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1.
Curr Eye Res ; : 1-12, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34986709

RESUMO

PURPOSE: To summarize the graft loading, transporting and delivery devices used for endothelial keratoplasty (EK). METHODS: A literature search of electronic databases was performed. RESULTS: New techniques and devices have been introduced and implemented to prepare, load, transport and transplant the grafts for EK. The advantages are not only limited to the surgical theatre but also widely spread across the eye banking field. Investigation of advanced materials and designs have been rapidly growing with continuous evolution in the field of eye banking and corneal transplantation. Innovative techniques and modern devices have been evaluated to reduce the endothelial cell loss and increase the precision of the transplant in order to benefit both surgeons and the patients. CONCLUSIONS: It is extremely important to reduce any potential wastage and optimize the use of every available donor cornea due to the limited availability of healthy cadaveric donor corneas required for transplants. As a result, the use of pre-cut and pre-loaded grafts supplied by the eye banks in calibrated devices have been gaining momentum. Innovation in the field of bioengineering for the development of new devices that facilitate excellent clinical outcomes along with reduction in learning curve has shown promising results.

2.
Cornea ; 41(1): 106-108, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34870624

RESUMO

PURPOSE: This study aimed to describe a case of keratitis secondary to Metarhizium robertsii, a soil-dwelling fungus with typical insect pathogenicity. METHODS: A Case report. RESULTS: A 58-year-old man with a ocular history of soft contact lens overwear, poor contact lens hygiene, and ocular exposure to ground well water supplying his house was referred to our university practice for a central corneal ulcer with 40% thinning. Same-day rapid microscopic detection with Giemsa stain identified the presence of many hyphae elements, and he was ultimately diagnosed with M. robertsii keratitis. The patient's course involved severe and progressive corneal thinning that stabilized over a 3-month course of antifungal therapy. CONCLUSIONS: Metarhizium robertsii seems more aggressive than other forms of fungal keratitis; therefore, this infection may be watched more closely with the risk for quick progressive corneal thinning, even while on antifungal management.

3.
Jpn J Ophthalmol ; 2021 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-34843024

RESUMO

PURPOSE: To compare outcomes of deep anterior lamellar keratoplasty (DALK) and corneal cross-linking (CXL) in patients with advanced keratoconus, with the primary aim of assessing CXL as a potential therapeutic alternative. STUDY DESIGN: Retrospective, multi-center, comparative study. METHODS: Patients with advanced keratoconus (maximum keratometry reading (K-max) > 58D, best spectacle-corrected visual acuity worse than 0.52logMAR), undergoing either DALK or CXL treatment at four tertiary ophthalmic centers in Wenzhou, Hangzhou, Nanjing and Wuhan were included. Visual acuity, refractive error, corneal topography and complications were evaluated at baseline and at least 2 year postoperatively. RESULTS: 75 eyes of 72 patients were included, of which 37 eyes underwent DALK and 38 eyes, CXL. A larger reduction in Kmax was observed in the DALK group (-18.18 ± 9.44 D versus -1.10 ± 2.70D, p < 0.001). Seven eyes (18%) in the CXL group showed progression of keratoconus. No disease progression was observed in the DALK group. Greater improvements in best spectacle-corrected visual acuity (logMAR) were observed in the DALK group (-0.59 ± 0.25 versus -0.24 ± 0.44, p < 0.001). CONCLUSIONS: Compared to CXL, DALK leads to larger reductions in Kmax and better improvement in visual acuity in advanced keratoconus.

4.
Exp Eye Res ; 214: 108864, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34826419

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen for coronavirus disease 2019 (COVID-19) pandemic. Its infection depends on the binding of spike protein to the host cell receptor angiotensin-converting enzyme 2 (ACE2), type II transmembrane serine protease (TMPRSS2) and neuropilin-1 (NRP1). Hydroxychloroquine has been applied as one of the COVID-19 treatment strategies. Here we aimed to evaluate hydroxychloroquine treatment on SARS-CoV-2 receptor expression in human primary pterygium and conjunctival cells and its potential influences. Expression of ACE2, TMPRSS2 and NRP1 proteins were found in the epithelial layer of both primary pterygium and conjunctiva tissues as well as in their isolated fibroblasts. High concentration of hydroxychloroquine treatment significantly reduced the viability of both primary pterygium and conjunctival cells. ACE2 protein expression was significantly decreased in both pterygium and conjunctival cells after hydroxychloroquine treatment. Hydroxychloroquine also reduced NRP1 protein expression in conjunctival cells. In contrast, TMPRSS2 protein expression showed slightly increased in conjunctival cells. Notably, ROS production and SOD2 expression was significantly elevated in both pterygium and conjunctival cells after hydroxychloroquine treatment. In summary, this study revealed the reduction of ACE2 and NRP1 expression by hydroxychloroquine in human primary pterygium and conjunctival fibroblasts; yet with the increase in TMPRSS2 expression and oxidative stress and decrease in cell viability. Implementation of hydroxychloroquine for COVID-19 treatment should be carefully considered with its potential side effects and in combination with TMPRSS2 inhibitor.

