AIM:To evaluate the efficacy and safety of decellularized conjunctival stroma(DCS)as a novel biomaterial by comparing its grafting outcomes with amniotic membrane(AM)when used for conjunctival reconstruction after pri...AIM:To evaluate the efficacy and safety of decellularized conjunctival stroma(DCS)as a novel biomaterial by comparing its grafting outcomes with amniotic membrane(AM)when used for conjunctival reconstruction after primary pterygium excision.METHODS:This randomized,parallel-controlled study with allocation concealment enrolled 40 patients with primary pterygium.Participants were randomly assigned to two groups using the sealed envelope method:the DCS group(n=20)and the AM group(n=18),receiving DCS and AM grafts respectively.Slit-lamp photography of the operative eyes was performed preoperatively and at 1,3,5,7,10,30,90,and 180d postoperatively.Best-corrected visual acuity(BCVA)and symptom scores were recorded simultaneously.In vivo confocal microscopy was conducted at 3 and 6mo postoperatively.RESULTS:All participants exhibited improved postoperative symptoms.The mean age was 60±9y(male/female ratio:6/14)in the DCS group and 56±12y(male/female ratio:7/11)in the AM group.The average epithelial healing time was 9.89±3.54d in the DCS group and 8.17±1.34d in the AM group(P=0.084).One recurrence case was observed in each group.Postoperative graft hemorrhage was significantly more severe in the DCS group than in the AM group only at 30d postoperatively(P=0.011).In vivo confocal microscopy revealed conjunctival epithelial cell growth in both groups at 90d postoperatively,while clear corneo-conjunctival cell boundaries were observed until 180d postoperatively.CONCLUSION:DCS used in primary pterygium surgery has a safety profile comparable to AM.It promotes rapid postoperative conjunctival healing,achieves a relatively low pterygium recurrence rate,and yields outcomes similar to AM.DCS provides a novel biomaterial option for conjunctival reconstruction after pterygium excision and the treatment of other conjunctival injuries.展开更多
Dear Editor,We present this case report which discusses a patient who underwent flap amputation after repeated attempts to resolve persistent and severe epithelial ingrowth following laser-assisted in situ keratomileu...Dear Editor,We present this case report which discusses a patient who underwent flap amputation after repeated attempts to resolve persistent and severe epithelial ingrowth following laser-assisted in situ keratomileusis(LASIK)surgery.Epithelial ingrowth is a known complication of LASIK surgery,typically manageable with minimal measures.However,severe cases may necessitate more aggressive interventions,such as flap amputation[1].LASIK is a widely performed refractive surgery with high success rates and excellent visual outcome[2].展开更多
AIM:To investigate the effects of shortening the duration of silicone oil tamponade on retinal structure and function in patients undergoing silicone oil removal(SOR)after surgery for primary rhegmatogenous retinal de...AIM:To investigate the effects of shortening the duration of silicone oil tamponade on retinal structure and function in patients undergoing silicone oil removal(SOR)after surgery for primary rhegmatogenous retinal detachment(RRD).METHODS:A total of 58 eligible patients were enrolled and randomly assigned to two groups based on tamponade duration:the short-term group(30-45d)and the conventional group(≥90d).Comprehensive evaluations were performed before and after SOR,including slitlamp examination,best-corrected visual acuity(BCVA)measurement,intraocular pressure(IOP)testing,optical coherence tomography(OCT),optical coherence tomography angiography(OCTA),microperimetry,electroretinography(ERG),and visual evoked potential(VEP)assessment.RESULTS:A total of 33 patients(23 males and 10 females;33 eyes)were enrolled in the short-term SO tamponade group with mean age of 52.45±9.35y,and 25 patients(15 males and 10 females;25 eyes)were enrolled in the conventional SO tamponade group with mean age of 50.80±12.06y.Compared with the conventional group,the short-term silicone oil tamponade group had a significantly lower incidence of silicone oil emulsification and cataract progression,with no significant difference in retinal reattachment success rate.Structurally,short-term tamponade was associated with increased thickness of the retinal ganglion cell layer(RGCL)in the nasal and superior macular regions and improved recovery of superficial retinal vascular density in these areas.Functionally,the shortterm group showed better BCVA and retinal sensitivity both before and 1mo after SOR;additionally,the P100 amplitude in VEP tests was significantly increased in this group.CONCLUSION:Shortening the duration of silicone oil tamponade effectively reduces damage to retinal structure and function without compromising the success rate of retinal reattachment in patients with primary RRD.展开更多
