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AIM:To analyze curative effect of phacoemulsification through clear corneal tunnel incision on cataract and the influences on subjective sylptols of dry eye questionnaire scores(SDES)and break-up time(BUT).METHODS: During the period from June 2015 to January 2019, 117 cataract patients(139 eyes)who underwent cataract surgery in the hospital were divided into group A(n=65, 72 eyes)and group B(n=52, 67 eyes)by random number table method. Groups A and B underwent phacoemulsification through 2.2mm and 3.0mm micro-incision, respectively. The general surgical status, SDES, BUT and curative effect indexes [best corrected visual acuity(BCVA), spherical equivalent(SE), endothelial cell density(ECD)] were compared between the two groups.RESULTS: There was no significant difference in ultrasound time, cumulative released energy, operation time or postoperative complications between two groups(P>0.05). After surgery, SDES scores in both groups were significantly increased, BUT was decreased compared with that at 1d before surgery. At 3mo after surgery, SDES and BUT recovered to preoperative levels. At 1d and 1wk after surgery, SDES score in group A was significantly lower than that in group B, while BUT was significantly higher than that in group B(P0.05). CONCLUSION:The curative effect of phacoemulsification through clear corneal tunnel incision is reliable on cataract. The tear film function is better through 2.2mm micro-incision.

AIM:To investigate the difference of non-invasive tear film break-up time(NIBUT)by Keratograph 5M before and after forced eye opening in healthy individuals. METHODS: Prospective case self-control study. Forty normal volunteers(79 eyes)were enrolled. Tear film images were captured, non-invasive first tear film break-up time(NIBUTf), non-invasive average tear film break-up time(NIBUTav)and dry eye level were measured by Keratograph 5M automatically before and after forced eye opening in each subject. For the first time, we checked the left eye after the right eye, and the second time checked the right eye after the left eye. RESULTS: The average of NIBUTf and NIBUTav were 9.18±5.52s, 11.74±5.59s respectively and percentage of every level of dry eye were 43%, 37%, 20% respectively before forced eye opening. The average of NIBUTf and NIBUTav were 8.91±5.54s, 11.76±5.58s and percentage of dry eye at different levels were 35%, 48%, 16% respectively after forced eye opening. There was no significant difference on NIBUT and dry eye level by Oculus keratograph 5M in normal subjects(t=0.37, P=0.72; t=-0.038, P=0.97; Z=-0.42, P=0.68). CONCLUSION: There is no influence on NIBUT and dry eye level by detected Keratograph 5M before and after forced eye opening in healthy subjects.

AIM: To analyze the relationship between tear film break-up time(BUT)and systemic factors. METHODS: From January 2015 to July 2016 in the medical examination center of Fuzhou General Hospital or hospitalized, there were 747 cases included. All participants were observed for systolic and diastolic blood pressure, blood glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein, break-up time equivalent. The relationship between tear film rupture time and systemic factors was analyzed with simple and multiple linear regression analysis by SPSS19.0. RESULTS: Simple linear regression analysis results showed that the diastolic pressure and tear break-up time were positively correlated(PPP=0.227). Multiple linear regression analysis suggested that the tear film rupture time was positively correlated with diastolic blood pressure(PPPP=0.019). The time of tear film rupture was not related to age, cholesterol, triglyceride, low density lipoprotein. CONCLUSION: The correlation between blood glucose and tear film BUT is the most significant among all the indexes involved, indicating that ocular surface damage may occur in diabetic patients.

AIM: To compare the non-invasive tear break-up time(NITBUT)and tear meniscus height(TMH)measurements in keratoconus patients and normal subjects, and to determine the relationship between these measurements with keratoconus disease by the Oculus Keratograph 5M(K5M). METHODS:Fifty keratoconus patients(100 eyes)and 50 healthy subjects(100 eyes)participated in the study. The age range in keratoconus group was 15-60(mean ± standard deviation=28.33±8.60)y, and in control group was 18-60(26.25±1.11)y. The measurements of NITBUT and TMH were performed using the K5M. RESULTS: The mean value of NITBUT between the keratoconus group and the control group showed no statistically significant different(P=0.58). Also, the mean of TMH between two groups was not significantly different(P=0.69). The results of correlation coefficient between the variables of the study demonstrated that there was no significant relationship between the NITBUT and TMH measurements with the two groups(keratoconus group: r= 0.053, P=0.721; control group; r=-0.0501, P=0.7098). CONCLUSION: Our study shows that the presence of keratoconus has no clinically significant impact on the quality and quantity of tear film.

AIM: To analyze the risk factors for recurrence after pterygium excision and the influence on corneal astigmatism and tear film break-up time.METHODS:Retrospective study. A total of 110 pterygium patients(110 eyes)admitted to our hospital from January 2020 to January 2023 were selected, including 77 primary pterygium patients(77 eyes)and 33 recurrent pterygium patients(33 eyes). Pterygium excision was performed in all patients. The corneal astigmatism and tear film break-up time of patients with pterygium were measured before and after operation. The recurrence of pterygium was analyzed and the risk factors of recurrence were analyzed.RESULTS:In this study, 8 eyes with pterygium recurred after excision, and the recurrence rate was 7.3%. There was no difference in corneal astigmatism of all patients before and after surgery(2.02±0.32 vs 2.00±0.32 D, P>0.05), and there was a difference in tear film break-up time(9.55±1.24 vs 13.46±2.56 s, P

AIM:To observe the clinical effect of different concentration of fluorometholone eye drops on severe mixed vernal keratoconjunctivitis in children.METHODS: A total of 50 cases(100 eyes)of children with severe mixed vernal keratoconjunctivitis treated in the outpatient department of our hospital from March to September, 2022 were selected and randomly divided into two groups. Group A consisted of 25 cases(50 eyes)who were treated with 0.1% fluorometholone eye drops combined with 0.05% cyclosporine eye drops(Ⅱ), while 25 patients(50 eyes)in group B were treated with 0.02% fluorometholone eye drops combined with 0.05% cyclosporine eye drops(Ⅱ). After 1mo of treatment, SPEED questionnaire score, corneal fluorescein staining(FL)score, tear break-up time(TBUT), Schirmer I test(SⅠt), R-scan, non-invasive tear meniscus height(NIKTMH), corneal optical density and other ocular parameters of the two groups were observed, and the occurrence of adverse reactions were recorded.RESULTS: After 1mo of treatment, there were significant differences in SPEED score, FL score and R-scan results between the two groups(all P0.05). However, there were statistical significance in corneal optical density in different corneal depth and diameter ranges(all P0.05), and no obvious adverse reactions occurred during treatment.CONCLUSION: The 0.1% fluorometholone eye drops can effectively treat severe mixed vernal keratoconjunctivitis in children, and its effect is better than 0.02% fluorometholone eye drops.

AIM: To investigate the postoperative ocular surface changes in acute attack eye and contralateral eye with primary angle-closure glaucoma(PACG)and cataract.METHODS: A total of 40 patients with monocular acute PACG combined with cataract who admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2021 to January 2022 were selected. Trabeculectomy combined with phacoemulsification and intraocular lens implantation was carried out in the acute attack eyes, and phacoemulsification and intraocular lens implantation were carried out in the contralateral eyes. The ocular surface disease index(OSDI)questionnaire, noninvasive first tear film break-up time(NifBUT), noninvasive average tear film break-up time(NiaBUT)and tear meniscus height(TMH)were assessed preoperatively and 1, 3 and 6mo postoperatively.RESULTS: The OSDI scores of the included patients at 1 and 3mo postoperatively(14.72±3.07, 11.39±2.24)were significantly higher than those preoperatively(9.68±1.98; all P0.05).CONCLUSION: The stability of tear film after surgery of PACG and cataract is decreased. The acute attack eye needs 6mo or even longer to recover, while the contralateral eye needs roughly 3mo.

