Table of Content

25 January 2013, Volume 22 Issue 1

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Anterior segment optical coherence tomography for the evaluation of primary angle closure glaucoma

LIU Xing, LI Mei

2013, 22(1):  1-5. 

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 Anterior segment optical coherence tomography (AS-OCT)  is an imaging instrument developped after ultrasound biomicroscopy (UBM). Moreover, AS-OCT is a non-invasive and non-contact instrument with a higher resolution than UBM. AS-OCT offers anterior segment images of the cornea, anterior chamber, anterior chamber angle, iris and lens. In this article, the value of AS-OCT is evaluated in the diagnosis and treatment of primary angle closure glaucoma (PACG), including the application of AS-OCT in observing the differences between PACG and normal controls, the changes in anterior segment configuration after peripheral iridectomy/trabeculectomy/ cataract surgery in PACG, and the morphology of filtering blebs after trabeculectomy. The present study showed that AS-OCT  would play an important role in the diagnosis, treatment choice and pathogenesis study of PACG. (Ophthalmol CHN, 2013, 22: 1-5) 

Clear lens extraction for primary angle closure glaucoma

MAN Xiao-fei, THAM Clement CY, LIANG Yuan-bo.

2013, 22(1):  5-9. 

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 The crystalline lens plays a pivotal role in the etiology of primary angle-closure glaucoma (PACG).  Recent anatomical, clinical and epidemiological studies revealed that lens extraction alone deepened the anterior chamber, widened the drainage angle and lowered the intraocular pressure in PACG. In recent years, clinicians have tried clear lens extraction in treating PACG, especially for those patients who were reluctant to accept the risk of complications of trabeculectomy. However, choice of surgical indication, the higher cost of phacoemulsification, the technical challenges of phacoemulsification, the loss of accommodation after surgery and the fear of over-treatment made the role of clear lens extraction as a treatment for PACG controversial. (Ophthalmol CHN, 2013, 22: 6-9) 

Pigment dispersion syndrome and pigmentary glaucoma

QING Guo-ping, WANG Ning-li

2013, 22(1):  10-13. 

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Pigment dispersion syndrome and pigmentary glaucoma are diseases that may manifest differently among different racial groups. Their prevalences differ dramatically between Caucasian and pigmented races. The present review focuses mainly on pathogenesis, clinical manifestations, clinical pathology, differential diagnosis, management and prognosis of pigment dispersion syndrome and pigmentary glaucoma. (Ophthalmol CHN, 2013, 22: 10-13)    

Comparison between the efficacy of laser peripheral iridotomy with and without laser peripheral iridoplasty in synechial angle closure: a 5-year follow-up study

GUO Chun-yu1, LI Si-zhen2, CAI Xiao-gu1, GUO Li-xia3, FAN Su-jie3, CUI Hong-yu3, ZHANG Zhi-hong3, ZHANG Qing1, SUN Lan-ping3, SUN Xia1, LIANG Yuan-bo4, WANG Ning-li1.

2013, 22(1):  14-18. 

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Objective To compare the long-term efficacy of laser peripheral iridotomy (LPI) with and without laser peripheral iridoplasty in primary angle closure (PAC) or primary angle closure glaucoma (PACG) patients with peripheral anterior synechiae (PAS). Design Randomized controlled clinical trial. Participants Consecutively included PAC or PACG patients with PAS in Handan Third Hospital, Handan, Hebei. Methods Patients randomly received LPI or LPI combined with laser peripheral iridoplasty which was conducted within 3 days after LPI. Patients underwent static and dynamic gonioscopy preoperatively and 3 days, 1 year and 5 years after laser procedures. PAS was defined as abnormal adhesions of the iris to the angle that are at least half a clock hour in width. Only one eye in each patient was included in the study. Main Outcome Measures PAS extent. Results Among the initially included 159 patients, recruiting rate 1 year and 5 years after the laser therapy was 79.25% (126/159) and 57.86% (92/159), respectively. PAS extent of the combined group and LPI group preoperatively and 3 days, 1 year and 5 years after the laser procedure were 5.00 (3.00-9.25) and 4.5 (1.50-8.00) clock hours (Z=-1.3, P=0.19) , 3.00 (0.50-5.00) and 2.00 (1.50-8.00) clock hours (Z=-3.08, P=0.001), 2.50 (0.75-6.00) and 2.00 (0.00-5.00) clock hours (Z=-0.72, P=0.47), 3.5 (1.0-8.0) and 3.0 (0.00-5.25) clock hours (Z=-1.54, P=0.12). PAS extent was significantly less in the combined group 3 days after the treatment, while no difference was observed between groups 1 or 5 years after the treatment. Five years after the initial treatment, best corrected visual acuity (BCVA) in the combined group was significantly lower than that in LPI group 0.29 (0.14-0.82) Vs 0.16 (0.02-0.36) (Z=-2.70, P=0.007). No difference was observed between groups in intraocular pressure (IOP) control rate, visual field mean deviation (MD), cup-to-disk ratio. Compared with the baseline data, PAS extent, IOP, BCVA, MD decreased significantly in the combined group, and cup-to-disk ratio remained unchanged; PAS extent, IOP, MD deceased significantly in the LPI group, but cup-to-disk ratio and BCVA unchanged. Conclusion PAS extent progression was seen in combined group within 5 years after treatment. Five years after the treatment of PAC or PACG patients with PAS, no significant difference was observed in PAS extent between combined laser group and LPI group. Laser peripheral iridoplasty combined with LPI should not be recommended to release PAS in PACG patients in consideration of the long-term efficacy. (Ophthalmol CHN, 2013, 22: 14-18)   

