Stromal lenticule addition keratoplasty with corneal crosslinking for corneal ectasia secondary to FS-LASIK: a case series.

AIM: To explore the clinical efficacy and safety of stromal lenticule addition keratoplasty (SLAK) with corneal crosslinking (CXL) on patients with corneal ectasia secondary to femtosecond laser-assisted in situ keratomileusis (FS-LASIK). METHODS: A series of 5 patients undertaking SLAK with CXL for the treatment of corneal ectasia secondary to FS-LASIK were followed for 4-9mo. The lenticules were collected from patients undertaking small incision lenticule extraction (SMILE) for the correction of myopia. Adding a stromal lenticule was aimed at improving the corneal thickness for the safe application of crosslinking and compensating for the thin cornea to improve its mechanical strength. RESULTS: All surgeries were conducted successfully with no significant complications. Their best corrected visual acuity (BCVA) ranged from 0.05 to 0.8-2 before surgery. The pre-operational total corneal thickness ranged from 345-404 µm and maximum keratometry (Kmax) ranged from 50.8 to 86.3. After the combination surgery, both the corneal keratometry (range 55.9 to 92.8) and total corneal thickness (range 413-482 µm) significantly increased. Four out of 5 patients had improvement of corneal biomechanical parameters (reflected by stiffness parameter A1 in Corvis ST). However, 3 patients showed decreased BCVA after surgery due to the development of irregular astigmatism and transient haze. Despite the onset of corneal edema right after SLAK, the corneal topography and thickness generally stabilized after 3mo. CONCLUSION: SLAK with CXL is a potentially beneficial and safe therapy for advanced corneal ectasia. Future work needs to address the poor predictability of corneal refractometry and compare the outcomes of different surgical modes.

Tumor-infiltrating macrophage associated lncRNA signature in cutaneous melanoma: implications for diagnosis, prognosis, and immunotherapy.

Along with the increasing knowledge of long noncoding RNA, the interaction between the long noncoding RNA (lncRNA) and tumor immune infiltration is increasingly valued. However, there is a lack of understanding of correlation between regulation of specific lncRNAs and tumor-infiltrating macrophages within melanoma. In this research, a macrophage associated lncRNA signature was identified by multiple machine learning algorithms and the robust and effectiveness of signature also validated in other independent datasets. The signature contained six specific lncRNAs (PART1, LINC00968, LINC00954, LINC00944, LINC00518 and C20orf197) was constructed, which could diagnose melanoma and predict the prognosis of patients. Moreover, our signature achieves higher accuracy than the previous well-established markers and regarded as an independent prognostic indicator. The pathway enrichment revealed that these lncRNAs were closely correlated with many immune processes. In addition, the signature was associated with different immune microenvironment and applied to predict response of immune checkpoint inhibitor therapy (low risk of patients well respond to anti-PD-1 therapy and high risk is insensitive to anti-CTLA-4 therapy). Therefore, our finding supplies a more accuracy and effective lncRNA signature for tumor-infiltrating macrophages targeting treatment approaches and affords a new clinical application for predicting the response of immunotherapies in melanomas.

Long-term observation of V4c implantable collamer lenses implantation for moderate to extreme high myopia correction: five years follow-up.

BACKGROUND: This study aims to assess the long term effectiveness, safety, predictability and stability of V4c implantable collamer lenses (ICL) for correction of moderate to extreme high myopia. METHODS: We reviewed 125 eyes from 64 patients who implanted V4c ICL at the Refractive Surgery Center of West China Hospital in Chengdu, China, between May 2015 and January 2017. The median spherical equivalent was -11.50 D (interquartile range [IQR]: -13.00 to -9.00 D). We followed up with the patients over five years and evaluated several parameters, including uncorrected visual acuity (UDVA), corrected visual acuity (CDVA), axial length, refractive error, endothelial cell density (ECD), intraocular pressure (IOP), white-to-white distance (WTW), and vault. We performed a correlation analysis to explore the potential impacts on vault following implantation. RESULTS: The median safety index (postoperative CDVA/preoperative CDVA) during the last follow-up was 1.00 (interquartile range [IQR]: 1.00-1.20), and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.20 (IQR: 1.00-1.25), 1.20 (IQR: 1.00-1.33), and 0.8 (IQR: 0.65-1.00) at postoperative 1 week, 1 month, and 5 years, respectively. At the five-year mark, 16% of the eyes were within ±0.50 D of expected correction, and 73% were within ±2.00 D. No significant difference in ECD was observed between pre-operative and post-operative measurements. Compared to baseline, we observed a significant increase in IOP at the one-week follow-up, which decreased significantly at the one-month visit. Furthermore, we identified ICL size and spherical equivalent (SE) as independent variables in a multiple linear regression model that accurately predicted the five-year vault after surgery. CONCLUSION: In conclusion, V4c ICL implantation is an effective and safe treatment for moderate to extreme high myopia with good predictability and stability over the long-term.

