AIM:To evaluate the reliability of measurements of corneal changes with accommodation in healthy eyes using a Scheimpflug imaging-based system and how these measurements distribute in the normal population.METHODS:Pro...AIM:To evaluate the reliability of measurements of corneal changes with accommodation in healthy eyes using a Scheimpflug imaging-based system and how these measurements distribute in the normal population.METHODS:Prospective,non-randomized,comparative study including 27 healthy subjects(54 eyes),including emmetropia(13 eyes),myopia(17 eyes),hyperopia(4 eyes)and astigmatism(20 eyes)groups.In all cases,a complete eye examination was performed,including the analysis of corneal changes with different accommodative stimuli(+2.00,0.00 and-3.00 D)using the Pentacam AXL system.The investigation was structured in 2 phases:repeatability analysis and characterization of accommodation-related corneal changes in healthy populations.RESULTS:In the repeatability analysis,the index of height asymmetry(IHA)showed the greatest variability with the three accommodative stimuli,being the results for the rest of parameters acceptable.The group of emmetropes showed significant differences with accommodative changes in the position of maximum keratometry(Kmax;P<0.05),whereas in the astigmatism group,significant changes were not only observed in the position of Kmax,but also in minimum corneal thickness(MCT),corneal spherical aberration,and total and low order aberration root mean square(all P<0.05).Likewise,a significant difference was found in the displacement of the X position of Kmax with+2.00 D and-3.00 D in the myopia group(P=0.033)as well as in changes with+2.00 D and-3.00 D in the magnitude of the position vector of Kmax in the emmetropia group(P<0.05).No significant changes were found between accommodative stimuli in the displacement of coordinates of MCT(P≥0.109).CONCLUSION:The position of Kmax and MCT in healthy corneas can change significantly when presenting different accommodative stimuli using the accommodation mode of the Pentacam system,with different trends in these accommodation-related corneal changes between refractive errors.Likewise,the consistency of the measurements obtained with Scheimpflug has been confirmed.展开更多
●AIM:To explore the clinical efficacy and safety of stromal lenticule addition keratoplasty(SLAK)with corneal crosslinking(CXL)on patients with corneal ectasia secondary to femtosecond laser-assisted in situ keratomi...●AIM:To explore the clinical efficacy and safety of stromal lenticule addition keratoplasty(SLAK)with corneal crosslinking(CXL)on patients with corneal ectasia secondary to femtosecond laser-assisted in situ keratomileusis(FS-LASIK).●METHODS:A series of 5 patients undertaking SLAK with CXL for the treatment of corneal ectasia secondary to FS-LASIK were followed for 4-9mo.The lenticules were collected from patients undertaking small incision lenticule extraction(SMILE)for the correction of myopia.Adding a stromal lenticule was aimed at improving the corneal thickness for the safe application of crosslinking and compensating for the thin cornea to improve its mechanical strength.●RESULTS:All surgeries were conducted successfully with no significant complications.Their best corrected visual acuity(BCVA)ranged from 0.05 to 0.8-2 before surgery.The pre-operational total corneal thickness ranged from 345-404μm and maximum keratometry(Kmax)ranged from 50.8 to 86.3.After the combination surgery,both the corneal keratometry(range 55.9 to 92.8)and total corneal thickness(range 413-482μm)significantly increased.Four out of 5 patients had improvement of corneal biomechanical parameters(reflected by stiffness parameter A1 in Corvis ST).However,3 patients showed decreased BCVA after surgery due to the development of irregular astigmatism and transient haze.Despite the onset of corneal edema right after SLAK,the corneal topography and thickness generally stabilized after 3mo.●CONCLUSION:SLAK with CXL is a potentially beneficial and safe therapy for advanced corneal ectasia.Future work needs to address the poor predictability of corneal refractometry and compare the outcomes of different surgical modes.展开更多
Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or injury.The formation of corneal neuromas results from dam...Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or injury.The formation of corneal neuromas results from damage to corneal nerves,such as following corneal pathology or corneal or intraocular surge ries.Initially,denervated areas of sensory nerve fibers become invaded by sprouts of intact sensory nerve fibers,and later injured axons regenerate and new sprouts called neuromas develop.In recent years,analysis of corneal nerve abnormalities including corneal neuromas which can be identified using in vivo confocal microscopy,a non-invasive imaging technique with microscopic resolution,has been used to evaluate corneal neuropathy and ocular surface dysfunction.Corneal neuromas have been shown to be associated with clinical symptoms of discomfort and dryness of eyes,and are a promising surrogate biomarker for ocular surface diseases,such as neuropathic corneal pain,dry eye disease,diabetic corneal neuropathy,neurotrophic keratopathy,Sjogren's syndrome,bullous keratopathy,post-refra ctive surgery,and others.In this review,we have summarized the current literature on the association between these ocular surface diseases and the presentation of corneal microneuromas,as well as elaborated on their pathogenesis,visualization via in vivo confocal microscopy,and utility in monitoring treatment efficacy.As current quantitative analysis on neuromas mainly relies on manual annotation and quantification,which is user-dependent and labor-intensive,future direction includes the development of artificial intelligence software to identify and quantify these potential imaging biomarkers in a more automated and sensitive manner,allowing it to be applied in clinical settings more efficiently.Combining imaging and molecular biomarkers may also help elucidate the associations between corneal neuromas and ocular surface diseases.展开更多
●AIM:To study the changes and effect factors of posterior corneal surface after small incision lenticule extraction(SMILE)with different myopic diopters.●METHODS:Ninety eyes of 90 patients who underwent SMILE were i...●AIM:To study the changes and effect factors of posterior corneal surface after small incision lenticule extraction(SMILE)with different myopic diopters.●METHODS:Ninety eyes of 90 patients who underwent SMILE were included in this retrospective study.Patients were allocated into three groups based on the preoperative spherical equivalent(SE):low myopia(SE≥-3.00 D),moderate myopia(-3.00 D>SE>-6.00 D)and high myopia(SE≤-6.00 D).Posterior corneal surfaces were measured by a Scheimpflug camera preoperatively and different postoperative times(1wk,1,3,6mo,and 1y).Posterior mean elevation(PME)at 25 predetermined points of 3 concentric circles(2-,4-,and 6-mm diameter)above the best fit sphere was analyzed.●RESULTS:All surgeries were completed uneventfully and no ectasia was found through the observation.The difference of myopia group was significant at the 2-mm ring at 1 and 3mo postoperatively(1mo:P=0.017;3mo:P=0.018).The effect of time onΔPME was statistically significant(2-mm ring:P=0.001;4-mm ring:P<0.001;6-mm ring:P<0.001).The effect of different corneal locations onΔPME was significant except 1wk postoperatively(1mo:P=0.000;3mo:P=0.000;6mo:P=0.001;1y:P=0.001).Posterior corneal stability was linearly correlated with SE,central corneal thickness,ablation depth,residual bed thickness,percent ablation depth and percent stromal bed thickness.●CONCLUSION:The posterior corneal surface changes dynamically after SMILE.No protrusion is observed on the posterior corneal surface in patients with different degrees of myopia within one year after surgery.SMILE has good stability,accuracy,safety and predictability.展开更多
