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.

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.

Synergistic Effects of Selenophene and Extended Ladder-Type Donor Units for Efficient Polymer Solar Cells.

Two pairs of polymer donor materials based on indacenodithiophene (IDT) and indacenodithieno[3,2-b]thiophene (IDTT) as the donor units are synthesized. Thiophene or selenophene is introduced as the π-bridge units and electron-deficient fluorine-substituted quinoxaline is used as acceptor unit. Selenophene-containing polymers PIDT-DFQ-Se and PIDTT-DFQ-Se show redshifted absorption and narrower bandgaps. Combined with IDTT donor unit, PIDTT-DFQ-Se shows the highest absorption coefficient. Both the IDTT unit and selenophene unit have positive effects on the hole mobilities, making PIDTT-DFQ-Se the highest one. The best power conversion efficiency of 7.4% is obtained from devices based on PIDTT-DFQ-Se:[6,6]-phenyl C71 butyric acid methyl ester (PC71 BM) with a Jsc of 12.6 mA cm-2 , a Voc of 0.89 V, and a fill factor (FF) of 0.66.

[Safety and immunogenicity on the formulation of trivalent split influenza vaccine among healthy people aged over 18 years].

OBJECTIVE: To evaluate the safety and immunogenicity of split influenza vaccine (Anflu(®)). METHODS: An open-labeled clinical trial was carried out in adults aged 18 - 60 years and elders aged over 60 years from August to September, 2010 in Shenyang, Liaoning province. One dose of split influenza vaccine was administered and adverse events were observed. Serum samples were obtained prior to vaccination and 21 days post vaccination. A/H1N1, A/H3N2 and B antibodies against influenza virus were measured using micro-hemagglutination inhibition (HI) assay. RESULTS: A total of 130 subjects were recruited and 120 paired serum samples were obtained. The overall rate of adverse events was 2.3% (3/130) and all of them with systemic reaction. No single serious adverse event was reported. 21 days after the vaccination, the sero-conversion rates of A/H1N1, A/H3N2 and B antibodies against influenza virus among adults were 82.5%, 93.7% and 92.1%, respectively. The Geometric Mean Titer (GMT) ratios were 20.2, 32.0 and 11.4, while the sero-protection rates were 92.1%, 98.4% and 98.4%, respectively. The sero-conversion rates of antibodies among elders were 89.5%, 91.2% and 87.7%, with the GMT ratios as 23.9, 39.8 and 15.1, respectively. The sero-protection rates were 93.0%, 94.7% and 96.5%, respectively. CONCLUSION: All indexes of A/H1N1, A/H3N2 and B antibodies exceeded the licensure criteria established by the EU Committee for Medicinal Products for Human Use, proving the trial vaccine Anflu(®) with good safety and immunogenicity.

Enzymic colorimetry-based DNA chip: a rapid and accurate assay for detecting mutations for clarithromycin resistance in the 23S rRNA gene of Helicobacter pylori.

Macrolide drugs, such as clarithromycin (CAM), are a key component of many combination therapies used to eradicate Helicobacter pylori. However, resistance to CAM is increasing in H. pylori and is becoming a serious problem in H. pylori eradication therapy. CAM resistance in H. pylori is mostly due to point mutations (A2142G/C, A2143G) in the peptidyltransferase-encoding region of the 23S rRNA gene. In this study an enzymic colorimetry-based DNA chip was developed to analyse single-nucleotide polymorphisms of the 23S rRNA gene to determine the prevalence of mutations in CAM-related resistance in H. pylori-positive patients. The results of the colorimetric DNA chip were confirmed by direct DNA sequencing. In 63 samples, the incidence of the A2143G mutation was 17.46 % (11/63). The results of the colorimetric DNA chip were concordant with DNA sequencing in 96.83 % of results (61/63). The colorimetric DNA chip could detect wild-type and mutant signals at every site, even at a DNA concentration of 1.53 x 10(2) copies microl(-1). Thus, the colorimetric DNA chip is a reliable assay for rapid and accurate detection of mutations in the 23S rRNA gene of H. pylori that lead to CAM-related resistance, directly from gastric tissues.