Anterior segment optical coherence tomography changes after iridectomy or trabeculectomy in primary chronic angle-closure glaucoma 

LI Mei, WANG Zhong-hao, MAO Zhen, LIU Xing.

2013, 22(1):  19-24. 

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Objective To evaluate the changes in anterior segment configuration after surgical peripheral iridectomy (SPI) or primary trabeculectomy (PT) in chronic primary angle closure glaucoma (CPACG). Design Prospective comparative cases series. Participants Fifty-three eyes of 45 patients with CPACG from Zhongshan Ophthalmic Center, Sun Yat-Sen University were successively collected. Methods PI was performed in patients with the clock hours of peripheral anterior synechiae (PAS) ≤6, while PT was performed to patients with the clock hours of PAS>6. Anterior segment optical coherence tomography (AS-OCT) examination was performed before and 3 month after PI/PT. Main Outcome Measures Central anterior chamber depth (ACD), angle opening distance (AOD), trabecular iris area (TISA), angle recess area (ARA), anterior chamber width (ACW), anterior chamber area(ACA), anterior chamber volume (ACV) and crystalline lens rise (CLR). Results After surgery, ARA (0.078±0.036 vs. 0.065±0.024 mm2 ), ACA (15.409±2.892 vs. 13.945±2.633 mm2 ) and ACV (91.021±22.387 vs. 83.445±21.791 mm3 ) increased significantly (t=-8.015～-2.727, P<0.001～0.042), while no changes were found in ACD, TISA, AOD, ACW and CLR (t=-1.374～0.561, P=0.102～0.774) in SPI group. However in PT group, all AS-OCT parameters shown no changes(t=-1.700～-0.002, P=0.388～0.998) after operation. Conclusions After SPI, AS-OCT parameters such as ARA, ACA and ACV increase, while PT can not change the anterior segment configuration in CPACG eyes. (Ophthalmol CHN, 2013, 22: 25-29)

he efficacy of releasable suture in trabeculectomy among patients with primary angle-closure glaucoma: a 18-month randomized controlled study 

LIANG Yuan-bo1, 2, MENG Hai-lin3, FAN Su-jie4, WANG Xing6, XIE Li-lian7, FENG Mei-yan1, 5, WANG Rui3, CHANG Xin-qi3, HE Yan-qing3, MA Jin-xia3, LUO Ying3, CUI Hong-yu4, JIA Chao6, ZHANG Yi-cao3, LIU

2013, 22(1):  25-29. 

