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Objective: To explore the effect of half volume ciliary body photocoagulation on the quality of life and serum endothelin-1 (ET-1) level of glaucoma patients. Methods: 80 patients (80 eyes) with glaucoma treated in our hospital from April 2018 to April 2021 were selected as the research object, and they were divided into the research group (n=40, treated with half volume ciliary body photocoagulation) and the control group according to the difference of operation methods (n=40, trabeculectomy), observe and record the postoperative anterior chamber reaction and corneal edema of the two groups, analyze the changes of preoperative and postoperative intraocular pressure, visual acuity and serum ET-1 level of the two groups, record the operation success rate and postoperative complications of the two groups, and compare the differences between the two groups. Results: (1) There was no difference in anterior chamber reaction and corneal endothelial edema between the study group and the control group at 1 d and 7 d after operation (P>0.05); (2) In the study group, 20 cases were completely successful, 19 cases were relatively successful, and the total success rate was 97.50 %. In the control group, 15 cases were completely successful, 22 cases were relatively successful, and the total success rate was 87.50 %. There was no difference in the operation success rate between the two groups (P>0.05); (3) At 7 d, 1 month and 3 months after operation, the intraocular pressure in the study group was lower than that in the control group (P<0.05); (4) At 1 month after operation, there was no difference in the level of ET-1 between the two groups (P>0.05), but the quality of life in the study group was higher than that in the control group (P<0.05); (5) There was no difference in the incidence of complications between the two groups (P>0.05). Conclusion: Half volume ciliary body photocoagulation has a better therapeutic effect on glaucoma, the surgical success rate of patients is higher than trabeculectomy, the postoperative intraocular pressure of patients is significantly reduced, and the surgical safety is worthy of affirmation. [ABSTRACT FROM AUTHOR]

The study of intraocular aqueous humor (AH) flow is helpful to understand the mechanism of some eye diseases such as glaucoma. A numerical study of AH flow inside human eyes with the computational fluid dynamics (CFD) were carried out to address the following flow processes: AH secreted in the posterior chamber by the ciliary body entering the anterior chamber through the iris?lens gap of 5 µm and 30 µm respectively, and discharging through the trabecular meshwork (TM). Detailed flow fields in different eye orientations were analyzed. Results show that, in general the intraocular pressure distributions are similar in all cases; the pres? sure in the posterior chamber is around 30 Pa higher than that in the anterior chamber with the 5 µm irislens gap, and they are almost equal with the 30 µm iris?lens gap. The pressure drop in the TM is noticeable. The pressure difference between the anterior and posterior chambers drives AH from the posterior chamber to the anterior chamber, while the temperature difference between cornea and iris surfaces causes the natural convection, which is the dominant flow in the anterior chamber. The pressure difference due to natural convection is in the magnitude of millipascal, and the higher?pressure region forms where warmer AH gathers. For the vertical orientation, warmer fluid rises along the iris surface and then turns downwards as it encounters the higher resistance in the upper TM regions. The flow then descends along the corneal surface toward the lower TM. For the upward?facing position, AH entering the pupil rises along the center line of the anterior chamber, and moves down along the cornea surface leading to axisymmetric recirculation zones. For the downward?facing position, the circulation route is opposite to that of the upward?facing position. With no buoyancy, the averaged velocity will be 1 to 2 orders of magnitude smaller than that with buoyancy. [ABSTRACT FROM AUTHOR]

Pupil abnormalities may be physiological, pathological or pharmacological. It can indicate the underlying disease of the visual afferent system or visual efferent system. Examination of the pupils is therefore a part of eye examination. Insufficient knowledge and inconsistent methods in the pupillary examination by some ophthalmologists lead to mistakes or unreliable results, hampering the disease diagnosis and clinical assessment. This article emphasizes the significance of pupillary examination outcomes, advocates for standardized examination methods, and highlights the need to enhance the awareness of pupillary abnormalities, aiming to provide a guide on how to recognize and interpret the clinical implications of pupillary abnormalities, and to offer valuable insights for clinical practice.

Presbyopia is a physiological aging situation that the plasticity and elasticity of the lens and the function of the ciliary muscle become weaker, resulting in a decreased accommodation and inability to focus on near objects. Nowadays, there are many clinical strategies to correct presbyopia, each of which has its own advantages and disadvantages, however, there is no true sense of way to restore accommodation function. This article reviews both worldwide and domestic research on presbyopia, and analyzes and summaries the status quo as well as research progress of presbyopia correction modalities, surgical approaches, and drug therapies, hoping to provide a reference for clinical works.