6.
Curr Eye Res ; 2021 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-34802349

RESUMO

PURPOSE: To retrospectively review the clinical characteristics of patients with herpes simplex virus type 2 (HSV-2) blepharokeratoconjunctivitis. METHODS: Laboratory-proven HSV-2 blepharokeratoconjunctivitis cases were reviewed between 1995 and 2021. RESULTS: 10 of 725 (1.4%) patients had HSV-2 infection. Data was available for 9 patients. Associated conditions included neonatal herpes (1/9, 11%), severe atopy (1/9, 11%), genital herpes (2/9, 22%), and systemic immune disorders (2/9, 22%). The most common presenting finding was pain and blurred vision (55.5%). Two patients (22%) had dendritic lesions and one patient (11%) had reduced corneal sensation. Complete resolution was reported in four patients (44.5%). Recurrence was noted in four patients (44.5%) despite antiviral prophylaxis. Corneal complications included scarring and neovascularization. The visual acuity at the last follow-up was 20/40 or worse in four patients (44.5%). CONCLUSIONS: HSV-2 is an uncommon cause of keratitis. Dendrites and loss of corneal sensation were uncommon. Recurrence was noted despite antiviral prophylaxis.

7.
J Refract Surg ; 37(11): 726-733, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34756141

RESUMO

PURPOSE: To explore the impact of different surgical sequences on the visual and refractive outcomes of bilateral small incision lenticule extraction (SMILE) surgery using propensity score matching (PSM) analysis. METHODS: Participants who underwent uneventful SMILE between March 2018 and September 2019 were retrospectively analyzed and were divided into two groups: Sequence A (laser scanning [LS] of the right eye, manual separation lenticule [MSL] of the right eye, and LS and MSL of the left eye) and Sequence B (LS of the right eye, LS of the left eye, MSL of the left eye, and MSL of the right eye). PSM was conducted to minimize the effect of confounding factors on postoperative visual outcomes at days 1 and 7 and months 1, 3, and 6. Safety, efficacy, predictability, and stability were compared between groups. RESULTS: Overall, 1,854 eyes of 927 participants were included (Sequence A, n = 280; Sequence B, n = 647). After PSM, there were no significant differences in baseline characteristics, and 534 eyes (267 patients) in the Sequence A group were matched (1:1) to the Sequence B group. The postoperative corrected distance visual acuity significantly differed between groups at 3 months (adjusted P = .007). The uncorrected distance visual acuity significantly differed between groups at all follow-up visits (adjusted P < .01). The safety index (1.341 ± 0.265 and 1.413 ± 0.294) and efficacy index (1.173 ± 0.191 and 1.251 ± 0.269) were different in the Sequence A and Sequence B groups, respectively, at 3 months (adjusted P < .01). No difference in visual outcomes was found between right and left eyes. CONCLUSIONS: Patients who had bilateral lenticule creation followed by bilateral lenticule separation had better postoperative visual outcomes than those who underwent complete SMILE surgery in each eye separately. Regardless of the surgical sequence chosen for the SMILE procedure, there was no impact on outcomes between the right and left eyes. Adjusting the sequence of the surgical procedure may be a way to improve the visual results. [J Refract Surg. 2021;37(11):726-733.].