[A rare case of neonatal-onset hepatic sinusoidal obstruction syndrome]. / æ–°ç”Ÿå„¿æœŸèµ·ç— çš„ç½•è§è‚çª¦é˜»å¡žç»¼åˆå¾1例.

A male infant, aged 1 month and 14 days, was admitted to the hospital due to abdominal distension lasting for 2 weeks and worsening for 3 days. The infant had a history of omphalitis. Physical examination revealed severe abdominal distension, prominent abdominal wall veins, hepatosplenomegaly, and massive ascites. There was a slight elevation in liver transaminase levels. Liver ultrasound and CT scans demonstrated the absence of visualization of the intrahepatic segment of the portal vein and the left, middle, and right veins of the liver, indicating occlusion of these vessels, along with surrounding fibrous hyperplasia. The clinical diagnosis was hepatic sinusoidal obstruction syndrome resulting from omphalitis. A large amount of bloody ascites developed after 12 days of hospitalization, resulting in hypovolemic shock and respiratory failure. The infant passed away following the family's decision to discontinue treatment. This article focuses on the diagnostic approach and multidisciplinary management of neonatal-onset hepatic sinusoidal obstruction syndrome, as well as provides insights into the differential diagnosis of hepatomegaly and ascites.

Deep Learning-Based Automatic Diagnosis of Keratoconus with Corneal Endothelium Image.

INTRODUCTION: The primary objective of this study was to develop an end-to-end model that can accurately identify corneal endothelial cells and diagnose keratoconus based on corneal endothelial images acquired from a non-contact specular microscope. METHODS: This was a retrospective case-control study performed at the Refractive Surgery Center of West China Hospital. A total of 403 keratoconus eyes (221 patients) and 370 myopic eyes (185 normal controls) were consecutively recruited from January 2021 to September 2022. Specular microscopy was used to image and measure the morphometric parameters of the corneal endothelial cells. A Fully Convolutional Network model with a ResNet50 (FCN_ResNet50) was established to perform the endothelial segmentation. The images were then classified using an ensemble machine learning system consisting of four pre-trained deep learning networks: DenseNet121, ResNet50, Inception_v3, and MobileNet_v2. The performance of the models was evaluated based on different metrics, such as accuracy, intersection over union (IoU), and mean IoU. RESULTS: We established a fully end-to-end deep-learning model for the segmentation of endothelial and diagnosis of keratoconus. For endothelial segmentation, the accuracy of the FCN_ResNet50 model achieved near 90% with mean IoU converging to about 80%. The ensemble machine learning system can achieve over 92% accuracy, and > 98% area under curve (AUC) values to diagnose keratoconus with endothelial cell images. In addition, we constructed a diagnostic model based on deep-learning features and developed an associated nomogram which manifested an excellent performance for diagnosis and monitoring the progression of keratoconus. CONCLUSIONS: Our research developed an end-to-end model to automatically identify and assess corneal endothelial morphological changes in keratoconus eyes. Moreover, we also constructed a novel nomogram, which can provide valuable information for the diagnosis, monitoring, and management of the disease.

Cross talk between tumor stemness and microenvironment for prognosis and immunotherapy of uveal melanoma.

