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Table of Content

    25 May 2013, Volume 22 Issue 3
    Application of immunosuppressant on the postoperative management of corneal penetrating keratoplasty
    JIE Ying, PAN Zhi-qiang
    2013, 22(3):  145-146. 
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     Immune rejection after corneal penetrating keratoplasty is still one of the main reasons leading failure of the surgery, especially in high-risk cases, in whom the rejection ratio can be as high as 50%. Glucocorticoid is still the first-line drug for the prevention and treatment of corneal graft rejection, and topical application of which is the main way of administration, but long-term using of which should be paid more attention to avoiding the side effects. Cyclosporin A (CsA) eye drops in combination with glucocorticoid can be better to prevent immune rejection episodes and reduce the side effects of steroid. Topical tacrolimus application also showes a good result.
    Clinical application of non-steroidal anti-inflammatory drugs in ophthalmology
    SUN Xu-guang
    2013, 22(3):  147-148. 
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    Non-steroid anti-inflammatory drugs (NSAID) are a class of medicines which has the effect of anti-inflammation and analgesia with the different chemical structure and similar pharmaceutical mechanism. Recently, clinical application of NSAIDs in ophthalmology gradually becomes popular. The proper application of them depends upon the knowledge on their pharmaceutical mechanism, indication, adverse reactions and constant summaries of the clinical experiences.
    Clinical observation of the characteristics and meibomian gland function in patients with keratitis associated with blepharitis
    DENG Shi-jing, WANG Zhi-qun, ZHANG Yang, SUN Xu-guang
    2013, 22(3):  149-153. 
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    Objective To observe the clinical characteristics of keratitis associated with blepharitis and the relationship among keratitis, blepharitis and meibomian gland dysfunction (MGD). Design Retrospective cases series. Participants Eighty-four patients (168 eyes) with blepharitis who presented in Beijing Tongren Eye Center from January to October 2012. Method The type of blepharitis, secretion function of meibomian gland, clinical characteristics of keratitis associated with blepharitis were evaluated and scored by slit lamp microscope. The relationship between the signs and extent of keratitis and the type of the blepharitis, MGD were analysed. Main Outcome Measures blepharitis type, secretion function of meibomian gland, and clinical characteristics of keratitis. Results The histories of blepharitis in the participants was 10 days to 12 years (average 22.25±40.46 months). Of all the patients, 1 case (2 eyes) was anterior blepharitis, 42 cases (84 eyes) were posterior blepharitis, and 41 cases (82 eyes) were mixed blepharitis. Among them, 65 cases (104 eyes) were diagnosed as associated keratitis as well. Typically clinical findings consisted of punctuate epithelial erosions, marginal infiltrates, corneal ulcer,and cornea scar. Corneal infiltration and ulcer were more common in mixed blephatitis than in posterior blepharitis(P=0.003). The scores of the secretion difficulty and the meibum in the patients with keratitis were higher significanly than in the patients without keratitis (t=-4.606 and 13.418, P=0.033 and 0.000). Conclusion The clinical signs of keratitis associated with blepharitis were various. Patients with mix blepharitis would be more commonly suffered infiltrates and ulcer in the cornea. The keratitis associated blepharitis is related closely to the dysfunction of the meibomain gland. 
    Clinical efficacy of polyethylene glycol eye drops combined with tobramycin dexamethasone ointment for dry eye with meibomian gland dysfunction
    NING Jian-hua, LI Shao-wei, CHEN Tie-hong, ,GUO Zuo-feng , LV Fang-qi
    2013, 22(3):  154-156. 
