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BACKGROUND: A cross-sectional population-based survey in the Beichen district of Tianjin was conducted to estimate the prevalence of dry eye disease (DED) among the population over 50 years old with Dry Eye Workshop (DEWS) II and Chinese expert consensus (CEC) criteria. METHODS: A total of 5791 subjects over 50 years old were enrolled. Ocular surface disease index (OSDI) questionnaire, lipid layer thickness (LLT), partial blink ratio (PBR), fluorescein tear film breakup time (FBUT), Schirmer I test (SIT), fluorescein staining, meibomian gland dropout, meibomian gland expression scores (MES) and quantity scores (MQS) was assessed. Additionally, basic information, weight, disease history, living habits, anxiety, and depression condition were collected. RESULTS: According to the CEC, the prevalence of DED was 39.0%, whereas 44.0% based on DEWS II. The prevalence of DED increased with age and was substantially greater among women (41.1%, 95% CI, 39.5-42.6%) than males (35.1%, 95% CI, 33.1 -37.2%) (p < 0.001). Furthermore, the severity of DED was more severe in women (p = 0.006). The associated risk factors were age, female, depression, smoking, insomnia, and glaucoma. On the other hand, 53.6% of these populations were diagnosed as asymptomatic DED, and the morbidity was higher in males (p = 0.007). CONCLUSIONS: The prevalence of DED in China was relatively high, which was associated with aging, female(sex), depression, smoking and sleep problems. Hence, it is crucial for clinicians and caregivers to be aware of the existence of asymptomatic DED within the susceptible population.
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Síndromes de Ojo Seco , Humanos , Estudios Transversales , Femenino , Masculino , Síndromes de Ojo Seco/epidemiología , Persona de Mediana Edad , China/epidemiología , Prevalencia , Anciano , Anciano de 80 o más Años , Encuestas y Cuestionarios , Factores de RiesgoRESUMEN
OBJECTIVES: To investigate the clinical characteristics and the expression of mucin 5AC (MUC5AC) in in diabetic and non-diabetic subjects with or without dry eye disease. METHODS: A total of 399 participants (796 eyes) aged 50-80 years were enrolled in this study. Participants were divided into 4 groups: non-diabetic without dry eye group (normal group), non-diabetic with dry eye group, diabetic without dry eye group and diabetic with dry eye group. Demographic information, fasting plasma glucose (FBG), and glycated haemoglobin A1C (HbA1C) data were collected. Additionally, ocular surface disease index (OSDI) questionnaire, signs of dry eye, tear osmolarity, and meibomian glands were evaluated. Tear MUC5AC expression and conjunctival goblet cells density (GCD) were tested. RESULTS: Compared with non-diabetic with dry eye group, diabetic with dry eye group showed significantly lower tear film osmolarity (TFO), but higher corneal fluorescein and conjunctival lissamine green staining scores. In comparison with diabetic without dry eye group, diabetic with dry eye group showed significantly higher TFO, corneal fluorescein and conjunctival lissamine green staining scorers. The MUC5AC concentration and GCD of diabetic with dry eye group was significantly lower than those of the non-diabetic with dry eye group. Diabetic subjects with higher HbA1c levels (≥7.8%) showed higher TFO and shorter fluorescein tear break time. CONCLUSION: Diabetics with dry eye exhibited notably higher corneal fluorescein and conjunctival lissamine green staining scores. Conjunctival goblet cells and MUC5AC were significantly reduced in diabetics. Higher TFO was associated with the duration of diabetes and HbA1c levels.
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Fungal keratitis (FK) is a leading cause of preventable blindness and eye loss. The poor antifungal activity, increased drug resistance, limited corneal permeability, and unsatisfactory biosafety of conventional antifungal eye drops are among the majority of the challenges that need to be addressed for currently available antifungal drugs. Herein, this study proposes an effective strategy that employs chitosan-poly(ethylene glycol)-LK13 peptide conjugate (CPL) in the treatment of FK. Nanoassembly CPL can permeate the lipophilic corneal epithelium in the transcellular route, and its hydrophilicity surface is a feature to drive its permeability through hydrophilic stroma. When encountering fungal cell membrane, CPL dissembles and exposes the antimicrobial peptide (LK13) to destroy fungal cell membranes, the minimum inhibitory concentration values of CPL against Fusarium solani (F. solani) are always not to exceed 8 µg peptide/mL before and after drug resistance induction. In a rat model of Fusarium keratitis, CPL demonstrates superior therapeutic efficacy than commercially available natamycin ophthalmic suspension. This study provides more theoretical and experimental supports for the application of CPL in the treatment of FK.
