Anterior segment reconstruction and secondary posterior chamber intraocular lens implantation supported by fibromembrane / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the methods and effects of secondary intraocular lens implantation based on proliferative membrane in anterior segment reconstruction.<p>METHODS: Totally 156 eyes with penetrating injury had varying degrees of anterior segment disorders which had secondary intraocular lens implantation based on proliferative membrane to anterior segment reconstruction. Including partial penetrating keratoplasty, front-adhesion release, iris root suture, post-adhesion release, pupillary plasty, hole making in pupil area proliferative membrane and secondary intraocular lens implantation based on proliferative membrane. All patients were followed up 3-18mo.<p>RESULTS: The surgeries were successful in all patients. The corrected visual acuity of 123 eyes(78.8%)were ≥0.5, 17 eyes(10.9%)were ≥0.8 and 33 eyes(21.2%)were ≤0.4. Postoperative intraocular lens position was 133 eyes(85.3%), intraocular lens slightly off the center of 23 eyes(14.7%). Anterior chamber hemorrhage occurred in 8 eyes, 6 of them were recovered by conservative treatment and the blood membrane in another 2 eyes were sucked out through primary incision, and 5 cases of corneal plaque dense in the center of the cornea are partially penetrating keratoplasty. After 2mo, a rejection reaction occurs, which is cured by conservative treatment. All patients had slight postoperative inflammation and without severe long-term complications.<p>CONCLUSION: Reconstruction of the anterior segment of the eye, proliferative membrane can support the intraocular lens at the pre-implantation of the intraocular lens, without the need for suture fixation, thus avoiding various complications due to sutures.

Influence of intravitreal avastin on the expression of cell factors in retinal proliferative membrane in proliferative diabetic retinopathy eye / 中华实验眼科杂志

Background A main cause of visual impairment in proliferative diabetic retinopathy (PDR) is vitreous hemorrhage and retinal detachment due to contraction of fibrovascular membrane.To explore the pathogenic mechanism of fibrovascular membrane is a new target for the prevention and management of PDR.Objective This study was to determine the change in expression of vascular endothelial growth factor (VEGF),connective tissue growth factor(CTGF) and pigment epithelium derived factor(PEDF) in the proliferative membranes of patients with PDR after intravitreal injection of avastin,an anti-VEGF agent.Methods This study was approved by the Medical Ethic Committee of Tianjin Medical College,and written informed consent was obtained from each patient before enrollment.A prospective randomized-controlled study was designed.Twenty-six eyes of 24 patients with PDR scheduled for surgery were enrolled from January to June,2008 in Tianjin Medical College Eye Hospital.The patients were randomized into the simple vitrectomy group and avastin injection combined with vitrectomy group,with matched gender,age and disease duration.1.25 mg (0.05 ml) of avastin was intravitreally injected prior to surgery,and vitrectomy was performed 10 days after injection in the avastin injection combined with vitrectomy group,and only vitrectomy was given in the simple vitrectomy group.Preretinal membrane was collected during the surgery.Expression of VEGF,CTGF and PEDF in the preretinal membranes was assayed by immunochemistry.Results VEGF,CTGF and PEDF were expressed in the cytoplasm.The rate of VEGF expression in the preretinal membranes was 30.77％ in the avastin injection combined with vitrectomy group,showing a significant reduction in comparison with the simple vitrectomy group(100.00％)(U =4.000,P＜0.01).The rate of expression CTGF was remarkable elevated in the avastin injection combined with vitrectomy group compared with the simple vitrectomy group (92.31％ vs.62.54％)(U=7.500,P=0.048).However,no significant difference was found in the expression rate of PEDF between the two groups(100.00％ vs.92.31％) (U =65.500,P =0.299).Conclusions The results suggest that intravitreal injection of anti-VEGF drugs resulted in the decrease of VEGF expression and increased CTGF expression in proliferative membranes from patients with PDR.

The Components of the Proliferative Membranes in Retinopathy of Prematurity

In order to evaluate the components of the proliferative membranes in the retinopathy of prematurity (ROP), 8 proliferative membranes obtained from 8 eyes with ROP stage 5 during lensectomy, vitrectomy and delamination of membrane were examined under electron mIcroscopy. Among the 8 proliferative membranes of ROP, fibrous astrocytes, myofibroblasts, lymphocytes, macrophages, calcifications were respectively found in 2 cases, vascular tissues in 4 cases and abundant collagen matrix in 7 cases. While in the 2 cases with fibrous astrocytic proliferations the membranes were hypercellular, in the other 6 cases the membranes were hypocellular and mainly composed of collagen matrix.

The components of the proliferative membranes in retinopathy of prematurity: an electron microscopic study

Electron microscopic examination of proliferative membranes in retinopathy of prematurity (ROP) was performed in order to evaluate the components of the membranes. The proliferative membranes were obtained from nine patients with ROP stage 5 during pars plicata lensectomy, vitrectomy, and delamination of membrane. Fibrous astrocytes, myofibroblasts, lymphocytes, macrophages, and calcification were found respectively in two cases, and fibroblast-like cells were found in one case. Varying amounts of collagen tissues were found in eight cases and vascular tissues in four cases. Most of membranes were hypocellular and composed mainly of collagen matrix. It is considered that fibrous astrocytes, myofibroblasts, fibroblasts, and vascular structures are involved in the formation of proliferative membranes of ROP, and that later these cells degenerate and disappear, and that finally only collagen matrix remains in the membranes.