Effect of Yangxue Runmu formula combined with sodium hyaluronate on dry eye after cataract surgery evaluated by ocular surface analyzer / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the effect of Yangxue Runmu formula combined with sodium hyaluronate on dry eye after cataract surgery by ocular surface analyzer.<p>METHODS: Totally 80 patients with dry eye after cataract surgery in our hospital from June 2019 to December 2020 were selected and divided into control group and observation group by random number table method, 40 cases in each group. The control group was treated with sodium hyaluronate eye drops, and the observation group was treated with Yangxue Runmu formula combined with sodium hyaluronate eye drops. The index levels of ocular surface analyzer and fluorescein staining(FL)score were compared between the two groups.<p>RESULTS: After treatment, the wet length of tear film, first non-invasive tear break-up time(NIBUTf), average non-invasive tear break-up time(NIBUTav)and tear meniscus height(LTMH)in the two groups were markedly higher than those before treatment(all <i>P</i><0.01), and the observation group were markedly higher than those in the control group(<i>P</i><0.05); after treatment, the conjunctival hyperemia score, meibomian gland loss score, FL score in the two groups were markedly lower than those before treatment(all <i>P</i><0.01), and the observation group were markedly lower than those in the control group(all <i>P</i><0.01); there were no obvious adverse reactions in the two groups. <p>CONCLUSION: Through the evaluation and analysis of ocular surface analyzer, Yangxue Runmu formula combined with sodium hyaluronate can effectively improve the ocular surface function of patients after cataract surgery, and has good safety.

Meta-analysis of the efficacy of sodium hyaluronate eye drops combined with rhEGF eye drops in the treatment of dry eye after cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To systematically evaluate the efficacy of sodium hyaluronate combined with recombinant human epidermal growth factor(rhEGF)eye drops in the treatment of dry eye after cataract surgery in recent 5a by Meta-analysis.<p>METHODS: The databases of CNKI, WanFang, Chongqing VIP, CBM, Cochrane Library, Pudmed and MEDLINE from January 2015 to May 2020 were searched. Meta analysis and statistical analysis were performed with Revman 5.3 software on the clinical control study of sodium hyaluronate eye drops combined with rhEGF eye drops in the treatment of dry eye after cataract surgery.<p>RESULTS: A total of 14 randomized controlled trials involving 1 529 eyes were included. Among them, 14 studies conducted corneal fluorescein staining(FL)score after the end of treatment, the results showed that the difference was statistically significant \〖<i>MD</i>= -0.86, 95%<i>CI</i>(-1.07 to -0.66), <i>P</i><0.00001\〗; 14 studies conducted tear film break-up time(BUT)measurement after the end of treatment, the results showed that the difference was statistically significant \〖<i>MD</i>=2.33, 95%<i>CI</i>(1.64, 3.03), <i>P</i><0.00001\〗, 95%<i>CI</i>(1.76 to 2.15), <i>P</i><0.00001\〗; tear secretion test(S I t)was measured in 12 studies after treatment, and the results showed that there was no significant difference \〖<i>MD</i>=0.49, 95%<i>Cl</i>(-0.52, 1.50), <i>P</i>=0.34\〗; the overall effective rate was calculated in 12 studies after treatment, and the results showed that the difference was statistically significant \〖<i>OR</i>=4.88, 95%<i>Cl</i>(3.34, 1.50), <i>P</i>=0.34\〗. The results showed that the difference was statistically significant \〖<i>MD</i>= -1.09, 95%<i>Cl</i>(-1.58, -0.61), <i>P</i><0.00001\〗.<p>CONCLUSION: Sodium hyaluronate combined with rhEGF eye drops in the treatment of dry eye after cataract surgery can significantly improve the corneal repair ability and tear film BUT, which has more advantages in the overall efficacy of the treatment of dry eye after cataract surgery.

Effect of rhEGF eye drops on xerophthalmia after cataract surgery and its influence on tear film stability / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To observe the effects of recombinant human epidermal growth factor(rhEGF)eye drops on xerophthalmia after cataract surgery and its influence on tear film stability.<p>METHODS: The clinical data of 114 patients(158 eyes)with xerophthalmia after cataract surgery were retrospectively analyzed. According to the treatment methods of xerophthalmia, the patients were divided into study group(rhEGF+sodium hyaluronate group)and control group(sodium hyaluronate group). After 4wk of treatment, the efficacy and dry eye symptoms(dry eye questionnaire)were evaluated, and the BUT, SⅠt and FL were examined. The levels of IL-1β, IL-6 and TNF-α in tear were detected.<p>RESULTS: The total effective rate in study group was greater than that in control group(<i>P</i><0.05). After 4wk treatment, the BUT and SⅠt in the two groups were higher than those before treatment, and the indexes in study group were higher than those in control group(<i>P</i><0.01). The dry eye questionnaire score and FL and levels of tears IL-1β, IL-6 and TNF-α were lower than those before treatment, and the indexes in study group were lower than those in control group(<i>P</i><0.05).<p>CONCLUSION: Addition of rhEGF eye drops for xerophthalmia after cataract surgery can significantly improve dry eye symptoms, tear film stability, tear secretion and corneal epithelial cell integrity, and reduce inflammatory response, and it has significant efficacy.

