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OBJECTIVE To investigate the effect and potential mechanism of sodium ferulate （SF） on corneal endothelial dysfunction and corneal endothelial cell （CEC） injury. METHODS The male New Zealand rabbits were divided into control group， benzalkonium chloride （BAK） group and BAK+SF group， with 6 rabbits in each group. Except for control group， the other groups were given BAK into the anterior chamber to induce bullous keratopathy model， and BAK+SF group then given SF solution 200 mg/kg intraperitoneally the next day after surgery， twice a day， for consecutive 14 d. The transparency of corneal and edema of corneal stroma in each group of rabbits （before and on the 1st， 7th， and 14th day after surgery） were observed， and the corneal thickness （14th day after surgery） and intraocular pressure （1st to 14th day after surgery） were measured. On the 14th day after operation， the corneal endothelial structure was evaluated and the expressions of functionally related proteins [phalloidin， zonula occludens-1 （ZO-1）， Na+/K+-ATPase， Ki67] were detected. On the 14th day after surgery， the corneal tissue was collected in BAK group， the primary rabbit CECs were isolated and cultured， and they were divided into blank group and SF groups with different mass concentrations. The cell viabilities after being cultured for different time， and the protein expressions of Ras homologous gene family A （RhoA）， bone morphogenetic protein receptor 1A （BMPR1A） and BMRP2 were determined in each group. RESULTS Compared with BAK group， the transparency of corneal and edema of corneal stroma were gradually improved， and the corneal thickness was significantly decreased in BAK+SF group （P＜0.05）. The rabbit CECs in BAK+SF group were only damaged to zone B and showed a normal hexagonal endothelial cells structure. The protein expressions of phalloidin， ZO-1， Na+/K+-ATPase and Ki67 in BAK+SF group were significantly increased （P＜0.05）. When SF concentration was lower than and equal to 200 mg/L， it could promote the proliferation of rabbit CEC， in concentration manner （P＜0.05） and time-dependent trend. SF at concentrations of 50， 100， and 200 mg/L could up-regulate the protein expressions of RhoA， BMPR1A and BMPR2 in concentration-dependent manner （P＜0.05）. CONCLUSIONS SF can improve the transparency of corneal and edema of corneal stroma in bullous keratopathy model rabbits， reduce corneal thickness， maintain the integrity of corneal endothelium structure， and promote the recovery of corneal endothelial function； this compound can promote the proliferation of CEC， the mechanism of which may be related to the activation of RhoA-ROCK-BMP pathway.
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AIM: To compare the clinical efficacy of the Balanced energy system versus the conventional torsional ultrasound system in phacoemulsification surgeries for cataracts with varying nuclear hardness.METHODS: In this study, 120 patients(122 eyes)with age-related cataracts scheduled for surgery between November 2021 and November 2022 at our hospital were randomly divided into two groups: 58 patients(59 eyes)in the experimental group underwent surgery using the Balanced energy system, while 62 patients(63 eyes)in the control group were treated with the conventional torsional ultrasound system. Intraoperative cumulative dissipated energy(CDE), case time(CT), aspiration time(AST), and estimated fluid used(EFU)were recorded. Patients were followed-up for 3mo to examine and record the best-corrected visual acuity(BCVA)and corneal endothelial cell density(ECD), and to calculate the rate of endothelial cell loss.RESULTS: Comparing the intraoperative parameters between the two groups, there was no significant difference in CT(P>0.05), but the CDE, AST and EFU of the patients in the experimental group were lower than those of the control group(P<0.05), and the CDE of patients with grade III nuclear hardness in the experimental group was lower than the control group(P<0.05), CDE, AST and EFU in patients with grade IV nuclear hardness were lower than those in the control group(P<0.05). After 3mo of follow-up, BCVA in both groups improved significantly, and the experimental group recovered faster than the control group. At 3mo after surgery, the ECD of the two groups of patients was reduced compared with that before surgery(P<0.01), but there were no significant differences in ECD and endothelial cell loss rates between the experimental and control groups before and at 3mo after surgery(P>0.05). In grade IV nuclear hardness cataracts, the rate of endothelial cell loss in the experimental group was significantly lower than that in the control group(4.63%±4.10% vs. 6.63%±4.49%, P<0.01).CONCLUSION: The Balanced energy system and the conventional torsional ultrasound system both show high safety and efficiency in phacoemulsification of cataracts with different nuclear hardness. However, the former demonstrates substantial advantages in cases with dense nuclei, offering lower ultrasound energy, shorter aspiration and infusion times, and reduced volume of infusion fluid.
