Comparison of Early Clinical Result of Deep Anterior Lamellar Keratoplasty Using FSlaser Versus Manual Trephine

PURPOSE: To compare outcomes of femtosecond laser-enabled deep anterior lamellar keratoplasty (IE-DALK) versus manual trephine using deep anterior lamellar keratoplasty (Manual DALK, M-DALK). METHODS: Seventeen eyes from 17 patients underwent manual deep anterior lamellar keratoplasty, and femtosecond laser-enabled deep anterior lamellar keratoplasty was performed in 13 eyes of 13 patients. Postoperative clinical outcomes such as best corrected visual acuity, refractive astigmatism, keratometric astigmatism, endothelial cell density were compared between the two groups. RESULTS: The mean log MAR best spectacle-corrected visual acuity (BSCVA) was 0.31 +/- 0.17, 0.23 +/- 0.15, 0.18 +/- 0.14 in the IE-DALK group, and 0.55 +/- 0.41, 0.45 +/- 0.28, 0.35 +/- 0.22 (p = 0.056, p = 0.025, p = 0.313) in the M-DALK group at postoperative 2, 4, and 6 months respectively. The mean keratometric cylinder was 5.35 +/- 1.57, 4.24 +/- 1.97, 3.65 +/- 1.31 in the IE-DALK, 8.32 +/- 2.75, 6.80 +/- 2.50, 4.54 +/- 1.25 (p = 0.031, p = 0.041, p = 0.370) in the M-DALK group at postoperative 2, 4, and 6 months respectively. Endothelial cell counts in the two groups did not differ significantly at postoperative 6 months. CONCLUSIONS: The IE-DALK showed better results in BSCVA and keratometric astigmatism in the early postoperative period, in comparison with the M-DALK, and can be considered as a valuable method in deep anterior lamellar keratoplasty.

Changes in Optical Quality of Cataract Patients' Corrected Visual Acuity before and after Phacoemulsification

PURPOSE: To evaluate objectively the improvement level of a patient's visual function using the NEI-VFQ-25 questionnaire pre- and post-operatively and the OQAS results from the patient group who had the same corrected visual acuity pre- and post-operatively. METHODS: We examined and compared the NEI-VFQ-25 test, OSI, MTF cut-off, strehl ratio, OQAS, and width at 50% and 10% in 24 eyes of 24 patients who had cataract surgery between December 2011 and February 2012. The patients' corrected visual acuity in both eyes had no change (0.8 and 0.8) pre-operatively and 2 months post-operatively (1.0 and 1.0). RESULTS: The satisfaction level regarding the patients' visual function increased. The NEI-VFQ-25 test was 71.54 +/- 14.88 points pre-operatively and 85.70 +/- 6.17 points post-operatively. OSI decreased to 3.13 +/- 1.66 (OSI value) and 1.53 +/- 0.58 (OSI value), and MTF cut off value improved from 14.51 +/- 6.97 (C/deg) to 27.63 +/- 8.98 (C/deg). Strehl ratio was improved to 0.09 +/- 0.03 and 0.14 +/- 0.03, width at 50% improved to 8.44 +/- 3.73 and 4.52 +/- 1.90 and width at 10% improved to 35.30 +/- 15.22 and 18.04 +/- 8.87 pre- and post-operatively, respectively. CONCLUSIONS: The NEI-VFQ-25 test reflected the vision improvement in patients where after cataract surgery, determination of the visual function improvement only through vision would not be possible. In addition, the OQAS showed the quality of vision improved through quantified values.

