OBJECT: To study a modified technique of "One-stitch anastomosis through the skin over the punctum with bicanalicular intubation" for the repair of canalicular laceration with ultrashort temporal segment (CLUTS), to preliminarily investigate the safety and efficacy of this surgical approach in cases when the horizontal distance between the lacrimal punctum and the broken end is less than 2 mm. METHOD：A retrospective analysis was conducted on 12 patients with CLUTS, occurring between December 2017 and December 2023, whose the horizontal distance between the lacrimal punctum and the broken end is less than 2 mm. All patients underwent repair of the canalicular laceration using the "one-stitch anastomosis through the skin over the punctum with bicanalicular intubation". The surgical procedure involved identifying the broken ends of the canalicular laceration under a surgical microscope, inserting a bicanalicular stent into the aimed canaliculus, and suturing it with 5-0 silk suture. The lacrimal stent was removed more than 3 months after operation, and the improvement degree of epiphora symptoms, the patency of lacrimal duct, the recovery of skin wound, and the complications such as poor wound healing, suture knot remained or exposure were observed. RESULT: A total of 12 cases (12 eyes) were included. All patients presented with canalicular laceration, and the distance between the broken end of the lacrimal punctum was less than 2mm but greater than 0.5mm. All patients underwent successful treatment using a "punctum-crossed one-stitch anastomosis through the skin with bicanalicular intubation". The patients were discharged after 7 days post-surgery, with an average interval of 12.5 weeks (± 0.8 weeks) prior to the removal of the lacrimal stent. Out of the 12 cases, 11 achieved complete recovery, while one showed improvement. One case exhibited laceration of inferior lacrimal punctum and partial canalicular erosion. Additionally, one patient experienced unexpected partial prolapse of the stent from the inner canthus at week six post-surgery; so underwent extraction of the stent in advance, which had no effect on the curative effect. The follow-up period lasted for an average duration of 13.6 weeks (± 0.5 weeks), during which all cases demonstrated satisfactory healing without any occurrence of traumatic deformity of eyelid and inner canthus, and there was no suture knot remained or was exposed, the symptoms of epiphora disappeared, the lacrimal canaliculus was unobstructed. CONCLUSION: One-stitch anastomosis through the skin over the punctum with bicanalicular intubation is a safe and effective modified method to repair the CLUTS, with good wound healing，there was no suture residual in the wound or exposed from it.

Purpose:To investigate the rhodopsin expression in form-deprived and defocus myopiain guinea pig and study the relationship between the rhodopsin expression andexperimental myopia.

Methods:Fourty guinea pigs were randomized into the form-deprived group and thedefocus group (n= 20 ). Guinea pigs in the form-deprived group wore a diffuser(rigidgass-permeable contact lens(RGP)on one eye since one week after birth. Those in defocus group wore a -4 D RGPon one eye. The contralateral eyes were left ascontrol. Refraction, axial length and depth of vitreous cavity were measured after 1and 2 weeks respectively. Retina were dissected at 10 ~ 12 o'clock in the moring.The level of rhodopsin and its mRNA were observed through Western-blot and real-time PCR respectively.

Result:There is no difference between form-deprived group, defocus group and controlgroups(except refraction in form-deprived group). One week later, there is nodifference between the form-deprived group, the defocus group and the control groups(except refraction in form-deprived group). Two weeks later, eyes in the form-deprivedgroup and the defocus group became myopic. Its axial length lengthened and depth ofvitreous cavity appeared deep. The form-deprived groups showed an increasedexpression of rhodopsin and its mRNA compared to the control groups. There is nodifference between the defocus group and the control groups.

Conclusion : Expression of rhodopsin might involve formation of form-deprived myopia,but has less influence on defocus myopia.

Purpose: To compare the effect of fresh versus preserved amniotic membrane transplant-ation for conjunctival surface reconstruction after symblepharon lysis and analyze the associated factors.

Methods: Fifty-one consecutive cases (55 eyes) with symblepharon at different degree due to eye burns or Stevens-Johnson syndrome were accepted lysis of symblepharon and amniotic membrane transplantation. Twenty-two eyes of them were performed with fresh amnion grafts, the others (33 eyes) with preserved human amniotic membrane. Eleven eyes were performed within 1 year and forty eyes in 1 to 8 years (mean value, 2.0 ± 0.7 years) after eye burns.

Results: The follow-up time varied from 12 to 32 months (mean value, 19.3 ± 4.1 months) . Fifty-six point four percent (31/55) eyes got enough deep conjunctival fornix and resolution of eye movement restrict. Sixteen percent of them (9/55) recurred less symblepharon and remained slightly eye movement restrict. Fifteen- five eyes of them (27.3%) recurred moderate symblepharon. The effects of surgery were similar between fresh and preserved AMT (X ² = 0.466, P = 0.797) . The effects of AMT for those patients with symblepharon at different degree had significant difference statistically (fresh amnions, X ²= 27.995, P = 0.000; preserved amnions, X ² =33.610, P = 0.000) . The same results were observed between those patients who were performed in different time periods after eye burns ( X ² = 4.243, P = 0.039) .

