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AIM: To compare binocular visual quality of bilateral implantation of a toric bifocal intraocular lens(IOL)or a nontoric bifocal IOL and mix-and-match implantation of a toric bifocal IOL and a nontoric bifocal IOL.METHODS: A cross-sectional study. One hundred and eight eyes of 54 cases were included from January 2020 to January 2021. All participants were divided into three groups according to preexist corneal astigmatism and IOL type. In group A, cornea astigmatism was less than 1.0D in both eyes of 21 cases and bifocal IOLs were implanted. In group B, cornea astigmatism was more than 1.0D in both eyes of 15 cases and toric bifocal IOLs were implanted. In group C, 18 cases of one eye with cornea astigmatism less than 1.0D were implanted with bifocal IOLs, and the other eye with astigmatism more than 1.0D were implanted with toric bifocal IOLs. Preoperative intraocular pressure(IOP), monocular uncorrected distance visual acuity(UDVA), equivalent spherical, postoperative binocular corrected distance visual acuity(CDVA), UDVA, uncorrected intermediate visual acuity(UIVA), uncorrected near visual acuity(UNVA), residual astigmatism, defocus curve and contrast sensitivity were compared among the three groups. Postoperative questionnaire was conducted to evaluate the visual quality of the three groups.RESULTS: There were no significant differences in preoperative UDVA and IOP among the three groups(P>0.05). The postoperative residual astigmatism in group A was significantly higher than the other two groups(P=0.012, P0.5).CONCLUSION: Mix-and-match implantation of a toric bifocal IOL and nontoric bifocal IOL can effectively improve postoperative binocular visual quality in cataract patients. Correcting astigmatism helps improve the visual contrast sensitivity, however, when astigmatism is completely corrected, it may result in a loss of intermediate vision in patients after surgery.

AIM: To compare the postoperative quality of life between patients who underwent binocular and unilateral Symfony continuous-vision intraocular lens(IOL)implantation. METHODS: A population-based cross-sectional study was performed. The visual function-related quality of life(QoL)was evaluated with the National Eye Institute Visual Functioning Questionnaire-25(NEI VFQ-25)which was developed by the National Eye Institute. Thirty patients(60 eyes)who underwent phacoemulsification combined with IOL implantation from March 2017 to March 2018 were divided into two groups according to the type of implanted IOL. For bilateral group(36 eyes in 18 cases), patients accepted TECNIS Symfony(ZXR00, AMO)in both eyes. For unilateral group(24 eyes in 12 cases), patients accepted TECNIS Symfony(ZXR00, AMO)in one eye and an aspherical monofocal IOL(PCB00,AMO)in the other eye. Follow-up was performed 3-6mo after surgery. Postoperative binocular uncorrected distant, intermediate and near visual acuity(bUCDVA, bUCIVA and bUCNVA)were compared and the quality of life was evaluated for every patient. RESULTS:There were no statistical differences in bUCDVA, bUCIVA and bUCNVA between two groups(P>0.05). There was no significant difference in composite scores of the NEI VFQ-25 questionnaire between bilateral group and unilateral group(88.95±4.01 vs 88.99±4.22, t=-0.025, P=0.980). A comparison of the 12 scales acquired from the questionnaire showed that there were no statistical differences in visual function-related quality of life in the two groups(P>0.05). CONCLUSION:Compared with bilateral implantation of ZXR00, the patients with the implantation of ZXR00 in one eye and PCB00 in the other eye share the excellent binocular uncorrected distant, intermediate and near visual acuity and postoperative quality of life. For patients who have undergone monofocal IOL implantation in one eye or whose one eye is not suitable for multifocal IOLs, unilateral implantation of Symfony continuous-vision IOL is feasible to meet patients' need for spectacle independency.

AIM: To observe the effects of different duration of diabetes on dry eye and ocular surface before cataract surgery. METHODS: The patients with diabetes and cataract were included from March to August in 2018. According to the duration of diabetes, the patients were divided into three groups(15a). Age, sex, break-up time(BUT), Schirmer Ⅰ test, corneal fluorescein cornea staining(FL), palpebral margin staining score, meibomian glands secretion function score, and ocular surface disease score(OSDI)were compared between the three groups. RESULTS: There were no significant differences in age and sex between the three groups. There were no significant difference in BUT and Schirmer Ⅰ test and OSDI score among the three groups, but the more duration of diabetes was, the more OSDI score was. FL and the secretion of tarsal gland were significantly different between groups(χ2=8.372, 9.346, P=0.015, 0.009, respectively). There was no significant difference in the shape of palpebral margin(χ2= 0.353, P=0.838). CONCLUSION: The more duration of diabetes is, more serious the ocular surface and dry eye diseases may be. For the patient with long-term diabetic, more attention should be paid to the eye surface health and perioperative recovery.