Assuntos
Cirurgia da Córnea a Laser , Miopia , Substância Própria/cirurgia , Humanos , Miopia/cirurgia , Refração Ocular , Estudos Retrospectivos , Resultado do Tratamento
8.
Prog Retin Eye Res ; : 101028, 2021 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-34813978

RESUMO

Bacterial keratitis continues to be one of the leading causes of corneal blindness in the developed as well as the developing world, despite swift progress since the dawn of the "anti-biotic era". Although, we are expeditiously developing our understanding about the different causative organisms and associated pathology leading to keratitis, extensive gaps in knowledge continue to dampen the efforts for early and accurate diagnosis, and management in these patients, resulting in poor clinical outcomes. The ability of the causative bacteria to subdue the therapeutic challenge stems from their large genome encoding complex regulatory networks, variety of unique virulence factors, and rapid secretion of tissue damaging proteases and toxins. In this review article, we have provided an overview of the established classical diagnostic techniques and therapeutics for keratitis caused by various bacteria. We have extensively reported our recent in-roads through novel tools for accurate diagnosis of mono- and poly-bacterial corneal infections. Furthermore, we outlined the recent progress by our group and others in understanding the sub-cellular genomic changes that lead to antibiotic resistance in these organisms. Finally, we discussed in detail, the novel therapies and drug delivery systems in development for the efficacious management of bacterial keratitis.

9.
J Agric Food Chem ; 69(41): 12209-12218, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34610737

RESUMO

Pterygium belongs to an ocular surface disease with triangular-shaped hyperplastic growth, characterized by conjunctivalization, inflammation, and connective tissue remodeling. We previously demonstrated neoplastic-like properties of pterygium cells. Green tea catechin, (-)-epigallocatechin gallate (EGCG), has been shown to possess antitumorigenic properties; herein, we aimed to determine the effects of green tea catechins on human primary pterygium cell survival and migration and compared to that on patients' conjunctival cells. Both human primary pterygium and conjunctival cells expressed EGCG receptor, the 67 kDa laminin receptor. Seven-day treatment of green tea extract (Theaphenon E; 16.25 µg/mL) and EGCG (25 µM) attenuated pterygium cell proliferation by 16.78% (p < 0.001) and 24.09% (p < 0.001) respectively, without significantly influencing conjunctival cells. Moreover, green tea extract (16.25 µg/mL) and EGCG (25 µM) treatments also hindered pterygium cell migration by 35.22% (p < 0.001) and 25.20% (p = 0.019), respectively, but not conjunctival cells. Yet, green tea extract and EGCG treatments did not significantly induce pterygium cell apoptosis. Furthermore, green tea extract and EGCG treatments significantly increased the phosphorylation of p38 protein but reduced the phosphorylation of p42/p44 protein in pterygium cells. In summary, this study revealed that green tea extract and EGCG attenuated human primary pterygium cell survival and migration in vitro without damaging conjunctival cells, suggesting a novel potential therapeutic approach for primary pterygium treatment.


Assuntos
Catequina , Pterígio , Catequina/farmacologia , Proliferação de Células , Sobrevivência Celular , Humanos , Pterígio/tratamento farmacológico , Pterígio/genética , Chá
10.
Front Med (Lausanne) ; 8: 695697, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34595185

RESUMO

Significance: Our study found that SP-A1 (stiffness parameter at time of first applanation) was statistically different between post-laser-assisted subepithelial keratomileusis (LASEK) and post-small incision lenticule extraction (SMILE) eyes. The stiffness of keratoconus was lower than that of post-refractive surgery corneas. Purpose: To compare corneal biomechanics among post-SMILE, post-LASEK, and keratoconic eyes. Methods: In this retrospective study, 36 eyes of 36 patients after SMILE, 36 eyes of 36 patients after LASEK, and 36 eyes of 36 patients with keratoconus with matching (±5 µm) central corneal thickness (CCT) were examined using Scheimpflug corneal topography (Pentacam HR) and dynamic Scheimpflug analyzer (CorVis ST). Mixed linear model analysis with Bonferroni-adjusted post-hoc comparisons was performed to compare the differences in corneal biomechanics and topographic parameters among the three groups with the CCT and the bIOP (intraocular pressure with biomechanical correction) as the random factor. Results: All groups had comparable CCT at baseline. The bIOPs between the three groups were comparable. The mean values of the Belin/Ambrósio Deviation (BAD-D) in the keratoconus group were significantly higher than those of the SMILE (post hoc p < 0.001) and LASEK groups (post hoc p < 0.001). The SP-A1 in the keratoconus group was the lowest when compared with those of the SMILE (post hoc p = 0.003) and LASEK groups (post hoc p < 0.001). The SMILE group SP-A1 values were slightly lower than those of the LASEK group (post hoc p = 0.044). Conclusions: Keratoconus eyes were significantly softer when compared to post-refractive surgery corneas with comparable corneal thickness in terms of SP-A1 and BAD-D values, while the LASEK group may have the greatest stiffness. Post-SMILE and post-LASEK corneas showed significant differences in SP-A1.