AIM: To explore the difference of tear film stability among different lipid layer thickness.METHOD: A total of 194 dry eye patients(384 eyes)admitted to our hospital from June 2020 to December 2021 were enrolled in this study. The tear meniscus height, the first tear film break-up time and lipid layer thickness were measured by corneal topographer. The tear meniscus height and the first tear film break-up time among different lipid layer thickness were compared and the correlation between them was analyzed.RESULTS: The included patients(384 eyes)were divided into lipid rich group(49 eyes), lipid balance group(27 eyes), slight lipid deficiency group(266 eyes)and significant lipid deficiency group(42 eyes)according to the lipid layer thickness. The differences of the tear meniscus height were statistically different(P=0.022), while the differences of the first tear film break-up time were not statistically different(P=0.322). The lipid layer thickness was positively correlated with tear meniscus height(rs=0.143, P=0.006). There was no correlation between lipid layer thickness and the first tear film break-up time(rs=-0.090, P=0.083), nor was there correlation between tear meniscus height and the first tear film break-up time(rs=0.038, P=0.460).CONCLUSION: There was no significant difference in tear film stability in dry eye patients with different lipid layer thickness.

AIM: To investigate the efficacy of optimal pulse technology(OPT)in the treatment of demodex blepharitis and its influence on ocular surface function.METHODS: A retrospective study was conducted from February 2018 to October 2020. A total of 127 patients(254 eyes)with demodex blepharitis were assigned to the observation group and the control group according to the treatment method. The control group(63 patients, 126 eyes)were given conventional hot compress, eye cleansing and drug therapy. On this basis, the observation group(64 patients, 128 eyes)was treated with OPT. Both groups were given 6wk of continuous treatment. Demodex count, Marx's line scores, meibum character scores, ocular surface disease index(OSDI)scores, non-invasive tear break-up time(NIBUT), non-invasive tear meniscus height(NITMH)and lipid layer thickness(LLT)were compared between the two groups, and safety was evaluated.RESULTS: After 6wk of treatment, demodex count, Marx's line scores, meibum character scores and OSDI scores of the two groups decreased. NIBUT, NITMH and LLT increased. Meanwhile, demodex count, Marx's line scores, meibum character scores and OSDI scores of the observation group were significantly lower than those in the control group. NIBUT, NITMH and LLT were longer/larger than those in the control group(P

AIM: To compare the non-invasive tear film break-up time(NIBUT), tear break up time(TBUT), basal tear secretion(BTS)and blink rate in four ethnic groups: Malay, Chinese, Indian and Nigerian.METHODS: Totally 120 healthy(61 males and 59 females)subjects(without dry eye symptoms and ocular surface disorder)with the age 20 to 39 years were recruited; 30 were Malays, 30 were Chinese, 31 were Indians and 29 were Nigerians. Based on McMonnies questionnaire and clinical examination, normal subjects were selected. NIBUT, TBUT, BTS were assessed in only one eye(right)of each subject and blink rate was also assessed.RESULTS: There was significant difference in the NIBUT, TBUT, BTS and blink rate among 4 different ethnic groups(P=0.018),(P=0.001),(P=0.011), and(P=0.004)respectively. No statistically significant difference of NIBUT, TBUT, BTS and blink rate was found between the genders among different ethnic groups. Indian had higher median for NIBUT(10±6s), TBUT(7±5s)and BTS(20±20 mm)than others races. Chinese had lower median for NIBUT(7.5±4s)and TBUT(4±2s)while Malay had low BTS(9.5±16 mm)among the groups. There was no significant correlation of blink rate with NIBUT, TBUT and BTS(r= -0.119, P=0.195),(r=-0.086, P=0.352),(r= -0.123, P=0.180)respectively.CONCLUSION: This study showed the variability in tear-film measurements values in four ethnic groups.

AIM: To analyze the effectiveness and safety of different concentrations of tea tree essential oil in the treatment of Demodex blepharitis. METHODS: The clinical data of 120 patients(240 eyes)with blepharitis caused by Demodex infection in our hospital from June 2017 to June 2019 were retrospectively analyzed. According to the use of tea tree essential oil concentrations of 10%, 15%, 20% and 25%, patients were divided into 4 groups(group A, group B, group C, group D), each group with 30 people. All patients were given meibomian gland massage, eyelid margin cleaning, and then scrubbed with different concentrations of tea tree oil to clean the eyelid margin. The number of demodex mites, clinical symptom score, clinical sign score, tear film break-up time(BUT), corneal fluorescein staining(FL)and SchirmerⅠtest(SⅠt)were compared before and 2, 4wk after treatment.RESULTS: The number of Demodex mites, clinical symptom score, clinical sign score, BUT, FL and SⅠt were not statistically significant in the four groups before treatment(P>0.05). After treatment, the number of Dmodex mites, clinical symptom score, and clinical sign score in each group were lower than those before treatment, and the number of Demodex mites, clinical symptom score, and clinical sign score after 4wk of treatment in each group were lower than those after 2wk of treatment(all P

AIM: To investigate the effect of strabismus surgery on tear film and the incidence of dry eye.METHODS: A total of 66 eyes of 58 patients admitted and underwent surgery in our hospital between September 2018 to September 2019 with concomitant strabismus were enrolled. The patients were divided into two groups based on surgical methods: Group 1 included 25 cases(33 eyes)who underwent a single horizontal rectus cut; Group 2 included 33 cases(33 eyes)who underwent both horizontal rectus cut in. The noninvasive tear film break-up time(NIBUT)was examined with sirius anterior analysis system at the time of 1d preoperatively and 3d, 1wk, 2wk and 3wk after operation. In addition, the tear film break-up time(BUT), Schirmer I test(SⅠt)and corneal fluorescein examination were tested. The patients were diagnosed with dry eye in both groups according to the consensus of clinical experts specialized in the diagnosis and treatment of dry eye. RESULTS: There were no statistically significant differences when compared to SⅠt between the two groups before and after surgery(P>0.05). The BUT of group 1 was higher than group 2 at postoperative 3d, 1wk and 2wk(PP>0.05); BUT returned to baseline by 2wk after surgery in group 1 and by 3wk after surgery in group 2. There were no differences between the NIBUT measured by sirius anterior segment analysis system and the BUT measured by traditional method before and after operation(P>0.05). The lowest incidence of dry eye was found at postoperative 2wk and 3wk in group 1(24%, 18%). The lowest incidence of dry eye was found at postoperative 3wk in group 2(15%). Besides, the incidence of dry eye in group 2 was higher than that in group 1 at postoperative 2wk(52% vs 24%, PCONCLUSION: There was no obvious influence on the SⅠt after strabismus surgery; the surgical effect on tear film was mainly reflected in BUT. The fewer muscles operated, the lesser tear film was affected and the tear film was recovered faster. The incidence of dry eye decreased as time went by.

