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Purpose : To report a case of late opacification of the hydrophilic acrylic Intraocular Lens (IOL) after uneventful Cataract Surgery. Methods : A 60-year-old male presented with chief complaint of gradual diminution of vision in right eye over the past one year. He was Normotensive, Non-diabetic and had a normal Lipid Profile. History revealed that he underwent uneventful phacoemulsification with posterior chamber hydrophilic intraocular in the bag implantation for pre-senile cataract in his Right Eye ten years ago. He had the best corrected visual acuity of 6/6 in his Right Eye for nine years Post Cataract Surgery. Slit-lamp examination confirmed Intraocular Lens Opacification. Results : Intraocular Lens exchange was performed in his Right Eye. The hydrophilic IOL was replaced with poly methyl methacrylate intraocular lens. The explanted IOL showed uniform grayish-white opacification. Post operative period was uneventful. Intraocular pressure by applanation tonometry was 16.4 mm Hg in both the eyes. Patient抯 best corrected visual acuity was 6/6 with -1 D Cyl. at 90 degree, Postoperatively. Over a follow up period of one year, the patient did not develop complications like posterior capsular IOL opacification. Conclusion: Intraocular Lens opacification is an extremely rare late postoperative complication of Phacoemulsification which can be managed effectively by IOL exchange procedure in cases of opacified IOL optics causing visual morbidity
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AIM: To evaluate the effect of anterior capsule polishing on visual quality after phacoemulsification.METHODS: Prospective randomized control study. A total of 65 patients(73 eyes)with age-related cataract who underwent phacoemulsification combined with intraocular lens(IOL)implantation in the Emergency General Hospital between November 2021 and June 2022 were included. These patients were randomly assigned to two groups, with one group(anterior polishing group)underwent anterior and posterior capsule polishing(30 cases, 35 eyes), while the other(control group)receive routine posterior capsule polishing(35 cases, 38 eyes). Best corrected visual acuity was observed at 1wk, 1, 3 and 6mo after operation. Area of anterior capsule orifice was measured at 3 and 6mo after operation. Meanwhile, posterior capsular opacification(P score), IOL tilt and decentration were recorded by Pentacam Scheimpflug system. In addition, wavefront aberration, Strehl ratio(SR)of point spread function(PSF)and modulation transfer function(MTF)were evaluated by OPD-Scan Ⅲ.RESULTS: At 1wk, 1, 3 and 6mo after operation, best corrected visual acuity in anterior polishing group is significantly better than that of control group(P<0.05). There were no significant differences in area of anterior capsule opening, P score, IOL decentration, SR of PSF and MTF between two groups at 3 and 6mo after operation(P>0.05). At 3mo follow-up, no significant differences in IOL tilt and wavefront aberration were measured between two groups either(P>0.05). However, IOL tilt [(1.65±0.60)° vs.(2.34±0.43)°, P<0.001] and wavefront aberration(0.03±0.01μm vs. 0.06±0.03μm, P<0.001)in anterior polishing group were significant lower compared to control group at 6mo after operation.CONCLUSION: 360° polishing of anterior and posterior capsule during phacoemulsification can improve best corrected visual quality, with reduced IOL tilt, lower wavefront aberration and better visual quality.
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Posterior capsule opacification (PCO), a common complication after cataract surgery, impacts a patient's long-term visual quality to various degrees. Although a neodymium:yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy is a very effective treatment, it may lead to a serial of complications. Accordingly, the search for simple, safe, and effective methods to prevent PCO has received widespread attention. Various researchers are committed to the interdisciplinary collaboration between medicine and engineering fields, such as functionalizing the surface of the intraocular lens (IOL) via supercritical fluid impregnation, coating the surface of the IOL, high-concentration drug immersion, and application of a drug delivery system, to effectively reduce the incidence and severity of PCO.