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AIM: To evaluate the efficacy of Ahmed glaucoma valve implanting through the ciliary sulcus in the treatment of intraocular lens(IOL)glaucoma.METHODS: Retrospective case series study. The clinical data of 18 patients(18 eyes)with IOL glaucoma from February 2020 to February 2022 in Liuzhou Red Cross Hospital were collected. All patients underwent Ahmed glaucoma valve implanting through the ciliary sulcus. The visual acuity, intraocular pressure, corneal endothelial cell density, corneal endothelial cell loss rate and complications were observed before operation and 1, 3, 6 and 12mo after operation.RESULTS: The mean intraocular pressure before operation was 43.41±5.33 mmHg. The mean intraocular pressure at 1, 3, 6 and 12mo after operation were 12.11±3.26, 13.82±4.12, 13.54±3.83 and 15.80±4.35 mmHg respectively. The mean intraocular pressure at each follow-up point after operation was significantly lower than that before operation(F=203.40, P<0.01). The corneal endothelial cell density at each time point after surgery was lower than that before surgery(F=6.18, P<0.01), but there were no significantly differences in the density and loss rate of corneal endothelial cell at 1, 3, 6 and 12mo after surgery(P>0.05). Furthermore, the overall surgery success rate was 83%.CONCLUSIONS: Ahmed glaucoma valve implanting through the ciliary sulcus is safe and effective in the treatment of IOL glaucoma, and the damage to corneal endothelial cells is mild. The corneal endothelial cells density doesn't decrease with time after surgery.
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@#AIM: To observe the safety and effect of cataract extraction combined with intraocular lens(IOL)implantation surgery in patients with abnormal morphology of corneal endothelium. <p>METHODS: We collected 72(90 eyes)age related cataract patients with abnormal morphology of corneal endothelium and 120(158 eyes)patients with normal morphology of corneal endothelium from January 2018 to January 2020 in our hospital. All of them measured corneal endothelial cell density(CD)>2 000cell/mm<sup>2</sup> and underwent phacoemulsification combined with IOL implantation. CD, coefficient of variation(CV), frequency of hexagonal cells(HEX), central corneal thickness(CT)were recorded at 1wk, 1, 3mo postoperatively and compared in each group.<p>RESULTS:There were significant differences in endothelial CD, CV, HEX and CT between the two groups 1wk and 1mo postoperative, while there were significant differences in CD and HEX between the two groups after 3mo, but there were no significant differences in CV and CT.<p>CONCLUSION: Endothelial damage after phacoemulsification in abnormal morphology of corneal endothelium group is comparable to that in control group, and we should pay more attention to the examination of corneal endothelium, especially the corneal endothelial cells morphology before operation and protect it during operation.
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@#AIM: To investigate the changes of corneal endothelial cells and ocular surface after phacoemulsification for age-related cataract(ARC)patients with diabetes mellitus. <p>METHODS: Retrospective case study. A total of 190 cataract patients with diabetes mellitus who received phacoemulsification combined with IOL implantation in 190 eyes admitted to our hospital from January 2017 to January 2019 were selected. In addition, 230 ARC patients without diabetes who underwent phacoemulsification and intraocular lens implantation at the same time were selected as the control group. Ocular surface disease index(OSDI)score, tear film rupture time(BUT), basal tear secretion test(S I t), corneal endothelial cell density and coefficient of variation were compared between the two groups.<p>RESULTS: There was no significant difference in preoperative OSDI score, BUT, S I t, corneal endothelial cell density and coefficient of variation between the two groups(<i>P</i>>0.05). In the observation group, OSDI scores were significantly increased 1wk, 1mo and 3mo after surgery compared with those before surgery, with statistically significant differences(all <i>P</i><0.01). The OSDI scores of patients in the control group increased significantly one week and one month after the operation compared with those before the operation, with statistically significant differences(all <i>P</i><0.01). The OSDI scores in the observation group at each time point after the operation were higher than those in the control group, with statistically significant differences(all <i>P</i><0.05). One week after surgery, 1mo after surgery, BUT and S I t in the two groups decreased significantly compared with that before surgery(<i>P</i><0.05), and the difference was not statistically significant compared with that before surgery 3mo after surgery. In addition, compared with BUT between the two groups, the observation group had a lower tear film stabilization time and a more significant decrease(<i>P</i><0.05). The corneal endothelial cell density in the two groups decreased significantly 1wk, 1mo and 3mo after surgery compared with that before surgery(<i>P</i><0.05). The variation coefficient of corneal endothelial cells in the two groups was statistically significant 1wk after the operation and 1mo after the operation compared with that before the treatment(<i>P</i><0.05). The variation coefficient of corneal endothelial cells in the observation group was more significant than that in the control group(<i>P</i><0.05).<p>CONCLUSION: Cataract patients with diabetes surgery tolerance is low, the corneal endothelial cell density and the central corneal thickness and corneal appears before tear secretion with stability and foundation treatment have significant changes, and its characteristic is cataract patients without diabetes more apparent, clinical intraoperative and postoperative corneal endothelial protection should be strengthened, and the surface of the eye protection ability of the organization.