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 compare the effects of trabeculectomy and phacotrabeculectomy on the ocular surface using ocular Keratograph 5M.METHODS: Totally 62 eyes of 62 patients with coexisting primary angle-closure glaucoma(PACG)and cataract were recruited. Thirty-two eyes accepted trabeculectomy, and the remaining thirty eyes accepted phacotrabeculectomy. Ocular surface parameters, including noninvasive first tear film break-up time(NifTBUT), noninvasive average tear film break-up time(NiaTBUT), corneal fluorescein staining scores(CFS)and tear meniscus height(TMH), were analyzed preoperatively, 3d, 1mo and 3mo postoperatively, with ocular Keratograph 5M.RESULTS: There was no significant difference in ocular surface parameters between the two groups preoperatively(P>0.05). The values of NifTBUT, NiaTBUT, CFS and TMH in phacotrabeculectomy eyes were at the worse levels, i.e. 10.13±1.48s, 12.59±1.96s, 0.80±0.22 and 0.31±0.02mm, respectively at 3d postoperatively, then improved gradually at 1mo postoperatively, but did not return to the preoperative levels at 3mo postoperatively.CONCLUSION: Ocular Keratograph 5M can be used to evaluate the changes of tear film in combined anti-glaucoma surgery accurately. The effects of phacotrabeculectomy on ocular surface are worse than that of trabeculectomy during 3mo after surgery. It is suggested that more eye care should be paid during that period of time.

AIM: To evaluate ocular surface functions in pregnant women with gestational diabetes mellitus(GDM)using Keratogragh 5M. METHODS: Pregnant women with GDM and normal pregnant women were enrolled. All subjects were asked to answer ocular surface disease index(OSDI)questionnaire survey, and then underwent ophthalmic examination including tear meniscus height(TMH), average noninvasive Keratograph tear film break-up time(NIKBUTav), ocular redness analysis, and meibomial gland analysis.RESULTS: There were no statistically significant differences in OSDI, TMH, NIKBUTav, eye redness analysis and meibomial gland analysis between the GDM group and the normal pregnant group(P>0.05). The OSDI scores were 8.02±4.25 and 7.50±4.28(P=0.557), TMH values were 0.22±0.05 and 0.20±0.04mm(P=0.158), NIKBUTav values were 8.01±2.15s and 8.02±1.53s(P=0.971).CONCLUSION: There was no statistically significant difference between the GDM group and the normal pregnant group in ocular surface indexes. GDM had no negative effects on ocular surface, which may be related to good controlling of the blood glucose.

AIM: To observe the clinical efficacy of Xiaoyao Powder combined with tobramycin dexamethasone in treating dry eye syndrome caused by Meibomian gland dysfunction(MGD). METHODS: Totally 134 eyes of 106 dry eye patients with MGD in the First People's Hospital of Wolong District, Nanyang City from November 2015 to November 2017. They were randomly divided into the control group and the observation group, each with 53 cases(67 eyes). The two groups were all given hot compress massage, and other basic treatment. The control group was given tobramycin dexamethasone treatment, while the observation group was treated with Xiaoyao Powder on the basis of the control group. The clinical effect of two groups of patients, the symptoms of dry eye, corneal fluorescence staining(FL), the scale of quality of life for diseases with visual impairment(SQOL DVI), tear film break-up time(BUT)and the Schirmer test(SⅠT)were observed. RESULTS: After treatment, the total effective rate of treatment in the observation group(86.6%)was significantly higher than that of the control group(67.2%). The symptoms of dry eye, corneal FL and SQOL DVI scores were significantly lower than those in the control group, and the values of BUT and SⅠT were significantly higher than those in the control group, the difference was statistically significant(PPCONCLUSION: The Xiaoyao Powder combined with tobramycin dexamethasone in the treatment of MGD dry eye can significantly improve the curative effect and improve the prognosis of the patients.

AIM: To evaluate the ocular surface in the patients after strabismus surgery. METHODS: One hundred and eighty-eight hospitalized patients(240 eyes)with strabismus from May 2015 to October 2016 in Aier Hospital were divided into 3 groups according to the type of incision: 85 cases(100 eyes)with the corneal limbus incision in Group A; 35 cases(50 eyes)with the cross-muscle incision in Group B; 68 cases(90 eyes)with the adjacent-fornix incision(including Parks incisions and improved Parks incisions)in Group C. And 75 eyes with single extraoeular muscle surgery, 110 eyes with 2 extraoeular muscle surgery, 55 cases with 3 extraoeular muscle surgery. The first noninvasive tear film break-up time(NITBUTf)and the tear meniscus height(TMH)were tested by Oculus anterior segment analyzer preoperatively and 1d, 1, 2 and 4wk postoperatively. The data were studied by statistics. RESULTS: Comparing with preoperative, TMH increased significantly at post-operatively 1d in all group, NIKBUTf reduced significantly(PCONCLUSION: Surgical incision and surgical muscle number may affect the ocular surface of the people after strabismus surgery. The adjacent fornix conjunctival incision has less effect. The less number of muscles in strabismus surgery, the less effect on ocular surface.

AIM: To investigate repeatability and accuracy of a latest Keratograph for evaluating the tear film stability and to compare its measurements with that of traditional examination methods. METHODS: The results of noninvasive tear film break-up time(NI-BUT)including the first tear film break-up time(BUT-f)and the average tear film break-up time(BUT-ave)were measured by Keratograph. The repeatability of the measurements was evaluated by coefficient of variation(CV)and intraclass correlation coefficient(ICC). Wilcoxon Signed-Rank test was used to compare NI-BUT with fluorescein tear film break-up time(FBUT)to confirm the correlation between NI-BUT and FBUT, Schirmer I test values. Bland-Altman analysis was used to evaluate consistency. RESULTS: The study recruited 48 subjects(48 eyes)(mean age 38.7±15.2 years). The CV and ICC of BUT-f were respectively 12.6% and 0.95, those of BUT-ave were 9.8% and 0.96. The value of BUT-f was lower than that of FBUT. The difference had statistical significance(6.16±2.46s vs 7.46±1.92s, PPCONCLUSION: Keratograph can provide NI-BUT data that has a better repeatability and reliability, which has great application prospects in diagnosis and treatment of dry eye and refractive corneal surgery.

AIM:To compare the effect of three types of pterygium surgery and on tear film in patients with type 2 diabetes mellitus.METHODS:A total of 102 patients(102 eyes)with pterygium combined with type 2 diabetes mellitus treated in our hospital from March 2013 to March 2016 were analyzed retrospectively. The patients were divided into three groups including the 34 cases(34 eyes)with simple excision of pterygium(resection group), pterygium excision combined with conjunctival flap transplantation in 34 cases(34 eyes, as conjunctival flap group)and pterygium excision combined with limbal stem cell transplantation in 34 cases(34 eyes, as stem cell group). The wound repair time, complications, recurrence rate, uncorrected visual acuity(UCVA), tear film break-up time(BUT)and basal tear secretion test(SⅠt)were observed before, and 6 and 12mo after surgery in the three groups, respectively. RESULTS: The postoperative UCVA of the three groups was significantly higher than that preoperation(P=0.039, 0.013, 0.024), and there was no significant difference among the three groups(P=0.317). The wound repair time was 5.67±1.45d in the resection group, which was significantly higher than that in the conjunctival flap group(4.18±0.76d)and the stem cell group(4.09±0.79 d)(PP=0.937). There were 4 cases in resection group reappeared, and the recurrence rate was 11.8%, which was significantly higher than the other two groups(P=0.037). There were 1 recurrences in the conjunctival flap group, and the recurrence rate was 2.9%, while the patients in the stem cell group had no obvious recurrence. SⅠt and BUT increased significantly after operation(PPP=0.845, 0.894). CONCLUSION: Pterygium excision combined with conjunctival flap transplantation or limbal stem cell transplantation for the treatment of type 2 diabetic patients with normal blood glucose and tear film function has the similar effect, and is better than simple pterygium excision.

