硬性和可折叠前虹膜固定人工晶状体植入治疗亚洲眼高度近视的疗效比较

目的:比较Artisan和Artiflex有晶状体眼人工晶状体(PIOL)矫正亚洲人群高度近视的屈光度和安全性。方法:历史队列研究。回顾2016/2020在印度尼西亚日惹市Yap眼科医院接受PIOL植入术的81例高度近视眼。根据植入PIOL分为Artisan组43眼,Artiflex组38眼。分别记录术前及术后1d、1、3mo的视力、角膜生物显微镜参数和眼压,包括术前前房深度。结果:Artisan和Artiflex组的平均随访时间分别为9.64±6.93mo和8.96±4.28mo(P=0.736)。Artisan组的疗效指数为1.03±0.47,Artiflex组为1.02±0.17(P=0.119);安全性指数分别为1.10±0.45和1.05±0.21(P<0.001)。Artisan组的平均等效球镜度(SE)为-0.64±0.996D,Artiflex组为-0.22±0.58D(P=0.076)。两组术后内皮细胞密度(ECD)较术前均显著下降(P<0.05),累积ECD缺失率为7.44%和5.79%(P=0.418)。结论:Artisan和Artiflex矫正亚洲人高度近视的屈光效果相当。与Artiflex相比,Artisan的安全指数略高,而两组的疗效指数和累积ECD缺失率相似。

双氯芬酸与奈帕芬胺在白内障术后抗炎疗效比较（英文）

目的:比较白内障患者术前局部应用0.1%双氯芬酸与0.1%奈帕芬胺的疼痛度和抗炎疗效。方法:该前瞻性随机临床试验于2017/06-08在Dr. Yap眼科医院进行。共56例患者诊断为老年性白内障并接受超声乳化术,未出现并发症。受试者按术前应用滴眼剂分为两组(双氯芬酸组和奈帕芬胺组)。炎症特征(第1,7和14d随访)如疼痛度、结膜充血、眼睑痉挛、房水闪辉和细胞水平为主要结果,而角膜内皮细胞密度和形态为次要观察结果。结果:术后1d(分别为P=0.284,效应量=0.29, 95%CI=-0.09～0.31;P=0.254,效应量=0.31, 95%CI=-0.13～0.49)和7d(P=1.000和P=0.556,效应量=0.18, 95%CI=-0.08～0.16),两组间结膜充血和眼睑痉挛水平无统计学差异。奈帕芬胺组疼痛指数(术中及术后1、4d)显著低于双氯芬酸组(分别为P=0.006,效应量=0.77, 95%CI=0.24～1.34;P=0.045,效应量=0.39, 95%CI=-0.10～0.62;P=0.014,效应量=0.69, 95%CI=-0.06～0.50)。术后1d奈帕芬胺组房水闪辉和细胞水平较低(P=0.029,效应量=0.59, 95%CI=0.02～0.36)。两组间角膜内皮密度降低无统计学差异,而术后7d奈帕芬胺组六角形细胞比例减少较多(P=0.042,效应量=-0.55, 95%CI=-2.33～-0.03)。结论:与双氯芬酸组相比,奈帕芬胺组疼痛度和房水闪辉细胞值较低。

乳酸林格液和BSS对白内障术后角膜内皮细胞密度和形态的影响（英文）

目的:比较超声乳化过程中分别使用乳酸林格液和平衡盐溶液进行灌注,对角膜内皮细胞密度和形态的影响。方法:前瞻性随机对照研究于2017-02/2017-04期间在印度尼西亚日惹市Dr.YAP眼科医院进行。共有年龄相关性白内障患者52例52眼纳入了研究,分为两组,一组26例26眼术中使用乳酸林格液作为灌注液,另一组26例26眼使用平衡盐溶液作为灌注液。术后1、7和28d,评估角膜内皮细胞的密度和形态,同时比较两组患者眼内炎症反应情况。结果:纳入的全部52例52眼接受了超声乳化白内障摘除术联合人工晶状体植入。术后28d,平衡盐溶液组角膜内皮细胞减少了173.96/mm^2,较乳酸林格液组低(253.20/mm^2);角膜内皮细胞变异系数增加了2.92%,也较乳酸林格液组低(3.42%);六角形细胞百分比减少程度(4.30%)较乳酸林格液组(4.84%)低。平衡盐溶液组角膜中央厚度增加程度与林格液组相当(4.69μm vs 4.53μm)。两组角膜内皮细胞相关指标的差异均无显著性。两组之间炎症反应情况也相似。结论:平衡盐溶液和乳酸林格液在避免老年白内障患者超声乳化术后角膜内皮细胞丢失和形态改变方面效果相当。

Transepithelial photorefractive keratectomy for myopia:effect of age and keratometric values

AIM:To investigate demographic and preoperative factors increasing the risk of ametropia following transepithelial photorefractive keratectomy(trans PRK)in myopia and myopic astigmatism.METHODS:This retrospective cohort study included myopic eyes(-0.50 to-8.75 D)with or without astigmatism(up to 3.50 D)enrolled at Dr.Yap Eye Hospital Yogyakarta.Trans PRK was performed using Technolaz 217 z100 excimer laser.Subjects were clustered into ametropia and emmetropia group based on uncorrected distance visual acuities(UDVA)3 mo post-operatively.Multiple preoperative and intraoperative parameters were analyzed using Logistic regression to obtain their effect on ametropia risk following trans PRK.RESULTS:A total of 140 eyes of 87 consecutive subjects were studied.Prevalence of ametropia following trans PRK was 20(14.29%)eyes.Subjects in ametropia group were significantly older than the emmetropia group(31.80±14.23 vs 18.88±2.41,respectively;P<0.001).Bivariate Logistic regression analysis showed that older age(OR=1.23),higher preoperative spherical equivalent(>-6 D;OR=12.78),steeper anterior keratometric readings(Kmax>45 D and mean K>44 D;OR=4.28 and 4.35,respectively)increased the risk of ametropia following trans PRK.Adjusted multivariate Logistic regression analysis showed that age was the strongest predictor for the incidence of ametropia following trans PRK.Complications of trans PRK were overcorrection,suspected posterior keratoectasia and accommodation insuffiency.CONCLUSION:Older age can be the strongest factor for increasing ametropia risk following trans PRK.Cut-off points of Kmax and mean K at 45 and 44 D respectively are proposed as the predictors for ametropia following trans PRK.

