Clinical Efficacy and Safety of Foldable Capsular Vitreous Body Implant Surgery in 22 Cases of Silicone Oil-dependent Eyes

Objective This study aimed to evaluate the clinical efficacy and safety of foldable capsular vitreous body(FCVB)implant surgery in silicone oil-dependent eyes.Methods A total of 22 participants with silicone oil-dependent eyes who received treatment with FCVB implant surgery between January 2019 and June 2020 were included in this retrospective study.The intraocular pressure(IOP),best-corrected visual acuity(BCVA),demographic data,and any recorded complications were evaluated.Results The postoperative IOP(12.73±4.20 mmHg)was significantly improved(P=0.03)compared to the preoperative IOP(10.23±3.69 mmHg)(the main endpoint).There was no significant difference(P=0.33)in the final BCVA preoperation and 3rd month postoperation(the secondary endpoint).The most common postoperative complication was hyphema.Other common postoperative complications included corneal opacity,a shallow anterior chamber,and a low IOP.Conclusion FCVB implant surgery is a safe and effective method for treating silicone oil-dependent eyes;however,attention should be paid to the prevention and timely treatment of complications.

Evaluation of the long-term effect of foldable capsular vitreous bodies in severe ocular rupture

AIM:To evaluate the long-term effect of foldable capsular vitreous body(FCVB)in the treatment of severe ocular rupture to provide a practical basis for clinical selection.METHODS:A total of 26 patients(26 eyes),23 men and 3 women,with severe ocular rupture who underwent FCVB implantation between March 2018 and September 2018 were retrospectively analysed.All open ocular wounds located in zone III,with preoperative visual acuity grade IV and above(Snellen less than 4/200).The best corrected visual acuity(BCVA),intraocular pressure(IOP),cornea,anterior chamber,iris,lens,choroid,and retina were evaluated before and after the surgery.The subjective feeling and the location of FCVB were also assessed.RESULTS:The average age of the 26 patients was 36y(20-60y).Postoperative follow-up was from 10 to 14mo.At the end of follow up,BCVA was light perception(LP)in 10 cases,no light perception(NLP)in 13 cases,hand motions(HM)in 3 cases.IOP was 11±5 mm Hg.Corneal degeneration was in 3 cases and corneal endothelial dystrophy was in 7 cases.Shallow anterior chamber was in 8 cases and hyphema was in 8 cases.Organized membrane in the pupil was in 14 cases.Epiphora occurred in 3 cases.FCVB drainage tube exposed in 3 cases.All FCVBs were in their normal location and no rejection occurred.CONCLUSION:FCVB implantation is a long-term effective treatment and may provide a practical selection for severe ocular rupture.

Vitreous substitutes: challenges and directions

The natural vitreous body has a fine structure and complex functions. The imitation of the natural vitreous body by vitreous substitutes is a challenging work for both researchers and ophthalmologists. Gases, silicone oil, heavy silicone oil and hydrogels, particularly the former two vitreous substitutes are clinically widely used with certain complications. Those, however, are not real artificial vitreous due to lack of structure and function like the natural vitreous body. This article reviews the situations, challenges, and future directions in the development of vitreous substitutes, particularly the experimental and clinical use of a new artificial foldable capsular vitreous body.

Expression levels of ROS and Atg proteins in the vitreous in rhegmatogenous retinal detachment

