目的:总结准分子激光原位角膜磨镶术(LA S IK)术后角膜上皮内生的原因及治疗体会。方法:对LA S IK术后眼角膜上皮内生46例48眼的临床资料进行回顾性分析。结果:术前配戴角膜接触镜22例25眼(52.1%),术中角膜上皮水肿、上皮脱落21例26眼(5...目的:总结准分子激光原位角膜磨镶术(LA S IK)术后角膜上皮内生的原因及治疗体会。方法:对LA S IK术后眼角膜上皮内生46例48眼的临床资料进行回顾性分析。结果:术前配戴角膜接触镜22例25眼(52.1%),术中角膜上皮水肿、上皮脱落21例26眼(54.2%),角膜血管翳出血10例10眼(20.8%),角膜瓣薄7例7眼(14.6%),术后层间弥漫性角膜基质炎11例11眼(22.9%)。17例17眼予糖皮质激素眼水滴眼后角膜上皮内生静止;另29例31眼行角膜上皮刮除冲洗,1眼角膜上皮内生复发,再次行上皮刮除冲洗后无再复发。结论:术前配戴角膜接触镜、术中角膜上皮水肿脱落、角膜血管翳出血、薄角膜瓣和术后层间弥漫性角膜基质炎是角膜上皮内生的主要原因,经过适当处理可取得良好疗效。展开更多
目的探讨准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)后角膜上皮内生的理想处理方法。方法1999年1月至2008年12月处理20例(22眼)LASIK术后角膜上皮内生患者,经历3个认识和处理时期。第一时期从1999年1月至2000年12月...目的探讨准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)后角膜上皮内生的理想处理方法。方法1999年1月至2008年12月处理20例(22眼)LASIK术后角膜上皮内生患者,经历3个认识和处理时期。第一时期从1999年1月至2000年12月,处理3例(3眼),均按术后炎症反应处理,无明确角膜上皮内生概念及相关处理方法。第二时期为2001年1月至2004年12月,处理8例(9眼),角膜上皮内生与角膜上皮植入未严格区分,按角膜上皮植入原则处理。第三时期为2005年1月至2008年12月,处理9例(10眼),均为不同情况下引起的角膜上皮内生,其中2例(2眼)为单纯角膜上皮内生,5例(6眼)为皱褶瓣处理后产生的上皮内生,2例(2眼)为角膜划伤后上皮内生。处理要点:①内生上皮处理净后用拖拽法将角膜瓣边晾干边原位复位。②角膜瓣复好位后晾干约5～8min。③处理后不戴角膜接触镜。结果第一时期处理3眼中,2眼角膜瓣被剪除,处理后1个月裸眼视力均为5.0;1眼角膜瓣颞上缘部分溶解,未波及光学区,裸眼视力为4.9。第二时期处理9眼中,6眼1次处理成功;3眼角膜上皮内生复发,处理2d后行再次冲洗处理。处理后1个月裸眼视力:2眼为4.9,6眼为5.0,1眼为5.1。第三时期所处理9例(10眼)均1次处理成功,角膜瓣均平整。2例(2眼)单纯角膜上皮内生患者术后第1个月的裸眼视力均为5.0;5例(6眼)皱褶瓣处理后又产生上皮内生患者,再处理后角膜上皮愈合时间分别为3眼2d、2眼3d、1眼4d,1个月后裸眼视力:2眼为4.8,1眼为4.9,3眼为5.0;2例(2眼)角膜划伤后上皮内生者,处理2d后上皮愈合,7d后角膜炎症消退,1个月后裸眼视力均为4.8。所处理的22眼中,3眼矫正视力下降1行,其余矫正视力均无下降。术后随访3个月以上,所有患者未再见有角膜上皮内生及其他异常。结论处理好角膜上皮内生是LASIK手术安全性的重要保障之一。展开更多
AIM:To investigate the effect of acetyl-L-carnitine(ALCAR)on cell viability,morphological integrity,and vascular endothelial growth factor(VEGF)expression in human retinal pigment epithelium(ARPE-19)cells using a hypo...AIM:To investigate the effect of acetyl-L-carnitine(ALCAR)on cell viability,morphological integrity,and vascular endothelial growth factor(VEGF)expression in human retinal pigment epithelium(ARPE-19)cells using a hypoxic model.METHODS:In the first set of experiments,the optimal CoCl_(2) dose was determined by exposing ARPE-19 cell cultures to different concentrations.To evaluate the effect of ALCAR on cell viability,five groups of ARPE-19 cell culture were established that included a control group,a sham group(200μM CoCl_(2)),and groups that received 1,10 and 100 mM doses of ALCAR combined with 200μM CoCl_(2),respectively.The cell viability was measured by MTT assay.The morphological characteristics of cells were observed by an inverted phase contrast microscope.The levels of VEGF and HIF-1α secretion by ARPE-19 cells were detected by enzyme linked immunosorbent assay(ELISA)assay.RESULTS:ARPE-19 cells were exposed to different doses of CoCl_(2) in order to create a hypoxia model.Nevertheless,when exposed to a concentration of 200μM CoCl_(2),a notable decrease in viability to 83% was noted.ALCAR was found to increase the cell viability at 1 mM and 10 mM concentrations,while the highest concentration(100 mM)did not have an added effect.The cell viability was found to be significantly higher in the groups treated with a concentration of 1 mM and 10 mM ALCAR compared to the Sham group(P=0.041,P=0.019,respectively).The cell viability and morphology remained unaffected by the greatest dose of ALCAR(100 mM).The administration of 10 mM ALCAR demonstrated a statistically significant reduction in the levels of VEGF and HIF-1α compared with the Sham group(P=0.013,P=0.033,respectively).CONCLUSION:The findings from the current study indicate that ALCAR could represent a viable therapeutic option with the potential to open up novel treatment pathways for retinal diseases,particular relevance for age-related macular degeneration(AMD).However,to fully elucidate ALCAR’s application potential in retinal diseases,additional investigation is necessary to clearly define the exact mechanisms involved.展开更多