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Humans , Capsule Opacification/surgery , Lens Implantation, Intraocular , Cataract/etiology , Lens Capsule, Crystalline/surgery , Lenses, Intraocular/adverse effects , Treatment Outcome , Postoperative Complications , Prosthesis DesignABSTRACT
Objective:To explore the effect of knockdown of the homeobox gene paired-box 6 ( Pax6) on the biological behavior and epithelial-mesenchymal transition (EMT) of human lens epithelial cells (LECs). Methods:The SRA01/04 human LECs were divided into small interfering RNA-Pax6 (siRNA-Pax6) group transfected with siRNA-Pax6 and siRNA negative control (siRNA-NC) group transfected with disordered siRNA.Cell survival rate was detected by cell counting kit-8 method at 24, 48 and 72 hours after transfection.Cell cycle distribution and apoptosis were analyzed by flow cytometry at 48 hours after transfection.Migratory capability of cells was examined by cell scratch test at 24 hours after transfection.The mRNA relative expression levels of Pax6, α-crystallin A (CRYAA), α-crystallin B (CRYAB), Sox2, α-smooth muscle actin (α-SMA) and E-cadherin were detected by quantitative real-time PCR at 48 hours after transfection.The relative expression of Pax6 protein was detected by Western blot at 48 hours after transfection.Results:There was a significant difference in cell survival rates at different time points between the two groups ( Fgroup=4.776, P<0.05; Ftime=13.535, P<0.05). The cell survival rate of siRNA-Pax6 group was obviously lower than that of siRNA-NC group at 48 and 72 hours after transfection, and the differences were statistically significant (both at P<0.05). Compared with siRNA-NC group, the proportion of cells in G 0/G 1 phase was significantly increased and the proportion of cells in S phase was significantly reduced in siRNA-Pax6 group ( t=9.971, -5.063; both at P<0.05). The cell migration rate of siRNA-Pax6 group was (19.73±6.07)%, which was lower than (70.56±2.97)% of siRNA-NC group, showing a statistically significant difference ( t=-7.245, P<0.05). The relative expressions of Sox2 mRNA and α-SMA mRNA were lower, and the relative expression of E-cadherin mRNA was higher in siRNA-Pax6 group than siRNA-NC group, with statistically significant differences between them ( t=-23.254, -5.294, 6.062; all at P<0.01). The relative expression of CRYAA mRNA and CRYAB mRNA was significantly higher in siRNA-Pax6 group than siRNA-NC group, and the differences were statistically significant ( t=5.521, 8.270; both at P<0.01). The relative expressions of Pax6 mRNA and protein in siRNA-Pax6 group were 0.27±0.01 and 0.24±0.05, respectively, which were both lower than 1.00±0.05 and 1.14±0.10 in siRNA-NC group, showing statistically significant differences ( t=-14.456, -4.458; both at P<0.001). Conclusions:Silence of Pax6 can suppress the proliferation and EMT of human LECs and enhance the expression of crystallin.
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BACKGROUND: PCO occurs commonly postoperatively followingcataract extraction in children, obscuring vision as did the initialcataract. It may require a second surgical procedure when it is dense.It is expected that this results in restoration of vision and it is importantto ascertain that this is the case as well as to examine any significantchanges in refraction thereafter.M ETHODS: A retrospective observational study extractingdemographic and clinical information from case notes of patients whohad membranectomy and/or capsule polishing between October 2017and September 2018.RESULTS: 57 eyes of 51 patients were enrolled. There was a 2:1male: female ratio. Mean age at cataract surgery was 6.33 ï±3.59yearswhilst that for PCO surgery was 9.68 ï±3.89years. Postoperativevisual acuity (by WHO definition) was good (between 6/6 and 6/18)in 33.3%, compared to 8.8% preoperatively. Whereas presenting visualacuity was poor (<6/60) in 61.4% preoperatively, this reduced to30% postoperatively. Visual outcome was influenced by age at cataractsurgery, age at PCO surgery, interval between cataract and PCO surgeryand type of cataract. Children >8 years of age at time of PCO surgeryhad a greater proportion of good post-operative best corrected visualacuity (BCVA) (52.6%), whilst 75% of children younger than 8yearsat time of surgery turned out with poor BCVA after surgery.Developmental cataracts proportionately had the best outcome ofvisual acuity. There was a range of refractive shift of +0.25D to 5.25D with a mean myopic shift of 1.51D following membranectomy. CONCLUSION: There was a good proportion of children withsignificant improvement in visual acuity on the short term,and a mildmyopic shift following membranectomy.
