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SH2 domains are key mediators of phosphotyrosine-based signalling, and therapeutic targets for diverse, mostly oncological, disease indications. They have a highly conserved structure with a central beta sheet that divides the binding surface of the protein into two main pockets, responsible for phosphotyrosine binding (pY pocket) and substrate specificity (pY + 3 pocket). In recent years, structural databases have proven to be invaluable resources for the drug discovery community, as they contain highly relevant and up-to-date information on important protein classes. Here, we present SH2db, a comprehensive structural database and webserver for SH2 domain structures. To organize these protein structures efficiently, we introduce (i) a generic residue numbering scheme to enhance the comparability of different SH2 domains, (ii) a structure-based multiple sequence alignment of all 120 human wild-type SH2 domain sequences and their PDB and AlphaFold structures. The aligned sequences and structures can be searched, browsed and downloaded from the online interface of SH2db (http://sh2db.ttk.hu), with functions to conveniently prepare multiple structures into a Pymol session, and to export simple charts on the contents of the database. Our hope is that SH2db can assist researchers in their day-to-day work by becoming a one-stop shop for SH2 domain related research.
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Sistemas de Informação , Proteínas , Domínios de Homologia de src , Humanos , Sequência de Aminoácidos , Sítios de Ligação , Fosfotirosina/metabolismo , Ligação Proteica , Proteínas/metabolismo , Internet , Bases de Dados de ProteínasRESUMO
Ascorbic acid (AA) has a pivotal role in corneal wound healing via stimulating the biosynthesis of highly organized extracellular matrix components, but its rapid degradation and low corneal permeability limits its therapeutic effects. In this paper, we present the pharmacokinetic properties of a liposomal-based formulation of AA in terms of corneal permeation. Chemical stability, shelf-life, and drug release rate of lyophilized liposome (AA-LLipo) formulation was determined in comparison to free-form of AA solution using high-performance liquid chromatography (HPLC) and rapid equilibrium dialysis. In vitro transcorneal permeability was studied using a parallel artificial membrane permeability assay (PAMPA). Ex vivo permeation was examined on AA-LLipo-treated porcine cornea by determining the AA content on the ocular surface, in the cornea as well as in the aqueous humor using HPLC, and by Raman-mapping visualizing the AA-distribution. Our results showed that the liposomal formulation improved the chemical stability of AA, while drug release was observed with the same kinetic efficiency as from the free-form of AA solution. Both corneal-PAMPA and porcine corneal permeability studies showed that AA-LLipo markedly improved the corneal absorption kinetics of AA, thus, increasing the AA content in the cornea and aqueous humor. AA-LLipo formulation could potentially increase the bioavailability of AA in corneal tissues.
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Lesões da Córnea , Lipossomos , Animais , Suínos , Córnea , Permeabilidade , Ácido AscórbicoRESUMO
PURPOSE: To report a case of a patient with central retinal vein occlusion (CRVO), 2 weeks after the first dose of a COVID-19 mRNA vaccine. RESULTS: A 35-year-old man presented with decreased vision on his right eye, 2 weeks after receiving the first dose of COVID-19 mRNA vaccine. During examination, signs of right CRVO were found. We started general checkup of the patient, extended with laboratory tests specific for VIPIT. No exact cause of the thromboembolic episode could be documented. With the applied therapy, symptoms resolved completely. CONCLUSION: CRVO after COVID-19 mRNA vaccination is reported only in one case in the literature. In our case, the young age of the patient, the close onset of the symptoms to the vaccination and the negative systemic, immunologic and hematologic tests are suggesting a vaccine-induced thrombotic mechanism. We propose further investigation of vaccine-induced thrombotic mechanisms and also close follow of the reported cases.
