[Research progress on camptothecin and its derivative nano-prodrugs based on tumor microenvironment response].

Nano-prodrug, one of the most widely used nano-formulation at present, has excellent efficacies in tumor treatment with high potential and clinical value. Camptothecin and its derivatives have broad prospects in the preparation of prodrugs for the treatment of tumors. Given the special microenvironment of tumors, including partial acidity, high concentration of reactive oxygen species, high concentration of glutathione and enzyme concentration, a large number of tumor microenvironment-responsive camptothecin and its derivative prodrugs were prepared. This paper classified them from the microenvironment response types and drug release characteristics, reviewed the research progress of camptothecin and its derivative prodrugs based on safety and clinical trials, and analyzed the existing problems and deficiencies, hoping to provide references for the development of camptothecin and its derivatives.

Timing and approaches in congenital cataract surgery: a four-year, two-layer randomized controlled trial.

AIM: To compare visual prognoses and postoperative adverse events of congenital cataract surgery performed at different times and using different surgical approaches. METHODS: In this prospective, randomized controlled trial, we recruited congenital cataract patients aged 3mo or younger before cataract surgery. Sixty-one eligible patients were randomly assigned to two groups according to surgical timing: a 3-month-old group and a 6-month-old group. Each eye underwent one of three randomly assigned surgical procedures, as follows: surgery A, lens aspiration (I/A); surgery B, lens aspiration with posterior continuous curvilinear capsulorhexis (I/A+PCCC); and surgery C, lens aspiration with posterior continuous curvilinear capsulorhexis and anterior vitrectomy (I/A+PCCC+A-Vit). The long-term best-corrected visual acuity (BCVA) and the incidence of complications in the different groups were compared and analyzed. RESULTS: A total of 57 participants (114 eyes) with a mean follow-up period of 48.7mo were included in the final analysis. The overall logMAR BCVA in the 6-month-old group was better than that in the 3-month-old group (0.81±0.28 vs 0.96±0.30; P=0.02). The overall logMAR BCVA scores in the surgery B group were lower than the scores in the A and C groups (A: 0.80±0.29, B: 1.02±0.28, and C: 0.84±0.28; P=0.007). A multivariate linear regression revealed no significant relationships between the incidence of complications and long-term BCVA. CONCLUSION: It might be safer and more beneficial for bilateral total congenital cataract patients to undergo surgery at 6mo of age than 3mo. Moreover, with rigorous follow-up and timely intervention, the postoperative complications in these patients are treatable and do not compromise visual outcomes.

Eye health is everyone's responsibility: China's first Western-style eye hospital improves in the prevention of blindness.

AIM: To investigate the relationship between China's first Western-style eye hospital development and the prevention of blindness in China and determine the main factor influencing eye health today. METHODS: Data about eye health, blindness and cataract surgery rate of China from public website of World Health Organization (WHO), ORBIS International, Ministry of Health (MOH) of China, Pubmed center and Historical Archives of Zhongshan Ophthalmic Center (ZOC) were reviewed and analyzed. RESULTS: ZOC is China's first Western-style eye hospital. In 2012, the ORBIS Flying Eye Hospital has chosen ZOC once again as one of its destinations, 30 years after ORBIS expanded internationally to train eye care professionals and treat underserved patients in developing countries in 1982. During the past 30 years, cataract surgery rate and public awareness of blindness prevention were improved greatly in China, in which ZOC plays a very important role. CONCLUSION: ZOC, as China's first Western-style eye hospital, has improved in the prevention of blindness. Eye health has become everyone's responsibility.

[Comparison of stability of acrylic intraocular lens and transparency of lens capsule using Pentacam Scheimpflug System].

