目的比较超声乳化白内障吸除联合人工晶体植入术治疗不同核硬度假性囊膜剥脱综合征性白内障(PEXC)的治疗效果。方法选择2017年6-12月于石家庄爱尔眼科医院就诊的PEXC患者96例(104只眼),根据Eemery核硬度分级分为4组:Ⅱ级核28只眼(Ⅱ级...目的比较超声乳化白内障吸除联合人工晶体植入术治疗不同核硬度假性囊膜剥脱综合征性白内障(PEXC)的治疗效果。方法选择2017年6-12月于石家庄爱尔眼科医院就诊的PEXC患者96例(104只眼),根据Eemery核硬度分级分为4组:Ⅱ级核28只眼(Ⅱ级组),Ⅲ级核28只眼(Ⅲ级组),Ⅳ级核27只眼(Ⅳ级组),Ⅴ级核21只眼(Ⅴ级组)。所有患者均行超声乳化白内障吸除联合人工晶体植入术。比较4组术后裸眼视力、矫正视力、眼压、角膜内皮细胞计数、术中术后并发症。结果术后3个月,4组裸眼视力≥0.5、矫正视力≥0.8、术后眼压增加≥21 mm Hg发生率、角膜内皮细胞丢失率及术中、术后并发症发生率比较,差异均有统计学意义(P<0.05)。结论PEXC早期手术视力恢复好,且并发症少。术前需仔细散瞳详查晶体状态、术中精细谨慎操作并选择恰当的手术方式是手术成功的关键。展开更多
Background/aims: Pseudoexfoliation syndrome (PXF) was recently found to be associated with increased expression of transforming growth factor β 1 (TGFβ 1) in the aqueous humour. As concern has been raised regarding ...Background/aims: Pseudoexfoliation syndrome (PXF) was recently found to be associated with increased expression of transforming growth factor β 1 (TGFβ 1) in the aqueous humour. As concern has been raised regarding anti-TGFβ therapy, which can potentially disrupt the maintenance of anterior chamber associated immune deviation, the authors explored the levels of tissue inhibitor ofmatrixmetalloproteinase-1 (TIMP-1),matrix metalloproteinase-9 (MMP-9), and connective tissue growth factor (CTGF) in aqueous humour to determine if these may represent alternative therapeutic targets. Methods: Aqueous humour samples were collected from patients who underwent routine cataract surgery. All patients were categorised into three main groups-PXF, uveitis, and control. The PXF group was further subcategorised into three grades based on the density of the exfoliative material observed on biomicroscopy, as well as the presence or absence of glaucoma. TIMP-1, MMP-9, and CTGF levels were measured using specific enzyme immunoassays (ELISA). Results: Eyes with PXF had significantly higher aqueous humour TIMP-1 concentration (n=56, mean (SE), 9.76 (1.10) ng/ml) compared with controls (n=112, 5.73 (0.43) ng/ml, P < 0.01). Similarly, the CTGF level in PXF eyes (n=36, 4.38 (0.65) ng/ml) was higher than controls (n=29, 2.35 (0.46) ng/ml, P< 0.05). Further, the CTGF concentration in the PXF glaucoma group is significantly higher compared with PXF eyes without glaucoma (6.03 (1.09) ng/ml v 2.73 (0.45) ng/ml, P< 0.01). The MMP-9 levels were low and below detection limit in all PXF and control samples with no statistical difference between groups. Conclusion: A raised TIMP-1 level and a low MMP-9 level in aqueous humour of PXF eyes may imply a downregulation in proteolytic activity. The increased CTGF concentration supports the proposed fibrotic pathology of PXF. Regulation of MMP/TIMP expression and anti-CTGF therapy may offer potential therapeutic avenues for controlling PXF associated ocular morbidity.展开更多
文摘目的比较超声乳化白内障吸除联合人工晶体植入术治疗不同核硬度假性囊膜剥脱综合征性白内障(PEXC)的治疗效果。方法选择2017年6-12月于石家庄爱尔眼科医院就诊的PEXC患者96例(104只眼),根据Eemery核硬度分级分为4组:Ⅱ级核28只眼(Ⅱ级组),Ⅲ级核28只眼(Ⅲ级组),Ⅳ级核27只眼(Ⅳ级组),Ⅴ级核21只眼(Ⅴ级组)。所有患者均行超声乳化白内障吸除联合人工晶体植入术。比较4组术后裸眼视力、矫正视力、眼压、角膜内皮细胞计数、术中术后并发症。结果术后3个月,4组裸眼视力≥0.5、矫正视力≥0.8、术后眼压增加≥21 mm Hg发生率、角膜内皮细胞丢失率及术中、术后并发症发生率比较,差异均有统计学意义(P<0.05)。结论PEXC早期手术视力恢复好,且并发症少。术前需仔细散瞳详查晶体状态、术中精细谨慎操作并选择恰当的手术方式是手术成功的关键。
文摘Background/aims: Pseudoexfoliation syndrome (PXF) was recently found to be associated with increased expression of transforming growth factor β 1 (TGFβ 1) in the aqueous humour. As concern has been raised regarding anti-TGFβ therapy, which can potentially disrupt the maintenance of anterior chamber associated immune deviation, the authors explored the levels of tissue inhibitor ofmatrixmetalloproteinase-1 (TIMP-1),matrix metalloproteinase-9 (MMP-9), and connective tissue growth factor (CTGF) in aqueous humour to determine if these may represent alternative therapeutic targets. Methods: Aqueous humour samples were collected from patients who underwent routine cataract surgery. All patients were categorised into three main groups-PXF, uveitis, and control. The PXF group was further subcategorised into three grades based on the density of the exfoliative material observed on biomicroscopy, as well as the presence or absence of glaucoma. TIMP-1, MMP-9, and CTGF levels were measured using specific enzyme immunoassays (ELISA). Results: Eyes with PXF had significantly higher aqueous humour TIMP-1 concentration (n=56, mean (SE), 9.76 (1.10) ng/ml) compared with controls (n=112, 5.73 (0.43) ng/ml, P < 0.01). Similarly, the CTGF level in PXF eyes (n=36, 4.38 (0.65) ng/ml) was higher than controls (n=29, 2.35 (0.46) ng/ml, P< 0.05). Further, the CTGF concentration in the PXF glaucoma group is significantly higher compared with PXF eyes without glaucoma (6.03 (1.09) ng/ml v 2.73 (0.45) ng/ml, P< 0.01). The MMP-9 levels were low and below detection limit in all PXF and control samples with no statistical difference between groups. Conclusion: A raised TIMP-1 level and a low MMP-9 level in aqueous humour of PXF eyes may imply a downregulation in proteolytic activity. The increased CTGF concentration supports the proposed fibrotic pathology of PXF. Regulation of MMP/TIMP expression and anti-CTGF therapy may offer potential therapeutic avenues for controlling PXF associated ocular morbidity.