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Vacinas contra COVID-19 , COVID-19 , Oclusão da Veia Retiniana , Adulto , Humanos , Masculino , COVID-19/complicações , Vacinas contra COVID-19/efeitos adversos , Olho , Oclusão da Veia Retiniana/diagnóstico , Oclusão da Veia Retiniana/etiologia , Vacinas de mRNARESUMO
Although gilt silver threads were widely used for decorating historical textiles, their manufacturing techniques have been elusive for centuries. Contemporary written sources give only limited, sometimes ambiguous information, and detailed cross-sectional study of the microscale soft noble metal objects has been hindered by sample preparation. In this work, to give a thorough characterization of historical gilt silver threads, nano- and microscale textural, chemical, and structural data on cross sections, prepared by focused ion beam milling, were collected, using various electron-optical methods (high-resolution scanning electron microscopy (SEM), wavelength-dispersive electron probe microanalysis (EPMA), electron backscattered diffraction (EBSD) combined with energy-dispersive electron probe microanalysis (EDX), transmission electron microscopy (TEM) combined with EDX, and micro-Raman spectroscopy. The thickness of the gold coating varied between 70-400 nm. Data reveal nano- and microscale metallurgy-related, gilding-related and corrosion-related inhomogeneities in the silver base. These inhomogeneities account for the limitations of surface analysis when tracking gilding methods of historical metal threads, and explain why chemical information has to be connected to 3D texture on submicrometre scale. The geometry and chemical composition (lack of mercury, copper) of the gold/silver interface prove that the ancient gilding technology was diffusion bonding. The observed differences in the copper content of the silver base of the different thread types suggest intentional technological choice. Among the examined textiles of different ages (13th-17th centuries) and provenances narrow technological variation has been found.
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Novel aleurone-rich wheat milling fraction developed and produced on industry scale is investigated. The special composition of the novel flour with high protein, dietary fiber and fat content results in a unique combination of the mixing and viscosity properties. Due to the high lipid concentration, the fraction is exposed to fast rancidity. Dry heat (100°C for 12min) and hydrothermal treatment processes (96°C for 6min with 0-20 L/h steam) were applied on the aleurone-rich flour to modify the technological properties. The chemical, structural changes; the extractability of protein, carbohydrate and phenolic components and the rheological characteristics of the flours were evaluated. The dry treated flour decreased protein and carbohydrate extractability, shortened dough development time, reduced gel strength and enhanced the gelling ability. Hydrothermal treatment caused changes in the phenolic content improved the dough stability and -resistance. Heat treatment processes were able to extend the stability of the flour.
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Fibras na Dieta/análise , Farinha/análise , Triticum , Carboidratos , Temperatura Alta , Fenóis , Proteínas , Reologia , ViscosidadeRESUMO
Wide research attention has been paid in the last two decades to the thermal comfort conditions of different outdoor and semi-outdoor urban spaces. Field studies were conducted in a wide range of geographical regions in order to investigate the relationship between the thermal sensation of people and thermal comfort indices. Researchers found that the original threshold values of these indices did not describe precisely the actual thermal sensation patterns of subjects, and they reported neutral temperatures that vary among nations and with time of the year. For that reason, thresholds of some objective indices were rescaled and new thermal comfort categories were defined. This research investigates the outdoor thermal perception patterns of Hungarians regarding the Physiologically Equivalent Temperature (PET) index, based on more than 5800 questionnaires. The surveys were conducted in the city of Szeged on 78 days in spring, summer, and autumn. Various, frequently applied analysis approaches (simple descriptive technique, regression analysis, and probit models) were adopted to reveal seasonal differences in the thermal assessment of people. Thermal sensitivity and neutral temperatures were found to be significantly different, especially between summer and the two transient seasons. Challenges of international comparison are also emphasized, since the results prove that neutral temperatures obtained through different analysis techniques may be considerably different. The outcomes of this study underline the importance of the development of standard measurement and analysis methodologies in order to make future studies comprehensible, hereby facilitating the broadening of the common scientific knowledge about outdoor thermal comfort.