PURPOSE: Tumor stem cells have emerged as a crucial focus of investigation and a therapeutic target in the context of cancer metastasis and drug resistance. They represent a promising novel approach to address the treatment of uveal melanoma (UVM). METHODS: According to the one-class logistic regression (OCLR) approach, we first estimated two stemness indices (mDNAsi and mRNAsi) in a cohort of UVM (n = 80). The prognostic value of stemness indices among four subtypes of UVM (subtype A-D) was investigated. Moreover, univariate Cox regression and Lasso-penalized algorithms were conducted to identify a stemness-associated signature and verify in several independent cohorts. Besides, UVM patients classified into subgroups based on the stemness-associated signature. The differences in clinical outcomes, tumor microenvironment, and probability of immunotherapeutic response were investigated further. RESULTS: We observed that mDNAsi was significantly linked with overall survival (OS) time of UVM, but no association was discovered between mRNAsi and OS. Stratification analysis indicated that the prognostic value of mDNAsi was only limited in subtype D of UVM. Besides, we established and verified a prognostic stemness-associated gene signature which can classify UVM patients into subgroups with distinct clinical outcomes, tumor mutation, immune microenvironment, and molecular pathways. The high risk of UVM is more sensitive to immunotherapy. Finally, a well-performed nomogram was constructed to predict the mortality of UVM patients. CONCLUSIONS: This study offers a comprehensive examination of UVM stemness characteristics. We discovered mDNAsi-associated signatures improved the prediction capacity of individualized UVM prognosis and indicated prospective targets for stemness-regulated immunotherapy. Analysis of the interaction between stemness and tumor microenvironment may shed light on combinational treatment that targets both stem cell and the tumor microenvironment.

Deep learning classification of uveal melanoma based on histopathological images and identification of a novel indicator for prognosis of patients.

BACKGROUND: Deep learning has been extensively used in digital histopathology. The purpose of this study was to test deep learning (DL) algorithms for predicting the vital status of whole-slide image (WSI) of uveal melanoma (UM). METHODS: We developed a deep learning model (Google-net) to predict the vital status of UM patients from histopathological images in TCGA-UVM cohort and validated it in an internal cohort. The histopathological DL features extracted from the model and then were applied to classify UM patients into two subtypes. The differences between two subtypes in clinical outcomes, tumor mutation, and microenvironment, and probability of drug therapeutic response were investigated further. RESULTS: We observed that the developed DL model can achieve a high accuracy of > = 90% for patches and WSIs prediction. Using 14 histopathological DL features, we successfully classified UM patients into Cluster1 and Cluster2 subtypes. Compared to Cluster2, patients in the Cluster1 subtype have a poor survival outcome, increased expression levels of immune-checkpoint genes, higher immune-infiltration of CD8 + T cell and CD4 + T cells, and more sensitivity to anti-PD-1 therapy. Besides, we established and verified prognostic histopathological DL-signature and gene-signature which outperformed the traditional clinical features. Finally, a well-performed nomogram combining the DL-signature and gene-signature was constructed to predict the mortality of UM patients. CONCLUSIONS: Our findings suggest that DL model can accurately predict vital status in UM patents just using histopathological images. We found out two subgroups based on histopathological DL features, which may in favor of immunotherapy and chemotherapy. Finally, a well-performing nomogram that combines DL-signature and gene-signature was constructed to give a more straightforward and reliable prognosis for UM patients in treatment and management.

A 3-month comparison study of subjective and objective visual quality of small incision lenticule extraction and transepithelial photorefractive keratectomy in patients with low and moderate myopia.

