香菇多糖Lentinan的提取分离、生物活性和构效关系的研究进展

香菇多糖Lentinan是从香菇中分离出来的具有重要生物活性的物质,文章系统地阐述了近年来有关香菇多糖Lentinan的提取分离纯化方法、生物活性、结构与活性关系等方面的研究进展,并展望了今后香菇多糖Lentian的研究方向。

Lentinan administration alleviates diarrhea of rotavirus-infected weaned pigs via regulating intestinal immunity

Background:Lentinan(LNT)may regulate many important physiological functions of human and animals.This study aimed to verify whether LNT administration could relieve diarrhea via improving gut immunity in rotavirus(RV)-challenged weaned pigs.Methods:Twenty-eight weaned pigs were randomly fed 2 diets containing 0 or 84 mg/kg LNT product for 19 d(n=14).RV infection was executed on d 15.After extracting polysaccharides from LNT product,its major monosaccharides were analyzed.Then,LNT polysaccharide was used to administrate RV-infected IPEC-J2 cells.Results:Dietary LNT supplementation supported normal function of piglets even when infected with RV,as reflected by reduced growth performance loss and diarrhea prevalence,and maintained gut immunity(P<0.05).The polysaccharide was isolated from LNT product,which molecular weight was 5303 Da,and major monosaccharides included glucose,arabinose and galactose.In RV-infected IPEC-J2 cells,this polysaccharide significantly increased cell viability(P<0.05),and significantly increased anti-virus immunity via regulating pattern recognition receptors and host defense peptides(P<0.05).Conclusion:Those results suggest that LNT administration increases the piglets’resistance to RV-induced stress,likely by supporting intestinal immunity.

Lentinan prolonged survival in patients with gastric cancer receiving S-1-based chemotherapy

AIM:To examine whether administration of lentinan,purifiedβ-1,3-glucan,can prolong survival in advanced gastric cancer patients receiving S-1-based chemotherapy.METHODS:Since 2004,78 patients with metastatic or recurrent gastric cancer have received S-1-based chemotherapy as first-line treatment.Survival,side effects,and the ratio of granulocytes/lymphocytes(G/L ratio)were compared between 2 groups of patients who received chemo-immunotherapy using lentinan and chemotherapy alone.RESULTS:Median overall survival was significantly longer in the former group than in the latter group[689 d(95%CI:431-2339 d)vs 565 d(95%CI:323-662 d),P=0.0406].In addition,the G/L ratio in patients who received lentinan was maintained around or below 2,which was significantly lower than that in patients who received chemotherapy alone(P<0.001).CONCLUSION:Chemo-immunotherapy with lentinan offers a significant advantage over S-1-based chemotherapy alone in terms of survival in patients with advanced gastric cancer.

Rapid Quantification of Bioactive Lentinan with an Aniline Blue Fluorescent Method

Lentinan is a clinically approved immune modulator and its anticancer and immunomodulatory bioactivity is found to be dependent on its triple helical conformation. Therefore, the development of rapid and convenient method for determination of bioactive lentinan with triple helical conformation holds great promise for the quality control of lentinan healthy products. In this work, an aniline blue fluorescent method was optimized and established to accurately and rapidly detect bioactive lentinan. In the presence of lentinan, the fluorescence intensity of aniline blue with 404 nm excitation and 492 nm emission dramatically enhanced within 15 min in pH 10 glycine-NaOH buffer solution, which allowed the analysis of lentinan in a very simple and fast manner. The method allowed for the sensitive determination of lentinan in the range of 1 to 60 μg/mL with a detection limit of 0.25 μg/mL. Notably, the protocol exhibited excellent selectivity for the determination of triple helical lentinan over other saccharides. The method was successfully applied to the detection of bioactive lentinan in health tonic solution, which demonstrated the method had great potential for quality control of lentinan contained products.

