Hydrophilic Intraocular Lens Opacification � A Case Report

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

Advances in the role of vascular endothelial growth factor in the pathogenesis of posterior capsule opacification / 中华实验眼科杂志

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.

Effect of anterior capsule polishing on the visual quality after cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

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.

Inhibitory effect of siRNA-Pax6 on biological behavior and epithelial-mesenchymal transition of human lens epithelial cells / 中华实验眼科杂志

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.

Inhibition of lens epithelial cell migration using different square-edge intraocular lenses in an in vitro capsular bag model / 中华实验眼科杂志

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.

Advances in interdisciplinary medical and engineering research of intraocular lens surface modifications to prevent posterior capsule opacification / 中南大学学报(医学版)

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.

Short Term Visual and Refractive Outcome following Surgical Intervention forPosterior Capsule Opacification (PCO) in Children in a Tertiary Eye Hospital

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 3.59yearswhilst that for PCO surgery was 9.68 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.

Observation of intraocular lens and posterior capsular attachment after high myopia cataract operation by new generation of AS-OCT / 国际眼科杂志(Guoji Yanke Zazhi)

@#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)mm² 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)mm² 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.

To Study the Outcome of Cataract Surgery in a Rural Indian Population Which Primarily Depends on Camps and NGOs for a Free Cataract Surgery

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.

Let-7a-5p represses proliferation, migration, invasion and epithelial-mesenchymal transition by targeting Smad2 in TGF-β2-induced human lens epithelial cells

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.

Posterior capsule opacification after cataract surgery in children over five years of age with square-edge hydrophobic versus hydrophilic acrylic intraocular lenses: a prospective randomized study

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.

A comparison of posterior capsular opacification after implantation of three different hydrophobic square edge intraocular lenses

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.

Objective evaluation of vision quality in pseudophakic patients with posterior capsular opacification using double-pass retinal imaging / Avaliação objetiva da qualidade da visão em pacientes pseudofácicos com opacificação capsular posterior pelo método de dupla passagem de luz

ABSTRACT Purpose: The purpose of this study was to objectively assess the optical vision quality of patients before and after Nd:YAG capsulotomy for posterior capsular opacification using a double-pass retinal imaging system. Methods: We retrospectively analyzed the data from 26 pseudophakic eyes with posterior capsular opacification that underwent Nd:YAG capsulotomy. The objective scatter indices, modulation transfer function cutoff frequencies, Strehl ratios, and logMAR corrected distance visual acuities were assessed before and after YAG capsulotomy with a double-pass retinal imaging system (OQAS II, Visiometrics, Spain). We also analyzed data from a subgroup of 10 patients with pre-YAG corrected distance visual acuity of 0.10 logMAR (20/25) or better. Results: Vision quality indices improved in all 26 eyes, resulting in a statistically significant improvement in the corrected distance visual acuity (p=0.007), objective scatter index (p=0.001), modulation transfer function cutoff frequency (p=0.001), and Strehl ratio (p=0.020). The overall mean improvements included 0.12 ± 0.04 logMAR for corrected distance visual acuity, 2.84 ± 0.76 for objective scatter index, 12.29 ± 2.77 for modulation transfer function cutoff frequency, and 0.06 ± 0.03 for Strehl ratio. Our sub-analysis of 10 eyes with 0.10 logMAR (20/25) corrected distance visual acuity or better also showed a statistically significant improvement in the mean objective scatter index (0.76 ± 16; p=0.001), resulting in approximately 35% decrease in intraocular light scatter. Conclusions: The objective vision quality measurements as assessed by the double-pass retinal imaging system showed a significant improvement after YAG capsulotomy. This suggests that the objective scatter index improves after YAG capsulotomy, even in eyes with pre-YAG 0.10 logMAR (Snellen 20/25) corrected distance visual acuity or better.

RESUMO Objetivo: Avaliar objetivamente a qualidade da visão óptica antes e depois da capsulotomia com Nd: YAG, obtida por imagem pelo metodo de dupla passagem de luz em pacientes com opacificação capsular posterior. Método: Análise retrospectiva de 26 olhos pseudofácicos com opacificação capsular posterior visualmente significativa, que foram submetidos à capsulotomia de Nd: YAG. O índice de dispersão objetiva, a função de transferência de modulação, a relação de Strehl e a acuidade visual à distância corrigida foram avaliados antes e após a capsulotomia com YAG usando o dupla passagem de luz (OQAS II, Visiometrics, Espanha). Também foi analisado um subgrupo de pacientes com acuidade visual à distância corrigida pré-YAG de 0,10 logMAR (20/25) ou melhor. Resultados: Os índices de qualidade da visão melhoraram em todos os 26 olhos, resultando em uma melhora estatisticamente significativa na acuidade visual à distância corrigida (p=0,007), índice de dispersão objetiva (p=0,001), função de transferência de modulação (p=0,001) e relação de Strehl (p=0,020). A melhora média na acuidade visual à distância corrigida foi de 0,12 ± 0,04 logMAR, no índice de dispersão objetiva foi de 2,84 ± 0,76, no função de transferência de modulação foi de 12,29 ± 2,77 e na razão de Strehl foi de 0,06 ± 0,03 em todos os olhos. Sub-análise de 10 olhos com 0.10 logMAR (20/25) acuidade visual à distância corrigida ou melhor também mostrou uma melhora estatisticamente significativa no índice de dispersão objetiva (p=0,001). A melhora média no OSI foi de 0,76 ± 16, uma diminuição de 35% na dispersão da luz intraocular. Conclusões: A qualidade da visão avaliada pelo dupla passagem de luz mostra uma melhora significativa nas medidas objetivas da qualidade da visão após a capsulotomia do YAG. O índice de dispersão objetiva melhora após a capsulotomia YAG, mesmo em olhos com acuidade visual à distância corrigida pré-YAG de 0,10 logMAR (Snellen 20/25) ou melhor.