AIM: To compare the subjective and objective visual quality between small incision lenticule extraction (SMILE) and transepithelial photorefractive keratectomy (tPRK) in patients with low and moderate myopia. METHODS: Patients undertaking SMILE or tPRK for the correction of low and moderate myopia were consecutively recruited in this prospective cohort study with a 3-month follow-up period. Objective evaluation [visual acuity test, manifest refraction, wavefront aberrations, the total cut-off value of the total modulation transfer function (MTFcut-off), and Strehl ratio (SR)] and subjective evaluation of visual quality (quality-of-life questionnaire) were conducted before surgery and at days 1, 7, 30, and 90 after surgery. RESULTS: A total of 47 patients (94 eyes) with SMILE and 22 patients (22 eyes) with tPRK were enrolled. The uncorrected visual acuity (UCVA) was better in SMILE patients on day 7 after surgery (1.13±0.13 vs 0.99±0.17, t=4.85, P<0.001) but was comparable at days 30 and 90. At day 90, the SMILE group had a lower spherical equivalent (SE) than the tPRK group (0.04±0.31 vs 0.19±0.43, t=2.08, P=0.042). Total higher order aberrations (HOAs) were induced in both surgical types, which were more evident in the tPRK group with 3-mm pupil diameter (0.16±0.07 vs 0.11±0.05, t=4.27, P<0.001) and 5-mm pupil diameter (0.39±0.17 vs 0.36±0.11, t=2.33, P=0.022). The MTFcut-off and SR showed a trend of improvement in both SMILE and tPRK patients but were statistically better in the SMILE group with both pupil diameters. There was a significant improvement of contrast sensitivity (CS) over baseline levels at the spatial frequency of 18 cycles/degree (c/d) in the SMILE group (F=2.72, P=0.033) and at 3 c/d (F=3.03, P=0.031), 12 c/d (F=3.72, P=0.013), and 18 c/d (F=4.62, P=0.004) in the tPRK group. The subjective quality of life questionnaire showed a steady improvement in the SMILE group (F=8.31, P<0.001) but not the tPRK group. CONCLUSION: SMILE and tPRK are both safe and effective ways to correct low and moderate myopia. A generally better and quicker recovery of visual quality favors the application of SMILE in qualified patients.

Prediction of Early Visual Outcome of Small-Incision Lenticule Extraction (SMILE) Based on Deep Learning.

INTRODUCTION: Deep learning (DL) has been widely used to estimate clinical images. The objective of this project was to create DL models to predict the early postoperative visual acuity after small-incision lenticule extraction (SMILE) surgery. METHODS: We enrolled three independent patient cohorts (a retrospective cohort and two prospective SMILE cohorts) who underwent the SMILE refractive correction procedure at two different refractive surgery centers from July to September 2022. The medical records and surgical videos were collected for further analysis. Based on the uncorrected visual acuity (UCVA) at 24 h postsurgery, the eyes were divided into two groups: those showing good recovery and those showing poor recovery. We then trained a DL model (Resnet50) to predict eyes with early postoperative visual acuity of patients in the retrospective cohort who had undergone SMILE surgery from surgical videos and subsequently validated the model's performance in the two prospective cohorts. Finally, Gradient-weighted Class Activation Mapping (Grad-CAM) was performed for interpretation of the model. RESULTS: Among the 318 eyes (159 patients) enrolled in the study, 10,176 good quality femtosecond laser scanning images were obtained from the surgical videos. We observed that the developed DL model achieved a high accuracy of 96% for image prediction. The area under the curve (AUC) value of the DL model in the retrospective cohort was 0.962 and 0.998 in the training and validation datasets, respectively. The AUC values in two prospective cohorts were 0.959 and 0.936. At the video level, the trained machine learning (ML) model (XGBoost) also accurately distinguished patients with good or poor recovery. The AUC value of the ML model was 0.998 and 0.889 in the retrospective cohort (training and test datasets, respectively) and 1.000 and 0.984 in the two prospective cohorts. We also trained a DL model which can accurately distinguish suction loss (100%), black spots (85%), and opaque bubble layer (96%). The Grad-CAM heatmap indicated that our models can recognize the area of scanning and precisely identify intraoperative complications. CONCLUSIONS: Our findings suggest that artificial intelligence (DL and ML model) can accurately predict the early postoperative visual acuity and intraoperative complications after SMILE surgery just using surgical videos or images, which may display a great importance for artificial intelligence in application of refractive surgeries.

Crosstalk of four kinds of cell deaths defines subtypes of cutaneous melanoma for precise immunotherapy and chemotherapy.