AIM: To investigate the effect of long-term wearing rigid gas permeable(RGP)contact lenses on the stability of tear film, and to observe its safety. METHODS: Totally 60 myopia patients(120 eyes)wearing RGP in our hospital from October 2014 to January 2016 and 30 low myopia patients(60 eyes)without a history of wearing RGP were selected. There were 26 patients(52 eyes)wearing RGP at daytime were included into daytime wearing group; 34 patients(68 eyes)only wearing RGP at night were set as the night wearing group. And patients without wearing RGP were set as control group. Schirmer Ⅰ test(SⅠt), tear film fern experiments, and break-up time(BUT)of tear film were performed before wearing RGP, wearing for 1mo, wearing for 6mo, wearing for 1a, wearing for 2a, respectively. RESULTS: After wearing RGP, the BUT and SⅠt of daytime wearing group and night wearing group significantly decreased, and were significantly lower than those of the control group at the time points, the difference was statistically significant(PPP>0.05). The number of the eyes ≥ Ⅲ in daytime wearing group and night wearing group was significantly higher than that of the control group after wearing for 1 and 2a, the difference was statistically significant(PP>0.05). CONCLUSION: Wearing RGP can result in reducing tear secretion and decreasing the stability of tear film.

AIM: To evaluate the influence of pseudoexfoliation syndrome(PEX)on conjunctival cells and tear functions.METHODS: This study included 86 eyes of 60 patients with PEX and 89 eyes from 55 normal age-matched individuals. Tear film break-up time(TBUT), Schirmer's tests were performed and impression cytology(IC)specimens were obtained from upper and interpalpebral inferonasal bulbar conjunctiva for all 175 eyes of 115 cases. IC specimens were graded according to Nelson's method. The correlations between results of TBUT, Schirmer's test and the findings of impression cytology specimens were evaluated.RESULTS: Patients with PEX had lower Schirmer's tests and TBUT and also revealed significant conjunctival cell alterations when compared with normal subjects. The median cytology scores were Grade 3 and Grade 0 in PEX patients and normal subject, respectively. Mixed involvement with more than one grade type change was observed in 45 specimens in cases with PEX and only in 3 specimens in the control cases. Besides, epithelial and goblet cell discordance was found in 45 specimens in the group with PEX which was not observed in the control group.CONCLUSION: Destruction of conjunctival cytology combined with decreasing in tear tests demonstrates the presence of ocular surface disease in PEX.

AIM:To explore the changes of tear film detected by Keratograph in the patients after laser in situ keratomileusis(LASIK)with corneal flap created by femtosecond laser. METHODS: Totally 75 myopic patients(150 eyes)were enrolled who underwent femtosecond laser LASIK from July 2014 to June 2015, including patientsRESULTS: Before surgeries, the dry eye symptoms score of three groups had no significant difference(P>0.05). After surgeries, there were significant difference at each follow-up time among the three groups on symptoms score(PPCONCLUSION: LASIK can affect the dry eye symptoms and the stability of tear film, which decreased by postoperative time. And the index recovered to preoperative levels earlier in younger patients.

AIM: To evaluate changes in tear function and corneal staining in patients who underwent laser in situ keratomileusis(LASIK)using two different femtosecond lasers.METHODS:Forty eyes underwent FS200 and 40 eyes underwent VisuMax. The tear film break-up time(TBUT), Schirmer I test(SⅠt)and fluorescein staining were assessed preoperatively at 1wk; 1 and 3mo postoperatively. The analysis of variance(ANOVA)for repeat measurements or Kruskal—Wallis ranks test were used. For the differences between FS200 and VisuMax-operated eyes, a independent-samples t test or Wilcoxon matched-samples rank sum test were used.RESULTS: There were no statistical differences in any clinical outcome measure between the two kinds of lasers(P<0.05), although there was a trend towards slightly reductions for TBUT in FS200-operated eyes. TBUT of the two groups eyes showed the same reductions(F=100.37, PF=112.25, PF=42.15, PF=37.27, PZ=4.88, PZ=4.28, PCONCLUSION: This study shows that changes in TBUT,Schirmer I test and corneal staining are statistically similar in LASIK using FS200 and VisuMax femtosecond lasers for flap creation. However, the VisuMax-operated eyes of TBUT after LASIK have faster recovery than in FS200 eyes.

AIM: To evaluate the effect of polyethylene glycol eye drops on tear film break-up time and symptoms for dry eyes after cataract surgery.METHODS: Eighty patients with dry eyes secondary to cataract surgery who were treated in our hospital from January to August 2013 were randomly divided into group A and group B. Group A was treated with sodium hyaluronate eye drops for one week, and Group B was treated with polyethylene glycol eye drops for one week. The break-up time of tear film was measured and the subjective symptoms were graded before and after the treatment.RESULTS: The tear film break-up time of group A was respectively 3.87±1.12s and 4.21±1.06s before and after the treatment, with no significant difference(P>0.05); it was respectively 3.98±1.04s and 8.98±1.30s with significant difference for group B(PPPPCONCLUSION: Polyethylene glycol eye drops can extend tear film break-up time and improve symptoms of dry eyes. It is an effective drug in treatment of dry eyes after cataract surgery.

AIM: To investigate the clinical characteristics and influencing factors of chronic renal failure(CRF)patients with dry eye, and to provide clinical reference. METHODS: Sixty-one cases(122 eyes)of patients with CRF(CRF group)and 61 cases(122 eyes)of healthy persons(control group)were carried out on Schirmer Ⅰ test(SⅠt), break-up time of tear film(BUT), corneal fluorescein staining(FL), test results of two groups were compared and related factors of dry eye in CRF patients were analyzed. RESULTS: The results of SⅠt and BUT in CRF group were lower than that in the control group(Pχ2=45.39, Pχ2=57.1, Pχ2= 24.34, PCONCLUSION: CRF patients with a decrease in tear film stability and tear secretion are susceptible population to dry eye, clinically should be paid attention to the treatment.

AIM: To investigate the effects of hypobaric hypoxia in plateau on tear indexes and related anatomical structures in rabbits.METHODS: A total of 18 healthy New Zealand rabbits were selected and randomly divided into plateau group and control group, with 9 rabbits(18 eyes)in each group. The plateau group was housed in the Simulated Climate Cabin for Special Environment of Northwest of China, simulating hypobaric hypoxia at an altitude of 6 000 m. The control group was housed in a clean animal room with atmospheric pressure and oxygen. Changes in the tear meniscus height and non-invasive tear break-up time were detected by using RHCT-1 corneal topographer dry eye comprehensive analysis system, changes in tear secretion was measured by Schirmer Ⅰ test, before intervention and on the 3, 7 d, 2 and 4 wk. Meanwhile, the changes in tear composition before and after intervention in the plateau environment were analyzed using Raman Spectroscopy. The histopathological changes of the lower lid conjunctiva, cornea, lacrimal gland, and Hardarian gland were observed by hematoxylin-eosin(HE)staining after 4 wk of intervention, and the expression of mucin 5AC(MUC5AC)in conjunctiva was detected by immunohistochemistry.RESULTS: Compared with the control group, Schirmer Ⅰ test, tear meniscus height, first and average non-invasive tear break-up time in the plateau group decreased significantly since 3 d, and the difference was significant with the extension of observation time(P

