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AIM: To analyze the correlation between ocular surface status and serum lipids in patients with meibomian gland dysfunction(MGD)during pregnancy, and to provide new ideas for the management and treatment of MGD during pregnancy.METHODS: Totally 120 pregnant women(240 eyes)treated in our hospital from May 2021 to May 2022 were selected and they were divided into MGD group(60 cases, 120 eyes)and control group(60 cases, 120 eyes)according to the presence or absence of MGD. All subjects received the ocular surface disease index scores(OSDI)and underwent examinations of meibomian gland morphology and function, tear film and blood lipid.RESULTS: The scores of OSDI, the related indexes of meibomian gland, corneal fluorescein staining(FL)scores, total cholesterol(TC), triglyceride(TG)and low density lipoprotein-cholesterol(LDL-C)in the MGD group were significantly higher than those in the control group(P<0.05). The scores of fluorescein breakup time(FBUT), Schirmer Ⅰ test(SIt)and high-density lipoprotein cholesterol(HDL-C)in the MGD group were significantly lower than those in the control group(P<0.05). Correlation analysis showed that the scores of TG, TC, LDL-C were negatively correlated with the values of FBUT(rs =-0.702, -0.647, -0.710, all P<0.001).CONCLUSION: The level of blood lipids in pregnant patients with MGD is significantly increased, and the levels of TC, TG and LDL-C may be related to the stability of tear film.
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Objective Corneal alkali burn is a major cause of corneal neovascularization ( CNV) .Confocal microscopy was used to observe the therapeutic effects of KH902 eye drops for the treatment of corneal alkali burns. Methods 24 adult rabbits were randomly divided into two groups( n=12) , alkali burn model being established:experimental group by KH902 eye drops and control group by saline solution 3 times a day.Confocal microscopy was given at 3, 7, 14, 28 d post-operatively (po). Results Corneal epithelium deletion or vacuolar necrosis was found at 3 d po, along with stromal edema.There was no obvious inflammatory cell or no immunocyte infiltration.No difference was found in the corneal structures between two groups.CNV appeared in the peripheral stroma in both groups at 7d po.Inflammatory cell infiltration was more severe in the limbus and peripheral sections in control group than in control group.At 14 d po, inflammatory cells declined gradually and CNV took shape.At 28 d po, scarring and decreased inflammatory cells were found in both groups, while the experimental group had fe-wer and smaller blood vessels than the control group.As to the area of CNV, it was respectively (35.42 ±6.40) mm2, (60.23 ±5.35) mm2, (60.23 ±5.35)mm2 at 7, 14, 28d po in control group, statis-tical difference being found among different time points(P0.05).The CNV area in experiment group is significantly less than that in the control group at 14 d and 30 d po(P<0.05).The inflammatory cell density in control group was respectively (74.21 ±9.33)mm2, (1883.39 ±43.11)mm2, (2532.10 ±98.00)mm2, (723.05 ± 23.34)mm2at 3,7, 14, 28 d po, and (58.0 ±10.22)mm2, (656.90 ±33.01)mm2, (432.32 ±60.11)mm2, (122.11 ±30.37) mm2respectively at 3,7, 14, 28d po in experiment group, significant difference was found at different time points in both groups(P<0.05), among which significant decreased inflammatory cells was found in experiment group compared with control group (P<0.05). Conclusion KH902 eye drops can be used for the inhibition of CNV and inflammatory cell infiltration after alkali burn.