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Humans , Child , Outcome Assessment, Health Care , Posterior Capsule of the Lens , Cataract , Capsule Opacification , Tertiary Care CentersABSTRACT
@#AIM: To quantify and evaluate the capsular adhesion to intraocular lens(IOL)in subjects with high myopia by the latest anterior segment optical coherence tomography(AS-OCT).<p>METHODS: Retrospective case observation study was designed. Sixty eyes of 60 patients who received extra-capsular extraction combined with IOL implantation in Shenzhen Eye Hospital from October 2019 to December 2019 were divided into two groups by axial length(AL), of which 30 eyes were highly myopic(AL>26mm)and 30 eyes were emmetropic(22mm<AL<24.5mm). All eyes were examinated by AS-OCT at 1, 7, and 30d after operation. The area between IOL and posterior capsule(AREAP)and residual side length of posterior capsule not adhesion were evaluated. Kaplan-Meier survival analyses of attachment rates were studied. The ratios of posterior capsule attached IOL of the two groups at different postoperative times were compared by Log-Rank.<p>RESULTS: In the emmetropic group, the AREAP was(0.81±0.37),(0.33±0.19)and(0.14±0.06)mm<sup>2</sup> at 1, 7, and 30d after operation, respectively. The residual side lengths of posterior capsule not adhesion were(7.93±3.03),(3.95±2.44)and(1.26±0.08)mm. The ratios of posterior capsule attached to IOL were 33%, 67% and 83%. In the highly myopic group, the AREAP were(3.29±0.43),(1.54±0.66)and(0.62±0.28)mm<sup>2</sup> at 1, 7, and 30d postoperatively, respectively. The residual side lengths of posterior capsule not adhesion were(13.56±4.02),(8.13±3.90)and(3.78±2.51)mm. The ratios of posterior capsule attached to IOL were 0, 7% and 23%. There were statistically significant differences between the two groups in AREAP, residual side lengths of posterior capsule not adhesion and the ratios of posterior capsule attached to IOL(<i>P<</i>0.05).<p>CONCLUSION: There is more space between posterior capsule and IOL after cataract surgery in highly myopic patients. The new generation of AS-OCT can clearly display the image of the posterior capsule of the lens, which is expected to be an effective examination device for the study of lens-related diseases.
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The present study was conducted as a rapid assessment of avoidable blindness survey by cluster sampling, aimed primarily to assess the outcome of cataract surgery in a rural Indian population. MethodsAn Observational Point Prevalence study including 407 pseudophakic eyes of 382 subjects, screened through Survey across District in Rural Wardha and admitted in the eye ward of a Rural Tertiary Care Teaching Centre, who gave informed consent were included in this study. History of cataract surgery (time, place, cost and provision of glasses), diabetes mellitus, past history of laser capsulotomy was recorded. Visual acuity and thorough ocular examination including grading of PCO were done. Ocular findings were recorded on pre-tested proforma. ResultsPrevalence of PCO among the pseudophakic eyes was 31.4%. Mean age of study population was 68.1 +8.3 years (range 14-86 years). Rates of PCO are noted to be minimum (21.4%) in the age group 55 - 59 years and maximum (36.1%) in the age group 75 - 79 years. Mean duration since surgery in eyes with PCO among the total 407 pseudophakic eyes included in the study was 27.9 +23.7 months (range 1 - 120 months), 14.9% eyes developed visually significant PCO in <12 months since surgery. Prevalence of PCO ranged from 14.9% in <12 months since surgery to 32.0% at <60 months since surgery (c2=23.99, p<0.05). In the study group which included 5 (23.9%) eyes with a Foldable IOL, developed PCO as compared to 133 (34.5%) in the eyes implanted with PMMA IOL. Prevalence of PCO was higher in PMMA IOL. In the study group, 45 (59.2%) eyes with a Decentered IOL had PCO as compared to 93 (28.1%) eyes within the Bag placed IOL group. There was a higher prevalence of visually significant PCO in eyes with decentered IOL, as compared to eyes within the Bag IOL placement. (c2=26.71, DF=1, p=0.00000). Out of 407 pseudophakic eyes included in the study, history of diabetes was noted in 14 persons, of whom 14 (3.4%) pseudophakic eyes were included in this study and 9 (64.3%) of these developed PCO. The prevalence of PCO was significantly higher among diabetic patients (c2=4.65, p<0.05). The presence of uveitis in pseudophakic eyes was significantly related to higher PCO rates as compared to pseudophakic eyes without uveitis. (c2=24.68, DF=1, p=0.000001). ConclusionsVisually Significant PCO is seen in 1/3rd of eyes following cataract surgery. Duration since cataract surgery is a major factor influencing its genesis. IOL material, cataract surgery type, and IOL position are also important factors. Role of diabetes and uveitis needs to be studied further.