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BACKGROUND: After phacoemulsification combined with trabeculectomy in patients with cataract and glaucoma, blood lipid ratio and insulin sensitivity are associated with intraocular pressure, visual acuity and corneal endothelial cells, which may be used for the evaluation of efficacy. Interleukins are the main mediators of the inflammatory response and are involved in the pathogenesis of cataract. OBJECTIVE: To examine the postoperative changes in interleukin-10, interleukin-2 and interleukin-13 levels in patients with cataract with glaucoma, and to analyze the correlation between insulin sensitivity and corneal endothelial cell density so as to assess whether inflammatory factors can be used to evaluate efficacy. METHODS: This prospective, single-center, open-label, self-controlled clinical trial will include 160 patients with cataract combined with glaucoma, 35-65 years of age, from the Department of Ophthalmology, First Affiliated Hospital of Kunming Medical University in China. All patients will receive phacoemulsification and trabeculectomy, and will be followed up at 5 days and at 1 and 3 months postoperatively. Data collection and patient recruitment will begin on December 30, 2019 and end on December 30, 2020. Analysis of the results will be performed from May 1, 2021 to May 30, 2021. This study is scheduled to end on June 30, 2021. This study was approved by the Medical Ethics Committee, First Affiliated Hospital of Kunming Medical University, China, on December 15, 2013 (approval No. 20131215085), and will be performed in accordance with the principles of the Declaration of Helsinki, adopted by the World Medical Association. Written informed consent to participate will be obtained from the participants. This study was registered with the Chinese Clinical Trial Registry on September 10, 2019 (registration number: ChiCTRI 900025837). Study protocol version is 1.0. RESULTS AND CONCLUSION: The primary outcome measure will be serum interleukin-2 level, as an index of the inflammatory response, 3 months after surgery. Secondary outcome measures will include serum interleukin-2 level before and 5 days and 1 month after surgery, serum levels of interleukin-1β, interleukin-10, C-reactive protein and tumor necrosis factor-a, best corrected visual acuity, endothelial cell density, mean cell area, coefficient of variation, insulin sensitivity index and intraocular pressure before and 5 days and 1 and 3 months after surgery, and incidence of adverse reactions at 5 days and 1 and 3 months after surgery. From January 2014 to June 2017, our team undertook and completed a small-sample study of 80 cataract patients (95 eyes) with glaucoma. The best corrected visual acuity was significantly improved, endothelial cell density and intraocular pressure were significantly reduced, interleukin-1β, interleukin-2, interleukin-10, C-reactive protein and tumor necrosis factor-a levels were significantly decreased (P < 0.05), and mean cell area, coefficient of variation and insulin sensitivity index were significantly increased (P < 0.05) after phacoemulsification and trabeculectomy. None of the patients had adverse reactions during the treatment. The trial will attempt to explore whether phacoemulsification combined with trabeculectomy has a good therapeutic effect in patients with cataract combined with glaucoma, and clarify whether the effect is associated with the regulation of insulin sensitivity index, comeal endothelial cells and inflammatory factors.
