Exosomal lncRNAs in gastrointestinal cancer.

Gastrointestinal cancer (GIC) remains a leading cause of morbidity and mortality worldwide. Unfortunately, these cancers are diagnosed in advanced metastatic stages due to lack of reliable biomarkers that are sufficiently specific and sensitive in early disease. There has been growing evidence that circulating exosomes can be used to diagnose cancer non-invasively with limited risks and side effects. Furthermore, exosomal long non-coding RNAs (lncRNAs) are emerging as a new class of promising biomarkers in cancer. This review provides an overview of the extraction and detection of exosomal lncRNAs with a focus on their potential role in GIC.

Comparison of three phakic intraocular lenses for correction of myopia.

PURPOSE: To compare the visual outcomes and complications of three different types of phakic intraocular lenses (PIOLs), for correction of moderate to high myopia. METHODS: We reviewed 112 myopic eyes undergoing PIOL implantation using Artisan (40 eyes), Artiflex (36 eyes), and implantable collamer lens (ICL, 36 eyes). Best corrected visual acuity (BCVA), intraocular pressure (IOP), pachymetry, corneal endothelial cell (CEC) loss, and higher order aberrations (HOA) were compared. RESULTS: Mean follow-up period was 30 ± 11 months. Preoperatively, spherical equivalent (SE) refractive error was -11.6 ± 3.7, -9.59 ± 1.97, and -12.3 ± 4.8 D in the Artisan, Artiflex and ICL groups, respectively. SE was comparable among the study groups at final follow-up (P = 0.237). Mean astigmatic reduction was 0.31 ± 0.72, 0.45 ± 0.62, and 0.0 ± 0.57 in the Artisan, Artiflex and ICL groups, respectively (P = 0.007). Emmetropia (±1 D) was achieved in 60%, 91.7% and 77.8% of eyes in the Artisan, Artiflex and ICL groups, respectively, the difference was significant between the Artisan and Artiflex groups (P = 0.017). BCVA improvement more than one line occurred in 25%, 19.4% and 38.9% of eyes (P = 0.158); pachymetric changes were minimal with no difference among the three groups (P = 0.754), and mean CEC loss was 10 ± 9%, 9 ± 6% and 9 ± 10% in the Artisan, Artiflex and ICL groups, respectively (P = 0.694). HOAs (P = 0.039), vertical trefoil (P = 0.032) and spherical aberration (P = 0.001) were higher with Artisan group as compared to ICL. Total aberrations (P = 0.028) and spherical aberration (P = 0.001) was also higher with Artisan group as compared to Artiflex. CONCLUSION: Visual and refractive outcomes were comparable with Artisan, Artiflex and ICL. In terms of HOAs and quality of vision, ICL and Artiflex seem to be better choices in highly myopic eyes.

Graft biomechanical properties after penetrating keratoplasty in keratoconus.

PURPOSE: To measure corneal graft biomechanical properties after penetrating keratoplasty (PKP) in a group of keratoconic eyes using the ocular response analyzer (ORA) and to evaluate the relationship between donor size, donor-recipient disparity and central graft thickness (CGT), and ORA parameters. METHODS: This cross-sectional study was conducted on 34 eyes of 34 keratoconus patients who had undergone PKP. Corneal hysteresis (CH), corneal resistance factor (CRF), and cornea-compensated intraocular pressure were measured at least 6 months after complete suture removal. Two groups of donor-recipient disparity (0.25 vs. 0.50 mm) were compared using the independent t test. Multivariate regression analysis was used to investigate the correlation of donor trephine size and CGT with ORA parameters. Factors influencing intraocular pressure measured with the Goldmann applanation tonometer (IOP GAT) after PKP were determined using multiple regression analysis. RESULTS: Mean patient age and follow-up period were 29.6 ± 6.2 years and 82.4 ± 59.6 months, respectively. Mean CGT, CH, and CRF were 564.7 ± 36.9 µm, 10.1 ± 2.1 mm Hg, and 10.0 ± 2.3 mm Hg, respectively. CH and CRF had a significant positive correlation with donor trephine size and CGT. Significantly greater values of CH and CRF were observed in the 0.5-mm disparity group compared with the 0.25-mm disparity group. Among the studied parameters, only CH, CRF, and cornea-compensated intraocular pressure had a significant positive correlation with IOP GAT. CONCLUSION: Graft biomechanics seem to be closer to normal values with larger grafts and greater donor-recipient disparity. These metrics had a significant correlation with IOP GAT after PKP.

