眼科学报最新文献

Purpose: To observe the efficacy of toric design orthokera- tology (ortho-k) for correcting myopia and astigmatism in myopic adolescents with moderate to high astigmatism.

Methods: This was a self-controlled clinical study. Twenty-four subjects (42 eyes) aged 9 to 16 years with myopia of 2.50-6.00 D complicated with rule astigmatism of 1.50-3.50 D were fitted with Lucid Night Toric Ortho-k Lenses (LUCID,KO- REA). The changes in uncorrected visual acuity (UCVA), spherical degree, refraction, axial length (AL), and corneal status were assessed at baseline, 1 night, 1 week, 1 month, 3 months, 6 months, and 1 year after the commencement of ortho-k lens wear.

Results: The success rate of the first lens fit was 92.8%. The UCVA after ortho-k wearing was improved significantly compared to the baseline during each visit (all P < 0.01), and became stable 1 month after ortho-k. The manifest myopia was significantly reduced from (-3.41 ± 1.27) D to (-0.41 ± 0.37) D by toric ortho-k and the degree of astigmatism from (-1.81 ± 0.53)D to (-0.41 ± 0.39) D after 1 month of lens wear (P < 0.01). The mean AL was (24.47 ± 0.91) mm at baseline, which did not significantly differ from (24.49 ± 0.87) mm and (24.48 ± 0.94) mm after 6 months and 1 year, respectively, of lens wear (both P > 0.05). Grade 1 corneal staining was observed at 1 week (23.8%), 1 month (21.4%), and 1 year (16.7%) following lens wear, and was improved by lens cleaning, discontinuing lens wear, and moistening the cornea with eye drops. No severe adverse events were reported.

Conclusion: The toric ortho-k lens was effective and safe for correction of low to moderate myopia in children with moderate to high astigmatism. The lens also effectively controlled axial length elongation during 1 year of observation. However, the long-term efficacy remains to be elucidated.

Purpose: To evaluate the effect of Avastin on human pterygium fibroblast migration and invasiveness.

Methods: VEGF secretion was compared between human pterygium fibroblasts and conjunctival fibroblasts by measuring VEGF-A by ELISA. The influence of Avastin on HPF migration and invasiveness was observed by wound scratch and Transwell migration assays. The expression of p-ERK1/2 and p-FAK was analyzed by western blotting.

Results: (1)VEGF was secreted in higher amounts by human pterygium fibroblasts than by conjunctival fibroblasts. (2) Avastin treatment decreased HPF migration and invasion. (3) Avastin significantly decreased the expression of p-ERK1/2 and p-FAK in human pterygium fibroblasts.

Conclusion: Avastin can inhibit migration and invasion of HPFs by decreasing the expression of p-ERK1/2 and p-FAK.

Purpose: To discuss the problems in perioperative nursing care for patients with postoperative infectious endophthalmitis.

Methods: The medical records of 34 patients (35 eyes) presenting with infectious endophthalmitis at Zhongshan Ophthalmic Center, Sun Yat-sen University between April 2002 and December 2013 were collected to analyze preoperative and postoperative nursing care for endophthalmitis after ocular surgery.

Results: Thirty-four patients (35 eyes) developed complications of infectious endophthalmitis after surgery. Thirty-three cases were successfully cured and only one patient (1 eye) was untreated due to Pseudomonas aeruginosa infection.

Conclusion: Perioperative nursing care plays a pivotal role in preventing and controlling the incidence and development of postoperative infectious endophthalmitis.

Purpose: To evaluate the effect of tear malate dehydrogenase 2 on monitoring ocular surface injury in mild dry eye (DE) disease.

Methods: A total of 15 DE patients (30 eyes) with mild subjective symptoms but no ocular surface fluorescein staining signs were enrolled in this study (DE group). The control group was 15 healthy age- and sex-matched volunteers (30 eyes). All subjects were asked to fill out a DE symptoms questionnaire and take different tests including tear MDH and MDH2 activities evaluation, tear breakup time (TBUT), Schirmer I, and slit-lamp examination of the ocular surface. We investigated different changes in tear MDH and MDH2 activities in the DE group and control group, discussed the association between tear MDH2 activity and DE symptoms, and the relationship between tear MDH2 activity and diagnostic tests (Schirmer I and TBUT). We also analyzed the changes in tear MDH2 activities after the treatment with artificial tears.