AIM:To evaluate the efficacy and safety of silicone oil(SO)as a corneal lubricant to improve visualization during vitrectomy.METHODS:Patients who underwent vitreoretinal surgery were divided into two groups.Group 1 wa...AIM:To evaluate the efficacy and safety of silicone oil(SO)as a corneal lubricant to improve visualization during vitrectomy.METHODS:Patients who underwent vitreoretinal surgery were divided into two groups.Group 1 was operated on with initial SO(Oxane 5700)as a corneal lubricant.Group 2 was operated on with initial lactated ringer’s solution(LRS)and then replaced with SO as required.Fundus clarity was scored during the surgery.Fluorescein staining was performed to determine the damage to corneal epithelium.RESULTS:Totally 114 eyes of 114 patients were included.Single SO use maintained a clear cornea and provided excellent visualization of surgical image.In group 1,the fundus clarity was grade 3 in 41/45 eyes and grade 2 in 4/45 eyes.In group 2,corneal edema frequently occurred after initial LRS use.The fundus clarity was grade 3 in 19/69 eyes,2 in 37/69 eyes and 1 in 13/69 eyes(P<0.05).SO was applied in 29 eyes of initial LRS use with subsequent corneal edema,which eliminated the corneal edema in 26 eyes.Corneal fluorescein staining score in group 1 was 0 in 28 eyes,1 in 11 eyes and 2 in 6 eyes,and 40,20 and 9,respectively,in group 2(all P>0.05).CONCLUSION:The use of SO as a corneal lubricant is effective and safe for preserving and improving corneal clarity and providing clear surgical field during vitrectomy.展开更多
AIM:To observe the effects of femtosecond laserassisted excimer laser in situ keratomileusis combined with accelerated corneal cross-linking(FS-LASIK Xtra)on corneal densitometry after correcting for high myopia.METHO...AIM:To observe the effects of femtosecond laserassisted excimer laser in situ keratomileusis combined with accelerated corneal cross-linking(FS-LASIK Xtra)on corneal densitometry after correcting for high myopia.METHODS:In this prospectively study,130 patients underwent FS-LASIK or FS-LASIK Xtra for high myopia.Their right eyes were selected for inclusion in the study,of which 65 cases of 65 eyes in the FS-LASIK group,65 patients with 65 eyes in the FS-LASIK Xtra group.Patients were evaluated for corneal densitometry at 1,3,and 6mo postoperatively using Pentacam Scheimpflug imaging.RESULTS:Preoperative differences in corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups in different ranges were not statistically significant(P>0.05).Layer-by-layer analysis revealed statistically significant differences in the anterior(120μm),central,and total layer corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups at 1 and 3mo postoperatively(all P<0.05),the FS-LASIK Xtra group is higher than that of the FS-LASIK group.Analysis of different diameter ranges showed statistically significant differences between the FS-LASIK group and the FS-LASIK Xtra group at 1mo postoperatively in the ranges of 0–2,2–6,and 6–10 mm(both P<0.05);At 3mo postoperatively,the FS-LASIK Xtra group is higher than that of the FS-LASIK group in the ranges of 0–2 and 2–6 mm(P<0.05).At 6mo postoperatively,there were no statistically significant differences in corneal densitometry between the FS-LASIK group and the FS-LASIK Xtra group in different diameter ranges(all P>0.05).CONCLUSION:There is an increase in internal corneal densitometry during the early postoperative period after FS-LASIK Xtra for correction of high myopia.However,the densitometry values decreased to the level of conventional FS-LASIK at 6mo after surgery,with the most significant changes observed in the superficial central zone.展开更多
Dear Editor,Corneal endotheliitis,first reported in 1982 as an autoimmune disorder by Khodadoust and Attarzadeh[1],is now recognized to be frequently induced by viral infections,including varicella zoster virus(VZV),c...Dear Editor,Corneal endotheliitis,first reported in 1982 as an autoimmune disorder by Khodadoust and Attarzadeh[1],is now recognized to be frequently induced by viral infections,including varicella zoster virus(VZV),cytomegalovirus(CMV)and herpes simplex virus(HSV),that can cause inflammatory and immune-related injuries or direct damages to corneal endothelial cells[2-3].In cases with this type of endotheliitis of viral origin,manifestations may include conjunctival ciliary congestion or mixed congestion,corneal subepithelial bulla,localized corneal edema,keratic precipitates(KP)characteristic to the edema area,puckered posterior elastic lamina,mild anterior chamber reaction,intraocular pressure(IOP)elevation in presence of inflammation in trabecular meshwork,and endothelial decompensation[3-4].Accurate diagnosis of viral corneal endotheliitis is challenging due to its complex presentation,leading to a high misdiagnosis rate.To the best of our knowledge,there was no previous report of viral corneal endotheliitis presenting with corneal endothelial defects in the English literature.展开更多
AIM:To evaluate the clinical efficacy of small-diameter acellular porcine corneal stroma(SAPS)for the treatment of peripheral corneal ulceration(PCU).METHODS:This retrospective clinical study included 18 patients(18 e...AIM:To evaluate the clinical efficacy of small-diameter acellular porcine corneal stroma(SAPS)for the treatment of peripheral corneal ulceration(PCU).METHODS:This retrospective clinical study included 18 patients(18 eyes)with PCU between April 2018 and December 2020.All patients had PCU and underwent lamellar keratoplasty with SAPS.Observation indicators included preoperative and postoperative best-corrected visual acuity(BCVA)and transparency of SAPS.The infection control rate in the surgical eye-lesion area was also calculated.RESULTS:Eighteen patients underwent lamellar keratoplasty with SAPS to treat PCU.None of the patients experienced rejection after 6mo(18/18)and 12mo(16/16)of follow-up.The BCVA(0.47±0.30)at the 6mo followup after operation was significantly improved compared with the baseline(0.99±0.80),and the difference was statistically significant(Z=-3.415,P<0.05).The BCVA at the 12mo follow-up after operation was not statistically significant compared to the 6mo(Z=0,P=1).With time,the SAPS graft gradually became transparent.At the 6mo(18/18)and 12mo(16/16)follow-up,none of the patients had recurrent corneal infection.CONCLUSION:SAPS is clinically effective in the treatment of PCU,improving the patient’s BCVA and reducing the incidence of rejection after keratoplasty.展开更多
Dear Editor,I ridocorneal endothelial syndrome(ICE)is a rare ocular disease first proposed by Eagle et al[1]in 1979.It is mainly characterized by corneal endothelial abnormalities,accompanied by iris atrophy,iris pigm...Dear Editor,I ridocorneal endothelial syndrome(ICE)is a rare ocular disease first proposed by Eagle et al[1]in 1979.It is mainly characterized by corneal endothelial abnormalities,accompanied by iris atrophy,iris pigmented nodules and peripheral anterior synechiae.ICE syndrome is typically unilateral,and classified into three clinical variants based on the changes of the cornea and iris,including progressive iris atrophy,Chandler’s syndrome,and Cogan-Reese syndrome.展开更多