AIM:To detect the concentrations of reactive oxygen species(ROS),transient receptor potential mucin-1(TRPML1),and autophagy-related(Atg)proteins(LC3-Ⅰ,LC3-Ⅱ,and Beclin1)in vitreous humor of patients with simple rhegmatogenous retinal detachment(RRD).METHODS:RRD patients enrolled as the RRD group,and patients with idiopathic macular hole(IMH)and idiopathic macular epiretinal membrane(IMEM)were enrolled as control group.The levels of ROS,TRPML1,LC3-Ⅰ,LC3-Ⅱ,and Beclin1 in vitreous humor of patients in the RRD and control groups were detected by enzyme-linked immunosorbent assay(ELISA).RESULTS:The RRD group included 28 eyes 28 patients and had a higher concentration of ROS in vitreous humor(631.86±18.05 vs 436.34±108.22 IU/m L,P<0.05).The ROS level in patients with a wide retinal detachment(RD)extent(RD range≥1/2)was higher than that with a narrow RD extent(RD range<1/2,P<0.05).ROS concentration was negatively correlated with RD time(r=-0.46,P=0.01).The expression levels of LC3-Ⅰand Beclin1 significantly decreased in RRD(P<0.05),but there were no correlations with the RD time,RD extent,or macular involvement.CONCLUSION:In eyes with RRD,the concentration of ROS in vitreous humor increases and the expression levels of Atg proteins decrease,reflecting possibly that autophagy is inhibited.

Structure of vitreous body and its relationship with liquefaction

The aim of the study is to clarify the vitreous body structure and liquefaction phenomena. It was found that when melting a frozen rabbit vitreous body, the gel-sol transition phenomenon occurs and the gel structure is broken. This is almost like the liquefaction of the vitreous body in vivo. We try to clarify the liquefaction phenomenon by using this animal model. The native vitreous body has three dimensional meshwork structures. After liquefaction, it is changed into two parts, namely fiber aggregates and soluble amorphous aggregates. The surface of native vitreous body meshwork is mucopolysacharide, but that of fiber aggregates after liquefaction is changed into connective tissue, which means the conformational change of vitreous body in liquefaction. The soluble proteins after liquefaction were analyzed and identified as crystallin family. It is suggested that the liquefaction is induced by detachment of non-collagenous protein beads containing crystallins, resulting in the collapse of the three dimensional structure to release watery liquid trapped within. And the new gel-sol transition model of vitreous bod is proposed.

Quantitative Study of Basic Fibroblast Growth Factor in Vitreous with Proliferative Vitreoretinopathy

Objective:To quantitatively study basic fibroblast growth factor(bFGF)in the vitreous ofproliferative vitreoretionopathy(PVR)inorder to understand the role of bFGFin the develop-ment of PVR.Method:High sensitive sandwich enzyme immunoassay technique(ELISA)was used to measure bFGF level in vitreous of normal eyes,the eyes of PVR-Cor pVR-Dgrade,eyes of vitreous hemorrhage and the serum levels of bFGF in PVR-Dpatients.Results:The levels of bFGF in the vitreous were:median5.20ng/L,quartile15.47ng/Lin20normal eyes;median3.12ng/L,quartile10.48ng/Lin35PVR-Ceyes;median46.56ng/L,quartile113.96ng/Lin26pPVR-Deyes;median1.40ng/L,quar-tile6.25ng/Lin25vitreous hemorrhage eyes.The vitreous bFGF level in PVR-D group was significantly higher than that in the normal group,PVR-Cgroup and vitreous hemorrhage group(P<0.01).The mean of serum-bFGFlevel was18.33±3.39ng/L.The vitreous bFGFlevel ofPVR-Dgroup was significantly higher than serum-bFGFlev-el(P<0.01).And the vitreous-bFGFlevel in PVR-Dgroup was significantly higher in larger retinal tear subgroup.Conclusion:The results suggested that bFGF is involved in the development of PVR.Eye Science2000;16:7-10.

S100钙结合蛋白A9与Toll样受体4在糖尿病视网膜病变患者玻璃体液的表达及临床意义

目的了解糖尿病视网膜病变患者玻璃体液中S100钙结合蛋白A9(S100A9)及Toll样受体4(TLR4)的表达并讨论其临床意义。方法选取2022年8月至2023年8月于合肥市第二人民医院行手术治疗的患者40例。研究组为糖尿病视网膜病变需行玻璃体切割手术治疗的20例患者,对照组为特发性黄斑裂孔或黄斑前膜需行玻璃体切除手术的20例患者。收集患者玻璃体液,用ELISA法测定其S100A9及TLR4蛋白浓度。结果研究组玻璃体液S100A9浓度为(5.95±1.55)μg/L高于对照组(2.19±0.76)μg/L,差异有统计学意义(P<0.05);研究组玻璃体液TLR4浓度为(1.54±0.79)μg/L,高于对照组(0.34±0.18)μg/L,差异有统计学意义(P<0.05);研究组玻璃体液S100A9与TLR4呈正相关(r=0.72,P<0.05)。结论糖尿病视网膜病变患者玻璃体液中S100A9及TLR4水平增高,提示炎症参与其发病过程。