Results: Tear MDH activities in the DE group and control group were 288 ± 102 U/L and 259 ± 112 U/L, respectively, and this difference was not statistically significant (P > 0.05). The tear MDH2 activities in DE group were significantly increased compared with control group. Tear MDH2 was significantly and negatively correlated with the Schirmer's value (r = -0.733, P < 0.01) and the TBUT value (r = -0.841, P < 0.01). MDH2 also had a significant positive correlation with soreness symptoms (r = 0.687, P < 0.01). Treatment with artificial tears relieved or eliminated all discomfort symptoms, together with a considerable decrease in MDH2 activities (P < 0.01), but no significant changes in the Schirmer and the TBUT tests were observed.

Conclusion: Tear MDH2 activity can indicate ocular surface injury in mild DE patients and may be used to monitor the response to therapy.

This study was designed to summarize the key points of surgical cooperation involving penetrating corneal transplantation combined with implantation of keratoprosthesis. Preoperative preparation and intraoperative procedures were fully implemented to ensure cooperation with the physicians, to observe the the severity of the disease, and to guarantee the success of the surgery.

Purpose: To test the safe clinical application of sufentanil as topical ophthalmic drops by examining treated rabbit eyes for ophthalmic irritation signs or short-time toxic reactions.

Methods: Twenty-four rabbits were randomly divided into 8 groups (n = 3): The ocular toxicity at 14 d after eye drop ad- ministration was evaluated in groups 1 to 4, and at 30 d post- administration in groups 5 to 8. Groups 1 and 5 were treated with blank vehicle and served as normal controls. The left eyes of rabbits in groups 2 and 6 were exposed to low-dose sufentanil.(5 μg, 2 drops within 5 min), groups 3 and 7 received moderate-dose sufentanil (7.5 μg, 3 drops within 10 min), and groups 4 and 8 received high-dose sufentanil.(10 μg, 4 drops within 15 min). As self-controls, the right eyes of each rabbit were administered an equivalent amount of sodium chloride (9 g/L) at the same drop intervals. At 14 and 30 d after exposure to sufentanil, ophthalmic irritation signs were evaluated and corneas were stained with fluorescein and observed by slit-lamp microscopy. Corneal endothelial counts were performed and toxic reactions were evaluated.

Results: Multiple parameters were compared in the control and experimental groups by visual inspection and slit-lamp examination at 14 and 30 d after sufentanil administration. No evidence of irritation signs (including corneal opacity, conjunctival congestion, or edema), eye secretions, iris abnormalities, or temporal eye closure were noted. Corneal en- dothelial cell counts did not significantly differ between the control and experimental groups. Light microscopy revealed no pathological or morphological injury to the cornea, conjunctiva, iris, ciliary body, retina, or optic nerve in either group. The same observation outcomes were noted at 14 and 30 d after administration.

Conclusion: Single ocular administration of sufentanil at a dose of 5-10 μg in rabbits yields no ocular irritation or toxic responses at 14 or 30 d following eye drop delivery.

Purpose: To compare toric intraocular lens implantation (Toric-IOL) with peripheral corneal relaxing incisions (PCRIs) for astigmatism correction in patients undergoing cataract surgery.

Methods: 54 patients (54 eyes) with more than 0.75 diopter (D) of preexisting corneal astigmatism were classified as group A (0.75-1.50D) or group B (1.75-2.50D). The patients were randomized to undergo Toric-IOL or PCRIs in the steep axis with spherical IOL implantation. LogMAR uncorrected visual acuity (LogMAR UCVA), LogMAR best corrected visual acuity (LogMAR BCVA), error of vector (|EV|), surgery induced refraction correction (|SIRC|), and correction rates (CR) were measured 1 month and 6 months postoperatively.