AIM:To study the effect of mitomycin C(MMC)applied during transepithelial photorefractive keratectomy(TPRK)on the corneal endothelium one week(W1)and three months(M3)after surgery and its determinants.METHODS:In this ...AIM:To study the effect of mitomycin C(MMC)applied during transepithelial photorefractive keratectomy(TPRK)on the corneal endothelium one week(W1)and three months(M3)after surgery and its determinants.METHODS:In this two-armed cohort study conducted in 2022,eyes treated with MMC during TPRK(group 1)were compared with eyes not treated with MMC(group 2).The corneal endothelial cell(EC)count,EC density(ECD;cells/mm2),average(μm2),standard deviation(μm2),coefficient of variation(CV%),ECmax,ECmin,and EC percentage of hexagonality were estimated at W1 and M3.The postoperative changes in the EC count in the two groups were compared and correlated with the other independent variables.RESULTS:Group 1 had 26 eyes,and group 2 had 78 eyes.All TPRK indices were significantly higher for the eyes in group 1 than for those in group 2.The MMC usage was not a significant predictor of the change in ECD(P=0.644),change in CV(P=0.374),and change in the percentage of hexagonality of EC(P=0.164)at W1.However,the use of MMC was a significant predictor of changes in CV(P=0.014)and the change in the percentage of hexagonality of EC(P=0.039)at M3.The duration of laser exposure and the size of the optical zone influenced the correlation of MMC use with the changes in EC indices,postoperatively.CONCLUSION:The use of MMC doesn’t affect ECD,CV,and percentage of hexagonality at W1 if other surgical indices are considered.At M3 after operating myopic eyes by TPRK,MMC significantly influence the CV and percentage of hexagonality.The duration of the laser application and the size of the optical zone should be considered when determining the effect of MMC on the EC indices.展开更多
●AIM:To investigate the long-term changes of corneal densitometry(CD)and its contributing elements after small incision lenticule extraction(SMILE).●METHODS:Totally 31 eyes of 31 patients with mean spherical equival...●AIM:To investigate the long-term changes of corneal densitometry(CD)and its contributing elements after small incision lenticule extraction(SMILE).●METHODS:Totally 31 eyes of 31 patients with mean spherical equivalent of-6.46±1.50 D and mean age 28.23±7.38y were enrolled.Full-scale examinations were conducted on all patients preoperatively and during followup.Visual acuity,manifest refraction,axial length,corneal thickness,corneal higher-order aberrations,and CD were evaluated.●RESULTS:All surgeries were completed successfully without complications or adverse events.Ten-year safety index was 1.17±0.20 and efficacy 1.04±0.28.CD value of 0–6 mm zones in central layer was statistically significantly lower 10y postoperatively,compared with preoperative values(0–2 mmΔ=-1.62,2–6 mmΔ=-1.24,P<0.01).There were no correlations between CD values and factors evaluated.●CONCLUSION:SMILE is a safe and efficient procedure for myopia on a long-term basis.CD values get lower 10y postoperatively,whose mechanism is to be further discussed.展开更多
AIM:To analyze the distribution of refractive status in school-age children with different corneal curvatures(CC)and the correlation between CC and refractive status.METHODS:A total of 2214 school-aged children of gra...AIM:To analyze the distribution of refractive status in school-age children with different corneal curvatures(CC)and the correlation between CC and refractive status.METHODS:A total of 2214 school-aged children of grade 4 in Hangzhou who were screened for school myopia were included.Uncorrected distance visual acuity(UCDVA),non-cycloplegic refraction,axial length(AL),horizontal and vertical corneal curvature(K1,K2)were measured and spherical equivalent(SE),corneal curvature radius(CCR)and axial length/corneal radius of curvature ratio(AL/CR)were calculated.UCDVA<5.0 and SE≤-0.50 D were classified as school-screening myopia.According to the different CCRs,the patients were divided into the lower corneal curvature(LCC)group(CCR≥7.92)and the higher corneal curvature(HCC)group(CCR<7.92).Each group was further divided into the normal AL subgroup and the long AL subgroup.The refractive parameters were compared to identify any differences between the two groups.RESULTS:Both SE and AL were greater in the LCC group(P=0.013,P<0.001).The prevalence of myopia was 38% in the LCC group and 44% in the HCC group(P<0.001).The proportion of children without screening myopia was higher in the LCC group(62%)than in the HCC group(56%).Among these children without screening myopia,the proportion of long AL in the LCC group(24%)was significantly higher than that in the HCC group(0.012%;P<0.001).The change of SE in the LCC group was less affected by the increase of AL than that in the HCC group.CONCLUSION:School-aged children in the LCC group have a lower incidence of screening myopia and longer AL.Low CC can mask SE reduction and AL growth to some extent,and the change of AL growth change more in children with low CC than high CC.Before the onset of myopia,its growth rate is even faster than that after the onset of myopia.展开更多
Among refractive errors,astigmatism is the most common optical aberration,where refraction changes in different meridians of the eye.It causes blurred vision at any distance and includes corneal,lenticular,and retinal...Among refractive errors,astigmatism is the most common optical aberration,where refraction changes in different meridians of the eye.It causes blurred vision at any distance and includes corneal,lenticular,and retinal astigmatism.Cataract surgery used to cause a progressive increase in the pre-exisiting corneal astigmatism because of creating a surgically induced astigmatism,for example,a large size surgery incision.The development of surgical techniques during last decades has made cataract surgery interchange to treat preoperative corneal astigmatism at time of surgery.Nowadays,three surgical approaches can be used.By placing a sutureless clear corneal incision on the steep meridian of the cornea,a preoperative corneal astigmatism less than 1.0 D can be corrected.Single or paired peripheral corneal relaxing incisions(PCRIs)provide 1.0-3.0 D corneal astigmatism correction.PCRIs are typically used for treating 1.0-1.5 D of regular corneal astigmatism,if more than 2.0 D,the risk of overcorrection and irregular astigmatism is increased.When toric intraocular lenses(IOLs)are unavailable in markets,PCRIs are still a reasonable option for patients with up to 3.0 D of pre-existing corneal astigmatism.Toric IOLs implantation can correct 1.0-4.5 D of corneal astigmatism.Several IOLs are approved to correct a high degree of corneal astigmatism with cylinder power up to 12.0 D.These approaches can be used alone or in combination.展开更多
Purpose: The study was to evaluate the efficacy of cyanoacrylate tissue adhesive (CTA) application in corneal perforations. Method: This was a prospective study on 20 patients of corneal perforations who received cyan...Purpose: The study was to evaluate the efficacy of cyanoacrylate tissue adhesive (CTA) application in corneal perforations. Method: This was a prospective study on 20 patients of corneal perforations who received cyanoacrylate tissue adhesive application as treatment between March 2021 and March 2022 at Preah Ang Duong Hospital. The primary outcome measure was success rate of CTA application, while the secondary outcome was to measure postoperative best-corrected visual acuity (BCVA) and ocular complications. Results: The mean age of patients was 44.15 ± 16.05 years old and 7 (35%) were female. Causes of perforation were microbial infection in 12 patients (60%), trauma in 5 patients (25%), and sterile melting in 3 patients (15%). The perforation of size smaller than 1.5 mm was in 8 patients (40%) while 12 patients (60%) had perforated size between 1.5 mm to 3 mm. The perforation was 60% (12 patients) central, 25% (5 patients) paracentral, and 15% (3 patients) peripherally. Out of 20 patients, 5 patients (25%) received CTA application more than 1 time. The mean glue retention was 57.60 ± 31.84 days. Success rate of glue application (defined as intact globe without surgical intervention regardless of number of CTA applications) was 85%. At the last visit, 7 patients (35%) had BCVA of 6/120 or better. Common complications were uveitis (45%), ocular hypertension (30%), cataract (25%) and neovascularization (20%). No serious complications were found. Conclusion: Cyanoacrylate tissue adhesive is an effective treatment option in sealing corneal perforations with no serious complications. .展开更多
Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement o...Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.展开更多
