Application of sustained delivery microsphere of cyclosporine A for preventing posterior capsular opacification in rabbits

AIM:To explore the inhibitory effect of a sustained cyclosporin A (CsA) delivery microsphere (CsA-MS) on posterior capsular opacification (PCO) in rabbit eyes after cataract extraction. ·METHODS:Twenty New Zealand white rabbits accepted cataract extraction plus intraocular lens implantation and their left eyes were intraoperatively injected CsA-MS prepared using polymer polylactioglycolic acid (PLGA) as a carrier and their right eyes were injected with empty MS. The changes in cornea, anterior chamber reaction, intraocular pressure, PCO and CsA concentration in aqueous humor were examined postoperatively and all the eyes were enucleated 3 months after surgery for histopathological and morphological examination with light microscopy and electron microscopy. · RESULTS:Conjunctival hyperemia, corneal edema, intraocular pressure and anterior chamber response of experimental and control eyes were similar, while PCO in CsA MS injected eyes was greatly improved compared with that in control eyes. Posterior capsules in CsA-MS injected eyes were smooth and lens epithelial cells (LEC) did not proliferate significantly (P 】0.05), while LEC in posterior capsule of control eyes had different degrees of proliferation and cortical regeneration. LEC in CsA-MS injected eyes were not functionally active and underwent apoptosis, whereas LEC in control eyes were functionally active (F-test, P =0.025). In addition, the cornealultrastructure showed no differences between CsA-MS and MS injected eyes. CONCLUSION:CsA-MS has high bioavailability in rabbit eyes and could inhibit postoperative PCO occurrence and development during the study period, suggesting that CsA-MS may be a promising, effective and safe administration route to prevent PCO in clinic.

Comparison of posterior capsule opacification at 360-degree square edge hydrophilic and sharp edge hydrophobic acrylic intraocular lens in diabetic patients

·AIM: To compare posterior capsule opacification(PCO)degree and visual functions after phacoemulsification in eyes implanted with 360-degree square edge hydrophilic acrylic intraocular lens(IOL)(570C C-flex, Rayner) and sharp edge hydrophobic acrylic IOL(Sensar AR40 e,AMO) in diabetic patients.· METHODS: Sixty diabetic patients underwent uneventful phacoemulsification and randomly implanted one of the two IOLs. The PCO value was measured by retroillumination photographs and Evaluation of Posterior Capsule Opacification(EPCO) 2000 image-analysis software at 1, 6, 12, and 24 mo after surgery. Visual acuity, and contrast sensitivity in photopic and mesopic conditions were also examined at each follow up time point. The incidence of eye that required Nd:YAG laser posterior capsulotomy were also compared.·RESULTS: There was not any statistically significant difference in PCO scores between Rayner C-flex 570 C group and Sensar AR40 e group at each follow up time point. Visual acuity, Nd:YAG capsulotomy incidence and contrast sensitivity also had no significant difference during the 24 mo follow-up.·CONCLUSION: For diabetic patients, Rayner 570 C Cflex and Sensar AR40 e IOLs are same effective for prevent PCO. The 360-degree square edge design maybe is a good alternative technique to improve PCO prevention.

Effect of four different intraocular lenses on posterior capsule opacification

AIM: To evaluate the impact of 4 different intraocular lenses(IOLs) on posterior capsule opacification(PCO) by comparing the neodymium: yttrium-aluminum-garnet(Nd:YAG) laser capsulotomy rates.METHODS: This retrospective study included 4970 eyes of 4013 cataract patients who underwent phacoemulsification and IOL implantation between January 2000 and January 2008 by the same surgeon at one clinic. Four different IOLs were assessed. The outcome parameter was the incidence of Nd:YAG laser posterior capsulotomies.· RESULTS: An Nd:YAG laser posterior capsulotomy was performed in 153(3.07%) of the 4970 eyes. The mean follow-up time was 84 mo for all of the IOL groups. The percentage of eyes developing PCO was significantly greater for the acrylic hydrophilic IOLs than for the hydrophobic IOLs, although eyes with acrylic hydrophilic IOLs did not require Nd:YAG laser capsulotomy as soon as eyes with acrylic hydrophobic IOLs. There was no difference between the long-term PCO rates when 1-and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared.· CONCLUSION: In this study, eyes with acrylic hydrophilic IOLs were more likely to develop PCO than those with acrylic hydrophobic IOLs. The lens design(1-piece versus 3-piece and varying haptic angles) did not affect the PCO rate.