Results: At 6 months postoperatively, all 54 eyes had LogMAR BCVA ≤ 0.2. Patients who underwent PCRIs and Toric-IOL with LogMAR BCVA ≤ 0.1 showed no significant differences in group A (P = 1.00) or in group B (P = 0.59). Group A showed no significant differences in LogMAR UCVA (P = 0.70), |EV| (P = 0.13), |SIRC| (P = 0.71), and CR (P = 0.56) in patients underwent PCRIs and Toric-IOL. However, group B showed significant differences in LogMAR UCVA (P < 0.01), |EV| (P < 0.01)), |SIRC| (P < 0.01), and CR (P < 0.01). The LogMAR UCVA and |EV| between 1 and 6 months showed no significant differences in patients in group A. However, in group B, they are significant differences.

Conclusion: The efficacy and stability of Toric-IOL and PCRIs were equal in low astigmatic patients. Toric-IOL achieved an enhanced effect over PCRIs in higher astigmatic patients. PCRIs had the more refractive regression than Toric-IOL in 6 months.

Purpose: To observe and compare the effects of pupil dilation between Mydrin-P and compound tropicamide in the screening of retinopathy of prematurity.

Methods: The right eyes of premature infants received My- drin-P eye drops as the treatment group, whereas the left eyes were administered with compound tropicamide as the control group. The eye drops were delivered every 5 min for three times. The pupil size was observed and recorded at 10, 15, and 20 min after administering mydriasis.

Results: The mean pupil diameter did not significantly differ between the treatment and control groups at 10 (6.24 ± 0.72 mm vs. 6.24 ± 0.68 mm, t = 0.00, P = 1.00), 15 (6.83 ± 0.55 mm vs. 6.78 ± 0.54 mm, t = 1.75, P = 0.083) or 20 min (7.22 ± 0.40 mm vs. 7.15 ± 0.50 mm, t = 1.62, P = 0.109), respectively. How- ever, the mean pupil size at any two time points significantly differed in both groups (all P < 0.001).

Conclusion: Both Mydrin-P and compound tropicamide exert similar clinical efficacy in the screening of retinopathy of pre- maturity. The most appropriate time for screening was at 20 min after mydriasis.

Purpose: To describe the image features of retinal astrocytic hamartoma in a 35-year-old male patient with tuberous sclerosis complex (TSC).

Methods: Fundus photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA), and spectral domain optical coherence tomography (SD-OCT) were performed for this retinal astrocytic hamartoma.

Results: Fundus photography showed that the retinal astrocytic hamartoma presented as a well-circumscribed, mulberry-like lesion consisting of glistening yellowish spherules of calcification. FAF demonstrated dense hyper-autofluorescence spots corresponding to retinal astrocytic hamartoma. FFA revealed leakage from dilated retinal capillaries over the hamartoma. SD-OCT indicated moth-eaten optically empty spaces and hyperreflective dots within the lesion. The lesion surface was fluctuate.

Conclusion: FAF is a useful imaging modality for obtaining greater contrast between a retinal astrocytic hamartoma and the surrounding retina due to hyper-autofluorescence of calcification in the lesion. FFA is beneficial for monitoring the abnormal blood vessels in these lesions. SD-OCT is capable of visualization the structural details, such as the uneven surface and inner hyperreflective dots.

Congenital cataract occurs during infancy when the axial length and corneal and visual function are in the sensitive stages of rapid development. Inappropriate surgical intervention not only fails to restore visual function, but also causes irreversible serious influences upon eyeball development in children diagnosed with congenital cataract. At present, the uncertainty of selection of intraocular lens (IOL) degrees during the eyeball development period is averted by using a main treatment of congenital cataract that includes two-stage surgery: stage I cataract extraction and stage II IOL implantation. However, the accurate selection of a refractive correction method and the timing of IOL implantation during stage II surgery for aphakic eyes remains controversial following stage I cataract extraction. This review retrospectively summarizes the current progress and existing problems indicated by related recent studies focusing on refractive correction pattern and IOL implantation timing.