AIM: To investigate the preoperative ocular symptoms and the characteristics of asymptomatic ocular surface abnormalities in hospitalized patients with primary pterygium.METHODS: Cross-sectional study. Hospitalized patients diagnosed with primary pterygium and scheduled to receive pterygium excision surgery at the Xiamen Eye Center of Xiamen University from August 2022 to October 2022 were enrolled. Ocular surface disease index questionnaire(OSDI), six examinations including non-invasive tear film break-up time, Schirmer I test, tear meniscus height, lid margin abnormality, meibomian gland dropout and tear film lipid layer thickness, and anterior segment optical coherence tomography(AS-OCT)were performed and statistically analyzed.RESULTS: A total of 178 cases(178 eyes), with a mean age of 54.39±10.75 years old, were recruited, including 75 males(42.1%)and 103 females(57.9%). The average values of ocular surface parameters in these patients included OSDI: 11.47±9.69, tear film break-up time: 7.10±3.86 s; tear meniscus height: 0.16±0.07 mm, Schirmer I test values: 14.39±7.29 mm/5 min, and pterygium thickness: 504.74±175.87 μm. Totally 161 eyes(90.4%)presented with abnormal lid margin, 44 eyes(24.7%)presented with meibomian gland dropout score ≥4, 52 eyes(29.2%)presented with low lipid layer thickness. In the 6 objective examinations, abnormalities in at least 4 of these tests were found in 85.4% of eyes. Pterygium morphology was classified into four grades: 10 eyes(5.6%)of grade Ⅰ, 93 eyes(52.2%)of grade Ⅱ, 60 eyes(33.7%)of grade Ⅲ, and 15 eyes(8.4%)of grade Ⅳ. In patients with a higher grade of pterygium, the tear film break-up time was lower, and the proportion of abnormal lid margin was also significantly higher(P

AIM: To analyze the effects of aromatase inhibitors(AIs)on the ocular surface microenvironment of the users.METHODS: A cross-sectional observational study was conducted. The study included postmenopausal women who received AIs treatment at galactophore department of our hospital from November 2022 to May 2023. Participants were divided into two groups based on the mechanism of AIs: the steroidal group and the non-steroidal group. The control group consisted of age-matched women who underwent occupational health examinations. All participants completed the ocular surface disease index(OSDI)questionnaire and underwent detailed ophthalmic examinations, including best-corrected visual acuity, intraocular pressure, axial length, corneal curvature, radius of curvature of curved lacrimal river surface, tear osmolarity, tear film break-up time, corneal fluorescein staining score, Schirmer Ⅰ test, and meibomian gland infrared score.RESULTS: There were no statistically significant differences in age, best-corrected visual acuity, intraocular pressure, axial length, and corneal curvature between control group and steroidal and non-steroidal group(P>0.05). The duration of drug treatment between the steroidal group and the non-steroidal group also showed no statistically significant difference(P>0.05). However, statistically significant differences were observed between the control group and the steroidal and non-steroidal group in OSDI scores, radius of curvature of curved lacrimal river surface, tear osmolarity, tear film break-up time, corneal fluorescein staining score, Schirmer Ⅰ test, and meibomian gland infrared score(P0.05).CONCLUSION: Postmenopausal patients receiving AIs treatment experienced significant changes in the ocular microenvironment, with both decreased tear secretion and excessive tear evaporation contributing to the occurrence of dry eye. Notably, patients receiving non-steroidal AIs treatment showed a more significant reduction in main lacrimal gland secretion.

AIM:To investigate the effect of 3% diquafosol sodium eye drops combined with intense pulsed light on the treatment of meibomian gland dysfunction and the change of meibomian glands.METHODS: Prospective study. A total of 141 patients(282 eyes)who were diagnosed with meibomian gland dysfunction from January 2021 to May 2022 in our hospital were selected and they were randomly divided into the control group(73 cases, 146 eyes)and the observation group(68 cases, 136 eyes)according to random number table. The control group was given 0.3% sodium hyaluronate eye drops combined with intense pulsed light, and the observation group was treated with 3% diquafosol sodium eye drops combined with intense pulsed light. The subjective symptom score, physical sign score, non-invasive tear break-up time, tear meniscus height, lipid layer thickness, and meibomian gland density before and after the treatment were compared between the two groups at 2wk after the end of treatment.RESULTS: There were no differences in the subjective symptom score, physical sign score, non-invasive tear break-up time, tear meniscus height, lipid layer thickness, and meibomian gland density between the two groups of patients before treatment(P>0.05). After 2wk of treatment, the symptom scores and physical sign scores of patients in the two groups continued to decrease, non-invasive tear break-up time and lipid layer thickness continued to increase, and the meibomian gland density also increased. The tear meniscus height in the observation group increased, while the control group showed no significant changes. The observation group had better clinical indicators than the control group(P

AIM: To investigate the efficacy and safety of frequency of intense pulsed light(IPL)in the treatment of meibomian gland dysfunction.METHODS: In this retrospective study, a total of 108 patients(216 eyes)with meibomian gland dysfunction admitted to our hospital from January 2021 to June 2022 were included. They were divided into two groups, with 54 cases(108 eyes)IPL group(energy density 13.0J/cm2, pulse width 6ms, delay time 50ms), and 54 cases(108 eyes)in advanced optimal pulsed technology(AOPT)group(energy density 10.0-16.0J/cm2, pulse width 7-4-4 ms in unequal-division mode). The clinical effects of the two groups were observed and compared, including ocular surface symptoms, corneal fluorescein staining score(FL), tear film lipid layer thickness(LLT), ocular surface disease index(OSDI)score, mean non-invasive tear film break-up time(NIBUTav)and first non-invasive tear film break-up time(NIBUTf), tear meniscus height, score of meibomian gland secretion and its secretion traits, and the incidence of adverse effects was also calculated.RESULTS: The effective rate of the AOPT group(106 eyes, 98.1%)was higher than that of the IPL group(90 eyes, 83.3%, P

AIM: To evaluate the clinical efficacy of P2Y2 agonist diquafosol sodium(DQS)eye drops in the treatment of diabetic dry eye.METHODS: A total of 80 patients(160 eyes)with diabetic dry eye who admitted to our hospital from January 2022 to March 2022 were selected. They were randomly divided into study group and control group. A total of 40 patients(80 eyes)in the study group were treated with 3% DQS eye drops and 40 patients(80 eyes)in the control group were treated with 0.3% sodium hyaluronate eye drops. The ocular surface disease index(OSDI)score, non-invasive tear meniscus height(NITMH), first non-invasive tear film break-up time(NIBUTf), average non-invasive tear film break-up time(NIBUTav), tarsal gland loss score, lipid layer thickness grade and bulbar redness analysis(including conjunctival grade and ciliary grade), were examined before treatment and at 1wk, 1 and 3mo after treatment, respectively. Furthermore, corneal fluorescence staining and conjunctival lissamine green staining were analyzed based on the ocular surface staining score(OSS), and the conjunctival impression cytology and confocal microscopy were evaluated before and 3mo after treatment, respectively.RESULTS: There were no differences in OSDI score, tarsal gland loss score, conjunctival grade score and ciliary grade score between the two groups before and after treatment(P>0.05). OSS scores in the study group were lower than those in the control group, while NITMH, NIBUTf and NIBUTav were higher than those in the control group at 1 and 3mo after treatment(P0.05).CONCLUSION: 3% DQS eye drops were effective in treating diabetic dry eye without serious complications.