AIM:To investigate changes in choroidal thickness and vascularity in keratoconus patients treated with corneal crosslinking.METHODS:This study evaluated 28 eyes of 22 patients with keratoconus who underwent corneal cr...AIM:To investigate changes in choroidal thickness and vascularity in keratoconus patients treated with corneal crosslinking.METHODS:This study evaluated 28 eyes of 22 patients with keratoconus who underwent corneal crosslinking.The choroidal thicknesses were evaluated on enhanced depth imaging optical coherence tomography at the preoperative and postoperative 3d,1,and 3mo.Choroidal thickness in the four cardinal quadrants and the fovea were evaluated.The choroidal vascularity index was also calculated.RESULTS:There was no significant difference in central choroidal thickness between the preoperative and postoperative 3d,1mo(P>0.05).There was a significant increase in the 3mo(P=0.034)and a significant decrease in the horizontal choroidal vascularity index on the postoperative 3d(P=0.014),there was no statistically significant change in vertical axes and other visits in horizontal sections(P>0.05).CONCLUSION:This study sheds light on choroidal changes in postoperative corneal crosslinking for keratoconus.While it suggests the procedure’s relative safety for submacular choroid,more extensive research is necessary to confirm these findings and their clinical significance.展开更多
●AIM:To evaluate the role of semaphorin 7A(Sema7A)and its associated regulatory mechanisms in modulating the barrier function of cultured human corneal epithelial cells(HCEs).●METHODS:Barrier models of HCEs were tre...●AIM:To evaluate the role of semaphorin 7A(Sema7A)and its associated regulatory mechanisms in modulating the barrier function of cultured human corneal epithelial cells(HCEs).●METHODS:Barrier models of HCEs were treated with recombinant human Sema7A at concentrations of 0,125,250,or 500 ng/mL for 24,48,or 72h in vitro.Transepithelial electrical resistance(TEER)as well as Dextran-fluorescein isothiocyanate(FITC)permeability assays were conducted to assess barrier function.To quantify tight junctions(TJs)such as occludin and zonula occludens-1(ZO-1)at the mRNA level,reverse transcriptionpolymerase chain reaction(RT-PCR)analysis was performed.Immunoblotting was used to examine the activity of the nuclear factor-kappa B(NF-κB)signaling pathway and the production of TJs proteins.Immunofluorescence analyses were employed to localize the TJs.Enzyme-linked immunosorbent assay(ELISA)and RT-PCR were utilized to observe changes in interleukin(IL)-1βlevels.To investigate the role of NF-κB signaling activation and IL^(-1)βin Sema7A’s anti-barrier mechanism,we employed 0.1μmol/L IκB kinase 2(IKK2)inhibitor IV or 500 ng/mL IL^(-1)receptor(IL-1R)antagonist.●RESULTS:Treatment with Sema7A resulted in decreased TEER and increased permeability of Dextran-FITC in HCEs through down-regulating mRNA and protein levels of TJs in a time-and dose-dependent manner,as well as altering the localization of TJs.Furthermore,Sema7A stimulated the activation of inhibitor of kappa B alpha(IκBα)and expression of IL-1β.The anti-barrier function of Sema7A was significantly suppressed by treatment with IKK2 inhibitor IV or IL-1R antagonists.●CONCLUSION:Sema7A disrupts barrier function through its influence on NF-κB-mediated expression of TJ proteins,as well as the expression of IL-1β.These findings suggest that Sema7A could be a potential therapeutic target for the diseases in corneal epithelium.展开更多
A corneal epithelial-stromal defect is recognized as a major contributor to corneal scarring.Given the rising prevalence of blindness caused by corneal scarring,increasing attention has been focused on corneal epithel...A corneal epithelial-stromal defect is recognized as a major contributor to corneal scarring.Given the rising prevalence of blindness caused by corneal scarring,increasing attention has been focused on corneal epithelialstromal defects.Currently,the etiology and pathogenesis of these defects remain inadequately understood,necessitating further investigation through experimental research.Various modeling methods exist both domestically and internationally,each with distinct adaptive conditions,advantages,and disadvantages.This review primarily aims to summarize the techniques used to establish optimal animal models of corneal epithelial-stromal injury,including mechanical modeling,chemical alkali burns,post-refractive surgery infections,and genetic engineering.The intention is to provide valuable insights for studying the mechanisms underlying corneal epithelial-stromal injury and the development of corresponding therapeutic interventions.展开更多
AIM:To report the safety,efficacy,and accuracy of small-incision lenticule extraction(SMILE)or femtosecondassisted laser in situ keratomileusis(FS-LASIK)for the correction of myopia or myopic astigmatism in patients w...AIM:To report the safety,efficacy,and accuracy of small-incision lenticule extraction(SMILE)or femtosecondassisted laser in situ keratomileusis(FS-LASIK)for the correction of myopia or myopic astigmatism in patients with deep corneal opacity denoted by anterior segment optical coherence tomography(AS-OCT).METHODS:Four patients with monocular corneal opacity(3 due to mechanical injury,1 due to a firecracker wound)were recruited and treated with refractive surgery(3 for SMILE,1 for FS-LASIK combined with limbal relaxing incision(LRI).Preoperative ocular manifestations,surgical details,postoperative visual outcomes,corneal opacity parameters,and corneal topography were analyzed.RESULTS:Preoperatively,spherical diopter ranged from-3.0 D to-4.75 D with cylinder ranging from-0.75 to-5.0 D,and corrected distance visual acuity(CDVA)ranging from 20/25 to 20/20.One eye’s corneal opacity was located in the central zone and three were in the mid-peripheral optical zone.Three patients underwent uneventful SMILE in both eyes,whilst one patient underwent FS-LASIK for high astigmatism in both eyes and LRI in the right eye.CDVA of the eye with corneal opacity ranged from 20/22to 20/20 one to six weeks postoperatively.Two patients achieved better CDVA and no patients lost Snellen lines.The postoperative diopter was within±0.75 D for all eyes.Significant edema existed above the corneal opacity in one eye and dissipated soon.No eccentric corneal topography or morphological anomaly of the corneal cap or flap was observed.CONCLUSION:The cases demonstrate that SMILE or FS-LASIK is safe and effective to treat myopic astigmatism combined with deep corneal opacity lesions after comprehensive preoperative evaluation and appropriate candidate selection.FS-LASIK combined with LRI is also sufficient for correcting high astigmatism due to corneal scarring.展开更多
Metal–organic frameworks(MOFs)have attracted significant research interest in biomimetic catalysis.However,the modulation of the activity of MOFs by precisely tuning the coordination of metal nodes is still a signifi...Metal–organic frameworks(MOFs)have attracted significant research interest in biomimetic catalysis.However,the modulation of the activity of MOFs by precisely tuning the coordination of metal nodes is still a significant challenge.Inspired by metalloenzymes with well-defined coordination structures,a series of MOFs containing halogen-coordinated copper nodes(Cu-X MOFs,X=Cl,Br,I)are employed to elucidate their structure–activity relationship.Intriguingly,experimental and theoretical results strongly support that precisely tuning the coordination of halogen atoms directly regulates the enzyme-like activities of Cu-X MOFs by influencing the spatial configuration and electronic structure of the Cu active center.The optimal Cu–Cl MOF exhibits excellent superoxide dismutase-like activity with a specific activity one order of magnitude higher than the reported Cu-based nanozymes.More importantly,by performing enzyme-mimicking catalysis,the Cu–Cl MOF nanozyme can significantly scavenge reactive oxygen species and alleviate oxidative stress,thus effectively relieving ocular chemical burns.Mechanistically,the antioxidant and antiapoptotic properties of Cu–Cl MOF are achieved by regulating the NRF2 and JNK or P38 MAPK pathways.Our work provides a novel way to refine MOF nanozymes by directly engineering the coordination microenvironment and,more significantly,demonstrating their potential therapeutic effect in ophthalmic disease.展开更多
