Concentrations of glucose metabolites in the aqueous humour of diabetic cataract eyes.

PURPOSE: Glucose metabolism underpins diabetic cataracts (DCs), but the relationship between the two remains unclear. Here, we tested the aqueous humour (AH) of patients with DCs to elucidate glucose metabolite levels. METHODS: In this study, aqueous humour (AH) samples were collected preoperatively from DC eyes (n = 37) and age-related cataract eyes (n = 37) from 74 patients (74 eyes) undergoing uncomplicated cataract surgery. The content of glucose, pyruvate, L-lactate were detected by biochemical methods and advanced glycation end-products (AGEs) was detemined using enzyme-linked immunosorbent assay (ELISA) technique. Furthermore, the ratios of glucose/pyruvate and L-lactate/pyruvate in the AH were calculated. In addition, we calculated the correlation between glucose levels and AGEs in the AH. RESULTS: The concentrations of glucose, pyruvate and AGEs in the DC group were higher than those in the control group. Significantly lower levels of L-lactate in the AH were found in the DC group. We calculated the glucose/pyruvate ratio and the L-lactate/pyruvate ratio in the AH, which showed that glucose metabolism was changed in the AH from DC patients. Interestingly, we observed that AGEs in the AH were significantly correlated with increased anterior chamber glucose permeability. A stronger correlation was found in the subgroups of male patients, younger patients, and patients with poor glycaemic control status. CONCLUSIONS: Comparison of the levels of glucose metabolism-related products in the AH in the DC group highlight a potential pathological mechanism for DC from a glucose metabolism perspective. The findings indicated an alteration in the metabolic pathways of energy metabolism and amino acids in the AH of DC patients.

Doxycycline Suppresses Vasculogenic Mimicry in Human Pterygium Fibroblasts.

PURPOSE: To explore the effect of doxycycline on vasculogenic mimicry (VM) formation and the potential mechanism in human pterygium fibroblasts in order to find novel targets for pterygium therapy. METHODS: First, we demonstrate the existence of VM in 73 pterygium specimens by CD31 and periodic acid Schiff (PAS) dual staining. Then we used cell counting kit-8, clone formation assay and flow cytometry to prove the inhibitory effect of doxycycline on cell proliferation and apoptosis. The VM formation was evaluated through wound healing assay, cell transwell assay and three-dimensional cell culture combined with PAS staining. Finally, we used Western blot to testify the correlation of the VM and the factors in protein level preliminarily. RESULTS: Our results showed that VM existed in human pterygium specimens exactly. Otherwise, in human pterygium fibroblasts, doxycycline induced a dose-dependent inhibitory effect on cell proliferation and apoptosis induction. Besides, doxycycline significantly suppressed vasculogenic mimicry tube formation, cell migration and invasion. Furthermore, doxycycline impaired the expression of MMP-9, MMP-2 and VEGF which may related to pterygium VM formation. CONCLUSIONS: Doxycycline decelerated pterygium progression might be through inhibiting VM formation according to the downregulation of MMP-9, MMP-2 and VEGF, which may provide the basis of further studies involving doxycycline for pterygium treatment.

Ganoderic acid A protects lens epithelial cells from UVB irradiation and delays lens opacity.

A contributory role of oxidative stress and protection by antioxidant nutrients have been suspected in cataract formation. Ganoderic acid A (GAA), an effective lanostane triterpene, is widely reported as an antioxidant. The aim of this study is to investigate the potential effects of GAA on cataract formation. After lens epithelial cells (LECs) were exposed to UVB radiation for different periods, cell viability, apoptosis-related protein levels, malondialdehyde (MDA) and superoxide dismutase (SOD) activities were monitored. We found that cell viability, the Bcl-2/Bax ratio and SOD activity were increased, while Cleaved caspase-3 levels and MDA activity were decreased compared with those in UVB-impaired LECs after GAA treated. Furthermore, GAA activated PI3K/AKT in UVB-impaired LECs and effectively delayed the occurrence of lens opacity in vitro. In conclusion, these findings demonstrated that GAA exhibited protective functions in SRA01/04 cells and rat lenses against UVB-evoked impairment through elevating cell viability and antioxidant activity, inhibiting cell apoptosis, activating the PI3K/AKT pathway and delaying lens opacity.