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    Objective To explore the clinical efficacy of polyethylene glycol eye drops combined with tobramycin dexamethasone ointment in treatment of meibomian gland dysfunction with dry eye. Design Retrospective comparative cases series. Participants Two hundred and thirty-eight cases (476 eyes) of meibomian gland dysfunction with dry eye. Method The participants were randomly divided into two groups: Group 1, 120 patients (240 eyes) using polyethylene glycol eye drops and tobramycin dexamethasone ointment in treatment; group 2, 118 cases (236 eyes) using polyethylene glycol eye drops and fusidic acid eye gel. Tear break-up time (BUT), Schirmer test (Schimer-I), corneal fluorescein staining (FL) and dry eye symptoms were recorded by questionaires and slit lamp microscope before and 2, 4 weeks after medication. Main Outcome Measures BUT, Schirmer-I,  FL score and dry eye symptoms. Results Before treatment, Schirmer-I, BUT, and FL score had no significant difference between group 1 and group 2 (P>0.05 ). At 2 weeks after medication, the Schirmer-I, BUT, and FL score in group 1 and group 2 was (13.6±4.2) mm and (12.5±3.8) mm (P=0.45), (12.4±3.2) s and (5.6±2.8) s(P=0.00), and  (1.3±0.7) and (4.7±1.1) (P=0.00) , respectively. At 4 weeks after medication, the Schirmer-I, BUT, and FL score in group 1 and group 2 was (14.7±3.7) mm and (13.4±2.5) mm (P=0.09), (14.2±2.8) s and (8.6±2.4) s (P=0.00), and  (1.1±0.4) and (3.4±0.8) (P=0.00), respectively. At 2 weeks after medication, the clinical symptoms score in group 1 and group 2 was (2.6±0.9) and (5.4±1.5), respectively (P=0.00); at 4 weeks after medication, the clinical symptoms score in group 1 and group 2 is (1.4±0.7) and (3.8±1.3) (P=0.00). Conclusion The short-term efficacy of polyethylene glycol eye drops combined with tobramycin dexamethasone ointment for the treatment of meibomian gland dysfunction dry eye is good.
    The treatment effectiveness of local application of glucocorticoid for meibomian gland dysfunction related dry eye
    LIN Lin, JIN Xiu-ming, TONG Nv-xia
    2013, 22(3):  157-160. 
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    Objective To investigate the treatment effectiveness of antibiotics alone or combined with glucocorticoid in patients with meibomian gland dysfunction (MGD) related dry eye. Design Prospective comparative case series. Participants 42 MGD related dry eye outpatients (84 eyes) in Second Affiliated Hospital of Zhejiang University School of Medicine in May 2012. Method The experimental group, 22 patients (44 eyes), were treated with the tobramycin and dexamethasone eye ointment +tears naturale eye drops+ local physical therapy of meibomian gland; the control group: 20 patients (40 eyes) were treated with the tobramycin eye ointment + tears naturale eye drops + local physical therapy of meibomian gland for 1 month, respectively. Meibomian glands function and correlated indexes of dry eye were investigated before treatment and at 1st, 2nd and 4th week after treatments. Slit lamp examination (the changes of limbus palpebralis and meibomian glands orifices, secretion characteristics, the difficulty of lipid excretion were evaluated for MGD degree); the symptom score, tear break-up time test (TBUT), corneal fluorescein staining (CFS), and Schirmer I test (SIt) were performed. Main Outcome Measures Secretion characteristics, the difficulty of lipid excretion,  the symptom score, TBUT, CFS, and SIt. Results Before treatment,there were no statistical difference in age, the course of disease, MGD physical signs and dry eye related indexes between experimental group and control group (all P>0.05). At each time point after treatment, the secretion characteristics, the difficulty of lipid excretion, and the subjective symptom score were all decreased obviously than before treatment in both groups; and TBUT increased significantly (all P<0.05). The CFS at 2nd and 4th week after treatment were significantly reduced compared with before treatment (all P<0.05). At 1st week and 2nd week after treatment, secretion characteristics and the difficulty of lipid excretion scores were significantly reduced in experimental group than in control group (all P<0.05). Significant increase of TBUT was also observed at all time points after treatment in experimental group than in control group (all P<0.05). Conclusion The anti-inflammatory treatments with antibiotics alone or comined with glucocorticoid were both effective for meibomian gland dysfunction related dry eye. The glucocorticoid can more significantly improve the symptoms and signs for patients with meibomian gland dysfunction related dry eye.