Objective: To investigate the impact of the iris and ciliary body morphology on the central vault after phakic posterior chamber intraocular lens (pIOL) implantation. Methods: This research was based on the retrospective analysis of 123 patients (123 eyes) who underwent pIOL implantation in the Department of Ophthalmology, Affiliated Hospital of Qingdao University between June 2018 and June 2020. The anterior segment structure was observed with an ultrasound biomicroscope before surgery, and all morphological parameters of the iris and ciliary body were measured manually using the ImageJ software, including iris span (IS), iris convexity (IC), iris-ciliary body contact distance (ICCD) and iris-lens contact distance (ILCD). The ICCD was divided into Q1, Q2 and Q3 groups according to the equidistant distance of 0.36 mm. The lens thickness was measured with the IOLMaster. The horizontal corneal diameter and anterior chamber depth were measured using the Pentacam. The central vaults were measured by optical coherence tomography at 1 week, 3 months and 1 year after surgery. The relationships between vault values and preoperative parameters of the anterior segment were evaluated using the Pearson correlation analysis, Spearman correlation analysis, and multiple linear regression. The repeated measures ANOVA was applied to identify changes of vault values over time. Results: The mean values of the vaults at 1 week, 3 months and 1 year after surgery were (723±265) μm, (642±255) μm and (613±280) μm, respectively. The difference among them was statistically significant ( F =50.143, P <0.001). The vaults continued to decline within 1 year after pIOL implantation, and the total decline was (122±86) μm. The vaults declined by (69±98) μm from postoperative 1 week to 3 months and by (52±54) μm from postoperative 3 months to 1 year. The regression formula showed that the pIOL size and ILCD were positively related with the vault, while the LT, IS and IC were negatively related with the vault at 1 week postoperatively (adjusted R ²=0.404, P <0.001). The pIOL size and ILCD were positively related with the vault, while the IS and IC were negatively related with the vault at 3 months postoperatively (adjusted R ²=0.342, P <0.001). The pIOL size was positively related with the vault, while the IS and IC were negatively related with the vault at 1 year postoperatively (adjusted R ²=0.661, P <0.001). The vault values were higher in group Q3 compared to group Q1 at every timepoint, and the vault value was higher in group Q2 compared to Q1 at 1 year postoperatively. Conclusions: In the early postoperative period, eyes with a larger pIOL, shorter iris span, longer contact distance between the iris and ciliary body, and longer contact distance between the iris and lens were associated with a higher rate of excessive vaults. Meanwhile, eyes with a thicker lens and larger iris reverse convexity were more likely to obtain insufficient vaults. Within one year after surgery, the pIOL size, IS, IC and ICCD continued to impact on the vault. The ICCD, ILCD and IC can reflect the posterior chamber volume and change the haptic location and force, thus affecting the vault.

In recent years, with the improvement of high-intensity focused ultrasound technology, ultrasound cycloplasty has once again gained clinical recognition, becoming one of the non-invasive procedures for glaucoma treatment. Although high-level evidence is still lacking so far, the existing literature has shown that ultrasound cycloplasty can effectively and safely decreases the intraocular pressure in glaucoma by reducing the formation of aqueous humor and increasing the drainage of aqueous humor through the uveoscleral pathway. This article focuses on the efficacy and safety of ultrasound cycloplasty in the treatment of glaucoma, reviews the existing literature, and summarizes the information on the development of equipment, treatment mechanisms, surgical procedures, effectiveness of intraocular pressure reduction, and post-operative complications, with the purpose to provide reference for clinical research and application. (Chin J Ophthalmol, 2020, 56: 66 - 70) .

Objective: To analyze the accuracy of cyclopexy on traumatic cyclodialysis cleft guided by anterior segment optic coherence tomography (AS-OCT). Methods: Fifty-six eyes of 56 consecutive patients[41 males, 15 females, with a mean age of (43.14±13.85) years]who diagnosed with traumatic cyclodialysis cleft confirmed by ultrasound biomicroscopy (UBM) and underwent cyclopexy surgery at Shanxi Eye Hosiptal from July 2013 to February 2016 were included in the study. Patients were measured with the AS-OCT system before cyclopexy. AS-OCT findings of the cyclodialysis clefts were recorded. Localizing and suturing the clefts was guided by AS-OCT imaging. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP) and anterior chamber depth (ACD) were recorded and analyzed. Results: Imaging of preoperative AS-OCT of the 56 eyes showed an annular ciliary body detachment, a cyclodialysis cleft and shallow anterior chamber. The ciliary body detachment detected by AS-OCT showed an echo free zone between the annular ciliary body and the sclera. The cyclodialysis cleft showed a new pathway between the anterior chamber and the suprachoroidal space. AS-OCT imaging showed that the extent of cyclodialysis clefts ranged from 30 degrees to 240 degrees, which had a 0 degree to 20 degrees difference compared with UBM imaging. Localizing and suturing of the cyclodialysis clefts was guided by AS-OCT imaging. The best corrected visual acuity (BCVA) was 0.21±0.17 at baseline and 0.29±0.21 at five days postoperatively. The initial and final BCVA showed a remarkable difference after treatment ( t =-4.98, P <0.01). The mean intra-ocular pressure (IOP) was (8.33±2.29) mmHg before surgery and (15.40±2.34) mmHg at five days postoperatively. There was a significant difference of IOP between preoperative and postoperative period ( t =-16.590, P <0.01). The mean ACD was (1.94±0.45) mm preoperatively and (2.69±0.44) mm at five days postoperatively. There was also a significant difference of ACD between preoperative and postoperative period ( t =-10.276, P <0.01). The postoperative reexamination found that ciliary body detachment or cyclodialysis clefts was not observed in the 56 eyes by AS-OCT. Conclusions: As a non-invasive method, AS-OCT is accurate, correlating well with UBM in the examination of cyclodialysis cleft, and can localize the extent of clefts before cyclopexy.

