ABSTRACT
Background Radiofrequency thermocoagulation is one of the effective therapies for trigeminal neuralgia.Corneal nerve is important substance of radiofrequency thermocoagulation ocular surface,which support the normal structure and function of cornea.Most of corneal nerves come from ophthalmic branch of trigeminal nerve.However,the change of ocular surface microenvironment following radiofrequency thermocoagulation treatment in the patient with trigeminal neuralgiais unclear.Objective This study was to analyze ocular surface change after radiofrequency thermocoagulation therapy in patients with trigeminal neuralgia.Methods Twenty-eight eyes of 28patients with trigeminal neuralgia underwent radiofrequency thermocoagulation therapy were enrolled in this study.The contralateral eyes were regarded as the control group.The central corneal sensitivity,function of lacrimal secretion (Schiemer 1 test),tear break-up time(BUT),corneal fluorescence staining and laser scanning confocal microscopic examination were performed before and after surgery in operative eyes and compared with the fellow eye.Informed consent was obtained before any relevant medical procedure from each patient.Results No significant differences was found before surgery in the central corneal sensitivity,the Schiemer Ⅰ test,BUT,corneal fluorescence staining and densities value of corneal subepithelial nerve plexus between the treating eyes and fellow eyes(Z =-1.511,-1.119,-0.428,-0.378,-0.854; P =0.131,0.263,0.669,0.705,0.393).1n the third day after radiofrequencythermocoagulation therapy,compared with pre-treatment,no significant differences were seen in BUT result,Schirmer Ⅰ test and the score of ocular surface fluorescence staining (Z =-0.620,-0.315,-1.732;P =0.535,0.753,0.083).Corneal sensitivity and subbasal nerve density were lowed 3 days after surgery (Z =-2.708,-2.813 ; P =0.007,0.005).One month after treatment,differences of all indexes mentioned above showed statistical significance between treating eyes and fellow eyes(Z=-3.888,-2.373,-3.311,-2.535 ; P =0.000,0.018,0.001,0.011).The corneal subepithelial nerve was thinner and sparse and dendritic cells on the cornea were found in the eyes received radiofrequency thermocoagulation therapy.Conclusions The secretion of tears and the stability of tear film are poorer and the corneal sensitivity and subbasal nerve density are affected in a certain extent in the eye received radiofrequency thermocoagulation therapy.
ABSTRACT
Background Blepharitis is a common ocular surface disease.It is associated with the disorder of lipid secretion of meibomian gland.The change of tear film stability can cause dry eye symptoms,so blepharitis is thought to be one of the factors causing dry eye,but the relation between them is in study. Objective This study was to observe the morphology of meibomian gland in blepharitis patients and to investigate the correlation of morphology of meibomian gland with dry eye. Methods A series of case-observational study was designed in this study.A total of 83 eyes of consecutive 83 blepharitis patients were enrolled in Henan Eye Institute from October 2010 to April 2011.Blepharitis was diagnosed based on American Preferred Practice Pattern Guidelines.Some relevant ocular examinations were performed under the informed consent of the subjects,including the anterior segment manifestation by the slit lamp,such as meibography,lid margin abnormality,and the dry eye-relevant examinations,such as tear film break-up time (BUT),Schirmer test Ⅰ and corneal fluorescein staining also been carried out.Tear film shape was examined by film interference images and scored.Absent degree of meibomian gland was graded under a Noncontact Infrared Meibography.The correlations of absent degree of meibomian gland with ocular syndrome score,dry eye examination results were evaluated using Spearman rank correlation coefficients.Informed consent was obtained prior to this trail. Results No significant difference in the frequencies of blepharitis was found between male and female among different ages (x2 =2.69,P =0.75 ).Absent grading of the meibomian glands was positively correlated with age of blepharitis patients ( r =0.58,P =0.00 ),lid margin abnormality scores ( r =0.64,P =0.00 ),conjuntival hyperemia score ( r=0.50,P =0.00),tear film interference imaging grade ( r =0.23,P =0.04 ),corneal fluorescein staining score( r =0.50,P =0.00 ) but was negatively correlated with BUT ( r =-0.32,P =0.00 ).No significant correlation was found between meibography grading and gender( r =-0.09 ; P =0.99 ) or Schirmer test Ⅰ ( r =-0.05;P =0.69 ).No significant difference was found in meibography grading between male and female in different age groups(Z=-0.09,P=0.93). Conclusions Blepharitis can irriter dry eye symptom because of overevaporation of tear fluid and abnormality of secreting function of meibomian glands.The missing of the meibomain glands increases with age in the patients with blepharitis.Noncontact Meibography System is an assistant tool to the diagnosis of blepharitis.
ABSTRACT
Background Human limbal allograft transplantation or limbal autograft transplantation are the primary approaches to the severe corneal-blindness,but their application in clinic were limited because of the defects of donor material.With the development of tissue engineering technology,transplantation of in vitro cultured limbal epithelial stem cells is being an advanced management.Objective The aim of this work was to expand human limbal epithelial stem cells ex vivo under the guidance of confocal microscope and to lay the foundation for fabricating ex vivo cultured cell sheets.Methods Ten eyes of ten patients were examined with the Heidelberg Retina Tomography Ⅲ Rostock Cornea Module(HRT3-RCM)to elucidate the structure of the human corneoscleral limbus and to correlate limbal epithelial dimensions.According to the analysis of the images of limbal epithelia,the limbal tissues provided by Eye Bank of Henan Eye Institute were cut into suitable explants.Then,this study was conducted to expand limbal epithelial stem cells ex vivo on denuded amniotic membrane.The phenotypes of primary cultured cells were evaluated by morphology and immunofluorescent staining with antibodies for limbal epithelial stem cell markers (p63,cytokeratinl9)and differentiation markers(keratin 3,involucrin).This experimental procedure was approved by the Ethic Committee of Henan Provincial People's Hospital.The written informed consent was obtained from subjects before initiation of any examination.Results The palisade morphology of human limbus was imaged clearly on the laser scanning in vivo confocal microscopy and many hyperreflective cells were observed in palisade basal cells.The cell-island phenomenon was seen in the basement membrane under the laser scanning in vivo confocal microscopy.The oblique sections of limbus showed many papilla-like epithelial columns below the superficial limbal epithelia.Throughout the experiment duration,the epithelial cells grew well with the migration rates from limbal tissue (68.62± 16.94)％ and the migration time(5.83 ±2.04)days,which depended on the tissue freshness.Compared with the second and forth batch of tissue,the migration rates of the third and sixth batch of tissues were significantly higher(P＜0.05),and the migration time was evidently longer in the forth and sixth batch of tissue compared with the first,second,third and fifth batch(P＜0.05).The positively expressing rates in the cultured corneal stem cells were 4.05％ and 36.52％ for p63,26.07％ and 40.55％ for CK19,57.88％ and 40.81％ for K3,64.66％ and 59.19％ for involucrin.Conclusion Human limbal epithelial stem cells can be successfully and purposefully obtained from the limbal tissue based on the guidance confocal miscroscope.The cultured corneal stem cells can grow well on the denuded amniotic membrane