AIM: To investigate the image features of dynamic changes of tear film break-up after corneal fluorescein staining(FL)combined with tear film lipid layer(TFLL)dynamic changes in patients with dry eye and its value of diagnosis in dry eye. METHODS: A prospective study. A total of 66 patients(132 eyes)with dry eye admitted to our hospital during September 2019 to December 2020 were divided area break-up group(17 cases, 28 eyes), circle break-up group(20 cases, 27 eyes), line break-up group(25 cases, 28 eyes), spot break-up group(21 cases, 24 eyes)and random break-up group(20 cases, 25 eyes)according to the different fluorescein tear film break-up patterns(BUPs). The image features of tear film break-up dynamic changes and the image features of TFLL dynamic changes were compared in each group, and the differences in the first non-invasive tear film break-up time(NIBUTf), average non-invasive tear film break-up time(NIBUTav), tear meniscus height(TMH)and fluorescein staining scores were compare,RESULTS:A statistically significant differences were observed in NIBUTf among the groups of patients(P

AIM: To investigate the effect of intense pulsed light(IPL)combined with Yuyin Runmu formula fumigation and meibomian gland massage on the treatment of patients with meibomian gland dysfunction(MGD)-related dry eye.METHODS: Prospectively selected 198 cases(396 eyes)of MGD-related dry eye patients admitted to our hospital from November 2021 to November 2023, and they were randomly divided into 99 cases(198 eyes)in control group treated with fumigation of Yuyin Runmu formula and meibomian gland massage, and 99 cases(198 eyes)in observation group treated with combined IPL on the basis of the control group. The efficacy of the two groups was compared, as well as the changes in the levels of ocular indexes [tear film break-up time(BUT), Schirmer I test(SⅠt)], visual quality [objective scattering index(OSI), Strehl ratio(SR), and modulation transfer function(MTF)], lipid layer thickness(LLT)of the tear film, and changes in tear fluid levels of inflammatory factors [tumour necrosis factor-α(TNF-α)and transforming growth factor-beta 1(TGF-β1)].RESULTS: All the patients completely received the treatment and follow-up. The levels of BUT, SⅠt, SR, MTF, and LLT increased and the levels of OSI, TNF-α, and TGF-β1 decreased in the two groups at 2 mo after treatment(all P

AIM:To observe the changes of Th17 related cytokines in tears of conjunctivochalasis(CCH)patients with liver-kidney yin deficiency treated with traditional Chinese medicine Qi Jing Mingmu decoction combined with artificial tears.METHODS:A total of 56 CCH patients(56 eyes)with liver-kidney yin deficiency of grade Ⅱ to Ⅲ were collected and randomly divided into treatment group(treated with Qi Jing Mingmu decoction combined with artificial tears)of 26 cases(26 eyes)and control group(treated with pure artificial tears)of 30 cases(30 eyes). The treatment course was 1 mo, and international ocular surface disease index(OSDI), tear film break-up time(BUT), tear meniscus height(TMH)and conjunctival congestion index of the patients were observed before and after treatment. The patients' tears were collected before and after treatment, and Th17 related cytokines in tears were detected using flow cytometry immunofluorescence luminescence method.RESULTS:After treatment, the OSDI, BUT and conjunctival congestion index of CCH patients in the treatment group and control group were significantly improved(all P0.05). After treatment, the levels of IL-6 and TNF-α in the tears of both groups of CCH patients decreased compared to those before treatment(both P

AIM: To study the effect of intense pulsed light(IPL)combined with meibomian gland massage on postoperative dry eye in cataract patients with meibomian gland dysfunction(MGD).METHODS: A retrospective analysis was conducted on the general data of 100 patients(100 eyes)with cataract and postoperative dry eye syndrome accompanied by MGD treated in our hospital from June 2022 to June 2023. They were divided into a control group(n=50)and an observation group(n=50)according to different treatment methods, and received meibomian gland massage and meibomian gland massage combined with IPL treatment, respectively. The tear film break-up time(BUT), Schirmer I test(S I t), meibomian gland secretion score, ocular surface disease index(OSDI), ocular staining score(OSS), and treatment efficacy of the two groups of patients were compared before treatment and at 1 wk and 1 and 3 mo after treatment.RESULTS: The BUT and SIt in both groups after treatment were higher than those before treatment, while the secretion of meibomian gland, OSS score, and OSDI score were lower than those before treatment(all P

AIM:To observe the clinical effect of ciliary sulcus suture fixation of intraocular lens(IOL)with the scleral tunnel technique.METHODS: The clinical data of 36 patients(38 eyes)who underwent ciliary sulcus suture fixation of IOL with the scleral tunnel technique in our hospital from May 2021 to September 2023 were retrospectively analyzed. The patients were followed up for a total of 3-26 mo. The postoperative IOL position, visual acuity, refraction, intraocular pressure and complications were observed, and the results of tear film break-up time(BUT), corneal fluorescein staining(FL)and Schirmer Ⅰ test(SⅠt )were evaluated.RESULTS: The uncorrected visual acuity and best corrected visual acuity of all eyes were improved at 3 mo after surgery(all P

AIM: To investigate the effect of intense pulsed light(IPL)combined with meibomian gland massage in patients with meibomian gland dysfunction(MGD)related dry eye.METHODS: Retrospectively selected 300 cases(300 right eyes)that diagnosed as MGD-related dry eye and treated in our hospital from October 2021 to October 2023, and they were divided into two groups according to the treatment modalities: 150 cases(150 eyes)in the control group were treated with meibomian gland massage, and 150 cases(150 eyes)in the observation group were treated with combined IPL. The efficacy of the two groups was compared, as well as the changes in tear film stability indexes [tear film break-up time(BUT), Schirmer I test(SIT)], ocular surface disease index(OSDI)scores, tear film lipid layer thickness(LLT), mean objective scattering index(OSI), and the levels of inflammatory factors in the tear fluid [interleukin-10(IL-10)and IL-6].RESULTS: There was a difference in efficacy between the two groups of patients after treatment(88% vs 74%, P=0.002). At 8 wk after treatment, OSDI score, OSI, and tear IL-6 levels decreased, while BUT, SIt, LLT, and tear IL-10 levels increased in the two groups, and the observation group was better than the control group(all P

AIM: To investigate the efficacy of lacrimal duct laser dacryoplasty combined with intubation and postoperative meibomian gland treatment in patients with chronic dacryocystitis complicated by meibomian gland dysfunction.METHODS: Data were collected from 128 patients with chronic dacryocystitis complicated by meibomian gland dysfunction treated at Xi'an No.1 Hospital from March 2021 to December 2022. All patients underwent lacrimal duct laser dacryoplasty combined with intubation. Postoperatively, those patients were randomly divided into two groups: group A(64 cases, without meibomian gland treatment)and group B(64 cases, with meibomian gland treatment). The lacrimal intubation was removed at 3 mo after surgery to evaluate the patency rate of lacrimal irrigation. Additionally, changes in the ocular surface disease index(OSDI)score, non-invasive tear film break-up time, tear meniscus height, conjunctival hyperemia analysis, meibomian gland analysis, tear lipid layer thickness, tear ferning test, and conjunctival impression cytology were compared between the two groups.RESULTS: The lacrimal irrigation patency rates in the group A and group B were 78.1% and 81.2% respectively, with no statistically significant difference between the two groups(P>0.05); compared with the group A, group B showed a significant extension in non-invasive tear breakup time at 3 mo after surgery, and the OSDI score, conjunctival hyperemia analysis, tear ferning test and conjunctival impression cytology grading were all significantly decreased(all P0.05).CONCLUSION: Comprehensive treatment for patients with chronic dacryocystitis combined with meibomian gland dysfunction have improved patients' comfort, tear film stability, and reduces local inflammatory response. It is important to simultaneously address ocular surface microenvironment abnormalities during surgical treatment to achieve satisfactory efficacy.

