-up period was 6mo. Postoperative best corrected visual acuity(BCVA), intraocular pressure(IOP), anterior chamber depth(ACD), filtration bleb and complications were observed.RESULTS: The IOPs were 14.37±4.83 and 15.86±3.74mm Hg at final follow-up in group A and B respectively, which were significantly decreased compared with pre-surgery(PPCONCLUSION: Phacoemulsification combined with anti-glaucoma surgery can get stable control on IOP, improve visual acuity,decrease the complication risk and is safe and effective.

AIM:To explore the diagnosis value of retina nerve fiber layer(RNFL)and ganglion cell complex(GCC)in the early stage of chronic primary angle-closure glaucoma(CPACG), and investigate their relationship with mean defect(MD)of visual field.METHODS: Twenty-one patients with CPACG(38 eyes), 25 patients with suspected glaucoma(SG)(46 eyes)and 25 normal controls(49 eyes)were selected to perform SD-OCT. Statistical difference was analyzed the thickness of RNFL and GCC of average and all quadrants, and correlation between RNFL, GCC and MD of visual field. RESULTS:There were significant differences in average and all quadrant thickness of RNFL and GCC between CPACG group and control group(PPPPPr=0.65), GCC(r=0.72)in CPACG group. CONCLUSION:RNFL and GCC are useful to diagnose and monitor the early stage of CPACG, and GCC may be more significant for the disease.

AIM:To investigate the effect of trichostatin A(TSA)on cell proliferation and the expressions of histone deacetylase 1(HDAC1)and HDAC2 in cultured human Tenon capsule fibroblast(HTF).METHODS: Human Tenon capsule fibroblasts were cultured in vitro after glaucoma filtration surgery. The third to sixth passage of cell were treated by 600nmol/L TSA or none. Cell viability measured by MTT assay after 1, 2 and 3d respectively. The expressions of HDAC1 and HDAC2 were analyzed by Western blot 2d after TSA treatment.RESULTS: Compared to the control, cell viability decreased significantly after treatment with TSA at 1d(PCONCLUSION: TSA inhibits the proliferation of Tenon capsule fibroblast by inhibiting the expression of HDAC1 and HDAC2, and reduces subconjunctival scar formation.

AIM: To observe the morphologic changes of of filtration blebs after trichostatin A treatment in an experimental glaucoma filtration surgery(GFS).METHODS: Subconjunctival injection TSA, mitomycin C(MMC)and PBS during the filtering surgery in rabbits. The morphologic changes of filtration blebs were evaluated by Krofeld score method postoperatively days 3, 7, 14, 21, and 28. RESULTS: TSA induced filteation bleds were elevated diffusely within 14d and cystic blebs formed 28d, filtration bleb score was significantly higher in TSA group than that in PBS group.CONCLUSION: TSA can keep the aqueous humor outflow by inhibiting scar formation and prolong the existence of the filtration bleb.