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Objective To observe the safety and effectiveness of liquid-immersion femtosecond laser assisted cataract surgery (FLACS).Methods A prospective study was conducted in together 70 age-related cataract patients (70 eyes) between October 2013 and April 2014,and these subjects were randomly divided into two groups:FLACS group,35 patients undergoing liquid-immersion LensAR FLACS,and ultrasound group,35 patients receiving conventional phacoemuisification.All patients were followed up 1 day,1 week,1 month and 3 months after operation.The variables,including uncorrected distance visual acuity (UCVA),best corrected distance visual acuity (BCVA),redness analysis,corneal thickness,aqueous humor protein concentration and corneal endothelial cell count were recorded and analyzed.Results All procedures in the FLACS group were successful.The ultrasound time and energy in the FLACS group were statistically less than those in the ultrasound group[(23.25 ±7.21)s,(7.91％ ±2.75％)vs.(34.08 ± 8.59) s,(16.95％ ± 4.60％)] (both P =0.000).The LogMAR UCVA and LogMAR BCVA were better and the corneal thickness in FLACS group were statistically less than those in the ultrasound group postoperative 1 day and 1 week (all P ＜ 0.05).And the corneal endothelial cell loss rate in the FLACS group was statistically lower than that in the ultrasound group postoperative 1 week and 3 months [(9.63％ ±3.67％),(11.22％ ±3.77％) vs.(13.29％ ±4.62％),(15.16％ ±5.02％)] (allP=0.000).One day,1 week and 1 month after operation,the aqueous humor protein concentration in the FLACS group [(16.88 ±4.76)nc · s-1,(14.12 ±4.96)nc · s-1,(9.71 ± 3.83)nc · s 1] was lower than those in the ultrasound group (all P ＜ 0.05).However,there was no significant difference in conjunctival hyperemia and ciliary congestion between the two groups at 1 day after operation (all P ＞ 0.05).Conclusion The liquid-immersion FLACS is efficient and safe for assisting cataract surgery that may have some advantages in reducing tissue damage and improving postoperative early visual recovery.
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AIM: To report the safety and effectiveness of LenSx femtosecond laser-assisted cataract surgery. ● METHODS: Sixty - seven patients ( 76 eyes ) were included in the study. All the cases underwent LenSx femtosecond laser-assisted cataract surgery between Jul. 2014 and Jul. 2015. The completion rate of anterior capsulotomy, lens fragmentation, intraocular lens implantation and corneal incisions, the best corrected distance visual acuity ( CDVA ) before and 1mo after femtosecond laser-assisted cataract surgery, the adverse events and equipment defect rate were recorded. The regression analysis of possible factors affecting the completion rate of corneal incision ( eye, age, location of incision, corneal diameter, peripheral corneal thickness, preoperative corneal astigmatism) was taken. ● RESULTS: All surgeries were uneventful. The completion rate of anterior capsulotomy, lens fragmentation, intraocular lens implantation and corneal incisions was 97%, 100%, 100% and 83%, respectively. No adverse events ( posterior capsule rupture, corneal edema, macular edema and retinal detachment ) and device defect occurred. The CDVA was significantly improved 1mo after surgery. Logistic regression analysis showed that there was a correlation between location of corneal incision and completion rate of corneal incision, and no correlation was found between eye, age, corneal diameter, peripheral corneal thickness, preoperative corneal and completion rate of corneal incision. ●CONCLUSION: The LenSx femtosecond laser-assisted methodis efficient and safe for cataract surgery.
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?AlM: To investigate the expression of miR-181 in the lens tissue of cataract and the regulating mechanism of miR-181 on apoptosis of human lens epithelial cell. ?METHODS:Real time q-PCR was used to measure the expression of miR-181 in the anterior lens capsules of age - related cataract and human lens epithelial cell apoptosis model. miR- 181 mimic and inhibitor were transfected using Lipofectamine 2 000 to regulate the expression of miR-181, and then Real time q-PCR was used to verify transfection efficiency. Flow cytometry was used to detect the change of cell apoptosis rate. ? RESULTS: Compared with control group, the expression of miR-181 was significantly higher in both the anterior lens capsules of age-related cataract and human lens epithelial cell apoptosis model; the relative expression of miR-181 in lens epithelial cells transfected with miR-181 mimic was increased, whereas decreased in cells transfected with miR-181 inhibitor;the apoptosis rate of cells transfected with miR - 181 mimic was increased, while reduced in miR-181 inhibitor group. Each result was statistically significant (P ?CONCLUSlON:High expression of miR-181 is detected in anterior lens capsule of age-related cataract. miR-181 might play a certain role in the pathogenesis of cataract via promoting human lens epithelial cell apoptosis. miR-181 probably becomes a new approach for the nonoperative treatment of cataract, but the concrete mechanism still needs to be further studied.
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Abstract?AlM:To investigate the influence of lOL refractive index ( Rl ) on measurement of straylight following cataract surgery.?METHODS:ln this case-control study, 77 eyes of 77 age-related cataract patients who underwent cataract phacoemulsification with posterior chamber aspherical arylic lOL implantation surgery in the Eye Hospital of China Medical University from Aug 2013 to Mar 2014, with a best corrected visual acuity ( BCVA) of 0. 5 or better, were classified into 3 groups randomly using 3 types of lOL: Tecnis ZCB00 Group ( Rl = 1. 47, 22 eyes of 22 subjects); Hoya PY60AD Group ( Rl=1. 52, 24 eyes of 24 subjects);Alcon SN60WF or lQ Group ( Rl=1. 55, 31 eyes of 31 subjects ) . BCVA, pupil size, astigmatism, axial length, intraocular straylight were measured respectively.? RESULTS: Age, axial length, BCVA, pupil size, astigmatism of the three groups were not significant difference (P>0. 05). The straylight of Tecnis, Hoya, lQ group were 1.04±0. 15, 1. 19±0. 14, 1. 14±0. 18. Straylight levels had significant differences among three groups ( F=5. 352, P = 0. 007 0. 05).?CONCLUSlON:Patients chosen the higher Rl lOL may have a higher straylight level after the surgery.