AIM:To investigate the association between functionaloutcomes and postoperative patient satisfaction 5y aftersmall incision lenticule extraction(SMILE)and femtosecondlaser-assisted in situ keratomileusis(FS-LASIK).MET...AIM:To investigate the association between functionaloutcomes and postoperative patient satisfaction 5y aftersmall incision lenticule extraction(SMILE)and femtosecondlaser-assisted in situ keratomileusis(FS-LASIK).METHODS:This is a cross-sectional study.Thepatients underwent basic ophthalmic examinations,axiallength measurement,wide-field fundus photography,andaccommodation function testing.Behavioral habits datawere collected using a self-administered questionnaire,andvisual symptoms were assessed with the Quality of Vision(QoV)questionnaire.Postoperative satisfaction was alsorecorded.RESULTS:Totally 410 subjects[820 eyes,160males(39.02%)and 250 females(60.98%)]who hadundergone SMILE or FS-LASIK 5y ago were enrolled.Themean(standard deviation,SD)age of all patients was29.83y(6.69).The mean(SD)preoperative manifest SEwas-5.80(2.04)diopters(D;range:-0.88 to-13.75).Patient satisfaction at 5y after undergoing SMILE or FSLASIKwas 91.70%.Patients were categorized into twogroups:dissatisfied group and satisfied group.Significantdifferences were observed between the two groups in termsof age(P=0.012),sex(P=0.021),preoperative degreeof myopia(P=0.049),postoperative visual symptoms(frequency,P=0.043;severity,P<0.001;bothersome,P=0.018),difficulty driving at night(P=0.001),andaccommodative amplitude(AMP,P=0.020).Multivariateanalysis confirmed that female sex(P=0.024),severityof visual symptoms(P=0.009),and difficulty driving atnight(P=0.006)were significantly associated with lowersatisfaction.The dissatisfied group showed higher rates ofstarbursts,double or multiple images,and high myopia,but lower age.The frequency,severity,and bothersome ofdistortion exhibited decreased with increasing age.CONCLUSION:Patient satisfaction 5y after SMILEand FS-LASIK is high and stable.Difficulty driving at night,sex,and severity of visual symptoms are important factorsinfluencing patient satisfaction.Special attention should bepaid to younger highly myopic female patients,particularlythose with starbursts and double or multiple images.It is crucial to monitor postoperative visual outcomesand provide patients with comprehensive preoperativecounseling to enhance long-term satisfaction.展开更多
AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional...AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional survey of ocular symptoms and clinical eye examinations were performed in a sample of 35 rural primary schools in the semi-arid region of Kajiado West sub-county in S.W.Kenya,amongst a seminomadic tribe(Maasai).Students in Grades 1-8 were included.Visual acuity was measured using the Snellen“tumbling E”chart at 6 m.Children with symptoms of refractive error underwent non-cycloplegic refraction.RESULTS:A total of 2036 children(1084 males)between the ages of 4-20y were examined.Conjunctival actinic changes were present in 22%(442/2036).Nine cases were seen with a potential squamous carcinoma.No overt classical ocular signs of vitamin A deficiency were noted,although 181(8.9%)children complained of nyctalopia.Three hundred thirty-six(16.5%)children had a visual acuity worse than 6/12 in either eye,were unable to read N10 near text at 40 cm or had symptoms suggestive of refractive error.Refractive data led to an estimate of hyperopia of+1.00 D or more in 3.9%and of myopia of-0.50 D or more in either eye in 3.0%of the study population.CONCLUSION:Solar exposure-and dust-related conjunctival pathology is common.As this may develop into potentially sight-or even life-threatening conditions,it warrants further study,and preventive strategies may be needed.Complaints of nyctalopia were common and could suggest vitamin A deficiency.The prevalence of refractive errors is low in this rural African population.展开更多
AIM:To describe the technique and the outcomes of manual Bowman layer and stroma transplant-onlay(BLST-o)for 2 cases of radial keratotomy(RK).METHODS:Two patients with visual fluctuations and corneal irregularity due ...AIM:To describe the technique and the outcomes of manual Bowman layer and stroma transplant-onlay(BLST-o)for 2 cases of radial keratotomy(RK).METHODS:Two patients with visual fluctuations and corneal irregularity due to RK were offered manual BLST-o as an alternative to penetrating keratoplasty(PKP).Visual acuity,refraction,corneal topography,corneal aberrometry,and corneal optical coherence tomography(OCT)pre-and postoperative were analyzed.Histology was obtained for 1 case.RESULTS:Both patients had corneal anatomical and morphological improvement,with elimination of the visual fluctuations.In one case,a subsequent excimer laser treatment improved corneal shape further,thus improving vision.The other case,whereas initially improved,developed epithelial ingrowth following suture removal.The latter was explanted and had a xenogeneic implant.The explanted sample was sent for histology,showing a viable graft of Bowman layer and anterior stroma.CONCLUSION:Manual BLST-o is a potential option for the management of symptoms post RK.These grafts may facilitate subsequent treatments such as laser corrections,and may not preclude from other interventions after explantation.展开更多
基金Supported by grants from the National Natural Science Foundation of China(No.82171018,No.82371022)Beijing Hospitals Authority’s Ascent Plan(No.DFL20240202)+2 种基金The Youth Beijing Scholars Program(No.022)High Level Public Health Technical Talents Construction Project from Beijing(Jie Y)Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(No.2023YFC2410401).
