Corneal stromal lenticule-combined accelerated transepithelial corneal collagen cross-linking for severe keratoconus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the clinical efficacy of corneal stromal lenticule-combined accelerated transepithelial corneal collagen cross-linking(SC-A-TE-CXL)in the treatment of severe keratoconus.METHODS: Prospective before-after self-control study. A total of 10 cases(14 eyes)of severe keratoconus with the thinnest corneal thickness(including epithelium)less than 400 μm were collected from March 2019 to July 2022 at the ophthalmology department of Affiliated Eye Hospital of Nanjing Medical University. Among them, 8 males(12 eyes)and 2 females(2 eyes)were treated with SC-A-TE-CXL. Corneal curvature, uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), the thinnest corneal thickness(TCT), central corneal thickness(CCT), non-contact intraocular pressure, endothelial cell density(ECD)and anterior or posterior elevations at the thinnest point before surgery and at 1, 3, 6 and 12 mo postoperatively were observed and recorded, as well as corneal cross-linking depth at 1 mo postoperatively.RESULTS: UCVA and BCVA at 1, 3, 6, and 12 mo after SC-A-TE-CXL were higher than those preoperatively, but there were no differences(F=0.793, P=0.535; F=0.783, P=0.542). K1, K2, Km and Kmax decreased at each time point postoperatively compared with those preoperatively, but there were no differences(F=0.627, P=0.574; F=1.264, P=0.296; F=0.727, P=0.520; F=1.115, P=0.359). Anterior and posterior elevations at the thinnest point both decreased compared with those preoperatively, but the differences were not statistically significant(F=1.046, P=0.359; F=1.164, P=0.337). The non-contact intraocular pressure at each time point postoperatively was higher than that preoperatively, but the differences were not statistically significant(F=0.814, P=0.522). There were no differences in CCT and TCT at any time points of the follow-ups compared with those preoperatively(F=0.931, P=0.453; F=0.782, P=0.542). There was no difference in ECD at 12 mo postoperatively versus preoperative value(t=1.266, P=0.228). At 1 mo postoperatively, anterior segment optical coherence tomography(AS-OCT)exhibited an increase of density in the anterior stroma, and there was a demarcation line with an average depth of 124.07±25.13 μm.CONCLUSION: SC-A-TE-CXL can be considered as a surgical treatment for severe keratoconus, which can delay the progression of severe keratoconus with high safety. However, the long-term efficacy of this treatment requires further observation.

Effect of small incision lenticule extraction on the treatment of myopia patients and the impact on corneal biomechanics / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the effect of small incision lenticule extraction(SMILE)on the treatment of myopia patients, and the impact on corneal biomechanics.METHODS:Retrospective study. A total of 120 myopic patients(240 eyes)who were scheduled to undergo corneal refractive surgery in Anyang Eye Hospital from January 2020 to December 2021 were selected. The patients were divided into SMILE group(64 patients, 128 eyes)and transepithelial photorefractive keratectomy(TransPRK)group(56 patients, 112 eyes)according to the surgical treatment method. The two groups were compared in terms of uncorrected visual acuity, corneal biomechanics, corneal endothelial cell count, posterior corneal surface height and corneal surface regularity index at 1, 7 d, 1, 3, 6 mo and 1 a after surgery, and surgical complications.RESULTS:The uncorrected visual acuity of the SMILE group at 1, 7 d and 1 mo after surgery was better than that of the TransPRK group(all P<0.001), but there was no statistically significant difference between the groups at 3, 6 mo and 1 a after surgery(all P>0.05). Compared with preoperative values, corneal-compensated intraocular pressure, Goldmann-correlated intraocular pressure, corneal resistance factor, and corneal hysteresis in both groups showed a first decreasing and then increasing trend after surgery. The corneal-compensated intraocular pressure, Goldmann-correlated intraocular pressure, corneal resistance factor, and corneal hysteresis in the SMILE group at 1, 7 d and 1 mo after surgery were higher than those in the TransPRK group(all P<0.05), but there was no statistically significant difference between the groups at 3, 6 mo and 1 a after surgery(all P>0.05). There were no significant changes of corneal endothelial cell count and corneal posterior surface height in the two groups after surgery(all P>0.05). Furthermore, corneal surface regularity index of the two groups showed a first increasing and then decreasing trend after surgery, with no statistically significant difference between the groups(P>0.05), and there was no statistically significant difference in the incidence of postoperative complications between the groups(P>0.05).CONCLUSION:Compared with TransPRK, SMILE has less influence on corneal biomechanics, and better visual recovery in the early stage. There is no difference in long-term visual acuity between the two surgeries, and both have good safety and effectiveness.