Management of late-onset flocculent after-cataract with capsular bag lavage and posterior continuous curvilinear capsulorhexis

We describe our technique for the management of late-onset liquefied after-cataract (LAC) to ensure long-term visual axis clarity. The densely adherent anterior capsular rim over the intraocular lens (IOL) optic was released with the help of microvitreoretinal blade, and multiple relaxing radial incisions were made on the capsular rim to facilitate easy access to the capsular bag. A thorough capsular bag lavage was performed with the help of bimanual irrigation-aspiration. Posterior continuous curvilinear capsulorhexis (PCCC) was performed after complete aspiration of fluid after-cataract to prevent recurrence. This technique was successfully performed in 14 cases. Postoperatively, IOL was stable and an uncorrected distance visual acuity of >20/32 was achieved in all cases. No recurrence was observed in any case over a follow-up of 1 year. Our technique of capsular bag lavage with PCCC is safe and effective for the management of LAC with optimal visual and anatomical outcomes.

The proliferative inhibition and apoptosis promotion of Smac on human lens epithelial cells / 中华实验眼科杂志

Background Posterior capsular opacification (PCO) is a primary complication after extracapsular cataract extraction.The mechanism of PCO is associated with proliferation,migration and epithelialmesenchymal transition (EMT) of human lens epithelial cells (LECs).To explore the target treatment of PCO is very important.Objective This study was to investigate the biological effects of second mitochondria-derived activator of caspases (Smac) on the proliferation and apoptosis of LECs.Methods Human LECs line (HLE-B3) and Smac-overexpressed LECs line were cultured,and the cells were transfected using small interfering RNA (siRNA)-Smac3 plasmid with green fluorescent protein (GFP) for 24 hours.Different concentration of transforming growth factor-β2 (TGF-β2) (5,10,20 and 50 μg/ml) or 200 μmol/L H2O2 were added respectively into the culture medium to establish PCO model and oxidative stress model.Cell counting kit-8 (CCK-8) assay was used to compare the cell proliferative activity among PBS group,TGF-β2 group and Smac-hyperexpression +TGF-β2 group.Flow cytometry was used to evaluate the apoptotic rate of the PBS group,H2 O2 group and siRNA-Smac+H2 O2 group.The expressions of Smac,caspase-3 and proliferating cell nuclear antigen (PCNA) mRNA and their proteins in the cells were detected by real-time quantitative PCR (RT-PCR) and Western blot.Results The GFP+ cells were≥ 80％ 12 hours after siRNA-Smac3 transfection,with the optimal plasmid of siRNA-Smac3.GFP+ cell rate was (72.32 ± 2.31)％ in the siRNA-Smac3 transfection group,which was significantly higher than that in the blank plasmid group ([4.91 ±0.24] ％) (t=116.342,P＜0.001).The relevant expression levels of Smac was 35.21 ±4.11 in the Smachyperexpression group,and that in the blank plasmid group was 15.24±2.48,with a significant difference between them (t =215.47,P＜0.05).The cell viability of 20 ng/ml TGF-β2 affected PBS group,TGF-β2 group and Smachyperepression+TGF-β2 group was (98.4 ± 1.7) ％,(98.9 ± 0.1) ％ and (64.2 ± 3.1) ％,and the cell viability of Smac-hyperepression+TGF-β2 group was significantly lower in the Smac-hyperepression+TGF-β2 group than that in the TGF-β2 group (P＜0.05).The apoptotic rate in the PBS group,H2 O2 group and siRNA-Smac+H2 O2 group were (2.9 ± 1.2) ％,(45.1 ±4.5) ％ and (27.5 ± 1.8) ％,and the apoptotic rate was evidently lower in the siRNA-Smac +H2O2 group than that in the H2O2 group (P＜0.05).RT-PCR results showed that the expression levels of caspase-3 mRNA in PBS group,H2 O2 group and siRNA-Smac + H2 O2 group were 0.321 ± 0.103,0.715 ± 0.112 and 0.479 ±0.209,respectively.Compared with the H2 O2 group,the relative expression level of caspase-3 mRNA in siRNA-Smac+ H2O2 group was significantly decreased,the difference was statistically significant (P＜ 0.05).The PCNA mRNA expression levels in PBS group,TGF-β2 group and Smac-hyperepression+TGF-β2 group were 0.299±0.013,0.645± 0.102 and 0.490±0.209,respectively.Western blot results showed that the relative expression of caspase-3 protein in siRNA-Smac+H2O2 group and H2O2 group was 0.712±0.012 and 0.973±0.051,with significant difference between the two groups (t =132.52,P＜0.05).The relative expression of PCNA protein in Smac-hyperepression+TGF-β2 group was 0.782±0.212,which was lower than 1.126±0.251 in the TGF-β2 group (P＜0.05).Conclusions Smac may prevent and treat PCO by inhibiting the proliferation and promoting apoptosis of human LECs.