折叠式人工玻璃体球囊在硅油依赖眼中的临床应用研究

目的探讨折叠式人工玻璃体球囊(FCVB)植入治疗硅油依赖眼的临床效果。方法回顾分析2021年4月—2022年2月就诊于复旦大学附属眼耳鼻喉科医院且因硅油依赖眼行FCVB植入术的患者临床资料,评价FCVB植入的效果。结果本研究共纳入104例(104眼),其中男性74例、女性30例。平均年龄为(36.00±18.25)岁(3~68岁)。所有眼均为硅油依赖眼,包括眼外伤94眼(90.4%),急性视网膜坏死3眼,复杂性视网膜脱离7眼。平均随访时间为(337.50±102.03)d(180~550 d)。所有患者行25 G玻璃体切除联合FCVB植入术,残留的视网膜均成功复位,术前眼压、眼轴及最佳矫正视力与术后相比,差异均无统计学意义。所有患眼FCVB植入均顺利,未发生眼内炎、引流阀暴露及球囊破裂等严重并发症。14眼(13.5%)术后角膜混浊程度加重。15眼(14.4%)术后发生前房积血,再次行前房冲洗术。5眼(4.8%)因虹膜缺失,球囊向前移位,再次行前房成形术。结论FCVB植入治疗硅油依赖眼,经短期随访,可以维持眼球形态,防止眼球萎缩,但其长远效果仍需进一步长期随访研究。

血清和玻璃体中miR-126和miR-325与增生性玻璃体视网膜病变严重程度的关系

目的:探讨血清和玻璃体中miR-126和miR-325与增生性玻璃体视网膜病变(PVR)严重程度的关系。方法:回顾性研究。选取2019-10/2022-10在本院治疗的PVR患者100例100眼。按照视网膜病变程度分为轻度组42眼和重度组58眼。选取同期因眼外伤在本院进行玻璃体切除术无视网膜病变的患者30例30眼为对照组。采用荧光定量PCR检测血清和玻璃体中miR-126和miR-325表达水平;ELISA检测血清、玻璃体中转化生长因子-β(TGF-β)、血小板衍生生长因子(PDGF)、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)水平;Pearson法分析血清和玻璃体中miR-126和miR-325水平与TGF-β、PDGF、VEGF、TNF-α水平的相关性;采用Logistic多因素分析影响发生重度PVR的因素。结果:PVR患者血清和玻璃体中miR-126水平较对照组降低,且重度组低于轻度组(均P<0.05);miR-325水平较对照组升高,且重度组高于轻度组(均P<0.05)。重度组患者血清和玻璃体中TGF-β、PDGF、VEGF、TNF-α水平较轻度组均上升(均P<0.05)。PVR患者血清和玻璃体中miR-126水平与miR-325、TGF-β、VEGF、TNF-α、PDGF水平均呈负相关(均P<0.05),miR-325与TGF-β、VEGF、TNF-α、PDGF水平均呈正相关(均P<0.05)。Logistic回归分析显示,血清和玻璃体中miR-325、TGF-β、PDGF、TNF-α均是发生重度PVR的危险因素,miR-126是保护因素(P<0.05)。结论:随PVR疾病的加重,患者血清和玻璃体中miR-126表达降低,miR-325表达升高,且与TGF-β、TNF-α、VEGF、PDGF具有相关性。