AIM: To evaluate the clinical effect of vitamin A palmitate eye gel on early ocular surface reconstruction after thermal or chemical injuries. METHODS: Seventy-eight cases with thermal or chemical injuries to eyes were selected and divided into two groups by randomized, double-blind, positive drug parallel controlled method: group A(40 cases were treated with vitamin A palmitate eye gel)and group B \〖38 cases were treated with basic fibroblast growth factor(bFGF)\〗. The bFGF and vitamin A palmitate eye gel were used 4 times a day. The treatment course was 14d. Restoration of epithelial defect, Schirmer's test values, tear break-up time(BUT), and subjective assessment of symptoms and signs were observed on D1, D3, D5, D7, D10 and D14.RESULTS: In group A, 31 cases were cured, 5 cases were effective, with the cure rate of 76% and efficiency 90%. In group B, 32 cases were cured, 3 cases were effective, with the cure rate of 84% and efficiency 92%. There were no significant differences between the two groups(P>0.05). However, there were significant differences on the results of Schirmer's test and BUT(PPCONCLUSION: Vitamin A palmitate eye gel is valuable and safe on early ocular surface reconstruction of the eyes suffered from thermal or chemical injuries.

AIM: To investigate the changes of electroretinogram in mice with the growth and development of retina. METHODS: The ERG of 50 mice(50 eyes)of KUNMING at the ages of postnatal 14d(P14), P21, P28, P35 and P56 were measured respectively. The implicit times and amplitudes of b wave of Rod-ERG, a and b waves of Max-ERG, a and b waves of Cone-ERG and O1 and O2 waves of OPs at different ages, as well as amplitude of Flick-ERG, were compared. RESULTS: The Max-ERG a-waves(the 95%CI were 15.00～18.60, 12.00～15.00, 13.20～14.40, 13.20～15.00, 13.20～15.00, respectively), OPs O1(the 95%CI were 15.00～19.80, 13.80～18.00, 13.20～14.40, 13.80～15.60, 13.80～15.60, respectively)waves shared the implicit times at the different stages, and the Flick-ERG(the 95%CI were 0.97～3.28, 0.85～2.32, 0.91～3.49, 0.94～2.68, 0.98～3.69μV, respectively)shared the amplitudes also. There was no significant difference among the weeks(P>0.05). The implicit times of the Cone-ERG a-waves(the 95%CI were 25.20～55.20, 27.00～40.20, 27.00～38.40, 25.20～43.80, 23.40～37.80, respectively)between P14 and P28 were distinct with statistical difference(PCI were 70.80～88.20, 56.40～78.60, 60.00～75.60, 60.60～87.00, 62.40～81.60ms, respectively)at P14 were statistically different from those at P21 and at P28. The implicit times and amplitudes of Rod-ERG b-waves(the 95%CI were 87.00～114.00, 53.40～73.80, 52.2～63.6, 55.20～71.40, 57.60～67.80ms, and 64.21～195.07, 133.79～355.71, 130.62～355.96, 190.92～448.97, 239.26～462.40μV, respectively), Max-ERG b-waves(the 95%CI were 67.20～107.40, 32.40～54.60, 31.20～36.60, 31.80～42.00, 34.20～41.40ms, and 160.64～344.48, 281.74～590.09, 284.91～716.80, 358.64～737.55, 406.98～810.55μV, respectively), and OPs O2 waves(the 95%CI were 49.8～69.6, 29.40～42.60, 28.80～33.60, 28.80～37.80, 31.20～37.20ms, and 5.43～24.84, 54.38～147.52, 65.55～201.60, 46.33～164.79, 49.07～148.32μV, respectively)at P14 were different from those at other stages, and the amplitudes of OPs O1(the 95%CI were 11.60～21.36, 6.77～53.71, 32.96～76.42, 34.06～70.37, 35.58～63.35μV, respectively)and Cone-ERG b-waves(the 95%CI were 5.10～15.85, 9.61～24.88, 14.96～40.73, 14.87～28.54, 13.83～51.98μV, respectively)were from those at other stages also, and there were significant differences. The O1 wave of OPs had been present at P14, but the second cluster of OPs of one mouse(1/10)had not been obvious at the same time. CONCLUSION: The experiment confirms that the different waves come from different cells in retina in mice at certain degree. Due to the change of the ERG in the development of mice, so it should be considered that the different development stages will affect the results when measuring the ERG of mice.