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Antifúngicos , Quitosano , Córnea , Farmacorresistencia Fúngica , Fusarium , Queratitis , Pruebas de Sensibilidad Microbiana , Polietilenglicoles , Quitosano/química , Quitosano/farmacología , Queratitis/tratamiento farmacológico , Queratitis/microbiología , Antifúngicos/farmacología , Antifúngicos/química , Fusarium/efectos de los fármacos , Animales , Ratas , Farmacorresistencia Fúngica/efectos de los fármacos , Polietilenglicoles/química , Córnea/efectos de los fármacos , Infecciones Fúngicas del Ojo/tratamiento farmacológico , Infecciones Fúngicas del Ojo/microbiología , Permeabilidad/efectos de los fármacos , Fusariosis/tratamiento farmacológico , Péptidos Antimicrobianos/farmacología , Péptidos Antimicrobianos/química , Natamicina/farmacología , Natamicina/administración & dosificación , Masculino , Modelos Animales de Enfermedad , Ratas Sprague-DawleyRESUMEN
This study explores the detonation characteristics and compositional changes of pulverized coal, focusing on its use in Rotary Detonation Wave (RDW) technologies. While pulverized coal has shown high fuel efficiency in RDW settings, transitioning from theory to practical detonation engineering presents substantial scientific and technical hurdles. A key issue is the reprocessing of detonation byproducts for in-situ coal mine gob filling, a topic that has received little attention. Utilizing advanced methods like X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR), this paper investigates the micro-morphology, composition, and aromatic structures of gas-solid products pre and post-detonation at the Tashan Coal Mine's 2305 working face. Results indicate that coal dust from the underground mining face has enhanced detonation characteristics, with the addition of coal powder fuel extending the gas detonation limits. This benefits economic aspects by reducing reliance on gas fuel and lowering detonation fuel costs. The highest recorded detonation wave velocity was 2450 m/s, 14.8% greater than that of coal dust from external sources, suggesting more effective energy release and pressure gain. Furthermore, the study links detonation combustion intensity to coal's aromatic properties, noting a post-detonation aromaticity index (I) of 0.4941. This indicates an improvement in the aromatic structure under high-temperature conditions, vital for coal's reactivity and energy efficiency in RDW applications. This research not only deepens the understanding of coal dust combustion mechanisms but also advances clean coal utilization and deep coal fluidization mining, addressing significant RDW technological challenges.
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We examined the effects of climatic factors and Demodex infestations on meibomian gland dysfunction (MGD)-associated dry eye disease (DED) in a cross-sectional study. This study included 123 patients from Tianjin and Chengdu regions, and climate factors and the Air Quality Index (AQI) were recorded for one year. Ocular surface parameters and Demodex infestations were evaluated using various tests. Significant differences in all climatic factors and AQI were observed between Tianjin and Chengdu (P < 0.01), and ocular surface parameters also differed significantly between the two regions (P < 0.05). Temperature, relative humidity, and precipitation positively correlated with tear break-up time (BUT), meibum gland expressibility, and lid margin irregularity but negatively correlated with lissamine green staining scores (P < 0.05). Wind speed and atmospheric pressure positively correlated with corneal fluorescein staining and lissamine green staining but negatively correlated with BUT and lid margin irregularity (P < 0.05). AQI positively correlated with DED symptoms and corneal findings but negatively correlated with tear film stability and meibomian gland characteristics (P < 0.05). Demodex infestation was only positively correlated with meibum quality scores (P < 0.05). Our findings suggest that geographic climates influence ocular surface characteristics in MGD-associated DED, with daily precipitation potentially playing a significant role, and Demodex infestation contributes to meibum gland degeneration.