Graft biomechanical properties after penetrating keratoplasty versus deep anterior lamellar keratoplasty.

PURPOSE: To compare biomechanical properties of transplanted corneas after penetrating keratoplasty (PK) with those after deep anterior lamellar keratoplasty (DALK) using Anwar's big-bubble technique. MATERIALS AND METHODS: This cross-sectional comparative study consisted of 45 PK eyes (group 1) and 23 DALK eyes (group 2) with the underlying pathology of keratoconus. The Ocular Response Analyzer was used to measure Goldmann-correlated intraocular pressure (IOPg) and cornea-compensated IOP (IOPcc), as well as graft biomechanical properties, namely corneal hysteresis (CH) and corneal resistance factor (CRF). The results were compared between the study groups using independent t-test. RESULTS: Mean patient age was 29.8 ± 6.1 years in group 1 and 27.2 ± 6.5 years in group 2 (P = 0.11) and they were followed up for 31.4 ± 19.0 months and 29.2 ± 17.3 months after corneal transplantation, respectively (P = 0.27). There was no significant difference between the study groups in terms of recipient (P = 0.21) and donor (P = 0.57) trephine sizes or BSCVA (P = 0.77). CH was measured 10.09 ± 2.5 mmHg in group 1 and 9.64 ± 2.1 mmHg in group 2 (P = 0.36). CRF was 10.13 ± 2.2 and 9.36 ± 2.1 mmHg, respectively (P = 0.17). Similarly, no significant difference was found between group 1 and group 2 in terms of IOPg (P = 0.25) and IOPcc (P = 0.80). CONCLUSION: DALK using the big-bubble technique for keratoconic eyes provides corneal biomechanics comparable to PK.

Comparison of the ocular response analyzer and the Goldmann applanation tonometer for measuring intraocular pressure after deep anterior lamellar keratoplasty.

PURPOSE: To compare intraocular pressure (IOP) measured using the Ocular Response Analyzer (ORA; Reichert Ophthalmic Instruments, Buffalo, NY) with that measured using the Goldmann applanation tonometer (GAT) in keratoconic eyes after deep anterior lamellar keratoplasty (DALK) and evaluate the influence of central graft thickness (CGT), corneal astigmatism, corneal hysteresis (CH), and corneal resistance factor (CRF) on the IOP measurements. METHODS: IOP using the GAT (IOP(GAT)), CH, CRF, Goldmann-correlated IOP (IOP(g)), cornea-compensated IOP (IOP(cc)) using the ORA, and CGT were measured in 23 keratoconic eyes undergoing DALK. Bland-Altman plots were used to evaluate agreement between the tonometers. The correlation between refraction, CH, CRF, and CGT with IOP readings was investigated using multivariate regression analysis. RESULTS: Mean patient age was 27.2 ± 6.5 years. Mean CGT, CH, and CRF were 547.0 ± 42.6 µm, 9.6 ± 2.1 mm Hg, and 9.4 ± 2.1 mm Hg, respectively. Mean IOP(GAT), IOP(g), and IOP(cc) were 11.3 ± 2.9, 14.1 ± 2.4, and 15.6 ± 2.6 mm Hg, respectively (P < 0.001). The 95% limit of agreement for IOP(g) and IOP(GAT) was between -2.61 and 8.19 mm Hg and for IOP(cc) and IOP(GAT) it was between -0.69 and 9.21 mm Hg. CH and CRF were significantly associated with IOP(GAT). No significant association was found between CGT and IOP readings obtained using either the ORA or GAT. CONCLUSIONS: IOP readings by the ORA were significantly greater than those by the GAT, and CH and CRF play a more important role in post-DALK IOP readings by both GAT and ORA than other graft characteristics including curvature and central thickness.