糖尿病黄斑水肿患者玻璃体腔注射康柏西普治疗效果的影响因素分析

目的探讨糖尿病黄斑水肿(DME)患者玻璃体腔注射康柏西普治疗效果的影响因素。方法选取2019年6月至2021年5月于江西医学高等专科学校第一附属医院就诊的127例DME患者作为研究对象,全部患者均接受玻璃体腔注射康柏西普治疗,治疗7 d后参照相关标准评估患者治疗效果;设计基线资料调查表,询问并记录患者基线资料,将可能的因素纳入,经logistic回归分析找出DME患者玻璃体腔注射康柏西普治疗无效的影响因素。结果127例DME患者经玻璃体腔注射康柏西普治疗,有36例无效,无效率为28.35%;单因素分析结果提示,吸烟史、糖化血红蛋白(HbA1c)水平、低密度脂蛋白(LDL)水平、高密度脂蛋白(HDL)水平升高是DME患者玻璃体腔注射康柏西普治疗效果的相关因素(P<0.05);多因素分析结果提示,吸烟史(β=0.900,OR=2.461,95%CI:1.118~5.413)、HbA1c水平升高(β=1.106,OR=3.023,95%CI:1.753~5.213)、LDL水平升高(β=0.576,OR=1.780,95%CI:1.167~2.713)是DME患者玻璃体腔注射康柏西普治疗无效的影响因素(OR>1,P<0.05);HDL水平升高(β=-3.699,OR=0.025,95%CI:0.003~0.191)是DME患者玻璃体腔注射康柏西普治疗无效的保护因素(OR<1,P<0.05)。结论DME患者玻璃体腔注射康柏西普治疗无效可能受吸烟史、HbA1c水平升高、LDL水平升高、HDL水平降低影响。

从肺论治内障眼病初探

内障眼病外无见症,在现代眼科中主要包括眼后段疾病,其病因病机十分复杂。“目病常统于肺”是阐述内障眼病病因病机的重要理论。肺为相傅之官,主一身之气,在眼的生理功能和病因病机中具有关键作用。肺对眼内气、血、津液有疏通和调节作用,尤以肺气宣降为要,在视网膜血氧调节中可见一斑;玻璃体属于手太阴肺经,手太阴肺经为阴经气化活动的开始,玻璃体在内眼中亦是如此。在现代研究中也可发现,玻璃体微粒在内障眼病中起着调节和信使的作用。本文分别从理论研究和现代研究2个方面,分析从肺论治内障眼病的依据,着重从经络和藏象的角度进行探讨。

循证护理对视网膜脱离患者术后康复的影响

目的探讨循证护理对孔源性视网膜脱离术后康复的影响。方法选取厦门大学附属第一医院眼科2021年10月—2023年10月行玻璃体切除+硅油植入手术治疗的单纯孔源性视网膜脱离患者72例,采用单纯随机抽样分为2组,各36例。对照组给予常规护理,观察组给予循证护理,对比2组患者术后1个月视力康复情况、用药准确性、体位依从性、术后不良反应情况。结果相较于对照组,观察组术后1个月视力>0.10者多(P<0.05),同时患者用药准确性高,患者体位正确性较好。观察组术后并发症发生率(2.78%)低于对照组(22.22%)(P<0.05)。结论循证护理比常规护理可能更有利于孔源性视网膜脱离患者术后的康复。

折叠式人工玻璃体球囊临床应用的疗效研究

目的本研究旨在通过临床实践对折叠式人工玻璃体球囊的应用效果和安全性进行分析,探讨其优势和局限性。方法选取2022年10月-2023年12月在空军特色医学中心行折叠式人工玻璃体球囊植入术患者5例(5只眼,硅油依赖眼2例,眼球破裂伤3例),其中男4例,女1例,回顾性分析5例患者的临床资料,包括患者的一般情况、术前和术后视力、术前和术后眼压、裂隙灯检查、眼轴长度测量、眼科B超、角膜内皮计数、球囊型号和填充硅油量等。结果 5例患者平均年龄为(28.20±9.15)岁,术后眼压(13.00±4.85)mmHg和术前眼压(9.40±4.62)mmHg相比,差异有统计学意义(t=-4.129,P=0.014)。截至2024年2月最后1次随访结束时,5例球囊位置均无偏斜、无破损,引流管均无暴露,术后最常见的并发症是前房积血和浅前房。结论折叠式人工玻璃体球囊植入术对于眼球破裂伤眼和硅油依赖眼等复杂眼病是一种安全有效的治疗方法,术后可以保持自由体位,但应注意术后并发症的及时治疗。