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Síndromes de Ojo Seco , Disfunción de la Glándula de Meibomio , Humanos , Estudios Transversales , Glándulas Tarsales , Síndromes de Ojo Seco/diagnóstico , LágrimasRESUMEN
PURPOSE: To explore the efficacy and relevant mechanism of 0.05% cyclosporine A (CsA) eye drops (II) monotherapy in patients with allergic conjunctivitis-associated dry eye (ACDE). METHODS: Prospective, randomized, controlled study. Fifty-three patients with mild-to-moderate ACDE were randomly assigned to two groups. The CsA group received 0.05% CsA eye drops (II) monotherapy four times daily. The control group received 0.1% olopatadine twice daily combined with 0.1% preservative-free artificial tears four times daily. Clinical symptoms and signs, tear total IgE, and lymphotoxin-α (LT-α) concentrations were assessed at pre- and post-treatment days 7, 30, and 60. And we further measured six tear cytokines levels using a microsphere-based immunoassay. RESULTS: The CsA group showed significant improvement in symptoms (Ocular Surface Disease Index and itching scores) and signs (conjunctival hyperaemia, conjunctival oedema, conjunctival papillae, tear break-up time (TBUT), corneal fluorescein staining, and goblet cell density) at each follow-up period compared to pre-treatment (all P < 0.050). And its improvement in itching scores (P7th < 0.001, P30th = 0.039, and P60th = 0.031) and TBUT (P7th = 0.009, P30th = 0.003, and P60th = 0.005) was more significant than the control group at all follow-up periods. The tear total IgE, interleukin (IL)-5, IL-6, periostin, eotaxin-3, and MMP-9 levels significantly decreased in the CsA group at day 60 after treatment (all P < 0.050). And the changed values in tear total IgE were positively correlated with the change in itching scores. CONCLUSIONS: 0.05% CsA eye drops (II) monotherapy can rapidly improve the symptoms and signs, especially in ocular itching and TBUT, in patients with ACDE. And its efficacy is superior to 0.1% olopatadine combined with artificial tears. Moreover, CsA downregulates the expression levels of tear inflammatory cytokines, including tear total IgE, IL-5, IL-6, periostin, eotaxin-3, and MMP-9. Among that, the reduction in tear total IgE levels may reflect the improvement of ocular itching.
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Conjuntivitis Alérgica , Síndromes de Ojo Seco , Humanos , Conjuntivitis Alérgica/tratamiento farmacológico , Ciclosporina/uso terapéutico , Soluciones Oftálmicas/uso terapéutico , Clorhidrato de Olopatadina/uso terapéutico , Quimiocina CCL26 , Metaloproteinasa 9 de la Matriz/uso terapéutico , Gotas Lubricantes para Ojos/uso terapéutico , Interleucina-6 , Estudios Prospectivos , Síndromes de Ojo Seco/tratamiento farmacológico , Citocinas/metabolismo , Prurito/tratamiento farmacológico , Inmunoglobulina E/uso terapéutico , Lágrimas/metabolismoRESUMEN
BACKGROUND: Phototherapeutic keratectomy (PTK) has been increasingly used to treat severe recurrent corneal erosion syndrome (RCES) patients who do not respond to other treatments. However, the efficacy and complication of each study are currently uncertain due to varying rates. OBJECTIVES: The objective of this study was to investigate the safety and efficacy of the PTK for recurrent corneal erosions. METHODS: This article performed a systematic literature research in Cochrane, Embase, PubMed, Scopus, and the Web of Science for the literature on PTK treatment of RCES until December 20, 2022. The extracted data including recurrence rate and the adverse event rate were used for meta-analysis. RESULTS: The recurrence rate was 18% (95% CI, 13%-24%) (129/700 eyes). Subgroup analysis showed that the RCE recurrence was 17% (95% CI, 9%-24%) after trauma and 22% (95% CI, 11%-32%) in the corneal dystrophy group. Treatment-related adverse events included subepithelial haze, hyperopic shift, and decrease of the best spectacle-corrected visual acuity. In this study, the incidence of these events was 13% (95% CI, 6%-21%), 20% (95% CI, 11%-28%), and 11% (95% CI, 5%-16%), respectively. CONCLUSIONS: PTK represented a valuable treatment option for patients with recurrent corneal erosions, especially those with traumatic injuries, which had minimal side effects.