Disease-specific protein corona formed in pathological intestine enhances the oral absorption of nanoparticles

Protein corona (PC) has been identified to impede the transportation of intravenously injected nanoparticles (NPs) from blood circulation to their targeted sites. However, how intestinal PC (IPC) affects the delivery of orally administered NPs are still needed to be elucidated. Here, we found that IPC exerted "positive effect" or "negative effect" depending on different pathological conditions in the gastrointestinal tract. We prepared polystyrene nanoparticles (PS) adsorbed with different IPC derived from the intestinal tract of healthy, diabetic, and colitis rats (H-IPC@PS, D-IPC@PS, C-IPC@PS). Proteomics analysis revealed that, compared with healthy IPC, the two disease-specific IPC consisted of a higher proportion of proteins that were closely correlated with transepithelial transport across the intestine. Consequently, both D-IPC@PS and C-IPC@PS mainly exploited the recycling endosome and ER-Golgi mediated secretory routes for intracellular trafficking, which increased the transcytosis from the epithelium. Together, disease-specific IPC endowed NPs with higher intestinal absorption. D-IPC@PS posed "positive effect" on intestinal absorption into blood circulation for diabetic therapy. Conversely, C-IPC@PS had "negative effect" on colitis treatment because of unfavorable absorption in the intestine before arriving colon. These results imply that different or even opposite strategies to modulate the disease-specific IPC need to be adopted for oral nanomedicine in the treatment of variable diseases.

Clinical analysis of functional optical zone after transepithelial photorefractive keratectomy in patients with different degrees of myopic astigmatism / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the effect of preoperative degrees of myopic astigmatism and anterior corneal curvature on the functional optical zone(FOZ)after transepithelial photorefractive keratectomy(TransPRK).METHODS: Retrospective study was conducted on 78 patients(130 eyes)with myopia and myopic astigmatism who underwent TransPRK, and they were divided into control group(cylinder 0D), moderate astigmatism group(-0.50～-2.00D)and high astigmatism group(>-2.00～<-6.00D). The FOZ was measured and compared among the three groups 6mo after operation. The correlations between attempted correction, anterior corneal curvature, corneal aberrations, Q value, and the FOZ were analyzed.RESULTS: At 6mo after operation, the mean FOZ was 5.16±0.12mm in the control group, 5.29±0.23mm in the moderate astigmatism group, and 5.49±0.23mm in the high astigmatism group(P<0.001), and the FOZ of the high astigmatism group was significantly higher than moderate astigmatism and control group(P<0.05, P<0.001); Pearson correlation analysis showed that the changes in spherical equivalent, total corneal higher-order aberrations(HOAs), coma, and spherical aberration were all negatively correlated with FOZ(all P<0.05); and FOZ positively correlated with changes in the steep curvature(K2), mean curvature(Km), corneal astigmatism, and Q value(all P<0.01). Multiple linear regression analysis showed that there was still positive correlation between preoperative K2 and FOZ after adjusting for other risk factors(P<0.001).CONCLUSION: Patients with high astigmatism can obtain a larger FOZ and less induced coma after TransPRK. A larger FOZ can be achieved in eyes with steeper keratometry.

Visual quality observation of transepithelial photorefractive keratectomy and femtosecond small incision lenticule extraction for the correction of low myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the changes in corneal aberrations and the characteristics of visual quality after transepithelial photorefractive keratectomy(T-PRK)and femtosecond small incision lenticule extraction(SMILE)in the correction of low myopia.METHODS: Prospective cohort study. A total of 32 cases(32 eyes)with low myopia who underwent T-PRK surgery and 45 cases(45 eyes)of SMILE surgery at Weifang Eye Hospital from April 2021 to April 2022 were selected. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), spherical equivalent(SE), corneal higher-order aberrations(HOAs)and objective visual quality were compared between the two groups.RESULTS:All patients completed the surgery successfully without complications such as infection. At 3mo postoperatively, the safety index was 1.13±0.16 and 1.16±0.17(P=0.48)and the efficacy index was 1.10±0.20 and 1.15±0.18(P=0.27)in the T-PRK and SMILE groups, respectively. The percentage of UCVA(LogMAR)≤0 in the T-PRK and SMILE groups was 94% and 98%, respectively. The percentage of the residual SE within ±0.5D was 88% and 87% in the two groups, respectively. The HOAs and spherical aberration in both groups were significantly increased(P≤0.01), and the increase was not statistically significant between the two groups(P=0.31, 0.89). There was no significant change in horizontal coma, horizontal trefoil and vertical trefoil in both groups(P>0.05). The vertical coma in SMILE group was significantly increased(P<0.001), while there was no significant change in T-PRK group(P>0.05), and the increase was significantly greater in SMILE group than in T-PRK group(P<0.001). There was no significant difference in objective scattering index(OSI), modulation transfer function cut off frequency(MTFcut off), Strehl ratio(SR), visual acuity(VA)100%, VA20% and VA9% between the two groups(P>0.05).CONCLUSION:Both T-PRK and SMILE showed good safety, efficacy, and visual quality in correcting low myopia, while SMILE induced more vertical coma than T-PRK.