Assessment of Posterior Capsular Opacification of Korean Using Straylight and Glare Sensitivity Meter

PURPOSE: To evaluate posterior capsular opacity (PCO) using straylight and glare sensitivity meter and to compare availability of straylight and glare sensitivity with known methods for PCO evaluation. METHODS: Thirty-six pseudophakic eyes with PCO were selected for this study. Best-corrected visual acuity (BCVA), straylight (C-quant, Oculus GmbH, Wetzlar, Germany) and glare sensitivity (Binoptometer, Oculus GmbH, Wetzlar, Germany) were measured before mydriasis. After mydriasis, PCO images were captured with a slit-lamp and analyzed using the Evaluation of Posterior Capsular Opacification (EPCO) program (EPCO software, University of Heidelberg, Heidelberg, Germany). The same measurements were taken after capsulotomy and compared with pre-capsulotomy data. RESULTS: After capsulotomy, BCVA, EPCO score and straylight were improved with statistical significance (p < 0.05). Cases of PCO with mildly decreased visual acuity showed statistically significantly improved EPCO score and straylight (p < 0.05). Glare sensitivity did not show significant improvement but was statistically significantly correlated with straylight (p = 0.023, Rho = 0.732). CONCLUSIONS: Straylight is an available measurement for evaluation of PCO. Glare sensitivity meter which correlates with straylight can be used as a supportive measurement.

Assessment of Posterior Capsular Opacification of Korean Using Straylight and Glare Sensitivity Meter

PURPOSE: To evaluate posterior capsular opacity (PCO) using straylight and glare sensitivity meter and to compare availability of straylight and glare sensitivity with known methods for PCO evaluation. METHODS: Thirty-six pseudophakic eyes with PCO were selected for this study. Best-corrected visual acuity (BCVA), straylight (C-quant, Oculus GmbH, Wetzlar, Germany) and glare sensitivity (Binoptometer, Oculus GmbH, Wetzlar, Germany) were measured before mydriasis. After mydriasis, PCO images were captured with a slit-lamp and analyzed using the Evaluation of Posterior Capsular Opacification (EPCO) program (EPCO software, University of Heidelberg, Heidelberg, Germany). The same measurements were taken after capsulotomy and compared with pre-capsulotomy data. RESULTS: After capsulotomy, BCVA, EPCO score and straylight were improved with statistical significance (p < 0.05). Cases of PCO with mildly decreased visual acuity showed statistically significantly improved EPCO score and straylight (p < 0.05). Glare sensitivity did not show significant improvement but was statistically significantly correlated with straylight (p = 0.023, Rho = 0.732). CONCLUSIONS: Straylight is an available measurement for evaluation of PCO. Glare sensitivity meter which correlates with straylight can be used as a supportive measurement.

Clinical effect of anterior vitrectomy for congenital cataract / 国际眼科杂志(Guoji Yanke Zazhi)

?AlM: To evaluate the clinical efficacy of posterior continuous curvilinear capsulorhexis ( PCCC ) combined with anterior vitrectomy in preventing posterior capsule opacification of congenital cataract surgery. ?METHODS:Postoperative clinical follow-up data of 82 cases ( 87 eyes ) with congenital cataract treated in Eye Center of our hospital from January 2011 to August 2014 were retrospectively analyzed. The patients were divided into the surgical control group ( 38 cases, 40 eyes, recieved phacoemulsification + PCCC ) and the study group ( 44 cases, 47 eyes, accepted phacoemulsification+ PCCC + anterior vitrectomy). The incidence of central optic axis opaque and postoperative visual acuity distribution were recorded at 1a follow - up. lntraoperative and postoperative complications were observed. ?RESULTS:The rate of central optic axis opaque grade 0 in control group was 37. 5%, compared to 76. 6% in study groups. The opacity distribution ratio of grade 1,2,3 and 4 in study group were lower than that of control group, and the central optic axis opacity distribution ratio in study group was significantly better than that of control group (P0. 5 in control group was lower than the 40 eyes ( 85. 11%) of that in study group. The visual acuity between two groups has statistical significance difference after 1a follow-up ( P ?CONCLUSlON: Combination of phacoemulsification, PCCC and anterior vitrectomy presents reliable clinical effects on postoperative central optic axis opacity distribution ratio and visual acuity, and it should be adopted to prevent the occurrence of posterior capsule opacification.