11.
Artigo em Inglês | MEDLINE | ID: mdl-34670943

RESUMO

PURPOSE: To determine the long-term clinical outcomes and change in posterior corneal elevation after small incision lenticule extraction (SMILE) in eyes with suspicious tomographic features. SETTING: Hospital clinic. DESIGN: Retrospective, case-controlled, observational. METHODS: This study included 43 patients with suspicious corneas (group A), defined by corneal morphology and a final D score from a Scheimpflug camera (Pentacam), and 43 patients with normal corneal topography (group B). Refraction, visual acuity, and posterior corneal elevation over a 6-mm central diameter, including posterior central elevation (PCE), posterior elevation at the thinnest point (PTE) and posterior maximal elevation (PME), were measured preoperatively and at 6, 12, and 36 months postoperatively. RESULTS: The preoperative spherical equivalent was -5.51±1.33 D in group A and -5.41±1.19 D in group B. Postoperative uncorrected distance visual acuity was 20/20 or better in 39/43 eyes (91%) in group A and 41/43 eyes (95%) in group B (P=0.160); all eyes in both groups remained stable or had gained corrected distance visual acuity. The mean change in PCE, PTE and PME at 3 years was -1.22±2.65 µm, -1.21±2.70 µm and -1.00±5.09 µm, respectively, in group A and -1.76±3.25 µm, -1.60±3.33 µm and -1.56±5.01 µm in Group B, indicating a tendency for backward displacement of the posterior surface while the between-group difference was not statistically significant (P=0.154, P=0.547, P=0.319). CONCLUSIONS: Refraction, visual outcomes, and posterior corneal shift seem comparable between corneas with normal and suspicious tomographic features three years after SMILE. More long-term studies are warranted to corroborate the findings of this study.

13.
J Cataract Refract Surg ; 47(9): 1196-1204, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34468458

RESUMO

PURPOSE: To compare myopia and astigmatic correction after small-incision lenticule extraction (SMILE) with or without prophylactic crosslinking (SMILE Xtra). SETTING: Shenyang Aier Eye Hospital, Central South University, China. DESIGN: Retrospective study. METHODS: Patients with comparable manifest sphere and cylinder undergoing SMILE Xtra or SMILE were enrolled. The crosslinking (CXL) energy was 2.7 J/cm2. Only right eyes were selected. Visual and refractive changes were evaluated for 1 year. Astigmatic correction was analyzed using Alpins method. RESULTS: Thirty-six eyes undergoing SMILE Xtra and 40 eyes undergoing SMILE were enrolled. The uncorrected distance visual acuity at 1-day visit was lower after SMILE Xtra than that after SMILE (P = .01). At 12 months, the mean manifest refraction spherical equivalent (MRSE) and manifest cylinder were 0.08 ± 0.32 diopters (D) and -0.29 ± 0.23 D in SMILE Xtra group, whereas -0.25 ± 0.29 D and -0.22 ± 0.19 D in SMILE group (P < .01 and P = .135), respectively. Thirty-four eyes (94%) and 32 eyes (89%) in SMILE Xtra group and 36 eyes (91%) and 39 eyes (98%) in SMILE group exhibited target MRSE and manifest cylinder within ±0.50 D (P = .771 and P = .294), respectively. Compared with SMILE group, spherical correction index (SCI), correction index (CI), and difference vector were higher in SMILE Xtra group since 1-week follow-up (all P < .05). SCI and CI were slightly more than 1.0 after SMILE Xtra even at postoperative 12-month follow-up. CONCLUSIONS: With CXL protocol of 30 mW/cm2 for 90 seconds, SMILE Xtra exhibited comparable astigmatic correction with SMILE up to 1-year follow-up, although slight spherical equivalent and astigmatic overcorrection were evident after SMILE Xtra.