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Objective To compare the post-operative intraocular pressure (IOP) and incidence of complications following trabeculectomy with releasable suture to standard trabeculectomy in Chinese patients with primary angle-closure glaucoma (PACG). Design Multi-centered randomized controlled clinical trial. Participants 175 PACG patients (175 eyes) with 6 clock-hours or more of peripheral anterior synechia from 4 eye centers. Methods Patients were randomly allocated to trabeculectomy with releasable suture group (2 permanent and 2 releasable sutures to the scleral flap) (n=88) and single trabeculectomy group (only 2 interrupted permanent sutures) (n=87). IOP, visual acuity, and complications were recorded during follow-up at post-operative day 1, day 7, 2 weeks, 4 weeks, 3 months, 6 months, 12 months, and 18 months. Absolute success was defined as the post-operative IOP was less than 21 mmHg without any anti-glaucoma medications. Conditional success was defined as the post-operative IOP could be lower than 21mmg with anti-glaucoma medications at the last visit. Main Outcome Measures IOP, success rate, complications. Results 150 subjects (85.7%) attended the 18 months follow up visit, with 74 in releasable suture group and 76 in single trabeculectomy group. There were no significant differences of the IOP between the two group at the visit of week 4, month 3, month 6, month 12 and month 18 (all P>0.05). The absolute success rate in releasable suture group was 91.9% (68/74), and 84.2% (64/76) in standard trabeculectomy group (P=0.148). The condition success rate was 91.9% (68/74) in releasable suture group while 88.2% (67/76) in single trabeculectomty group (P=0.448). Presenting visual acuity decreased by 2 lines or more accounted for 20.3% in releasable suture group and 14.5% in single trabeculectomy group (P=0.348). A transient hypotony occured in 19.7% of the subjects in single trabeculectomy group, higher than that in releasable suture group (9.6%) but not reaching statistically significance (P>0.05). While other complications, shallow chamber, choroidal detachment, hypotonic maculopathy were comparable in both groups. Conclusions Combination of releasable suture with trabeculectomy has a slight higher success rate in PACG than single trabeculectomy in an observation of 18 months while the complications incidences are comparable with both procedures. It shows that releasable suture may be indicated for those cases with high risk of shallow chamber after trabeculectomy. (Ophthalmol CHN, 2013, 22: 19-24)

Changes of anterior chamber morphology after water drinking test in healthy subjects

2013, 22(1):  30-33. 

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 Objective To observe the changes of the intraocular pressure (IOP) and anterior chamber morphology after water drinking test (WDT) in healthy volunteers. Design Prospective case series. Participants 23 healthy volunteers (23 eyes) aged 20-31 years-old. Methods All subjects underwent IOP(with Goldmann applanation tonometry) and anterior chamber morphology(with Pentacam three-dimensional anterior segment analyzer) measurement before and 15, 30, 45, 60 minutes after water drinking test(WDT)(drinking 1000 ml water within 5 minutes). Main Outcome Measures IOP, anterior chamber volume (AV), anterior chamber angle (ACA), central anterior chamber depth (CACD). Results The IOP before and at 15, 30, 45, 60 min after WDT was 12.3±1.5, 15.8±1.3, 17.6±1.5, 14.7±1.4, 13.3±1.6 mmHg, respectively (P=0.000). The peak IOP was at 30 min after WDT (P=0.000). The AV before and at 15, 30, 45, 60 min after WDT was 198.6±30.6, 190.6±28.2, 189.1±26.6, 195.0±27.9, 197.4 ±29.6 μl, respectively (P=0.000)). The minimum of AV was at 30 min after WDT (P=0.000). The ACA before and at 15, 30, 45, 60 min after WDT was 37.8±3.7°, 36.7±3.3°, 37.1±3.7°, 37.5±3.8°, respectively (P=0.000). The minimum of ACA was at 30 min after WDT (P=0.000). The CACD before and at 15, 30,45, 60 min after WDT was 2.66±0.37, 2.67±0.36, 2.64±0.33, 2.68±0.33, 2.706±0.39 mm, respectively (P=0.370). There was a significant correlation between the changes of IOP and AV(P=0.041). Conclusion The water drinking test can significantly decrease the anterior chamber volume and anterior chamber angle. The expansion of choroid caused by blood low permeability may play an important role in this process. (Ophthalmol CHN, 2013, 22: 30-33)

The establishment of a rat partial optic nerve transection model and assessment of its reproducibility

2013, 22(1):  34-37. 

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Objective To design an instrument to complish helpfully partial optic nerve transection model and evaluate the repeatability of the transection model in rat. Design Experimental study. Participants 15 healthy Wistar rats. Methods The rat partial optic nerve transection model was established with the new designed rat optic instrument. After 13 models established successfully, fluorogold(FG) was used to label retinal ganglion cells of each model. The images of retinal ganglion cells in the retina were captured with fluorescence microscope. The retina blood circulation of the model was recorded with Ret-cam. Main Outcome Measures The morphology and distribution of retinal ganglion cells in the retina of each model was observed and measured. Results The measurement of unlabled FG retina area showed that the boundaries of unlabled FG retina were clear. The maximum coefficient of variation was 1.85%, average coefficient of variation 0.67%±0.44 %. Additionally, in the process of partial optic nerve transection, there was no retinal ischemia phenomenon. Conclusion This new rat optic instrument can be easily used to establish the partial optic nerve transection model with a satisfactory reproducibility. (Ophthalmol CHN, 2013, 22: 34-37) 

Surgical treatment of 34 cases of malignant glaucoma: a retrospective case series

2013, 22(1):  38-41. 