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@#AIM:To systematically evaluate the effect of trypan blue capsule staining on corneal endothelial cells in phacoemulsification. <p>METHODS: RCTs on the use of trypan blue for capsular staining in phacoemulsification were retrieved from China Knowledge Network(CNKI), Wanfang Database, Weipu Database, SinoMed, PubMed, SpringerLink, Clinicalkey, Medline, Cochrane Library, Web of Science, OVID, Embase. The search time was from the establishment of the databases to April 2019.The Meta-analysis of the included literature was made by Revman 5.3 and R 3.7.<p>RESULTS: Eight trials included 378 eyes were selected. Meta-analysis showed that the number of corneal endothelial cell loss between 0.02%, 0.06% or 0.1% trypan blue capsule staining group(193 eyes)and non-stained or placebo staining group(185 eyes)changed without statistical significance \〖Within 1mo after operation(<i>WMD</i>=-10.47, 95% <i>CI</i>=-26.44-5.61, <i>P</i>=0.20); 1mo after operation(<i>WMD</i>=-60.72, 95% <i>CI</i>=-170.92-49.49, <i>P</i>=0.28)\〗. The percentage of corneal endothelial hexagonal cell loss at 1mo after operation changed without statistical significance(<i>WMD</i>=0.50, 95% <i>CI</i>=-2.09-3.09, <i>P</i>=0.71). The central corneal thickness(CCT)at 1mo after operation changed without statistical significance(<i>WMD</i>=3.10, 95% <i>CI</i>=-5.77-11.98, <i>P</i>=0.49). The coefficient of variation(CV)changed without statistical significance(<i>WMD</i>=-1.00, 95% <i>CI</i>=-2.86-0.86, <i>P</i>=0.29).<p>CONCLUSION: 0.02%, 0.06% or 0.1% trypan blue capsule staining in phacoemulsification have no significant effect on the number and function of corneal endothelial cells.
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@#AIM:To systematically evaluate the effect of trypan blue capsule staining on corneal endothelial cells in phacoemulsification. <p>METHODS: RCTs on the use of trypan blue for capsular staining in phacoemulsification were retrieved from China Knowledge Network(CNKI), Wanfang Database, Weipu Database, SinoMed, PubMed, SpringerLink, Clinicalkey, Medline, Cochrane Library, Web of Science, OVID, Embase. The search time was from the establishment of the databases to April 2019.The Meta-analysis of the included literature was made by Revman 5.3 and R 3.7.<p>RESULTS: Eight trials included 378 eyes were selected. Meta-analysis showed that the number of corneal endothelial cell loss between 0.02%, 0.06% or 0.1% trypan blue capsule staining group(193 eyes)and non-stained or placebo staining group(185 eyes)changed without statistical significance \〖Within 1mo after operation(<i>WMD</i>=-10.47, 95% <i>CI</i>=-26.44-5.61, <i>P</i>=0.20); 1mo after operation(<i>WMD</i>=-60.72, 95% <i>CI</i>=-170.92-49.49, <i>P</i>=0.28)\〗. The percentage of corneal endothelial hexagonal cell loss at 1mo after operation changed without statistical significance(<i>WMD</i>=0.50, 95% <i>CI</i>=-2.09-3.09, <i>P</i>=0.71). The central corneal thickness(CCT)at 1mo after operation changed without statistical significance(<i>WMD</i>=3.10, 95% <i>CI</i>=-5.77-11.98, <i>P</i>=0.49). The coefficient of variation(CV)changed without statistical significance(<i>WMD</i>=-1.00, 95% <i>CI</i>=-2.86-0.86, <i>P</i>=0.29).<p>CONCLUSION: 0.02%, 0.06% or 0.1% trypan blue capsule staining in phacoemulsification have no significant effect on the number and function of corneal endothelial cells.
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Objective@#To explore the effects of shear stress on morphology, adhesion and proliferation of human umbilical cord blood mesenchymal stem cells(hUC-MSCs).@*Methods@#The hUC-MSCs were cultured in vitro until confluence and then placed in a flow system.The cells were subjected to different shear stress (1, 2, 3, 4 dye/cm2) for 2 hours and 6 hours, and no shear stress treatment cells served as a static control.The morphological changes of hUC-MSCs in different groups were analyzed by phase contrast microscopy and immunofluorescence.The mRNA expression levels of intercellular adhesion molecule-1 (ICAM-1) and Ki67 were detected by real-time PCR.@*Results@#Compared with the static control group, the hUC-MSCs cells were arranged in the direction of fluid after treated with shear stress.The immunofluorescence results showed that the cytoskeletal protein F-actin filaments was prolonged after shear stress.The cytoskeleton was further elongated in the 2 dye/cm2 for 6 hours group when compared with 2 dye/cm2 for 2 hours group, and the cytoskeleton was loosened when time extended to 6 hours.Real-time PCR results showed that the relative expressions of ICAM-1 mRNA and Ki67 mRNA in the static control group and different gradient shear stress groups were significantly different, with significant differences among them (F=17.141, P=0.000; F=11.336, P=0.001). The relative expression of ICAM-1 mRNA in the 1, 2, 3, 4 dye/cm2 shear stress group was 2.74±0.32, 9.77±1.19, 6.70±0.92 and 5.69±0.72, respectively, which was significantly higher than 1.00±0.28 in the static control group, with significant differences between them (all at P<0.05). The relative expression of Ki67 mRNA in the 3 dye/cm2 and 4 dye/cm2 shear stress group was 0.39±0.09 and 0.04±0.02, respectively, which was significantly lower than 1.00±0.24 in the static control group, with statistically significant differences between them (both at P<0.05).@*Conclusions@#After treated with fluid shear stress, hUC-MSCs are arranged in the direction of fluid.Shear stress can promote the adhesion of hUC-MSCs.As the increase of shear stress intensity, cell proliferation is inhibited.