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Transforming growth factor b2 (TGF-b2)/Smad signaling is widely accepted as a key inducer of proliferationand epithelial-mesenchymal transition (EMT) of human lens epithelial cells (LECs), contributing to thedevelopment of posterior capsule opacification (PCO). Increasing evidence shows that microRNAs (miRNAs)play important roles in PCO pathogenesis. Herein, we aimed to explore the role and molecular mechanism oflet-7a-5p on TGF-b2-induced proliferation and EMT in LECs. qRT-PCR was performed to detect theexpression of let-7a-5p and Smad2 mRNA. Western blot was used to determine the Smad2 level and theinduction of EMT. The targeted correlation between let-7a-5p and Smad2 was confirmed using dual-luciferasereporter and RNA immunoprecipitation assays. CCK-8 assay was employed to determine cell proliferation, andtranswell assays were performed to assess cell migration and invasion. We found that TGF-b2 induced EMT ofLECs, and TGF-b2 upregulated Smad2 expression and reduced let-7a-5p expression in LECs. Smad2 was adirect target of let-7a-5p. Moreover, let-7a-5p upregulation repressed proliferation, migration, invasion andEMT in TGF-b2-induced LECs. But, Smad2 expression restoration abrogated the inhibitory effect of let-7a-5pupregulation. In conclusion, our data indicated that let-7a-5p upregulation repressed TGF-b2-induced proliferation, migration, invasion and EMT at least partly by targeting Smad2 in LECs, highlighting that let-7a-5pmight act as a promising therapeutic target to intervene to the progression of PCO.
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OBJECTIVE: To compare the effects of hydrophobic and hydrophilic materials in square-edged acrylic intraocular lenses (IOLs) on the development of posterior capsule opacification (PCO) after pediatric cataract surgery. METHODS: Patients were randomly assigned to group 1 (hydrophobic acrylic square-edged IOLs; 13 eyes) or group 2 (hydrophilic acrylic square-edged IOLs; 13 eyes). The study evaluated PCO rates using Evaluation of Posterior Capsule Opacification (EPCO) 2000 software at one, three, six and 12 months postoperatively. Postoperative measurements also included corrected distance visual acuity (CDVA), neodymium:yttrium‐aluminum‐garnet (Nd:YAG) capsulotomy and postoperative complications other than PCO. RESULTS: Both groups had significant increases in PCO rates after one year. Comparison of the groups showed no significant differences in the EPCO scores at three (group 1, 0.007±0.016 vs group 2, 0.008±0.014; p=0.830), six (group 1, 0.062±0.103 vs group 2, 0.021±0.023; p=0.184), or twelve months postoperatively (group 1, 0.200±0.193 vs group 2, 0.192±0.138; p=0.902). We also found no significant group differences regarding the change (delta, Δ) in EPCO scores between three and six months (group 1, 0.055±0.09 vs group 2, 0.013±0.02; p=0.113) or between six and twelve months postoperatively (group 1, 0.139±0.14 vs group 2, 0.171±0.14; p=0.567). Twenty-three percent of patients required Nd:YAG capsulotomy at the twelve-month visit. CONCLUSIONS: No differences in PCO rates were found between hydrophobic and hydrophilic acrylic square-edged IOLs in children between five and twelve years of age at one year of follow-up.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Cataract , Capsule Opacification , Lenses, Intraocular , Postoperative Complications , Prosthesis Design , Acrylic Resins , Prospective Studies , Phacoemulsification , Lens Implantation, IntraocularABSTRACT
Purpose: To compare the posterior capsular opacification (PCO) after implantation of three types of hydrophobic square edge intraocular lenses (IOLs). Methods: A single-center, hospital-based, cross-sectional, observational study was conducted wherein patients with senile cataract who had undergone phacoemulsification by a single surgeon, with the implantation of three different types of square edge, hydrophobic IOLs [Group 1: enVista, Bausch and Lomb; Group 2: Tecnis 1 ZCBOO, AMO and Group 3: Acrysof IQ SN60WF, Alcon], and followed up for 12 months were included. The PCO was graded clinically and scored using the EPCO 2000 software. Results: 90 eyes of 90 patients were included. There was no significant difference in the PCO with respect to age, gender, or associated presence of systemic disease. The median PCO score was 0.035, 0.045 and 0.085 in groups 1, 2 and 3, respectively. The PCO grade and score differences between the groups were statistically significant with P < 0.001. Conclusion: The hydrophobic nature and posterior square edge design in the IOLs probably contributed to the minimal visually-significant PCO in all the groups, in our study. However, PCO scores were lesser in the square edge IOLs having a continuous 360 degrees posterior enhanced barrier, than those without this feature.