AIM:Toevaluate the recurrence andcomplicationsafter bare sclera resection (BSR) combined with mitomycin C (MMC) treatment and/or autograft limbus conjunctiva (ALC) in the surgery for pterygium.METHODS:Meta-analysis was used to evaluate the differences in patient outcomes between BSR of pterygium with or without MMC and/or ALC. All included studies were randomized trials of patients with pterygium who received BSR followed by MMC and/or ALC in the surgery. The recurrence of pterygium and other complications resulting from different treatments were extracted for analysis.RESULTS:Thirteen studies met the inclusion criteria. The recurrence of pterygium with intraoperative (IO) MMC was higher than that with ALC (OR=2.38，95% confidence interval 1.45-3.91, I2=29%). Postoperative MMC resulted in an incidence of recurrence similar to that of ALC (OR=0.66, 95% confidence interval 0.30-1.42, I2=0%), and IO MMC treatment in combination with ALC produced similar patient outcomes to ALC alone (OR=0.41, 95% confidence interval 0.16-1.01, I2=16%). Other complications such as punctate epitheliopathy, scleral thinning and ischemia, irritation and persistent epithelium defect, were more common in patients in the MMC group as compared to those treated with ALC.CONCLUSION:The recurrence of pterygium with BSR followed by ALC is lower than that of BSR followed by MMC, and the incidence of other complications is lower. While ALC is a more effective strategy for treating pterygium, the quality of the ALC transplant should be considered when the patient has a history of glaucoma.

AIM:To investigate the changes in anterior segment parameters by Sirius anterior system after orthokeratology and the possible mechanisms. METHODS: Twenty-eight patients(56 eyes)with myopia in our hospital from August 2014 to October 2014 were included. Spherical equivalent were -3.83±1.19D. Data of central corneal thickness(CCT), anterior chamber depth(ACD), anterior corneal curvature(a-K)and posterior corneal curvature(p-K)were collected and analyzed at before, 1d, 1wk and 3mo after orthokeratology.RESULTS: After orthokeratology, spherical equivalent of all eyes decreased to predicted level. There were no significant differences in CCT and p-K between different times(P>0.05). There were significant differences in a-K between different times except between 1wk and 3mo after orthokeratology(PPPP=0.016), a-Kc-1wk(P=0.047)were correlated with a-Kpre and axial, respectively. And there were correlations between a-Kpre and a-Kc-3mo(P=0.024), between ACDpre and ACDc-1d(P=0.036), between CCTpre and CCTc-3mo(P=0.012), respectively.CONCLUSION: CCT, ACD and p-K has no significant changes after orthokeratology, while there is significant difference in a-K, which is considered one of the most key factor in orthokeratology. Sirius anterior system for examination before orthokeratology and postoperative assessment, non-invasive, reliable and has a good clinical value.

AIM:To observe the effect of posterior chamber phakic intraocular lens implantation for high myopia on the stereopsis. To evaluate the implantation of implantable contact lens from the highest form of visual angle. METHODS:Fourty-six patients(92 eyes)with high myopia were included from January to December 2014. The average age of patients was 26.13±3.37(19～32)years, and 20 males(43%)and 26 females(57%)were observed. Analysis the stereopsis of these patients before and after the implantation of posterior chamber phakic intraocular lens. RESULTS:The mean spherical equivalent of all the eyes was 10.02±2.71D before and -0.02±0.25D after surgeries. There was significant difference on the spherical equivalent(t=14.062, P=0.000).There were 6 patients with the blind of near stereopsis, the near stereopsis of the rest patients were 637.50±462.08arcsec before the surgeries and there were none with the blind of near stereopsis after surgeries. The near stereopsis of all the patients were 126.09±165.78arcsec after surgeries. There were 12 patients with the blind of far stereopsis, the far stereopsis of the rest patients were 400.59±257.00arcsec before the surgeries. After surgeries there were 2 patients with the blind of far stereopsis, the far stereopsis of the rest patients were 152.73±111.65arcsec. There were both significant differences on the near stereopsis(Z=-5.725, P=0.000)and the far stereopsis(Z=-4.976,P=0.000)before and after surgeries.CONCLUSION:Posterior chamber phakic intraocular lens implantation not only correct the ametropic of the high myopia, but also improve the visual acuity and the stereopsis.

AIM: To compare the prediction errors(PE)in cataract surgery with Lenstar and conventional ultrasound. METHODS: The data of age-related cataract patients were retrospectively analyzed from March, 2013 to June, 2013 in our hospital. Preoperative measurements of ocular biological parameters and calculation of intraocular lens(IOL)degree using SRK/T's formula with ultrasound, keratometry and Lenstar were performed. Cataract extraction combined with IOL implantation in capsule was taken in every patient. Retinoscopy was taken postoperatively after 3 months. Comparison of the two inspection methods for measuring axial length, mean corneal curvature and postoperative refractive PE and absolute value of PE(APE). RESULTS: Preoperative axial length was 24.68±1.70mm and 24.42±1.65mm with Lenstar and ultrasound, respectively, and there was significant difference(t=-12.688, Pr=0.992, Pt=-1.241, P=0.217), but was the significant correlation(r=0.963, Pt=-5.494, Pt=6.379, PCONCLUSION: Accurate ocular biological parameters can be achieved with Lenstar, and postoperative PE is more precise with Lenstar compared with conventional ultrasound. Lenstar can be used for precise calculation of IOL degree in cataract operation.