Liquefied after cataract and its surgical treatment.

Aims: To describe liquefi ed after cataract (LAC) and its surgical management following an uneventful phacoemulsifi cation with posterior chamber in-the-bag intraocular lens (IOL) implantation and continuous curvilinear capsulorrhexis (CCC). Design: Interventional case series. Materials and Methods: Eleven patients with LAC, following uneventful phacoemulsifi cation with CCC and in-the-bag IOL implantation were enrolled. After the basic slit lamp examination, each case was investigated with Scheimpfl ug photography and ultrasound biomicroscopy (UBM). Each case was treated with capsular lavage. Biochemical composition of the milky fl uid was evaluated and ring of anterior capsular opacity (ACO) was examined under electron microscope. Results: All 11 cases presented with blurring of vision after 6-8 years of cataract surgery with IOL implantation. All cases had IOL microvacuoles, 360° anterior capsule, and anterior IOL surface touch along with ACO, ring of Soemmering, and posterior capsule distension fi lled with opalescent milky fl uid with whitish fl oppy or crystalline deposits. Biochemically, the milky fl uid contained protein (800 mg/dl), albumin (100 mg/dl), sugar (105 mg/dl), and calcium (0.13%) and was bacteriologically sterile. Histologically, the dissected ACO showed fi brous tissue. All cases were successfully treated with capsular lavage with good visual recovery and with no complication. There was no recurrence of LAC during 2 years postoperative follow-up in any of the cases. Conclusions: LAC is a late complication of standard cataract surgery. It may be a spectrum of capsular bag distension syndrome (CBDS) without shallow anterior chamber and secondary glaucoma. Capsular bag lavage is a simple and eff ective treatment for LAC and a safe alternative to neodymium-doped y􀄴 rium aluminum garnet (Nd-YAG) capsulotomy.

The Influence of Vitrectomy of Nd:YAG Laser Posterior Capsulotomy

PURPOSE: This study aimed to investigate factors that cause after-cataract such as diabetes, intravitreal gas injection during vitrectomy, and other factors in relation to the vitrectomy. METHODS: The relationship between the vitrectomy and the frequency of Nd:YAG laser posterior capsulotomy was investigated in a sample of 947 monitored patients' eyes that underwent cataract surgery. The patients' eyes were classified into Group 1, which comprised 715 patients' eyes that underwent cataract surgery only, Group 2, which comprised 152 eyes that underwent both vitrectomy and cataract surgery at the same time, and Group 3, which comprised 80 eyes that underwent cataract surgery after vitrectomy. The age, gender, diabetes status, gases injected during the vitrectomy, and other factors were investigated. RESULTS: It was found that 50 eyes (6.99%) in Group 1 received the posterior capsulotomy, 28 eyes (18.4%) had the procedure in Group 2, and 16 eyes (20.00%) had the procedure in Group 3, respectively. In Group 1, 21 eyes (8.86%) that received the posterior capsulotomy were from diabetic patients, 20 eyes (19.8%) were diabetic in Group 2, and 10 eyes (21.73%) were diabetic in Group 3. In Group 1, 29 eyes (6.06%) were from non-diabetics that received posterior capsulotomy, 8 eyes (15.68%) were from non-diabetic patients in Group 2, and 6 eyes (17.64%) were from non-diabetic patients in Group 3. In the group that had vitrectomy with gas injection, 6 eyes (25%) received the posterior capsulotomy in Group 2, and 10 eyes (24.39%) had the procedure in Group 3, respectively, while those in the group that had vitrectomy without gas injection included 22 eyes (17.46%) in Group 2 and 6 eyes (15.38%) in Group 3. CONCLUSIONS: The Nd:YAG laser posterior capsulotomy was more frequently applied to patients who underwent vitrectomy, younger patients, diabetes patients, and patients who had vitrectomy with gas injection.