Comparison of visual quality after refractive surgery between smart pulse technology-assisted transepithelial photorefractive keratectomy of 1 050Hz ablation frequency and small incision lenticule extraction / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the visual quality between smart pulse technology-assisted(SPT)transepithelial photorefractive keratectomy(TransPRK)of 1 050Hz ablation frequency and small incision lenticule extraction(SMILE)for myopia and astigmatism.METHODS: A total of 138 cases(248 eyes)who received corneal refractive surgery in the Eye Hospital of Chengdu University of TCM were enrolled from July 2020 to January 2021. The patients were divided into TransPRK group(64 cases, 123 eyes)and SMILE group(74 cases, 125 eyes)according to the surgical method. The follow-up duration was 6mo. Strehl ratio(SR)and high-order aberration at 6mm pupil diameter measured by Sirius anterior segment integrated analyzer and LogMAR visual acuity were recorded at different preoperative and postoperative time points.RESULTS: The uncorrected visual acuity(UCVA)of TransPRK group was worse than SMILE group at 1wk and 1mo after surgery(all P<0.05), but UCVA was better in TransPRK group at 6mo after surgery(P<0.05). SR in TransPRK group was lower than that in SMILE group at 1wk and 1mo after surgery(all P<0.05). There was no significant difference in SR between the two groups at 3 and 6mo after surgery(P=0.968, 0.433). At 1wk after surgery, there was no significant difference in coma between the two groups(P=0.554). At 1, 3, and 6mo after surgery, coma in the TransPRK group was lower than that in SMILE group(all P<0.05). At 1wk, 1 and 3mo after surgery, the trefoil aberration in TransPRK group was higher than that in SMILE group(all P<0.05). At 6mo after surgery, there was no significant difference in trefoil aberration between the two groups(P=0.167). At 6mo after surgery, UCVA of TransPRK group and SMILE group were -0.13±0.05 and -0.11±0.08, respectively, which were better than the best corrected visual acuity(BCVA)before surgery(-0.07±0.05 and -0.07±0.05; all P<0.05). Furthermore, the SR of both groups was higher than that before surgery(all P<0.05).CONCLUSION: Both SPT-assisted TransPRK of 1 050Hz ablation frequency and SMILE can achieve better visual acuity after refractive surgery, while SMILE has better visual quality at 1wk and 1mo after surgery. However, SPT-assisted TransPRK of 1 050Hz ablation frequency has better visual acuity at 6mo after surgery than SMILE, and the coma is smaller.

Transepithelial phototherapeutic keratectomy for post-traumatic recurrent corneal erosions

Purpose: To evaluate the outcomes of transepithelial phototherapeutic keratectomy (transepithelial PTK) for treatment of posttraumatic recurrent corneal erosions. Methods: Twenty?four eyes of 22 patients with posttraumatic recurrent corneal erosions who were treated with transepithelial PTK from April 2018 to July 2020 were included in this retrospective study. The rates of recurrent erosions and complications were evaluated during the follow?up after surgery. Visual acuity and refraction were recorded preoperatively and 1 year after surgery. Total corneal astigmatism, total corneal irregular astigmatism, and total corneal spherical aberrations were recorded using corneal tomography preoperatively and 1 year after surgery. Results: Mean postoperative follow?up was 13 months (range: 12� months). None of the patients suffered from any complications or further erosions. Uncorrected distance visual acuity, best?corrected distance visual acuity, spherical equivalent, and cylinder remained stable at 1?year postoperatively compared with the baseline (P = 0.214, P = 0.461, P = 0.084, and P = 0.879, respectively). Moreover, there was no significant difference in total corneal astigmatism, total corneal irregular astigmatism, and total corneal spherical aberrations between baseline and 1?year postoperative visit (P = 0.938, P = 0.136, and P = 0.981, respectively). Conclusion: Transepithelial PTK was an effective treatment for patients with posttraumatic recurrent corneal erosions.