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 Objective To investigate the efficacy of different surgical treatments for malignant glaucoma. Design Retrospective case series. Participants 31 malignant glaucoma patients (34 eyes) admitted in Wuhan Aier Eye Hospital in 2009-2011. Methods Disease characteristics, treatment methods and results of all patients were reviewed. The mean follow-up time was 21.7 ± 6.5 months. Main Outcome Measures  corrected visual acuity, intraocular pressure, anterior chamber depth and complications. Results Over the 34 eyes,  malignant glaucoma occurred after trabeculectomy in 28 eyes (82.4%), during trabeculectomy in 4 eyes (11.8%), after combined cataract extraction with trabeculectomy in 2 eyes (5.9%). Four eyes (11.8%) were well controlled with atropine. Nd-YAG laser capsulotomy and disruption of anterior hyaloid face were performed in 2 eyes (5.9%), vitrectomy combined with anterior chamber reconstruction in 12 eyes (35.3%), cataract extraction and intraocular lens implantation in 8 eyes (23.5%), and combined cataract extraction with vitrectomy in 8 eyes (23.5%). Recurrent malignant glaucoma 1 month after treatments was observed in 3 eyes. Intraocular pressure before and after treatment was 42.5±11.8, 15.3±4.2 mm Hg, respectively (P=0.000). Anterior chamber depth before and after treatment was 0.3±0.4, 2.4±0.4 mm, respectively (P=0.000). Eighteen eyes with counting finger or more of corrected visual acuity before treatment became 0.1-0.3 in 7 eyes, and 0.3 or more in 6 eyes after treatment. Vitreous hemorrhage, corneal endothelial decompensation and topical atropine allergy appeared respectivel each in 1 eye. Conclusions Malignant glaucoma usually needs lens-vitreous surgery. Timely surgical treatments based on specific circumstances of patients may archive better vision effect. (Ophthalmol CHN, 2013, 22: 38-41)

Clinical characteristics of glaucoma associated with retinitis pigmentosa

YOU Yu-xia, LI Jian-jun, XU Liang, MA Ke.

2013, 22(1):  42-44. 

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 Objective To study the clinical characteristics of glaucoma associated with retinitis pigmentosa (RP). Design Retrospective case series. Participants 37 patients (62 eyes) of RP associated with glaucoma and 109 patients (215 eyes) of RP without glaucoma were evaluated in Beijing Tongren Hospital from Aug. 2008 to Sep. 2012. Methods The clinical electronic records and medical records of the participants were reviewed. Main Outcome Measures The classification of glaucoma, corrected visual acuity and intraocular pressure(IOP). Results In 37 patients（62 eyes）of glaucoma associated with RP, there were 9 cases (18 eyes, 29.0%) with acute angle closure glaucoma, 21 cases (34 eyes, 54.8%) with chronic angle closure glaucoma and 7 cases (10 eyes, 16.1%) with primary open angle glaucoma. The percentage of visual acuity below 0.05 of RP with glaucoma and without glaucoma was 58.9% and 33.6%, respectively (P=0.000). The mean IOP of glaucoma with RP was 23.1±14.0 mm Hg. Conclusion In this retrospective case series, RP was associated with primary angle closure glaucoma much frenquently than with primary open angle glaucoma, and their visual impairment was more serious. (Ophthalmol CHN, 2013, 22: 42-44)

Detection of herpes simplex virus DNA in corneal tissue with different corneal diseases

2013, 22(1):  45-48. 

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 Objective To investigate herpes simplex virus type-1(HSV-1) DNA expression in the corneal tissue lesions in different corneal diseases and its significance. Design Experimental study. Participants The corneal tissue after penetrating keratoplasty were collected between May 2010 to Dec. 2010 in Beijing Tongren Hospital, including 20 corneal specimens from viral keratitis and the other 20 specimens from keratoconus, bollous keratopathy, corneal destrophy and other noninfecive disease. Methods The HSV-1 DNA in the corneal specimens was detected by polymerase chain reaction(PCR). Main Outcome Measures Detection rate of HSV-1 DNA. Results 12 cases (60%) were detected HSV-1 DNA positive from 20 cases of herpetic simplex keratitis, while 6 cases (30%) were detected HSV-1 DNA positive from non-infectious corneal tissues (P=0.057). Conclusion HSV-1 DNA was expressed in corneal tissues of stationary phase HSK and normal subjects as well. Corneal latent virus may be the cause of herpes simplex keratitis. (Ophthalmol CHN, 2013, 22: 45-48)

Effects of carteolol application on the refractive outcomes after laser in situ keratomileusis

2013, 22(1):  49-52. 