Assuntos
Cirurgia da Córnea a Laser , Miopia , Córnea , Substância Própria/cirurgia , Humanos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Estudos Prospectivos , Refração Ocular , Estudos Retrospectivos , Resultado do Tratamento
14.
Clin Ophthalmol ; 15: 3697-3704, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34511873

RESUMO

Purpose: Prophylactic topical antiseptics used to eliminate bacteria on the ocular surface prior to ocular surgery should be both effective and non-irritating. Five percent povidone iodine (PI) is an accepted antiseptic used for prophylaxis. Dilute 2.5% PI and 0.01% hypochlorous acid (HOCl) may be more patient comfortable and equally effective. PI at 5% and 2.5% were compared to HOCl against a battery of bacterial endophthalmitis isolates using corneoscleral tissue as a solid-phase medium to determine antiseptic efficacy. Methods: Bacteria from 20 cases of endophthalmitis were tested for the elimination of growth against topical 5% PI, 2.5% PI, HOCl, and no antiseptic using donor corneoscleral tissue. The tissue was inoculated with 103 colony forming units of bacteria prior to a 3-minute contact time with the antiseptics, placed in liquid growth medium, and monitored for growth at three days. No growth indicated antiseptic treatment success. Differences were analyzed using Chi square (χ2). Results: For 20 isolates, 5% PI was comparable to 2.5% PI for preventing bacteria growth (p=0.71), and both were more effective than HOCl (p=0.004). Estimated weighted comparison over a 27-year period indicated that for all bacterial groups, except Streptococcus viridans, 5% PI was equally effective to 2.5% PI for preventing bacterial growth (p=1.0). For Streptococcus viridans, 5% PI was more effective than 2.5% PI (p=0.0001). Both concentrations of PI were more effective than HOCl (p=0.00001). Conclusion: Five percent PI appears to be optimal as a prophylaxis prior to ocular surgery.

15.
Exp Eye Res ; 211: 108747, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34450184

RESUMO

PURPOSE: Cornea epithelial-stromal scarring is related to the differentiation of fibroblasts into opaque myofibroblasts. Our study aims to assess the effectiveness of Lycium barbarum polysaccharide (LBP) solution as a pre-treatment in minimizing corneal scarring. METHODS: Human corneal fibroblasts were cultured in a three-dimensional collagen type I-based hydrogel in an eye-on-a-chip model. Fibroblasts were pre-treated with 2 mg/mL LBP for 24 h, followed by another 24-h incubation with 10 ng/mL transforming growth factor-beta 1 (TGF-ß1) to induce relevant physiological events after stromal injury. Intracellular pro-fibrotic proteins, extracellular matrix proteins, and pro-inflammatory cytokines that involved in fibrosis, were assessed using immunocytochemistry and enzyme-linked immunosorbent assays. RESULTS: Compared to the positive control TGF-ß1 group, LBP pre-treated cells had a significantly lower expression of alpha-smooth muscle actin, marker of myofibroblasts, vimentin (p < 0.05), and also extracellular matrix proteins both collagen type II and type III (p < 0.05) that can be found in scar tissues. Moreover, LBP pre-treated cells had a significantly lower secretion of pro-inflammatory cytokines interleukin-6 and interleukin-8 (p < 0.05). The cell-laden hydrogel contraction and stiffness showed no significant difference between LBP pre-treatment and control groups. Fibroblasts pretreated with LBP as well had reduced angiogenic factors expression and suppression of undesired proliferation (p < 0.05). CONCLUSION: Our results showed that LBP reduced both pro-fibrotic proteins and pro-inflammatory cytokines on corneal injury in vitro. We suggest that LBP, as a natural Traditional Chinese Medicine, may potentially be a novel topical pre-treatment option prior to corneal refractive surgeries with an improved prognosis.


Assuntos
Cicatriz/prevenção & controle , Doenças da Córnea/prevenção & controle , Substância Própria/efeitos dos fármacos , Medicamentos de Ervas Chinesas/uso terapêutico , Epitélio Corneano/efeitos dos fármacos , Actinas/metabolismo , Administração Oftálmica , Biomarcadores/metabolismo , Cicatriz/metabolismo , Doenças da Córnea/metabolismo , Ceratócitos da Córnea/efeitos dos fármacos , Ceratócitos da Córnea/metabolismo , Substância Própria/metabolismo , Citocinas/metabolismo , Ensaio de Imunoadsorção Enzimática , Epitélio Corneano/metabolismo , Proteínas da Matriz Extracelular/metabolismo , Humanos , Imuno-Histoquímica , Medicina Tradicional Chinesa , Soluções Oftálmicas , Fator de Crescimento Transformador beta1/farmacologia
16.
Antibiotics (Basel) ; 10(6)2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34208455