Analysis of clinical and pathological features of 29 cases of perforating pilomatricoma / 中华皮肤科杂志

Objective:To analyze clinical and pathological features of childhood perforating pilomatricoma, and to explore its pathogenesis.Methods:A retrospective analysis was conducted on clinical and histopathological data from 29 children with perforating pilomatricoma in Department of Dermatology, Beijing Children′s Hospital from 2014 to 2020.Results:Among the 29 patients, 11 were males, and 18 were females, with a male-to-female ratio of 1∶1.64. Their age at onset ranged from 3 months to 14 years and 10 months, and the median age at onset was 4.58 years. The disease duration ranged from 2 months to 2 years, with an average of 8.72 months. The perforation occurred 2 days to 1 year and 6 months after the onset of pilomatricoma, with an average of 1.85 months. Ulceration occurred in 1 patient after the treatment with ichthammol, as well as in 3 patients after local scratching or bumping, and spontaneous ulceration without definite precipitating factors occurred in the remaining 25 patients. The average duration from the onset of disease to tumor perforation was 6.87 months. Skin lesions occurred on the face in 15 cases, on the lateral neck in 8, on the upper limb in 4, as well as on the scalp in 2. Perforating pilomatricoma clinically manifested as indurated subcutaneous nodules with crusts or ulcers, and was classified into 3 subtypes: ulcerative type (19 cases) , horny type (8 cases) , and crusted type (2 cases) . The tumor diameter ranged from 0.3 to 2.5 cm, with an average of 1.2 cm. Histopathological examination showed that the tumor was located in the superficial to middle dermis, and mainly consisted of basophils and ghost cells; in 19 cases, the tumor mass was extruded onto the skin surface through a perforated epidermal channel, and the epidermis around the perforation site was hyperplastic and invaginated into the dermis, forming epithelial tunnels surrounding the tumor; in 4 cases, the skin on the tumor surface was thinned and ruptured; in 6 cases, the perforation site could not be observed due to surgical separation of the epidermis and tumor. All lesions were resected, and no infection or recurrence was observed during the postoperative follow-up.Conclusions:Childhood perforating pilomatricoma mostly occurs on the face and neck, usually with rapid progress, and can be classified into ulcerative type, horny type and crusted type. Histological findings suggest that transepithelial elimination is an important mechanism underlying the occurrence of perforation in pilomatricoma.

Trans-epithelial accelerated corneal collagen cross-linking for progressive keratoconus / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the clinical efficacy and safety of trans-epithelial accelerated corneal collagen cross-linking in the treatment of progressive keratoconus.METHODS: A prospective before-after self-control study. A total of 47 eyes of 37 patients with progressive keratoconus who underwent trans-epithelial accelerated corneal collagen cross-linking in our hospital from August 2016 to November 2019 were collected. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), refractive status, corneal transparency, maximum keratometry value of the anterior corneal surface, thinnest corneal thickness, corneal endothelial cell counts and intraocular pressure(IOP)were analysed preoperatively and at 1, 3, 6 and 12mo postoperative.RESULTS: UCVA of patients 1, 3, 6 and 12mo after surgery was higher than that before surgery, but there was no difference(<i>F</i>=1.372, <i>P</i>=0.261). BCVA at 1, 3, 6 and 12mo after surgery was higher than that before surgery, the difference was statistically significant(<i>F</i>=3.308, <i>P</i>=0.019). There were no differences in the spherical and cylindrical power, Kmax and thickness of the thinnest point of cornea at 1, 3, 6 and 12mo postoperatively compared with those before surgery(<i>F</i>=0.293, 1.378, 2.448, 1.970; <i>P</i>=0.881, 0.258, 0.061, 0.116). There was no difference in corneal endothelial cell counts between 1mo after surgery and before surgery(<i>t</i>=1.156, <i>P</i>=0.25). There was no difference in IOP at all postoperative time points compared with that before surgery(<i>F</i>=1.221, <i>P</i>=0.321). The corneal Haze(grade 1-2)appeared in 7 eyes after surgery, and subsided in 5 eyes from 3-6mo after surgery, and the corneal transparency recovered. The corneal nebula remained in 1 eye, and the corneal central stroma linear opacity existed in 1 eye, but the visual acuity of both eyes was not affected.CONCLUSION: Trans-epithelial accelerated corneal collagen cross-linking can significantly improve BCVA, stabilize refractive status, corneal morphology and thickness, prevent or delay the progression of keratoconus, and enable patients to obtain better visual function. At the same time, the operation time is short, postoperative complications are less, and the operation has good safety.

Corneal morphology and visual quality observation after Trans-PRK with smart pulse technology in the correction of myopia and astigmatism / 中华实验眼科杂志