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Objective To assess the effects on refraction and intraocular pressure by early carteolol eyedrops application on eyes after laser in situ keratomileusis (LASIK). Design Prospective comparative case series. Participants 32 eyes of 32 patients with myopia undergone LASIK at Beijing Tongren Hospital were included. Methods 2% carteolol hydrochloride eye drops (15 eyes) were administered topically twice a day from the second week after LASIK to the end of the first month for patients with low to moderate myopia and through the end of the 1.5 months for patients with high myopia. 2% carteolol hydrochloride in control group (17 eyes) wasn't administered. The changes of spherical equivalent correction (SE) , the posterior corneal surface different value (Diff) and intraocular pressure (IOP) were observed preoperatively and 1 month, 3 months and 6 months after LASIK, respectively. Main Outcome Measures SE, the posterior corneal surface different value and IOP. Results The average SE of treatment group was (-0.150±0.742) D, (-0.170±0.595) D and (-0.525±0.618) D respectively at 1 month, 3 months and 6 months postoperatively, while it was (-0.258±0.581) D, (-0.290±0.657) D, and (-0.459±0.591) D respectively in the control group (all P>0.05). The posterior corneal surface Diff of treatment group was (7.47±2.326) μm, (6.60±3.158) μm, and (5.86±2.610) μm respectively at 1 month,3 months and 6 months postoperatively, while it was (6.59±3.355) μm, (7.35±3.622) μm, and (7.33±2.992) μm respectively in the control group (all P>0.05). The IOP of treatment group was (7.80±0.941)mm Hg,(8.07±1.534) mm Hg and (8.70±1.337) mm Hg respectively at 1 month, 3 months and 6 months postoperatively, while it was (9.35±2.827) mm Hg, (9.59±2.717) mm Hg and (8.73±1.580) mm Hg, respectively in the control group. The difference between the two groups was only significant (P=0.045) at 1 month. Conclusions Carteolol is effective to reduce IOP in early stage after LASIK and helpful to enhance the stability of the corneal biomechanical and the refraction. (Ophthalmol CHN, 2013, 22: 49-52)

Calculation methods of foreign scleral belt length for posterior scleral reinforcement surgery

Sucijanti1, DUAN An-li1, SHE Hai-cheng1, QI Yue1, LEI Kun2, LI Si-zhen1, WANG Ning-li1.

2013, 22(1):  53-57. 

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Objective  To evaluate the accuracy of three methods to caculate the length of foreign scleral materials (LSM) for posterior scleral reinforcement surgery. Design Evaluation of technique.  Participants 62 patients (65 eyes) with high myopia in Beijing Tongren Hospital from 2008-2010.  Methods All patients received revised Synder-Thompson posterior scleral reinforcement (PSR). The refraction, corneal curvature, anterior chamber depth and axial length (AL) were examined preoperatively. Three methods were used for calculation of the length of foreign scleral material. Method 1 and method 2 were based on geometric calculation of anterior chamber depth or corneal curvature. Method 3 was based on regression equation according to the actual length of foreign scleral material used during the surgery. Main Outcomes Measures Length of sclera material, corneal curvature, anterior chamber depth and axial length.  Results The actual length of sclera material in all 65 eyes was 47.8±4.0 mm. Mean length of foreign scleral materials in method 1, 2, 3 was 58.7±8.0 mm, 58.6±8.0 mm, 47.8±3.3 mm, respectively.  The regression equation of method 3: LSM=9.576+1.271×AL. All three methods were highly correlated with actual length of scleral material (r=0.822, 0.829, 0.835). Conclusions The regression equation method based on eyeball axial length can predict the length of scleral material more accurately than the other two methods based on geometric calculation of eyeballs. (Ophthalmol CHN, 2013, 22: 53-57)

Long-term intravitreal silicone oil tamponade after vitreo-retinal surgery in severe ocular injury: 18 case reports

WANG Cong, PANG Xiu-qin, ZHANG Yong-peng.

2013, 22(1):  58-61. 