Hydrophobic versus hydrophilic acrylic intraocular lens on posterior capsule opacification: a Meta-analysis

AIM: To conduct a Meta-analysis pooling randomized controlled trials(RCTs) to compare hydrophobic with hydrophilic acrylic intraocular lenses in terms of posterior capsule opacification(PCO) development.METHODS: Electronic databases including PubMed,Embase, and the Cochrane Library were queried from their starting till January 2020. RCTs investigating the impact of hydrophobic versus hydrophilic acrylic intraocular lenses on PCO were considered eligible in this study. The pooled effect estimates were calculated using the random-effects model.RESULTS: Thirteen RCTs comprising of 939 patients(1263 eyes) were covered in this study. Patients with hydrophobic acrylic intraocular lenses had a lower PCO score than those with a hydrophilic acrylic intraocular lenses [standard mean difference:-1.80;95% confidence interval(CI):-2.62 to-0.98;P<0.001]. Moreover, the frequency of neodymium-doped yttrium aluminum garnet(Nd:YAG)capsulotomy in patients with hydrophobic acrylic intraocular lenses was significantly lower than patients with hydrophilic acrylic intraocular lenses(relative risk: 0.38;95%CI: 0.20-0.71;P=0.003).CONCLUSION: These findings suggest that hydrophobic acrylic intraocular lenses are superior to hydrophilic acrylic intraocular lenses in patients after cataract surgery due to lower PCO score and reduced Nd:YAG capsulotomy. While similar studies are conducted by other researchers, the present study conducted subgroup analyses that show superior results with hydrophobic lenses in trials conducted in western countries.

“NIR-triggered ROS storage”photodynamic intraocular implant for high-efficient and safe posterior capsular opacification prevention

Posterior capsular opacification(PCO)is the leading cause of vision loss after cataract,mainly caused by the adhesion,proliferation and trans-differentiation of post-operative residual lens epithelial cells(LECs).Effective PCO prevention remains a huge challenge to ophthalmologists and researches for decades.Herein,we developed a“NIR-triggered ROS storage”intraocular implant(CTR-Py-Pp IX)based on capsular tension ring(CTR),which is concurrently linked with photosensitizer protophorphyrin IX(Pp IX)and energy storage2-pyridone derivative(Py),to guarantee instantaneous and sustainable ROS generation for LECs killing,aiming to achieve more efficient and safer photodynamic therapy(PDT)to effectively prevent PCO.The silylated Pp IX-Si and Py-Si were covalently conjugated to the plasma activated CTR surface to obtain CTR-Py-Pp IX.Results demonstrated that CTR-Py-Pp IX had dual functions of PDT and battery,in which Pp IX could generate ROS extracellularly under irradiation,with one part directly inhibiting LECs by lipid peroxidation(LPO)induction of cell membranes.Meanwhile,the excess ROS stored in Py could be continuously released to amplify LPO levels after the irradiation was removed.Ultimately,the proliferation of LECs in capsular bag was completely inhibited under mild irradiation conditions,achieving a sustainable and controlled PDT effect for effective PCO prevention with good biocompatibility.This NIR-triggered ROS storage intraocular implant would provide a more efficient and safer approach for long-term PCO prevention.