The Influence of Vitrectomy of Nd:YAG Laser Posterior Capsulotomy

PURPOSE: This study aimed to investigate factors that cause after-cataract such as diabetes, intravitreal gas injection during vitrectomy, and other factors in relation to the vitrectomy. METHODS: The relationship between the vitrectomy and the frequency of Nd:YAG laser posterior capsulotomy was investigated in a sample of 947 monitored patients' eyes that underwent cataract surgery. The patients' eyes were classified into Group 1, which comprised 715 patients' eyes that underwent cataract surgery only, Group 2, which comprised 152 eyes that underwent both vitrectomy and cataract surgery at the same time, and Group 3, which comprised 80 eyes that underwent cataract surgery after vitrectomy. The age, gender, diabetes status, gases injected during the vitrectomy, and other factors were investigated. RESULTS: It was found that 50 eyes (6.99%) in Group 1 received the posterior capsulotomy, 28 eyes (18.4%) had the procedure in Group 2, and 16 eyes (20.00%) had the procedure in Group 3, respectively. In Group 1, 21 eyes (8.86%) that received the posterior capsulotomy were from diabetic patients, 20 eyes (19.8%) were diabetic in Group 2, and 10 eyes (21.73%) were diabetic in Group 3. In Group 1, 29 eyes (6.06%) were from non-diabetics that received posterior capsulotomy, 8 eyes (15.68%) were from non-diabetic patients in Group 2, and 6 eyes (17.64%) were from non-diabetic patients in Group 3. In the group that had vitrectomy with gas injection, 6 eyes (25%) received the posterior capsulotomy in Group 2, and 10 eyes (24.39%) had the procedure in Group 3, respectively, while those in the group that had vitrectomy without gas injection included 22 eyes (17.46%) in Group 2 and 6 eyes (15.38%) in Group 3. CONCLUSIONS: The Nd:YAG laser posterior capsulotomy was more frequently applied to patients who underwent vitrectomy, younger patients, diabetes patients, and patients who had vitrectomy with gas injection.

Effect of cyclosporine A on the Pl - 3 k pathway in proliferation of rat lens epithelial cells / 国际眼科杂志(Guoji Yanke Zazhi)

AlM:To investigate the effect of cyclosporine A ( CsA) on the phosphatidylinositol-3 kinase ( Pl-3k ) pathway during procession of proliferation in epithelial cells of rabbit lens, and provide treatment strategies for after cataract on the basis of experiment. METHODS: Sixty eyes of 30 healthy white rabbits were operated by lens cortex removal in cataract surgery, and 30 right eyes were divided in treatment group and the other 30 eyes were divided in control group. From the first postoperative day, the control group eyes were dropped with normal saline 6 times each day, and the treatment group eyes were dropped with 1% CsA 6 times each day. Six rabbits were selected randomly and killed on the day before dropping and 1, 2wk, 1 and 2mo of postoperative day respectively. The lens of those killed rabbits were removed by surgery. The strategies of immunohistochemistry and mount in situ hybridization were used to detect the content of proliferating cell nuclear antigen ( PCNA) , gene of phosphate and tension homology deleted on chromsome ten ( PTEN) mRNA, Ser473-R, respectively. RESULTS:The expression of PCNA and Ser473-R were both down-regulate after operation in treatment group and control group, and the PCNA levels were significantly lower among treatment group than those in control group on 1wk (0.690±0.035 vs 0.785±0.015, t=6.099, P CONCLUSlON:1% CsA could inhibit the proliferation of epithelial cells in lens of rabbits with after cataract through preventing Pl-3k pathway.

Utility of optomap panoramic 200Tx in postoperative fundus examination among cataract patients / 国际眼科杂志(Guoji Yanke Zazhi)

To investigate the utility of optomap panoramic 200Tx in screening fundus disease among the patients after cataract surgery. ●METHODS: From November 18 th to December 31st , 2013 all 146 post- cataract surgery patients were recruited. All non - mydriatic fundus images were taken with the optomap panoramic 200Tx and were diagnosed by one masked retinal specialist. Non - mydriatic direct ophthalmoscope exam and mydriatic slit-lamp lens exam were also done by other two masked specialists. Comparisons of the three methods were made. ●RESULTS: Among 146 patients ( 161 eyes), 40 eyes (24. 8%) of retinal lesions was detected by non-mydriatic direct ophthalmoscope exam, 59 ( 36. 7%) by non -mydriatic optomap 200Tx exam, and 61 (37. 9%) by slit-lamp lens exam. Nine eyes ( 5. 6%) needed medical intervention immediately. Results of optomap 200Tx exams and slit - lamp lens exams were similar without statistically significant difference ( P > 0. 05), better than direct ophthalmoscope exam ( P ● CONCLUSlON: Opacification of the refractive medium makes thorough fundus examination impossible. So post-operative fundus examination is highly necessary and should be a routine. Optomap panoramic 200Tx, which shows no statistically difference from mydriatc slit- lamp lens exam, is a convenient and feasible method in discovering fundus pathological changes.

