Early clinical research on the femtosecond laser assisted penetrating keratoplasty / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To evaluate the therapeutic effects and safety of femtosecond laser assisted penetrating keratoplasty ( FS-PKP) . METHODS: ln the retrospective case series study, 46 cases ( 48 eyes ) with FS- PKP holds were analyzed. Preoperative best corrected visual acuity ( BCVA) was 2. 35 ± 1.01 (with a standard logarithmic eye chart). Opacities were all from epithelium to endothelium, including keratoconus, keratolukoma and corneal scarring etc. The full-thickness corneal donor-recipient grafts in different diameter and incision kerfangle were made by femtosecond laser in keratoplasty. The patients were treated according to the conventional penetrating keratoplasty after surgery. Evaluation indexes included preoperative and postoperative 1, 6, 10mo uncorrected visual acuity (UCVA), BCVA, corneal astigmatism (CA) and surgical complications. Forty-three cases (44 eyes) with traditional PKP were as control group. The data of two groups were analyzed by mean comparison of two groups and Chi-square test in SPSS 18. 0. RESULTS: All the operations were completed successfully, postoperative visual acuity of all patients had different degrees of increase. Comparison with the postoperative UCVA of traditional PKP surgery, UCVA was 3. 48 ± 0. 43 and 2. 97 ± 1. 14 at 1mo after operation, respectively, with statistically significant difference ( P=0. 009). The UCVA was 3. 86±0. 25 and 3. 74±0. 73 at 3mo after operation, respectively; the UCVA was 4. 04 ± 0. 23 and 3. 98 ± 0. 29 at 6mo after operation, respectively, with no statistically significant difference (P=0. 146, P=0. 56). ln FS-PKP group, BCVA was better than traditional PKP surgery group, with statistically significant difference ( P=0. 002 ). While there had no statistically significant difference between two groups of BCVA at 6, 10mo after operation (P6mo =0. 132, P10mo =0. 47). The incidence of complication of FS-PKP surgery, such as postoperative astigmatism, postoperative intraocular pressure and postoperative incision dehiscence were significantly lower than the one of traditional PKP surgery(P CONCLUSlON:Compared with traditional penetrating keratoplasty, FS-PKP provides significantly faster visual recovery in the early postoperative period, and induces significantly less corneal astigmatism and lower incidence of complication. lt reflected the clinical superiority of this new technology .

Awareness of cornea donation of registered tissue donors in Nanjing / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the current cornea donation awareness of tissue donors in the city of Nanjing, China.</p><p><b>METHODS</b>Altogether 2000 registered tissue donors in the Red Cross Eye Bank of Nanjing by the end of 2010 and 2000 control residents of Nanjing in February to June 2011 were randomly selected to participate in our field questionnaire survey. The questionnaire consisted of questions regarding the understanding of cornea donation, the attitude toward cornea donation, and attitude toward legislation and free donation. The awareness of cornea donation between the registered tissue donors and residents was compared. Related factors of the willing-ness to donate corneas and to become a tissue donor were evaluated with univariate and multiple logistic regression analysis.</p><p><b>RESULTS</b>A total of 1867 (response rate: 93.4%) tissue donors and 1796 (response rate: 89.8%; effective questionnaires: 1697) residents participated in this survey. For the questions about the knowledge of cornea donation, 90.3% tissue donors (residents: 78.9%) knew that donated corneas could be used for transplantations; 71.2% tissue donors (residents: 47.6%) knew that the appearance would not be destroyed after cornea donation; 70.7% tissue donors (residents: 20.0%) knew the formalities to become a cornea donor. For attitude toward cornea donation, 82.2% tissue donors (residents: 45.1%) were willing to donate corneas or eyeballs after death; 84.0% tissue donors (residents: 30.2%) had discussed with their families about donation; 85.1% tissue donors (residents: 24.8%) supported their families' or friends' cornea donation. For attitude toward legislation and free donation, 88.3% tissue donors (residents: 61.3%) approved of legislation to regular cornea