Effect of femtosecond laser-assisted steepest-meridian clear corneal incisions on preexisting corneal regular astigmatism at the time of cataract surgery.

AIM: To investigate the clinical efficacy and safety of femtosecond laser-assisted steepest-meridian clear corneal incisions for correcting preexisting corneal astigmatism performed at the time of cataract surgery. METHODS: This prospective case series study comprised consecutive age-related cataract patients with corneal regular astigmatism (range: +0.75 to +2.50 D) who had femtosecond laser-assisted steepest-meridian clear corneal incisions (single or paired). Corneal astigmatism was performed with the Pentacam preoperatively and 3mo postoperatively. Total corneal astigmatism and steepest-meridian measured in the 3-mm central zone were used to guide the location, size and number of clear corneal incision. The vector analysis of astigmatic change was performed using the Alpins method. RESULTS: Totally 138 eyes of 138 patients were included. The mean preoperative corneal astigmatism was 1.31±0.41 D, and was significantly reduced to 0.69±0.34 D (equivalent to difference vector) after surgery (P<0.01). The surgically-induced astigmatism was 1.02±0.54 D. The correction index (ratio of target induced astigmatism and surgically-induced astigmatism: 0.72±0.36) as well as the magnitude of error (difference between surgically-induced astigmatism and target induced astigmatism: -0.29±0.51) represented a slight under correction. For angle of error, the arithmetic mean was 1.11±13.70, indicating no significant systematic alignment errors. CONCLUSION: Femtosecond-assisted steepest-meridian clear corneal incision is a fast, customizable, adjustable, precise, and safe technique for the reduction of low to moderate corneal astigmatism during cataract surgery.

Folate-Modified Photoelectric Responsive Polymer Microarray as Bionic Artificial Retina to Restore Visual Function.

A high-optical-resolution artificial retina system that accurately communicates with the optic nerve is the main challenge in the modern biological science and bionic field. Here, we developed a bionic artificial retina possessing phototransduction "cells" with measurements even smaller than that of the neural cells. Using the technique of micrometer processing, we constructed a pyramid-shape periodic microarray of a photoreceptor. Each "sensing cell" took advantage of polythiophene derivative/fullerene derivative (PCBM) as a photoelectric converter. Because folic acid played an essential role in eye growth, we particularly modified the polythiophene derivatives with folic acid tags. Therefore, the artificial retina could enlarge the contact area and even recognize the nerve cells to improve the consequence of nerve stimulation. We implanted the artificial retina into blinded rats' eyes. Electrophysiological analysis revealed its recovery of photosensitive function 3 months after surgery. Our work provides an innovative idea for fabricating a high-resolution bionic artificial retina system. It shows great potential in artificial intelligence and biomedicine.

Effects of steep-axis incision on corneal curvature in one-handed phacoemulsification.

AIM: To examine the effects of one-handed phacoemulsification with steep-axis incision on corneal curvature and analyze surgically induced astigmatism (SIA) on the true net power, anterior and posterior corneal surfaces. METHODS: Patients with cataracts underwent one-handed phacoemulsification with a 2.4-mm steep-axis of clear corneal incision (CCI) based on true net power. CCI was created under the guidance of Verion. Central corneal thickness (CCT), keratometry readings of the true net power and anterior and posterior corneal surface were obtained using Pentacam. Biometry, such as axial length, anterior chamber depth (ACD) and white-to-white (WTW) were performed using Lenstar pre- and 3mo post-operatively. RESULTS: The study evaluated 68 eyes of 65 patients. The mean age was 65.93±9.40y; CCT was 529.21±37.40 µm; WTW was 11.59±0.35 mm. Regarding true net power, keratometric value at the flattest corneal meridian for the 3-mm central zone (Ks) was significantly decreased postoperatively (P=0.031). Keratometric value at the steepest corneal meridian for the 3-mm central zone (Kf) was increased postoperatively (P>0.05). Astigmatism of true net power was 1.21±0.56 D preoperatively and significantly decreased to 1.02±0.58 D postoperatively (P=0.021). On the anterior corneal surface, no significant difference in Ks and Kf was noted pre- versus postoperatively. Anterior corneal astigmatism was 1.08±0.51 D preoperatively and significantly decreased to 0.87±0.46 D postoperatively (P=0.002). On the posterior corneal surface, Ks and Kf were significantly increased postoperatively (all P<0.05), and posterior corneal astigmatism also increased (P=0.008). The SIA values of true net power and the anterior and posterior corneal surfaces at 3mo postoperatively were 1.26±0.63 D (range: 0.11 to 2.80 D), 1.05±0.54 D (range: 0.23 to 2.40 D), and 0.21±0.17 D (range: 0.01 to 0.07 D), respectively. CONCLUSION: One-handed phacoemulsification with steep-axis incision can effectively decrease astigmatism of true net power and anterior corneal astigmatism. In the same surgery, the difference in personal SIA potentially originated from a difference in personal corneal thickness and diameter, both CCT and WTW distance should always be measured preoperatively when planning steep-axis phacoemulsification.