Experimental study on cyclosporine A drug delivery system in prevention of posterior capsule opacification after intraocular lens implantation in rabbits

Objective To study the effect of cyclosporine A drug delivery system (CsA-DDS) on the prevention of posterior capsule opacification (PCO) after experimental intraocular lens implantation in rabbit eyes. Methods Twenty healthy New Zealand white rabbits, whose left eyes and right eyes were used respectively as experiment eyes and controls, were subjected to extracapsular lens extraction and artificial lens implantation. During the operation, CsA-DDS with poly (lactideco-glycolide) as carriers or empty DDS was implanted in the capsular bag for the experimental eyes and controls respectively. After the operation, anterior chamber reaction, intraocular pressure (IOP) and CsA concentration were monitored and twelve weeks after the operation, the eyes were extracted for histopathological and morphological examinations. Results There were no differences between the two groups in conjunctival congestion, IOP change and anterior chamber reaction. PCO was less severe in the experimental eyes than in the controls. Light microscopy revealed that posterior capsular membrane in the experimental eyes was slick, with no obvious proliferation, whereas in the controls, there were lens epithelial cell proliferation and cortex regeneration of different degrees. Morphological examination with electron microscope showed that in the experimental eyes, lens epithelial cells did not function actively and apoptosis occurred, whereas in the controls, epithelial cells presented active function. No marked ultrastructural changes were found in either group. Conclusion Cs-DDS can inhibit PCO after intraocular lens implantation in rabbit eyes and does not have toxic effects on the surrounding ocular tissues. Therefore, it has a good potential for clinical use in prevention of PCO.

Etiology, pathogenesis, and management of acute intraocular lens opacification: a systematic review

Millions of cataract surgeries with intraocular lens(IOL) implantation are performed worldwide. Although cataract surgery brings many benefits to the patients, the risk of various complications is still a concern. One of the infrequent adverse events but potentially affecting on patients’ visual acuity and contrast sensitivity is losing the transparency of IOL. IOL opacification may lead to IOL removal or exchange, which is unpleasant to both the patient and the surgeon. Several reports of acute IOL clouding are available in the literature describing various etiologies of this phenomenon, however, the exact mechanism remained unclear in some cases. Herein, we aimed to review the causes and outcomes of intraoperative and early postoperative IOL opacification.

Staged lensectomy and vitrectomy in the management of stage 5C retinopathy of prematurity with corneal opacification:long-term follow up

·AIM:To verify the feasibility and safety of staged lensectomy and vitrectomy in stage 5 C retinopathy of prematurity(ROP)with corneal opacification.·METHODS:This was a retrospective,interventional,consecutive case series.Twenty-two eyes of 18 stage 5 C ROP patients with corneal opacification were included.Regular combined lensectomy and vitrectomy were not prescribed due to the invisible fundus.Staged lensectomy and posterior vitrectomy were performed.The anatomical and visual outcomes were reviewed at the final follow-up visit.·RESULTS:The mean gestational age of ROP patients was29.3±1.6 wk(range:27-32 wk),comprising 8 males and 10 females.The average birth weight was 1363.0±300.0 g.All the eyes had corneal opacity and flat or disappeared anterior chambers pre-operatively.Two eyes had complicated cataract and 7 eyes had retrolental fibroplasia.Six eyes had posterior pupillary synechiae or membranes.Seven(31.8%)eyes had vascularly active retinas.The average interval between two procedures was 6.8±4.6 mo(2.5-18.5 mo).After surgeries,all the patients had normal anterior chambers.Fourteen eyes had clear corneas.The intraocular pressure of 3 eyes with glaucoma was controlled by medication.Two eyes had ocular phthisis.The retina was reattached in 3 eyes and partially attached in 11 eyes.Visual acuity ranged from no light perception to hand motion.·CONCLUSION:Staged lensectomy and vitrectomy are procedures that can halt progression to further complications and preserve some useful eyesight in stage5 C ROP patients with corneal opacification.The earlier the lensectomy is performed,the better the prognosis is.