Background: Cell death patterns can give therapeutic and biological clues that facilitate the development of individualized treatments for this lethal form of skin cancer. Methods: We employed unsupervised clustering to establish robust classifications based on the four kinds of cell death-associated gene expression of 462 melanoma patients in the Cancer Genome Atlas (TCGA) and tested their reproducibility in two independent melanoma cohorts of 558 patients. We then used dimensionality reduction of graph learning to display the different characteristics of cell death patterns and immune microenvironments. Results: We examined 570 cell death-associated gene expression data of melanoma patients for exploration, independent verification, and comprehensive classification of five reproducible melanoma subtypes (CS1 to CS5) with different genomic and clinical features. Patients in death-inactive subtypes (CS1, CS2, and CS5) had the least immune and stromal cell infiltration, and their prognosis was the poorest. A death-active subtype (CS4), on the other hand, had the highest infiltrated immune and stromal cells and elevated immune-checkpoints. As a result, these patients had the highest response to immunotherapy and the best prognosis. An additional subtype (CS3) had more diversified cell death and immune characteristics with moderate prognoses. Based on graph learning, we successfully divided the CS3 subtype into two subgroups (group A and group B) with distinct survival outcomes and immune features. Finally, we identified eight potential chemical drugs that were specifically targeted for the therapy of melanoma subtypes. Conclusions: This research defines the intrinsic subtypes of melanoma based on the crosstalk of four kinds of cell deaths, which affords a blueprint for clinical strategies and guiding precise immunotherapy and chemotherapy for melanoma patients.

Transgenic dry eye mouse models: powerful tools to study dry eye disease.

Dry eye disease (DED) is one of the most common chronic multifactorial ocular surface diseases with high prevalence and complex pathogenesis. DED results in several ocular discomforts, vision fluctuation, and even potential damage of the ocular surface, bringing heavy burdens both on individuals and the society. The pathology of DED consists of tear film hyperosmolarity and immune responses on the ocular surface. Mice are widely used for developing models that simulate human DED features for investigating its pathogenesis and treatment. DED can be classified into aqueous-deficiency dry eye (ADDE) and evaporative dry eye (EDE). ADDE can be further divided into Sjögren syndrome dry eye (SSDE) and non-Sjögren syndrome dry eye (NSSDE). SSDE mouse models include natural strains, typified by non-obese diabetic (NOD) mice, and genetically engineered ones, like Aire-/- and Id3 knockout mice. Intrinsic EDE mainly refers to meibomian gland dysfunction (MGD). Eda-/- Tabby, Sod1-/-, Elovl1-/- are the most common transgenic MGD mouse models. Transgenic mouse models provide useful tools for studying the pathogenesis of DED and evaluating its novel therapies. This review compares the major transgenic dry eye mouse models and discusses their applications in DED research.

Androgen and meibomian gland dysfunction: from basic molecular biology to clinical applications.

Meibomian gland, the largest sebaceous gland of the body, is responsible for the biosynthesis of lipid layer of the tear film to prevent excessive evaporation. The loss of normal functions of meibomian gland, known as meibomian gland dysfunction (MGD), is a chronic disease and is the leading cause of dry eye symptoms in the clinics. Studies have found sex hormones, especially androgen, play vital roles in the regulation of the functions of meibomian gland. Recently, androgen has also been preliminarily applied in clinics for the treatment of MGD and showed promising results, especially in people with endogenous androgen deficiency. This review summarized the mechanisms of the function of androgen on meibomian gland based on molecular, animal, and clinical studies, and proposed evidence-based views about its potential applications for the treatment of MGD.

Effect of body position on the pathogenesis of asymmetric primary open angle glaucoma.

AIM: To explore the pathogenesis of asymmetric primary open angle glaucoma (POAG) in both eyes by comparing the intraocular pressure (IOP) of patients who sleep in different positions and to investigate the relationship between IOP variations and sleep positions. METHODS: One hundred and thirty-one patients with asymmetric POAG and forty-six healthy volunteers were enrolled. All participants completed a questionnaire that provided information about their sleep laterality. The cup disc ratio (C/D) and visual field defect established binocular asymmetry. The IOP of both eyes was measured using iCare parameters after the patients were asked to change body position. The "worse" and "better" eyes were identified according to the diagnosis, whereas the "dependent" and "independent" eyes were defined according to the lateral position. RESULTS: No significant difference in sleep laterality was observed between healthy people and patients with POAG (F=3.195, P=0.362). Among the enrolled patients, the IOP of the dependent eye was always greater than that of the independent eye in the lateral position (P<0.05). In the patients with binocular asymmetric POAG, the questionnaire clearly showed that 85.7% of left side preferences were found their left eyes to be the worse eyes and the right eyes of 71.4% patients with a right side preference were the more serious. When the asymmetric C/D ratio was greater than or equal to 0.2, the worse eye of patients with POAG and a preferred sleeping position was the dependent eye (χ2 =16.762, P=0.001). CONCLUSION: A higher IOP was measured in the dependent eye in the lateral position. The long-term tendency to choose a lateral sleeping position might lead the dependent eye to manifest more severe symptoms than the independent eye. Thus, the lateral sleeping position might be one cause of asymmetric POAG.