[Cautious choice of new intraocular lenses in patients with cataract rehabilitation surgery in China].

We must choose new intraocular lenses (IOL) cautiously and strictly in patients with cataract rehabilitation surgery in China because of following reasons. Firstly, there are no differences in visual acuity between traditional poly-methylmethacrylate (PMMA) IOL implantation group and new IOL (multifocal IOL, aspherical IOL) implantation group. Secondarily, there are many factors which affect visual performance after cataract surgery. Thirdly, many patients with cataract can not afford new intraocular lenses .Fourthly, there are several faultiness and clinical problems in new intraocular lenses. Therefore, correct selection of IOL should be affordable PMMA IOL in cataract rehabilitation surgery in China.

Improvement in visual function and quality of life following a blindness prevention surgery program in a rural area of Eastern China.

The aim of this study was to assess the changes in visual function (VF) and quality of life (QOL) among patients following blindness prevention surgery in a rural area of Eastern China. The prospective study selected cataract patients via mobile eye screening camps. VF and QOL questionnaires originally developed by Fletcher et al were completed prior to and 6 months after surgery. Small-incision cataract surgery (SICS) with posterior chamber intraocular lens (IOL) implantation was performed on patients by a blindness prevention surgery group. The VF and QOL scores of 178 cataract patients preoperatively were 48.58±31.18 and 65.97±26.77, respectively. The scores decreased in proportion to decreasing vision status. The VF and QOL scale scores were significantly correlated with the vision grade of the patient (rVF=-17.2093, t=-10.87, P<0.001, rQOL=-13.1399, t=-8.87, P<0.001) and age (rVF=-0.6505, t=-3.87, P<0.001, rQOL=- 0.3309, t=-2.10, P=0.037). A total of 131 patients responded to the second survey, VF and QOL scores increased significantly over a six-month postoperative period (VF=83.21±16.40, P<0.001; QOL=86.53±16.33, P<0.001). The VF scale scores were correlated with the grade of vision and residence area, the QOL scale scores were correlated with the grade of vision and gender. The VF and QOL of patients were significantly improved by performing SICS with posterior chamber IOL implantation collectively in a short period in rural areas of Eastern China. It is important to follow-up cataract patients postoperatively as untreated complications of the surgery may affect the stability of VF and QOL postoperatively.

[Prevalence and surgical status of cataract among adults aged 50 years or above in rural Jiangsu Province].