Nd-YAG laser damage affects the optical properties of intraocular lens / 中国组织工程研究

BACKGROUND:Posterior capsulotomy with Nd-YAG laser is the main method in clinic for the treatment of after-cataract, but it often damages the intraocular lens during the treatment. OBJECTIVE:To research the effect of Nd-YAG laser damage on the intraocular lens optical properties based on the laboratory testing. METHODS:Ten hydrophobic acrylic intraocular lenses were col ected as the test samples, and then Nd-YAG laser with the pulse energy of 5.0 mJ was used for 50 single-pulse laser shooting on the center of a circle with the diameter of 3 mm on the back surface of each sample. The shapes of the damaged area on the samples were observed under scanning electron microscope after laser shooting. Optical analyzer was used to test the average optical power and optical power distribution. RESUTLS AND CONCLUSION:The intraocular lenses were observed under scanning electron microscope under 40 times and 1 000 times enlargement and showed that there was circle-like depression with the diameter about 50μm on the back surface of the intraocular lenses, and there was protruding around the depression. Intraocular lens optical analyzer test results showed that there was no significant change in the average optical power of intraocular lenses after laser damage, but the optical power distribution was changed significantly. In the center of the circle with the diameter of 3 mm, the optical power showed annular distribution radiating to the surrounding tissue with the center of circle-like depression area. The Nd-YAG laser damage has less effect on the optical power, but has great effect on the optical power distribution of intraocular lenses.

Randomized-controlled study on anti-inflammation and safety of three drugs after Nd : YAG laser posterior capsulotomy / 中华实验眼科杂志

Background Nd: YAG laser posterior capsulotomy is an important way for after cataract.Usually the patient will use glucocorticoid eye drops to treat the anterior chamber inflammation after operation,but there is potential risk of elevating intraocular pressure (IOP).Objective This study was to compare the clinical effectiveness and safety of loteprednol etabonate ophthalmic suspension,tobramycin+ dexamethasone eye drops and fluorometholone eye drops following Nd: YAG laser posterior capsulotomy.Methods A randomized-controlled clinical trail was performed.One hundrcd and seventy-onc cycs of 127 paticnts who received Nd: YAG laser posterior capsulotomy for after cataract were randomly divided into four groups.Loteprednol etabonate ophthalmic suspension,fluorometholone eye drops,tobramycin+dexamethasone eye drops and systane eye drops was topically administered respectively in the four groups after laser posterior capsulotomy and 6 times per day for 5 days.IOP was measured with Goldmann tomometer 1 hour before operation and 1 hour,1 day,3 days and 7 days after operation.The ocular anterior segment inflammatory response was examined under the slit lamp and scored based on the Peizeng criteria.Written informed consent was obtained from each patient before any relevant medical procedure.Results The IOP was (18.2 ±4.7),(20.1 ±5.7),(18.7±5.5),(19.0 ±4.1),(19.5 ±3.5) mmHg in various time points in the loteprednol etabonate group; (18.7 ±5.3),(20.9±5.7),(21.3±4.5),(21.0±4.9),(22.5±6.5) mmHg in the fluorometholone eye drops group ; (17.9± 6.3),(20.3 ± 6.1),(23.0 ± 3.7),(24.7 ± 4.9),(24.5 ± 6.5) mmHg in the tobramycin +dexamethasone group and(18.4±6.3),(20.7±3.7),(22.7±6.5),(19.6±4.8),(18.5±3.5) mmHg in the systane group,showing a significant difference among the 4 groups (Fgroup =3.876,P =0.023).With the time lapse,the IOP was gradually reduced in the loteprednol etabonate group and systane group,but that in the fluorometholone group and tobramycin+dexamethasone group was elevated,showing a significant difference among them (Ftime =3.801,P =0.031).No any ocular and systemic adverse effect was found in various groups.The percentage of grade 1 and 2 of aqueous inflammatory cells was lower in the loteprednol etabonate group and tobramycin+dexamethasone group than the fluorometholone group and fluorometholone group and systane group(H =8.276,P =0.012).The percentage of Ⅰgrade of aqueous flare was 8％ in the loteprednol etabonate group,22％ in the fluorometholone group,18％ in the tobramycin+dexamethasone group and 30％ in the systane group,with a significant difference among them (H=9.305,P=0.000).Conclusions The use of corticosteroid eye drops can relieve the inflammatory response of ocular anterior chamber after Nd: YAG laser posterior capsulotomy.Loteprednol etabonate ophthalmic suspension has a better anti-inflammatory effect and less influence on IOP.