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Background Fungal keratitis is one of primary infectious ocular diseases in China.Conventional diagnostic method is fungal cultivation.In vivo laser confocal microscope is a noninvasive examination of ocular surface.However,the study on features of in vivo laser confocal microscope images of frequent fungal keratitis is still not thorough.Objective This study was to analyze laser confocal microscope imaging features of four typical fungal keratitis.Methods The clinical data of 65 eyes from 65 patients with fungal keratitis were retrospectively analyzed.The patients were initially diagnosed in Nanjing General Hospital of Nanjing Military Command PLA from January 2007 to November 2011, and laser confocal microscope examination of ocular surface and fungal cultivation were performed.The characteristics of laser confocal microscope images were investigated,including shape and type of hypha,distribution of spores and the relationship of hypha with lesion.The differentiation between fungal hypha and other corneal tissues was summarized.Results Fungal cultivation showed that among the 65 patients,Fusarium,Aspergillus,Candida and Alternaria were common pathogenic fungus with the infected proportion 63.0％ , 16.9％,3.0％ and 4.6％ ,respectively, and 12.5％ patients were infected by other fungus.In the images of laser confocal microscope,hyphae of Fusarium presented the branch-like high reflective structure in the corneal superficial stromal layer and thinning line shape in the deep stromal layer.Few inflammatory cells were found.The peudohyphae and spores from Candida were seen in corneal superficial and mid stroma layers, with few inflammatory cells and many proliferating stromal fibers in the lesions.The hyphae of Aspergillus presented worm-like, showing the thinner and shorter shapes in comparison with those of Candida.The hyphae of Alternaria were long,straight and thick in shape,and spherical chlamydospores were found on the hyphal tip.The hyphae, subepithelial plexus, dendritic cells, fibrosis of the cornea all showed high reflection under the laser confocal microscope, but evidently differences appeared in shape,distribution and course in corneas.Conclusions Hyphae are the main basis to diagnose fungal keratitis and differentiate fungi.As a non-invasive examination method,laser confocal microscope can provide useful information for the early diagnosis and treatment of fungal keratitis in vivo.
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Background Full femtosecond laser refractive surgery has been generally applied,but the improvement of visual quality after surgery is a vital problem.It is well-known that modulation transfer function (MTF) is a major evaluation indicator.Objective To investigate the change of the MTF of operated eyes after the full femtosecond laser refractive surgery.Methods A retrospective series of cases study was adopted.Forty eyes of 23 patients with the spherical equivalent of-2.25 to-5.75 D who received full femtosecond laser refractive surgery were enrolled in Nanjing General Hospital of Nanjing Military Command from July to October,2012.The change of visual acuities was analyzed and compared among before operation and 1 day,1 week and 1 month after operation.MTF value in total aberration,low and high order aberrations under the 3.0 mm and 6.0 mm pupil size conditions were detected with i-Trace Visual Function Analyzer at above time points.The MTF values among various time points,between different pupil diameters and different spatial frequencies (5,10,15,20,25 c/d) were compared respectively.Results Compared with the preoperation,the visual acuity improved in postoperative 1 day,1 week and 1 month,showing a significant improvement among various time points (F =10.341,P =0.000).Corrected diopter was 3.795 D at average.MTF values under the 3 mm pupil diameter gradually elevated with the lapse of time after operation,without significant differences among different time points whatever total aberration,low and high order aberrations(all at P＞0.05).The MTF values under 6 mm pupil diameter of total aberration and low order aberration were significantly higher in postoperation than those in preoperation(all at P＜0.05),but no significant difference was seen in MTF of high order aberration among various time points (F =0.260,P =0.854).Compared with the MTF under the 3 mm pupil diameter,those of low and high order aberrations under the 6 mm pupil diameter considerably declined in preoperation and postoperative 1 month (preoperation:P =0.050,0.001 ; postoperation:P =0.012,0.001).MTF values under the 3 mm pupil diameter were not different at various spatial frequencies (all at P＞ 0.05).However,MTF values under the 6 mm pupil diameter were gradually increased from preoperation through postoperative 1 month at 10,15,20 and 25 c/d (P =0.044,0.043,0.024,0.014).Conclusions Full femtosecond laser refractive surgery can eliminate low aberration,increase the MTF and acuity,and therefore improve the visual quality.MTF is one of the key indicators assessing visual quality after full femtosecond laser refractive surgery.