文摘AIM:To evaluate the reliability of measurements of corneal changes with accommodation in healthy eyes using a Scheimpflug imaging-based system and how these measurements distribute in the normal population.METHODS:Prospective,non-randomized,comparative study including 27 healthy subjects(54 eyes),including emmetropia(13 eyes),myopia(17 eyes),hyperopia(4 eyes)and astigmatism(20 eyes)groups.In all cases,a complete eye examination was performed,including the analysis of corneal changes with different accommodative stimuli(+2.00,0.00 and-3.00 D)using the Pentacam AXL system.The investigation was structured in 2 phases:repeatability analysis and characterization of accommodation-related corneal changes in healthy populations.RESULTS:In the repeatability analysis,the index of height asymmetry(IHA)showed the greatest variability with the three accommodative stimuli,being the results for the rest of parameters acceptable.The group of emmetropes showed significant differences with accommodative changes in the position of maximum keratometry(Kmax;P<0.05),whereas in the astigmatism group,significant changes were not only observed in the position of Kmax,but also in minimum corneal thickness(MCT),corneal spherical aberration,and total and low order aberration root mean square(all P<0.05).Likewise,a significant difference was found in the displacement of the X position of Kmax with+2.00 D and-3.00 D in the myopia group(P=0.033)as well as in changes with+2.00 D and-3.00 D in the magnitude of the position vector of Kmax in the emmetropia group(P<0.05).No significant changes were found between accommodative stimuli in the displacement of coordinates of MCT(P≥0.109).CONCLUSION:The position of Kmax and MCT in healthy corneas can change significantly when presenting different accommodative stimuli using the accommodation mode of the Pentacam system,with different trends in these accommodation-related corneal changes between refractive errors.Likewise,the consistency of the measurements obtained with Scheimpflug has been confirmed.
基金Supported by the Science&Technology Department of Sichuan Province(China)Funding Project(No.2021YFS0221,No.2023YFS0179)1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(No.2022HXFH032,No.ZYJC21058)the Postdoctoral Research Funding of West China Hospital,Sichuan University,China(No.2020HXBH044).
文摘●AIM:To explore the clinical efficacy and safety of stromal lenticule addition keratoplasty(SLAK)with corneal crosslinking(CXL)on patients with corneal ectasia secondary to femtosecond laser-assisted in situ keratomileusis(FS-LASIK).●METHODS:A series of 5 patients undertaking SLAK with CXL for the treatment of corneal ectasia secondary to FS-LASIK were followed for 4-9mo.The lenticules were collected from patients undertaking small incision lenticule extraction(SMILE)for the correction of myopia.Adding a stromal lenticule was aimed at improving the corneal thickness for the safe application of crosslinking and compensating for the thin cornea to improve its mechanical strength.●RESULTS:All surgeries were conducted successfully with no significant complications.Their best corrected visual acuity(BCVA)ranged from 0.05 to 0.8-2 before surgery.The pre-operational total corneal thickness ranged from 345-404μm and maximum keratometry(Kmax)ranged from 50.8 to 86.3.After the combination surgery,both the corneal keratometry(range 55.9 to 92.8)and total corneal thickness(range 413-482μm)significantly increased.Four out of 5 patients had improvement of corneal biomechanical parameters(reflected by stiffness parameter A1 in Corvis ST).However,3 patients showed decreased BCVA after surgery due to the development of irregular astigmatism and transient haze.Despite the onset of corneal edema right after SLAK,the corneal topography and thickness generally stabilized after 3mo.●CONCLUSION:SLAK with CXL is a potentially beneficial and safe therapy for advanced corneal ectasia.Future work needs to address the poor predictability of corneal refractometry and compare the outcomes of different surgical modes.
文摘Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or injury.The formation of corneal neuromas results from damage to corneal nerves,such as following corneal pathology or corneal or intraocular surge ries.Initially,denervated areas of sensory nerve fibers become invaded by sprouts of intact sensory nerve fibers,and later injured axons regenerate and new sprouts called neuromas develop.In recent years,analysis of corneal nerve abnormalities including corneal neuromas which can be identified using in vivo confocal microscopy,a non-invasive imaging technique with microscopic resolution,has been used to evaluate corneal neuropathy and ocular surface dysfunction.Corneal neuromas have been shown to be associated with clinical symptoms of discomfort and dryness of eyes,and are a promising surrogate biomarker for ocular surface diseases,such as neuropathic corneal pain,dry eye disease,diabetic corneal neuropathy,neurotrophic keratopathy,Sjogren's syndrome,bullous keratopathy,post-refra ctive surgery,and others.In this review,we have summarized the current literature on the association between these ocular surface diseases and the presentation of corneal microneuromas,as well as elaborated on their pathogenesis,visualization via in vivo confocal microscopy,and utility in monitoring treatment efficacy.As current quantitative analysis on neuromas mainly relies on manual annotation and quantification,which is user-dependent and labor-intensive,future direction includes the development of artificial intelligence software to identify and quantify these potential imaging biomarkers in a more automated and sensitive manner,allowing it to be applied in clinical settings more efficiently.Combining imaging and molecular biomarkers may also help elucidate the associations between corneal neuromas and ocular surface diseases.
基金Supported by Shandong Provincial Natural Science Foundation(No.ZR2022QH384).
文摘●AIM:To study the changes and effect factors of posterior corneal surface after small incision lenticule extraction(SMILE)with different myopic diopters.●METHODS:Ninety eyes of 90 patients who underwent SMILE were included in this retrospective study.Patients were allocated into three groups based on the preoperative spherical equivalent(SE):low myopia(SE≥-3.00 D),moderate myopia(-3.00 D>SE>-6.00 D)and high myopia(SE≤-6.00 D).Posterior corneal surfaces were measured by a Scheimpflug camera preoperatively and different postoperative times(1wk,1,3,6mo,and 1y).Posterior mean elevation(PME)at 25 predetermined points of 3 concentric circles(2-,4-,and 6-mm diameter)above the best fit sphere was analyzed.●RESULTS:All surgeries were completed uneventfully and no ectasia was found through the observation.The difference of myopia group was significant at the 2-mm ring at 1 and 3mo postoperatively(1mo:P=0.017;3mo:P=0.018).The effect of time onΔPME was statistically significant(2-mm ring:P=0.001;4-mm ring:P<0.001;6-mm ring:P<0.001).The effect of different corneal locations onΔPME was significant except 1wk postoperatively(1mo:P=0.000;3mo:P=0.000;6mo:P=0.001;1y:P=0.001).Posterior corneal stability was linearly correlated with SE,central corneal thickness,ablation depth,residual bed thickness,percent ablation depth and percent stromal bed thickness.●CONCLUSION:The posterior corneal surface changes dynamically after SMILE.No protrusion is observed on the posterior corneal surface in patients with different degrees of myopia within one year after surgery.SMILE has good stability,accuracy,safety and predictability.