AIM:To evaluate the effect of Yangxue Runmu formula combined with sodium hyaluronate on dry eye after cataract surgery by ocular surface analyzer.METHODS: Totally 80 patients with dry eye after cataract surgery in our hospital from June 2019 to December 2020 were selected and divided into control group and observation group by random number table method, 40 cases in each group. The control group was treated with sodium hyaluronate eye drops, and the observation group was treated with Yangxue Runmu formula combined with sodium hyaluronate eye drops. The index levels of ocular surface analyzer and fluorescein staining(FL)score were compared between the two groups.RESULTS: After treatment, the wet length of tear film, first non-invasive tear break-up time(NIBUTf), average non-invasive tear break-up time(NIBUTav)and tear meniscus height(LTMH)in the two groups were markedly higher than those before treatment(all P

AIM: To compare the efficacy of small-incision lenticule extraction(SMILE)and femtosecond assisted laser in situ keratomileusis(FS-LASIK)in the treatment of patients with myopia and astigmatism.METHODS: Retrospective analysis. A total of 100 cases(200 eyes)of patients with myopia and astigmatism treated in our hospital from December 2021 to December 2022 were collected. Among them, 50 cases(100 eyes)were divided into SMILE group and 50 cases(100 eyes)were divided into FS-LASIK group according to the treatment plans. The visual acuity and astigmatism, corneal morphology parameters, subjective visual quality scores, ocular surface indicators, postoperative complications, and quality of life were compared between the two groups before and after surgery.RESULTS: There was no significant difference in uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), astigmatism, corneal asphericity Q value, corneal surface regularity index(SRI), corneal thickness, and corneal curvature between the two groups before surgery and at 1 d, 1, and 6 mo after surgery(all P>0.05). At 1 and 6 mo after surgery, the subjective visual quality score, the quality of life score, Schirmer I test(SⅠt)and tear film break-up time(BUT)in the SMILE group were better than that in the FS-LASIK group(all P

AIM:To build prediction model of dry eye with data mining techniques.METHODS: From March 2020 to January 2021, 218 patients(436 eyes)with dry eye were selected as dry eye group, and 212 patients(424 eyes)without dry eye were selected as control group. Schirmer Ⅰ test(SⅠt), fluorescein staining tear film break-up time(FBUT), non-contact tear film break-up time(NI-BUT), tear meniscus height(TMH), corneal fluorescein staining(FL)and meibomian gland function score(MG-SCORE)were performed in both groups. Totally 200 eyes of 100 samples were randomly selected from the dry eye group and the control group to form a test set of 400 eyes of 200 samples. The remaining 118 samples(236 eyes)in the dry eye group and 112 samples(224 eyes)in the control group were used as the training set. Correlation feature searching(CFS)feature selection algorithm was used to search the factors related to the detection of dry eye. C4.5, Random Forest, Rondom Tree, Naïve Bayes, KNN, SVM, Decision Stump and Bagging methods were used to construct the prediction model, respectively.RESULTS:By using CFS feature selection algorithm, an optimal sub-feature set including SⅠt, NI-BUT, TMH and FL were obtained. Based on the four features, eight machine learning algorithms were employed to build the prediction model, respectively. The results show that the prediction accuracies were all higher than 75%. Among the eight prediction models, the prediction accuracy model by using Random Forest is the highest, which achieved 91.8% and 88.3%, respectively. And the total prediction accuracy reached 90.1%. In addition, through the analysis of single factor modeling, we found that FL and NI-BUT had the highest prediction accuracy, which exceeded 74%.CONCLUSION: Random Forest could be considered as a stable and well generalization algorithm to build prediction model for dry eye with well generalization. NI-BUT and FL have a strong correlation with dry eye, which can be considered as the standard for clinical examination of dry eye.

AIM: To examine the effects of blepharoplasty on the ocular surface and refractive state.METHODS:Retrospective study. A total of 70 patients(108 eyes)who underwent blepharoplasty in our ophthalmology department from January 2022 to June 2023 were selected, among which 40 cases(48 eyes)diagnosed with ptosis received levator muscle shortness, and 30(60 eyes)diagnosed with eyelid laxity/single eyelids received blepharoplasty. The ocular surface disease index(OSDI), tear meniscus height(TMH), Schirmer Ⅰ test(SⅠt), tear film break-up time(BUT), corneal fluorescein staining(FL), cylindrical(Cyl), surface regularity index(SRI), surface asymmetry index(SAI), keratometry(Km), and cylindrical(C).RESULTS:There were statistical differences in preoperative and postoperative OSDI, BUT, SⅠt, and FL of patients who received levator resection(all P0.05). At 1 mo postoperatively, OSDI, BUT, SⅠt, and FL were significantly different compared to preoperative values(all P0.05). No significant differences were found in Cyl, SRI, SAI, Km, or C in either group before and after surgery(all P>0.05).CONCLUSION:The levator resection has an early impact on the ocular surface of patients with ptosis, and corneal protection measures should be taken early. There was no significant impact on patients undergoing blepharoplasty; there was no significant effect on the refractive status of all patients.

AIM:To observe the clinical efficacy of 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops in the treatment of dry eyes after pterygium surgery with lacrimal insufficiency.METHODS: A total of 64 cases(64 eyes)of pterygium patients with lacrimal insufficiency were treated with pterygium resection combined with limbal stem cell transplantation, and they were given routine anti-inflammatory and infection prevention treatment postoperatively. In terms of postoperative dry eye treatment, all patients were randomly divided into two groups. The observation group was treated with 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops, and the control group was treated with sodium hyaluronate eye drops. The break-up time of tear film(BUT), fluorescein(FL), Schirmer's Ⅰ test(SⅠt), ocular surface disease index(OSDI)score, central corneal thickness(CCT)changes, adverse reactions and complications were observed and compared between the two groups at different times postoperatively.RESULTS: Both groups of pterygium patients were accompanied with mild to moderate dry eyes with insufficient tear secretion preoperatively. At 2 wk after operation, both groups showed shorter BUT and higher FL score compared with those preoperatively(P0.05). At 4 wk after operation, BUT in the observation group was prolonged, OSDI score was decreased(both P0.05).CONCLUSION: In the treatment of dry eye after pterygium surgery with lacrimal insufficiency, 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops can effectively reduce the postoperative dry eye symptoms, and its clinical effect is better than that of sodium hyaluronate eye drops alone.

AIM:To establish a model of meibomian gland dysfunction in rats induced by eyeliner tattoo and investigate its potential mechanisms.METHODS:A total of 40 SD rats were selected, with 30 randomly chosen to have eyeliner tattoo applied their right eyes and designated as the eyeliner group. The remaining 10 rats were not given any treatment and served as the normal group. The corneal morphology of both groups was observed using a slit lamp at 1, 2, and 4 wk after establishment, and the tear film break-up time(BUT), Schirmer I test(SIt), corneal fluorescein staining score, and corneal irregularity score were calculated. The corneal Placido rings were examined using an ocular surface analyzer, and the corneal tissue structures of both groups were observed under a confocal microscope. After 4 wk and completion of clinical indicator recording, the eyeballs and upper and lower eyelid tissues were taken for pathological examination. The meibomian gland structures were observed through HE staining, the conjunctival goblet cells were observed using PAS staining, and the lipid droplets were observed with ORO staining.RESULTS:The slit lamp examination results showed that the eyeliner group rats exhibited in situ black pigmentation in the eyelids, with no eyelid deformation or scarring. The corneal epithelium was rough, with positive fluorescein staining, presenting as spotty staining that worsened over time. Compared with the normal group, the BUT was significantly shortened, tear secretion volume was significantly decreased, and the corneal fluorescein staining score and corneal irregularity score were significantly increased at 1, 2, and 4 wk after modeling in the eyeliner group(all P