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@#AIM: To compare the short-term and long-term effects of sub-Bowmans keratomileusis(SBK), femtosecond laser SBK(FS-SBK)and small incision lenticule extraction(SMILE)treatments on corneal endothelial cells density(ECD)in myopia.<p>METHODS: Thirty-four myopia patients(34 eyes)were performed with SBK, and 41 patients(41 eyes)underwent FS-SBK, 49 patients(49 eyes)underwent SMILE. The corneal endothelial cells, in terms of central corneal ECD, the coefficient of variation(CV)and the percentage of hexagonal endothelial cells, were measured by non-contact corneal endothelial microscope(Topcon SP-1P )at 1wk and 1a preoperative, and postoperative, separately. <p>RESULTS:There were no significant differences in the visual acuity and diopter among three groups at preoperative, 1wk and at 1a postoperative, separately(all <i>P</i>>0.05). The central corneal ECDs statistically decreased at 1wk postoperative in three groups, compared to preoperatively(all <i>P</i><0.01), while the ECDs recovered at 1a postoperative. The changes of CVs and the percentage of hexagonal endothelial cells at 1wk,1a after operation were not statistically significantly different compared with preoperative results in the three groups(all <i>P</i>>0.05).The differences of ECD, CVs, and the percentage of hexagonal endothelial cells among three groups at preoperatively and postoperatively were not statistically significant(all <i>P</i>>0.05).<p>CONCLUSION: The SBK, FS-SBK and SMILE used to treat myopia were safe for the corneal endothelium. The central corneal ECDs decreased slightly at early period after operation, and recovered 1a later in all groups. The CVs and percentages of hexagonal endothelial cells in three groups do not change at short-term and long-term postoperatively. The differences of ECD, CVs, and the percentage of hexagonal endothelial cells among three groups were not found at postoperative.
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Corneal endothelial cells (CECs) are essential for maintenance of corneal transparency.Proliferative potency of human CECs is poor in vivo,so endothelial dysfunction is irreversible.Many studies have showed that CECs are able to proliferate in vitro.However,endothelial to mesenchymal transition (EndMT) will emerge with CECs acquire a myofibroblastic phenotype and lose their specific markers,which hinders the development of corneal regenerative medicine.EndMT participates in corneal disorders,but its process has not been clarified yet.Now,researchers have found that the mechanism of EndMT may include transforming growth factor-β (TGF-β)signaling pathway,fibroblast growth factors (FGFs),and Notch signaling pathway.Therefore,there are several ways to prevent EndMT,such as inhibiting TGF-β signaling pathway,using anti-phosphatidylinositol 3-kinase antibody,small interfering RNA (siRNA) against pl20,Leucine-rich repeat-containing G protein-coupled receptor 5 (LGR5) and LGR5 ligand,inhibiting Notch signaling pathway,making connexin43 knockdown,inhibiting matrix metalloproteinase activity and using Asc-2P.This review elaborated the mechanism of EndMT and ways to prevent or reverse it.