Anterior segment OCT application in quantifying posterior capsule opacification severity with varied intraocular lens designs

AIM:To evaluate the application of anterior segmentoptical coherence tomography(AS-OCT)in posterior capsule opacification(PCO)severity assessment and analyse the relationship between PCO severity and intraocular lens(IOL)characters.METHODS:PCO patients were prospectively recruited.Cross-sectional images of the anterior segment at horizontal and vertical meridians were acquired with AS-OCT.The area of the IOL-PC(posterior capsular)space and PCO severity(area,thickness,and density at 3 mm and 5 mm IOL optic regions)were measured.The relationship between PCO severity and visual acuity,comparisons of PCO severity and IOL-PC space using varied IOL designs were analysed.RESULTS:One hundred PCO eyes were enrolled.IOL-PC space,PCO thickness and area were positively correlated with axial length.In addition,PCO area and thickness were positively correlated with visual acuity when it was≤0.52 log MAR.The cut-off level of visual acuity should be 0.52 log MAR.With varied IOL designs,3-piece C haptic IOL showed a smaller PCO area and thickness than the 1-piece 3 haptic IOL and 1-piece 4 haptic IOL.PCO area and thickness values for an IOL with a diameter≤11.0 mm was greater than for an IOL with a diameter of 12.5 mm,and the differences were statistically significant.PCO area and thickness increased when IOL haptic angulation increased(from 0 to 12 degrees).CONCLUSION:In PCO eyes,cut-off level of visual acuity is 0.52 log MAR.With more severe PCO,visual acuity maybenot enough to describe the visual function impairment.PCO severity and IOL-PC space are significantly correlated with axial length and IOL design and material.

Effect of Liposome-Encapsulated Total Alkaloid of Harmaline on Rabbit Lens Epithelial Cells:Experimental Study on the Prevention of Posterior Capsule Opacification

Purpose: To investigate whether liposome encapsulated total alkaloid of Harmaline (TAH) as a therapeutic agent is beneficial to prevention of posterior capsular opacifi-cation (PCO).Methods: Liposome-encapsulated TAH was prepared by modified freeze-thawing method. 0. 1ml of liposome-encapsulated TAH (0. 2mg/ml) was injected into the capsular bag during extracapsular lens extraction (ECLE) of each eye in total 10 rabbit eyes. Blank liposome or balance salt solution (BSS) was used as control. Slit-lamp examination and histopathological examination was used to evaluated capsule opacifica-tion. Intraocular pressure (IOP) , density and morphology of corneal endothelia cells, the amplitude and latency of b wave of ERG were measured.Results: The inflammatory response was mild both in TAH treated and the control group. PCO formation occurred in the control group 2 weeks postoperatively, but the posterior capsule was clear in TAH treated eyes. 4 weeks and 8 weeks after operation, PCO occurred both in TAH

左心腔声学造影评估恶性肿瘤化疗患者左室容积、射血分数及整体纵向应变的可重复性研究

目的:探讨左心腔声学造影(left ventricular opacification,LVO)评估恶性肿瘤化疗患者左室容积、射血分数(left ventricular ejection fraction,LVEF)及整体纵向应变(left ventricular global longitudinal strain,LVGLS)的可重复性研究。方法:前瞻性收集经病理证实且需抗肿瘤化疗的患者53例,根据二维心脏超声图像质量分为图像清晰组23例和图像不清晰组30例(两个及以上节段显示不清)。然后将6名不同职称资历超声医师分为高级、中级及初级3组,每组2人,均可独立完成心脏超声检查(心脏超声工作年限均≥4年),分别对患者进行心尖四腔心、二腔心、三腔心、左心长轴及左室乳头肌短轴切面图像的常规经胸超声心动图(TTE)与LVO的数据采集,用PACS系统将所有患者测量的数据进行左室容积、LVEF及LVGLS的评估。结果:3组6名超声医师分别对所有患者的图像资料进行分析,其测量参数经Kendall's W检验分析及信度分析,ICC为0.301~0.936。在图像清晰组中,左室容积、LVEF及LVGLS的一致性均较好(P<0.001)。在图像不清晰组中,对于LVEF、LVEDV及LVGLS的测量,TTE一致性较差(P>0.001),LVO测量一致性有了明显改善,但Kendall's W检验值仍偏低。对于LVESV的测量,各组及造影前后测量的一致性均较好(P<0.001)。结论:LVO能明显改善心脏超声图像不清晰的恶性肿瘤化疗患者左室容积、LVEF及LVGLS测量的准确性及可重复性,减少不同超声医师测量操作之间的差异。