Conclusion: Fresh amnion has the same effect as preserved one for conjunctival surface reconstruction. The degree of symblepharon and the surgical environment of the ocular surface in the affected eye before surgery will influence the results of amniotic membrane transplantation for conjunctival surface reconstruction.

Objective: To evaluate the clinical effect of safflor yellow injection combined with intravitreal ranibizumab (IVR) for macular edema secondary to non-ischemic branch retinal vein occlusion (BRVO-ME). Methods: A total of 76 patients (76 eyes) diagnosed with non-ischemic BRVO-ME in Affiliated Eye Hospital of Nanchang University from January 2018 to October 2022 were selected. Patients were randomly divided into observation group (38 eyes, safflower yellow injection combined with IVR treatment) and control group (38 eyes, IVR treatment alone). Follow-up for 11 months,Follow-up for 11 months，the best corrected visual acuity (BCVA) and macular central retinal thickness (CRT) of the two groups were observed,and the times of intravitreal ranibizumab injections ,the cases of ischemic BRVO, and the occurrence of complications were recorded. Results At 1, 2, 3, 5, 7, 9, 11mo after treatment, the BCVA and CRT in observation group and control group were significantly improved compared with before treatment,and BCVA in the observation group was superior to the control group at 5th, 7th, 9th, and 11th months after treatment, (P < 0.05), and CRT in the observation group was superior to the control group at 3rd, 5th, 7th, 9th, and 11th months after treatment (all P < 0.05). During the follow-up period, the IVR injection in the observation group and in the control group was no significantly (4.34±1.17 vs 4.39±0.76，P ＜ 0.05), and the incidence of ischemic BRVO in the observation group was significantly lower than that in the control group (53% vs 87%, P ＜ 0.05), and there were no treatment-related systemic and ocular complications in both groups. Conclusion Safflor yellow injection combined with IVR is an safe and effective method for the treatment of non-ischemic BRVO-ME, which can significantly improve vision and obtain anatomical morphological benefits. Compared with monotherapy with IVR, this treatment regimen can reduce the incidence of ischemic BRVO.

Dominant optic atrophy (DOA) is an inherited optic neuropathy and more than 75% of DOA patients harbor pathogenic mutations in OPA1. We reported a 39-year-old female harboring c.2119G>T mutation of OPA1 and manifested progressive visual impairment after hydroxychloroquine (HCQ) therapy. The patient’s visual impairment remained stable for 10 years until she began to take HCQ 13 months ago. She complained about progressively decreased vision in both eyes. Bilateral pale temporal optic disc was similar with that of 11 years ago. Optical coherence tomography showed bilateral moderate retinal nerve fiber layer thinning other than the nasal quadrant and general thinning of the inner retina in the macular. Microcystic macular edema was noted in nasal macular in both eyes. Visual field testing showed paracentral scotoma and microperimetry showed decrease sensitivity in the macular in both eyes. After the patient stopped taking HCQ, her functional tests including visual acuity, field testing and microperimetry testing was stable compared with those of 2 years ago. However, progressive inner macular and RNFL thinning was shown by OCT. OPA1 c.2119 G>T found in this patient was a mutation that had been rarely reported in previous studies. The patient has been followed up for over 10 years and her visual acuity stayed stable for decades long until she took HCQ for 13 months. Her vision decline terminated after she stopped taking HCQ. Although HCQ toxicity is highly related to the duration and daily dose, HCQ may aggravate visual impairment in certain individuals harboring OPA1 mutation. Patients with DOA should avoid using neurotoxic HCQ and other medications that may interfere mitochondrial metabolism.

Purpoes: To assess the success rate of the formation of functional filtration bleb in eyes undergoing different incision of conjunctiva flap after trabeculectomy.

Methods: To study the formation of functional filtration bleb after trabeculectomy, the result of trabeculectomy with the limbus based conjunctival flap in 165 eyes and the fornix based conjunctival flap in 207 eyes (372 eyes in 372 cases with primary glaucoma in total) was compared.

Results: All patients were observed after trabeculectomy in 1 week, but only 127 eyes were followed up in 3 months. In patients with trabeculectomy using the limbus based conjunctival flap, the success rate of the formation of the filtration bleb was 83.03 % in 1 week and 78.69 % in three months postoperatively, while in those using the fornix based conjunctival flap, the success rate was 55.07 % in 1 week and 53.03 % in 3 months. There was significant difference between the two groups in terms of the success rate of the formation of the filtration bleb.

Conclusions: The result showed that limbus based conjunctival flap was especially effective and had better postoperative intraocular pressure decline.

Purpose: To explore the effect of tear film changes on the intraocular pressure (IOP) measurement by Goldmann applantion tonometer.