    Clinical characteristics and treatments of herpes simplex keratitis after phacoemulsification
    SUN Li, CHEN Wei
    2013, 22(3):  161-164. 
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     Objective To discuss the clinical characteristics and treatments of herpes simplex keratitis (HSK) after phacoemulsification. Design Retrospective case series. Participants Twelve patients (15 eyes) who presented in Eye Hospital of Wenzhou Medical College with HSK after cataract surgery from April 2005 to August 2012. Method All patients data including demographic informations, clinical classification(Holland diagnostic classification), history of surgery, treatment protocols and duration, were reviewed retrospectively. Epithelial keratitis were treated with oral acyclovir, ganciclovir gel and preservative-free artificial tears. The stromal and endothelial keratitis were treated with intravenous acyclovir and dexamethasone followed by oral acyclovir and prednisone, 0.02% fluorometholone and topical autohemotherapy. Main Outcome Measures Clinical classification, symptoms, signs and duration of the disease. Results Twelve patients (15 eyes) presented with different stage of HSK between 3 days and 4 weeks after cataract surgery. There were 5 patients(6 eyes) with epithelial keratitis and 7 patients(9 eyes)with stromal and endothelial keratitis. All patients presented with redness,pain,foreign body sensation,photophobia,tearing and decreased vision after surgery. Visual acuity of patients with epithelial HSK improved from 0.3~0.6 to 0.6~0.8 after treatment and duration of disease was between 1~3 weeks. In patients with stromal and endothelial HSK, visual acuity improved from hand motion ~ 0.6 to counting finger ~ 0.9 after treatment with a duration of disease between 1~3 months. Conclusion Because the prevalence of HSK after cataract surgery is lower, it can be easily misdiagnosed. Duration of HSK after cataract surgery was related to the extent of the corneal lesion. It is important for visual function restoration to diagnose in time and treat adequately in patients with HSK after cataract surgery .
    The role of the parameters measured with RTVueOCT in the screening of subclinical keratoconus
    ZHU Xiao-bo, ZHOU Yue-hua
    2013, 22(3):  165-169. 
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    Objective To estimate the role of the pachymetry paramerers measured with high-speed anterior segment optical coherence tomography (RTVueOCT) in the screening of  subclinical keratoconus. Design Evaluation of diagnosis technique. Participants Thirty-six cases (56 eyes) with keratoconic, 37 cases (57 eyes) with subclinical keratoconic, and 30 normal subjects (60 eyes) were enrolled. Method Kertoconus or suspected keratoconus were diagnosed based on the examinations with the slit lamp microscope and Tomey corneal topographic map. If the results of the two exams suggested to be suspect, the eyes whose KSI value and local curvature increased after the following up for 3~6 months were diagnosed as subclinical keratoconus. The pachymetry paramerers were measured by RTVueOCT and compared among the normal eyes, subclinical kertoconus group, and the kertoconus group. The parameters included superior-inferior (S-I), superonasal-inferotemporal (SN-IT), minimum(MIN), minimum-median(MIN-MED), minimum-maximum(MIN-MAX), and the location of the thinnest cornea (X-location,Y-location). Receiver operating characteristic (ROC) curves were used to analyzed the optimal cutoff points, sensitivity, and specificity of the pachymetry pamameters to differentiate the keratoconic eyes, or subclinical keratoconus eyes from the normal eyes. Main Outcome Measures S-I, SN-IT, MIN, MIN-MED, MIN-MAX, X-location,  Y-location, area under the ROC curve (AROC),  sensitivity, and specificity. Results IT-SN, I-S, MIN, MIN-MED, and MIN-MAX in the subclinical keratoconus group and keratoconic group were significantly increased than in the control group, and which were significantly increased in keratoconic group than in the subclinical keratoconus group (all P<0.05). To differentiate the subclinical keratoconic eyes from the normal eyes, the AROC of the IT-SN, I-S, MIN, MIN-MED, and MIN-MAX was 0.757, 0.732, 0.858, 0.769, and 0.790, respectively; the cutoff point was -28.5, -33.5, 487.0, -22.5, and -53.0 μm, respectively; the sensitivity was 0.632, 0.404, 0.667, 0.596 and 0.632; the specificity was 0.833, 0.967, 0.900, 0.937 and 0.917, respectively. Conclusion RTVueOCT can play an important role in the screening of the subclinical keratoconus.