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Sensação Térmica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Cidades , Feminino , Humanos , Umidade , Hungria , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Estações do Ano , Temperatura , Pressão de Vapor , Adulto JovemRESUMO
PURPOSE: To describe the topographic and tomographic characteristics of normal fellow eyes of unilateral keratoconus cases and to evaluate the accuracy of machine learning classifiers in discriminating healthy corneas from the normal fellow corneas. SETTING: Department of Ophthalmology, Semmelweis University, Budapest, Hungary. DESIGN: Retrospective case-control study. METHODS: Patients with bilateral keratoconus (keratoconus group), clinically and according to the keratoconus indices of the Pentacam HR Scheimpflug camera; normal fellow eyes of patients with unilateral keratoconus (fellow-eye group); and eyes of refractive surgery candidates (control group) were compared. Tomographic data, topographic data, and keratoconus indices were measured in both eyes using the Scheimpflug camera. Receiver operating characteristic (ROC) analysis was used to assess the performance of automated classifiers trained on bilateral data as well as individual parameters to discriminate fellow eyes of patients with keratoconus from control eyes. RESULTS: Keratometry, elevation, and keratoconus indices values were significantly higher and pachymetry values were significantly lower in keratoconus eyes than in fellow eyes of unilateral keratoconus cases (P < .001). These fellow eyes had significantly higher keratometry, elevation, and keratoconus index values and significantly lower pachymetry values than control eyes (P < .001). Automated classifiers trained on bilateral data of index of height decentration had higher accuracy than the unilateral single parameter in discriminating fellow eyes of patients with keratoconus from control eyes (area under ROC 0.96 versus 0.88). CONCLUSION: Automatic classifiers trained on bilateral data were better than single parameters in discriminating fellow eyes of patients with unilateral keratoconus with preclinical signs of keratoconus from normal eyes. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
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Córnea/patologia , Técnicas de Diagnóstico Oftalmológico , Ceratocone/classificação , Ceratocone/diagnóstico , Aprendizado de Máquina/classificação , Fotografação/instrumentação , Adulto , Estudos de Casos e Controles , Paquimetria Corneana , Topografia da Córnea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Adulto JovemRESUMO
PURPOSE: To determine if pretreatment with topical nonsteroidal anti-inflammatory drug (NSAID) prior to femtosecond laser-assisted cataract surgery (FLACS) prevents intraoperative prostaglandin level elevation as a potential risk factor of postoperative complications. PATIENTS AND METHODS: Thirty-six patients with clinically significant cataract and without any concomitant general or ophthalmic disease were enrolled into the three age-matched groups of the study. The mean age of the patients was 62.3 ± 13.1 years. The first group of patients underwent traditional phacoemulsification (Control group), on the second group of patients FLACS was performed, and the third group of patients received topical 0.1% nepafenac pretreatment for 1one day prior to FLACS. Before the phacoemulsification part of the cataract surgery, approximately 110 µL of aqueous humor was collected in all groups. Total prostaglandin concentrations of the collected aqueous humor samples were evaluated by enzyme immunoassay (EIA). RESULTS: The mean of the total prostaglandin concentrations of the aqueous humor samples was 208.8 ± 140.5 pg/mL in patients in the control group, 1449.1 ± 1019.7 pg/mL in the FLACS group (p > 0.001), and 92.2 ± 51.7 pg/mL in the group pretreated with topical NSAID before the FLACS (p > 0.001 compared to FLACS; p > 0.01 compared to control), respectively. CONCLUSIONS: FLACS surgery increases intracameral prostaglandin concentration. However, using preoperative 1-day-long nonsteroid anti-inflammatory drops prior to FLACS, this intraoperative increase diminishes. Our study raises the possibility that NSAID pretreatment may be routinely administered before FLACS cataract surgeries to achieve a further decrease in the potential complications of increased total prostaglandin concentration during FLACS surgeries.
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Anti-Inflamatórios não Esteroides/administração & dosagem , Humor Aquoso/metabolismo , Terapia a Laser/métodos , Facoemulsificação/métodos , Cuidados Pré-Operatórios/métodos , Prostaglandinas/metabolismo , Biomarcadores/metabolismo , Feminino , Seguimentos , Humanos , Técnicas Imunoenzimáticas , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Soluções Oftálmicas/administração & dosagem , Complicações Pós-Operatórias/prevenção & controle , Fatores de Tempo , Acuidade VisualRESUMO
Dry and hydrothermal heat treatments are efficient for modifying the technological-functional and shelf-life properties of wheat milling products. Dry heat treatment process is commonly used to enhance the volume of cakes. Hydrothermal heat treatment makes wheat flours suitable as thickener agents. In this study, cake and bread wheat flours that differed in baking properties were exposed to dry (100 °C, 12 min) and hydrothermal (95 °C, 5 min, 5-20 l/h water) heat treatments. Rheological differences caused by the treatments were investigated in a diluted slurry and in a dough matrix. Dry heat treatment resulted in enhanced dough stability. This effect was significantly higher in the cake flour than the bread flour. Altered viscosity properties of the bread flour in the slurry matrix were also observed. The characteristics of hydrothermally treated samples showed matrix dependency: their viscosity increases in the slurry and decreases in the dough matrix. These results can support us to produce flour products with specific techno-functional properties.