The Clinical Outcomes of 23-Gauge Transconjunctival Sutureless Vitrectomy for Endophthalmitis after Cataract Surgery

PURPOSE: To report the clinical outcomes and utility of 23-gauge (G) transconjunctival sutureless vitrectomy (TSV) in patients with postoperative endophthalmitis following cataract surgery. METHODS: The medical records of 16 patients (17 eyes) who underwent 23-G TSV between January 2008 and December 2009 at Konyang University Hospital due to postoperative endophthalmitis following cataract surgery were retrospectively analyzed. The pre- and post-operative best-corrected visual acuities (BCVA), changes in intraocular pressure, the time from diagnosis to surgery, the intraoperative and postoperative complications, and the average duration of hospitalization were investigated. RESULTS: The mean BCVA significantly improved from log MAR 1.89 +/- 1.03 to log MAR 0.42 +/- 0.82 (p = 0.001), and the mean intraocular pressure changed from 16.1 +/- 4.1 mm Hg at baseline to 16.2 +/- 3.3 mm Hg on the first postoperative day without any significant difference (p = 0.955). In addition, none of the patients required sutures to treat wound leakage or showed hypotony on follow-up observation. The average operation time was 64.7 +/- 22.5 minutes, and the average duration of hospitalization was 5.4 +/- 4.5 days. CONCLUSIONS: The use of 23-G TSV in patients with postoperative endophthalmitis following cataract surgery may offer more convenience for the surgeon and more comfort for the patient. In addition, the patient may return to normal life earlier with a shortened duration of hospitalization.

Inhibition of polylysine-EDTA on rabbit lens epithelial cell growth in vitro / 中华实验眼科杂志

BackgroundPosterior capsule opacification(PCO) is the main cause inducing low vision after extacapsular cataract extraction. Our previous study determined that polylysine-ethylene diamine tetraacetic acid (EDTA) (PLE) can suppress the incidence of PCO. ObjectiveThe goal of this experiment was to investigate the inhibition of polylysine-EDTA on rabbit lens epithelial cells (LECs)proliferation in vitro and the effective concentrations of polylysine-EDTA. MethodsThe anterior capsular membranes from 10 3-month-old clean New Zealand white rabbits were digested and then cultured to obtain the LECs. The second and third generation of LECs were inoculated on the 96-hole culture plate with the cell density of the 1 × 105/ml. 12.5,25.0,50. 0,100. 0 μmol/Lof PLE were added into the culture medium for 48 hours respectively,and the DMSO medium was used at the same way as the control group. The proliferation of the LECs was then detected by MTT method and the inhibitory rate of PLE on LECs growth was calculated. ResultsLECs grew at a near normal state in ≤25.0 μmol/L PLE groups,however,cultured LECs were out of shape and the numbers decreased with the weakened adhesion ability in ≥50.0 μ mol/L PLE groups. The A490 values of LECs were 0. 278±0. 013,0. 266±0. 028,0. 260±0. 022 and 0. 247±0. 012 in 12. 5,25.0,50. 0, 100. 0 μmol/L polylysine-EDTA groups respectively and were lower than 0. 311 ±0. 038 of DMSO control group( P=0. 035,0. 011,0. 009,0.013 ). The inhibitory rates of 12. 5,25.0,50. 0, 100.0 μmoL/L PLE on LECs proliferation were 10.61％ , 14.47％ , 16.40％ and 20. 58％ respectively. ConclusionsPolylysine-EDTA can inhibit the growth and proliferation of LECs in vitro at a dose-dependent manner.

Pars Plana Vitrectomy Combined With Surgical Removal of Anterior and Posterior Capsular Opacity

PURPOSE: To evaluate the efficacy and intraocular lens (IOL) stability of vitrectomy combined with the surgical removal of anterior capsular opacity (ACO) and posterior capsular opacity (PCO). METHODS: Forty-four pseudophakic eyes of 43 patients with retinal disorders underwent vitrectomy with surgical removal after cataract diagnosis. Nineteen eyes of 19 patients (group 1) had ACO and PCO removed while 25 eyes of 24 patients (group 2) had only PCO removed. Total removal of the entire lens capsule, except for the area around the haptics, was performed when capsular opacity with fibrosis was observed around the capsulorrhexis margin. LogMAR best corrected visual acuity (BCVA), intraoperative complications and postoperative complications were compared. RESULTS: The retina was flat and postoperative BCVA improved in both groups. Intraoperative complications of IOL dislocation occurred in 3 eyes (15.8%) in group 1 and in 1 eye (4.0%) in group 2 (p=0.178). Among the 4 IOLs, 3 were open-loop haptic IOLs and 1 was a closed-loop haptic IOL. Late postoperative complications of IOL capture occurred in 1 eye (5.3%) in group 1. CONCLUSIONS: Removal of ACO and PCO for better visualization of the peripheral retina resulted in an improved visual recovery while intraoperative complications and postoperative complications were comparable to PCO removal alone. Removal limited to the optic zone would be more stable when considering any adhesion between the lens capsule and the IOL.

