Trends in operating room-based glaucoma procedures at a single eye center from 2016–2020

AIM:To evaluate trends in glaucoma procedures at the Peking University Eye Center in 2016–2020.METHODS:A retrospective search of all glaucoma procedures performed at our institution were performed.Data were analyzed by calculating the absolute numbers and relative weightage of each procedure per year.RESULTS:The average age of glaucoma patients undergoing surgical procedures was 62.33±17.87y,and 55%were women.From 2016 to 2019,the number of surgical procedures performed in glaucoma patients showed an overall upward trend from 749 to 1460,although it decreased slightly in 2020(n=1393),probably due to the COVID-19 pandemic.The number of trabeculectomies did not change significantly in 2016(n=161)to 2018(n=164)but decreased in 2019(n=139)to 2020(n=121),indicating a reduction in its relative weightage among glaucoma procedures(from 21.50%to 8.69%).The number of glaucoma drainage device implantations and minimally invasive glaucoma surgeries both increased(50and 58 respectively in 2019),except in 2020.The number of transscleral cyclophotocoagulation procedures was relatively stable,increasing until 2017(n=218)and then decreasing.Cataract surgeries with or without glaucoma procedures accounted for a large number of the total surgeries,increasing from 247(32.97%)in 2016 to 967(69.42%),among which cataract extraction combined with goniosynechialysis was the most frequent.CONCLUSION:The overall increase in the number of operating room-based surgical procedures is significant.Trabeculectomy is one of the most commonly performed procedures,despite the relative decline in its weightage.Other procedures,including use of glaucoma drainage devices and mini shunts and minimally invasive glaucoma surgeries,are gaining greater acceptance.Notably,lensrelated surgery plays an important role in glaucoma management.

In vivo observation of cerebral microcirculation after experimental subarachnoid hemorrhage in mice

Acute brain injury caused by subarachnoid hemorrhage is the major cause of poor prognosis. The pathology of subarachnoid hemorrhage likely involves major morphological changes in the microcirculation. However, previous studies primarily used fixed tissue or delayed injury models. Therefore, in the present study, we used in vivo imaging to observe the dynamic changes in cerebral microcirculation after subarachnoid hemorrhage. Subarachnoid hemorrhage was induced by perforation of the bifurcation of the middle cerebral and anterior cerebral arteries in male C57/BL6 mice. The diameter of pial arterioles and venules was measured by in vivo fluorescence microscopy at different time points within 180 minutes after subarachnoid hemorrhage. Cerebral blood flow was examined and leukocyte adhesion/albumin extravasation was determined at different time points before and after subarachnoid hemorrhage. Cerebral pial microcirculation was abnormal and cerebral blood flow was reduced after subarachnoid hemorrhage. Acute vasoconstriction occurred predominantly in the arterioles instead of the venules. A progressive increase in the number of adherent leukocytes in venules and substantial albumin extravasation were observed between 10 and 180 minutes after subarachnoid hemorrhage. These results show that major changes in microcirculation occur in the early stage of subarachnoid hemorrhage. Our findings may promote the development of novel therapeutic strategies for the early treatment of subarachnoid hemorrhage.