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Pão/análise , Farinha/análise , Triticum/química , Temperatura Alta , Reologia , ViscosidadeRESUMO
BACKGROUND: NOTCH signaling can exert oncogenic or tumor suppressive functions and can contribute to chemotherapy resistance in cancer. In this study, we aimed to clarify the clinicopathological significance and the prognostic and predictive value of NOTCH1 and NOTCH2 expression in gastric cancer (GC). METHODS: NOTCH1 and NOTCH2 expression was determined immunohistochemically in 142 primarily resected GCs using tissue microarrays and in 84 pretherapeutic biopsies from patients treated by neoadjuvant chemotherapy. The results were correlated with survival, response to therapy, and clinico-pathological features. RESULTS: Primarily resected patients with NOTCH1-negative tumors demonstrated worse survival. High NOTCH1 expression was associated with early-stage tumors and with significantly increased survival in this subgroup. Higher NOTCH2 expression was associated with early-stage and intestinal-type tumors and with better survival in the subgroup of intestinal-type tumors. In pretherapeutic biopsies, higher NOTCH1 and NOTCH2 expression was more frequent in non-responding patients, but these differences were statistically not significant. CONCLUSION: Our findings suggested that, in particular, NOTCH1 expression indicated good prognosis in GC. The close relationship of high NOTCH1 and NOTCH2 expression with early tumor stages may indicate a tumor-suppressive role of NOTCH signaling in GC. The role of NOTCH1 and NOTCH2 in neoadjuvantly treated GC is limited.
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PURPOSE: To evaluate and compare the mechanical properties of anterior capsule opening performed with femtosecond laser capsulotomy at different energy settings in ex vivo porcine anterior lens capsule specimens. METHODS: Twenty-five fresh porcine eyes per group were included in the study. Femtosecond laser capsulotomy was performed with three different pulse energy levels: 2 µJ (low energy group), 5 µJ (intermediate energy group), and 10 µJ (high energy group). The capsule openings were stretched with universal testing equipment until they ruptured. The morphologic profile of the cut capsule edges was evaluated using scanning electron microscopy. RESULTS: The high energy group had significantly lower rupture force (108 ± 14 mN) compared to the intermediate energy group (118 ± 10 mN) (P < .05) and low energy group (119 ± 11 mN) (P < .05), but the difference between the intermediate energy and low energy groups was not significant (P = .9479). The high energy group had significantly lower circumference stretching ratio (144% ± 3%) compared to the intermediate energy group (148% ± 3%) (P < .05) and low energy group (148% ± 3%) (P < .05), but the difference between the intermediate energy group and low energy group was not significant (P = .9985). Scanning electron microscopy images showed that the edge was only serrated with low and intermediate energy, but additional signs of collagen melting and denaturation were observed at high energy. CONCLUSIONS: Anterior capsule openings created at a high energy level were slightly weaker and less extensible than those created at low or intermediate levels, possibly due to the increased thermal effect of photo-disruption.
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Cápsula Anterior do Cristalino/fisiologia , Elasticidade/fisiologia , Capsulotomia Posterior/métodos , Animais , Cápsula Anterior do Cristalino/cirurgia , Cápsula Anterior do Cristalino/ultraestrutura , Fenômenos Biomecânicos , Microscopia Eletrônica de Varredura , SuínosRESUMO
INTRODUCTION: Femtosecond laser-assisted cataract surgery improved the results of cataract surgeries. AIM: Outcome analysis of femtosecond laser-assisted cataract surgery using the novel 2.16 software and the SoftFit(®) Patient Interface. METHOD: The novel software and the newly developed Patient Interface were used in 100 eyes of 100 patients. RESULTS: Length of femtosecond laser pretreatment decreased to 45-60 seconds. The smaller size of the new patient interface resulted in easier docking even on pediatric eyes. Suction force used for docking decreased from 40-50 mmHg to 16-20 mmHg. Incidence rate of subconjunctival suffusion decreased from 40% to 15-20% and its clinical severity was reduced, too. No corneal microfolds evolved, thus the incidence rate of the free-floating capsulotomies increased from 30% to 97%. The total energy of femtosecond laser pretreatment was decreased by almost 50%. Corneal wounds had the desired structure, and they were easy to open and closed precisely. CONCLUSIONS: The SoftFit(®) patient interface and the novel software widened the possible uses of the femtosecond laser-assisted cataract surgery, e.g. in pediatric ophthalmology. Innovations improved the safety and the predictability of the method.