Inhibition of H_(2)O_(2)-induced apoptosis of GC2-spg cells by functionalized selenium nanoparticles with lentinan through ROSmediated ERK/p53 signaling pathways

AH_(2)O_(2)-induced oxidative stress injury cell model was established to investigate the antioxidant effect of nanoselenium on mouse spermatocyte lines and the regulation mechanism of the expression level and activity of seleniumcontaining antioxidant enzymes induced by oxidative stress.A safe and effective nano-drug system of functionalized selenium-containing nanoparticles(SeNPs)was developed with lentinan(LNT)(SeNPs@LNT).Mice spermatocyte line GC2-spg cells were treated with SeNPs@LNT(1,2,4,8,16,32μM)for 24-72 h to evaluate the cytotoxicity of selenium.GC2-spg cells were randomly divided into the following groups:control,hydrogen peroxide(H_(2)O_(2)),SeNPs@LNT,and H_(2)O_(2)+SeNPs@LNT groups.H_(2)O_(2)+SeNPs@LNT group was pretreated with SeNPs@LNT 4μM for 12 h,followed by H_(2)O_(2)600μM for 8 h.The cell viability decreased in the H_(2)O_(2) group and increased significantly in the SeNPs@LNT group.Compared with the H_(2)O_(2) group,the SeNPs@LNT+H_(2)O_(2) group exhibited obvious red fluorescence,indicating a higher level of mitochondrial membrane potential.The content of intracellular reactive oxygen species(ROS)in the SeNPs@LNT group reduced significantly,and the intensity of green fluorescence in the SeNPs@LNT+H_(2)O_(2) group decreased significantly compared with the H_(2)O_(2) group,indicating the inhibitory effect of SeNPs@LNT on the generation of ROS-induced oxidative stress.The activity of GPx and SOD increased significantly in the SeNPs@LNT group.The expression of p53 decreased significantly under the intervention of nano-selenium,and GPx1 expression increased.In the oxidative stress group,the expressions of DNA damage-related proteins and apoptosis-related proteins were higher than those in other groups.Thus,SeNPs@LNT can promote GC2-spg cell proliferation,improve GPx and SOD activities,remove intracellular ROS,and reduce mitochondrial damage and functional abnormalities caused by oxidative stress by regulating the ERK and p53 protein levels.SeNPs@LNT has good biological activity and antioxidant effect,which can be used to protect the male reproductive system from oxidative stress.

Inhibition of H_(2)O_(2)-induced TM3 cell apoptosis by oxidative stress by lentinan functionalized selenium nanoparticles through JAK2/STAT-3 and P53 pathways

Background:Nano-selenium has been widely used in antiviral and anticancer therapy,and has the advantages of good targeting and low toxicity.For the first time,we combined male reproduction with nano-selenium to investigate its antioxidant effect.This study investigated the protective effect of lentinan functionalized selenium nanoparticles on oxidative stress injury of the hydrogen peroxide(H_(2)O_(2))-induced Leydig cell line,TM3.Methods:The suitable concentration of nano-selenium treatment to promote cell proliferation was also discussed.The concentration of 4μM could significantly promote the growth of TM3 cells.Oxidative stress damage was caused using an 800μM concentration of hydrogen peroxide.The cells were divided into four groups:normal control group,oxidative stress treatment group,H_(2)O_(2)+SeNPs@LNT group,and SeNPs@LNT group.The H_(2)O_(2)+SeNPs@LNT group was pretreated with 4μM of SeNPs@LNT for 12 h,followed by 800μM of H_(2)O_(2)for 8 h.Results:Nano-selenium could significantly promote the proliferation and viability of TM3 cells.SeNPs@LNT treatment increased the level of mitochondrial membrane potential in normal cells and slowed down the decline in mitochondrial membrane potential level caused by oxidative stress injury.In addition,the increase in reactive oxygen species caused by oxidative stress was inhibited by SeNPs@LNT treatment.The apoptosis of TM3 cells was detected,and SeNPs@LNT alleviated the necrosis and apoptosis of TM3 cells induced by H_(2)O_(2).Nano-selenium plays a protective role against oxidative H_(2)O_(2)-induced stress injury in TM3 cells through the changes in the Janus kinase 2/signal transducer and activator of transcription 3 signaling pathway and P53 pathway,and the expression levels of other related proteins,protein kinase B(AKT)and C3.Conclusion:SeNPs@LNT exhibited good biological activity and antioxidant effect and can thus be used to protect the male reproductive system from oxidative stress.