基金Supported by the Shanghai Key Clinical Specialty,Shanghai Eye Disease Research Center(No.2022ZZ01003)the Science and Technology Commission of Shanghai(No.20DZ2270800).
文摘AIM:To evaluate the efficacy and safety of silicone oil(SO)as a corneal lubricant to improve visualization during vitrectomy.METHODS:Patients who underwent vitreoretinal surgery were divided into two groups.Group 1 was operated on with initial SO(Oxane 5700)as a corneal lubricant.Group 2 was operated on with initial lactated ringer’s solution(LRS)and then replaced with SO as required.Fundus clarity was scored during the surgery.Fluorescein staining was performed to determine the damage to corneal epithelium.RESULTS:Totally 114 eyes of 114 patients were included.Single SO use maintained a clear cornea and provided excellent visualization of surgical image.In group 1,the fundus clarity was grade 3 in 41/45 eyes and grade 2 in 4/45 eyes.In group 2,corneal edema frequently occurred after initial LRS use.The fundus clarity was grade 3 in 19/69 eyes,2 in 37/69 eyes and 1 in 13/69 eyes(P<0.05).SO was applied in 29 eyes of initial LRS use with subsequent corneal edema,which eliminated the corneal edema in 26 eyes.Corneal fluorescein staining score in group 1 was 0 in 28 eyes,1 in 11 eyes and 2 in 6 eyes,and 40,20 and 9,respectively,in group 2(all P>0.05).CONCLUSION:The use of SO as a corneal lubricant is effective and safe for preserving and improving corneal clarity and providing clear surgical field during vitrectomy.
基金Supported by Shandong Province Medical Staff Science and Technology Innovation Program Project(No.SDYWZGKCJH2022021).
文摘AIM:To observe the effects of femtosecond laserassisted excimer laser in situ keratomileusis combined with accelerated corneal cross-linking(FS-LASIK Xtra)on corneal densitometry after correcting for high myopia.METHODS:In this prospectively study,130 patients underwent FS-LASIK or FS-LASIK Xtra for high myopia.Their right eyes were selected for inclusion in the study,of which 65 cases of 65 eyes in the FS-LASIK group,65 patients with 65 eyes in the FS-LASIK Xtra group.Patients were evaluated for corneal densitometry at 1,3,and 6mo postoperatively using Pentacam Scheimpflug imaging.RESULTS:Preoperative differences in corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups in different ranges were not statistically significant(P>0.05).Layer-by-layer analysis revealed statistically significant differences in the anterior(120μm),central,and total layer corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups at 1 and 3mo postoperatively(all P<0.05),the FS-LASIK Xtra group is higher than that of the FS-LASIK group.Analysis of different diameter ranges showed statistically significant differences between the FS-LASIK group and the FS-LASIK Xtra group at 1mo postoperatively in the ranges of 0–2,2–6,and 6–10 mm(both P<0.05);At 3mo postoperatively,the FS-LASIK Xtra group is higher than that of the FS-LASIK group in the ranges of 0–2 and 2–6 mm(P<0.05).At 6mo postoperatively,there were no statistically significant differences in corneal densitometry between the FS-LASIK group and the FS-LASIK Xtra group in different diameter ranges(all P>0.05).CONCLUSION:There is an increase in internal corneal densitometry during the early postoperative period after FS-LASIK Xtra for correction of high myopia.However,the densitometry values decreased to the level of conventional FS-LASIK at 6mo after surgery,with the most significant changes observed in the superficial central zone.
文摘Dear Editor,Corneal endotheliitis,first reported in 1982 as an autoimmune disorder by Khodadoust and Attarzadeh[1],is now recognized to be frequently induced by viral infections,including varicella zoster virus(VZV),cytomegalovirus(CMV)and herpes simplex virus(HSV),that can cause inflammatory and immune-related injuries or direct damages to corneal endothelial cells[2-3].In cases with this type of endotheliitis of viral origin,manifestations may include conjunctival ciliary congestion or mixed congestion,corneal subepithelial bulla,localized corneal edema,keratic precipitates(KP)characteristic to the edema area,puckered posterior elastic lamina,mild anterior chamber reaction,intraocular pressure(IOP)elevation in presence of inflammation in trabecular meshwork,and endothelial decompensation[3-4].Accurate diagnosis of viral corneal endotheliitis is challenging due to its complex presentation,leading to a high misdiagnosis rate.To the best of our knowledge,there was no previous report of viral corneal endotheliitis presenting with corneal endothelial defects in the English literature.
基金Key R&D Plan of Shaanxi Province(No.2021SF-331).
文摘AIM:To evaluate the clinical efficacy of small-diameter acellular porcine corneal stroma(SAPS)for the treatment of peripheral corneal ulceration(PCU).METHODS:This retrospective clinical study included 18 patients(18 eyes)with PCU between April 2018 and December 2020.All patients had PCU and underwent lamellar keratoplasty with SAPS.Observation indicators included preoperative and postoperative best-corrected visual acuity(BCVA)and transparency of SAPS.The infection control rate in the surgical eye-lesion area was also calculated.RESULTS:Eighteen patients underwent lamellar keratoplasty with SAPS to treat PCU.None of the patients experienced rejection after 6mo(18/18)and 12mo(16/16)of follow-up.The BCVA(0.47±0.30)at the 6mo followup after operation was significantly improved compared with the baseline(0.99±0.80),and the difference was statistically significant(Z=-3.415,P<0.05).The BCVA at the 12mo follow-up after operation was not statistically significant compared to the 6mo(Z=0,P=1).With time,the SAPS graft gradually became transparent.At the 6mo(18/18)and 12mo(16/16)follow-up,none of the patients had recurrent corneal infection.CONCLUSION:SAPS is clinically effective in the treatment of PCU,improving the patient’s BCVA and reducing the incidence of rejection after keratoplasty.
基金Supported by the National Natural Science Foundation of China(No.82271087)Science and Technology Innovation Committee of Shenzhen(No.JCYJ20190807153005579)Shenzhen Science and Technology Program(KCXFZ20230731093359004).
文摘Dear Editor,I ridocorneal endothelial syndrome(ICE)is a rare ocular disease first proposed by Eagle et al[1]in 1979.It is mainly characterized by corneal endothelial abnormalities,accompanied by iris atrophy,iris pigmented nodules and peripheral anterior synechiae.ICE syndrome is typically unilateral,and classified into three clinical variants based on the changes of the cornea and iris,including progressive iris atrophy,Chandler’s syndrome,and Cogan-Reese syndrome.