Assuntos
Extração de Catarata/instrumentação , Extração de Catarata/métodos , Terapia a Laser/métodos , Implante de Lente Intraocular , Capsulotomia Posterior/estatística & dados numéricos , Software , Adolescente , Adulto , Idoso , Extração de Catarata/efeitos adversos , Criança , Feminino , Humanos , Terapia a Laser/instrumentação , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade VisualRESUMO
PURPOSE: To evaluate femtosecond laser-assisted and manual clear corneal incisions and their effect on surgically induced astigmatism (SIA) and corneal higher-order aberrations (HOAs). METHODS: In a prospective randomized study, conventional phacoemulsification with a 2.8-mm clear corneal incision using a disposable keratome was performed in 20 eyes of 20 patients (manual group), and femtosecond laser-assisted cataract surgery with a 2.8-mm biplanar clear corneal tunnel created by a femtosecond laser (LenSx; Alcon Laboratories, Inc., Aliso Viejo, CA) was performed in 20 eyes of 20 patients (femtosecond laser group). Corneal topography readings and corneal wavefront aberrations (diameter: 9.0 mm) were obtained using a Scheimpflug camera (Pentacam HR; Oculus Optikgerate, Wetzlar, Germany) preoperatively and 3 months postoperatively. RESULTS: There was no significant difference in SIA between the groups (femtosecond laser group: 0.47 ± 0.13 vs manual group: 0.41 ± 0.14; P = .218), but the axis deviation of the SIA axis from the previously planned axis was significantly smaller in the femtosecond laser group compared to the manual group (4.47°± 2.59° vs 7.38°± 4.72°, respectively; P = .048). Corneal HOAs increased significantly in both groups (femtosecond laser group: 0.13 ± 0.09 to 0.18 ± 0.12, P = .025; manual group: 0.13 ± 0.05 to 0.15 ± 0.05, P = .002), but preoperative and postoperative values did not differ significantly between them (P = .472 and .078, respectively). Lower-order and total corneal aberration values remained stable in both groups (P > .05). CONCLUSIONS: There was no difference in SIA and induced HOAs between manual and femtosecond laser-created clear corneal incisions.
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Astigmatismo/etiologia , Córnea/cirurgia , Cirurgia da Córnea a Laser/efeitos adversos , Aberrações de Frente de Onda da Córnea/etiologia , Implante de Lente Intraocular/métodos , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Facoemulsificação/métodos , Idoso , Astigmatismo/diagnóstico , Topografia da Córnea , Aberrações de Frente de Onda da Córnea/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
PURPOSE: To assess the correlation between keratoconus severity and intereye asymmetry of pachymetric data and posterior elevation values and to evaluate their combined accuracy in discriminating normal corneas from those with keratoconus. METHODS: This study included 97 patients: 65 subjects with bilateral normal corneas (NC) and 32 with keratoconus (KC). Central corneal thickness (CCT), thinnest corneal thickness (ThCT) and posterior elevation (PE) at the thinnest point of the cornea were measured in both eyes using Scheimpflug imaging. Intereye asymmetry and its correlation with keratoconus severity were calculated for each variable. The area under the receiver operating characteristic curve (AUROC) was used to compare predictive accuracy of different variables for keratoconus. RESULTS: In normal eyes, intereye differences were significantly lower compared with the keratoconus eyes (p<0.001, for CCT, ThCT and PE). There was a significant exponential correlation between disease severity and intereye asymmetry of steep keratometry (r2â=â0.55, p<0.001), CCT (r2â=â0.39, p<0.001), ThCT (r2â=â0.48, p<0.001) and PE (r2â=â0.64, p<0.001). After adjustment for keratoconus severity, asymmetry in thinnest pachymetry proved to be the best parameter to characterize intereye corneal asymmetry in keratoconus. This variable had high accuracy and significantly better discriminating ability (AUROC: 0.99) for KC than posterior elevation (AUROC: 0.96), ThCT (AUROC: 0.94) or CCT (AUROC: 0.92) alone. CONCLUSIONS: There is an increased intereye asymmetry in keratometry, pachymetry and posterior corneal elevation values in keratoconic patients compared to subjects with normal corneas. Keratoconus patients with more severe disease are also more asymmetric in their disease status which should be taken into account during clinical care.
