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Purpose: To study posterior capsular opacification (PCO) and neodymium?doped yttrium aluminum garnet (Nd:YAG) capsulotomy rates in patients implanted with square?edged and non?square?edged intraocular lenses (IOLs) in manual small?incision cataract surgery (MSICS). Setting: Tertiary eye care center. Design: Prospective, comparative, and randomized controlled study. Methods: This study included patients with senile cataracts scheduled for MSICS and IOL implantation. One eye of each patient was randomized to the implantation of square?edged (S group) or non?square?edged IOL (NSQ group). An independent observer analyzed PCO at 6, 12, 18, and 24 months under slit?lamp illumination. Results: A total of 104 eyes were included in this study. The mean age of the participants in the two groups was 63.2 (�2) years, and there were 65 (62.5%) men and 39 women (37.5%). The mean best?corrected visual acuity (BCVA) values at 6, 12, and 18 months were 0.157 (�10), 0.11 (�12), and 0.12 (�11), respectively, in the S group and 0.17 (�10), 0.17 (�12), and 0.20 (�17), respectively, in the NSQ group. At 12 (P = 0.03) and 18 months (P = 0.01) follow?up, the BCVA of the S group was significantly better than that of the NSQ group. Four eyes in the NSQ group and one eye in the S group required Nd:YAG. Conclusion: Evaluation of PCO and Nd:YAG capsulotomy rates showed that the 360� square of the posterior IOL edge plays a role in the prevention of PCO. Owing to the low cost of the material and the easy availability of IOLs manufactured from it, square?edged IOL has a definite role in the prevention of PCO in MSICS.
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Purpose: To study the complication rate following Nd: YAG posterior capsulotomy posterior capsular opacification (PCO) in patients with and without comorbid conditions. Methods: This was a prospective, interventional, comparative, and observational study. A total of 80 eyes, consisting of 40 eyes without ocular comorbidities (group A) and 40 eyes with ocular comorbidities (group B) that were being treated with Nd: YAG capsulotomy for PCO, were included. Visual outcome and complications of Nd: YAG capsulotomy were studied. Results: The mean age of group A patients was 61.65 ± 8.85 years and that of group B patients was 63 ± 10.46 years. Of the total, 38 (47.5%) were men and 42 (52.5%) were women. In group B, the ocular comorbidities were moderate nonproliferative diabetic retinopathy (NPDR) (n = 14 eyes; 14/40 = 35%), subluxated intraocular lens (IOL; <2 clock hours of subluxation; n = 6), age?related macular degeneration (ARMD; n = 6), post?uveitic eyes (having old signs of uveitis, no episode of uveitis since the last 1 year; n = 5), and operated cases of traumatic cataract (n = 4). The mean energy required in groups A and B was 46.95 ± 25.92 and 42.62 ± 21.85 mJ, respectively (P = 0.422). The average energy requirement in Grade 2, Grade 3, and Grade 4 PCO was 22.30, 41.62, and 79.52 mJ, respectively. An increase in intraocular pressure (IOP) of >5 mmHg from pre?YAG levels was observed in one patient in each group on day 1 postprocedure, for which medical treatment was given to both patients for 7 days. One patient in each group had IOL pitting. No patient had any other complications attributable to ND:YAG capsulotomy. Conclusion: Nd:YAG laser posterior capsulotomy is a safe procedure for PCO in patients with comorbidities. Visual outcomes were excellent after Nd:YAG posterior capsulotomy. Although a transient increase in IOP was noted, the response to treatment was good and a long?term increase in IOP was not observed
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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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Una de las causas de la disminución de la visión es la catarata. El tratamiento es la extracción del cristalino opaco con reemplazo por un lente intraocular (LIO). La opacidad de cápsula posterior (OCP) es una complicación frecuente a largo plazo. Las modificaciones en el diseño del LIO tanto del material y la forma tienen mayor importancia para prevenir la OCP. Como tratamiento está la capsulotomía neodimio YAG láser. Objetivo: identificar la OCP relacionado con el tipo de LIO implantado en pacientes pseudofáquicos en la FBO, entre el periodo de marzo del 2019 hasta febrero del 2022. Métodos: estudio observacional, tipo analítico, subtipo cohorte histórica, retro- prospectiva y longitudinal, con enfoque de análisis estadístico de tipo cuantitativo. Resultados: predominó el género femenino con un 60 % y un 40 % representaba al masculino; un 60,3 % del total tenían entre 65 a 80 años. La OCP en los 3 tipos de lentes intraoculares (acrílico y PMMA) ocasionó una disminución en la agudeza visual: el 37 %, predominó, por el LIO hidrofóbico, 36 % por el LIO PMMA y destacamos que el 27 % fue por el LIO hidrofílico. La incidencia de OCP a 5 años fue del 32 %. No se registró ningún efecto adverso en nuestro estudio. Conclusiones: la OCP provoca una baja de agudeza visual leve a moderada en los 3 tipos de LIOs; con un mínimo predominio de BAV leve para el tipo de LIO hidrofóbico comparado con el hidrofílico. Además después de la capsulotomía un gran porcentaje tiene entre 20/20 a 20/25 de AV mejor corregida.