RESUMO

Coagulase-negative staphylococci (CoNS) are frequently occurring ocular opportunistic pathogens that are not easily identifiable to the species level. The goal of this study was to speciate CoNS and document antibiotic susceptibilities from cases of endophthalmitis (n = 50), keratitis (n = 50), and conjunctivitis/blepharitis (n = 50) for empiric therapy. All 150 isolates of CoNS were speciated using (1) API Staph (biochemical system), (2) Biolog GEN III Microplates (phenotypic substrate system), and (3) DNA sequencing of the sodA gene. Disk diffusion antibiotic susceptibilities for topical and intravitreal treatment were determined based on serum standards. CoNS identification to the species level by all three methods indicated that S. epidermidis was the predominant species of CoNS isolated from cases of endophthalmitis (84-90%), keratitis (80-86%), and conjunctivitis/blepharitis (62-68%). Identifications indicated different distributions of CoNS species among endophthalmitis (6), keratitis (10), and conjunctivitis/blepharitis (13). Antibiotic susceptibility profiles support empiric treatment of endophthalmitis with vancomycin, and keratitis treatment with cefazolin or vancomycin. There was no clear antibiotic choice for conjunctivitis/blepharitis. S. epidermidis was the most frequently found CoNS ocular pathogen, and infection by other CoNS appears to be less specific and random. Antibiotic resistance does not appear to be a serious problem associated with CoNS.

17.
J Refract Surg ; 37(7): 446-452, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34236902

RESUMO

PURPOSE: To investigate the effect of wavefront aberrations on night vision problems and mesopic contrast threshold after small incision lenticule extraction (SMILE). METHODS: Forty-two participants (84 eyes) who underwent SMILE were included in this prospective observational study. Visual outcomes including uncorrected distance visual acuity (UDVA), subjective manifest refraction, mesopic contrast threshold (Binoptometer 4P; Oculus Optikgeräte GmbH), and higher order aberrations (HOAs) were analyzed before and 3 months after surgery. The patient's night vision satisfaction was assessed using a questionnaire. RESULTS: The mean spherical equivalent was -5.30 ± 1.38 diopters (D) preoperatively and -0.06 ± 0.15 D postoperatively. UDVA was better than 20/20 in 98.81% of the patients and better than 20/25 in all patients. Scores of night vision satisfaction and glare changed significantly in the postoperative period (F = 8.463, P = .001; F = 69.518, P < .001, respectively). Preoperative spherical diopters (lower order aberrations) were positively correlated with night vision satisfaction (r = -0.329, P = .041) and glare score (r =-0.332, P = .039). Age (odds ratio [OR] = 1.272, 95% CI = 1.019 to 1.589) and preoperative spherical diopter (OR = 0.437, 95% CI = 0.199 to 0.975) were correlated with night vision satisfaction scores by analysis of binary regression. The root mean square value of total HOAs increased 3 months after surgery (t = -6.873, P < .001) with an increase in horizontal coma (Z31) and spherical aberration (Z40) (P < .001). No correlation was observed between glare score and HOAs; however, patients with higher preoperative myopia demonstrated continuously decreasing contrast under mesopic conditions and higher postoperative horizontal coma. CONCLUSIONS: Myopic patients with higher preoperative spherical errors experienced more glare at night after SMILE surgery. Postoperative horizontal coma was associated with worse mesopic contrast thresholds. [J Refract Surg. 2021;37(7):446-452.].


Assuntos
Aberrações de Frente de Onda da Córnea , Miopia , Aberrações de Frente de Onda da Córnea/etiologia , Humanos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Visão Noturna , Refração Ocular
18.
Transl Vis Sci Technol ; 10(7): 17, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34128966