Usefulness of Open Ring Guider for Continuous Curvilinear Capsulorrhexis

PURPOSE: To compare the size, circularity and repeatability between the conventional manual technique and the open-ring guided continuous curvilinear capsulorrhexis (CCC) technique in cataract surgery. METHODS: The present study comprised 120 eyes divided into two equal groups. In the first group (group A), CCC was performed using a 5.3-mm open ring-shaped caliper and in the second group (group B), CCC was performed using the conventional manual technique. Photographs were taken after each surgical step (CCC, phacoemulsification, Intraocular lens insertion and corneal stromal hydration). The diameter, area and circularity of the anterior capsule were compared between the two groups. RESULTS: The anterior capsule diameter was 5.32 +/- 0.26 mm for group A (coefficient of variation 0.049) and 5.14 +/- 0.64 mm for group B (coefficient of variation 0.125); the area was 22.9 +/- 0.71 mm2 for group A (coefficient of variation 0.031) and 21.40 +/- 1.37 mm2 for group B (coefficient of variation 0.064). Circularity was 0.93 +/- 0.24 for group A (coefficient of variation 0.258) and 0.86 +/- 0.78 for group B (coefficient of variation 0.907). CONCLUSIONS: The open ring-guided CCC technique resulted in an increase of diameter and capsulorrhexis area. This method showed superior circularity and repeatability compared to conventional manual technique and can be useful in cataract surgery.

Surgical Outcome of Levator Recession for Correction of Upper Eyelid Retraction

PURPOSE: To assess the efficacy of levator recession under local anesthesia to treat upper eyelid retraction. METHODS: Records of 12 patients (12 lids) were reviewed retrospectively. Postoperative cosmetic results were assessed as good, fair, or poor based on the upper lid height and symmetry. Preoperative and postoperative marginal reflex distance (MRD1, mm), upper eyelid asymmetry, lid lag, lagophthalmos, and ocular exposure symptoms were compared. The reoperation rate was also evaluated. RESULTS: Causes accounting for upper lid retraction were Graves ophthalmopathy (9 lids, 75.0%), orbital pseudotumor (2 lids, 16.7%), and hypercorrection from previous ptosis operation (1 lid, 8.3%). At a mean +/- standard deviation of 27.7 +/- 24.0 months follow-up (range, 5-60 months), 11 patients (91.7%) showed significantly better cosmetic results. MRD1 decreased an average of 3.1 +/- 1.3 mm from 6.3 +/- 1.5 mm preoperatively to 3.2 +/- 0.9 mm postoperatively (p < 0.001). Upper lid asymmetry, lagophthalmos, and lid lag were also reduced significantly (p < 0.001). Overcorrection occurred in 3 lids (25%) and required levator advancement. Eleven patients (91.7%) experienced complete resolution of dry eye symptoms following levator recession. CONCLUSIONS: Levator recession showed good cosmetic results up to 2 years after surgery for upper eyelid retraction.

Photonic explorers based on multifunctional nanoplatforms for biosensing and photodynamic therapy.

Nanoparticle-based photonic explorers have been developed for intracellular sensing and photodynamic therapy (PDT). The design employs nanoparticles made of various matrices as multifunctional nanoplatforms, loading active components by encapsulation or covalent attachment. The nanoplatform for biosensing has been successfully applied to intracellular measurements of important ionic and molecular species. The nanoplatform for PDT has shown high therapeutic efficacy in a rat 9L gliosarcoma model. Specifically, a multifunctional nanoplatform that encompasses magnetic resonance imaging (MRI) and PDT agents inside, as well as targeting ligands on the surface, has been developed and applied in vivo, resulting in much improved MRI contrast enhancement and PDT efficacy.

Brain cancer diagnosis and therapy with nanoplatforms.

Treatment of brain cancer remains a challenge despite recent improvements in surgery and multimodal adjuvant therapy. Drug therapies of brain cancer have been particularly inefficient, due to the blood-brain barrier and the non-specificity of the potentially toxic drugs. The nanoparticle has emerged as a potential vector for brain delivery, able to overcome the problems of current strategies. Moreover, multi-functionality can be engineered into a single nanoplatform so that it can provide tumor-specific detection, treatment, and follow-up monitoring. Such multitasking is not possible with conventional technologies. This review describes recent advances in nanoparticle-based detection and therapy of brain cancer. The advantages of nanoparticle-based delivery and the types of nanoparticle systems under investigation are described, as well as their applications.

Ratiometric singlet oxygen nano-optodes and their use for monitoring photodynamic therapy nanoplatforms.