血清及房水IGF-1、SOD水平在预测糖尿病性白内障患者术后发生囊膜混浊中的应用

目的探讨血清及房水胰岛素样生长因子1(IGF-1)、超氧化物岐化酶(SOD)水平在预测糖尿病性白内障(DC)患者术后发生囊膜混浊(PCO)中的应用价值。方法选择120例DC患者为DC组,同期选择接受手术治疗的单纯白内障患者77例为对照组。所有DC患者术后至少随访6个月,根据是否并发PCO将DC患者分为PCO组(21例)和非PCO组(99例)。术前用酶联免疫吸附试验检测血清及房水中IGF-1、SOD,收集DC患者术后发生PCO的相关资料。用多因素Logistic回归分析血清及房水IGF-1、SOD对DC患者术后发生PCO的影响;绘制受试者工作特征(ROC)曲线,用曲线下面积比较血清及房水IGF-1、SOD预测DC患者术后发生PCO的价值。结果DC组血清及房水IGF-1水平高于对照组(P均<0.05),SOD水平低于对照组(P均<0.05)。PCO组年龄、C反应蛋白水平、亲水型人工晶体比例高于非PCO组(P均<0.05)。亲水型人工晶体、房水IGF-1水平高是DC患者术后发生PCO的危险因素(P均<0.05),房水SOD水平高是保护因素(P<0.05)。血清及房水IGF-1、SOD预测DC患者术后发生PCO的曲线下面积分别为0.749、0.720、0.859、0.884,房水IGF-1、SOD预测DC患者术后发生PCO的曲线下面积大于血清IGF-1、SOD预测的曲线下面积(P均<0.05),房水IGF-1、SOD联合预测DC患者术后发生PCO的曲线下面积为0.967,大于房水IGF-1、SOD单独预测的曲线下面积(P均<0.05)。结论房水IGF-1水平升高、SOD水平降低与DC患者术后发生PCO有关,血清及房水中IGF-1、SOD可用于预测DC患者术后PCO的发生,且房水中IGF-1、SOD联合预测的价值较高。

术前HbA1c水平对糖尿病患者白内障超声乳化术后后囊膜混浊的影响及阈值效应分析

目的:分析术前糖化血红蛋白(HbA1c)水平对糖尿病患者白内障超声乳化术后后囊膜混浊(PCO)的预测价值及阈值效应。方法:回顾性研究。收集2018-09/2020-09于本院就诊的糖尿病合并白内障患者106例106眼,根据患者术后36 mo是否发生PCO分为PCO组52例52眼和非PCO组54例54眼。分析患者术后发生PCO的影响因素。对患者术前HbA1c水平与患者术后发生PCO的发生情况进行阈值效应分析。采用受试工作者特征(ROC)曲线评估术前HbA1c水平对患者术后发生PCO的预测价值。构建预测模型,采用Bootstrap重采样对预测模型进行验证,并对模型的区分度和准确度进行评价。结果:两组患者糖尿病病程、有无糖尿病视网膜病变、空腹血糖、餐后2 h血糖、术前HbA1c、眼轴长度、核硬度分级均有差异(P<0.05)。糖尿病病程≥12 a、有DR、空腹血糖≥8 mmol/L、餐后2 h血糖≥12 mmol/L、术前HbA1c≥7%、眼轴长度≥30 mm、核硬度分级Ⅲ级及以上均为影响患者术后发生PCO的因素(P<0.05)。曲线拟合发现随着HbA1c水平的升高,糖尿病患者白内障超声乳化术后发生PCO的概率呈现上升趋势。阈值效应分析发现,当HbA1c≥7%时,术后PCO的发生率随着HbA1c水平的增加而升高。敏感性分析显示E值=2.129。术前HbA1c与糖尿病患者白内障超声乳化术后发生PCO程度的关联效应分析结果显示,调整后术前HbA1c水平是糖尿病患者术后发生PCO不同程度混浊的影响因素,存在独立相关性(OR=1.65,95%CI:1.42-1.76,P=0.021)。当预测模型P=0.6时,模型预测准确度为88.51%,敏感度和特异度分别为86.33%和86.82%,表示糖尿病白内障患者出现PCO的结局。结论:糖尿病病程、有DR、空腹血糖、餐后2 h血糖、术前HbA1c、眼轴长度、核硬度分级是影响糖尿病患者白内障超声乳化术后发生PCO的因素,且术前HbA1c可作为评估患者术后发生PCO的敏感指标。