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Objective To study the clinical necessity and feasibility of long-term intravitreal silicone oil tamponade after vitreo-retinal surgery in severe ocular injury. Design Retrospective case series. Participants 18 patients (18 eyes) treated in Ocular Trauma Department of Beijing Tongren Eye Center from 2005 to 2010 were followed up, whose time of intravitreal silicone oil tamponade was at least 2 years. Method A standard 20G pars plana vitrectomy was performed in all cases with ordinary silicone oil tamponade at the end of surgery. Visual acuity, intraocular pressure, slit lamp microscopy and ocular fundus were examined every 3 months during follow-up. Main Outcome Measures  Ocular manifestation of silicone oil eyes. Results All 18 patients were male with a mean age of 37.83±14.92 years. The causes of vitreo-retinal surgery were ocular trauma (17 cases) and acute retinal necrosis (1 case). The retaining time of intravitreal silicone oil was 2-14 years with mean retaining time of 6.41±3.97 years. During the follow-up silicone oil was removed in 3 patients for severe silicone emulsification. Silicone oil was reserved in 15 patients in which 8 patients (53.33%) for saving eyeball, 3 patients (20%) for single eye, 2 patients (13.33%) for repeated operation and 2 patients (13.33%) for hypotony. The corrected visual acuity of patients after operation was from no light perception to 0.2. The retina of 15 patients (83.33%) was reattached and the retina of 3 patients (16.67%) was still not attached. The main complication of long-term intravitreal silicone oil retaining was secondary glaucoma (33.33%), corneal degeneration (27.78%) and silicone oil emulsification (22.22%). Conclusion In cases of complex ocular trauma, single eye, multiple vitreo-retinal surgeries, hypotony, and retinal redettachment or retina in place but with marked proliferation, silicone oil can be retained in the eyes for long time to preserve the aspect of eyeball and the visual acuity of patients when the complication of silicone oil are treated promptly and correctly. (Ophthalmol CHN, 2013, 22: 58-61)

Comparison of efficacy and complications in treatment of macular edema secondary to branch retinal vein occlusion by intravitreal bevacizumab with intravitreal triamcinolone acetonide for first priority: a meta-analysis

MA Nan1, LI Dan2, GAO Fu-lin1, ZHAO Hong-wei1, BAI Feng-hua1, HU Lian-na1

2013, 22(1):  62-66. 

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Objective To evaluate the efficacy and safety in treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO) by intravitreal bevacizumab(IVB) with intravitreal triamcinolone acetonide(IVT) for first priority. Design Meta-analysis. Participants Published literature in Medline (1966-2012), EMbase (1966-2011), Cochrane library (2011) and CBM (1979-2011) which comparing IVB with IVT in treatment of ME secondary to BRVO for first priority. Methods According to evaluation guidelines of Cochrane collaboration, clinical controlled trials (CCTs) were searched using Medline, EMbase, the Cochrane Library and CBM. Methodology evaluation of publications was performed by experienced researchers according to the Jadad Score. RevMan 5.1 offered by Cochrane was used to do the meta-analysis. Main Outcome Measures Central macular thickness (CMT), best corrected visual acuity (BCVA) and adverse events. Results Only 8 publications (376 eyes) were included into this meta-analysis. No significant difference in either CMT (P=0.22) or BCVA (P=0.06) was observed between IVB and IVT group. Adverse event rates (mainly elevation of intraocular pressure and progression of cataracts) in IVT group was 20 times (95%CI, 8.3-50 times) more than IVB group (P=0.000).  Conclusion This meta-analysis shows that IVT group had an equal reduced CMT and BCVA compared with IVB group in treatment of ME secondary to BRVO, while the adverse event rates were much frequent than in the IVB group. More high quality prospective studies are still required for further analysis. (Ophthalmol CHN, 2013, 22: 62-66)

Some consideration on the skill training for residents of ophthalmology

DONG Zhe, CHEN Feng-hua, PENG Xiao-yan.

2013, 22(1):  67-69. 

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The problems in the skill training for residents in ophthalmology at the present stage are that the medical environment is poor, the positivity of the teacher still needs to be encouraged, and the automaticity of the residents should be enhanced. To successfully finish the clinical skill training for residents of ophthalmology, they should make more effort in grasping the theory basic skill, and make the best use of assistant teaching system for diagnosis and treatment of eye diseases. The positive attitude will be helpful for the step by step skill training. (Ophthalmol CHN, 2013, 22: 67-69)