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Background The potential protective effect of ischemia postconditiomng for hypoxia has been determined in many tissues and organs.But its mechanism in retina is still lack.Objective The aim of this study was to investigate the protective effect of ischemia postconditioning on retinal ischemia reperfusion injury.Methods Thirty-six health male Wistar rats were randomized into the normal control group,sham group,ischemia reperfusion group and ischemic postconditioning group.Retinal ischemia reperfusion models were induced by elevating the intraocular pressure to 110 mmHg for 60 minutes,and then the ischemic postconditioning was performed right away,1 minute and 10 minutes after ischemia in the rats of the ischemic postconditioning Ⅰ,Ⅱ,Ⅲ group,respectively.Electroretinogram (ERG) was recorded in the rats 7 days after operation,and the rats were sacrificed by excessive anesthesia.Retinal specimens were prepared for the histopathological examination.The retinal thickness and the recovery rates of ERG a,b waves and oscillation potentials (OPs) were compared among the groups using ANOVA of SPSS software.Results One day after experiment,the structure of rat retinas was nearly normal.However,retinal edema and vacuolar degeneration were seen in the rats of the ischemia reperfusion group and ischemic postconditioning Ⅰ,Ⅱ,Ⅲ groups primarily in the inner plexiform layer (IPL),inner nuclear layer (INL).The retinal thickness values of the entire layer,IPL and INL were significantly higher in the ischemia reperfusion group and ischemic postconditioning Ⅰ,Ⅱ,Ⅲ groups compared with the normal control group (all at P＜0.05).Seven days after experiment,the retinas were thinner in the rats of the ischemia reperfusion group than those of the rats in the sham group,but the retinal thickness values in the ischemic postconditioning Ⅰ,Ⅱ,Ⅲ groups were significantly increased in comparison with the ischemia reperfusion group (all at P＜0.05).In addition,the recovery rates of ERG a,b,OPs amplitudes were significantly lower in the ischemia reperfusion group and ischemic postconditioning Ⅰ,Ⅱ,Ⅲ groups compared with the normal control group (all at P＜0.05).However,the recovery rates of ERG a,b,OPs amplitudes evidently elevated in the ischemic postconditioning Ⅰ,Ⅱ,Ⅲ groups in comparison with the ischemia reperfusion group (all at P＜0.05).Conclusions Ischemia postconditioning can protect the structure and function of retina from ischemia reperfusion injury.Ischemia postconditioning plays the maximal effect immediately to 1 minute after ischemia reperfusion injury in Wistar rat.
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Refractive surgery for myopia is a common operation and has been performed on millions of patients .Improved technology has increased the satisfaction of patients and physicians .Surgery must follow the basic requirements of medical ethics , to ensure the safety and best interests of the patients .The choice of procedure depends on individual patient indications and ocular exami -nations .Before the surgery , the opthalmologists must ensure that the patient understands the potential risk of the operation and has re -alistic expectations for the visual acuity postoperatively .
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Objective Acrysof IQ Restor multifocal toric intraocular lens ( IOL) is a new product , which allows a single sur-gical procedure for presbyopia correction and corneal astigmatism management .This study was to evaluate the early clinical effects of phacoemulsification cataract surgery with implantation of a diffractive multifocal toric IOL . Methods We retrospectively analyzed 7 cases (9 eyes) of corneal astigmatism ≥1.0 diopter (D) treated by phacoemulsification with implantation of an Acrysof IQ Restor toric IOL.The patients were followed up for 3 months for observation of uncorrected distance visual acuity ( UDVA) , best corrected distance visual acuity ( CDVA) , uncorrected near visual acuity ( UNVA ) , best corrected near visual acuity ( CNVA ) , spherical equivalent (SE) refraction, focal depth, residual astigmatism, rotational stability of the IOL, contrast sensitivity (CS), and spectacle independ-ence preoperatively and at 1 week, 1 month, and 3 months after operation . Results At 3 months after surgery , the UDVA ( log-MAR), CDVA, UNVA, and CNVA were 0.07 ±0.10, 0.02 ±0.11, 0.12 ±0.06, and 0.08 ±0.07, respectively, with an SE re-fraction within ±0.50 D of the attempted spherical correction in 8 eyes (88.9%) and a focal depth of (5.32 ±1.78) D.The residual astigmatism at 3 months was significantly reduced as compared with the baseline ([0.25 ±0.28] vs [1.55 ±0.39] D, P0.05).At 3 months, the mean IOL axis rotation was (3.11 ±1.61)°and CS was remarkably im-proved ( P0.05) except at 18.0 cpd (P<0.05). Conclusion Implantation of the Acrysof IQ Restor multifocal toric IOL provides excellent overall quality of vision, spectacle independence, visual quality, and rotational stability for patients with cataract and corneal astigmatism.