HSYA对人晶状体上皮细胞系SRA01/04生物学特性的影响

目的探讨羟基红花黄色素A(HSYA)对重组人表皮生长因子(rhEGF)诱导的人晶状体上皮细胞系SRA01/04(HLEC-SRA01/04)增殖、迁移及上皮-间质转化(EMT)的影响。方法研究时间为2022年6月至2023年9月。不同浓度HSYA溶液处理rhEGF诱导的HLEC-SRA01/04不同时长,四甲基偶氮唑蓝(MTT)比色法检测各组细胞的增殖状态并计算半数抑制浓度值(IC50)。细胞划痕实验与Transwell小室测定不同浓度组细胞的迁移能力。逆转录荧光定量聚合链式反应法(RT-qPCR)与蛋白印迹法(Western Blot)测定不同浓度组细胞内增殖细胞核抗原(PCNA)及EMT标记物波形蛋白(Vimentin)的mRNA表达水平与蛋白含量。计量资料采用t检验。结果MTT实验结果示:选取20、40、60、80、100μmol/L的HSYA溶液处理5μg/L rhEGF诱导人晶状体上皮细胞24 h后,增殖抑制率分别为(12.1±0.6)%、(19.0±3.8)%、(31.5±2.2)%、(53.7±0.4)%、(70.8±0.3)%,IC50值为(76.520±0.954)μmol/L,48 h增殖抑制率分别为(14.3±3.7)%、(27.4±3.1)%、(42.6±2.7)%、(59.2±2.2)%、(81.0±1.0)%,IC50值为(66.094±2.508)μmol/L,呈明显剂量依赖性。细胞划痕实验结果显示:空白组及0、20、40、70、100μmol/L组的24 h细胞迁移率分别为(46.9±1.8)%、(90.0±1.5)%、(88.4±2.1)%、(43.3±6.6)%、(31.5±16.2)%、(5.82±5.2)%,48 h细胞迁移率分别为(81.1±2.3)%、100%、(95.5±0.1)%、(72.6±3.5)%、(58.5±6.1)%、(37.4±7.1)%。Transwell小室实验结果显示:空白组及0、20、40、70、100μmol/L组的细胞数分别为(171.667±20.407)个、(290.222±24.135)个、(198.667±16.826)个、(161.222±5.981)个、(134.111±6.850)个、(67.444±7.351)个,HSYA对rhEGF诱导人晶状体上皮细胞迁移的抑制呈明显浓度依赖性。RT-qPCR法及Western Blot法结果示:HSYA可明显下调rhEGF诱导的人晶状体上皮细胞内PCNA、Vimentin及mRNA表达水平,呈剂量依赖性。结论HSYA可明显抑制rhEGF诱导的HLEC-SRA01/04增殖、迁移及EMT,可能成为预防后发性白内障的潜在药物。