文摘AIM:To study the effect of mitomycin C(MMC)applied during transepithelial photorefractive keratectomy(TPRK)on the corneal endothelium one week(W1)and three months(M3)after surgery and its determinants.METHODS:In this two-armed cohort study conducted in 2022,eyes treated with MMC during TPRK(group 1)were compared with eyes not treated with MMC(group 2).The corneal endothelial cell(EC)count,EC density(ECD;cells/mm2),average(μm2),standard deviation(μm2),coefficient of variation(CV%),ECmax,ECmin,and EC percentage of hexagonality were estimated at W1 and M3.The postoperative changes in the EC count in the two groups were compared and correlated with the other independent variables.RESULTS:Group 1 had 26 eyes,and group 2 had 78 eyes.All TPRK indices were significantly higher for the eyes in group 1 than for those in group 2.The MMC usage was not a significant predictor of the change in ECD(P=0.644),change in CV(P=0.374),and change in the percentage of hexagonality of EC(P=0.164)at W1.However,the use of MMC was a significant predictor of changes in CV(P=0.014)and the change in the percentage of hexagonality of EC(P=0.039)at M3.The duration of laser exposure and the size of the optical zone influenced the correlation of MMC use with the changes in EC indices,postoperatively.CONCLUSION:The use of MMC doesn’t affect ECD,CV,and percentage of hexagonality at W1 if other surgical indices are considered.At M3 after operating myopic eyes by TPRK,MMC significantly influence the CV and percentage of hexagonality.The duration of the laser application and the size of the optical zone should be considered when determining the effect of MMC on the EC indices.
文摘●AIM:To investigate the long-term changes of corneal densitometry(CD)and its contributing elements after small incision lenticule extraction(SMILE).●METHODS:Totally 31 eyes of 31 patients with mean spherical equivalent of-6.46±1.50 D and mean age 28.23±7.38y were enrolled.Full-scale examinations were conducted on all patients preoperatively and during followup.Visual acuity,manifest refraction,axial length,corneal thickness,corneal higher-order aberrations,and CD were evaluated.●RESULTS:All surgeries were completed successfully without complications or adverse events.Ten-year safety index was 1.17±0.20 and efficacy 1.04±0.28.CD value of 0–6 mm zones in central layer was statistically significantly lower 10y postoperatively,compared with preoperative values(0–2 mmΔ=-1.62,2–6 mmΔ=-1.24,P<0.01).There were no correlations between CD values and factors evaluated.●CONCLUSION:SMILE is a safe and efficient procedure for myopia on a long-term basis.CD values get lower 10y postoperatively,whose mechanism is to be further discussed.
基金Supported by Key Research and Development Projects of Zhejiang Science and Technology Plan(No.2021C03103).
文摘AIM:To analyze the distribution of refractive status in school-age children with different corneal curvatures(CC)and the correlation between CC and refractive status.METHODS:A total of 2214 school-aged children of grade 4 in Hangzhou who were screened for school myopia were included.Uncorrected distance visual acuity(UCDVA),non-cycloplegic refraction,axial length(AL),horizontal and vertical corneal curvature(K1,K2)were measured and spherical equivalent(SE),corneal curvature radius(CCR)and axial length/corneal radius of curvature ratio(AL/CR)were calculated.UCDVA<5.0 and SE≤-0.50 D were classified as school-screening myopia.According to the different CCRs,the patients were divided into the lower corneal curvature(LCC)group(CCR≥7.92)and the higher corneal curvature(HCC)group(CCR<7.92).Each group was further divided into the normal AL subgroup and the long AL subgroup.The refractive parameters were compared to identify any differences between the two groups.RESULTS:Both SE and AL were greater in the LCC group(P=0.013,P<0.001).The prevalence of myopia was 38% in the LCC group and 44% in the HCC group(P<0.001).The proportion of children without screening myopia was higher in the LCC group(62%)than in the HCC group(56%).Among these children without screening myopia,the proportion of long AL in the LCC group(24%)was significantly higher than that in the HCC group(0.012%;P<0.001).The change of SE in the LCC group was less affected by the increase of AL than that in the HCC group.CONCLUSION:School-aged children in the LCC group have a lower incidence of screening myopia and longer AL.Low CC can mask SE reduction and AL growth to some extent,and the change of AL growth change more in children with low CC than high CC.Before the onset of myopia,its growth rate is even faster than that after the onset of myopia.
基金Supported by Independent Research Foundation of the 305 Hospital of PLA(No.24ZZJJLW-010).
文摘Among refractive errors,astigmatism is the most common optical aberration,where refraction changes in different meridians of the eye.It causes blurred vision at any distance and includes corneal,lenticular,and retinal astigmatism.Cataract surgery used to cause a progressive increase in the pre-exisiting corneal astigmatism because of creating a surgically induced astigmatism,for example,a large size surgery incision.The development of surgical techniques during last decades has made cataract surgery interchange to treat preoperative corneal astigmatism at time of surgery.Nowadays,three surgical approaches can be used.By placing a sutureless clear corneal incision on the steep meridian of the cornea,a preoperative corneal astigmatism less than 1.0 D can be corrected.Single or paired peripheral corneal relaxing incisions(PCRIs)provide 1.0-3.0 D corneal astigmatism correction.PCRIs are typically used for treating 1.0-1.5 D of regular corneal astigmatism,if more than 2.0 D,the risk of overcorrection and irregular astigmatism is increased.When toric intraocular lenses(IOLs)are unavailable in markets,PCRIs are still a reasonable option for patients with up to 3.0 D of pre-existing corneal astigmatism.Toric IOLs implantation can correct 1.0-4.5 D of corneal astigmatism.Several IOLs are approved to correct a high degree of corneal astigmatism with cylinder power up to 12.0 D.These approaches can be used alone or in combination.
文摘Purpose: The study was to evaluate the efficacy of cyanoacrylate tissue adhesive (CTA) application in corneal perforations. Method: This was a prospective study on 20 patients of corneal perforations who received cyanoacrylate tissue adhesive application as treatment between March 2021 and March 2022 at Preah Ang Duong Hospital. The primary outcome measure was success rate of CTA application, while the secondary outcome was to measure postoperative best-corrected visual acuity (BCVA) and ocular complications. Results: The mean age of patients was 44.15 ± 16.05 years old and 7 (35%) were female. Causes of perforation were microbial infection in 12 patients (60%), trauma in 5 patients (25%), and sterile melting in 3 patients (15%). The perforation of size smaller than 1.5 mm was in 8 patients (40%) while 12 patients (60%) had perforated size between 1.5 mm to 3 mm. The perforation was 60% (12 patients) central, 25% (5 patients) paracentral, and 15% (3 patients) peripherally. Out of 20 patients, 5 patients (25%) received CTA application more than 1 time. The mean glue retention was 57.60 ± 31.84 days. Success rate of glue application (defined as intact globe without surgical intervention regardless of number of CTA applications) was 85%. At the last visit, 7 patients (35%) had BCVA of 6/120 or better. Common complications were uveitis (45%), ocular hypertension (30%), cataract (25%) and neovascularization (20%). No serious complications were found. Conclusion: Cyanoacrylate tissue adhesive is an effective treatment option in sealing corneal perforations with no serious complications. .
文摘Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.