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Objective To investigate the roles of long noncoding RNA-myocardial infarction-associated transcript (MIAT) on lens epithelial cells (LECs) fibrosis induced by transforming growth factor-β2(TGF-β2).Methods LECs line (SRA01/04) was cultured in conventional DMEM (normal control group) and DMEM containing 10 ng/ml TGF-β2(TGF-β2 induced group) for 48 hours.The morphology of the cells was observed under the optical microscope,and the relative expression levels of M IAT,E-cadherin (E-cad),α-smooth muscle action (α-SMA),collagen Ⅰ (Coll Ⅰ) in protein level and mRNA level were detected by real-time fluorescence quantitative PCR and Western blot,respectively.The cells cultured in DMEM or DMEM containing 10 ng/ml TGF-β2 were transfected by siNRA empty carrier (siNRA group,siNRA+TGF-β2 group) and siRNA-MIAT (siRNA-MIAT group,siNRA-MIAT+ TGF-β2 group) for 48 hours,and the morphology of the cells was observed under the optical microscope,and the relative expression levels of MIAT,E-cadherin (E-cad),α-smooth muscle action (α-SMA),collagen Ⅰ (Coll Ⅰ) in protein level and mRNA level were detected by real-time fluorescence quantitative PCR and Western blot.Results The cells in the normal control group showed the round and polygon in shape,and those in the TGF-β2 induced group showed the spindle-like.Compared with the normal control group,the relative expression levels of MIAT mRNA,α-SMA mRNA and Coll Ⅰ mRNA were significantly elevated (2.497 ± 0.644 vs.0.827 ± 0.062;2.951 ±0.146 vs.1.085±0.517;2.115 ±0.090 vs.1.002 ± 0.088),and the expression of E-Cad mRNA was significantly reduced (0.102±0.027 vs.1.020±0.262) in the TGF-β2 induced group (P =0.045,0.004,0.000,0.025).The expressions of MIAT,α-SMA,Coll Ⅰ and E-Cad showed a similar trend between two groups.The relative expressions of MIAT protein and mRNA were evidently reduced in the SiRNA-MIAT group compared with the siRNA empty vector group (all at P＜0.05).Compared with the siRNA+TGF-β2 group,the relative expressions of α-SMA and Coll Ⅰ in protein and mRNA levels were significantly reduced,and the expressions of E-cad protwin and mRNA were elevated in the siRNA-MIAT+TGF-β2 group (all at P＜0.01).Conclusions MIAT might participate in TGF-β2-induced LECs-EMT.The down-regulation of MIAT in the LECs inhibits the fibrosis of LECs.
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Posterior capsule opacification (PCO) is a common complication after cataract phacoemulsification with intraocular lens (IOL) implantation.The mechanism of lens epithelial cells (LECs) fibrosis,PCO and capsular wrinkle is mainly related with residual LECs migration,proliferation and epithelialmesenchymal transition (EMT) after cataract surgery.Transforming growth factor β2 (TGF-β2) has been proposed as the most important factor driving the EMT and pathologic fibrosis of LECs,TGF-β2 induces LECs EMT by the Smad signaling pathway.Besides,PI3K/AKT/mTOR signaling pathway was studied to participate in TGF-β2 induced EMT.As one of the gene regulation methods,RNA interference (RNAi) technology shows an important application prospect in inhibiting LECs fibrosis and proliferation by interfering signaling pathway.This review highlights RNAi effects on LECs biological behavior by interfering PI3K/AKT/mTOR and TGF-β2/Smad signaling pathways.
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Posterior capsule opacification (PCO) is the most common complication after cataract surgery.How to prevent and treat PCO is an urgent problem we need to solve at present.Non-coding RNA(ncRNA) is a kind of RNA, which can not encode proteins.Studies have shown that non-coding RNA is closely related to the occurrence and development of human diseases.This paper has collected the progress of research on different kinds of ncRNA in PCO and may raise new ideas and methods on the prevention and treatment of PCO.
