Changes in Corneal Higher-Order Aberrations and Ocular Biometric Measurements after Phacoemulsification Combined with Goniosynechialysis in Primary Angle Closure/Glaucoma Patients.

Purpose: To compare corneal higher-order aberrations (HOAs), refractive error, and ocular biological parameters before and after phacoemulsification combined with goniosynechialysis (Phaco-GSL) in primary angle closure/glaucoma (PAC/PACG) patients with different axial lengths (ALs). Methods: In this prospective study, cataract patients diagnosed with PAC/PACG were categorized into two groups based on their ALs: the short AL group (AL ≤ 22.5 mm) and the normal AL group (22.5 < AL ≤ 24.5 mm). The pre- and postsurgery measurements of intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were conducted at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months. Additionally, the assessments included corneal HOAs, the number of antiglaucoma medications, visual field parameters, manifest refraction, and other ocular biological parameters before surgery and at the final follow-up. Results: Prior to surgery, the two groups exhibited no significant differences, except for AL, curvature value, and Z (4, 0) of the posterior corneal surface (all P < 0.01). Following surgery, BCVA improved, and IOP decreased significantly in both groups (P < 0.01). Both anterior and total corneal HOAs, along with Z (3, -3), increased in the two groups (all P < 0.05), with the normal AL group exhibiting a significantly greater increase in total cornea Z (3, -3) than the short AL group (P=0.047). The normal AL group also exhibited a slight tendency towards hyperopia (P < 0.01). Significant changes were observed in the visual field index and mean deviation in both groups (P < 0.05). Conclusions: Phaco-GSL resulted in an increased corneal HOAs, particularly trefoil, with variations based on the patient's AL. Patients with normal ALs tended to shift towards hyperopia after surgery.

Efficacy and safety of microneedling, fractional CO2 laser, and cryotherapy combined with 5-aminolevulinic acid photodynamic therapy in the treatment of actinic keratosis: A multicenter prospective randomized controlled study.

BACKGROUND: Photodynamic therapy (PDT) for actinic keratosis (AK) is limited by the depth of treatment. Microneedling or fractional CO2 laser can facilitate the penetration of photosensitizer, while cryotherapy can treat deeper tissues but is not suitable for field cancerization. OBJECTIVE: To investigate the efficacy of microneedling, fractional CO2 laser, and cryotherapy in combination with PDT for AK. METHODS: Patients with AK were randomized into 4 groups, including group A with microneedling + PDT, group B with fractional CO2 laser + PDT, group C with cryotherapy + PDT, and group D with PDT. After 12 weeks, the clinical, dermoscopic, and reflectance confocal microscopy (RCM) outcomes were assessed. RESULTS: A total of 129 patients were included in this study, with 31, 30, 35, and 31 patients in each group, yielding clinical response rates of 90.3%, 93.3%, 97.1%, and 74.2%, respectively (P=0.026). The RCM response rates were 71.0%, 80.0%, 85.7%, and 54.8%, respectively (P=0.030). The dermoscopic response rates were 77.4%, 83.3%, 88.6%, and 60.0%, respectively (P=0.039). Group C showed the best efficacy in terms of clinical, dermoscopic, and RCM outcomes. CONCLUSIONS: All three treatments improved the efficacy of PDT and were well tolerated, with cryotherapy + PDT showing the best efficacy.

Surface modification of commercial intraocular lens by zwitterionic and antibiotic-loaded coating for preventing postoperative endophthalmitis.