donation; 72.2% tissue donors (residents: 38.8%) thought that cornea or organ donation should be gratis. The difference between two groups was significant (P<0.001). However, some tissue donors did not know cornea donation well, some even opposed the legislation of cornea donation and free donation protocol. For the factors influencing the willingness to donate corneas, population was the most relevant factor (P<0.001), since tissue donors were more willing to donate corneas than residents. Other significantly related factor were age, gender, occupation, and education level (P<0.001), while political status or religion were not significant. For the factors related to becoming a tissue donor, older age, male, white-collars (including white-collar, civil servant, teacher, soldier, lawyer, salesman, healthcare provider), higher education level, party members (including the Chinese Communist Party members, democratic party members, and the Communist Youth League members) (P<0.05).</p><p><b>CONCLUSIONS</b>The registered tissue donors have better understanding and more positive attitude towards cornea donation than control residents do. They approve of the legislation of cornea donation and free donation protocol. It may be more effective to target the population of over 58 years old, male, white-collars, well-educated people, and party members in the promotion of cornea donation.</p>

Mitomycin C "straight scleral tunnel incision"--trabeculectomy with a releasable suture / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the efficacy of "straight scleral tunnel incision" -trabeculectomy with a releasable suture supplemented with mitomycin C (MMC) on reducing intraocular pressure (IOP), complications, and corneal astigmatism in patients with primary angle-closure glaucoma (PACG).</p><p><b>METHODS</b>Totally 217 acute or chronic PACG patients with occludable angle above 180 degrees and IOP above 21 mm Hg were divided into 3 groups. Patients in group A (98 cases, 128 eyes), B (71 cases, 95 eyes), and C (48 cases, 60 eyes) were treated with "straight scleral tunnel incision"-trabeculectomy with a releasable suture supplemented with MMC, releasable suture trabeculectomy with MMC, and trabeculectomy with MMC, respectively. IOP, complications, and surgically induced astigmatism (SIA) were evaluated preoperatively and up to 12 months postoperatively.</p><p><b>RESULTS</b>IOP of 2 weeks after treatment was significantly lower than preoperative IOP in all the 3 groups (all P <0. 001). Success rates (IOP < or = 20 mm Hg) in group A, B, and C were 87.91%, 89.23%, and 83.72% respectively at 12 months after treatment (P = 0.256). The incidence of shallow anterior chamber and hypotony had no significant difference between group A and B, but both of them were lower than that in group C (P < 0.05). There were no significant differences in preoperative corneal astigmatism among the 3 groups. The corneal astigmatism after 2 weeks in group A (1.71 +/- 1.47D) was higher than that before operation (1.28 +/- 1.05D, P = 0.126). With 12 months gone, the astigmatism almost returned to preoperative levels. The corneal astigmatisms after 2 weeks in group B and C (1.99 +/- 1.20D and 2. 22 +/- 1.39D) were significantly higher than those before operation (1.20 +/- 0.85D and 1.18 +/- 0.93D, P = 0.002, P = 0.001), respectively. With 12 months gone, the mean astigmatisms in group B and C (1.87 +/- 0.91D and 1.90 +/- 1.16D) were still significantly higher than those before operation (P = 0.001, P = 0.003). The highest astigmatic polar values in group A, B, and C (1.00D, 1. 89D, and 1. 77D) occurred after 2 weeks, 1 month, and 1 month postoperation, respectively, which were significantly higher than those before operation (0.19 +/- 1.32D, 0.12 +/- 1.22D, and 0.17 +/- 1.25D, P < 0.01), respectively. With 12 months gone, they were 0. 03D, -0. 18D, and -0. 13D higher than those before operation, respectively. The rates of function bleb and thin-wall bleb were 71.43% and 26.37% in group A, 75.38% and 29.23% in group B, 72.09% and 25.58% in group C, respectively at 12 months after treatment There were no significant differences among the 3 groups.</p><p><b>CONCLUSION</b>"Straight scleral tunnel incision" -trabeculectomy with a releasable suture supplemented with MMC can reduce complications and get satisfactory results in reducing IOP and SIA.</p>