冠状动脉CTA腔内密度校正差诊断冠状动脉支架内再狭窄的应用价值

目的探讨冠状动脉电子计算机断层扫血管成像(CTA)腔内密度校正差(DCCO)诊断冠状动脉支架内再狭窄(ISR)的临床价值。方法回顾性选取2021年1月至2024年2月在新疆医科大学第一附属医院接受冠状动脉支架植入治疗的患者86例作为研究对象。均为术后出现疑似复发的冠状动脉疾病或支架内再狭窄症状,并在1个月内接受CTA与有创冠状动脉造影(ICA)检测。比较ISR与血管开放的DCCO值以及不同方法诊断ISR的结果。结果ICA检查结果显示,152支血管中通畅89支,ISR 63支;CTA检测为通畅82支,ISR 70支。CTA与ICA对ISR诊断的Kappa值为0.613,一致性一般。ISR组血管的DCCO值相比通畅组血管明显升高,差异有统计学意义(P<0.05)。DCCO结合CTA检测为通畅87支,ISR 75支。DCCO结合CTA与ICA对ISR诊断的Kappa值为0.838,一致性较高。DCCO结合CTA诊断ISR的敏感度、特异度、阳性预测值、阴性预测值、诊断符合率分别为92.06%、92.13%、89.39%、95.35%、92.76%,均明显高于单纯CTA(82.54%、79.78%、74.29%、86.59%、80.92%),差异均有统计学意义(P<0.05)。结论冠状动脉CTA腔内密度校正差,能够在一定水平上提升对ISR的检测精确度,可作为评价动脉狭窄程度的定量指标参数,具有较高的临床应用价值。

Overexpression of TRPV1 activates autophagy in human lens epithelial cells under hyperosmotic stress through Ca^(2+)-dependent AMPK/mTOR pathway

●AIM:To explore whether autophagy functions as a cellular adaptation mechanism in lens epithelial cells(LECs)under hyperosmotic stress.●METHODS:LECs were treated with hyperosmotic stress at the concentration of 270,300,400,500,or 600 mOsm for 6,12,18,24h in vitro.Polymerase chain reaction(PCR)was employed for the mRNA expression of autophagyrelated genes,while Western blotting detected the targeted protein expression.The transfection of stub-RFP-sens-GFPLC3 autophagy-related double fluorescence lentivirus was conducted to detect the level of autophagy flux.Scanning electron microscopy was used to detect the existence of autolysosome.Short interfering RNA of autophagy-related gene(ATG)7,transient receptor potential vanilloid(TRPV)1 overexpression plasmid,related agonists and inhibitors were employed to their influence on autophagy related pathway.Flow cytometry was employed to test the apoptosis and intracellular Ca^(2+)level.Mitochondrial membrane potential was measured by JC-1 staining.The cell counting kit-8 assay was used to calculate the cellular viability.The wound healing assay was used to evaluate the wound closure rate.GraphPad 6.0 software was utilized to evaluate the data.●RESULTS:The hyperosmotic stress activated autophagy in a pressure-and time-dependent manner in LECs.Beclin 1 protein expression and conversion of LC3B II to LC3B I increased,whereas sequestosome-1(SQSTM1)protein expression decreased.Transient Ca^(2+)influx was stimulated caused by hyperosmotic stress,levels of mammalian target of rapamycin(mTOR)phosphorylation decreased,and the level of AMP-activated protein kinase(AMPK)phosphorylation increased in the early stage.Based on this evidence,autophagy activation through the Ca^(2+)-dependent AMPK/mTOR pathway might represent an adaptation process in LECs under hyperosmotic stress.Hyperosmotic stress decreased cellular viability and accelerated apoptosis in LECs and cellular migration decreased.Inhibition of autophagy by ATG7 knockdown had similar results.TRPV1 overexpression increased autophagy and might be crucial in the occurrence of autophagy promoted by hyperosmotic stress.●CONCLUSION:A combination of hyperosmotic stress and autophagy inhibition may be a promising approach to decrease the number of LECs in the capsular bag and pave the way for improving prevention of posterior capsular opacification and capsular fibrosis.

Fabrication of a 3D bioprinting model for posterior capsule opacification using GelMA and PLMA hydrogel-coated resin