Ratiometric photonic explorers for bioanalysis with biologically localized embedding (PEBBLE) nanoprobes have been developed for singlet oxygen, using organically modified silicate (ORMOSIL) nanoparticles as the matrix. A crucial aspect of these ratiometric singlet-oxygen fluorescent probes is their minute size. The ORMOSIL nanoparticles are prepared via a sol-gel-based process and the average diameter of the resultant particles is about 160 nm. These sensors incorporate the singlet-oxygen-sensitive 9,10-dimethyl anthracene as an indicator dye and a singlet-oxygen-insensitive dye, octaethylporphine, as a reference dye for ratiometric fluorescence-based analysis. We have found experimentally that these nanoprobes have much better sensitivity than does the conventional singlet-oxygen-free dye probe, anthracene-9,10-dipropionic acid disodium salt. The much longer lifetime of singlet oxygen in the ORMOSIL matrix, compared to aqueous solutions, in addition to the relatively high singlet oxygen solubility because of the highly permeable structure and the hydrophobic nature of the outer shell of the ORMOSIL nanoparticles, results in an excellent overall response to singlet oxygen. These nanoprobes have been used to monitor the singlet oxygen produced by "dynamic nanoplatforms" that were developed for photodynamic therapy. The singlet oxygen nanoprobes could potentially be used to quantify the singlet oxygen produced by macrophages.

Optochemical nanosensor PEBBLEs: photonic explorers for bioanalysis with biologically localized embedding.

Nanosized photonic explorers for bioanalysis with biologically localized embedding (PEBBLEs) have been created for the intracellular monitoring of small analytes (e.g. H(+), Ca(2+), Mg(2+), Zn(2+), O(2), K(+), Na(+), Cl(-), OH and glucose). The probes are based on the inclusion of fluorescent analyte-sensitive indicator dyes and analyte-insensitive reference dyes in a polymer (polyacrylamide, polydecylmethacrylate) or sol-gel (silica, ormosil) nanoparticle. The probes are ratiometric, reversible and protected from interaction with the cellular environment, a quality which is of benefit to the integrity of both the cell and the sensor functionalities. Herein we describe two types of PEBBLE sensors, direct measurement sensors and ion correlation sensors, as well as the use of these PEBBLEs in intracellular sensing.

Real-time measurements of dissolved oxygen inside live cells by organically modified silicate fluorescent nanosensors.

Optical PEBBLE (probes encapsulated by biologically localized embedding) nanosensors have been developed for dissolved oxygen using organically modified silicate (ormosil) nanoparticles as a matrix. The ormosil nanoparticles are prepared via a sol-gel-based process, which includes the formation of core particles with phenyltrimethoxysilane as a precursor followed by the formation of a coating layer with methyltrimethoxysilane as a precursor. The average diameter of the resultant particles is 120 nm. These sensors incorporate the oxygen-sensitive platinum porphyrin dye as an indicator and an oxygen-insensitive dye as a reference for ratiometric intensity measurement. Two pairs of indicator dye and reference dye, respectively, platinum(II) octaethylporphine and 3,3'-dioctadecyloxacarbocyanine perchlorate, and platinum(II) octaethylporphine ketone and octaethylporphine, were used. The sensors have excellent sensitivity with an overall quenching response of 97%, as well as excellent linearity of the Stern-Volmer plot (r(2) = 0.999) over the whole range of dissolved oxygen concentrations (0-43 ppm). In vitro intracellular changes of dissolved oxygen due to cell respiration were monitored, with gene gun injected PEBBLEs, in rat C6 glioma cells. A significant change was observed with a fluorescence ratio increase of up to 500% after 1 h, for nine different sets of cells, which corresponds to a 90% reduction in terms of dissolved oxygen concentration. These results clearly show the validity of the delivery method for intracellular studies of PEBBLE sensors, as well as the high sensitivity, which is needed to achieve real-time measurements of intracellular dissolved oxygen concentration.

disappearance of hCG following surgery in ectopic gestation / 대한산부인과학회잡지

No abstract available.

A case of immunologic trombocytopenic purpura in pregnancy / 대한산부인과학회잡지

No abstract available.