Advances in Research of Biological Activity,Action Mechanism and Structure-Activity Relationship of Lentinan

Lentinula edodes is the second largest edible mushroom in the world and is widely used as food and medicine.Modern research shows that lentinan(LNT)is the main active component of L.edodes.It has anti-cancer,treatment of diabetes,intestinal protection,anti-inflammatory,anti-oxidation,anti-aging,hepatoprotective,immune-regulating effects.In this review,the biological activity,action mechanism and structure-activity relationship of LNT in recent years are reviewed.On this basis,the existing problems were discussed,and the future research and application of LNT were prospected.Finally,it is hoped that this review will promote the in-depth study of LNT and provide a reference for its development as a drug and functional food.

Effects of lentinan and thymopentin combined with adjuvant chemotherapy on immunity, oxidative stress, matrix metalloproteinases and related factors in patients with tongue squamous cell carcinoma

Objective:To investigate the effects of lentinan and thymopentin combined with adjuvant chemotherapy on immunity, oxidative stress, matrix metalloproteinases and related factors in patients with tongue squamous cell carcinoma.Methods: Retrospective analysis of 78 patients with tongue squamous cell carcinoma admitted to our hospital from February 2013 to November 2017, according to the postoperative chemotherapy scheme, the patients were divided into control group (n=42) and observation group (n=36). The patients in control group were given PF chemotherapy scheme (cisplatin + compound fluorouracil injection), on this basis, the patients in observation group were given lentinan and thymopentin injection combined treatment. The immune index, oxidative stress, matrix metalloproteinase, cyclin D1 (CyclinD1) and B lymphocyte tumor-2 (BCL-2) were detected and analyzed before and after treatment.Results:After treatment, the immunoglobulin level in the control group was not statistically significant compared with that before treatment (P>0.05);the levels of IgA, IgG and IgM in the observation group were significantly higher than those before treatment (P<0.05), and the levels of IgA, IgG and IgM in the observation group were significantly higher than those in the control group (P<0.05);the level of SOD in control group was significantly lower than that before treatment (P<0.05), and the level of MDA was significantly higher than that before treatment (P<0.05);the observation group was the opposite, and its SOD level was significantly higher than that of the control group (P<0.05), and the MDA level was significantly lower than the control group (P<0.05);the levels of MMP-2 and MMP-9 in the two groups were significantly lower than those before treatment (P<0.05), and the levels of MMP-2 and MMP-9 in the observation group were significantly lower than those in the control group (P<0.05);the levels of CyclinD1 and BCL-2 in the two groups were significantly lower than those before treatment (P<0.05), and the levels of CyclinD1 and BCL-2 in the observation group were significantly lower than those in the control group (P<0.05).Conclusions:Lentinan and thymopentin assisted PF chemotherapy regimen can enhance the immune function of patients with tongue squamous cell carcinoma after radical surgery, improve oxidative stress response, inhibit tumor cell proliferation and metastasis. It has the significance of clinical popularization.