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Córnea/anormalidades , Córnea/anatomia & histologia , Ceratocone/patologia , Adulto , Topografia da Córnea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
PURPOSE: To evaluate and compare the mechanical properties of anterior capsule openings performed with the continuous curvilinear capsulorhexis (CCC) technique and femtosecond laser capsulotomy (FLC) in ex vivo porcine lens capsule specimens. METHODS: Fresh porcine eyes were included in the study (CCC group, n = 50; FLC group, n = 30). The capsule openings were stretched with universal testing equipment until they ruptured. The rupture force and circumference stretching ratio were evaluated. The morphologic profile of the cut capsule edges was evaluated using scanning electron microscopy (SEM). RESULTS: The average rupture force was higher in the CCC group (median: 155 mN; interquartile range [IQR]: 129 to 201 mN; range: 71 to 294 mN) than in the FLC group (median: 119 mN; IQR: 108 to 128 mN; range: 91 to 142 mN) (P < .01, Mann-Whitney U test). The average circumference stretching ratio in the CCC group was greater (median: 150%; IQR: 146% to 156%; range: 136% to 161%) than in the FLC group (median: 148%; IQR: 145% to 150%; range: 141% to 154%) (P = .0468, Mann-Whitney U test). When less than 71 mN, no capsular tear occurred in either group. When less than 91 mN, no capsular tear occurred in the FLC group, whereas at 91 mN, the probability of capsular tears was 9% for the CCC group. SEM examination found that the CCC group had smooth edges, whereas those of the FLC group were gently serrated. CONCLUSIONS: According to the current results in a porcine eye model, FLC had less average resistance to capsule tear than CCC, but the weakest openings were seen in the CCC group.
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Cápsula Anterior do Cristalino/fisiologia , Fenômenos Biomecânicos/fisiologia , Capsulorrexe , Terapia a Laser , Animais , Cápsula Anterior do Cristalino/cirurgia , Cápsula Anterior do Cristalino/ultraestrutura , Microscopia Eletrônica de Varredura , Ruptura da Cápsula Posterior do Olho/fisiopatologia , Estresse Mecânico , SuínosRESUMO
PURPOSE: To report the use of femtosecond laser cataract surgery in a traumatic case. METHODS: A 38-year-old man had a penetrating eye injury while working with wire. The corneal laceration was sutured first. In the postoperative period, cortical cataract appeared in the crystalline lens; therefore, in the second session, cataract surgery was performed using a femtosecond laser system (Alcon-LenSx Lasers Inc.). RESULTS: Corneal incisions, an intact 4.5 mm capsulorhexis, and nucleus liquefaction were performed with the femtosecond laser. Corrected distance visual acuity was 0.9 1 month after surgery. CONCLUSIONS: Femtosecond laser is an effective method in traumatic cataract cases after penetrating eye injury. Corneal incisions, capsulorhexis, and nucleus liquefaction can be performed precisely and safety.