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Patients with early cataract may have normal visual acuity ( VA ) but complain that they have problems in driving at night, like seeing things through a veil. This phenomenon is defined as disability glare which maybe caused by growing stray light. Patients with intraocular lens following cataract surgery may complain about glare, halos and shadows in visual field, which are also resulted from dysphotopia. Disability glare is the VA loss due to disturbing luminance in visual field. ln other words, it's the retinal contrast sensitivity reduction because of the straylight. This article contains the consensus and new progress of disability glare. lt provides solutions according to its effect factors and offers clues for further study.
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Background Epidemiological investigation showed that 15％-29％ of patients with cataract have preexisting astigmatism of ＞ 1.50 D.So to control astigmatism is very important to the improvement of visual function after cataract surgery.The implantation of Toric intraocular lens (IOL) is a new option for the correction of preexisting astigmatism during cataract surgery,now.Short-term clinical studies of cataract patients with AcrySof Toric IOL implantation have revealed a good stability.However,the evaluation of long-term clinical result is seldom.Objective This study was to evaluate the long-term clinical results of Toric intraocular lens(IOL) implantation.Methods A serial case-observational study was designed.One hundred and twenty eyes of 78 cataract patients were included in this study.Phacoemulsification combined with AcrySof Toric IOL implantation was performed and the patients received a 2-year follow-up.Uncorrected distance visual acuity (UCDVA),best corrected distance visual acuity(BCDVA),residual cylinder,IOL rotation,vector analysis and accuracy of astigmatic correction were clinically evaluated in 1 day,1 month,3 months,6 months,1 year and 2 years,respectively.Comparison of these results of different follow-up periods were made.Results Sixty-seven patients (101 eyes)finished the follow-up and 19patients(19 eyes)lost visit due to other diseases affected.At 2 years visit after AcrySof SN60TT implantation,UCDVA,BCDVA,residual cylinder,absolute value of IOL rotation degree,vector magnitude of surgically induced astigmatism (SIA) was 0.16 (0.20),0 (0.1),0.75 (0.5) D,(2.9± 1.8) °,(1.2 ± 0.6) D,and the correction index (CI)was 0.90±0.41.A positive correlation was found between SIA and TIA(r=0.74,P =0.000).Compared to 1 month,3,6 months and 1 year,there was a mild tendency of decrease in accuracy of astigmatism correction and CI.Residual cylinder and degree of IOL rotation at 2 years after surgery were also slightly higher.However these changes were not statistically significant (P＞0.05).Conclusions After 2 years of follow-up,patients with AcrySof Toric implantation remain good visual acuity.AcrySof Toric IOL presents excellent long-term rotational stability and accuracy of astigmatism correction.
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AIM: (1) To investigate the effect of amniotic membrane transplantation (AMT) on rabbit conjunctival surface reconstruction with severe alkali burns. (2) To evaluate the possibility of AMT treatment for ocular alkali burns during recovering stage.METHODS: Animal models were established on 30 eyes of rabbits by creating severe alkali burns on the conjunctiva from the upper corneal limbus to the upper conjunctival fornix.Preserved human amniotic membrane transplantations and reconstruction of conjunctival fornix were performed at one week after injury (recovering stage). Epithelium growth of burned area after transplantation was observed using light microscope at 1, 2, 3, 4, and 8 weeks. Conjunctival tissue in transplantation area was collected at 1, 4 and 8 weeks. The ultrastructure of the collected tissue was studied by electron microscope. The results were compared with control group,which received only vitamin C subconjunctival injection and antibiotic eye drops as treatment for alkali burn. Exterior eye pictures were also taken at the end of the observation, the width from upper corneal limbus to the edge of upper fornix was measured. Data was analyzed statistically.RESULTS: 1) Tn the transplant group, conjunctival epithelium growth was observed in the area of AMT under both light and electron microscope 1 week after surgery. At 4weeks, conjunctival epithelium with goblet cells that resembled normal conjunctival tissues was observed in the whole amniotic membrane area. At 12 weeks, the conjunctival epithelium on the amniotic membrane was well formed, and the connective tissue under the epithelium was loose at the fornix. No fibrosis was identified. In contrast, conjunctival epithelium necrosis was observed in the control group at 2weeks after alkali burns. Re-epithelization did not occur through the 12-week observation. Severe fibrosis with inflammatory cells infiltration was observed between 4 to 8weeks. At 12 weeks, fibrosis of the connective tissue at the fornix developed and there were no conjunctival epithelium covering the burned area. 2) In the transplant group, the conjunctiva in transplanted area had no scarring and appeared smooth at 12 weeks. Upper fornix was reconstructed. The depth of fornix was 7.9±0.3mm (7.6-8.2mm), which was approximate to the normal depth 8.2±0.2mm (8.0-8.4 mm,P＞.05). While in the control group, the burned area appeared rough with granuloma formation and severe scarring. Upper fornix became shallow. The depth of fornix was 3.1±1.7mm(1.0 to 4.5mm.), and significant difference was found between control and transplant group (P＜0.01).CONCLUSION: Human amniotic membrane preserved in glycerin can promote cell adhering, migrating and differentiating of normal conjunctival epithelium.Reconstruction of conjunctival surface in early stage of alkali burn can be achieved by AMT. AMT can effectively prevent symblepharon formation.