Low-level laser therapy combined with scleral graft transplantation in the treatment of contracted socket: a clinical study.

OBJECTIVE: To analyse the efficacy of the therapeutic use of low-level laser therapy (LLLT) on the tissue repair process of allogeneic scleral grafts in patients with contracted sockets by analysing the speed of graft vascularisation and fornice depth of contraction percentage. METHODS: A retrospective chart review was performed from April 2015 to April 2021 including 39patients with socket contraction. Allogeneic scleral grafts were used to repair the sockets in all patients. They were randomly enrolled into two groups. The laser group included 18 patients treated with LLLT after the surgery, whereas the control group included 21 patients without LLLT after the surgery who healed naturally. The LLLT equipment used in the research had a wavelength of 650 nm, 10 mW power, and 3.8 J/cm2 dosimetry, and the procedure was performed once daily for 5 min over 7 days, beginning 1 week postoperatively. All patients were followed up over 6 months to examine the changes in the size of the area of the non-vascularised graft and upper and inferior fornice depth. RESULTS: The laser group presented a significantly increased speed of conjunctival vascularisation compared with the control group (P = 0.003). The fornice depth of contraction percentage was more apparent in the control group than that in the laser group (P = 0.000). CONCLUSION: LLLT accelerates conjunctival vascularisation, stimulates conjunctival incision healing within a short period, shortens the tissue repair process, reduces the local inflammatory response, and causes no significant shrinkage of the conjunctival sac.

Comparison of the cutaneous orbicularis oculi excision treatment with the inferior eyelid margin fixation treatment for congenital lower eyelid entropion.

PURPOSE: To modify the traditional surgical approach to treat patients diagnosed with congenital lower eyelid entropion using inferior eyelid margin fixation of the orbicularis eyelid muscle. METHODS: Ninety-six participants (180 eyes) with congenital lower eyelid entropion diagnosed between January 2019 and April 2021 were included in this study. The patients were divided into Group A (cutaneous orbicularis oculi excision treatment) and Group B (inferior eyelid margin fixation treatment). The efficiency and recurrence rate of treatments were used to compare the two treatments. RESULTS: There was no significant difference in age, sex, and eyes distribution in both groups. And higher efficiency rate was found in Group B (P < 0.05). And Group A had a higher recurrence rate in the follow-up after surgical treatment (P < 0.05). CONCLUSIONS: This modified inferior eyelid margin fixation of the orbicularis eyelid muscle treatment is an ideal procedure with a high degree of efficacy and low recurrence rate in patients with congenital lower eyelid entropion.

Clinical observation on healing of tarsal plate defect after reconstruction with xenogeneic acellular dermal matrix.

OBJECTIVE: To evaluate the safety, function, and cosmetic outcome of eyelid reconstruction using a xenogeneic acellular dermal matrix as a tarsal plate replacement in the repair of 50 to 100% eyelid defects following excision of large malignant tumours. METHODS: A retrospective, non-comparative, interventional study of 21 eyes was performed over 26 months. Fourteen patients were female and seven were male. In all cases, a xenogeneic acellular dermal matrix was used for total or subtotal replacement of the tarsal plate. The central vertical height of the palpebral fissure was measured immediately after eyelid margin incision and at 1 and 6 months postoperatively. RESULTS: In patients who underwent surgery, the mean palpebral fissure height (PFH) was not significantly different between immediately and 1 month after incision (8.10 ± 0.562 mm vs 8.17 ± 0.577 mm, respectively; P > 0.05). After 6 months, PFH was 8.26 ± 0.605 mm, which was significantly different from that immediately after incision (P < 0.05). After 6 months of follow-up, all patients had a good aesthetic appearance after eyelid reconstruction, with no obvious graft dissolution or rejection, normal eyelid activity, and normal opening, closing, and lifting function. None of the 21 patients experienced tumour recurrence during postoperative follow-up. CONCLUSION: The xenogeneic acellular dermal matrix was a successful tarsal plate replacement. This material is readily available, and a second surgical site is avoided. The xenogeneic acellular dermal matrix is considered a promising alternative material for tarsal replacement in future generations.

Low-level laser therapy induces human umbilical vascular endothelial cell proliferation, migration and tube formation through activating the PI3K/Akt signaling pathway.

Low-level laser therapy (LLLT) has been recognized as a light therapy that may be used for tissue regeneration, inflammation reduction, and pain relief. We intended to evaluate the effects of LLLT on the proliferation, migration, and tube formation of HUVECs as well as their related mechanisms. HUVECs were exposed to laser irradiation under different laser parameters (irradiation dose, interval and power intensity) in order to choose the optimal parameters, which were determined by the increase in proliferation of HUVECs as follows: irradiation dose of 4.0 J/m2, interval time of 12 h and 6 times in total. The HUVEC proliferation, migration, and tube formation, and levels of angiogenesis-related genes (HIF-1α, eNOS and VEGFA) were examined following LLLT. As suggested by the obtained data, LLLT (1.0, 2.0 and 4.0 J/m2) increased the HUVEC proliferation, migration, and tube formation in dose-and time-dependent manner, accompanied with increases in the levels of HIF-1α, eNOS, and VEGFA. Furthermore, the regulatory mechanism regarding the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway was explored, phosphorylation levels of PI3K and Akt proteins were assessed by Western blot assay, which showed the enhancement of phosphorylation of PI3K, Akt, and mTOR by LLLT. The inhibitor for the PI3K/Akt axis was used to verify the involvement of PI3K/Akt signaling pathway. The obtained results suggested that the inhibition of the PI3K/Akt signaling pathway attenuated the effects of LLLT on proliferation, migration, and angiogenesis of HUVECs. In conclusion, LLLT promotes the proliferation, migration, and angiogenesis of HUVECs via activation of the PI3K/Akt signaling pathway.