Chondroitin sulfate proteoglycans impede myelination by oligodendrocytes after perinatal white matter injury.

Hypomyelination is the major cause of neurodevelopmental deficits that are associated with perinatal white matter injury. Chondroitin sulfate proteoglycans (CSPGs) are known to exert inhibitory effects on the migration and differentiation of oligodendrocytes (OLs). However, few studies describe the roles of CSPGs in myelination by OLs and the cognitive dysfunction that follows perinatal white matter injury. Here, we examined the alterations in the expression of CSPGs and their functional impact on the maturation of OLs and myelination in a neonatal rat model of hypoxic-ischemic (HI) brain injury. Three-day-old Sprague-Dawley rats underwent a right common carotid artery ligation and were exposed to hypoxia (6% oxygen for 2.5h). Rats were given chondroitinase ABC (cABC) via an intracerebroventricular injection to digest CSPGs. Animals were sacrificed at 7, 14, 28 and 56days after HI injury and the accompanying surgical procedure. We found that the expression of CSPGs was significantly up-regulated in the cortical regions surrounding the white matter after HI injury. cABC successfully degraded CSPGs in the rats that received cABC. Immunostaining showed decreased expression of the pre-oligodendrocyte marker O4 in the cingulum, external capsule and corpus callosum in HI+cABC rats compared to HI rats. However HI+cABC rats exhibited greater maturation of OLs than did HI rats, with increased expression of O1 and myelin basic protein in the white matter. Furthermore, using electron microscopy, we demonstrated that myelin formation was enhanced in HI+cABC rats, which had an increased number of myelinated axons and decreased G-ratios of myelin compared to HI rats. Finally, HI+cABC rats performed better in the Morris water maze task than HI rats, which indicates an improvement in cognitive ability. Our results suggest that CSPGs inhibit both the maturation of OLs and the process of myelination after neonatal HI brain injury. The data also raise the possibility that modifying CSPGs may repair this type of lesion associated with demyelination.

[Effect of KH902 in inhibiting suture induced corneal neovascularization].

OBJECTIVE: To evaluate the effect of topical KH902 on experimental corneal neovascularization (CNV) in rats. METHODS: Suture models of CNV were established in 60 adult healthy rats. The rats were randomly divided into 3 groups: Group A (20 rats) were treated with KH902 (KH902 30 mg/mL was injected subconjunctivally once every other day); Group B (20 rats) were treated with dexamethasone (0.1% dexamethasone was injected subconjunctivally once every other day); Group C (20 rats) served as blank control. CNV growth were observed by slitlamp microscopy 3, 7 and 14 d after suture. Medicines were administered 14 d after operations. CNV changes were observed and recorded 1, 7, 14, and 21 d after administration of medicines. VEGF expression in cornea was measured by immunohistochemistry. RESULTS: No significant differences were found in average areas of CNV between groups at 1 and 7 d after administration of medicines. At 14 and 21 d after administration of medicines, significant differences in average areas of CNV were found between Group A and Group C, and between Group B and Group C (P < 0.01). Maximum expression of VEGF in corneal stroma was observed 14 d after corneal suture. The expression of VEGF decreased with medications, which was associated with neovascularization. CONCLUSION: Topical use of KH902 inhibits corneal suture-induced CNV in rats without significant adverse corneal effect on eyes.

Retinoblastoma: concerning its initiation and treatment.