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Cápsula Anterior do Cristalino/lesões , Lesões da Córnea , Ferimentos Oculares Penetrantes/etiologia , Terapia a Laser/métodos , Facoemulsificação/métodos , Adulto , Cápsula Anterior do Cristalino/cirurgia , Córnea/cirurgia , Ferimentos Oculares Penetrantes/cirurgia , Humanos , Implante de Lente Intraocular , Masculino , Tomografia de Coerência Óptica , Acuidade VisualRESUMO
PURPOSE: To analyze complications of femtosecond lasers used for cataract surgery. SETTING: Department of Ophthalmology Semmelweis University, Budapest, Hungary. DESIGN: Retrospective analysis. METHODS: Intraoperative complications of the first 100 femtosecond laser-assisted (Alcon-Lensx, Inc.) cataract surgeries were collected. Possible complications of femtosecond capsulotomies and their management were also assessed. RESULTS: The complications were as follows: suction break (2%), conjunctival redness or hemorrhage (34%), capsule tags and bridges (20%), anterior tear (4%), miosis (32%), and endothelial damage due to cut within the endothelial layer (3%). There were no cases of capsule blockage or posterior capsule tear. During the learning curve, there was no complication that would require vitrectomy. All complications occurred during the first 100 cases. CONCLUSIONS: Femtosecond laser cataract surgery had a learning curve during the first 100 cases. With cautious surgical technique, the complications can be avoided. The femtosecond laser-assisted method was efficient and safe for cataract surgery.
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Extração de Catarata/métodos , Complicações Intraoperatórias , Terapia a Laser/métodos , Extração de Catarata/educação , Humanos , Curva de Aprendizado , Implante de Lente Intraocular , Refração Ocular/fisiologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual/fisiologiaRESUMO
PURPOSE: To report the use of femtosecond laser-assisted cataract surgery in management of phacomorphic glaucoma. METHODS: An 89-year-old patient developed acute phacomorphic glaucoma in her right eye with elevated intraocular pressure (62 mm Hg), shallow anterior chamber, and mature cataract. After conservative antiglaucoma therapy and Nd:YAG iridotomy, femtosecond laser-assisted cataract surgery was performed. A Malyugin ring was implanted for mechanical pupil dilatation and a 4.8-mm capsulorrhexis and lens fragmentation was performed using a femtosecond laser system (Alcon LenSx Inc., Aliso Viejo, CA) followed by in-the-bag intraocular lens implantation. RESULTS: Intact 4.8-mm capsulorrhexis and successful lens fragmentation could be performed using femtosecond laser. After cataract surgery, the patient's visual acuity increased from hand motions to 0.4 (Snellen 4/10) and the intraocular pressure returned to normal range without antiglaucoma drop therapy. CONCLUSIONS: The results indicate that femtosecond laser can be successfully used in certain cases of phacomorphic glaucoma, even if mechanical pupil dilatation is needed.
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Capsulorrexe/métodos , Catarata/complicações , Córnea/cirurgia , Glaucoma de Ângulo Fechado/cirurgia , Terapia a Laser/métodos , Refração Ocular , Idoso de 80 Anos ou mais , Catarata/fisiopatologia , Feminino , Glaucoma de Ângulo Fechado/complicações , Glaucoma de Ângulo Fechado/fisiopatologia , Humanos , Acuidade VisualRESUMO
PURPOSE: To report the anterior segment imaging characteristics after femtosecond laser assisted cataract surgery. METHODS: Cataract surgery was performed with the LenSx femtosecond laser (Alcon-LenSx Inc., Aliso Viejo, CA) in 40 eyes of 40 patients. The laser was programmed to perform a 4.5-mm capsulorhexis, a cross-pattern fragmentation of the nucleus, a 2.8-mm main incision, and a 1.0-mm side-port incision. The anterior segment was then analyzed using the Visante OCT anterior segment program (Zeiss-Meditec AG, Jena, Germany). RESULTS: The preoperatively set treatment parameters correlated well with the achieved results. For the capsulorhexis, the femtosecond laser cut was programmed to start 350 µm behind the anterior lens capsule and OCT measured 377 ± 55.3 µm. Nucleus fragmentation was programmed to start 750 µm in front of the posterior capsule and end 550 µm behind the anterior capsule, and OCT measured 794 ± 111 and 568 ± 147 µm, respectively. The diameter of the capsulorhexis measured by OCT was 4.54 ± 0.2 mm, compared to the 4.5 mm programmed. CONCLUSIONS: Anterior segment OCT imaging was able to detect the tissue changes within the lens after femtosecond laser capsulorhexis and nucleus fragmentation. The measured values correlated well with the planned treatment parameters.