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Objective Xerophthalmia is a common disease of the ocular surface .Lupus nephritis ( LN) may induce changes in the ocular surface , which has aroused increasing attention in ophthalmology .This study was to observe the morphological changes of the tear meniscus in LN patients with xerophthalmia after treated with artificial tears . Methods This clinical trial included 60 LN patients with xerophthalmia (120 eyes) and another 60 without.The xerophthalmia group received artificial tear eye-drops for 1 month. The tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were measured by anterior segment optical coherence tomography ( AS-OCT) before and after intervention . Results There were significant differences between the xe-rophthalmia and control groups in the baseline TMH ([0.159 ±0.051] vs [0.269 ±0.053] mm, P<0.01), TMD ([0.154 ± 0.012] vs [0.198 ±0.007] mm, P<0.01), and TMA ([0.021 ±0.069] vs [0.052 ±0.021] mm2, P<0.01).After 1 month of intervention with artificial tears, the xerophthalmia patients showed dramatically increased TMH ([0.179 ±0.014] vs [0.159 ± 0.051] mm, P<0.01), TMD ([0.163 ±0.015] vs [0.154 ±0.012] mm, P<0.01), and TMA ([0.040 ±0.017] vs [0.021 ± 0.069] mm2, P<0.01). Conclusion AS-OCT, with its advantages of clearly and objectively imaging and measuring the cross section of the tear meniscus , can be applied to the diagnosis and assessment of xerophthalmia in LN patients , and artificial tear eye-drops can effectively relieve their xerophthalmia symptoms .
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Objective Many researches have demonstrated the lowing-intraocular pressure(IOP) effects of bimatoprost and timolol.However,no powerful evidence showed which drug has the better efficacy.This study was to perform a meta-analysis to evaluate the efficacy and tolerability of bimatoprost compared with latanoprost in lowing IOP.MethodsThis was a evidence-based medicine science study.Pertinent studies were identified through searches of PubMed,EMBASE,the Cochrane Liberary Controlled Trials Register and Chinese Biomedicine Database using the terms of timolol,blocardren,temserin,timoptic,bimatoprost,lumigan.The intensive searching by hand and up to October 1,2008 was also designed.ResultsSix randomized and controlled studies enrolling a total of 2 094 patients were included in the meta-analysis and three clinical indexes were analyzed.Bimatoprost was associated with greater decline value from baseline IOP in comparison with timolol(P＜0.01) with a weight mean difference -2.04 at final point(95% CI:-2.44 to -1.64).Numerically greater proportions of bimatoprost patients than timolol patients achieved the target IOP at 3 months(from 3 literature) and ＞6 months(from 2 literature) with a pooled RR of 1.87(95% CI:1.45 to 2.41),1.60(95% CI:1.36 to 1.90) (P＜0.01),respectively.Bimatoprost showed a more frequencies in the adverse effects such as conjunctival hyperemia and eyelash growth than timolol with an RR of 4.18 (95% CI:2.89 to 6.05),9.40 (95% CI:5.62 to 15.71).No obvious drug-related side effect was found from literature analysis included both drugs.Conclusion Searched literature offers grade A of evidences for the comparison clinical evaluation of therapy efficacy between bimatoprost and timolol in lowing IOP.Bimatoprost has a better efficacy in lowering IOP and reaching comparable proportions of patients with target IOP than timolol.Both agents are well tolerated.
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Retinal neovascularization is a phenomenon observed in various kinds of eye diseases and it can threaten the visual function of patients. Medical treatment to inhibit retinal neovascularization will give them effective help. This article reviewed animal models of retinal neovascularization and researching development of medicine in this field.