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Enfermedades de la Córnea , Distrofias Hereditarias de la Córnea , Úlcera de la Córnea , Queratectomía Fotorrefractiva , Humanos , Láseres de Excímeros/uso terapéutico , Estudios de Seguimiento , Agudeza Visual , Distrofias Hereditarias de la Córnea/complicaciones , Distrofias Hereditarias de la Córnea/cirugía , Córnea/cirugía , Recurrencia , Resultado del Tratamiento , Enfermedades de la Córnea/cirugíaRESUMEN
Oxidative stress is closely associated with diabetes and can cause free radical accumulation and eventually lead to ocular surface tissue damage. The purpose of this study was to investigate peroxisome proliferator-activated receptor-γ (PPARγ) expression in the lacrimal gland (LG), meibomian gland, and cornea of diabetes-related dry eye mice and whether the PPARγ agonist rosiglitazone can alleviate the oxidative stress of the ocular surface, thereby improving the condition of diabetes-related dry eye. Quantitative RT-PCR (Q-PCR) showed that the PPARγ, catalase, glutathione peroxidase 3, and heme oxygenase-1 (HO-1) mRNA expression levels in the LG of diabetes-related dry eye mice decreased at 8 and 12 weeks. In addition, the increased levels of oxidative stress were confirmed by western blot. Although the mRNA expression levels of antioxidant enzymes in the cornea and meibomian gland decreased at 8 weeks, some of them recovered by 12 weeks. Rosiglitazone alleviated ocular surface damage and increased corneal sensitivity and tear production in diabetes-related dry eye mice. Moreover, the reactive oxygen species accumulation was reduced and the PPARγ, HO-1, and glutathione peroxidase 3 mRNA expression levels were increased in the LG. The PPARγ, HO-1, translocase of the outer membrane 20, and mitochondrial transcription factor A protein levels were also significantly increased. These results demonstrated that rosiglitazone reduced oxidative stress in the LG of diabetes-related dry eye mice, at least in part, by activating PPARγ to up-regulate antioxidant enzyme expression.
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Diabetes Mellitus , Síndromes de Ojo Seco , Ratones , Animales , PPAR gamma/genética , Rosiglitazona/farmacología , Antioxidantes/farmacología , Estrés Oxidativo , ARN Mensajero/genética , ARN Mensajero/metabolismoRESUMEN
Background: The precise diagnostic and prognostic biological markers were needed in immunotherapy for sepsis. Considering the role of necroptosis and immune cell infiltration in sepsis, differentially expressed necroptosis-related genes (DE-NRGs) were identified, and the relationship between DE-NRGs and the immune microenvironment in sepsis was analyzed. Methods: Machine learning algorithms were applied for screening hub genes related to necroptosis in the training cohort. CIBERSORT algorithms were employed for immune infiltration landscape analysis. Then, the diagnostic value of these hub genes was verified by the receiver operating characteristic (ROC) curve and nomogram. In addition, consensus clustering was applied to divide the septic patients into different subgroups, and quantitative real-time PCR was used to detect the mRNA levels of the hub genes between septic patients (SP) (n = 30) and healthy controls (HC) (n = 15). Finally, a multivariate prediction model based on heart rate, temperature, white blood count and 4 hub genes was established. Results: A total of 47 DE-NRGs were identified between SP and HC and 4 hub genes (BACH2, GATA3, LEF1, and BCL2) relevant to necroptosis were screened out via multiple machine learning algorithms. The high diagnostic value of these hub genes was validated by the ROC curve and Nomogram model. Besides, the immune scores, correlation analysis and immune cell infiltrations suggested an immunosuppressive microenvironment in sepsis. Septic patients were divided into 2 clusters based on the expressions of hub genes using consensus clustering, and the immune microenvironment landscapes and immune function between the 2 clusters were significantly different. The mRNA levels of the 4 hub genes significantly decreased in SP as compared with HC. The area under the curve (AUC) was better in the multivariate prediction model than in other indicators. Conclusion: This study indicated that these necroptosis hub genes might have great potential in prognosis prediction and personalized immunotherapy for sepsis.
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Fungal hyphae deeply invade the cornea in fungal keratitis. The corneal stroma hinders the infiltration of antifungal drugs and reduces their bioavailability. Here, this work reports a peptide conjugate nano-assembly that permeates the stroma and kills the pathogen without irritating the ocular cornea. The hydrophilic surface of the nano-assembly ensures deep permeation into the stroma. When encountering a fungal hyphal cell, the nano-assembly disassembles and exposes the α-helical peptide to destroy the fungal membrane, thus inactivating the pathogen. In a rabbit model of fungal keratitis, the nano-assembly exhibits a better therapeutic effect than commercially available natamycin ophthalmic suspension. Peptide conjugates with a nano-assembled structure and assembly-disassembly behavior could serve as the foundation of a new therapy for fungal keratitis.