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Background Sulforaphane (SFN) is an effective chemopreventive agent and can regulate the biological molecular mechanisms to inhibit the overgrowth of cells.Autophagy is a biological process of maintaining cellular internal environment.Understanding the affection of SFN to biological behavior of human lens epithelial cells (LECs) and the association of SFN with autophagy is helpful for the prevention and target treatment of posterior capsule opacification (PCO).Objective This study was to investigate the eradication effeccts of SFN on residual lens cell population in vitro posterior capsule opacification (PCO) model and evaluate the mechanism of SFN-induced cell death.Methods In vitro human capsular bag models were generated from fresh donor eyes by phacoemulsification and were cultured in EMEM containing 2％ fetal bovine serum (FBS).Different concentrations of SFN (0,1,10 and 100 μ mol) were added in the medium for 30 days respectively according to grouping,and the growth of LECs was observed by optical microscope and immunofluorescence technique.FHL124,a human LEC line,was cultured with EMEM containing 5％ FBS and divided into 0,1,10,30 and 100 μmol SFN groups.Lactate dehydrogenase (LDH) release rate in the medium was detected to evaluate cell damage/death.The migration of the cells on capsular bags was assessed by scratch test.The ultrastructure and number of autophagosomes were examined under the transmission electron microscope.The expression of LC3 in the cells were detected using Western blot in the presence or absence of autophagy inhibitors.Results The cell coverage rates on the capsular bags were significantly lower in the 10 and 100 μ mol/L SFN groups than those in the 0 and 1 μmol/L SFN groups,with a statistically significant difference among the groups (F =48.57,P ＜ 0.01).Immunofluorescence showed that the density of F-actin-and Vimentin-positive cells was evidently decreased in the 10 and 100 μmol/L SFN groups compared with 0 and 1 μ mol/L SFN groups.The releasing levels of LDH (absorbancy) were 0.19± 0.03,0.39±0.06,0.56±0.07,0.68±0.08 and 0.89±0.09 in the 0,1,10,30 and 100 μ mol/L SFN groups,respectively,and the releasing level of LDH was gradually increased in the 10 and 100 μ mol/L SFN groups in comparison with the 1 μmol/LSFN group (all at P＜0.01).With the increase of SFN concentration,the reduction rate of scratched area decreased with the increase of SFN concentration,and the decrease of scratch area was significantly lower than that of adjacent low mass concentration group and the differences were statistically significant (P＜0.05).The relative expressions of LC3-Ⅱ protein were 0.423±0.003,14.543±0.024,0.668±0.024 and 0.576±0.056 in the blank control group,SFN group,SFN + 3-MA group and 3-MA group,respectively,and the relative expressions of LC3-Ⅱ protein were significantly lower in the SFN+3-MA group and 3-MA group than those in the SFN group (all at P＜0.01).The number of autophagosomes was 4.07±0.32,4.13±0.34,9.21 ±0.53 and 21.02± 1.34 in the blank control group,and 1,10,100 μmol/L SFN groups,and the number of autophagosomes in the 10 and 100 μ mol/L SFN groups was significantly higher than that in the blank control group and 1 μmol/L SFN group (all at P＜0.01).Conclusions SFN mediates LECs death by promoting autophagy in ex vivo capsular bags,and SFN may be a novel agent of potential chemopreventive and target treatment for PCO.
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PURPOSE: To compare neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rates between hydrophobic and hydrophilic intraocular lenses. METHODS: The present retrospective study enrolled patients who received cataract surgery from a single surgeon between July 2006 to December 2009. Patients included in the study were implanted with SA60AT hydrophobic spherical intraocular lenses (Alcon, Fort Worth, TX, USA, 268 eyes) or I-FLEX hydrophilic spheric intraocular lenses (i-Medical®, Ophthalmic International Heidelberg GmbH, Mannheim, Germany, 331 eyes). The Nd:YAG capsulotomy rates and best-corrected visual acuity (BCVA) were compared between the two groups for 2 years after the operation. RESULTS: The mean follow-up period was 23.5 months and 22.6 months and the mean age was 68.6 years and 70.3 years in the SA60AT and I-FLEX groups, respectively. Follow-up periods were longer in the SA60AT group (p = 0.035), but ages were not significantly different between the two groups (p = 0.367). Nd:YAG laser capsulotomy rates were 6.3% in the SA60AT group and 11.2% in the I-FLEX group. Nd:YAG laser capsulotomy rates were significantly higher in the I-FLEX group (p = 0.020). BCVA before and after the Nd:YAG laser capsulotomy was not significantly different. CONCLUSIONS: Nd:YAG laser capsulotomy rates were higher in the I-FLEX hydrophilic spheric intraocular lens group than in the SA60AT hydrophilic spheric intraocular lens group. Adhesion between capsular bag and intraocular lens by bioadhesive character of hydrophobic acryl intraocular lens may contribute to the prevention of lens epithelial migration and posterior capsule opacification.