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Objective:To observe the changes in the anterior chamber before and after cataract surgery by ultrasound biomicroscopy (UBM) in eyes with primary angle closure glaucoma. Methods: Ultrasound biomicroscopy was used for anterior chamber imaging in 78 eyes of 50 patients with primary angle closure glaucoma before and 1 month after cataract phacoemulsification and intraocular lens implantation. And the intraocular pressures were recorded at the same time. Results: UBM allowed the imaging of the entire anterior eye segment. In the images, the differences between iris thickness (IT), iris zonule distance (IZD) and iris lens angle (?2) before and after the operation were statistically insignificant. After the operation, marked increases were observed in the anterior chamber depth (ACD), angle opening distance at 500 ?m from the scleral spur (AOD500), trabecular iris angle (?1) and trabecular ciliary process distance (TCPD), with statistically very significant differences from preoperation (P
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Objective: To study the effect of ?-cyanoacrylate on corneal perforation in rabbits. Methods:Eighteen adult rabbits were divided into a left eye group and a right eye group.Bilateral corneas of the rabbits were perforated and subsequently occluded with ?-alkyl cyanoacrylate synthetic adhesive in the former group and by separated single points using the 10-0 polyglactin thread in the latter.The time for the obliteration of the corneal perforations and intraocular pressure(IOP) were recorded preoperatively and 3 days after the operation in both the two groups.The ocular contents of the two groups were observed by slit-lamp biomicroscopy after the operation.Results: The mean time of the corneal perforation obliteration was shorter in the left than in the right eyes.IOP was recovered to normal within 3 days postoperatively and the ocular contents were stabilized,with no significant difference in IOP between the two groups 3 days after the operation.Conclusion: ?-Cyanoacrylate is an effective adhesive agent for corneal perforation.
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Objective:To evaluate the therapeutic effects and value of preserved amniotic membrane combined with conjunctival autograft transplantation for recurrent symblepharon. Methods:A group of 38 eyes in 38 patients with recurrent symblepharon due to recurrent pterygium,chemical burn and other causes were undertaken preserved amniotic membrane combined with conjunctival autograft transplantation.The patients were followed for 6 to 36 monthes.Results:No infections occurred.The amniotic membrane changed into transparent 10 days postoperatively.The conjunctival epithelium emigrated to the surface of amniotic membrane.Impression cytology showed a stable conjunctival epithelium on the surface of amniotic membrane.Efficient movement ability was recovered in 34 eyes(89.5%).Four eyes(10.5%) were still restricted in movement due to partly recurrent symblepharon.Conclusion:The preserved amniotic membrane combined with conjunctival autograft transplantation for is effective recurrent symblepharon
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Objective: To observe the clinical results of eyeball double perforation caused by metal foreign body treated by virectomy. Methods: By clinical examination combined with orbital CT, 12 eyes in 12 cases were diagnosed as eyeball double perforation caused by metal foreign body, all these eyes underwent vitrectomy, endocoagulation, and C_3F_8 vitreous cavity tamponade. Postoperative follow-up ranged from 6 months to 5 years. Results: Nine eyes’ retina remained attached. 3 eyes with retina detachment and PVR were reoperated with vitrectomy and silicon oil tamponade, and the retina reattached. Conclusion: Orbital CT is an accurate and sensitive method in diagnosing eyeball double perforation caused by metal foreign body, vitrectomy is an efficacious surgical method in the treatment of eyeball double perforation.
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Objective:To observe the flap complications after LASIK and analyze their clinical characters and treatment. Methods:The flap complications after LASIK in 35 eyes of 27 patients was reviewed.Visual acuity were measured at 3,7,15,30,60 days after the operation,at the same time, the eyes were examined with slit lamp. Results:After the therapy,diffuse lamellar keratitis of 10 eyes were recovered in 1 to 2 months,the visual acuity were 0.8 to 1.5.Flap slippage of 9 eyes were treated with replacement and the visual acuity were 1.0 to 1.2.One eye with trauma induced flap lose underwent allogeneic keratomileusis and the visual actity was 0.5 to 0.6.One eye with interface infection was treated by removing the infected flap and PTK.The corneal surface was healed but remained with little haze.The visual acuity were 0.8 to 1.0 after the therapy in three eyes with epithelial ingrowth.Three eyes with fiap breaking in the procedure were reoperated half a year later,and the visual acuity were 1.0 to 1.2. Conclusion:Flap complications after LASIK occurred at various period and are related with surgical technic,patient~(,)s eyes conditions and the treatment after the surgery.Early detection and therapy can obtain an comparatively excellent recovery.