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Objective To evaluate the clinical changes of corneal epithelial cells,dendritic cells,endothelial cells and corneal nerves in contralateral eyes of patients with unilateral infectious keratitis.Methods A prospective serial case observation study was conducted in patients with unilateral infectious keratitis from January to August 2018 in the First Affiliated Hospital of Harbin Medical University.The corneal epithelial cells density,dendritic cells density,endothelial cells density,total nerve density,total number of nerves and branch nerve density were analyzed with in vivo confocal microscopy (IVCM),slit lamp microscopy was performed on all subjects to observe the conjunctiva,cornea and anterior chamber.Corneal branch nerve density and total nerve density were compared with the control group by homogeneity test of variance.This study was approved by the Ethics Committee of the First Affiliated Hospital of Harbin Medical University (No.IRB-AF/SC-04/01.0).Results Slit lamp microscopy showed no significant changes in anterior segment of the contralateral uninfected eyes in the 3 groups.The corneal epithelial cells density of uninfected eyes in viral keratitis group,bacterial keratitis group and fungal keratitis group was 1 834 (1 584,2 107),1 905 (1 651,2 332) and 1 859 (1 477,1 995)/mm2,respectively,which were significantly lower than 3 479 (3 080,3 910)/mm2 in the control group,the dendritic cells densities in viral keratitis group and bacterial keratitis group were 175 (139,214)/mm2 and 156 (118,190)/mm2,which were higher than 69(57,76)/mm2 in the control group,the differences were statistically significant (all at P＜0.05).The corneal endothelial cells density of uninfected eyes in viral keratitis group was 1 107(945,1 270)/mm2,which was less than 1 905(1 651,2 332)/mm2 in the bacterial keratitis group and 1 859(1 477,1 995)/mm2 in the fungal keratitis group (both at P＜0.05).The corneal nerve number and total nerve density of uninfected eyes in viral keratitis group were l0(7,11)/mm2 and (1 822.85±622.34) μm/mm2,which were lower than 11 (9,13)/mm2 and (2 340.91±:408.70)μm/mm2 in the bacterial keratitis group,with significant differences between them (P＜ 0.05,P＜ 0.008 3).The morphology of corneal epithelial cells and endothelial cells in each infectious keratitis group was larger than that in the control group,while the morphology and number of dendritic cells in the contralateral eye of patients with viral and bacterial keratitis increased.Conclusions In unilateral uninfected eyes of infectious keratitis,the density of corneal epithelial cells,dendritic cells,endothelial cells and corneal nerves changes correspondingly.There may be a close relationship of corneal immunity and nervous system between the two eyes.
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@#AIM: To study the effect of intravitreal conbercept on corneal thickness and endothelial cells in macular edema patients.<p>METHODS:Intravitreal conbercept was performed on 30 eyes of 30 patients with macular edema due to different diseases from Jan. 2017 to Dec. 2017 in our hospital. The central corneal thickness was identified by ultrasonic biomicroscope(UBM)before and after surgery. Specular microscopy was also used to detect the density of central corneal endothelial cells and proportion of hexagonal cells before and after surgery.<p>RESULTS:The central corneal thickness were 551.68±12.80μm before surgery, 552.06±13.22μm at the first day after surgery and 552.49±13.83μm at 1wk after surgery(<i>P</i>>0.05). The density of central corneal were 2551.03±287.55/mm2 before surgery, and 2563.79±292.34, 2543.32±282.41, 2526.18±280.24, 2519.60±279.89/mm2 at 1d, 1wk, 3mo and 6mo after surgery respectively, meanwhile, the proportion of hexagonal cells were(50.23±7.51)% before surgery, and(50.93±8.23)%,(50.60±7.91)%,(50.40±7.50)%,(50.93±8.19)% at 1d, 1wk, 3mo and 6mo after surgery respectively(<i>P</i>>0.05).<p>CONCLUSION: Intravitreal injections of conbercept demonstrated a safety in the treatment of macular edema. It seems no affects on corneal thickness and corneal endothelial cells at 6mo after intravitreal conbercept.
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Endothelium keratoplasty (EK),due to its short operation time,fast postoperative healing and better postoperative visual prognosis,has gradually replaced penetrating keratoplasty in recent years as the preferred surgery for treating corneal endothelial decompensation.A recent study has reported the clinical results of the successful treatment of bullous keratopathy with human corneal endothelial cells cultured in vitro and anterior chamber injection,which opened a new era of EK.This method simplifies the operation procedure,avoids the complications related to the dislocation of corneal endothelial graft,and significantly improves the utilization rate of donor corneal materials.Nevertheless,long-term prognosis and outcome of patients undergoing this treatment remain to be clarified before introducing this approach into wider clinical practice.
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Objective To evaluate of the effect and safety of wearing orthokeratology contact lens or frame glasses for controlling myopia in children. Methods The clinical data from myopia children, who wore orthokeratology contact lens or frame glasses to control myopia, were analyzed retrospectively. Of 219 children (396 eyes), 145 children (277 eyes) wore orthokeratology contact lens, and 74 (119) frame glasses. The changes of diopter, axial length and corneal endothelial cells were observed and compared one year after treatment in the two groups. Results After wearing one year, the diopter and the variation of diopter were significantly less in the children wearing orthokeratology contact lens than those in the children wearing frame glasses ([-3.03±0.89] DS vs [-3.83±1.25] DS, [-0.84±0.90] DS vs [-1.83±0.71] DS; both P<0.05). There was no significant difference in the axial length between the children wearing orthokeratology contact lens and frame glasses. While the extension of axial length was significantly less in the children wearing orthokeratology contact lens than that in the children wearing frame glasses ([0.14±0.15] mm vs [0.40±0.17] mm, P<0.05). No significant differences in the area or density of corneal endothelial cells were found between the children wearing orthokeratology contact lens and frame glasses. Conclusion Wearing orthokeratology contact lens can effectively control myopia in children within one year, and it had no adverse effects on corneal function.