文摘AIM:To investigate changes in choroidal thickness and vascularity in keratoconus patients treated with corneal crosslinking.METHODS:This study evaluated 28 eyes of 22 patients with keratoconus who underwent corneal crosslinking.The choroidal thicknesses were evaluated on enhanced depth imaging optical coherence tomography at the preoperative and postoperative 3d,1,and 3mo.Choroidal thickness in the four cardinal quadrants and the fovea were evaluated.The choroidal vascularity index was also calculated.RESULTS:There was no significant difference in central choroidal thickness between the preoperative and postoperative 3d,1mo(P>0.05).There was a significant increase in the 3mo(P=0.034)and a significant decrease in the horizontal choroidal vascularity index on the postoperative 3d(P=0.014),there was no statistically significant change in vertical axes and other visits in horizontal sections(P>0.05).CONCLUSION:This study sheds light on choroidal changes in postoperative corneal crosslinking for keratoconus.While it suggests the procedure’s relative safety for submacular choroid,more extensive research is necessary to confirm these findings and their clinical significance.
基金Supported by the National Natural Science Foundation of China(No.81770889)Zhuhai Science and Technology Program(No.ZH22036201210134PWC).
文摘●AIM:To evaluate the role of semaphorin 7A(Sema7A)and its associated regulatory mechanisms in modulating the barrier function of cultured human corneal epithelial cells(HCEs).●METHODS:Barrier models of HCEs were treated with recombinant human Sema7A at concentrations of 0,125,250,or 500 ng/mL for 24,48,or 72h in vitro.Transepithelial electrical resistance(TEER)as well as Dextran-fluorescein isothiocyanate(FITC)permeability assays were conducted to assess barrier function.To quantify tight junctions(TJs)such as occludin and zonula occludens-1(ZO-1)at the mRNA level,reverse transcriptionpolymerase chain reaction(RT-PCR)analysis was performed.Immunoblotting was used to examine the activity of the nuclear factor-kappa B(NF-κB)signaling pathway and the production of TJs proteins.Immunofluorescence analyses were employed to localize the TJs.Enzyme-linked immunosorbent assay(ELISA)and RT-PCR were utilized to observe changes in interleukin(IL)-1βlevels.To investigate the role of NF-κB signaling activation and IL^(-1)βin Sema7A’s anti-barrier mechanism,we employed 0.1μmol/L IκB kinase 2(IKK2)inhibitor IV or 500 ng/mL IL^(-1)receptor(IL-1R)antagonist.●RESULTS:Treatment with Sema7A resulted in decreased TEER and increased permeability of Dextran-FITC in HCEs through down-regulating mRNA and protein levels of TJs in a time-and dose-dependent manner,as well as altering the localization of TJs.Furthermore,Sema7A stimulated the activation of inhibitor of kappa B alpha(IκBα)and expression of IL-1β.The anti-barrier function of Sema7A was significantly suppressed by treatment with IKK2 inhibitor IV or IL-1R antagonists.●CONCLUSION:Sema7A disrupts barrier function through its influence on NF-κB-mediated expression of TJ proteins,as well as the expression of IL-1β.These findings suggest that Sema7A could be a potential therapeutic target for the diseases in corneal epithelium.
基金Supported by the National Key Research and Development Program of China(No.2020YFE0204400)the National Natural Science Foundation of China(No.82271042)the Zhejiang Province Key Research and Development Program(No.2023C03090).
文摘A corneal epithelial-stromal defect is recognized as a major contributor to corneal scarring.Given the rising prevalence of blindness caused by corneal scarring,increasing attention has been focused on corneal epithelialstromal defects.Currently,the etiology and pathogenesis of these defects remain inadequately understood,necessitating further investigation through experimental research.Various modeling methods exist both domestically and internationally,each with distinct adaptive conditions,advantages,and disadvantages.This review primarily aims to summarize the techniques used to establish optimal animal models of corneal epithelial-stromal injury,including mechanical modeling,chemical alkali burns,post-refractive surgery infections,and genetic engineering.The intention is to provide valuable insights for studying the mechanisms underlying corneal epithelial-stromal injury and the development of corresponding therapeutic interventions.
基金Supported by the Science and Technology Program of Zhejiang Province(No.2019C03046)the Natural Science Foundation of Zhejiang Province under Grant(No.LQ20H120007)。
文摘AIM:To report the safety,efficacy,and accuracy of small-incision lenticule extraction(SMILE)or femtosecondassisted laser in situ keratomileusis(FS-LASIK)for the correction of myopia or myopic astigmatism in patients with deep corneal opacity denoted by anterior segment optical coherence tomography(AS-OCT).METHODS:Four patients with monocular corneal opacity(3 due to mechanical injury,1 due to a firecracker wound)were recruited and treated with refractive surgery(3 for SMILE,1 for FS-LASIK combined with limbal relaxing incision(LRI).Preoperative ocular manifestations,surgical details,postoperative visual outcomes,corneal opacity parameters,and corneal topography were analyzed.RESULTS:Preoperatively,spherical diopter ranged from-3.0 D to-4.75 D with cylinder ranging from-0.75 to-5.0 D,and corrected distance visual acuity(CDVA)ranging from 20/25 to 20/20.One eye’s corneal opacity was located in the central zone and three were in the mid-peripheral optical zone.Three patients underwent uneventful SMILE in both eyes,whilst one patient underwent FS-LASIK for high astigmatism in both eyes and LRI in the right eye.CDVA of the eye with corneal opacity ranged from 20/22to 20/20 one to six weeks postoperatively.Two patients achieved better CDVA and no patients lost Snellen lines.The postoperative diopter was within±0.75 D for all eyes.Significant edema existed above the corneal opacity in one eye and dissipated soon.No eccentric corneal topography or morphological anomaly of the corneal cap or flap was observed.CONCLUSION:The cases demonstrate that SMILE or FS-LASIK is safe and effective to treat myopic astigmatism combined with deep corneal opacity lesions after comprehensive preoperative evaluation and appropriate candidate selection.FS-LASIK combined with LRI is also sufficient for correcting high astigmatism due to corneal scarring.
基金the National Key R&D Program of China(Grant No.2020YFA0908100)the National Nature Science Foundation(Grant Nos.12274356,82070931,and 82271045)+1 种基金Fundamental Research Funds for the Central Universities(20720220022)the 111 Project(B16029)。
文摘Metal–organic frameworks(MOFs)have attracted significant research interest in biomimetic catalysis.However,the modulation of the activity of MOFs by precisely tuning the coordination of metal nodes is still a significant challenge.Inspired by metalloenzymes with well-defined coordination structures,a series of MOFs containing halogen-coordinated copper nodes(Cu-X MOFs,X=Cl,Br,I)are employed to elucidate their structure–activity relationship.Intriguingly,experimental and theoretical results strongly support that precisely tuning the coordination of halogen atoms directly regulates the enzyme-like activities of Cu-X MOFs by influencing the spatial configuration and electronic structure of the Cu active center.The optimal Cu–Cl MOF exhibits excellent superoxide dismutase-like activity with a specific activity one order of magnitude higher than the reported Cu-based nanozymes.More importantly,by performing enzyme-mimicking catalysis,the Cu–Cl MOF nanozyme can significantly scavenge reactive oxygen species and alleviate oxidative stress,thus effectively relieving ocular chemical burns.Mechanistically,the antioxidant and antiapoptotic properties of Cu–Cl MOF are achieved by regulating the NRF2 and JNK or P38 MAPK pathways.Our work provides a novel way to refine MOF nanozymes by directly engineering the coordination microenvironment and,more significantly,demonstrating their potential therapeutic effect in ophthalmic disease.