One of the causes of decreased vision is cataract. Treatment is removal of the cloudy lens with replacement by an intraocular lens (IOL). Posterior capsule opacity (PCO) is a common long-term complication. Modifications in the design of the IOL both in terms of material and shape are of greater importance in preventing PCO. Treatment is neodymium YAG laser capsulotomy. Objective: to identify the PCO related to the type of IOL implanted in pseudophakic patients in the FBO, from March 2019 to February 2022. Methods: observational study, analytical type, historical cohort subtype, retro-prospective and longitudinal, with a quantitative statistical analysis approach. Results: the female gender predominated with 60% and 41% represented the male; 60.3% of the total was between 65 and 80 years old. PCO in the 3 types of intraocular lenses (acrylic and PMMA) caused a decrease in visual acuity: 37%, predominated, due to the hydrophobic IOL, 36% due to the PMMA IOL and we highlight that 27% was due to the hydrophilic IOL. The incidence of PCO at 5 years was 32%. No adverse effect was recorded in our study. Conclusion: PCO causes mild to moderate visual acuity loss in all 3 types of IOLs; with a minimal predominance of mild AVB for the hydrophobic IOL type compared to the hydrophilic one. In addition, after capsulotomy, a large percentage has between 20/20 and 20/25 better corrected visual acuity.
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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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Despite the continuous improvement and development of modern cataract surgery technology, posterior capsule opacification (PCO) is still the common long-term complication causing secondary visual acuity decline after cataract surgery.Previous studies have shown that the occurrence of PCO is closely related to the proliferation, migration, epithelial-mesenchymal transition (EMT) and myofibroblast fibrosis of lens epithelial cells in the anterior capsule and lens equator.In terms of pathogenesis, recent research focuses on the role of cytokines, especially various growth factors.Vascular endothelial growth factor (VEGF) is a kind of growth factor that can promote vascular endothelial cell proliferation and migration, extracellular matrix degeneration and angiogenesis.In addition, there is increasing evidence showing that VEGF plays an important role in fibrosis, inflammation, neuroprotection and other aspects.In recent years, VEGF has been found to promote PCO formation directly or cooperatively with transforming growth factor-β2.Based on the function of VEGF and the relationship between VEGF and EMT, this paper mainly reviewed the advances in the role of VEGF in the eye and the pathogenesis of posterior capsule opacification.