Objective:To observe the corneal morphology and visual quality after transepithelial photorefractive keratectomy (Trans-PRK) with smart pulse technique (SPT) and 1 050 Hz cutting frequency in the correction of myopia and astigmatism.Methods:A self-controlled case series study was conducted.Sixty five eyes of 33 patients who underwent Trans-PRK surgery in Ineye Hospital of Chengdu University of TCM from July 2017 to June 2018 were followed up for 6 months.The uncorrected visual acuity (UCVA) converted to logarithm of the minimum angle of resolution (LogMAR) unit, best corrected visual acuity (BCVA) (LogMAR), and spherical equivalent (SE) of the subjects were recorded.The anterior corneal surface symmetry index (SI), the anterior corneal surface Q value in the range of 6, 7, 8, and 9 mm diameter, the spherical aberration, coma, trefoil and total higher-order aberration of the anterior corneal surface, the strehl ratio (SR), and the modulation transfer function (MTF) of 10, 20, 30, and 40 c/d in the horizontal and vertical meridian directions before and after surgery were measured with Sirius corneal topography analyzer.The differences of each index among different time points were compared, and the correlation between indexes was analyzed by Pearson correlation analysis.This study followed the Declaration of Helsinki.The study protocol was approved by the Medical Ethics Committee of Ineye Hospital of Chengdu University of TCM (No.2020yh-004). All patients signed the informed consent form before surgery.Results:The average preoperative BCVA and SE were -0.09±0.06 and (-4.24±1.24)D.The mean UCVA and SE at 7 days, 1, 3 and 6 months postoperatively were -0.10±0.08 and (0.03±0.63)D, -0.12±0.06 and (0.08±0.53)D, 1.16±0.06 and (0.02±0.79)D, -0.18±0.05 and (0.08±0.37)D, respectively.The SI at different time points after the surgery were significantly higher than that before operation (all at P<0.05). At 1, 3 and 6 months after surgery, the Q value of anterior corneal surface in different diameter ranges increased from negative to positive, showing statistically significant differences (all at P<0.05). At each time point after surgery, the trefoil and total higher-order aberrations of the anterior corneal surface increased to varying degrees.Coma at 7 days and 6 months after surgery were significantly higher than that before surgery, and spherical aberration at 3 and 6 months after surgery were significantly higher than that before surgery (all at P<0.05). The SR values at 3 and 6 months after operation were significantly higher than that before operation (all at P<0.05). At 6 months after operation, the MTF values at different spatial frequencies of the horizontal meridian and the MTF values at 30 and 40c/d spatial frequencies of the vertical meridian were lower than those before operation, and the differences were statistically significant (all at P<0.05). The correlation analysis showed that the Q value of different diameter ranges was positively correlated with spherical aberration ( r=0.798-0.925, P<0.05), total higher-order aberration ( r=0.596-0.630, P<0.05), SI ( r=0.235-0.303, P<0.05) and corneal ablation depth ( r=0.583-0.659, P<0.05) at 6 months after surgery.SI was positively correlated with spherical aberration ( r=0.307, P<0.05), coma ( r=0.424, P<0.05), total higher-order aberration ( r=0.300, P<0.05), corneal ablation depth ( r=0.227, P<0.05), and eccentric cutting amount ( r=0.281, P<0.05). There was no correlation between SR and aberration, corneal ablation depth, eccentric cutting amount, etc.(all at P≥0.05). Conclusions:Trans-PRK using SPT to correct myopic astigmatism can improve vision, stabilize diopter, enhance retinal imaging quality, increase the asymmetry of the anterior corneal surface, and introduce different degrees of higher-order aberrations.

Effect of Trans-PRK combined with 0.02% MMC on corneal density in patients with moderate myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the effect of 0.02% mitomycin-C(MMC)on the corneal density after transepithelial photorefractive keratectomy(Trans-PRK). METHODS: Retrospective case analysis. Selected 28 patients with 56 eyes in moderate myopia who underwent Trans-PRK surgery from January 2021 to June 2021 in our hospital. They were divided into MMC group in 28 eyes with a combination of 0.02% MMC 20s during the surgery and the control group in 28 eyes was not use MMC during the surgery. The Pentacam anterior segment analyzer was used to measured the corneal density in different diameter ranges and different thickness layers before and after surgery at 14d, and after surgery at 1 and 3mo.RESULTS: The total corneal density value of MMC group was 16.60(15.70,17.10 )before the surgery, after the surgery at 14d was 16.63(15.90,17.50 ), at 1mo was 16.57(15.10,16.70 ), at 3mo was 16.04(14.60,16.60 ). The total corneal density value of control group was 16.30(15.50,17.30 )before the surgery, after the surgery at 14d was 16.20(15.20,17.10 ), at 1mo was 16.08(14.90,16.40 )and at 3mo was 15.60(14.60,16.40 ). In the zone of 0-2mm diameter was centered on the corneal vertex, the corneal density of the two groups at 14d after the surgery was higher than those before surgery(P<0.001 ). In the zone of 2-6mm diameter, the corneal density of the two groups at 1mo and 3mo after surgery was higher than those before the surgery(P<0.001). In the zone of 6-10mm, the corneal density of the two groups at 14d, 1 and 3mo after surgery was higher than those before the surgery(P<0.001). In the layer of anterior 120 μm, the corneal density of the two groups at 1mo and 3mo after the surgery was decreased than that before surgery(P<0.01). In the middle layer, the corneal density of the two groups at 1mo after the surgery was decreased than those before surgery(P<0.01).CONCLUSION:The use of 0.02% MMC during the operation can reduce the corneal density and increase the corneal light transmittance in the early postoperative period. The occurrence and prognosis of haze can be effectively quantified by observing the changes of corneal optical density in different ranges in different time periods after operation.