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· AIM:To investigate the effects of mitomycin C (MMC) on corneal endothelial cells at different exposure time during laser-assisted subepithelial keratomileusis (LASEK).· METHODS:Patients who received LASEK were included and divided into Group T1 (15s≤t≤45s) and T2 (5s＜t≤70s) based on the exposure time of MMC with corneal stroma.Cell density (CD) of corneal endothelial cells in central and peripheral cornea,average cell area (ACA),area standard deviation (SD),coefficient of variation (CV) and percentage of hexagonal cells (HEX) before surgery and at 1wk,1,3 and 6mo after surgery were compared between and within the groups.· RESULTS:A total of 196 eyes of 98 patients were included with 98 eyes in Group T1 and 98 eyes in Group T2.With the exception of peripheral ACA,central CV and HEX in Group T1 and T2,which significantly changed at 1wk after the surgery (P＜0.05),there was no significant difference in central and peripheral parameters within both groups or between the groups (P ＞0.05).· CONCLUSION:Although transient acute changes in central CV and HEX and peripheral ACA were observed,there is no significant effect on the long-term corneal health status when MMC is applied in a reasonable time range in LASEK surgery.
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·AIM:To investigate the factors related to the decrease of corneal endothelial cell number after phacoemulsification in cataract patients. ·METHODS: We selected 98 patients (120 eyes) in Ophthalmic Center from July 2014 to July 2016 underwent phacoemulsification and they were retrospectively analyzed. According to the central corneal endothelial cell density before and 2mo after the operation, they were divided into serious loss group of 52 cases (67 eyes, density of central corneal endothelial cells loss rate no less than 12.3%),the general loss group of 46 cases (53 eyes, the density of central corneal endothelial cell loss rate <12.3%). Relevant indicators of general information, operation of the two groups were compared, the influence factors of non conditional Logistic regression analysis method was used to investigate the effect for corneal endothelial cell loss in cataract patients. ·RESULTS:Serious loss group and the general group on gender, rate with hypertension, rate with diabetes, rate with high blood lipids, with shallow anterior chamber, corneal diameter and suction time comparison, had no statistically significant differences (P > 0. 05). Nuclear hardness classification of Emery lens, ultrasonic power, ultrasonic emulsification time, age between groups were significantly different(P<0.05). By using Logistic analysis method, the results showed that increased Emery lens nucleus grading, ultrasonic energy, phacoemulsification time, age were independent risk factors for corneal endothelial cells after phacoemulsification (P<0.05). ·CONCLUSION: The main factors that influence the decrease of corneal endothelial cell number after phacoemulsification are Emery lens, higher grade of nucleus of lens, increase of ultrasonic energy, longer time of phacoemulsification and increased age.
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·AIM: To investigate the effect of femtosecond laser assistedcataractsurgeryconventional phacoemulsification surgery on corneal endothelial cell morphology and function. ·METHODS: This study included 80 cases of cataract patients (88 sicked eyes) treated in our hospital from January 2016 to January 2017. All patients underwent phacoemulsification combining with intraocular lens implantation for treatment. Based on the review of treatment, 40 cases ( 43 sicked eyes ) receiving femtosecond laser assisted cataract surgery were included into the observation group, 40 cases (45 sicked eyes) receiving conventional phacoemulsification only were divided into the control group. The proportion of patients whose postoperative uncorrected visual acuity >0.5 of the two groups were compared, and sac diameter, capsule size, intraoperative cumulative energy release (CDE) were recorded, the corneal endothelial cell density and variation were recorded before and after operation, the preoperative and postoperative ratio of hexagonal cells were compared between the two groups subsequently. and ·RESULTS: At 1d postoperatively, uncorrected visual acuity >0.5 of the observation group was no significant difference with that of the control group; the ratio was 74% at 6mo after surgery, which was significantly higher than that of the control group(53%),there was statistical significance (P < 0. 05). The diameter of the anterior capsulotomy,the size of the capsule,the grade Ⅱ nuclear CDE, and the grade Ⅲ nuclear CDE of the observation group were sharply different from those of the control group, there was statistical significance (P<0.05). The differences of corneal endothelial cell density and variation, proportion of hexagonal cells before and after surgery of the two groups were significant, and the difference after 6mo between the two groups was huge, there was statistical meaning (P<0.05). · CONCLUSION: Femtosecond laser assisted cataract surgery can reduce the effect of ultrasound energy on cornea,and can sharply decrease the damage to corneal endothelial cell morphology and function.