Methods: Sixty-eight normal subjects were randomly divided into two groups (Gruop A and B) , 34 in each group. One eye of each subject by random selection was given Dextran (in Group A) and Viscoat (in Group B) , respectively. And the fellow eyes were used as controls. IOP was measured in all subjects twice using Goldmann applantion tonometer. And the difference between first and second measurements was compared.

Result: In the control eyes of Group A, the average IOP of first and second measurements were (14.44 ± 2.68) mmHg (1 mmHg= 0.133 KPa) and (14.47 ± 2.69) mmHg, there was no difference between the two measurements (t =- 0.329, P = 0.744) . In eyes given Dextran, the average IOP of two measurements were (14.41 ± 2.63) mmHg and (12.94 ± 2.59) mmHg, there was significant difference between the two mea-surements (t =13.949, P= 0.000) . In control eyes of Group B, the average IOP of first and second measurements were (14.53 ± 3.13) mmHg and (11.18 ± 3.07) mmHg, and there was no difference between the two measurements (t = -0.466, P = 0.644) . In eyes given Viscoat, the average IOP of two measurements were (14.53 ± 3.13) mmHg and (11.18 ± 3.07) mmHg, and there was significant difference between the two measurements (t = 22.126, P = 0.000) . After being given Dextran or Viscoat, the IOP values decreased consistently in both Group A and Group B.

Conclusions: The change of tear film components can affect IOP values by Goldmann applantion tonometer.

Candida, as a conditionally pathogenic fungus, often exhibits increased resistance to current systemic antifungal drugs such as fluconazole, amphotericin B, itraconazole, and fluconazole due to the special effects of its cells and biofilm after opportunistic infections. Recently, there has been an increasing amount of research on the use of nanomaterial mediated drug delivery systems for the treatment of candidal keratitis. This article reviews the research status and progress of new nanomaterials as novel drug delivery carriers for the treatment of candidal keratitis, providing new feasible ideas for improving the limited availability of antifungal drugs in clinical practice.

Objectives: To assess the efficacy of the inverted internal limiting membrane (ILM) flap technique with air tamponade for macular holes (MHs). Methods: A retrospective analysis was conducted on 71 patients (71 eyes) who underwent inverted ILM flap surgery combined with air tamponade for macular holes at Zhongshan Ophthalmic Center from 2016 to 2019. Patients were positioned face down for 1-3 days postoperatively and followed up for more than 6 months. OCT was used to determine the closure rate of macular holes, and the best corrected visual acuity (BCVA) before and after surgery was compared. The MAIA microperimeter was used to assess the average macular sensitivity, macular integrity index, and fixation stability P1 and P2 before and after surgery. Results: Of the total 71 eyes, 91.5% achieved complete MH closure. The best corrected visual acuity (BCVA) significantly improved before and after surgery (P<0.001), average macular sensitivity significantly increased (P<0.0001), macular integrity index significantly decreased (P<0.0001), and fixation stability P1 and P2 both significantly improved (P＜0.0001，P＜0.001). Conclusion: Inverted ILM flap technique combined with air tamponade provides an effective approach for the management of MHs. The air tamponade should be considered as the preferred in MH surgeries, reducing the discomfort caused by prolonged face-down positioning. Parameters in microperimetry can serve as good indicators for assessing the recovery of macular structure and function.

Objective: To investigate the clinical characteristics and surgical interventions for patients suffering from prelacrimal sac obstruction and conjunctivochalasis, as well as to identify effective treatment approaches for such conditions. Methods: This study enrolled 74 patients presenting with anterior lacrimal duct obstruction and conjunctival laxity, who were treated in our hospital between 2020 and 2022. Their clinical profiles were analyzed, and they underwent lacrimal laser plasty, Tao Ⅰ type intubation of an lacrimal stent and excision of the conjunctivochalasis segment. Results: Among 74 patients, 60 (81.08%) presented with monocular symptoms, while 14 (18.92%) exhibited binocular symptoms. The cohort comprised 29 males (39.19%) and 45 females (60.81%). Patient ages ranged from 49 to 87 years, with a mean age of (64.27 ± 8.07) years. In terms of obstruction, six patients (8.11%) had lacrimal point obstruction, 38 (51.35%) had canalicular obstruction, and 30 (40.54%) had common canalicular obstruction. Postoperatively, the stent were removed after 3-6 months of review. Notably, 70 patients (81 eyes) experienced complete resolution of their lacrimal and purulent symptoms, with unobstructed irrigation of the lacrimal passage, yielding a cure rate of 92.05%. 4 patients (7 eyes) showed improvement in their symptoms, resulting in an improvement rate of 7.95%. Two patients developed a tear of the lacrimal puncta as a postoperative complication, but no recurrences were observed during the follow-up period. Conclusion: This approach simultaneously addresses both prelacrimal sac obstruction and conjunctivochalasis, demonstrating significant therapeutic effectiveness. Lacrimal Laser plasty, Tao Ⅰ type intubation of an lacrimal stent, and cexcision of the conjunctivochalasis segment are regarded as superior methods for treating prelacrimal sac obstruction accompanied by conjunctivochalasis.