Gastrointestinal lipolysis and trans-epithelial transport of SMEDDS

Self-microemulsifying drug delivery systems (SMEDDSs) have recently returned to the limelight of academia and industry due to their enormous potential in oral delivery of biomacromolecules. However, information on gastrointestinal lipolysis and trans-epithelial transport of SMEDDS is rare. Aggregation-caused quenching (ACQ) fluorescent probes are utilized to visualize the

Evaluation of the effectiveness and safety of TransPRK assisted by smart pulse technology for high myopia / 中华实验眼科杂志

Objective:To evaluate the effectiveness and safety of transepithelial photorefractive keratectomy (TransPRK) assisted by smart pluse technology (SPT) for the correction of high myopia.Methods:An observational case series study was conducted.Sixty high myopic patients (107 eyes) with spherical equivalent (SE)≥-6.0 D who received TransPRK assisted by SPT from January to December 2016 in Eye Hospital of Wenzhou Medical University were enrolled.Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) of the patients were examined and recorded in logarithm of the minimum angle of resolution (LogMAR) units, and refraction was examined with a subjective refractometer.The healing of corneal epithelium and corneal haze was observed with a slit lamp.Intraocular pressure (IOP) was measured with the non-contact tonometer.Safety index (SI) and efficacy index (EI) were analyzed.The follow-up time was 12 months.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Eye Hospital of Wenzhou Medical University (No.2019-197-k-177). Written informed consent was obtained from each patient prior to any medical examination.Results:The mean epithelial healing time was (3.77±1.02) days.There were statistically significant differences in UCVA and BCVA between before and after surgery ( Z=380.812, 267.313; both at P<0.001). And the 7-day, 6-month, and 12-month postoperative BCVA were better than preoperative BCVA, showing statistically significant differences (all at P<0.05). Mean SI was 1.10±0.12, and mean EI was 1.05±0.17 at 12 months after surgery.There was no significant difference between the attempted SE before surgery (-8.02±1.36)D and the achieved SE at 12 months after surgery (-8.04±1.51)D ( P=0.523). SE in the predictive range within ±0.50 D accounted for 79% (85/107) and that within ±1.0 D accounted for 92% (98/107). The IOP was slightly increased in 3 eyes at 7 days and 7 eyes at 1 month after surgery, respectively, which returned to normal after the use of ophthalmic solution for lowing IOP.The incidence of haze severer than grade 1 was less than 1% (1 eye), and haze gradually disappeared after application of drugs. Conclusions:TransPRK assisted by SPT for high myopia shows good safety, effectiveness and predictability.It is an ideal corneal surface surgery to correct high myopia.

Changes of corneal anterior surface morphology and higher-order aberrations after Smart / 中华实验眼科杂志

Objective:To compare the changes of corneal asphericity and higher-order aberrations after smart pulse technology-assisted transepithelial photorefractive keratectomy (Smart) for low and moderate myopia and to investigate the changes in the shape of the front corneal surface in patients with different diopters.Methods:A non-randomized controlled study design was used.Ninety-eight eyes of 54 patients with moderate or low myopia who underwent Smart surgery in Tianjin Medical University Eye Hospital from November 2018 to March 2019 were included.The 41 eyes of 23 patients with low myopia were set as the low-myopia group, and 57 eyes of 31 patients with moderate myopia were assigned as the moderate-myopia group.The Pentacam anterior segment analysis system was used to measure Q value, index of surface variance (ISV), corneal higher-order aberration (HOA), corneal vertical coma (Z 3-1), corneal horizontal coma (Z 31) and spherical aberration (Z 40) before surgery, 1 month and 3 months after surgery.The anterior surface morphology was compared between the low-myopia and moderate-myopia group.Pearson correlation analysis was used to analyze the correlations between measurement parameters.The study protocol was approved by an Ethics Committee of Tianjin Medical University Eye Hospital (No.2019KY-17). Written informed consent was obtained from each patient before surgery. Results:Corneal Q value, ISV, HOA and Z 40 were 0.445±0.191, 26.973±5.611, 0.671±0.142 and 0.384±0.188, respectively, in the low-myopia group at one month after surgery, which were significantly increased than corresponding preoperative values of -0.273±0.817, 13.784±2.376, 0.433±0.687 and 0.231±0.062 (all at P<0.05). Corneal Q value, ISV, HOA and Z 40 were 0.693±0.203, 34.038±5.773, 0.874±0.216 and 0.520±0.129, respectively, in the moderate-myopia group at one month after surgery, which were significantly increased than corresponding preoperative values of -0.309±0.104, 14.838±3.992, 0.409±0.081 and 0.228±0.089 (all at P<0.05). Corneal Q values, ISV, HOA and Z 40 in the moderate-myopia group were higher than those in the low-myopia group at different time points after surgery, showing significant differences between the two groups (all at P<0.05). There was no significant difference in postoperative 1-month and 3-month corneal Z 3-1 and Z 31 between the two groups (both at P>0.05). The results of correlation analysis showed that there were no significant differences in ΔQ value and ΔISV between the two groups, both of which were negatively correlated with spherical equivalent (ΔQ value: low-myopia group: r=-0.364, P=0.044; moderate-myopia group: r=-0.589, P<0.01; ΔISV: low-myopia group: r=-0.298, P=0.039; moderate-myopia group: r=-0.409, P=0.022). ΔQ value and ΔZ 40 were positively correlated in the moderate-myopia group ( r=0.348, P=0.009); there was no significant correlation between ΔQ value and ΔZ 40 in the low-myopia group ( r=0.180, P=0.266). Conclusions:The corneal high-order aberrations and ISV after Smart are increased in comparison with preoperative values in the low-myopia and moderate-myopia eyes, and the corneal Q values change from negative to positive.The effect of Smart on corneal asphericity is less in the low-myopia eyes.

