Change of Optical Intensity during Healing Process of Corneal Wound on Anterior Segment Optical Coherence Tomography.

The purpose of this study is to investigate the process of corneal wound healing after penetrating injury with the change in optical intensity on anterior segment optical coherence tomography (AS-OCT) and to investigate factors associated with severity of corneal scar. Forty-seven eyes from 47 patients with repaired corneal laceration were included. AS-OCT was performed on 1day, 1week, 1, 3 and 6 months after primary repair. Internal aberrations of wound edges were observed on AS-OCT images. Parameters including height of steps, width of gaps, maximal corneal thickness, area and optical intensity of corneal wound/scar were measured. The relationship between the parameters at day 1 and the optical intensity at 6 months were analyzed. The results showed that optical intensity of corneal wound/scar increased from 124.1 ± 18.8 on day 1 postoperatively to 129.3 ± 18.7, 134.2 ± 23.4, 139.7 ± 26.5, 148.2 ± 26.4 at 1 week, 1 month, 3 months and 6 months postoperatively. Height of steps at 1 day after surgery was the only factor identified as correlated with optical intensity of corneal scar at 6 months (beta = 0.34, p = 0.024). The increase of optical intensity represents the process of fibrosis of corneal wound healing. Higher step after suturing is associated with more severity of corneal scar at last.

Risk factors for endophthalmitis requiring evisceration or enucleation.

Endophthalmitis has devastating sequelae resulting in blindness and even loss of eyeball. Although the prognosis of endophthalmitis has much improved with the advances of antibiotics and vitreoretinal surgery, of the number of patients that required evisceration or enucleation is still significant. We retrospectively reviewed the charts of 210 eyes of 210 patients with endophthalmitis andcompared the group that required evisceration or enucleation with those that received salvaging therapies. Regression analysis was used to identify the risk factors for evisceration or enucleation. Thirty eyes (14.3%) underwent enucleation or evisceration. The group of eviscerated or enucleated eyes were older (58.7 vs. 42.2 years, p < 0.001), had more women (56.7% vs. 22.2%, p = 0.003), had poorer initial visual acuity (2.79 vs. 2.10 LogMAR, p < 0.001), and had longer duration before intervention (18.03 vs. 5.74 days, p = 0.031). The most common primary indications for endophthalmitis were infections from corneal ulcer (50.0% vs. 4.4%, p < 0.001) andfrom endogenous source (23.3% vs. 5.6%, p < 0.001). Less common indications were trauma (26.7% vs. 67.8%, p < 0.001) and postoperative (6.7% vs. 22.2%, p = 0.049) endophthalmitis. After adjusting for confounding factors, corneal ulcer-related endophthalmitis, endogenous endophthalmitis and initial visual acuity were the independent risk factors for evisceration or enucleation.

Comparison of pterygium recurrence rates after limbal conjunctival autograft transplantation and other techniques: meta-analysis.

PURPOSE: Meta-analysis to compare pterygium surgery outcomes using limbal conjunctival autograft (LCAG) and other techniques. METHODS: A comprehensive literature search was conducted through June 2011 using PubMed, Embase, and the Cochrane Registry to identify all randomized control trials reported so far, comparing the recurrence rates of pterygium after LCAG and other surgical techniques. The odds ratios (ORs) and 95% confidence intervals (CIs) of rates of pterygium recurrence were pooled using the Mantel-Haenszel method. RESULTS: Overall, 13 randomized control trials were included in the analysis (Jadad score, 1-3). The pooled OR from individual studies showed that the recurrence rates after pterygium excision with LCAG were lower as compared with pterygium excision with bare sclera technique (95% CI, 0.04-0.17; pooled OR=0.08, P<0.01), bulbar conjunctival autograft (95% CI, 0.04-0.23; pooled OR=0.10, P<0.01), or intraoperative mitomycin C (95% CI, 0.09-0.52; pooled OR=0.22, P<0.01). There was no statistically significant difference in the recurrence rates after LCAG and amniotic membrane graft (95% CI, 0.26-1.70; pooled OR=0.66, P=0.39). CONCLUSIONS: According to the current evidence from literature, recurrence rates after pterygium excision with LCAG are lower when compared with the use of bare sclera, bulbar conjunctival autograft, or intraoperative mitomycin C. Although recurrence rates of LCAG were similar to the amniotic membrane graft, further large-scale randomized controlled trials would be required to confirm these results.