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Purpose: To study the effect of intraocular lens (IOL) implantation with and without ocular viscoelastic device (OVD) on posterior capsular opacification (PCO) in eyes with phacoemulsification. Methods: This prospective, comparative, and randomized case series included 70 patients (140 eyes) with senile cataracts scheduled for phacoemulsification and IOL implantation in a tertiary eye c are center. One eye of each patient was randomized to one of the two groups, namely, control and OVD. After phacoemulsification, the IOL was placed in the capsular bag under balanced salt solution (BSS) in the control group, whereas the IOL was placed under OVD in the OVD group. PCO was analyzed by an independent observer at 6, 12, and 18 months under slit?lamp illumination. Results: The mean age of the participants in the two groups was 61.2 (±9.9) years. Of the total participants, 68 (48.5%) were men and 72 (51.5%) were women. The mean keratometry (K1, K2) values of the OVD (44.26 ± 1.43, 44.93 ± 1.66) and control (44.51 ± 1.74, 44.69 ± 1.49) groups were similar. The mean IOL powers of the control and OVD groups were 21.25 (±1.94) and 21.53 (±1.86), respectively (P = 0.463). The mean best?corrected visual acuity (BCVA) of the control group at 6?, 12?, and 18?month follow?ups were 0.622 (±0.253), 0.315 (±0.203), and 0.063 (±0.163), respectively, whereas those of the OVD group were 0.592 (±0.253), 0.336 (±0.169), and 0.066 (±0.118), respectively (P = 0.922). None of the patients had postoperative raised intraocular pressure (IOP), uveitis, or endophthalmitis. Three and four eyes in the control and OVD groups, respectively, required neodymium?doped yttrium aluminum garnet (ND: YAG) capsulotomy at study termination (P = 0.999). Conclusion: The hydroimplantation technique of the placement of hydrophilic IOL did not reduce the PCO rate in the 18?month follow?up period. The ND: YAG capsulotomy rate did not differ between the groups
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Purpose: Remnant lens epithelial cells (LECs) within the capsular bag (CB) undergo epithelial?to?mesenchymal transition (EMT) and acquire a myofibroblast phenotype, depositing extracellular matrix (ECM) components, leading to posterior capsular opacification (PCO). This study histopathologically analyzes the LEC?to?myofibroblast transition and de novo ECM component deposition (i.e., smooth muscle actin (SMA) and fibronectin (FN) expression) and determines the intraocular lens (IOL) and patient factors associated with these changes. Methods: In total, 190 CBs with IOLs were removed from donor eyes. Digital images were obtained, and PCO was graded using published software (ADOS, Medical Parachute). Automated immunohistochemistry was performed using anti?SMA to detect EMT and anti?FN to document ECM remodeling. Slides were digitized and analyzed using the Positive Pixel Count v9 algorithm. Linear regression and Poisson regression were performed (P < 0.05). Results: SMA positive expression decreased as the time of IOL implantation increased (P < 0.0001). Positivity of SMA and FN demonstrated a positive correlation (P = 0.0002). Controlling for confounding factors in Poisson regression, hydrophobic and hydrophilic materials showed higher FN and SMA expression when compared to silicone material lenses (FN; P = 0.018; P < 0.0001, SMA; P = 0.001; P = 0.003, respectively). The square optic design had 29% higher SMA positivity compared to the opti?edge design (P = 0.042). One?piece haptic lenses had higher SMA expression compared to three?piece haptic (P = 0.042). A higher risk of expression of SMA and FN was seen in patients with a history of smoking, hypertension, and glaucoma (P < 0.05). Conclusion: This study demonstrated that SMA and FN expression is different according to IOL design and patient factors, thus indicating that LEC changes depend on lens biocompatibility. Therefore, by analyzing the histopathological composition of PCO by using LECs, further insight into the characteristics of IOLs that are important for biocompatibility can be ascertained.
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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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Humains , Enfant , , Capsule postérieure du cristallin , Cataracte , Opacification de la capsule postérieure , Centres de soins tertiairesRésumé