Subject(s)
Humans , Aluminum , Capsule Opacification , Cataract , Follow-Up Studies , Germany , Lenses, Intraocular , Retrospective Studies , Visual Acuity , YttriumABSTRACT
PURPOSE: To compare neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rates between hydrophobic and hydrophilic intraocular lenses. METHODS: The present retrospective study enrolled patients who received cataract surgery from a single surgeon between July 2006 to December 2009. Patients included in the study were implanted with SA60AT hydrophobic spherical intraocular lenses (Alcon, Fort Worth, TX, USA, 268 eyes) or I-FLEX hydrophilic spheric intraocular lenses (i-Medical®, Ophthalmic International Heidelberg GmbH, Mannheim, Germany, 331 eyes). The Nd:YAG capsulotomy rates and best-corrected visual acuity (BCVA) were compared between the two groups for 2 years after the operation. RESULTS: The mean follow-up period was 23.5 months and 22.6 months and the mean age was 68.6 years and 70.3 years in the SA60AT and I-FLEX groups, respectively. Follow-up periods were longer in the SA60AT group (p = 0.035), but ages were not significantly different between the two groups (p = 0.367). Nd:YAG laser capsulotomy rates were 6.3% in the SA60AT group and 11.2% in the I-FLEX group. Nd:YAG laser capsulotomy rates were significantly higher in the I-FLEX group (p = 0.020). BCVA before and after the Nd:YAG laser capsulotomy was not significantly different. CONCLUSIONS: Nd:YAG laser capsulotomy rates were higher in the I-FLEX hydrophilic spheric intraocular lens group than in the SA60AT hydrophilic spheric intraocular lens group. Adhesion between capsular bag and intraocular lens by bioadhesive character of hydrophobic acryl intraocular lens may contribute to the prevention of lens epithelial migration and posterior capsule opacification.
Subject(s)
Humans , Aluminum , Capsule Opacification , Cataract , Follow-Up Studies , Germany , Lenses, Intraocular , Retrospective Studies , Visual Acuity , YttriumABSTRACT
AIM:To observe and analyze visual quality changes of the patients with posterior capsule opacification ( PCO ) Nd:YAG laser posterior capsular dissection, including the change of the best corrected vision acuity ( BCVA ) , total high- order aberration ( tHOA ) , and the modulation transfer function ( MTF) . METHODS:In this prospective observational study, 100 cases of patients ( 100 eyes ) with posterior cataract underwent Nd:YAG laser posterior capsular dissection ( posterior capsular diameter dissected was 5mm or higher). The mean age was 65. 52±7. 01 years old. The change of the BCVA was collected. The tHOA and MTF under the 3mm and 5mm pupil diameter were assessed by iTrace respectively before and after Nd:YAG laser posterior capsular dissection. RESULTS:All the surgery went well without obvious intraoperative and postoperative complications happened. The preoperative BCVA was 0. 451 ± 0. 023 while the postoperative BCVA was 0. 763±0. 025. The difference of BCVA before and after Nd: YAG laser surgery was statistically significant (PCONCLUSION: Patients with posterior capsule opacification ( PCO ) Nd:YAG laser posterior capsular dissection can help improve BCVA, reduce tHOA, increase MTF tHOA values, and significantly improve visual quality of patients.
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Background Posterior capsule opacification (PCO) is a common complication following cataract surgery.Establishing an objective morphological evaluation method of PCO is of important clinical significance for the prevention of PCO,but there are many problems in previous evaluating methods,and pentacam picture appears to be a useful method of assessing PCO.Recognizing the characters of different types of posterior capsule disorder and optimizing the evaluation details in tentacam picture are helpful for us to prevent and treat PCO.Objective This study was to investigate the characters of posterior capsule disorders with Pentacam tomograms.Methods Eightyfour eyes of 82 patients were included in Zhongshan Ophthalmic Center from January to October in 2011.Slit-lamp photography and retroilluminated photography were captured after full mydriasis,and then the Pentacam imaging was performed by using 50-scan acquisition protocol,and high-resolution Pentacam tomograms were reconstructed and analyzed by Image J software.The features of the posterior capsule disorders in Pentacam tomogram were assessed,and the mean pixel-intensity at the central 4-mm diameter and 3-mm diameter was calculated and compared.The percentage of eyes being interfered by the anterior capsule in the two analyed areas was calculated.This study was approved by Zhongshan Ophthalmic Center,and uritten informed consent was obtained from each patient prior to any examination.Results The posterior capsular membranes were completely clear under the blue background in 30 eyes without posterior capsulaopathy on the Pentacam images.In 54 eyes of 52 patients with PCO,different intensities of gray patches were exhibited on the blue background in the elschnig-pearl-type PCO,and white-color nontransparence patches were seen in the fibrosis-type PCO.The mean pixel-intensity value (inter-quartile range) was 37.07 U and 38.65 U at the central 4-mm area and 3-mm area respectively,without significant difference between them (P=0.606).Capsular block syndrome was found in 3 eyes of 3 patients,showing even gray appearance on the Pentacam images and mean pixel-intensity of 12.40,15.68 and 36.77 U at the central 3-mm area.The gray strip-like appearance on the blue background was seen in 1 eye with capsular shrinkage,and the mean pixel-intensity was 48.34 U at the central 3-mm area.The examination outcomes of 14.81％ (8/54) eyes were disturbed by the anterior capsule in the central 4-mm analysis mode,but the outcomes were unaffected in central 3-mm analysis mode.Conclusions Different types of posterior capsule disorders appear particular scenery in Pentacam tomograms.There is no difference of mean pixel-intensity between the central 4-mm analysis mode and the central 3-mm analysis mode.A central 3-mm analysis mode is more available to justify the penetrability of the posterior capsule.