OBJECTIVE: To survey the prevalence, operative status, surgical coverage rate and social burden rate of cataract blindness among older adults aged 50 years or above in 2 typical counties (district) of Jiangsu Province, China in 2010. METHODS: Cluster sampling was used in randomly selected 12 867 individuals aged 50 years or above in 58 clusters in Funing County of Northern Jiangsu and Binhu District of Southern Jiangsu. Among them, 12 053 individuals received visual acuity and eye examinations (response rate 93.8%). Lens and cataract operative status were evaluated by slit-lamp biomicroscope. Data bank was established by Epidata3.0 Software. Statistical analyses were performed with Stata/SE Statistical Software, version 10.0. Confidence intervals and P values (significant at P < 0.05) for prevalence of cataract, surgical coverage rate of cataract, social burden rate and surgical outcomes of cataract blindness were calculated with adjustment for clustering effects and stratification associated with the sampling design. RESULTS: Among 12 503 individuals, there were 2208 cases of cataract with a prevalence of 18.3%. The prevalence of cataract was higher in the aged, female and lower-income persons (P < 0.05). Among 2208 cataract patients, cataract surgery was performed in 263 cases (11.9%). The surgical coverage rate of cataract was 59.7% and the social burden rate of cataract blindness 1.93%. The social burden rate of cataract blindness was higher in the aged persons (P < 0.01). In 357 eyes with cataract surgery, the rate of intraocular lens implantation was 85.7%. At Binhu, 71.0% of eyes with cataract surgery underwent phacoemulsification. At Funing, 73.6% of eyes underwent modern extra-capsular surgery respectively. Post-operative presenting and best corrected visual acuity over 0.7 was 11.2% and 19.6% of operated eyes respectively. The main causes of post-operative eyes with worse visual acuity (< 0.3) were post-capsular opacity and retinal disorders. CONCLUSION: Cataract is the most common and important eye disease that may lead into blindness and severe visual impairment among older adults aged 50 years or above. The coverage rate of cataract surgery is higher in Jiangsu province than in other provinces. The visual outcomes of surgery is less than ideal. An important task in blindness prevention of Jiangsu province still is the elimination of cataract blindness and the improvement of visual outcomes for cataract surgery in the future.

[Cataract surgery rate and its impacting factors in Jiangsu Province in 2012].

OBJECTIVE: To survey the cataract surgery rate (CSR) according to the report data and its influencing factors of Jiangsu Province in 2012 so as to further improve CSR in China. METHODS: Through government websites in 2012, gross domestic product (GDP) and GDP per capital of 13 cities in Jiangsu Province and 7 counties of Nantong City reported to the Ministry of Health in China were collected to calculate CSR. The relationship between GDP and CSR of Jiangsu Province and Nantong City were analyzed with Spearman's rank correlation, and the differences in the proportion of cataract surgery between government and private hospitals were analyzed by Chi-square test. RESULTS: CSR in Jiangsu Province in 2012 was 939 cases per million population per year. Nantong City had the highest CSR (1362 cases per million population per year) and Suqian City the lowest (129 cases per million population per year). The GDP of 13 cities in Jiangsu Province had a positive correlation with CSR (spearman r = 0.59, P = 0.03), but there was no significant correlation with GDP per capital (spearman r = 0.50, P = 0.08). No significant correlation existed between GDP, GDP per capital and CSR of 7 counties of Nantong City (spearman r = -0.04, P = 0.94; spearman r = -0.29, P = 0.53). The proportion of private hospitals of Nantong was 33.3% and surgery cases were 4557 (45.9%). The CSR of Rugao County in 2012 was 3317 cases per million population per year. CONCLUSION: Socioeconomic level may be related with CSR. Providing village cataract screening services and lowering surgical costs help to boost CSR in China.

[Prevalence and surgery status of cataract among adults aged 50 years or above in Qidong City of Jiangsu Province: the China Nine-Province Survey].