After cataract surgery, to prevent possible postoperative endophthalmitis (POE) caused by attached pathogenic bacteria onto the surface of implanted intraocular lens (IOL), various antibiotic-loaded IOLs have been proposed and widely studied to inhibit bacterial infection. However, most of these developed antibiotic-loaded IOLs still suffer from shortcomings such as insufficient drug loading, short release time, poor biocompatibility, and risk of secondary infection. Herein, we propose a zwitterionic and high-drug loading coating for surface modification of commercial hydrophobic IOL with both antifouling and antibacterial properties to effectively prevent POE. In this strategy, zwitterionic poly(carboxylbetaine-co-dopamine methacrylamide) copolymers (pCBDA) and dopamine (DA) were first robustly co-deposited onto IOL surface via facile mussel-inspired chemistry, resulting in a hydrophilic coating (defined as PCB) without sacrificing the high light transmittance of the native IOL. Subsequently, amikacin (AMK), an amine-rich antibiotic was reversibly conjugated onto the coating through the acid-sensitive Schiff base bonds formed by the reaction between amino and catechol groups, with high-drug payload over ∼35.5 µg per IOL and 30 days of sustained drug release under weak acid environment. Benefiting from the antifouling property of zwitterionic pCBDA copolymers, the intraocularly implanted PCB/AMK-coated IOL could effectively resist the adhesion and proliferation of residual LECs to inhibit the development of posterior capsule opacification (PCO) without affecting the normal ocular tissues, demonstrating excellent in vivo biocompatibility. Moreover, the synergy of zwitterionic pCBDA and conjugated AMK with acidic-dependent release behavior endowed this PCB/AMK-coated IOL strong antibacterial activity against both in vitro biofilm formation and in vivo postoperative Staphylococcus aureus infection, suggesting its promising application in preventing POE.

Compound heterozygous mutations in the SLC4A11 gene associated with congenital hereditary endothelial dystrophy in a Chinese family.

BACKGROUND: In this case report, we have described congenital inherited endothelial dystrophy (CHED) caused by two heterozygous missense mutations in two patients. METHODS: A Chinese family affected by CHED was recruited to identify potential genetic mutations. The proband developed bilateral corneal opacity after birth, and was diagnosed with CHED based on the clinical manifestations. Her younger sister had the same symptoms. Blood samples were collected from four members of the family, including the two sisters and their parents, and full exon sequencing (WES) was used to identify potential genetic mutations in the proband. To verify the identified mutations, Sanger sequencing was performed on samples from other family members. RESULTS: Two heterozygous missense variants were found in SLC4A11, a variant NM_032034.4; c.1237 G > A (p.G413R, rs1286683365) in exon 10 and a variant NM_032034.4, c. 698 G > T (p.R233L) in exon 6, and the latter was reported for the first time in this disease. Bioinformatics tools, such as SIFT and PolyPhen, showed that changes in these two amino acids probably affected protein function. CONCLUSIONS: This study reported the typical clinical symptoms of CHED caused by two heterozygous missense variants (c.1237 G > A and c. 698 G > T) in the SLC4A11 gene in a Chinese family.

A case of verruciform xanthoma of the vulva with generalized verrucous nevus on extremities.

BACKGROUND: Verruciform xanthoma is a rare benign proliferative lesion of the skin and mucosa which mainly affects oral mucosa. Cases of verruciform xanthomas occurring outside the oral mucosa are rare. Verrucous nevus, also called epidermal nevus, is a cutaneous hamartoma caused by abnormal proliferation of epidermal keratinocytes. AIM: Here, we reported a 39-year-old woman diagnosed verruciform xanthoma of the vulva with generalized verrucous nevus on extremities. PATIENT: A 39-year-old woman presented to the dermatology department. The vulva cauliflower tumor was accompanied by verrucous tumor of limbs for 33 years. The skin lesions showed cauliflower like growth in the size of fist in the perineum, and the Yellow verrucous vegetations of limbs were arranged in strips. Results The pathological diagnosis confirmed that the vulva verrucous xanthoma was combined with generalized verrucous nevus of limbs. No clinically relevant genes with pathogenic variants were detected by high-throughput sequencing technology and whole exome sequencing of genetic diseases. RESULTS: The pathological diagnosis confirmed that the vulva verrucous xanthoma was combined with generalized verrucous nevus of limbs. No clinically relevant genes with pathogenic variants were detected by high-throughput sequencing technology and whole exome sequencing of genetic diseases. CONCLUSION: The case was confirmed to be verruciform xanthoma, a benign proliferative xanthoma-like lesion with high incidence on the oral cavity. Combinded with generalized verrucous nevus,which is caused by excessive development of the epidermis, resulting in localized epidermal developmental abnormalities. Vulvar and peripheral lesions were treated through surgical approach. Lesions on the extremities were treated through oral administration of Acitretin capsules after obtaining informed consent from the patient. After a 3-month follow-up, the skin lesions on the hands and feet had partially disappeared. However, the outcome needs further follow-up and examination.