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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Objective:To establish an in vitro capsular bag model and compare the inhibitory effects of different 360° square-edge intraocular lens (IOL) on lens epithelial cells (LECs) migration. Methods:In vitro capsular bag model with posterior capsule opacification (PCO) was established using Transwell compartment, cell climbing slices, human collagen type Ⅳ, and IOL.The models were divided into Plate-loop HydroSmart group, C-loop HydroSmart group, and C-compensation-loop Hydrophobic group according to the different square-edge IOL implanted.A blank control group was set using the Transwell compartment without IOL.The early PCO pathological manifestations in lens epithelial cell line SRA01/04 cultured in the Transwell compartment were observed with an inverted microscope.The cell morphology in different groups was observed by hematoxylin and eosin staining.The cell counting and cell migration inhibition rate of anterior capsule and posterior capsule were calculated by Transwell assay and cell-exclusion zone assay, respectively. Results:The early pathological characteristics of PCO, such as early Soemmering ring and small Elschnig pearl, could be found in cells in the in vitro capsular bag model after 48-hour culture.The migrating cells in model groups were fibrous.No changes mentioned above were found in blank control group.The number of migrating cells in the anterior capsule of Plate-loop HydroSmart group, C-loop HydroSmart group, C-compensation-loop Hydrophobic group was 18.80±5.53, 24.67±9.80, and 34.47±10.80, respectively, and the number of migrating cells in the optical area of the posterior capsule of the three groups was 56.43±9.00, 162.20±16.38, and 121.30±12.01, respectively.The cell migration inhibition rate in the anterior capsule of Plate-loop HydroSmart group, C-loop HydroSmart group, C-compensation-loop Hydrophobic group was (92.02±1.94)%, (89.76±3.10)%, (86.27±4.54)%, respectively, and the cell migration inhibition rate in optical area of the posterior capsule of the three groups was (91.60±3.65)%, (70.14±5.35)%, (78.43±3.48)%, respectively.The number of migrating cells in the anterior capsule was lower and the cell migration rate inhibition was higher in Plate-loop HydroSmart group than C-compensation-loop Hydrophobic group, with significant differences (both at P<0.05). The number of migrating cells in the optical area of the posterior capsule and the cell migration inhibition rate was greater than those of C-loop HydroSmart group and C-compensation-loop Hydrophobic group, showing statistically significant differences (all at P<0.001). Conclusions:The in vitro capsular bag model can be used in PCO research.Compared with C-loop HydroSmart IOL and C-compensation-loop Hydrophobic IOL, Plate-loop HydroSmart IOL can more effectively inhibit the migration of LECs to the optical area of the posterior capsule.
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【Objective】 In recent years, granulocyte colony stimulating growth factor (G-CSF) has been proved to be expressed in the posterior capsule of the lens of posterior capsular opacification (PCO), but its specific role remains unclear. The purpose of this study was to explore whether G-CSF plays a role in PCO. 【Methods】 First, human lens epithelial cells (HLEC-B3) were treated with different concentration of recombinant G-CSF protein and screened for effective appropriate concentration. Then, Western blotting was used to detect the effects of extracellular matrix (ECM) synthesis and epithelial mesenchymal transdifferentiation (EMT) marker genes after G-CSF treatment on HLEC-B3 cells. Finally, the effects of G-CSF treatment on the migration and invasion of HLEC-B3 cells were detected by scratch experiment and Transwell test. 【Results】 G-CSF at 80 μg/L could promote the proliferation of HLEC-B3 cells. After G-CSF was treated for 48 h, the expressions of EMT and ECM synthesis marker genes in HLEC-B3 cells were significantly upregulated with time. G-CSF could significantly promote HLEC-B3 cell invasion after 48 h induction. Similarly, G-CSF could also significantly induce cell migration compared to the CTRL group. 【Conclusion】 G-CSF can promote the proliferation, migration and invasion of HLEC-B3 cells, as well as EMT and ECM synthesis, which might be involved in the occurrence of PCO. Inhibiting the expression of G-CSF may be a new strategy for PCO prevention.
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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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Humains , Opacification de la capsule postérieure/chirurgie , Pose d'implant intraoculaire , Cataracte/étiologie , Capsule du cristallin/chirurgie , Lentilles intraoculaires/effets indésirables , Résultat thérapeutique , Complications postopératoires , Conception de prothèseRésumé
Posterior cataract opacification(PCO)is the epithelial-mesenchymal transformation(EMT)of residual lens epithelial cells(LECs)after cataract surgery, resulting in opaque scar which is one of the main complications of cataract surgery. A large amount of fibronectin(FN)produced by LECs after cataract surgery binds to a variety of cell surface receptors, matrix components and growth factors to regulate cell behavior. The purpose of this article is to review the literatures on the treatment of PCO targeting fibronectin and provide references for clinical treatment of PCO. In this paper, the research status of fibronectin in PCO in recent years is reviewed.