文摘目的:总结准分子激光原位角膜磨镶术(LA S IK)术后角膜上皮内生的原因及治疗体会。方法:对LA S IK术后眼角膜上皮内生46例48眼的临床资料进行回顾性分析。结果:术前配戴角膜接触镜22例25眼(52.1%),术中角膜上皮水肿、上皮脱落21例26眼(54.2%),角膜血管翳出血10例10眼(20.8%),角膜瓣薄7例7眼(14.6%),术后层间弥漫性角膜基质炎11例11眼(22.9%)。17例17眼予糖皮质激素眼水滴眼后角膜上皮内生静止;另29例31眼行角膜上皮刮除冲洗,1眼角膜上皮内生复发,再次行上皮刮除冲洗后无再复发。结论:术前配戴角膜接触镜、术中角膜上皮水肿脱落、角膜血管翳出血、薄角膜瓣和术后层间弥漫性角膜基质炎是角膜上皮内生的主要原因,经过适当处理可取得良好疗效。
文摘目的探讨准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)后角膜上皮内生的理想处理方法。方法1999年1月至2008年12月处理20例(22眼)LASIK术后角膜上皮内生患者,经历3个认识和处理时期。第一时期从1999年1月至2000年12月,处理3例(3眼),均按术后炎症反应处理,无明确角膜上皮内生概念及相关处理方法。第二时期为2001年1月至2004年12月,处理8例(9眼),角膜上皮内生与角膜上皮植入未严格区分,按角膜上皮植入原则处理。第三时期为2005年1月至2008年12月,处理9例(10眼),均为不同情况下引起的角膜上皮内生,其中2例(2眼)为单纯角膜上皮内生,5例(6眼)为皱褶瓣处理后产生的上皮内生,2例(2眼)为角膜划伤后上皮内生。处理要点:①内生上皮处理净后用拖拽法将角膜瓣边晾干边原位复位。②角膜瓣复好位后晾干约5～8min。③处理后不戴角膜接触镜。结果第一时期处理3眼中,2眼角膜瓣被剪除,处理后1个月裸眼视力均为5.0;1眼角膜瓣颞上缘部分溶解,未波及光学区,裸眼视力为4.9。第二时期处理9眼中,6眼1次处理成功;3眼角膜上皮内生复发,处理2d后行再次冲洗处理。处理后1个月裸眼视力:2眼为4.9,6眼为5.0,1眼为5.1。第三时期所处理9例(10眼)均1次处理成功,角膜瓣均平整。2例(2眼)单纯角膜上皮内生患者术后第1个月的裸眼视力均为5.0;5例(6眼)皱褶瓣处理后又产生上皮内生患者,再处理后角膜上皮愈合时间分别为3眼2d、2眼3d、1眼4d,1个月后裸眼视力:2眼为4.8,1眼为4.9,3眼为5.0;2例(2眼)角膜划伤后上皮内生者,处理2d后上皮愈合,7d后角膜炎症消退,1个月后裸眼视力均为4.8。所处理的22眼中,3眼矫正视力下降1行,其余矫正视力均无下降。术后随访3个月以上,所有患者未再见有角膜上皮内生及其他异常。结论处理好角膜上皮内生是LASIK手术安全性的重要保障之一。
文摘AIM:To investigate the effect of acetyl-L-carnitine(ALCAR)on cell viability,morphological integrity,and vascular endothelial growth factor(VEGF)expression in human retinal pigment epithelium(ARPE-19)cells using a hypoxic model.METHODS:In the first set of experiments,the optimal CoCl_(2) dose was determined by exposing ARPE-19 cell cultures to different concentrations.To evaluate the effect of ALCAR on cell viability,five groups of ARPE-19 cell culture were established that included a control group,a sham group(200μM CoCl_(2)),and groups that received 1,10 and 100 mM doses of ALCAR combined with 200μM CoCl_(2),respectively.The cell viability was measured by MTT assay.The morphological characteristics of cells were observed by an inverted phase contrast microscope.The levels of VEGF and HIF-1α secretion by ARPE-19 cells were detected by enzyme linked immunosorbent assay(ELISA)assay.RESULTS:ARPE-19 cells were exposed to different doses of CoCl_(2) in order to create a hypoxia model.Nevertheless,when exposed to a concentration of 200μM CoCl_(2),a notable decrease in viability to 83% was noted.ALCAR was found to increase the cell viability at 1 mM and 10 mM concentrations,while the highest concentration(100 mM)did not have an added effect.The cell viability was found to be significantly higher in the groups treated with a concentration of 1 mM and 10 mM ALCAR compared to the Sham group(P=0.041,P=0.019,respectively).The cell viability and morphology remained unaffected by the greatest dose of ALCAR(100 mM).The administration of 10 mM ALCAR demonstrated a statistically significant reduction in the levels of VEGF and HIF-1α compared with the Sham group(P=0.013,P=0.033,respectively).CONCLUSION:The findings from the current study indicate that ALCAR could represent a viable therapeutic option with the potential to open up novel treatment pathways for retinal diseases,particular relevance for age-related macular degeneration(AMD).However,to fully elucidate ALCAR’s application potential in retinal diseases,additional investigation is necessary to clearly define the exact mechanisms involved.