Pars Plana Posterior Capsulectomy during Phacovitrectomy

PURPOSE: To evaluate the efficacy and safety of pars plana posterior capsulectomy (PPPC) during phacovitrectomy. METHODS: In this retrospective study, 76 patients (76 eyes) who underwent phacovitrectomy were enrolled. The patients were divided into two groups according to whether PPPC was performed during phacovitrectomy. In group A, PPPC using a vitreous cutter was combined with phacovitrectomy; in group B, only phacovitrectomy was performed. The best-corrected visual acuity (BCVA), predicted and actual refractive errors, adverse events, and posterior capsular opacity (PCO) were analyzed and compared between the two groups. RESULTS: Age, sex, and pre- and postoperative BCVA were not significantly different between group A (n = 37) and group B (n = 39). No intraoperative complications were identified in either group. In group A, the actual refraction (postoperative 2 months) was −0.44 ± 0.88 diopters (D) and a mild hyperopic shift was found compared to the preoperative predicted refraction (−0.56 ± 0.40 D). In group B, the actual refraction was −0.70 ± 0.72 D and a mild myopic shift was found compared to the preoperative predicted refraction (−0.60 ± 0.81 D). The difference in refraction shifts between the two groups was not significant but very close to it (p = 0.050). In group A, yttrium-aluminum-garnet (YAG) laser posterior capsulotomy was not required. However, PCO was observed in 10 eyes in group B, 6 of which subsequently underwent YAG laser posterior capsulotomy at the last follow-up. Lens instability such as dislocation or subluxations was not observed during the follow-up period. CONCLUSIONS: PPPC combined with phacovitrectomy may lead to hyperopic refractive changes. However, this was a safe and effective approach to prevent PCO and additional YAG laser posterior capsulotomy.

Comparison of the Neodymium-doped Yttrium Aluminum Garnet Capsulotomy Rate with Viscoimplantation and the Hydroimplantation Intraocular Lens Technique

PURPOSE: To investigate the rate of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy in the hydroimplantation intraocular lens (IOL) technique. METHODS: This retrospective study was comprised of 6,192 eyes in 3,790 patients who underwent surgery from January 2013 to September 2017 and then were followed up for at least 1 year. The eyes of these patients were divided into two groups: either viscoimplantation or hydroimplantation. The follow-up examinations were carried out on the 1st day, 4th day, 1st month, and 3 months to 1 year postoperatively. The Nd:YAG capsulotomy rates were evaluated by the different IOL implantation techniques and IOL materials. RESULTS: The mean follow-up duration of the patients was in the viscoimplantation group 14.85 ± 2.43 and 15.05 ± 1.93 months in the hydroimplantation group. The Nd:YAG capsulotomy rate was significantly lower in the hydroimplantation group compared with the viscoimplantation group for the entire hydrophilic IOL model (p < 0.001). In addition, the Nd:YAG rate was lower in the hydroimplantation group that used a hydrophilic IOL than it was in the viscoimplantation group, which used a hydrophobic IOL. CONCLUSIONS: The hydroimplantation technique reduced the Nd:YAG capsulotomy rate.

Effects of long noncoding RNA-MIAT on lens epithelial to mesenchymal transition induced by transforming growth factor-β2 / 中华实验眼科杂志

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.

Research progress of non-coding RNA in posterior capsule opacification / 国际眼科杂志(Guoji Yanke Zazhi)

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.

Influence of posterior capsular opacity and its removal on retinal nerve fiber layer thickness measured with spectral domain optical coherence tomography / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the influence of posterior capsular opacity(PCO)and its removal on retinal nerve fiber layer(RNFL)thickness measured with spectral domain optical coherence tomography(SD-OCT).<p>METHODS: Fifty patients underwent RNFL measurements using SD-OCT before and after Nd: YAG laser posterior capsulotomy. The patients were divided into groups according to the value of signal to noise ratio(SNR)measured by SD-OCT as group 1: SNR 3 and 4, group 2: SNR 5 and 6 and group 3: SNR 7 and 8. The other eye served as control(control group).<p>RESULTS: The mean BCVA, SNR and RNFL measurements significantly increased in eyes underwent Nd: YAG laser capsulotomy. The preoperative and postoperative mean BCVA, SNR and RNFL measurements were significantly different in group 1 and group 2. Although the preoperative and postoperative mean BCVA and SNR were significantly different, the preoperative and postoperative RNFL thickness weren't significantly different in group 3.<p>DISCUSSION: PCO has an influence on OCT image quality. SNR improved in all cases after removal of the PCO. However, RNFL thickness significantly improved after Nd:YAG laser capsulotomy in patients with preoperative SNR under 7.

Application of RNA interference in posterior capsule opacification by interfering signaling pathway / 中华实验眼科杂志

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.

Inhibition effects of sulforaphane-induced autophagy flux to cell proliferation on ex vivo human capsular bags / 中华实验眼科杂志

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.