    The two years efficacy of early intervention by laser peripheral iridotomy on high-risk primary angle-closure glaucoma
    ZHAO Xin, HAO Yun-he, ZHANG Xin-lei, ZHAI Jiang-he, TIAN Jing, HE Yan
    2013, 22(3):  171-175. 
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     Objective To observe the impact of early intervention with YAG laser peripheral iridotomy (LPI) on high-risk patients of primary angle clouse glaucoma (PACG). Design Cohort study. Participants 52 patients (104 eyes) with high-risk PACG. Method The patients with high-risk PACG were randomly divided into two groups. One group [26 patients (52 eyes)] was treated with LPI, and another group [26 patients (52 eyes)] was control group in which, the patients wasn't given any intervention. Following up for 2 years, routine ophthalmic examination and UBM were performed at the first visit (before LPI), 2 weeks, 6, 12 months and 2 years after LPI, respectively. The parameters of anterior chamber were measured and calculated by UBM. Main Outcome Measures Intraocular pressure(IOP), the parameters of anterior chamber measured by UBM. Results The average postoperative IOP in the intervention group was (15.20±2.39) mm Hg in the final follow-up, which was lower than pre-operation (16.89±3.01 mm Hg); The central anterior chamber depth, the mean angle-opening distance, the trabecular iris angle and the mean chamber angle width was increased after LPI (all P<0.01). There was no significant change in IOP in the control group  at 12 months visit (P>0.05), but  the angle-opening distance, the trabecular iris angle and the mean chamber angle width was decreased (all P<0.05); The average intraocular pressure in the control group was (17.31±2.27) mm Hg in the final follow-up, which was higher than pre-operation (P<0.05); there were two cases (2 eyes) suffered PACG acute attacks in control group, while there was no PACG in the intervention group after two year's follwing up. Conclusion LPI can effectively prevent the development of high-risk PACG to PACG and improve the anterior chamber and anterior chamber angle structures.
    The repeatability of objective optical quality parameters measured by the Optical Quality Analysis System in normal subjects
    WAN Xiu-hua*, ZHANG Ye*, QIAO Li-ya, CAI Xiao-gu, TAN Jia-xuan, LI Lei, WANG Ning-li
    2013, 22(3):  175-179. 
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     Objective To evaluate intra-session repeatability of objective optical quality parameters measured by the Optical Quality Analysis System (OQAS). Design Evaluation of diagnostic technology. Participants Twenty-six Chinese healthy adults (48 eyes) aged 18 to 41-years old (11 males and 15 females) were enrolled. Method Optical quality of each subject was evaluated by the OQAS with the pupil diameter of 4.0 mm. Ten consecutive measurements of the following parameters: the modulation transfer function cutoff frequency (MTFcutoff), the Strehl2D ratio, the OQAS values (OVs) at contrasts of 100%, 20%, 9% and the objective scatter index (OSI), were performed by one experienced examiner. The repeatability limit (RL) of each parameter was evaluated using SAS software. Main Outcome Measures The RLs of the six parameters of OQAS. Results The MTFcutoff , Strehl2D ratio, OV100%, OV20%, OV9% and OSI of the participants was 39.55±10.99, 0.23±0.07, 1.32±0.37, 1.36±0.46, 1.38±0.52, and 0.70±0.43, respectively. The RLs (percentage) of which were 17.74%, 24.95%, 17.74%, 20.59%, 23.31%, and 37.07%, respectively. Conclusion Measurements of objective optical quality provided by OQAS showed a good repeatability in normal subjects.
