ABSTRACT
@#AIM: To Study the anti-fungal effect of corneal collagen cross-linking combined with natamycin <i>in vivo</i> and <i>in vitro</i>, so as to provide the treatment and experimental basis for the treatment of clinical fungal keratitis. <p>METHODS: Three common pathogenic fungi(<i>Aspergillus flavus</i>, <i>Fusarium Solani</i> and <i>Candida albicans</i>)were used. The experimental group was divided into cross-linking combined natamycin group, natamycin combined riboflavin group, natamycin combined UVA irradiation group, cross-linking group and natamycin group as the control group. The drug was added to the center of the Sabouraud dextrose agar(SDA)plate coated with liquid with each fungal spores with the same maid turbidity of 1.5. Ten minutes later, it was irradiated with collagen cross-linking instrument for 10min and cultured at 28℃ for 36h, and then the inhibition zone size was measured and analyzed statistically. The rabbit model of <i>Fusarium Solani</i> corneal infection was prepared. The model rabbits were randomly divided into model control group, cross-linking treatment group, natamycin treatment group, cross-linking combined natamycin group, 5 rabbits in each group. And another 5 normal rabbits were taken as control, and five rabbits were irradiated in accordance with corneal collagen cross-linking therapy. The results were observed by anterior segment photography, corneal scraping and confocal microscopy, and the ultra micro structural changes of the corneas were observed by electron microscope after the treatment.<p>RESULTS: Corneal collagen cross-linking alone had shown no effect on each fungus <i>in vitro</i>. Corneal collagen cross-linking combined with natamycin produced significant anti-fungal effect(<i>P</i><0.05). However, the anti-fungal effect of natamycin combined riboflavin group and natamycin combined ultraviolet light group showed no statistical difference(<i>P</i>>0.05)comparing with the control group. For the model of rabbit fungal infection, the course of disease was about 14d in the natamycin group and CXL combined with natamycin group, and it was about 21d in CXL group. After the treatment, all the groups healed. There were no defects in the corneal epithelium, no mycelium in the corneas, except for more corneal neovascularization. The results of the anterior segment photography showed that the treatment effect of the cross-linking combined natamycin group was better than other groups, with fewer scar tissue, better corneal healing and relatively short course of disease.<p>CONCLUSION: Corneal collagen cross-linking combined with natamycin treatment is able to enhance anti-fungal effect, promote corneal healing, and shorten the course of disease. So it is a promising therapeutic technique for the clinical treatment of fungal keratitis.
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AIM: To study the roles of tumor necrosis factor alpha ( TNF-α) , interferon gamma ( IFN-γ) in pathogenesis of primary pterygium and to explore the mechanism of tears in pterygium.?METHODS: Concentrations of TNF-α and interferon gamma IFN - γ were quantified by enzyme - linked immunosorbent assay ( ELISA ) in asymptomatic control group (30 eyes of 30 healthy volunteers) and 60 primary pterygium patients ( 30 eyes of the 30 progressive cases, 30 eyes of the 30 quiescent cases) . The data was analyzed by analysis of variance.?RESULTS:The concentration of TNF-αand IFN-γin the patients with primary pterygium were statistically significant (P<0. 05), compared with the normal control group. Tear concentration of TNF-α was significantly higher in primary pterygium compared with the control group. Tear concentration of IFN - γ was significantly reduced in primary pterygium compared with the control group (P<0. 05).?CONCLUSION:TNF-α and IFN-γmay be important in the pathogenesis and development of pterygium tissues.It can provide some new directions and ideas for the treatment of primary pterygium.
ABSTRACT
AIM:To observe the sustained-release effect of compound betamethasone by subconjunctival injection on immunological rejection after ostrich-rabbit lamellar keratoplasty.METHODS:Sixteen healthy New Zealand white rabbits with 6wk old received corneal lamellar keratoplasty,and the corneal graft was ostrich acellular corneal stroma.After surgery all subjects were divided into two groups,Group A (experimental group) were administrated with subconjunctival injection of compound betamethasone injection (once every 7d),and Group B (control group) were administrated with subconjunctival injection of dexamethasone sodium phosphate (once every 7d).At 1,2wk,1,2mo after the surgery,rabbit corneas were taken for paraffin sections,and were observed with H-E staining,in the meantime changes of CD4+ and CD8+ T lymphocytes were observed by immunofluorescence.RESULTS:Two months after surgery,in Group A corneal grafts remained transparenct,and showed little neovascularization;HE staining and indirect immunofluorescence showed that only a few neutrophil infiltration,no CD4+ and CD8+T lymphocytes.In Group B,the inflammatory reaction was observable at different time points,the corneal graft was turbid;and the tissue sections and indirect immunofluorescence staining showed that neutrophil infiltration was predominant,and CD4+,CD8+T lymphocytes were also seen.CONCLUSION:Compound betamethasone is able to inhibit the ostrich-rabbit corneal transplantation immune rejection,prolong the survival time of the grafts.The present study lay the foundation for further research and clinical application.