Sutured scleral fixation of existing subluxated/dislocated acrylic one-piece intraocular lenses

AIM:To evaluate the visual and refractive outcomes in cases after sutured scleral fixation of existing subluxated or dislocated acrylic one-piece intraocular lenses(IOLs).METHODS:This study retrospectively enrolled a consecutive series of patients who underwent a surgery of sutured existing subluxated or dislocated IOLs from October 2018 to June 2020.All patients underwent comprehensive preoperative and postoperative ophthalmologic examination,and data were collected including age,sex,surgical indications,best-corrected visual acuity,refractive error,intraocular pressure.Presence of intraoperative and postoperative surgical complications was documented.RESULTS:A total of 20 consecutive cases were enrolled for analysis with mean final follow-up period 9.8±5.3mo.Visual acuity improved from a mean of 0.35(0.46±0.32 logMAR)preoperatively to 0.61(0.21±0.18 logMAR)at the 3-month follow-up(P=0.002).The mean amount of preoperative keratometric astigmatism and total postoperative refractive astigmatism was-1.24±0.80 diopters(D)and-1.42±0.97 D,respectively.There was no statistically significant difference between preoperative and postoperative astigmatism(P=0.156).The mean IOL-induced astigmatism was-0.23±0.53 D.The mean spherical equivalent at the 3-month follow-up was-0.1±0.94 D.No major complications were noted during the follow-up period.CONCLUSION:Surgical techniques using sutured scleral fixation of existing subluxated or dislocated acrylic one-piece IOLs result in favorable visual and refractive outcomes without major complications.

Early clinical outcome with lens position adjustment following implantable collamer lens surgery

AIM:To observe early clinical outcome with lens position adjustment following the implantable collamer lens(ICL)surgery.METHODS:Sixty patients were selected for this retrospective study.One eye from each patient received Toric ICL for astigmatism correction,and the other received non-astigmatic ICL surgery using horizontal position.Patients with higher postoperative arch height were selected,and their non-astigmatic eye clinical outcome were observed after ICL surgery at 1wk,1,and 3mo.The clinical measurements included uncorrected visual acuity(UCVA),intraocular pressure(IOP),refractive state,corneal endothelium cell count,and arch height.Three months later,the ICL in each patient’s non-astigmatic eye was adjusted to the vertical from the horizontal position.The results were compared before and 1wk,1,and 3mo after adjustment.RESULTS:UCVA and IOP were significantly reduced 1wk after position adjustment compared to 1wk after ICL implantation(P<0.05).The patients demonstrated significantly reduced arch height and corneal endothelium cell count 1wk,1,and 3mo after adjusting position compared to 1wk,1,and 3mo after ICL implantation(P<0.05).However,there was no significant difference in refraction between 1wk,1,and 3mo after ICL implantation and position adjustment(P>0.05).CONCLUSION:Early positioning adjustment postphakic ICL implantation can benefit patients with adjusted arch height or higher IOP.Despite the good clinical effects,the doctors should pay attention to the potential for adverse effects on UCVA and corneal endothelium cells following early position adjustment after posterior chamber phakic ICL implantation.

Evaluating the Effects of Graviton Redshift upon Spiral Galaxy Rotation Curves, Surface Brightness Magnitudes and Gravitational Lensing

The effects of the gravitational redshift of gravitons upon spiral galaxy rotation energy are compared to the standard mass to light analyses in obtaining rotation curves. The derivation of the total baryonic matter compares well with the standard theory and the rotation velocity is matched to a high precision. The stellar mass distributions obtained from the fit with graviton energy loss are used to derive the surface brightness magnitudes for the galaxies, which agree well with the observed measurements. In a new field of investigation, the graviton theory is applied to the observations of gravitational lenses. The results of these applications of the theory suggest that it can augment the standard methods and may eliminate the need for dark matter.

Optical Microsphere Nano-Imaging:Progress and Challenges

The optical diffraction effect imposes a radical obstacle preventing conventional optical microscopes from achieving an imaging resolution beyond the Abbe diffraction limit and thereby restricting their usage in a multitude of nanoscale applications.Over the past decade,the optical microsphere nanoimaging technique has been demonstrated to be a cost-effective solution for overcoming the diffraction limit and has achieved an imaging resolution of up to about k6k8 in a real-time and label-free manner,making it highly competitive among numerous super-resolution imaging technologies.In this review,we summarize the underlying nano-imaging mechanisms of the microsphere nanoscope and key advancements aimed at imaging performance enhancement:first,to change the working environment or modify the peripheral hardware of a single microsphere nanoscope at the system level;second,to compose the microsphere compound lens;and third,to engineer the geometry or ingredients of microspheres.We also analyze challenges yet to be overcome in optical microsphere nano-imaging,followed by an outlook of this technique.