    Comparison of efficacy and complications in treatment of macular edema secondary to central retinal vein occlusion by intravitreal bevacizumab with intravitreal triamcinolone acetonide for first priority: a meta-analysis
    LI Dan1, MA Nan2, LUO Ling2, GAO Fu-lin2, ZHAO Jun2, QIU Chang-yu2, BAI Feng-hua2, HU Lian-na2
    2013, 22(3):  180-184. 
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    Objective To evaluate the efficacy and safety in treatment of macular edema (ME) secondary to central retinal vein occlusion(CRVO) by intravitreal bevacizumab (IVB) with intravitreal triamcinolone acetonide (IVT) for first priority. Design Meta-analysis. Participants Published literature in Medline, EMbase, Cochrane library and CBM which comparing IVB with IVT in treatment of ME secondary to CRVO for first priority. Method According to evaluation guidelines of Cochrane collaboration, clinical controlled trials (CCTs) were searched using Medline, EMbase, the Cochrane Library and CBM. Methodology qualities of literatures were 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 6 literatures came into meta-analysis (242 eyes). No significant difference in either CMT(P=0.12) or BCVA (P=0.92) was observed between IVB and IVT group. Adverse event rates (mainly elevation of intraocular pressure and progression of cataracts) in IVT group was 33 times (95%CI: 10 times~100 times) more than IVB group(P<0.001).  Conclusion Meta-analysis shows that the equal reduced CMT and BCVA  was observed in IVT group and in IVB group for treatment of ME secondary to CRVO, while the adverse event rate in IVT group is much more than in IVB group. More high quality perspective studies are still required for further analysis.
    Relationship between ambulatory blood pressure and visual impairment in patients with nonarteritic anterior ischemic optic neuropathy
    YAN Hong-xin1, WEI Shi-hui2
    2013, 22(3):  185-188. 
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     Objective To investigate the relationship between parameters of ambulatory blood pressure monitoring and the impairment of vision in patients with nonarteritic anterior ischemic optic neuropathy (NAION). Design Retrospective case series. Participants sixty-three cases (41 males and 22 females) who were diagnosed as NAION were involved. Method All patients were divided into low visual group and better visual group according to the visual impairment; and divided into double eyes group and single eye group according to the affected eye in the current. General condition, biochemical indexes and parameters of ambulatory blood pressure were compared between the two groups respectively. Main Outcome Measures The age, gender, body mass index (BMI), triglyceride (TG), total cholesterol (TC), the parameters and incidence of abnormal circadian rhythm of ambulatory blood pressure. Results The diastolic blood pressure at night in double eyes group (78.5±11.3 mm Hg) was significantly higher than in single eye group(72.2±10.8 mm Hg) (P=0.044). The age in low visual group (57.1±10.3 years) was significantly older than in better visual group (47.6±9.7 years) (P=0.001). The incidence of normal circadian rhythm of 24-hour ambulatory blood pressure was significantly lower in low visual group (11.4%) than in better visual group(36.8%) (P=0.018). Conclusion In terms of NAION, the patients with onset older and abnormal circadian rhythm of ambulatory blood pressure more likely to suffer poor visual acuity.
    Experimental study of the effects of hyperopic defocus induction on the refraction in guinea pigs
    LV Meng, MA Dong-li
    2013, 22(3):  189-194. 