OBJECTIVE: To compare the amounts of intraocular lens (IOL) decentration and tilt, the anterior chamber depth (ACD) and the degree of posterior capsule opacification (PCO) using the Pentacam Scheimpflug System after cataract surgery between eyes with 1-piece acrylic IOL and 3-piece acrylic IOL. METHODS: It was a perspective study. Fifty-one patients with bilateral senile cataract had implantation of a 1-piece SA60AT IOL in one eye and a 3-piece MA60BM IOL in the contralateral eye. The amount of IOL decentration, tilt, the ACD, and the degree of PCO was measured using the Pentacam Scheimpflug System 1 day and 1, 6, 12 and 24 months postoperatively. RESULTS: There were no significant changes during the 24 m follow-up period in the decentration (0.37 ± 0.16, 0.36 ± 0.15, 0.36 ± 0.16, 0.37 ± 0.15, 0.38 ± 0.16), tilt (3.59 ± 0.91, 3.64 ± 0.92, 3.61 ± 0.90, 3.63 ± 0.90, 3.70 ± 0.89) or PCO (22.20 ± 3.99, 21.96 ± 4.00, 22.40 ± 4.03, 22.53 ± 4.00, 22.95 ± 3.87) in the 1-piece SA60AT group (F = 1.938, 0.785, 1.814; P > 0.05) or in the 3-piece MA60BM group (0.34 ± 0.14, 0.33 ± 0.14, 0.34 ± 0.14, 0.35 ± 0.14, 0.36 ± 0.14), (3.55 ± 0.90, 3.57 ± 0.92, 3.63 ± 0.88, 3.61 ± 0.88, 3.65 ± 0.89), (21.14 ± 3.88, 20.98 ± 3.87, 21.23 ± 3.83, 21.59 ± 3.82, 21.65 ± 3.87) (F = 1.004, 0.525, 1.963; P > 0.05). There was no significant difference between the two groups in IOL decentration (t = 0.802, 0.701, 0.588, 0.898, 0.631), tilt (t = 0.199, 0.337, 0.094, 0.121, 0.248) or PCO (t = 1.214, 1.119, 1.334, 1.082, 1.517) at any time points (P > 0.05). The ACD did not change after the surgery in the 1-piece group (3.90 ± 0.99, 3.88 ± 1.07, 3.91 ± 1.01, 3.90 ± 1.02, 3.92 ± 1.02) (F = 1.333, P > 0.05) but was significantly deeper in the 3-piece group (4.37 ± 1.02, 3.90 ± 0.98, 3.95 ± 0.99, 3.93 ± 0.96, 3.97 ± 0.99) (F = 92.757, P < 0.05) one day after the operation. The ACD was more shallow in the 1-piece SA60AT group than in the 3-piece MA60BM group at all time points. However, the difference was statistically significant only at 1 day after surgery (t = 102.944, P < 0.05). CONCLUSIONS: The degrees of IOL decentration, tilt, ACD and PCO in eyes with a 1-piece acrylic IOL with flexible haptics implanted in the capsular bag were similar to those in eyes with a 3-piece acrylic IOL with rigid PMMA haptics. But the 1-piece acrylic IOL provides a better stability than the 3-piece acrylic IOL in the early stage postoperatively.

[Changes of blood-aqueous barrier after phacoemulsification in patients with previous glaucoma filtering surgery].

OBJECTIVE: To evaluate the effect of trabeculectomy and/or phacoemulsification surgery on blood-aqueous barrier function. METHODS: Phacoemulsification with implantation of intraocular lens was performed on 46 cataract eyes of 40 glaucoma patients following previous trabeculectomy (group 1), and 64 cataract eyes of 60 patients (group 2). The aqueous flare and cells were examined preoperatively and on days 1, 7, 30, 90 postoperatively using a laser flare-cell meter (LFCM). RESULTS: The mean aqueous flare values were (15.12 +/- 2.87), (40.24 +/- 3.75), (24.33 +/- 3.38), (21.18 +/- 1.77), (16.51 +/- 1.70) photon counts/ms in group 1 preoperatively and on days 1, 7, 30, 90 after surgery (P < 0.05) respectively; and were (6.94 +/- 2.34), (26.27 +/- 10.21), (13.96 +/- 6.44), (9.07 +/- 2.67), (7.16 +/- 1.89) photon counts/ms in group 2 (P < 0.05) respectively. CONCLUSIONS: Trabeculectomy can breakdown blood-aqueous barrier permanently while phacoemulsification damage the blood-aqueous barrier transiently. Phacoemulsification combined with a previous trabeculectomy can enhance this damage.

[Disorders of the blood-aqueous barrier after phacoemulsification].

OBJECTIVE: To determine the status of blood-aqueous barrier after small incision phacoemulsification with implantation of foldable intraocular lens. METHODS: The blood-aqueous barrier status in 64 eyes of 60 patients who underwent cataract surgery was examined using a laser flare cell meter. The protein level of anterior chamber aqueous humor was evaluated by measurement of the flare value preoperatively and postoperatively. RESULTS: The mean preoperative flare intensity was (6.94 +/- 0.34) photon counts/ms, which increased to (26.27 +/- 1.37), (13.96 +/- 1.05), (9.07 +/- 0.43) and (7.16 +/- 0.27) photon counts/ms on days 1, 7, 30 and 90 after the surgery, respectively. Significantly statistical differences on flare values were found between preoperative data and those on days 1, 7 and 30 after surgery. The blood-aqueous barrier was recovered on day 90 postoperatively. The variables such as age, gender, eye (left/right) had no influence on the flare value. Patients with iris prolapse had a higher flare value at day 1 and day 7 after the surgery. CONCLUSIONS: Blood-aqueous barrier after phacoemulsification with implantation of intraocular lens can be measured quantitatively by the laser flare cell meter. The blood-aqueous barrier disorders can be recovered shortly after phacoemulsification.