粉煤灰中玻璃体含量测试方法的研究进展

粉煤灰是一种硅铝质材料,具有火山灰活性,而粉煤灰玻璃体是粉煤灰活性的主要来源,其含量是影响粉煤灰活性的主要因素。综述粉煤灰玻璃体结构和玻璃体含量的测试方法,结果表明,粉煤灰玻璃体结构主要为低钙粉煤灰中含较低网络改性剂(CaO+MgO+Na_(2)O+K_(2)O≈8%)的Ⅰ型铝硅酸盐玻璃体,及高钙粉煤灰中含较高网络改性剂(CaO+MgO+Na_(2)O+K_(2)O≈27%)的Ⅱ型铝硅酸钙玻璃体;玻璃体含量的测定方法主要有X射线衍射分析(XRD)结晶度计算法、XRD的Rietveld图谱拟合法、酸溶解法、碱溶解法等。最后对主要的测试方法作比较分析,旨为粉煤灰的资源综合利用提供借鉴和参考。

俯卧位垫枕在玻璃体视网膜显微术患者舒适护理中的应用效果

目的:探讨俯卧位垫枕在玻璃体视网膜显微术患者舒适护理中的应用效果.方法:选取2019年2月至2022年2月本院收治并进行玻璃体视网膜显微术治疗的患者106例作为研究对象.按照随机数表法将其分为观察组(n=53,在常规舒适护理的基础上加用俯卧位垫枕干预),和对照组(n=53,予以常规舒适护理).观察并比较两组患者在术后2周每天平均维持低头位时间、睡眠时长以及出现其他临床症状等情况.结果:在护理2周后,观察组患者平均每天低头位维持时间、睡眠时长均高于对照组;同时观察组肩颈不适、呼吸困难等症状少于对照组,差异均有统计学意义(P<0.05).结论:在玻璃体视网膜显微术患者的舒适护理中加用俯卧位垫枕,可以促使患者更长时间维持低头位,有利于患者尽早恢复,在临床护理工作中具有重要的应用价值.

Characteristic analysis on susceptibility weighted imaging of intravitreous foreign body Of autologous eyelashes in rabbits

Objective： To explore the characteristics of susceptibility weighted imaging （SWI） of the intravitreous foreign body of autologous eyelashes in rabbits. Methods： A total of 12 New Zealand white rabbits, either sex, weighing 2.5-3.5 kg, and provided by the Experimental Animal Center of Henan Province were employed in this study. For each rabbit, 5 autologous eyelashes （1 cm in length and 0.2-0.3 mm in diameter） were implanted into the right ocular vitreum, while the left control ocular vitreum received sham operation but nothing was implanted. SWI sequential test was made 2 hours postoperatively. Then the rabbits were killed and the specimens of the vitreous bodies of the rabbits were obtained. Hematoxylin and eosin staining and histological examinations were performed. Results： The autologous eyelashes in 8 ocular vitreums of rabbits showed linear low signal intensity on the magni-tude images and susceptibility weighted images, but linear high signal intensity on the phase images. Among the 12 experimental rabbits, 5 eyelashes in the right vitreum were completely shown in 3 rabbits, partly shown in 5 rabbits （2 eyelashes shown in 3 rabbits and 3 eyelashes shown in 2 rabbits）, and not shown in 4 rabbits. Conelusions： SWI of the foreign body ofintravitreous autologous eyelashes in rabbits has its own characteristics. The combined application of SWI sequential magnitude images, susceptibility weighted images and phase images is helpful to the detection and diagnosis of intravitreous autologous eyelashes in rabbits.