The mechanisms of primary angle closure are complex and varied. It is well known that the anatomic features of iris and lens may have influence on the presence of angle closure. However, the effect of structural features of ciliary body on primary angle closure remain unclear yet. The anterior situation of ciliary processes was extensively proved to be one of the predisposing factors of angle closure. While it's still controversial how the thickness of ciliary body may affect angle closure. Recent researches found that primary angle closure was associated with thinner ciliary body thickness. This review is aimed at introducing current researches of the effects of ciliary processes position and ciliary body thickness on primary angle closure. (Chin J Ophthalmol, 2018, 54: 716-720) .

Objective: To observe the manifestations of RetCam Ⅱ and color Doppler imaging (CDI) in a retrospective case series of persistent hyperplastic primary vitreous (PHPV)., Methods: Retrospective study. The medical records of 9 eyes/9 patients with PHPV went through RetCamⅡ and CDI from 2009 to 2014., Results: There were 6 young boys and 3 young girl in this study, age from 2 months to 5 years. All the patients were born at full term. 9 eyes had complication (cataract). The manifestations of RetCam Ⅱ: There were pale in optic disc. There were white fibre rod connected with optic disc, then prolonged to vitreous cavity, connected with posterior lens capsule. CDI showed arterial blood stream signal in band-shaped echogenic structure within vitreous cavity, prolonged to lens from the optic disc, or showed funnel-shaped echogenic mass at the posterior surface of lens and anterior of vitreous body, adhered to ciliary body, lens and the optic disc., Conclusions: PHPV is congenital ocular anomalies because of a failure of primary vitreous and the hyaloids vascular system to regress. It manifests as unilateral and boys. We diagnosis PHPV by RetCamⅡ and CDI.

Objective: To analysis the clinical and pathological characteristics of primary iris stromal cyst., Methods: Retrospective cases series study. 14 cases of primary iris stromal cyst which were treated in Tianjin Eye Hospital from Jan.1979 to Dec. 2012 were collected. They were all proved by pathological results. Their clinical and pathological features were analyzed., Results: The age of 14 patients were 5 months to 50 years old, the median is 10 years old.10 patients (71.4%) were attacked from children or adolescence, among which onset age of 8 patients were less than 1-year-old. 4 patients (28.6%) occurs when they were adults. 10 cases were female and 4 cases were males. 10 cases were left eyes, 4 cases were right eyes. All cases were unilateral involvement. In these cases, 11 cases appeared as a single translucent or gray-white cystic mass on the iris surface, which 6 cases located in the inferior aspect of the iris, 2 cases appeared with diffused iris cyst and another 1 case's cyst was found occasionally in the eyeball enucleating specimen. 8 cases had corneal opacity or leucoma, 7 cases had secondary glaucoma, and 3 cases had complicated cataract. Pathological features showed: cysts located on the iris surface or in the stroma layer. The cysts of 9 cases were constructed of non-cuticular stratified squamous epithelium cells. 3 cases' cysts were constructed of lens epithelium cells and lens capsular analogical tissues, and the cysts adhesion to the lenstightly. The other 2 cysts were constructed of single or stratified epithelium cells, similar to ciliary epithelium cells. 2 cases complicated with crystalline lens dysplasia, 3 cases complicated with iris tissue dysplasia, 2 cases complicated with ciliary cysts and 1 case had chamber angle dysplasia., Conclusions: Primary iris stoma cyst is rare and it usually occurs in infant, more often in the children less than 1-year-old. Pathological examination showed that most of the cysts originated from the conjunctivaepithelium, minority cysts originated from crystalline lens epithelium or ciliary epithelium. Some cases complicated with iris, ciliary or crystalline lens malformation.