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Infecciones Fúngicas del Ojo , Queratitis , Animales , Conejos , Queratitis/tratamiento farmacológico , Queratitis/microbiología , Córnea , Infecciones Fúngicas del Ojo/tratamiento farmacológico , Infecciones Fúngicas del Ojo/microbiología , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Antifúngicos/química , Péptidos/farmacología , Péptidos/uso terapéuticoRESUMEN
Purpose: To observe the decentration and tilt of implantable collamer lens (ICL) as well as possible visual effects postimplantation in primary iridociliary cysts. Methods: The present investigation was a retrospective cohort study. All 48 patients (91 eyes) who underwent ICL surgery at the Center of Refraction Surgery of Tianjin Medical University Eye Hospital between July 2018 and May 2020 were split into two groups based on the absence or presence of primary iridociliary cysts established by ultrasonic biological microscopy (UBM) examination. Intraocular pressure (IOP), corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), anterior chamber angle (ACA), anterior chamber volume (ACV), and anterior chamber depth (ACD) were recorded preoperatively and postoperatively at 1, 6, and 12 months. Additionally, we performed an analysis of the ICL vault, decentration, and tilt using a rotating Scheimpflug Oculus Pentacam camera system at 1, 6, and 12 months after surgery. Results: No serious complications were observed. Significant postoperative improvement (P < 0.05) of UDVA was established in the two studied groups; however, we did not observe statistically significant intergroup differences (P > 0.05) throughout the entire research period. In each group, the preoperative ACA, ACV, and ACD were statistically significantly reduced (P < 0.05), but no such decrease was established between their postoperative values (P > 0.05). We observed no statistical differences between both groups with regard to their values of IOP, ACA, ACV, ACD, ICL vault, ICL decentration, and tilt at 1, 6, and 12 months after surgery. Similarly, no statistically significant within-group correlation (P > 0.05) of the decentration of ICL and the tilt and the CDVA values was established. Conclusion: No postimplantation effect of ICL with a central hole on vision was established in myopia patients with primary iridociliary cysts, within certain limits of ICL decentration and tilt values.
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PURPOSE: To assess the position of implantable collamer lens (ICL) haptic after ICL V4C implantation using standardized panoramic ultrasound bimicroscopy (UBM), to analyze its characteristics, associated factors, and the relationship with the clinical vault quantitatively. SETTING: Hankou Aier Eye Hospital, Wuhan, Hubei, China. DESIGN: Cross-sectional study. METHODS: 167 subjects (323 eyes) implanted with ICL V4C who had a 3-month follow-up with UBM examination were included in this study. The relative position of ICL to the adjacent structure and ICL haptic-related parameters (the final tip point of ICL haptic [ftICL haptic], measured from the scleral spur to the final tip of the ICL haptic, the posterior of the ICL to ICL haptic [ICL arc], measured from the posterior surface of the ICL to the ICL haptic plane, and the height of the crystalline lens from the ICL haptic (lens arc), measured from the anterior surface of the crystalline lens to the ICL haptic plane and other parameters), were estimated on the UBM image. Eyes were divided into 3 subgroups according to the ftICL haptic (Group 1: ≤0.5 mm; Group 2: 0.5 to 1.0 mm; and Group 3:≥1.0 mm, respectively), and the factors associated with the ICL haptic-related parameters and their impact on the clinical vault were evaluated. RESULTS: The haptics could be imaged in the ciliary sulcus, on the ciliary body, and under the ciliary body in 629 (48.7%), 525 (40.6%), and 138 (10.7%) eyes, respectively. The ftICL haptic and the summation of ICL arc and lens arc showed a correlation with the clinical vault ( r = -0.34, P = .00; r = 0.87, P = .00). When the ftICL haptic results were divided into 3 groups, the percentage of eyes that exhibited clinical vault >750 µm were lowest in Group 3. Multivariate regression analysis showed spherical equivalent, white-to-white (WTW), anterior chamber volume (ACV) and iris-ciliary angle (ICA); the difference between the implanted ICL size and horizontal sulcus-to-sulcus (ICL size-STS) were associated with the ftICL haptic. The IOP, WTW, ACV, and the ICL size-STS were significantly associated with ICL arc, while the ICA and lens rise were associated with lens arc. CONCLUSIONS: The position of ICL haptic was associated with the clinical vault. Its quantitative evaluation may provide valuable information to help clinicians to select the best ICL size before surgery and understand the formation of clinical vault after surgery.