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AIM:To investigate the clinical effect of excimer laser in situ keratomileusis ( LASIK ) for high myopia and its effects on central corneal thickness ( CCT ) , corneal endothelial cell density, and contrast sensitivity.?METHODS: Totally 120 cases (240 eyes) in Ophthalmic Center in our hospital with high myopia were retrospectively analyzed from November 2014 to July 2016. According to the operation method, those cases were divided into LASIK group (60 cases 120 eyes), laser assisted sub-epithelial keratectomy ( LASEK ) group ( 60 cases 120 eyes ) , and treatment effect between the two groups was compared.?RESULTS: After surgery, at 1, 3, 6 and 12mo, visual acuity, refraction spherical equivalent value between the two groups were not significantly different at each time point ( P>0. 05 ); spherical equivalent refractive power were significantly improved compared with preoperative values in the two groups (P<0. 05); at 1a after surgery, the CCT, corneal endothelial cell density of the LASIK group were greater than those of the LASEK group, the difference was statistically significant (P<0. 05). Before surgery, contrast sensitivity with 3c/d, 6c/d, 12c/d, 18c/d spatial frequency was not statistically significant between the two groups ( P > 0. 05 ); at 1a after the operation, contrast sensitivity of LASIK group with 6c/d, 12c/d spatial frequency was significantly lower than that of the LASEK group, the difference was statistically significant (P<0. 05).?CONCLUSION: The clinical effect of LASIK on high myopia is certain, and it has little effect on CCT and corneal endothelial cell density, but it has obvious influence on the contrast sensitivity.
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Objective To study the therapeutic effect and safety of orthokeratology in the teenagers with high myopia.Methods A retrospective cohort study was carried out.The clinical data of 120 eyes from 60 high myopia patients wearing orthokeratology contact lens for 1 year in Henan Eye Hospital from June 2013 to June 2014 was analyzed,and the data of contemporaneous 118 eyes from 59 matched high myopia patients wearing conventional glasses were used as controls.The initial spherical equivalent (SE) of all the patients was-6.00 to-9.00 D.The maximum correction amplitude of the orthokeratology contact lens was set as 6.00 D based on the Regulation of China Food & Drug Administration.The contact lenses were worn for 1 month firstly and then the conventional glasses were used at daytime and contact lenses were consecutively worn at night for 1 year in the contact lenses group,and only glasses were worn in the conventional glasses group.The uncorrective visual acuity (UCVA),SE,corneal fluorescein staining were examined 1 week,1 month,3 months,6 months and 12 months after wearing lenses.The changes of corneal endothelial cells were examined 6 and 12 months after wearing lenses.Results The UCVA was improved and SE was reduced 1 month and 3,6 and 12 months after wearing lenses in comparison with 1 week after wearing lenses in the contact lenses group (all at P＜0.01);while no significant change was seen in UCVA in the conventional glasses group (all at P＞0.05).Compared with wearing contact lenses,the SE was increased in various time points after wearing glasses in the conventional glasses group (all at P＜0.01).The axial length and SE extended by (0.08±0.12)mm and (0.19±0.21)D in the contact lenses group and those in the conventional glasses group were (0.29±0.14)mm and (0.69±0.27)D,showing significant differences between the two groups (t =10.024,5.691,both at P＜0.01).No significant differences were found in corneal endothelial cell density,percentage of hexagonal cells and coefficient of variation of corneal endothelial cells in various time points after wearing contact lenses (corneal endothelial cell density:Fgroup =0.090,P =0.769;Ftime =0.133,P =0.563.percentage of hexagonal cells:Fgroup =0.071,P=0.836;Ftime =1.091,P =0.203.coefficient of variation:Fgroup =0.107,P =0.734;Ftime =1.948,P =0.156).The incidence of corneal fluorescein staining was 31.67％ in the contact lens group,which was much higher than 3.51％ in the conventional glasses group (x2 =97.910,P =0.001).Conclusions Compared with wearing only conventional glasses,orthokeratology can improve UCVA and control axial length extension in juvenile with high myopia,but orthokeratology is more likely to damage the corneal superficial layer.