OBJECTIVE: To estimate the prevalence of cataract, the rate of cataract surgical coverage rate,and the rate of cataract-blindness social burden among older adults aged 50 years or above in Qidong City of Jiangsu Province, China, in 2006. METHODS: Cluster sampling was used in randomly selected 5662 individuals aged 50 years or above in 16 clusters in Qidong City. 5141 individuals received visual acuity and eye examination from September to December 2006. Lens and cataract operation status were evaluated by slit lamp. Multiple logistic regression analysis was employed to analyzed the prevalence of cataract, cataract surgical coverage rate, cataract blindness social burden rate and outcomes of surgery among different ages, sex and educational background. RESULTS: In 5141 individuals, 1098 cases of cataract were found, the prevalence of cataract was 21.35% among adults aged 50 or above. The prevalence of cataract was higher in the aged, female, illiterate persons (P < 0.01). In 89 eyes with cataract surgery, 25.84% and 42.70% of eyes were performed by the modern extra-capsular surgery and Phacoemulsification respectively. The rate of intraocular lens implantation was 69. 66%. Post-operative presenting and best corrected visual acuity more than 0.7 was 24.70% and 48.31% of operated eyes respectively. The main causes of the post-operated eyes with worse visual acuity were retinal disorders post-capsular opacity and glaucoma. The cataract surgical coverage rate was 37.96%, and the cataract blindness social burden rate was 2.10%. The cataract blindness social burden rate was higher in the aged persons (P < 0.01). CONCLUSIONS: Cataract is the most common and important eye disease that may lead into blindness and severe visual impairment among older adults aged 50 years or above. The cataract surgical coverage rate is not so high in Qidong City, and even lower in the aged persons. The first important task in blindness prevention still is the elimination of cataract blindness. The visual outcomes of the cataract surgery should be further improved in the future.

Effects of bone marrow mesenchymal stem cells on cell proliferation and growth factor expression of limbal epithelial cells in vitro.

Mesenchymal stem cells (MSCs) can play an active role in there construction of the ocular surface; however, the mechanisms by which the implanted MSCs exert their effects remain elusive. In the present study, we investigated the influences of MSCs on cell proliferation and growth factor expression of corneal limbal epithelial cells (LECs) in vitro. Rat LECs were either cocultured with rat MSCs or cultured in rat MSC condition edmedium. The harvested LECs were subjected to light microscopy, MTT assay, bromodeoxyuridine (BrdU)staining, flow cytometry and real-time quantitative RT-PCR analysis, respectively. Light microscopy showed that coculturing of LECs with MSCs significantly increased the proliferation of LECs. The MTT assay showed that MSC-conditioned medium significantly increased the cell viability of LECs compared to those incubated with plain medium. BrdU immunostaining and flow-cytometric analysis of the cell cycle showed that the cell proliferation rate of LECs cocultured with MSCs was significantly higher than that of LECs cultured alone. Real-time quantitative RT-PCR analysis showed that expression of epidermal growth factor in LECs cocultured with MSCs was significantly higher than that in LECs cultured alone. However, expression of basic fibroblast growth factor showed no difference under the two culture conditions. These results indicate that MSCs promote the survival and proliferation of LECs, and these effects may be mediated ina paracrine manner.

[Present status and development of prevention of blindness and ophthalmic epidemiologic studies in China].

Blindness prevention and ophthalmic epidemiology studies in China have obtained greatest progress in the past five years since 2005. For example, the secondary sampling epidemiologic study of disabled persons in China in 2006 showed that the major causes of blindness and vision impairment were cataract (56.7%), retinal and uveal diseases (14.1%) and corneal diseases (10.3%). Important blindness prevention projects, such as "Sight first, China action" stage II project and "Free cataract surgeries for one million poor patients" project, have achieved their goals. From 2005 to 2009, 3.871 millions of cataract surgeries were performed in China, and the cataract surgical rate increased to 796.2 per million population in 2009. Cataract surgery obstacle-free areas have been built in 673 counties, 70 cities and 2 provinces since 2007. The visual performance of 175,501 low-vision patients have been improved by low-vision aids, and 47,009 blind persons have been offered walk mobility training course. Furthermore, achievements and progress have been obtained in primary eye care, prevention and treatment for trachoma, childhood eye diseases and diabetic retinopathy. These results has met the requirements established by Chinese government, but has not reached the goal of "Vision 2020". Certain problems still exist in China, including low cataract surgical rate, major avoidable blinding diseases not eliminated, and lack of innovative and profound epidemiological studies. Future Chinese ophthalmic epidemiology studies may focus on original investigation and molecular research. In order to realize the goal of "Vision 2020" and eliminate avoidable cataract blindness, all kinds of eye care services should be integrated, and various prevention and treatment strategies with low cost and superior quality for cataract, retinal diseases, corneal diseases, trachoma, refractive error, low vision, and glaucoma should be used.

[A case-control study of factors associated with primary angle-closure glaucoma].