SOME USEFUL FORMULAE IN SU(N) ALGEBRA

Some useful relations in SU(N) algebra are given in this paper. These relations may be useful in deriving the many-body interaction in QCD.

玻璃体注射雷珠单抗联合玻璃体切除术治疗增生性糖尿病视网膜病变患者的临床效果

目的探讨玻璃体注射雷珠单抗联合玻璃体切除术治疗增生性糖尿病视网膜病变患者的临床效果及对眼底血流动力学的影响。方法选取2018年1月至2019年6月来源于辽宁省大连市第三人民医院的122例(共122只患眼)增生性糖尿病视网膜病变患者作为研究对象,采用随机数字表法将其分为试验组61例(61眼)和对照组61例(61眼)。对照组患者采用单纯玻璃体切除术治疗,试验组在行玻璃体切除术前3~10 d给予玻璃体腔内注射雷珠单抗。使用彩色多普勒血流显像(CDFI)分别测量两组患者治疗前后的视网膜中央动脉参数变化,并比较术前、术后1、3、6个月等不同时间段内两组患者的各种眼科指标。结果术后1、3、6个月,试验组患者的光敏感度高于对照组,最佳矫正视力(BVCA)、黄斑中心凹视网膜厚度(CMT)、视野灰度值低于对照组,差异有统计学意义(P<0.05);术后1、3、6个月,试验组患者的视网膜中央动脉收缩期峰值流速(PSV)、舒张末期血流速度(EDV)、平均血流速度(AVP)高于对照组,搏动指数(PI)、阻力指数(RI)试验组低于对照组,差异有统计学意义(P<0.05);两组患者的并发症总发生率比较,差异无统计学意义(P>0.05)。结论对增生性糖尿病视网膜病变患者采用玻璃体注射雷珠单抗联合玻璃体切除术治疗有利于获得确切效果,促进玻璃体积血吸收、新生血管消退的同时,还能明显增强视力,积极改善患者的眼底动脉灌注。

Estimates of energy expenditure using the RT3 accelerometer in patients with systemic lupus erythematosus

This study aimed to characterize energy expenditure patterns using the triaxial accelerometer and to identify the association of energy expenditure with clinical parameters in patients with systemic lupus erythematosus (SLE). Estimates of energy expenditures represented by total activity calorie (TA), physical activity calorie (PA), total activity calorie per body weight (TABW), and physical activity calorie per body weight (PABW) of 49 female SLE patients were assessed using the RT3 triaxial accelerometer (StayHealthy, Monrovia, CA) in a sevenday period. SLE patients in the highest body mass index (BMI) tertile showed significantly lower values of TABW compared to those in the lowest tertile, while SLE patients in the lowest TABW tertile showed significantly higher body weight, waist circumference, BMI, SLE disease activity index (SLEDAI), dosage of prednisone, and blood pressure. There was a high prevalence of metabolic syndrome and SLE patients with metabolic syndrome showed significantly lower TABW. In addition, both TABW and PABW significantly but negatively correlated with SLEDAI. In conclusion, the RT3 accelerometer is suitable for evaluating total and physical activity-related energy expenditure in patients with SLE. TABW measured by the triaxial accelerometer is inversely related with body weight status and disease activity in SLE patients. This suggests that estimates of energy expenditure by the tri-axial accelerometer may be applied in the management of SLE.

折叠式人工玻璃体球囊植入术患者的围手术期护理

总结2017年7月至2018年11月在中山大学中山眼科中心行折叠式人工玻璃体球囊植入术的46例患者(46眼)围手术期护理要点,其中男42例、女4例,年龄(38.54±11.42)岁。围手术期护理主要包括:术前眼部及全身评估、术中核心步骤的配合、术后术眼保护及并发症护理、患者及家属心理支持、开展延续性护理。46例患者经过精心治疗和护理后,症状得到有效改善,均未发生严重并发症。术后随访,患者恢复良好。