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Objective:To improve the contrast between the myocardium and the cardiac cavity by left ventricular opacification and to diagnosis the suspected cardiac space occupying.Methods:25 patients with suspected cardiac space occupying by two-dimensional echocardiography were selected into the observation group. All patients were limited by near-field artifacts and sound window, gas interference or unclear display of two-dimensional echocardiography due to obesity. After left ventricular opacification, the images were sorted and analyzed. 10 subjects without heart disease served as the normal control group. The left ventricular function measured by routine two-dimensional echocardiography and cardiography were compared in the observation group.Results:In the observation group, 25 patients had no discomfort during the contrast-enhanced, and the contrast-enhanced echocardiography was successful. Among them, 7 cases excluded the diagnosis of cardiac space occupying, 3 cases were judged to be caused by near-field artifacts, 3 cases were judged to be spontaneous intracardiac development, and 1 case was judged to be ventricular septal hypertrophic cardiomyopathy; 18 patients were diagnosed as intracardiac thrombus, and the smallest thrombus diagnosed was 7 mm×8 mm hypoechoic fresh thrombus at the apex of the heart after myocardial infarction. In the observation group, there was no significant difference between ejection fraction (EF) value measured by two-dimensional image echocardiography and cardiography ( P>0.05), but the ventricular end diastolic volume (EDV) and ventricular end systolic volume (ESV) of cardiography were larger than those of two-dimensional echocardiography ( P<0.05). At the same time, 6 of the 25 patients could clearly observe the vortex phenomenon in the cardiac cavity after angiography, indicating the hypercoagulable state of the cardiac cavity. All 10 cases in the control group were developed successfully, and there was no discomfort in the course of angiography. Conclusions:Left ventricular contrast echocardiography can improve the clarity of cardiac ultrasound images, accurately judge the presence or absence of cardiac space occupying, and more accurately judge the change of cardiac cavity size, so as to provide diagnostic information for cardiac space occupying.
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@#AIM: To study the incidence and risk factors of posterior capsular opacification(PCO)after cataract surgery in diabetic patients.<p>METHODS: Clinical data of 182 cases(203 eyes)who underwent cataract phacoemulsification combined with intracellular lens implantation in our hospital from April 2016 to August were collected. The patients were divided into diabetic group(DM group, 98 eyes)and non-diabetic group(non-DM group, 105 eyes)according to whether they had diabetes before operation. DM group were divided into groups according to whether PCO occurred 30mo after cataract surgery, 26 eyes in the PCO group, and 72 eyes in non-PCO group. The incidence and grading of PCO in the DM group and the non-DM group were compared. The effects of preoperative diabetic course, HbA1c level and the presence of diabetic retinopathy on PCO in DM group were tested.<p>RESULTS: The incidence of PCO was 10.2%, 14.3%, 22.4%, 26.5% at 12, 18, 24 and 30mo in the DM group and 2.8%, 4.8%, 10.5%, and 14.3% in the non-DM group. Two groups of patients with the degree of PCO are gradually increasing, and the degree of each point in time the PCO patients with DM group were heavier than patients without DM group(all P<0.05). There were differences in the preoperative course of diabetes and the presence of DR between PCO and non-PCO groups(P<0.05), but there was no difference in the preoperative level of HbA1c(P>0.05).<p>CONCLUSION: The incidence of PCO in diabetic patients after cataract surgery was higher than that in non-diabetic patients, and the degree of opacity was more severe. Preoperative course of diabetes and the presence of DR were risk factors for PCO.
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The biological effects of ionising radiation vary according to its linear energy transfer (LET) density, with higher LET radiation having stronger biological effects than lower LET radiation at the same absorbed dose. Though we have done more research in the area of radiation effects on the ocular lens, we know little about the effects of high LET on the ocular lens. This article briefly describes the historical changes in the dose limits of the human ocular lens, investigates the epidemiology of high LET radiation eye lens, summarizes various biological experiments of high LET particles, and briefly analyzes the reasons for the high prevalence of cataracts in the plateau. It also discusses the factors that need to be considered in the future research on high LET, aiming to provide valuable information for the future research of high LET eye lens in China.
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@#Posterior capsular opacification is the most common complication after cataract extraction, which seriously influences the quality of life of patients. At present, there is no effective measure to prevent posterior capsular opacification. Surgery or Nd:YAG laser is often used in clinical, and a new treatment is urgently needed. Hippo signaling pathway is involved in the steady-state regulation of many mammalian cells and organs. Recent studies have shown that Hippo signaling pathway can regulate the proliferation, apoptosis, differentiation and other behaviors of lens epithelial cells. Hippo signaling pathway may provide a new target in the treatment of posterior capsular opacification. This article reviews the composition, regulatory mechanism of Hippo signaling pathway and its application in posterior capsular opacification. In order to provide a broader idea for the prevention and treatment of posterior capsular opacification.
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@#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.
Résumé
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.