AIM: To analyze changes in the ocular surface parameters of keratoconus after long-term wearing of rigid gas permeable contact lens(RGPCL).METHODS:Prospective case study. A total of 113 keratoconus patients(213 eyes)fitted with RGPCL in the optometry center of Gansu Provincial Hospital from January 2018 to January 2022 were included. They were divided into three groups according to the severity of keratoconus, including 42 cases(80 eyes)in mild keratoconus group, 54 cases(102 eyes)in moderate keratoconus group and 17 cases(31 eyes)in severe keratoconus group. Furthermore, the non-invasive tear break-up time(NIBUT), non-invasive tear meniscus height(NITMH), red eye index, lipid layer thickness, fluorescent corneal staining, meibomian gland secretory function, Schirmer I test and ocular surface disease index(OSDI)scores were observed by Keratograph analyzer before and after wearing RGPCL for 1 wk, 1, 3, 6, 12 mo, respectively.RESULTS: There were no statistical significance in the age, NIBUT, NITMH, lipid layer thickness, meibomian gland secretory function and Schirmer I test among the three groups(P>0.05), while there were statistical significance in the sphere, cylinder, spherical equivalent, best corrected visual acuity(BCVA), non-contact intraocular pressure(IOPNCT), anterior, posterior corneal surface Kmax, corneal surface thickness at the thinnest point, eye redness index, fluorescent corneal staining, and OSDI(P

AIM:To compare the corneal refractive power and visual quality after three kinds of corneal refractive surgery: laser subepithelial keratomileusis(LASEK), transepithelial photorefractive keratectomy(TransPRK)and femtosecond laser assisted in situ keratomileusis(FS-LASIK).METHODS: Retrospective study. A total of 232 patients(464 eyes)who underwent elective corneal refractive surgery in our hospital from January 2021 to December 2022 were selected as the study subjects. They were divided into the LASEK group of 70 cases(140 eyes), TransPRK group of 76 cases(152 eyes), and FS-LASIK group of 86 cases(172 eyes)according to the different surgical choices made by the patients. Uncorrected visual acuity(UCVA), visual quality, biomechanical stability, tear film break-up time(BUT), Schirmer Ⅰ test(SⅠt)and quality of life were compared among the three groups at 1 and 3 mo postoperatively.RESULTS: The UCVA of the three groups significantly improved at 1 and 3 mo postoperatively, the total high-order aberrations, spherical aberration, horizontal coma, and vertical coma of the entire cornea were significantly increased, while the biomechanical stability in all three groups were significantly reduced(all P0.05).CONCLUSION:In the treatment of ametropia, LASEK, TransPRK and FS-LASIK all have certain effects, and have similar results in improving UCVA and increasing visual quality. However, TransPRK and LASEK have more stable biomechanical properties than FS-LASIK, and have better efficacy in improving patients' quality of life.

AIM: To evaluate the therapeutic effect of emedastine difumarate eye drops combined with fluorometholone eye drops on allergic conjunctivitis.METHODS: Retrospective study. A total of 115 patients(230 eyes)with allergic conjunctivitis who received treatment from June 2020 to August 2022 were selected, and they were divided into the observation group(56 cases, 112 eyes)and the control group(59 cases, 118 eyes)according to whether to use fluorometholone eye drops combined with the conventional use of emedastine difumarate eye drops. The clinical symptoms and signs, tear film break-up time(BUT), corneal fluorescein staining score and complications of the two groups were observed before treatment and at 4 wk after treatment.RESULTS: After treatment, the scores of eye symptoms and signs in the two groups were decreased, and the observation group was lower than the control group(P0.05).CONCLUSION: With high therapeutic safety and effectiveness, the combination of emedastine difumarate eye drops and fluorometholone eye drops in the treatment of allergic conjunctivitis can significantly reduce the patient's symptom and sign scores, prolong BUT, promote a decrease in corneal fluorescein staining scores, improve efficacy, and do not increase the risk of complications.

AIM: To observe and analyze the effectiveness and safety of wearing corneal refractive therapy(CRT)and vision shaping treatment(VST)designed orthokeratology in controlling myopic progression in adolescents with low E-value corneal morphology.METHODS: This prospective study involved 100 cases(100 eyes)of adolescent myopia patients fitted with orthokeratology at our optometry clinic from January 2020 to December 2021. The data of right eye were collected for research, and they were divided into low myopia group(-1.00 to -3.00 D)and moderate myopia group(-3.25 to -5.00 D)according to spherical equivalent, with 50 cases in each group. Each group of patients was further randomly divided into the CRT group and the VST group, with 25 cases in each group. Uncorrected visual acuity, refractive error, axial length(AL), tear film break-up time(BUT), corneal endothelial cell density, corneal staining grading, lens decentration, and refractive power at 15°-30° were measured before and after wearing orthokeratology, with a follow-up duration of 1.5 a.RESULTS: The uncorrected visual acuity of CRT and VST subgroups in the low myopia group showed no statistical significance at any time point after wearing orthokeratology. However, in the moderate myopia group, CRT subgroup showed better uncorrected visual acuity than the VST subgroup, with significant differences at 1 d and 1 wk(t=-9.474, -12.067, both P

AIM: To investigate the effect of unilateral endoscopic dacryocystorhinostomy on binocular surface indexes.METHODS: Totally 45 cases with monocular primary acquired nasolacrimal duct obstruction(PANDO)who successfully underwent endoscopic dacryocystorhinostomy between 1 December 2022 and 31 July 2023 were enrolled in the study. Ocular surface indexes, including the non-invasive tear break-up time(NIBUT), Sjögren's International Collaborative Clinical Alliance ocular staining score(SICCA OSS), Korb score of lid wiper and Schirmer test scores, were collected preoperatively and at 0.5, 1 and 3 mo post-operatively. Subsequently, various indexes were compared at each time point between the operated and healthy eyes pre- and post-operatively.RESULTS: There was no significant differences between operated and healthy eyes in NIBUT, SICCA OSS, Korb scores and Schirmer test(all P>0.05). Furthermore, the Korb scores of operated eye at 0.5, 1 and 3 mo post-operatively were significantly lower than the preoperative value(P=0.034, 0.044, 0.027). Moreover, the Schirmer test score of the operated eye at 1 mo post-operatively was significantly lower than the preoperative value(P=0.0461).CONCLUSION:After a successful endoscopic dacryocystorhinostomy, tear drainage is restored, however, ocular surface damage worsens. These changes typically peak at 1 mo post-operatively before gradually improving.

AIM: To observe the effectiveness, safety and ethnic differences of 0.005% atropine eye drops combined with orthokeratology in controlling adolescents' low myopia between different ethnic groups.METHODS:A total of 246 Han and Hani patients(246 eyes)with low myopia treated in our hospital from January to October 2021 were selected, with 120 patients(120 eyes)treated with 0.005% atropine eye drops combined with orthokeratology in experimental group, and 126 patients(126 eyes)treated with orthokeratology in control group. The uncorrected visual acuity, spherical equivalent(SE), axial length(AL), intraocular pressure, tear film break-up time(BUT), corneal curvature and corneal thickness of the two groups before and 1 a after wearing lenses were observed, and the incidence of complications were recorded.RESULTS:At 1 a after wearing lenses, the changes of AL and SE in the experimental group(0.16±0.35 mm, -0.39±0.47 D)were lower than those in the control group(0.22±0.89 mm, -0.48±0.54 D), uncorrected visual acuity(LogMAR)was better than the control group(0.11±0.25 vs 0.14±0.19; P0.05). In the Han and Hani groups, there were no differences in the changes of uncorrected visual acuity, AL and SE(P>0.05). During the follow-up period, no significant local or systemic adverse reactions occurred in the two groups, and there was no difference in the incidence of ocular complications between the two groups of patients(P>0.05).CONCLUSION: The 0.005% atropine eye drops combined with orthokeratology can effectively delay the progression of low myopia in adolescents without significant adverse reactions and ethnic differences.