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    Objective  To observe the changes of the refractive state and axial length induced by two different hyperopic defocus methods in the infant guinea pigs; to discuss the sensitivity of guinea pigs to these two methods. Design Experimental study. Participants 18 male pigmented guinea pigs (age of 6 weeks). Method 18 pigmented guinea pigs (age of 6 weeks) were randomly assigned to 3 groups: normal control group (group A, 3 cases), Goggle myopia induction group (group B, 10 cases), aphakia induction group (group C, 5 cases). In the latter two groups, right eyes were used to be performed by the corresponding induced method, while left eyes were the control eyes. Refraction and axial lengths were examed before experiment and three weeks after induction. Compared the refractive developmental differences in the experimental eyes with the control eyes before and after the experiment, and comprehensively assessed the effectiveness of different methods of induction. Main Outcome Measures Axial lengths and refractive states. Results Before the inducement, the refrection and axial length were no significantly different among the three groups (P>0.05). Three weeks later, in comparison to the control eyes,the right eyes of group B and group C became more myopic (on average -2.83±0.80 D and-5.50±0.58 D, respectively) and elongated (on average 1.18±0.22 mm and 1.98±0.14 mm, respectively) (all P<0.05). Conclusions Aphakia and negative lens can interfere vision development and induce the myopic development  and axial growth in the infant guinea pigs.
    Construction of a lentiviral vector of HTRA1 shRNA and identification of its RNA interference effect in a RPE cell line
    PEI Xue-ting, LIU Ning-pu, XU Jun
    2013, 22(3):  195-200. 
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    Objective This study was aimed to construct lentivirus-mediated shRNA expression vector targeting HTRA1 and identify the RNA interference effect in a RPE cell line. Design Experimental study. Participants HTRA1 shRNA lentivirus vector and RPE cells. Method One pair of oligonucleotide sequences targeted at human HTRA1 mRNA was designed and synthesized. The annealed oligonucleotide fragments were subcloned into plasmid vector. Virus particles were collected and enveloped into HEK-293T cells.The RPE cells were infected with recombinant lentivirus. Real-time PCR and Western Blot were used respectively to detect the expression of HTRA1 after lentivirus infection. Main Outcome Measures The mRNA and protein expression of HTRA1. Results DNA sequencing demonstrated that the lentivirus shRNA vector of HTRA1 was constructed successfully and the virus was packaged in 293 T cells.The titer of virus was 8×108 TU/ml. The RPE cell line was successfully infected. The mRNA and protein levels of HTRA1 were reduced significantly in RPE cells after lentivirus infection, compared with blank control and negative control. Conclusion It is concluded that the lentiviral shRNA vector of HTRA1 is constructed, and successfully reduced HTRA1 expression in a RPE cell line.
    Retrospective analysis on 1022 inpatients with open-globe injuries
    WANG Chao-jun, ZHANG Ling-jie, XIN Qin-hui, GONG Yi
    2013, 22(3):  201-204. 
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    Objective  To summarize the epidemiology, causes, prognosis and the prevention methods of inpatients with open-globe injuries in Taizhou Eye Hospital, a middle first-class hospital in Zhejiang Province. Design Retrospective case series. Participants  One thousand and twenty-two inpatients (1022 eyes) with open-globe injuries from June 2006 to June 2011 in Taizhou miniciple Hospital. Method The medical records were retrospectively analysed to summarize the causes, locations, types, and prognosis of the injuries. Main Outcome Measures Essential information, visual acuity,causes and types of the trauma. Results The main population of the injuries was in the male migrant workers aging 21 to 50 years old, accounted for 69.8%. 90% trauma position were in the area I (cornea) and Ⅱ (within the 5 mm outer of limbal ). “industrial production” was main course of open-globe injuries, accounted for 71.6%. The effects of the treatment of ocular trauma were related to the trauma position. Intraocular foreign bodies and vitreous and retina injuries were related to intraocular infection. Conclusion The retrospective analysis of open-globe injuries shows  a certain place of getting it’s basic characteristics, prognosis and guiding clinical treatment.
    The clinical efficacy of the combined operation for involutional lower eyelid entropion
    QIN Yi, CHEN Tao, LI Dong-mei
    2013, 22(3):  205-208. 