Posterior capsule opacification(PCO)remains the predominant complication following cataract surgery,significantly impairing visual function restoration.In this study,we developed a PCO model that closely mimics the anatomical structure of the crystalline lens capsule post-surgery.The model incorporated a threaded structure for accurate positioning and observation,allowing for opening and closing.Utilizing 3D printing technology,a stable external support system was created using resin material consisting of a rigid,hollow base and cover.To replicate the lens capsule structure,a thin hydrogel coating was applied to the resin scaffold.The biocompatibility and impact on cellular functionality of various hydrogel compositions were assessed through an array of staining techniques,including calcein-AM/PI staining,rhodamine staining,BODIPY-C11 staining and EdU staining in conjunction with transwell assays.Additionally,the PCO model was utilized to investigate the effects of eight drugs with anti-inflammatory and anti-proliferative properties,including 5-aminoimidazole-4-carboxamide ribonucleotide(AICAR),THZ1,sorbinil,4-octyl itaconate(4-OI),xanthohumol,zebularine,rapamycin and caffeic acid phenethyl ester,on human lens epithelial cells(HLECs).Confocal microscopy facilitated comprehensive imaging of the PCO model.The results demonstrated that the GelMA 605%þPLMA 2%composite hydrogel exhibited superior biocompatibility and minimal lipid peroxidation levels among the tested hydrogels.Moreover,compared to using hydrogel as the material for 3D printing the entire model,applying surface hydrogel spin coating with parameters of 2000 rpm�2 on the resin-based 3D printed base yielded a more uniform cell distribution and reduced apoptosis.Furthermore,rapamycin,4-OI and AICAR demonstrated potent antiproliferative effects in the drug intervention study.Confocal microscopy imaging revealed a uniform distribution of HLECs along the anatomical structure of the crystalline lens capsule within the PCO model,showcasing robust cell viability and regular morphology.In conclusion,the PCO model provides a valuable experimental platform for studying PCO pathogenesis and exploring potential therapeutic interventions.

Consilience and unity in ocular anterior segment research

In his beautiful book,Consilience:The Unity of Knowledge,the eminent biologist Edward O Wilson,advocates the need for integration and reconciliation across the sciences.He defines consilience as“literally a‘jumping together’of knowledge with a linking of facts…to create a common groundwork of explanation”.It is the premise of this paper that as much as basic biomedical research is in need of data generation using the latest available techniques–unifying available knowledge is just as critical.This involves the necessity to resolve contradictory findings,reduce silos,and acknowledge complexity.We take the cornea and the lens as case studies of our premise.Specifically,in this perspective,we discuss the conflicting and fragmented information on protein aggregation,oxidative damage,and fibrosis.These are fields of study that are integrally tied to anterior segment research.Our goal is to highlight the vital need for Wilson’s consilience and unity of knowledge which in turn should lead to enhanced rigor and reproducibility,and most importantly,to greater understanding and not simply knowing.

超声乳化联合玻璃体腔抗VEGF注药术对后发性白内障预防价值分析

目的 分析白内障手术联合玻璃体腔抗血管内皮生长因子(VEGF)治疗对后发性白内障的影响。方法 采用回顾性临床队列研究,回顾性分析2020年1月至2021年3月就诊于苏州大学附属第三医院眼科行白内障手术的患者41例(54眼)。其中,试验组23例(27眼)行白内障超声乳化吸除+人工晶体植入联合玻璃体腔抗VEGF药物注射术;对照组18例(27眼)行单纯白内障超声乳化吸除+人工晶体植入术。所有患者术后随访24个月,比较两组患者术后最佳矫正视力、后发性白内障以及其他眼部并发症的发生情况。结果 术后24个月患者的最佳矫正视力均有不同程度的提高;试验组后发性白内障的发生率明显低于对照组,差异有统计学意义(P <0.05);仅有1例试验组患者出现术后一过性眼压升高,其余患者术后眼压均正常。结论 白内障超声乳化吸除+人工晶体植入联合玻璃体腔抗VEGF药物注射术安全可靠,并可有效降低后发性白内障的发生率。

人工晶状体混浊的研究进展

人工晶状体(IOL)混浊是白内障术后一种少见的并发症。其发生与IOL生产制作过程、IOL本身材质、患者因素以及手术干预等多种因素相关。各种材质的IOL混浊均有报道,且不同材质IOL混浊形态学改变、病理学特征各有特点,临床表现不尽相同。随着相关研究的开展,对IOL混浊的认识也越来越全面。文章对IOL混浊的形态学、病因、诊断及治疗的最新进展进行综述,以便为当前的临床工作提供指导,以及未来的科学研究提供潜在方向。