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Miopía , Lentes Intraoculares Fáquicas , Humanos , Agudeza Visual , Implantación de Lentes Intraoculares/métodos , Estudios Transversales , Tecnología Háptica , Miopía/cirugía , Cuerpo Ciliar , Estudios RetrospectivosRESUMEN
PURPOSE: Evaluate the efficacy and safety of LipiFlow® thermal pulsation treatment system compared with lid massage combined warm compress in Chinese patients with meibomian gland dysfunction (MGD). METHODS: Patients (n = 100 eyes, 50 subjects) diagnosed with MGD were recruited for this prospective, randomized, 3-month clinical trial. In Lipiflow group, patients (n = 50 eyes) received a single LipiFlow® thermal pulsation system treatment. In warm compress group, patients (n = 50 eyes) underwent warm compress daily for two weeks after an initial manual lid massage. Patients' symptoms were evaluated using Standard Patient Evaluation for Eye Dryness (SPEED) questionnaire. Safety parameters included best-corrected visual acuity (BCVA), intraocular pressure (IOP) and objective parameters including meibomian glands yielding lipid secretion (MGYLS) number, meibomian glands secretion (MGS) score, lipid layer thickness (LLT), tear-film breakup time (TBUT), corneal fluorescein staining (CFS) were measured and presented from baseline and to 3 months post-treatment. RESULTS: Baseline parameters in both groups were comparable (p > 0.05). SPEED score and TBUT improved in two groups from baseline to 3 months. MGYLS number, MGS score, LLT improved in LipiFlow group and these improvements were maintained with no significant regression at 3 months. CFS showed significant improvement in warm compress group at 1 month compared with LipiFlow group. Moreover, the correlation analysis indicated LLT was positively correlated with TBUT, MGS score, and MGYLS number. CONCLUSION: A single 12-min LipiFlow treatment is an effective therapy for MGD patients and can achieve improvements in symptoms alleviation and meibomian gland lipid secretion function lasting for at least 3 months.
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Síndromes de Ojo Seco , Enfermedades de los Párpados , Hipertermia Inducida , Disfunción de la Glándula de Meibomio , Humanos , Disfunción de la Glándula de Meibomio/terapia , Enfermedades de los Párpados/terapia , Estudios Prospectivos , Glándulas Tarsales , Lágrimas , Síndromes de Ojo Seco/terapia , LípidosRESUMEN
Shape memory polymers (SMPs) with multiple functionalities have great potential in implantable biomedical devices, especially vascular stents. However, stents made of SMPs are generally faced with the problem of insufficient radial support due to the sharp decline of the modulus after shape recovery. Therefore, it is necessary to improve the modulus of SMPs after opening the narrow part by other means. In this study, the novel SMPs available for vascular stents were developed with impressive water-induced stiffening when shape recovered in a physiological environment. Herein, a series of shape memory polyurethanes (SMPUs) containing full hard segments on the main chains and bearing hydrophilic tertiary amine soft segments on the side chains were synthesized. When immersed in water, the soft segments were dramatically separated from the hard segments, which were aggregated more to form densely packed hard domains with stronger hydrogen bonding and higher crystallinity. Both Young's modulus and the shape recovery ratio were thus promoted due to the segmental rearrangement in water. At the same time, hydrophilic side chains migrated to the surface driven by the segmental rearrangement in water, which promotes the adhesion and growth of vascular endothelial cells and inhibits the activation of the coagulation system. The ingenious structural design provided SMPUs with adequate mechanical strength and hemocompatibility to qualify for potential applications in self-expanding vascular stents.
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Poliuretanos , Materiales Inteligentes , Poliuretanos/química , Agua , Células Endoteliales , StentsRESUMEN
(1) Purpose: Here, we describe the clinical characteristics and predisposing factors of acute foggy corneal epithelial disease, a rare disease newly found during COVID-19 pandemic; (2) Methods: In this single-arm, ambispective case series study, ten patients with acute foggy corneal epithelial disease admitted between May 2020 and March 2021 were enrolled. Their detailed medical history and clinical and ophthalmic findings were recorded and analyzed; (3) Results: All the patients were female (100%), aged from 28 to 61 years (mean age of 40.4 ± 9.3 years). Seven cases (70%) had excessive eye use, and six cases (60%) had stayed up late and were overworked. Ten subjects (100%) presented with acute onset and a self-healing tendency. There was a mild-to-moderate decrease in the corrected visual acuity (0.35 ± 0.21 (LogMAR)). Slit-lamp examination showed diffuse dust-like opacity and edema in the epithelial layer of the cornea. By in vivo confocal microscope, epithelial cells presented characteristically a "relief-like" appearance. Anterior segment optical coherence tomography examination revealed that the mean epithelial thickness was increased (69.25 ± 4.31 µm, p < 0.01); (4) Conclusions: Acute foggy corneal epithelial disease is a rare disease in clinic, which tends to occur in young and middle-aged females. The typical clinical symptom is sudden foggy vision, which occurs repeatedly and can be relieved without treatment. Sex, an abnormal menstrual cycle, overuse of the eyes, fatigue and pressure might be risk factors. Changes in lifestyle and eye use habit during the COVID-19 pandemic may have possibly contributed to this disease incidence.