OBJECTIVE: To understand the risk factors of primary angle-closure glaucoma. METHODS: One to one matched case-control study was conducted in this study. One hundred and ninety two PACG cases and 192 controls, matched by age and gender, were collected from Department of Ophthalmology, Affiliated Hospital of Nantong University. All of the participants were investigated for their demographic information, behavioral habits, disease history, glaucoma family history and received clinical ocular examinations. The difference between these two groups was analyzed. RESULTS: Several factors, including hypertension (OR = 2.004, P = 0.009), glaucoma family history (OR = 6.726, P = 0.003), presbyopia (OR = 3.192, P = 0.031), shallow anterior chamber (OR = 12.804, P = 0.000) and high cup-to-disc ratio (OR = 9.401, P = 0.007) were associated with PACG by multiply Logistic regression. The results did not support that smoking, drinking, myopia, diabetes mellitus and blood style were related to PACG. CONCLUSION: Follow up the populations with glaucoma family history, shallow anterior chamber or high cup-to-disc ratio are the main procedures for the decrease of incidence of PACG.

[Pathological study on effects of preservative-free 1% lidocaine on lens epithelial cells of patients with age-related cataract].

OBJECTIVE: To assess whether preservative-free 1% lidocaine is capable of destroying the LECs in age-related cataract (ARC) in order to provide scientific basis for pursuing safe and effective drugs to eliminate LECs in cataract surgery. METHODS: Lens anterior capsule (LAC) specimens were collected from 75 patients (82 eyes) with age-related cataract (ARC), including forty males (44 eyes) and thirty-five females (38 eyes). The age range was 41 - 85 years, the mean age was 67.97 years. There were 34 cortical cataracts, 22 nuclear cataracts and 26 subcapsular cataracts. Capsule specimens were divided into 4 groups: balanced salt solution (BSS) group I and group II (exposed to BSS for 1 minute), lidocaine group (exposed to preservative-free 1% lidocaine for 1 minute) and the control group. Specimens were stained with trypan blue and alizarin red. Photomicrographs of each capsule were taken to observe the viability of LECs and to count the number of necrosis LECs. The pathologic changes of LECs were evaluated by histological methods (11 LAC, 22 pieces) as well as transmission and scanning electron microscopes (5 LAC, 10 pieces). In the control and BSS group I (23 LAC), one half of each capsule specimen was used for the control group and the other half was used for BSS group I. In lidocaine group and BSS group II (43 LAC), one half of each capsule specimen was used for lidocaine group and the other half was used for BSS group II. RESULTS: The rate of necrosis LECs of the anterior capsules in the control group and BSS group I was (56.19 +/- 2.71)% and (57.23 +/- 1.98)%, respectively. The rate of necrosis LECs of the capsules in lidocaine group and BSS group II was (99.86 +/- 8.22)% and (57.64 +/- 7.00)%, respectively. Matching t-test showed that the rate of necrosis LECs in lidocaine group was greater than that in the BSS group II (t = 27.6781, P = 0.0000). There was no significant difference in the number of necrosis LECs between the control group and BSS group I (t = 2.0693, P = 0.0505). There was also no significant difference between males and females; between different cataract, types and between varying age groups (P > 0.05). After irrigated with lidocaine, LECs showed vacuoles and detached from the capsule, and many cavities appeared between the LECs and the capsule. The capsules of BSS and control group showed a normal layer of LECs attached to the capsule. Under transmission and scanning electron microscopes, in lidocaine group, the junction between the LECs and between the cells and the capsule were destroyed; many cells detached from the capsule and the rest arranged loosely. Some LECs dented and many vacuoles emerged, resulting in destruction of the cellular structures. CONCLUSION: Preservative-free 1% lidocaine may loose the junction between LECs and between the cells and the capsule, and also destroy cellular structures, resulting in degeneration and necrosis of the LECs.

[Comparative study of gentamycin and povidone-iodine on eliminating the conjunctival bacteria].