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Objective:To investigate the efficacy of Vitreoretinal surgery for retinal detachment due to macular hole in high myopia. Methods:20 cases( 20 eyes) of retinal detachment due to macular hole in high myopia from Dec. 2000 to Apr. 2004 were analysed retrospectively. 3 cases were male and 17 were female, with a following up of 2 to 30 months (15 months in average). The Pars Plana Vitrectomy with long acting gas or silicon oil tamponade were used. The patients were kept face down at least 7 days after the surgery. Results:5 eyes used silicon oil and the others used gas tamponade. The successful rate of retinal reattachment was 80% ( 16/20) with one procedure in a month after the surgery . There were 4 cases of retinal redetachment in the follow-up duration, among them 3 cases used gas and one used silicon oil tamponade. All of them refused to accept another surgery. There were 3 eyes ( 15%) of the best corrected visual acuity greater than or equal to 0.05 before surgery and 11 eyes ( 55%) equal to or greater than 0.05 after the surgery. There was a significant difference between them(P= 0.0386 ). The main complications were slight retinal bleeding in 3 eyes ( 15%); second glaucoma in 2 eyes (10 %); nuclear cataract in 4 eyes ( 20%). Conclusion:Vitreoretinal surgery for retinal detachment with macular hole is available to improve visual acuity in high myopia.
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0.05).The iris diaphragm was flat to mild concave which lead the width of anterior chamber angle increased postoperation, no peripheral synechia was found. Conclusion: Phacoemulsification and foldable posterior chamber intraocular lens implantation through clear corneal incision had no significant influence on the long term intraocular pressure in simple senile cataract patients, the width of anterior chamber angle increased postoperation.
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The technique of amniotic membrane transplantation is developping rapidly in treating ocular surface disease recently. Amniotic membrane is widely used in this area due to its unique structure, procurment and graft puparation. The authors describe the methods of processing and preservation of human amniotic membrane, and the histological study and clinical application experiences as well.
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Obiective: To observe the changes in corneal tissue after seawater soaking following explosive injury in rabbits and the effects of seawater soaking on the healing of cornea after explosive injury. Methods:Make 20 similar explosive injury models of rabbit's eyeball using 10 adult grey rabbits. For each rabbit, the right eye was in experiment and the left one was for comparison. After the injury, the experimental eyes were soaked in seawater for 30 minutes and the comparable eyes were soaked in 0.9% sodium chloride injection for the same time. All eyes were underwent slit lamp examinations, fluorescein dyeing, and ultrasonic cornea thickness metering on the corneas before the injury and 1,2,3,4,5,7,9,10,15 and 20 days after the injury respectively. At the same time, 2 rabbits were killed and the eyes were examined pathologically. The cornea thickness numbers were compared using self- comparison t test and grouping t test. Results: After seawater soaking following explosive injury, slit lamp microscope examination found that the corneas were edema and turbidity, the experimental eyes were stricter than the control eyes. The corneas of the experimental eye were vascularized 10 days after the injury. Fluorescein dyeing showed that more apparent pigmentations were found on the experimental eyes than that on the control ones.Comparative examination under the optical microscope showed that the corneal tissues of the experiment eyes changed distinctly, their inflammations were patency and healing was delayed and the vascularization degree became high after the injury. Cornea thickness of the experimental eyes became apparently thicker than that of the control eyes. The difference was statistically significant. Conclusion:Scars and vascularization of various degrees will appear in corneal stroma after the explosive injuries. Seawater soaking will have bad effects on the healing of the cornea injured in explosions.
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Keratoconus is a relatively common, bilateral, non-inflammatory corneal ectasia characterized by thinning and scarring of the central portion of the cornea,seriously destroyed the vision. The aetiology of this condition is probably multiple factors,such as collagen themry,genetic themry,epithelia themry,etc.Now,recent investigations devote to gene,and think it one of the major aetiological factors. Laboratory studies suggest a role for degradative enzymes and proteinase inhibitors and a possible role for the interleukin-1 system in its pathogenesis, but these roles need to be more clearly defined. It has well-described clinical signs, but early forms of the disease may go undetected unless the anterior corneal topography is studied. Contact lenses are the most common treatment modality. When contact lenses fail, corneal transplant is the best and most successful surgical option.