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Background The primary pathologic mechanism of posterior capsular opacification (PCO) is proliferation,migration and epithelial-mesenchymal transformation of residuary lens epithelial cells (LECs) following cataract surgery.Matrix metalloproteinases (MMPs) play a role during the migration of LECs.Researches showed that GM6001,a broad inhibitor of MMPs,can arrest the migration of LECs,but as specific inhibitors of MMPs,the efficacy and safety of MMP-2/9 inhibitor Ⅰ and Ⅱ on LECs migration remain unclear.Objective This study was to determine and compare the inhibitory efficacy among GM6001,MMP-2/9 inhibitor Ⅰ and Ⅱ on human LECs and search the clinical medication to prevent PCO.Methods Human LECs were cultured and passaged in vitro,and the cells of 3-4 generation were incubated in 6-well plates.Then the cells of 70％ confluent monolayer were cultured in DMEM without fetal bovine serum for 12 hours.GM6001,MMP-2/9 inhibitor Ⅰ and Ⅱ at different concentrations (0.25,0.50,1.00,2.00,4.00,8.00,16.00,32.00,64.00,128.00 μmol/L) were added into the culture medium for 24 hours separately,and regularly cultured cells served as the control group.A bare area was made by a 200 μl sterile spear on the cell layer,and the migrated distance and inhibitory rate were calculated.The second or third generation of cells were incubated in 96-well plates at a density of 5×105/ml (200 μl/well).GM6001 (128.00 μmol/L),MMP-2/9 inhibitor Ⅰ (64.00 μmol/L) and Ⅱ (32.00 μmol/L) were added into the culture medium for 24 hours,and the cell viability was assayed by using MTT assay.Results Cultured cells grew well with irregular arrangement and presented the polygon in shape.The migrated distance was gradually reduced as the increase of concentrations of GM6001,MMP-2/9 inhibitor Ⅰ and Ⅱ,showing significant differences among the various concentration groups (GM6001:F=248.647,P＜0.05;MMP-2/9 inhibitor Ⅰ:F=357.125,P＜0.05;MP2/9 inhibitor Ⅱ:F=396.374,P＜ 0.05).The cell migrated distance in the control group was set to 1,the relative migrated distances were 0.478 ± 0.091,0.294±0.088 and 0.191 ±0.081 in the GM6001 group,MMP-2/9 inhibitor Ⅰ group and MMP-2/9 inhibitor Ⅱ group at the concentrations of 32.00 μmol/L,respectively,showing a significant difference among the groups (F =116.031,P＜0.01),and cell migrated distance was obviously shorter in the MMP-2/9 inhibitor Ⅱ group than that in the GM6001 group or MMP-2/9 inhibitor Ⅰ group (all at P＜0.01).The A values were 0.607±0.016,0.567±0.015,0.583±0.010 and 0.595 ±0.0138 in the control group,GM6001 group (128.00 μmol/L),MMP-2/9 inhibitor Ⅰ group (64.00 μmol/L) and MMP-2/9 inhibitor Ⅱ group (32.00 μmol/L),respectively,without significant difference among the groups (F=1.403,P＞0.05).Conclusions GM6001,MMP-2/9 inhibitor Ⅰ and Ⅱ reduce the mobility of human LECs effectively but do not affect the viability of the cells in vitro.MMP-2/9 inhibitor Ⅱ appears to be most dominant in inhibiting migration of human LECs.
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The mammalian TOR ( mTOR ) pathway is a key regulator of cell growth and proliferation which is also a fundamentally important player in a large variety of human diseases. The pathway regulates many key cellular processes and is implicated in a large number of pathological conditions, including cancer, obesity, diabetes, and cardiovascular disease, age - related diseases and other proliferative disease. It integrates signals from nutrients, energy status and growth factors to regulate many processes, including autophagy, ribosome biogenesis and metabolism. Our article reviews the advancement of laboratory results on mTOR pathway in proliferative diseases in ophthalmology.