The effects of TiO_2 nano thin film on the migration and adherence of BLEC in vitro / 眼科研究

Objective The generate of posterior capsular opacification(PCO)is associated with the adhensive and migration of residual subcapsular lens epithelial cells(LECs).Titanium dioxide(TiO_2)nanometer is proved to have the ability of killing tumor cells and cultured bovine LECs.This study tried to observe the effects of TiO_2 nanometer thin film provoked by light on adhesiveness and migration of bovine LECs in vitro.MethodsThe fresh bovine lenses were obtained and cultured in DMEM containing 10% of newborn bovine serum.The second to fifth generation of cells were used in this experiment.The slide modified by TiO_2 photocatalyst film was prepared by sol-gel method.Cultured cells were seeded in filmed or unfilmed slides respectively and exposed to ultraviolet(wavelength 365 nm)for 20 or 40 minutes.The contact angle between water drop and slide was measured by droping method and the cells adhered to slides were calculated after 24 and 48 hours of culture.The growth status and migration distance of bovine LECs were assayed and compared between filmed and unfilmed groups.ResultsThe contact angle between water drop and slide was 0°±2°and 18.825°±2.342° in filmed and unfilmed group respectively,indicating a obviously smaller contact angle in TiO_2 filmed group than unfilmed one.The numbers of bovine LECs adhered to filmed slide was considerably reduced in TiO_2 filmed group compared with unfilmed group in different UVA exposure time(t_(0 min)=5.492,P=0.001;t_(20 min)=6.031,P=0.000;t_(40 min)=6.828,P=0.000).However,no significant difference was found in the numbers of adhensive cells among 3 UVA irradiation time points(F=1.278,P=0.297).The migration distance of the cells was significantly shorter in TiO_2 filmed group in comparison with unfilmed group in 24 and 48 hours after UVA irradiation(F_(group)=14.965,P=0.000;F_(time)=38.033,P=0.000).ConclusionThe TiO_2 nanometer thin film is characterized by the superhydrophilic property.So it can effectively impede the adhesion and migration of bovine LECs in vitro.

The effects of elemene on proliferation and cell cycle of human lens epithelial cells / 眼科研究

Objective To suppress the proliferation of lens epithelial cells (LECs) is a primary goal in prevention of after cataract. Recent study demonstrated an effective inhibition of elemene(Ele) on tumor cells. Present study was to investigate the effects of Ele on proliferation and cell cycle of human LECs B3 (HLE-B3). Methods Recombinant human basic fibroblast growth factor(rhbFGF) was utilized to induce proliferation of HLE-B3. Proliferative HLE-B3 was incubated with 80 mg/L Ele in CO_2 incubator for 24 hours. Then the inhibitory effects of Ele on proliferation of HLE-B3 was evaluated by methyl thiazolyl tetrazolium(MTT). The effect of Ele on HLE-B3 morphology was observed under the optical microscope. The effect of Ele on HLE-B3 cell cycle was analyzed by flow cytometer(FCM). Results MTT test showed that the optical density (OD) value of rhbFGF group was remarkably higher than that of control group(0. 599 0 ± 0. 053 1 versus 0. 409 1 ± 0. 042 2) (P ＜ 0. 01), and that of Ele group(0. 450 0 ±0. 061 4) was obviously declined in comparison to rhbFGF group(P ＜0. 01) . The inhibitory rate of Ele was 24.90 %. In proliferation group, the number of HLE-B3 was increased with the normal cell structure and abundant cytoplasm under the optical microscope. However, in Ele group, the number of HLE-B3 was evidently decreased with less cytoplasm, undistinguished cell structure, condensed and aggregated nucleuses. The result of flow cytometer showed that the percentage of HLE-B3 in G_1 phase in rhbFGF group was 42. 062% ± 1. 270% and that in control group was 46. 422% ±3. 765% with a significant difference(P ＜ 0. 05). HLE-B3 in G_1 phase in Ele group (60. 665% ±2.069%) was evidently increased in comparison with rhbFGF group (P ＜ 0. 01). HLE-B3 in S phase in rhbFGF group compared with control group was increased (51.647% ±1.123% versus 31.842% ± 2. 798%) (P ＜ 0. 01), but that in S phase in Ele group(30. 222% ±3.429%) was lower than rhbFGF group (P ＜ 0. 01). HLE-B3 in G_2 phase in rhbFGF group was decreased in comparison with control group (6. 288% ± 0. 966% versus 21. 735% ± 3. 806%, P ＜ 0. 01), and that in G_2 phase in Ele group (9. 112% ± 1. 659%) compared with proliferation group was increased (P ＜ 0. 01). Conclusion Ele could alter the cell cycle of HLE-B3 and effectively inhibit the HLE-B3 proliferation induced by rhbFGF. Ele may be a reliable and effective drug for prevention and treatment of after cataract.