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BACKGROUND: Implantable collamer lens (ICL) surgery techniques are constantly progressing. The purpose of this study was to investigate the application effect of the modified technique and its impact on the change in corneal astigmatism in EVO-ICL surgery. METHODS: The analysis of retrospective cohort data included 153 eyes of 81 patients with myopia from July 2018 to May 2020. An EVO-ICL was inserted by modified surgical skills, including a single 3.0 mm corneal incision and no ophthalmic viscosurgical device (OVD) before the insertion of the ICL (modified technique group: 41 cases, 80 eyes) and standard procedure (standard technique group: 40 cases, 73 eyes). Early postoperative intraocular pressure (IOP) was monitored at 2 and 24 h. IOP, corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), vault, and anterior chamber depth (ACD) were measured 1, 6, and 12 months following the initial examination. The corneal endothelial cell density (ECD) was monitored at 6 and 12 months after the operation. Surgically induced astigmatism (SIA) in the total, anterior, and posterior corneal surfaces was analysed 1 month after the operation. RESULTS: No serious complications were detected. The two groups had no difference in visual outcomes, ICL vaults, or ACD at any time point (P > 0.05). Two hours postoperatively, IOP was significantly lower in the modified technique group (16.22 ± 2.22 vs. 18.37 ± 1.92 mmHg, P < 0.05) than in the standard technique group. IOP decreased gradually after 24 h to preoperative levels. The postoperative IOP remained stable over a 12-month period. The ECD at 6 and 12 months was not significantly different between the groups (P > 0.05). SIA in the total, anterior, and posterior corneal surfaces were assumed to have no clinically meaningful differences between groups at one month after operation (P > 0.05). CONCLUSIONS: The modified technique is efficient and safe, producing comparable visual and structural outcomes without adversely affecting ECD, and reduces fluctuations in IOP at the early postoperative stages. The auxiliary incision in the standard technique does not increase corneal SIA, which is also a factor to consider for inexperienced surgeons.
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Astigmatismo , Enfermedades de la Córnea , Lentes Intraoculares Fáquicas , Astigmatismo/cirugía , Córnea/cirugía , Enfermedades de la Córnea/cirugía , Humanos , Implantación de Lentes Intraoculares/métodos , Refracción Ocular , Estudios RetrospectivosRESUMEN
Biodegradable shape memory polymers are promising biomaterials for stents used in minimally invasive surgical procedures such as intestinal stents. Herein, a series of biodegradable shape memory polyurethanes (SMPUs) containing a novel phenylalanine-derived chain extender (PHP) are synthesized. Inspired by the fact that the function of biomacromolecules such as proteins is rich and varied because of the multiple combinations of the amino acid in highly evolved biosystems, this study finds that the sequence distribution of PHP in SMPU will also have a great influence on the phase structure and degradation behavior, especially the difference of surface morphology caused by degradation. Considering that the transition temperature (Ttrans ) of SMPU obtained is higher than physiological temperature, oxidized carbon black (OCB) with the ability of photothermal conversion is introduced into SMPU, which can not only endow SMPU with near-infrared response shape recovery characteristics, but also enhance phase separation degree and mechanical properties of them. SMPU/OCB composites show excellent shape memory effect and rapid photothermal response, and they can be degraded by chymotrypsin with an adjustable degradation rate. These SMPU/OCB composites show broad potential for application as intestinal stents.
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Poliuretanos , Materiales Inteligentes , Poliuretanos/química , Quimotripsina , Materiales Biocompatibles/química , TemperaturaRESUMEN
Shape-memory polymers (SMPs) induced by heat or water are commonly used candidates for biomedical applications. Shape recovery inevitably leads to a dramatic decrease of Young's modulus due to the enhanced flexibility of polymer chains at the transition temperature. Herein, the principle of phase-transition-induced stiffening of shape-memory metallic alloys (SMAs) is introduced to the design of molecular structures for shape-memory polyurethane (SMPUs), featuring all-hard segments composed of main chains that are attached with poly(ethylene glycol) (PEG) dangling side chains. Different from conventional SMPs, they achieve a soft-to-stiff transition when shape recovers. The stiffening process is driven by water-triggered segmental rearrangement due to the incompatibility between the hard segments and the soft PEG segments. Upon hydration, the extent of microphase separation is enhanced and the hard domains are transformed to a more continuous morphology to realize more effective stress transfer. Meanwhile, such segmental rearrangement facilitates the shape-recovery process in the hydrated state despite the final increased glass transition temperature (Tg ). This work represents a novel paradigm of simultaneously integrating balanced mechanics, shape-memory property, and biocompatibility for SMPUs as materials for minimally invasive surgery such as endoluminal stents.