RESUMO

Purpose: Ocular surface mucins and glycocalyx are critical for providing ocular hydration as well lubrication and repelling pathogens or allergens. Elevated levels of tear proinflammatory cytokines in dry eye may have detrimental effect on mucins and glycocalyx. The present study tested the effect of proinflammatory cytokines IL-6, TNF-α, and IFN-γ on membrane-tethered mucins expression, glycocalyx, and viability of ocular surface epithelial cells. Methods: Stratified cultures of human corneal and conjunctival epithelial cells were exposed to different concentrations of IL-6, TNF-α, and IFN-γ for 24 hours. The mucins gene and protein expressions were quantified by real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA). The glycocalyx was imaged using confocal microscopy after staining with Alexa 488-conjugated wheat germ agglutinin lectin. Apoptotic and necrotic cell death was quantified using flow cytometry. Results: IL-6, TNF-α, and IFN-γ treatment resulted in a significant increase in mucins (MUC)1 and MUC4 gene and protein expression in human corneal epithelial cells but caused no significant changes in the levels of these mucins in conjunctival epithelial cells. Further, these cytokines decreased MUC16 expression in both corneal and conjunctival epithelial cells. Moreover, no notable change in glycocalyx or apoptotic cell death in corneal and conjunctival epithelial cells was noted with any of the tested cytokines, but IL-6 and TNF-α exposure increased necrotic cell death in corneal and conjunctival epithelial cells, respectively. Conclusions: Our results demonstrate that proinflammatory cytokines have differential effects on human corneal and conjunctival epithelial cell mucins expression, but do not cause any damage to ocular surface epithelial cell glycocalyx.


Assuntos
Citocinas , Células Epiteliais , Glicocálix , Mucinas , Células Cultivadas , Túnica Conjuntiva/citologia , Córnea/citologia , Humanos , Mucinas/genética
19.
Front Pharmacol ; 12: 671405, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34122095

RESUMO

Corneal opacification is the fourth most common cause of blindness globally behind cataracts, glaucoma, and age-related macular degeneration. The standard treatment of serious corneal scarring is corneal transplantation. Though it is effective for restoring vision, the treatment outcome is not optimal, due to limitations such as long-term graft survival, lifelong use of immunosuppressants, and a loss of corneal strength. Regulation of corneal stromal wound healing, along with inhibition or downregulation of corneal scarring is a promising approach to prevent corneal opacification. Pharmacological approaches have been suggested, however these are fraught with side effects. Tissue healing is an intricate process that involves cell death, proliferation, differentiation, and remodeling of the extracellular matrix. Current research on stromal wound healing is focused on corneal characteristics such as the immune response, angiogenesis, and cell signaling. Indeed, promising new technologies with the potential to modulate wound healing are under development. In this review, we provide an overview of cell-free strategies and some approaches under development that have the potential to control stromal fibrosis and scarring, especially in the context of early intervention.

20.
J Refract Surg ; 37(5): 344-350, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34044695

RESUMO

PURPOSE: To investigate the relationship between severity of myopia and corneal deformation characteristics after removing confounding factors using propensity score matching (PSM) analysis. METHODS: A prospective study was conducted from April 1 to December 30, 2019 in Tianjin Eye Hospital. Participants were divided into low (spherical equivalent [SE] > -6.00 diopters) and high (SE ⩽ -6.00 diopters) myopia groups. Corneal deformation parameters were obtained using corneal visualization Scheimpflug technology. PSM analysis was conducted to minimize the effect of confounding factors (age, intraocular pressure, and corneal thickness) on corneal deformation. Correlation analysis and logistic regression models were applied to investigate the relationships between SE and corneal deformation parameters. RESULTS: A total of 2,126 eyes from 1,063 patients with a mean age of 23.81 ± 5.68 years were enrolled. The left and right eyes were analyzed separately. After PSM analysis, logistic regression indicated that the peak distance was a significant indicator for high myopia in both eye models (left: odds ratio [OR] = 1.978, 95% CI: 1.303 to 3.004; right: OR = 2.089, 95% CI: 1.362 to 3.202; P < .001). The maximum amplitudes of deformation and deflection and peak distance were significantly negatively correlated with SE in both eyes, whereas the whole eye movement was significantly positively correlated with SE (P < .01), as well as the deformation amplitude at the second applanation (P < .001). CONCLUSIONS: Eyes with high myopia exhibited larger deformation and deflection amplitude compared to eyes with low myopia. The high distance between bending points of the cornea at the highest concavity (peak distance) may be a feature of high myopia. [J Refract Surg. 2021;37(5):344-350.].


Assuntos
Miopia , Tonometria Ocular , Adolescente , Adulto , Fenômenos Biomecânicos , Córnea , Humanos , Pressão Intraocular , Pontuação de Propensão , Estudos Prospectivos , Adulto Jovem
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