Retinoblastoma (RB) is the most common intraocular cancer of infancy and childhood. This cancer is initiated by mutation on RB1, the tumor suppressor gene that is responsible for the regulation of both cell cycle and gnome stability in retinal cells. Patients with a constitutional mutation on RB1 can be inherited. RB occurs approximately 1 in every 15 000-20 000 live births. The worldwide mortality for this cancer is about 5%-11%. However, this rate rises to about 40%-70% in developing countries due to a delay in diagnosis. A wide variety of options are available for the treatment, but often a combination of therapies is adopted to optimize individualized care.

[An experimental study on inhibition effects of KH902 on rat corneal neovascularization].

OBJECTIVE: To observe the inhibition effect of subconjunctival injection of KH902 on rat corneal neovascularization (CNV)induced by alkaline burn. METHODS: Alkaline burn was adopted to make rat corneal neovascularization models. The rats were randomly divided into four groups: (1) Experimental group, subconjunctival injection of KH902 (30 mg/mL); (2) Masculine comparison group, subconjunctival injection of dexamethasone (1 mg/mL); (3) Comparison group I, subconjunctival injection of solvent of KH902; (4) Comparison group II, subconjunctival injection of saline. At the 28th day after the treatments, the maximal length, area of corneal neovascularization, and the average optical density value of vascular endothelial cell growth factor (VEGF) immunohistochemical staining in the four groups were measured. RESULTS: On the 28th day after molding, the corneal neovascularization area of KH902 experimental group was distinctly smaller than that of dexamethasone group, solvent group and saline group (P < 0.05 or P < 0.01). The expression of VEGF in the experimental group was distinctly lower than that of other groups (P < 0.01). CONCLUSION: Subconjunctival injection of KH902 (30 mg/mL) may inhibit rat corneal neovascularization.

Comparisons of morphologic characteristics between thin-flap LASIK and SBK.

AIM: To compare the morphologic characteristics between thin-flap laser in situ keratomileusis (LASIK) and Sub-Bowman keratomileusis (SBK), and to evaluate the uniformity of flap and to explore the correlative factors of corneal flap thickness. METHODS: A prospective, randomized, comparative clinical study was performed in Department of Ophthalmology, West Hospital of China, Chengdu, Sichuan Province, China. Totally 59 patients 114 eyes underwent LASIK or SBK to correct myopia, 29 patients 57 eyes underwent SBK, 30 patients 57 eyes underwent LASIK. Anterior optical coherence tomography(OCT) was used to measure corneal flap thickness in all the patients 1 week after surgeries, 16 positions were set to be measured in each eye. Comparisons of flap thickness in each group and between 2 groups were evaluated. Correlative factors of flap thickness were evaluated. RESULTS: Coefficient of variation (CV, s/×%) in SBK group were lesser than that in LASIK group, t test showed there was significant statistical difference between 2 groups(P=0.000). Comparisons of the difference of 2 paired positions(temporal-nasal; superior-inferior) showed there were no significant differences in each group, but between 2 groups, there were statistical significance of value of difference (D-value) of superior and inferior positions between SBK and LASIK group(P=0.036). Linear regression analysis of correlative factors of flap thickness showed there were no statistic significances related to central corneal thickness(CCT)(P=0.060, t=1.921) and corneal curvature(P=0.083, t=1.766). CONCLUSION: SBK is better than LASIK in creating much uniform corneal flap. There was no evidence showing correlations between flap thickness and CCT or corneal curvature.

[Analysis of ocular higher-order aberrations in refractive amblyopia].

OBJECTIVE: To compare the distribution of ocular higher-order aberrations in control group and amblyopia group and to explore the mechanism of the higher-order aberrations in refractive amblyopia. METHODS: The root-mean-square (RMS) values of the higher-order aberrations were measured 3 times across 6.5 mm dilated pupil of 74 eyes using Allegro Wave Analyzer. The results were compared in normal control group and amblyopia group which were determined by the best corrected visual acuity. RESULTS: RMS4, RMS5, RMS6 and RMSh in amblyopia were all significantly greater than those in control group. RMS values presented a degressive trend from RMS3 to RMS6, and RMS3 was the dominant higher-order aberration in the two groups. Coma and Y-axis coma had significant differences in the two groups. CONCLUSION: The high level of higher-order aberrations is related to amblyopia. Coma, particularly y-axis coma plays an important part in the corrected vision. It suggests that the diagnosis of amblyopia should include ocular higher-order aberrations.