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Poliuretanos , Materiales Inteligentes , Poliuretanos/química , Agua/química , Polímeros , Polietilenglicoles , Materiales Biocompatibles/farmacología , Materiales Biocompatibles/químicaRESUMEN
AIM: To compare the changes in the objective visual quality of patients with low and moderate myopia postoperatively after transepithelial photorefractive keratectomy using the smart pulse technology (SMART) and femtosecond laser in situ keratomileusis (FS-LASIK). METHODS: Corneal higher-order aberrations (HOAs), horizontal coma, vertical coma and spherical aberration were measured using Pentacam, and cutoff for modulation transfer function (MTF cutoff), objective scatter index (OSI) and Strehl ratio (SR) was measured using an optical quality analysis system (OQAS-II), before and after operation at 1, 3, and 6mo, and data were analyzed by repeated measurement two-way analysis of variance. RESULTS: The difference in uncorrected distance visual acuity between SMART and FS-LASIK was statistically significant only 1wk postoperatively. Approximately 86.36% and 80.69% of patients with spherical equivalent (SE) in ±0.50 D were observed in the SMART and FS-LASIK groups, respectively. No significant difference was observed in SE between the two groups (P=0.509). The HOAs increased postoperatively compared with those before surgery in both groups (P<0.05). No significant difference in HOA, corneal horizontal coma, spherical aberration, ΔHOA, Δhorizontal coma, and Δspherical aberration were observed between the two group (P>0.05). Corneal vertical coma and Δcorneal vertical coma in the FS-LASIK group were higher than those in the SMART group (P<0.05). The OSI of both groups at 1mo after surgery was higher than that before surgery (P<0.05). At 3 and 6mo postoperatively, the OSI in the FS-LASIK group was slightly higher than that in the SMART group (P=0.040 and 0.047, respectively). At 6mo after surgery, the MTF cutoff was statistically significant different between the two groups (P=0.026). No significant difference in SR between the FS-LASIK and SMART groups was observed at 1, 3, and 6mo postoperatively (P>0.05). CONCLUSION: The HOAs increase and visual quality is delayed in both groups postoperatively, and the long-term objective visual quality after SMART is slightly better than that after FS-LASIK.
RESUMEN
The aim of this study was to explore the correlation between intraoperative hyperalgesia of the second eye and the dynamic changes of tumor necrosis factor (TNF)-α and interleukin (IL)-1ß levels in aqueous humor (AH) of the second eye and whole blood after the first eye cataract surgery. A rabbit model of monocular phacoemulsification was established by administration of 0.3% levofloxacin. Whole blood and AH samples from non-surgical eyes in the experimental group (n =25) and second eye in the blank control group (n =15) were obtained and corneal sensitivity was examined after surgery (1, 3, 7, 14, and 21 days postoperatively). TNF-α and IL-1ß levels in AH and TNF-α mRNA and IL-1ß mRNA levels in whole blood were measured. In a clinical study, 30 patients who underwent bilateral phacoemulsification within 1 month were divided into six groups in accordance with the operation intervals (1, 3, 7, 10, 14, and 21days). TNF-α and IL-1ß levels in AH were measured at the beginning of surgery and intraoperative pain was assessed immediately after surgery. Corneal sensitivity (F =244.910, P <0.05), TNF-α and IL-1ß levels in AH (F =184.200, 82.900, P <0.05) of non-surgical eyes and in whole blood (F =272.800, 193.530, P <0.05) in the experimental group were significantly higher than the baseline levels after phacoemulsification. In the clinical study, NRS scores of second eye surgery were higher than those of the first eye(P =0.0025) and 19 (63.3%) patients reported more pain during the second eye surgery. TNF-α and IL-1ß concentrations in AH of the second eye were significantly higher than those of the first eye (F =123.60, P <0.05; F =59.60, P <0.05). In conclusion, within 1 month after the first eye phacoemulsification, higher pain sensitivity (hyperalgesia) exists in the second eye, which may be related to dynamic changes in TNF-α, IL-1ß levels in AH or whole blood.