[Clinical study on the recurrence of fungal keratitis after lamellar keratoplasty].

OBJECTIVE: To study the characters, diagnosis, treatment and risk factors of the recurrence of fungal keratitis after lamellar keratoplasty (LKP). METHODS: In this nonrandomized retrospective case series, two hundred and eighteen cases of fungal keratitis were undertaken partial LKP from January 1998 to July 2005. The case history was inquired in detail preoperatively. A trephine with diameter 0. 5 mm larger than the area of fungal infection was used to incise the lamellar corneal ulcer, and the hyphae of some cases were inspected with microscope during the operation. The recurrence of fungal keratitis was observed after the surgery. Medical treatment and/or operation were used in the management of recurrent cases. The risk factors for the recurrence of fungal keratitis after LKP, such as fungal species, glucocorticoid or immunosuppressant therapy, hypopyon or endothelial plague, were also analyzed. RESULTS: Seventeen cases (7.80%) recurred within 2 weeks after surgery and mainly (15 cases) within 1 week. The recurrence displayed with increased local irritation and hypha infiltration on recipient LKP bed. All recurrent fungal infections were controlled by performing penetrating keratoplasty (PKP). Risk factor analysis: (1) The recurrent rate of Aspergillus infection (19.23%) was higher than that in Fusarium infection (5.63%) (P = 0.0323). (2) The recurrence rate of cases treated with glucocorticoid or immunosuppressant preoperatively (21.70%) was much higher than that in non-treated cases (6.15%) (P =0.0219). (3) The recurrence rate of cases with hypopyon or endothelial plague preoperatively (17.02%) was much higher than that without these signs (5.26%) (P = 0.0134). CONCLUSIONS: The recurrence of fungal keratitis after LKP occurs mainly within the 1st week. Aspergillus infection, glucocorticoid or immunosuppressant therapy, hypopyon or endothelial plague are the risk factors for LKP.

[Expression and significance of transforming growth factor-beta1, matrix metalloproteinase-2 and its inhibitor in lens epithelial cells of diabetic cataract].

OBJECTIVE: To investigate the expression and significance of transforming growth factor-beta(1) (TGF-beta(1)), matrix metalloproteinase-2 (MMP-2) and tissue inhibitor of metalloproteinase-2 (TIMP-2) in human Lens epithelial cells (LEC) of diabetic cataract. METHODS: Immunohistochemical staining was used to detect the expression of TGF-beta(1), MMP-2 and TIMP-2 in the diabetic LEC (23 cases) and the normal LEC (7 cases). RESULTS: There was significant difference of expression of MMP-2 and TGF-beta(1) between diabetic LEC and normal LEC (P < 0.01). But there was no statistic significance for TIMP-2 expression (P > 0.05). There was correlation between the expression of TGF-beta(1) and MMP-2. CONCLUSION: The imbalance induced by TGF-beta(1) between the expression of MMP-2 and TIMP-2 may play a critical role in the pathological fibrosis of anterior and posterior subcapsular during the development of diabetic cataract.