Biocompatibility of light responsive materials prepared for accommodative intraocular lenses manufacturing

AIM:To investigate the biocompatibility and bacterial adhesion properties of light responsive materials(LRM)and analyze the feasibility and biosafety of employing LRM in the preparation of accommodative intraocular lenses(AIOLs).METHODS:Employing fundamental experimental research techniques,LRM with human lens epithelial cells(hLECs)and human retinal pigment epithelium cells(ARPE-19 cells)were co-cultured.Commercially available intraocular lenses(IOLs)were used as controls to perform cell counting kit-8(CCK-8),cell staining under varying light intensities,cell adhesion and bacterial adhesion experiments.RESULTS:LRM exhibited a stronger inhibitory effect on the proliferation of ARPE19 cells than commercially available IOLs when co-cultured with the undiluted extract for 96h(P<0.05).Under other culturing conditions,the effects on the proliferation of hLECs and ARPE-19 cells were not significantly different between the two materials.Under the influence of light irradiation at intensities of 200 and 300 mW/cm^(2),LRM demonstrated a markedly higher inhibitory effect on the survival of hLECs compared to commercially available IOLs(P<0.0001).They also showed a stronger suppressive effect on the survival rate of ARPE-19 cells,with significant differences observed at 200 mW/cm^(2)(P<0.001)and extremely significant differences at 300 mW/cm^(2)(P<0.0001).Additionally,compared to commercially available IOLs,LRM had a higher number of cells adhering to their surface(P<0.05),as well as a significantly greater number of adherent bacterium(P<0.0001).CONCLUSION:LRM,characterized by their excellent non-contact tunable deformability and low cytotoxicity to ocular tissues,show considerable potential for use in the fabrication of AIOLs.These materials demonstrate strong cell adhesion;however,during photothermal conversion processes involving shape deformation under various light intensities,the resultant temperature rise may harm surrounding cells.These factors suggest that while the material plays a positive role in reducing the incidence of posterior capsule opacification(PCO),it also poses potential risks for retinal damage.Additionally,the strong bacterial adhesion of these materials indicates an increased risk of endophthalmitis.

Modeling monocular form deprivation in rabbits using a simulated-cataract intraocular lens

AIM:To establish an animal model of form deprivation amblyopia based on a simulated cataract intraocular lens(IOLs).METHODS:Poly(dimethyl siloxane)-SiO_(2) thin films(PSF)with different degrees of opacity as IOL materials were prepared.The light transmission of the PSF-IOL was measured,and its in vitro biosafety was determined by cell counting kit(CCK)-8 assay using the HLEC-B3 cell line and ARPE-19 cell line.Subsequently,the in vivo safety was determined by implanting the PSF-IOL with 10%wt SiO_(2) into the right eyes of New Zealand white rabbits(PSF-IOL group),and compared with two control groups:contralateral comparison group and normal control(NC)group(Contralateral comparison group:the fellow eye;NC group:a group of binocular normal rabbits without intervention).The flash visual-evoked potentials(F-VEPs)were measured to verify amblyopia.RESULTS:PSFs containing 0,2%,and 10%wt SiO_(2) were successfully constructed.The 0 SiO_(2) PSF was transparent,while the 10%wt SiO_(2) PSF was completely opaque.It was found that PSF did not induce unwanted cytotoxicity in HLECs and ARPE19 cells in vitro.In vitro,PSF-IOL with 10%wt SiO_(2) was also non-toxic,and no significant inflammation or structural changes occurred after four weeks of PSF-IOL implantation.Finally,our IOL-simulated congenital cataract rabbit detected by F-VEPs suggested tentative amblyopia.CONCLUSION:A PSF-IOL that mimics cataracts is created.A novel form deprivation model is created by the IOL-simulated congenital cataract rabbit.It can be developed fast and stable and holds great potential for future study.