[Effect of Rosiglitazone on the proliferation and the production of transforming growth factor-beta 1 in cultured human Tenon' s capsule fibroblasts].

OBJECTIVE: To investigate the effect of Rosiglitazone on the proliferation and the production of transforming growth factor-beta 1 (TGF-beta 1) in cultured humans Tenon's capsule fibroblasts (HTFs). METHODS: It was a experimental study. HTFs were cultured and subcultured in vitro. After HTFs were treated with different concentrations of Rosiglitazone, the proliferation was detected by MTT assay. The migration ability was detected by a scratch method. The production of TGF-beta 1 was determined by ELISA. TGF-beta 1 mRNA expression was examined by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). RESULTS: Compared with control group, Rosiglitazone significantly (F = 178.293, P < 0.01) inhibited the proliferation (0.33 +/- 0.01 vs 0.29 +/- 0.02) and the migration of HTFs in a dose-dependent manner with the concentrations ranged from 20 to 500 mg/L. Rosiglitazone also significantly (F = 86.404, P < 0.01) reduced the production of TGF-beta 1 in HTFs (323.48 +/- 13.69 vs 267.48 +/- 20.31). TGF-beta 1 mRNA was significantly (F = 176.102, P < 0.01) down-regulated (0.69 +/- 0.02 vs 0.55 +/- 0.02). CONCLUSIONS: This study suggests that the inhibition of the proliferation of Tenon's capsule and the migration of HTFs by Rosiglitazone is due, at least in part, to decrease the production of TGF-beta 1.

[The comparison study of glaucoma trabeculectomy applying amniotic membrane or mitomycin C].

PURPOSE: To probe the results of trabeculectomy with human amniotic membrane (HAM) or mitomycin(MMC) in the treatment of glaucoma. METHODS: In a randomized control clinical trial, 48 eyes of 28 glaucoma patients were divided into two groups, each group has 24 eyes, and each group was divided into two sub-groups according to the age. The former was underwent trabeculectomy with HAM transplanted, the later was administrated intra operatively with MMC, 0.2-0.4mg/ml, for 2-4 minutes, the follow-up was 6 months. RESULTS: The operation success rate of both groups was higher than the standard trabeculectomy, and the difference between the two groups was not significant. Complications induced by HAM were mainly shallow anterior chamber, whereas by MMC were thin wall bleb, bleb leaking, persistent hypotony and hypotonous maculopathy. CONCLUSION: Application properly HAM or MMC can improved the operation success rate, maintain the functional bleb long time and decreased the complications.

Clinic analysis of Behçet disease.

PURPOSE: To analyze the clinic manifestation and prognosis of Behçet disease. METHOD: Twenty patients requiring inpatient treatment with Behçet disease were retrospectively analyzed. RESULTS: The morbidity of Behçet disease is 5.5/100 000. In the systemic damage, stomatocace and skin lesion are 95%, eye lesion and genital ulcer 50%, joint lesion 45%, gastrointestinal lesion 35%, Uveitis is the major disease in eye lesion, and followed in order by retinal vasculitis and obstruction of retinal artery. Attack age average 30.3 years old. Diagnosis age average 34.8 years old. The patients stay in hospital for 41 days on the average. Cure rate is 55%, improvement rate 40%, blinding rate of eye lesion is 36%. CONCLUSIONS: Behçet disease is a multisystem lesion disease. Stomatocace and skin lesion is the major lesion, the next in common occurrence are eye and genital lesions. Repeated attack of uveitis, complicated cataract and secondary glaucoma are the major causes of blindness.