Repeatability and comparison of Corvis ST parameters before and after accelerated transepithelial corneal cross-linking in keratoconus eyes / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the repeatability and comparison of corneal visualization scheimpflug technology(Corvis ST)parameters in keratoconus eyes before and after accelerated transepithelial corneal cross-linking(ATE-CXL).<p>METHODS: Thirty eyes of 30 progressive keratoconus patients were included in the prospective study. Three repeated corneal biomechanical measurements were performed preoperatively and one month postoperatively by Corvis ST. The interclass correlation coefficient(ICC)and 95% confidence interval(<i>CI</i>), Cronbach'α, repeatability coefficient(RC), and coefficient of variation(CV)were used to evaluate the repeatability of Corvis ST parameters. Paired <i>t</i>-test or Wilcoxon rank test was used to evaluate the differences between preoperative and postoperative data.<p>RESULTS: At preoperative, 26 of 39(66.67%)parameters showed good to excellent repeatability, 6(15.38%)showed moderate, and 7(17.95%)showed poor repeatability. Similarly, 34(87.18%)parameters showed good to excellent repeatability, 3(7.69%)showed moderate, and 2(5.13%)showed poor repeatability after ATE-CXL. After ATE-CXL 1mo, the intraocular pressure(IOP), biomechanical corrected IOP(bIOP), first applanation time(A1T), Radius, deformation amplitude at the first applanation(A1DA), deflection length at the maximum deformation(HCDLL)and stiffness parameter at first applanation(SP A1)parameters increased, while the steep keratometry(Ks), flat keratometry(Kf), mean keratometry(Kmean), second applanation time(A2T), DA Ratio Max(2 mm)and integrated radius parameters decreased(all <i>P</i><0.05). <p>CONCLUSION:The repeatability of the Corvis ST parameters before and 1mo ATE-CXL follow up were both acceptable, and the corneal stiffness was improved after 1mo ATE-CXL.

Effect of intraoperative Trans-PRK combined with MMC on postoperative haze in the treatment of high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the mitomycin-C(MMC)0.02% efficacy in preventing haze after trans-epithelial photorefractive keratectomy(Trans-PRK)in the treatment of the high myopia. <p>METHODS: Retrospective case series. Trans-PRK were performed on 142 eyes with a preoperative spherical equivalent. They were divided into with 0.02% MMC(MMC group)and without MMC(control)groups. In MMC group there were 94 eyes with MMC 0.02%; in control group there were 48 eyes. Patients were treated with an intraoperative application of MMC 0.02% for 30-45s depending on refractive error in MMC group. After surgery, fluorometholone 0.1% eye drops were used for 4mo in all groups. The mean follow-up time was 6mo. The regression trees were used to analyse the relationship between different related factors and haze. <p>RESULTS:Haze was quantified with Fantes. Incidence of haze was 8.5% eyes in MMC group and 33.3% in without MMC group(<i>P</i>=0.001). In the regression trees, optical zone and ablation depth MAX were related to haze(<i>P</i><0.01). It was possibility induce haze when optical zone is ≤5.6mm. When optical zone is >5.6mm, ablation depth MAX becomes the main factor for haze.<p>CONCLUSION: The design of optical zone and ablation depth MAX in Trans-PRK should be considered for the treatment of the high myopia with thin cornea and abnormal corneal morphology. MMC 0.02% was effective in preventing haze after Trans-PRK in the treatment of the high myopia.