Clinical prediction of insufficient vaults after implantable collamer lens implantation

AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(<250μm)after implantable collamer lens(ICL V4c;STAAR Surgical)implantation.METHODS:The participants underwent ICL surgery and were divided into the low(<250μm)and normal(250-1000μm)vault groups based on the postoperative vault at 3mo.The preoperative biometric parameters and clinical outcomes were compared between the two groups.The relationship between the 3-month vault values and preoperative ocular parameters were evaluated by Generalized estimating equations.RESULTS:Sixteen(23 eyes)and 36 patients(63 eyes)were in the low and normal vault groups,respectively.All implantation procedures were uneventful with no cataract formation in the early postoperative period.The sulcusto-sulcus lens rise(STSL)and iris ciliary angle(ICA)were correlated with vault at 3mo after surgery.Every 0.1 mm increase in STSL was associated with 38.9μm decrease in the postoperative 3-month vault.A rise of 1 degree in ICA is associated with a reduction of 4μm in vault.CONCLUSION:Eyes with a narrow ciliary sulcus are associated with a higher rate of low vault after ICL implantation,suggesting a need for adjustments to the ICL size in these patients.Evaluating the characteristics of the ciliary sulcus contributes valuable information to predict low vault after surgery.

Intraocular lens selection in diabetic patients:How to increase the odds for success

The incidence of cataracts is significantly higher in diabetic individuals,particularly in younger age groups,with rates quadrupled in those under 65 and doubled in those over 65 compared to non-diabetics.Cataract surgery in diabetic patients poses many challenges:Poor epithelial healing,decreased corneal sensitivity,increased central corneal thickness,decreased endothelial cell count,variable topography,poor pupillary dilatation,anterior capsular phimosis,posterior capsular opacification(PCO),chances of progression of diabetic retinopathy(DR),zonular weakness,and vitreous prolapse and diabetic macular edema.Selection of an appropriate intraocular lens(IOL)is crucial for visual rehabilitation and monitoring DR.The choice of IOL in diabetic cataract patients is a challenging scenario.Square-edge IOLs are favored for their capacity to mitigate PCO,whereas hydrophilic counterparts may incur calcification in the setting of proliferative DR.The advisability of premium IOLs for achieving spectacle independence warrants judicious evaluation,particularly in the presence of advanced retinopathy.Optimal IOL placement within the capsular bag is advocated to minimize postoperative complications.Rigorous preoperative assessment and informed patient counseling regarding IOL options are indispensable for optimizing surgical outcomes.This review article covers various aspects regarding the choice of IOLs in different case scenarios and complications in the diabetic population.

Impact of multifocal gas-permeable lens designs on short-term choroidal response, axial length, and retinal defocus profile

AIM:To investigate the impact of multifocal gas permeable contact lens(MFGPCL)in various add power and distance/near area allocation on short-term changes of choroidal thickness(ChT),axial length(AL),and retinal defocus profile in young adults.METHODS:Seventeen young adults(2 males and 15 females;age 23.17±4.48y)were randomly assigned to wear two designs binocularly with a one-week washout period in between.Total of four MFGPCL designs were assessed.All designs were distance-center that varied in two add power(+1.50 and 3.00 D)and/or two distance zone(DZ)diameters(1.50 and 3.00 mm;design A:DZ 1.5/add 3.0,B:DZ 1.5/add 1.5,C:DZ 3.0/add 3.0,D:DZ 3.0/add 1.5).ChT,AL,and peripheral refraction data were collected on each subject at baseline,on days 1 and 7 of MFGPCL daily wear.ChT was assessed in four quadrants using a spectraldomain optical coherence tomography.RESULTS:AL was shortened by-26±44μm with lens C,-18±27μm with lens D,-13±29μm with lens A,and-8±30μm with lens B(all P<0.05).A significant overall increase in ChT was observed with all 4 designs(lens A:+6±6μm,B:+3±7μm,C:+8±7μm,and D:+8±7μm).Temporal and superior choroid exhibited more choroidal thickening associated with MFGPCL.All designs induced significant relative peripheral myopia(RPM)beyond the central 20o across the horizontal meridian in both nasal and temporal fields(P<0.05).CONCLUSION:MFGPCLs show a significant influence on ChT and AL,which are associated with significant increase in RPM after short-term wear.The reliability and feasibility of quantifying short-term changes in ChT support its use as a promising marker for the long-term efficacy of myopia-controlling treatments.