Objective: To study the feasibility and effectiveness of the extraction of intraocular foreign body (IOFB) at or near the ciliary body by using endoscopic vitrectomy., Methods: It was a retrospective case series study. Clinical materials and data of 15 patients (16 eyes) with IOFB at or near the ciliary body from July 2002 to December 2010 were analyzed retrospectively. Vitrectomy and IOFB extraction under endoscope were conducted in all cases., Results: Thirty six IOFB (18 magnetic and 18 nonmagnetic IOFBs) were extracted successfully. The size of IOFB ranged from smaller than 1 mm×1 mm×1 mm to 9 mm×6 mm×4 mm. Among them, 31 IOFB were extracted from ciliary body or nearby and 5 IOFB were located at other places. The cornea was opaque before the operation in 11 eyes. Postoperative visual acuity was improved in 12 eyes. Vision was improved from finger-counting and below to 0.1-0.3 in 4 eyes. Intraocular pressure was normal in 14 eyes. The retina was reattached in 12 eyes. The cornea was clearer than before in 8 eyes. After the end of the fellow-up, vision was remained in finger-counting and below in only 7 eyes., Conclusions: There was almost no blind spot by using endoscope to observe the ciliary body, periphery retina tear or other pathological changes, the IOFB at or near ciliary body and the whole retina in the vitrectomy. This makes the extraction of IOFB at or near the ciliary body and the conduct of cyclophotocoagulation more accurate and simple.

Objective: To investigate the peak time of refractive error obtained by Cyclopentolate Hydrochloride 1.0% (Cyclopentolate 1.0% for short) and Cyclopentolate 1.0% combined with Proparacaine Hydrochloride 0.5% (Proxymetacaine) and to compare the refractive error obtained by Cyclopentolate 1.0% and Atropine 1.0% in the children with hyperopia., Methods: Seventy one children (141 eyes) with hyperopia (mean age 7.9 ± 2.1) were divided into two groups randomly according to the different cycloplegic methods:group A (Pro+Cyc group) and group B (NS+Cyc group). There were 34 patients (67 eyes) in group A and 37 patients (74 eyes) in group B. One drop of Proparacaine Hydrochloride 0.5% or physiological saline was used respectively in group A and group B, five minutes before three drops of Cyclopentolate 1.0% were given at intervals of ten minutes. Cycloplegic autorefraction and pupil diameter were compared at 30, 40, 50, 60, 70minutes after the first drop of Cyclopentolate 1.0% was given in both A and B groups. Atropine 1.0% was used in both groups one week later for three days with three times per day (group A' and group B'). Cycloplegic autorefraction and pupil diameter were compared between group A and A, ' and group B and B', respectively., Results: The peak time of cycloplegic autorefraction was 50 minutes after the first drop of cyclopentolate 1.0% in group A, while the peak time was 60 minutes in group B. The maximal cycloplegic autorefraction of group A was significantly lower than that in group A' [(+4.44 ± 2.34) D vs. (+4.86 ± 2.26) D, t = 11.16, P < 0.01]. The maximal cycloplegic autorefraction of group B was significantly lower than that in group B' [(+4.50 ± 2.19) D vs. (+5.04 ± 2.10) D, t = 11.44, P < 0.01]. The difference of cycloplegic autorefraction between group A' and the peak refraction of group A was less than the difference between group B' and the peak refraction of group B [(0.42 ± 0.32) D vs. (0.54 ± 0.39) D, t = -1.99, P = 0.048]. The peak time of pupil diameter is 50 minutes after the first drop of cyclopentolate 1.0% in group A, while the peak time of pupil diameter is 60 minutes in group B. The time course of cycloplegic was consistent with mydriasis., Conclusion: In 3 to 14 years old Chinese hyperopia children, using cyclopentolate 1.0% three drops for optometry examination, the maximal cycloplegic autorefraction can be measured from 50 minutes to 70 minutes after the first drop of Cyclopentolate 1.0%. The Cyclopentolate 1.0% can achieve the peak time of refraction 10 minutes early as well as increase the effect of mydriasis when it is used combined with topical anaesthetic. Cyclopentolate 1.0% can be used for the optometry examination in the hyperopia children. However neither Cyclopentolate 1.0% nor Cyclopentolate 1.0% combined with Proparacaine Hydrochloride 0.5% can instead of the use of Atropine 1.0%.

51 cases (17%) of cilio-choroidal detachment were associated with rhegmatogenic retinal detachment in a series of 305 cases of the latter. The prominent feature in these cases was extraordinary hypotony, which was an important factor in pathogenesis of the transudative ciliochoroidal detachment. Among the 46 cases that underwent surgical operation, the rate of successful retinal reattachment was 70% (32/46) after a follow-up of 26 months. The good results were believed to have been due to early diagnosis, high dosage topical and systemic steroid therapy, intensive mydriasis, and performance of the retinal surgery as soon as the severe uveitis became alleviated.