Vitreoretinal surgery for proliferative diabetic retinopathy with two types of bandage contact lenses: clinical results and protection of corneal epithelium / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To observe the effect of two kinds of bandage contact lenses on epithelial erosions and corneal thickness after vitreoretinal surgery for proliferative diabetic retinopathy ( PDR) .· METHODS: In this prospective, nonrandomized, comparative clinical study, 69 eyes of 69 patients with PDR were divided into two groups. They underwent vitreoretinal surgery. Group A, 36 eyes of 36 cases, the bandage contact lens with diameter of 13. 8mm were covered on corneal surface during surgery under noncontact wide-angle viewing systems. Group B, 33 eyes of 33 cases, the bandage contact lens with diameter of 14. 0mm were covered on corneal surface during the same surgery. Visual acuity, intraocular pressure, slit-lamp examination, corneal fluorescein sodium staining, count of corneal endothelium cells, measure of corneal thickness before and after operation were assessed.·RESULTS: Pre-operation, corneal fluorescein sodium staining positive rate was 42% in Group A and 42% in Group B (x2=0. 004, P=0. 949). At 1d after surgery, the positive rate of was 47% in Group A and 45% in Group B (x2=0. 022, P=0. 883). At 2d after surgery, the positive rate of was 44% in Group A and 45% in Group B ( x2 =0. 007, P=0. 933). At 3d after surgery, the positive rate of was 44% in Group A and 42% in Group B (x2=0. 029, P=0. 886). At 7d after surgery, the positive rate of was 42%in Group A and 39% in Group B (x2=0. 037, P=0. 848). Count of corneal endothelium cells showed no significant difference between Group A and Group B(P>0. 05). Count of corneal endothelium cells of Group A before surgery and at 7d after surgery were 2779. 25 ± 329. 55 /mm2 , 2777. 14±331. 17 /mm2, without significant difference (t=0. 551, P=0. 585);those of Group B were 2678. 61±335. 64/mm2 , 2672. 45 ± 336. 25 /mm2 , without significant difference(t = 1. 774, P = 0. 086). Measure of corneal thickness was 519. 25±23. 42μm before surgery and 542. 03± 25.94μm after surgery in Group A (t=-6.854, P<0.001). Measure of corneal thickness was 525. 64 ± 20. 97μm before surgery and 551. 33±27. 87μm after surgery in Group B (t=-7. 204, P<0. 001).·CONCLUSION:Two kinds of bandage contact lenses are used in vitreoretinal surgery in diabetic patients. The corneal epithelial integrity shows no difference before and after surgery. Both the bandage contact lens could protect the corneal epithelium and maintain good corneal transparency during vitreoretinal surgery.

Hypersensitivity toward bacterial stimuli in patients with age-related macular degeneration.

Although the pathogenesis of age-related macular degeneration (AMD) is unclear, genetic screening has revealed that polymorphisms in the complement system may be associated with AMD development. Production of autoantibodies was also found in AMD patients. In this study, we analyzed the antibody response in AMD patients. We found that purified B cells from AMD patients tended to respond to lower concentrations of bacterial antigen stimulation, and produced higher amounts of antibodies, especially in IgM and IgA secretions. When examining clinical symptoms, patients with more severe wet-form AMD tended to exhibit higher sensitivity to bacterial antigens and secreted more IgM and IgA antibodies than those with less severe dry-form cases. In conclusion, our study discovered an altered B-cell antibody production in response to bacterial antigens in AMD patients, which potentially contributes to AMD pathogenesis.

Characteristics and visual outcomes of patients hospitalized for ocular trauma in central China: 2006-2011.

AIM: To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in this region. METHODS: A retrospective study of patients hospitalized for ocular trauma in central China from 2006 to 2011 was performed. RESULTS: This study included 5964 eyes of 5799 patients. The average age was 35.5±21.8y with a male-to-female ratio of 2.8:1. The most common age was 45-59y age group. Most patients were farmers and workers (51.9%). The most common injuries were firework related (24.5%), road traffic related (24.2%), and work related (15.0%). Among the most common causative agents were firecrackers (24.5%), followed by metal/knife/scissors (21.4%). Most injuries occurred in January (14.2%), February (27.0%), and August (10.0%). There were 8.5% patients with ocular injuries combined with other injuries. The incidence of open ocular injuries (4585 eyes, 76.9%) was higher than closed ocular injuries (939 eyes, 15.7%). The incidences of chemical and thermal ocular injuries were 1.2% and 0.6%. Ocular trauma score (OTS) predicted final visual acuity at non light perception (NLP), 20/200-20/50 and 20/40 with a sensitivity of 100%, and light perception (LP)/hand motion (HM) and 1/200-19/200 with a specificity of 100%. CONCLUSIONS: This study provides recent epidemiological data of patients hospitalized for ocular trauma in central China. Some factors influencing the visual outcome include time interval between injury and visit to the clinic, wound location, open or closed globe injury, initial visual acuity, and OTS.