Changes in interleukin-6 tear concentration and clinical outcome in moderate-to-severe bacterial corneal ulcers after corneal collagen cross-linking

We aimed to evaluate interleukin-6(IL-6) tear concentration and clinical outcome in patients with moderate-to-severe bacterial corneal ulcers post corneal collagen cross-linking(CXL) therapy. This pre-post designed study involving 21 moderate-to-severe corneal ulcer patients who underwent CXL therapy. Patients with infectious corneal ulcer were given CXL therapy as adjunctive treatment after 5 d of broadspectrum antibiotic treatment. Patients with moderate to severe infectious bacterial corneal ulcers were included in this study. Tear sampling was performed before CXL therapy, using sterile Schimer paper from conjunctival inferior fornix. CXL therapy was performed in accordance with the CXL Dresden protocol. Data recording and tear sampling were then performed at day 1 and day 7 after CXL therapy. Data recording included, presence of conjunctival hyperemia, visual analogue scale(VAS), size of corneal defects, and decemetocele. There was a decrease in IL-6 tear concentration by day 7 after CXL therapy(P=0.001). IL-6 concentration at 1 h after therapy(2274.67±2120.46 pg/m L) tended to be lower than before therapy(4330.09±3169.70 pg/m L), but the difference was not statistically significant(P=0.821). The size of corneal defects decreased significantly post CXL(P=0.007). The log MAR visual acuity before and after CXL therapy was not found to be significantly different(P=0.277). There was a significant decrease in VAS values(P=0.018) and blepharospasm(P=0.011) pre and post CXL. There was no significant decrease in conjunctival hyperemia pre and post CXL(P=0.293). There was significant reduction in IL-6 tear concentration and clinical improvement in moderateto-severe bacterial corneal ulcers which underwent CXL therapy.

Neurofibromatosis type 2 gene mutation and progesterone receptor messenger RNA expression in the pathogenesis of sporadic orbitocranial meningioma

AIM: To investigate neurofibromatosis type 2(NF2) gene mutation at mRNA levels in sporadic orbitocranial meningioma and its association with progesterone receptor(PR) mR NA expression.METHODS: This was a case-control study. Thirty-four sporadic meningioma patients with no familial NF2-related meningioma history were recruited. They were interviewed for their obstetric, gynecologic, and contraception history. PR investigation was performed with real-time polymerase chain reaction(PCR). NF2 mutation was investigated using Qbiomarker Somatic Mutation PCR Assay at NF2 mRNA level after its cDNA extraction(four mRNA mutation cytoband coordinates for nucleotide change: c.634 C>T/p.Q212, c.655 G>A/p.V219 M, c.784 C>T/p.R262 and c.1228 C>T/p. Q410). RESULTS: After mutation analysis at mRNA level, NF2 gene mutation was found in 35.29% patients. Non-mutation group was strongly associated with exogenous hormonal exposure(non-mutation vs mutation: 95.5% vs 83.3%, P<0.001). PR mR NA was found significantly lower in nonmutation group(P=0.033) which presumed as long term exogenous progesterone exposure. However, mutation group was associated with higher rate of progression to gradeⅡ(mutation vs non-mutation, 18.2% vs 5%, P<0.001) and was associated more in fibrous and anaplastic tumor tissue.CONCLUSION: NF2 mutation-meningioma is associated with higher grade of meningioma. Non NF2 mutationmeningioma is strongly associated with exogenous progesterone exposure and lower PR expression.

Lag time,high-risk histopathological features,metastasis,and survival interrelation in retinoblastoma:a perspective from lower-middle income country

AIM:To investigate the impact of lag time to metastasis and survival rates among patients with retinoblastoma.METHODS:This retrospective study was conducted with 52 patients from the Department of Ophthalmology and the Department of Pediatrics of Dr.Sardjito General Hospital,between 1^(st) January 2014 and 31^(st) December 2020.Lag time was defined as the time delay between the first sign of retinoblastoma to the diagnosis of retinoblastoma.The subjects with lag time>one year were included in the case group,while the subjects with lag time<one year were included in the control group.RESULTS:The lag time was significantly correlated with American Joint Committee on Cancer and Intraocular Classification of Retinoblastoma staging of retinoblastoma(P=0.005 and P=0.006,respectively).The lag time was also significantly correlated with both metastasis event[odds ratio(OR):5.06,95%Cl:1.56-16.44,P=0.006]and mortality(OR:4.54,95%Cl:1.37-15.07,P=0.011).The follow-up was continued for 32 subjects for 3y after initial diagnoses.Survival analysis revealed a significant difference among these two groups(P=0.021).Furthermore,lag time was significantly correlated with survival of retinoblastoma(r=-0.53,P=0.046).CONCLUSION:The study highlights the importance of lag time between the onset of first symptoms and the time of retinoblastoma diagnosis which significantly contribute to metastasis and mortality of patients with retinoblastoma.Examinations for the early detection of retinoblastoma should be performed for individuals at-risk to minimize lag time and improve the outcomes.