OBJECTIVE: To study the efficacy of gentamycin, 0.5% povidone-iodine and 5.0% povidone-iodine in eliminating rate of positive conjunctival bacteria cultures and aqueous humor contamination, and to observe their adverse effects. METHODS: It was a comparative study. Three hundred patients (300 eyes) were randomized to three groups: gentamycin group, 0.5% povidone-iodine group and 5.0% povidone-iodine group. All patients received 1-day (6 times) topical application of 0.3% ofloxacin before surgery. Approximately 5 minutes before surgery, the conjunctival sac was irrigated with 5 - 8 ml gentamycin, 0.5% povidone-iodine or 5.0% povidone-iodine, correspondingly. Conjunctival cultures were obtained at the following time points: before receiving any topical medications; after application of 1-day topical 0.3% ofloxacin, before irrigating the conjunctival sac; immediately before surgery approximately 5 minutes after conjunctival sac irrigation and at the end of the surgery. Anterior chamber aspirates were obtained at the beginning of the surgery. Bacteria isolated were identified and antibiotic susceptibility was determined. The rate of positive conjunctival cultures among each group was compared and significance of the difference was tested with the Pearson chi-square test. RESULTS: Rate of positive conjunctival cultures before the conjunctival irrigation was 79.7%, 76.6% and 77.8% in the gentamycin group, 0.5% povidone-iodine group and 5.0% povidone-iodine group, respectively. The difference between these three groups was not statistically significant (chi2 = 0.28, P = 0.86). At the end of surgery, the rate of positive conjunctival cultures in these three groups was 11.7%, 8.3% and 6.3%, respectively. The difference between these three groups was also not statistically significant (chi2 = 1.74, P = 0.41). The average rate of anterior aqueous contamination was 4.9% and there was no significant difference among these three groups (P > 0.05). CONCLUSIONS: Both 0.5% povidone-iodine and 5.0% povidone-iodine using for irrigating conjunctival sac are safe. Gentamycin, 0.5% povidone-iodine and 5.0% povidone-iodine have similar effects on the reduction of the bacteria in conjunctival sac.

[Histopathological study of the effect of preservative-free 1% lidocaine on rabbit lens epithelial cells].

OBJECTIVE: To assess whether preservative-free 1% lidocaine is capable of loosing the junction between the rabbit lens epithelial cells (LECs) and between the cells and capsules and is capable of destroying the LECs, in order to provide scientific basis for pursuing safe and effective drugs to eliminate LECs in cataract surgery and to prevent capsular pacification. METHODS: Lens capsule specimens were collected from 29 rabbits (58 eyes) and divided into 3 groups: balanced salt solution (BSS) group (exposed to BSS for 1 minute), lidocaine group (exposed to preservative-free 1% lidocaine for 1 minute) and the control group. Specimens were stained with trypan blue and alizarin red. Photomicrographs of each capsule were taken to observe the viability of LECs and count the number of dead LECs. The histopathologic changes of LECs treated with lidocaine were evaluated by histological method and transmission electron microscope. RESULTS: The rate of dead LECs of the anterior and the equatorial lens capsules in control group was (1.51 +/- 0.39)%, and (1.52 +/- 0.32)%, respectively. The rate of dead LECs of the anterior and the equatorial lens capsules irrigated with BSS was (1.78 +/- 0.50)% and (1.77 +/- 0.47)%. The rate of dead LECs of the anterior and the equatorial lens capsules irrigated with preservative-free 1% lidocaine was (13.01 +/- 4.67)% and (9.59 +/- 3.35)%, respectively. The nested design ANOVA showed that the rate of dead LECs in the lidocaine group was greater than that in the control group or BSS group (P < 0.05), There was no significant difference in the number of dead cells between the anterior lens capsules and the equatorial lens capsules. After irrigated with lidocaine, cavities appeared ibetween the LECs and the capsule, cells detached from the capsule and showed vacuoles. The capsules of control group and BSS group showed a normal layer of LECs attached to the capsule. Under transmission electron microscope, in the lidocaine group, the junction between LECs and between the cell and the capsule were destroyed, many cells detached from the capsule and the rest arranged loosely. Some LECs dentes, and many vacuoles emerged, resulting in destruction of the cellular frame. CONCLUSION: Preservative-free 1% lidocaine may loose the junction between the LECs and between the cells and capsules, resulting in degeneration and death of the LECs.