Rhegmatogenous retinal detachment in highly myopic eyes with implantable collamer lens

AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who received treatment for nontraumatic RRD after ICL implantation surgery at the Retinal Department of Zhongshan Ophthalmic Center from Jan 2018 to Dec 2022 were reviewed.Comprehensive ophthalmologic examinations including visual acuity measurement and digital fundus photography were performed in each patient.RESULTS:A total of nine RRD eyes from nine patients who received V4c-ICL implantation were included.The mean time from ICL implantation surgery to the diagnosis of RRD was 32.44±22.56mo(range,1-60mo).At the initial visit for RRD,giant retinal tear(GRT),horseshoe tear,simple round hole,and horseshoe tear combined with round hole were detected in 3,3,2,and 1 eye(s),respectively,with maculaoff in eyes.Eight patients received surgical treatment,and one patient was treated by retinal laser photocoagulation alone.The ICL was preserved in 7 eyes.At the last followup,the mean best corrected visual acuity(BCVA)improved significantly from 1.76±1.06 logMAR at presentation to 0.81±1.01 logMAR(P=0.035),and no case of recurrent retinal detachment was found.CONCLUSION:The morphological presentation of retinal breaks is diverse in this study.The ICL can be preserved in most cases during the course of retinal detachment repair surgery in our data,companied with acceptable visual and anatomical outcomes.

Effectiveness and safety of early lens extraction during par plana vitrectomy for proliferative diabetes retinopathy with mild cataract:a randomized clinical trial

●AIM:To evaluate the effectiveness and safety of early lens extraction during pars plana vitrectomy(PPV)for proliferative diabetic retinopathy(PDR)compared to those of PPV with subsequent cataract surgery.●METHODS:This multicenter randomized controlled trial was conducted in three Chinese hospitals on patients with PDR,aged>45y,with mild cataracts.The participants were randomly assigned to the combined(PPV combined with simultaneously cataract surgery,i.e.,phacovitrectomy)or subsequent(PPV with subsequent cataract surgery 6mo later)group and followed up for 12mo.The primary outcome was the change in best-corrected visual acuity(BCVA)from baseline to 6mo,and the secondary outcomes included complication rates and medical expenses.●RESULTS:In total,129 patients with PDR were recruited and equally randomized(66 and 63 in the combined and subsequent groups respectively).The change in BCVA in the combined group[mean,36.90 letters;95%confidence interval(CI),30.35–43.45]was significantly better(adjusted difference,16.43;95%CI,8.77–24.08;P<0.001)than in the subsequent group(mean,22.40 letters;95%CI,15.55–29.24)6mo after the PPV,with no significant difference between the two groups at 12mo.The overall surgical risk of two sequential surgeries was significantly higher than that of the combined surgery for neovascular glaucoma(17.65%vs 3.77%,P=0.005).No significant differences were found in the photocoagulation spots,surgical time,and economic expenses between two groups.In the subsequent group,the duration of work incapacity(22.54±9.11d)was significantly longer(P<0.001)than that of the combined group(12.44±6.48d).●CONCLUSION:PDR patients aged over 45y with mild cataract can also benefit from early lens extraction during PPV with gratifying effectiveness,safety and convenience,compared to sequential surgeries.