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    Objective To evaluate the efficacy of the combined entropion repair for lower eyelid involutional entropion: lateral canthoplasty, excision the preseptal orbicularis oculi, and Quickert suture (LEQ). Design Retrospective case series. Participants Nineteen patients (23 eyes) with lower eyelid involutional entropion underwent the combined procedure in Beijing Tongren Eye Center. Method Surgical technique addressed all 3 anatomic factors underlying the entropion and was performed through a transcutaneous incision. Lateral canthoplasty procedure addressed horizontal eyelid laxity; Quickert suture addressed retractor disinsertion; and excision of a strip of the preseptal orbicularis oculi addressed preseptal orbicularis override. Morphology of eyelid, position of eyelid and epiphora were judged to evaluate the efficiency of this method. The follow-up time was 8~12 months. Main Outcome Measures Morphology of eyelid, position of eyelid, with or without epiphora. Results Transcutaneous LEQ entropion repair resulted in great resolution of involutional entropion in all cases without entropion recurrence or secondary ectropions. Only one case was found that the eyelid failed to contact with the eyeball closely, however, the patient didn’t feel any discomfort. Conclusion The LEQ is a simple and effective operation for the correction of involutional entropion.
    Functional influence of p.Y225X mutation on FOXL2 in Blepharophimosis-ptosis-epicanthus-inversus syndrome
    GENG Yu-lei1, WANG Ping-zhang2, LI Dong-mei1
    2013, 22(3):  209-213. 
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    Objective To investigate the effect of p.Y225X mutation on FOXL2, and explore the potential mechanism of Blepharophimosis-ptosis-epicanthus-inversus syndrome (BPES). Design Experimental study. Participants The wild-type and p.Y225X mutant FOXL2 genes. Method Wild-type and mutant sequence of FOXL2 genes were amplified, and then cloned into green fluorescence protein expression vector (pEGFP-N1) to construct GFP labeled expression vectors, which were later transfected into COS7 cells.  The confocal microscope was used to locate FOXL2 in COS7 cells and compare the difference between them. Wild-type and mutant FOXL2 genes were cloned into pcDNA3.1-myc-his(-)B vector, then transfected into HEK-293T and KGN cells. Proteins were extracted to make sure that wild-type and mutant FOXL2 were expressed after transient transfection. And then total RNA and protein were extracted to analyze OSR2 and StAR expression on transcriptional and protein levels by RT-PCR and Western blotting. Main Outcome Measures GFP locations,  target RNA and protein expression. Results The expression plasmids of wild-type and mutant FOXL2 labeled by GFP and myc/his flags were constructed successfully. The expression of FOXL2 was identified by Western blot assay in transfected HEK-293T and KGN cells. Under the confocal microscope, wild type FOXL2 evenly located in the nucleus, while the mutant FOXL2 located in both cytoplasm and nucleus. Furthermore, wild-type FOXL2 inhibited StAR in transcriptional and protein levels in KGN cells, while this inhibition effect in p.Y225X mutant were dramatically attenuated. Besides, wild-type FOXL2 enhanced OSR2 transcription and expression in HEK-293T cells, while the promotion of OSR2 expression in FOXL2 mutants was also reduced. Conclusion p.Y225X mutation, leading to FOXL2 dislocation in the cytoplasm, attenuates its regulation function, disturbs the expression of target genes, OSR2 and StAR, which contribute to impaired development of eyelid and ovary, and probably eventually lead to type I BPES.
    Teaching pattern of corneal diseases in training primary level eye doctors
    JIE Ying
    2013, 22(3):  214-215. 
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    Corneal diseases are common and frequently occurring eye diseases, which account for high proportion in the primary hospital. Targeted outpatient clinical training, special surgery teaching and theoretical system education will make the eye doctors in primary level master the standard diagnosis and treatment methods in short term and improve the level of primary eye care.