Acid-functionalized single-walled carbon nanotubes alter epithelial tight junctions and enhance paracellular permeability

The T(EB4)Nta, T(IBj5)Nta, and T(B362i)NtA strains were constructed by introgressing the insertionaltranslocations EB4, IBj5, and B362i from Neurospora crassa into the related species N. tetrasperma. Theprogeny from crosses of T(IBj5)Nta and T(B362i)NtA with opposite mating-type derivatives of the standard N.tetrasperma strain 85 exhibited a unique and unprecedented transmission ratio distortion (TRD) that disfavoredhomokaryons produced following alternate segregation relative to those produced following adjacent-1 segregation. The TRD was not evident among the [mat A ? mat a] dikaryons produced following either segregation. Further, crosses of the T(IBj5)Nta and T(B362i)NtA strains with the Eight spore (E) mutant showed anunusual ascus phenotype called ‘max-4’. We propose that the TRD and the max-4 phenotype are manifestations of the same Bateson-Dobzhansky-Muller incompatibility (BDMI). Since the TRD selects against 2/3 ofthe homokaryotic progeny from each introgression cross, the BDMI would have enriched for the dikaryoticprogeny in the viable ascospores, and thus, paradoxically, facilitated the introgressions.

Analysis of short-term objective visual quality after two kinds of corneal refractive surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze changes in objective visual quality before and after femtosecond laser <i>in situ</i> keratomileusis(FS-LASIK)and smart pulse technology-assisted transepithelial photorefractive keratectomy(SMART).<p>METHODS: Prospective study. We collected 50 cases(100 eyes)treated with FS-LASIK(FS-LASIK group)and another 50 cases(100 eyes)treated with SMART(SMART group)from the Ophthalmology Department of our hospital between October 2018 and December 2018 using Optical Quality Analysis System(OQAS)to measure objective scatter index(OSI), modulation transfer function cut off frequency(MTF cut off), strehl ratio(SR)before and after surgery.<p>RESULTS: In the FS-LASIK and SMART groups, the OSI values were higher in the 1 and 3mo after surgery, whereas the MTF cut off and SR were lower in the 1 and 3mo after surgery(<i>P</i><0.05). There was no statistical difference between the two groups in the objective visual quality index before and after 1mo(<i>P</i>>0.05). However, after 3mo, the OSI value of the FS-LASIK group was higher than the SMART group(0.88±0.28 <i>vs</i> 0.70±0.27, <i>P</i><0.001), whereas the SR was lower than SMART group(0.21±0.05 <i>vs</i> 0.24±0.05, <i>P</i>=0.002).<p>CONCLUSION: Both FS-LASIK and SMART caused an increase in the intraocular scattering index and a decrease in objective visual quality. However, the visual quality of the SMART group was generally better than that of the FS-LASIK group, and long-term visual quality was more dominant.

Clinical observation of transepithelial photorefractive ketatectomy on the anterior corneal surface parameters / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the effect of transepithelial photorefractive ketatectomy(TPRK)on corneal curvature, asphericity and aberrations. <p>METHODS: Twenty-nine patients(58 eyes)were enrolled. The 1mm-8mm zone curvature, target curvature and 3mm ring curvature, corneal asphericity(Q value)and corneal aberration was measured and analyzed before and 6mo after TPRK surgery. <p>RESULTS: In the 1mm-8mm zone, the corneal curvature all had significant decrease after TPRK surgery. The curvature 3mm ring after operation was 39.20±1.99D, and the curvature target was 39.51±1.99D. And both values had a significant correlation(<i>r</i>=0.98). The Q values before and after operation were -0.44 to -0.30, 0.34-0.66 respectively <i>(P</i><0.05). The total high-order aberration, spherical aberration and vertical coma of cornea before and after operation were 0.41±0.10, 0.17±0.08, -0.07±0.23 and 0.72±0.23, 0.41±0.17, -0.24±0.32, respectively, and these differences were significant. The pre-and postoperative horizontal coma was -0.03±0.12, and -0.03±0.30 respectively(<i>P</i>>0.05).<p>CONCLUSION: After TPRK operation, corneal curvature decreased significantly, and the change in zone of 3mm was the largest. The Q value, total high-order aberration, spherical aberration and vertical coma increased significantly after TPRK operation.

Primary Nasal Epithelial Cells From Allergic and Non-allergic Individuals Show Comparable Barrier Function

Previous reports suggested that ex vivo cultured primary nasal epithelial cells from allergic patients differ from those from non-allergic individuals by genuinely reduced barrier function. By contrast, we found that primary nasal epithelial cells from allergic and non-allergic individuals showed comparable barrier function and secretion of cytokines.