文摘AIM:To evaluate the efficacy and safety of decellularized conjunctival stroma(DCS)as a novel biomaterial by comparing its grafting outcomes with amniotic membrane(AM)when used for conjunctival reconstruction after primary pterygium excision.METHODS:This randomized,parallel-controlled study with allocation concealment enrolled 40 patients with primary pterygium.Participants were randomly assigned to two groups using the sealed envelope method:the DCS group(n=20)and the AM group(n=18),receiving DCS and AM grafts respectively.Slit-lamp photography of the operative eyes was performed preoperatively and at 1,3,5,7,10,30,90,and 180d postoperatively.Best-corrected visual acuity(BCVA)and symptom scores were recorded simultaneously.In vivo confocal microscopy was conducted at 3 and 6mo postoperatively.RESULTS:All participants exhibited improved postoperative symptoms.The mean age was 60±9y(male/female ratio:6/14)in the DCS group and 56±12y(male/female ratio:7/11)in the AM group.The average epithelial healing time was 9.89±3.54d in the DCS group and 8.17±1.34d in the AM group(P=0.084).One recurrence case was observed in each group.Postoperative graft hemorrhage was significantly more severe in the DCS group than in the AM group only at 30d postoperatively(P=0.011).In vivo confocal microscopy revealed conjunctival epithelial cell growth in both groups at 90d postoperatively,while clear corneo-conjunctival cell boundaries were observed until 180d postoperatively.CONCLUSION:DCS used in primary pterygium surgery has a safety profile comparable to AM.It promotes rapid postoperative conjunctival healing,achieves a relatively low pterygium recurrence rate,and yields outcomes similar to AM.DCS provides a novel biomaterial option for conjunctival reconstruction after pterygium excision and the treatment of other conjunctival injuries.
文摘Dear Editor,We present this case report which discusses a patient who underwent flap amputation after repeated attempts to resolve persistent and severe epithelial ingrowth following laser-assisted in situ keratomileusis(LASIK)surgery.Epithelial ingrowth is a known complication of LASIK surgery,typically manageable with minimal measures.However,severe cases may necessitate more aggressive interventions,such as flap amputation[1].LASIK is a widely performed refractive surgery with high success rates and excellent visual outcome[2].
基金Supported by the Key Science&Technology Project of Guangzhou(No.202103000045)the National Natural Science Foundation of China(No.82070972,No.82271093).
文摘AIM:To investigate the effects of shortening the duration of silicone oil tamponade on retinal structure and function in patients undergoing silicone oil removal(SOR)after surgery for primary rhegmatogenous retinal detachment(RRD).METHODS:A total of 58 eligible patients were enrolled and randomly assigned to two groups based on tamponade duration:the short-term group(30-45d)and the conventional group(≥90d).Comprehensive evaluations were performed before and after SOR,including slitlamp examination,best-corrected visual acuity(BCVA)measurement,intraocular pressure(IOP)testing,optical coherence tomography(OCT),optical coherence tomography angiography(OCTA),microperimetry,electroretinography(ERG),and visual evoked potential(VEP)assessment.RESULTS:A total of 33 patients(23 males and 10 females;33 eyes)were enrolled in the short-term SO tamponade group with mean age of 52.45±9.35y,and 25 patients(15 males and 10 females;25 eyes)were enrolled in the conventional SO tamponade group with mean age of 50.80±12.06y.Compared with the conventional group,the short-term silicone oil tamponade group had a significantly lower incidence of silicone oil emulsification and cataract progression,with no significant difference in retinal reattachment success rate.Structurally,short-term tamponade was associated with increased thickness of the retinal ganglion cell layer(RGCL)in the nasal and superior macular regions and improved recovery of superficial retinal vascular density in these areas.Functionally,the shortterm group showed better BCVA and retinal sensitivity both before and 1mo after SOR;additionally,the P100 amplitude in VEP tests was significantly increased in this group.CONCLUSION:Shortening the duration of silicone oil tamponade effectively reduces damage to retinal structure and function without compromising the success rate of retinal reattachment in patients with primary RRD.
基金Supported by Research and Transformation Application of Capital Clinical Diagnosis and Treatment Technology by Beijing Municipal Commission of Science and Technology(No.Z201100005520043).
文摘AIM:To investigate the association between functionaloutcomes and postoperative patient satisfaction 5y aftersmall incision lenticule extraction(SMILE)and femtosecondlaser-assisted in situ keratomileusis(FS-LASIK).METHODS:This is a cross-sectional study.Thepatients underwent basic ophthalmic examinations,axiallength measurement,wide-field fundus photography,andaccommodation function testing.Behavioral habits datawere collected using a self-administered questionnaire,andvisual symptoms were assessed with the Quality of Vision(QoV)questionnaire.Postoperative satisfaction was alsorecorded.RESULTS:Totally 410 subjects[820 eyes,160males(39.02%)and 250 females(60.98%)]who hadundergone SMILE or FS-LASIK 5y ago were enrolled.Themean(standard deviation,SD)age of all patients was29.83y(6.69).The mean(SD)preoperative manifest SEwas-5.80(2.04)diopters(D;range:-0.88 to-13.75).Patient satisfaction at 5y after undergoing SMILE or FSLASIKwas 91.70%.Patients were categorized into twogroups:dissatisfied group and satisfied group.Significantdifferences were observed between the two groups in termsof age(P=0.012),sex(P=0.021),preoperative degreeof myopia(P=0.049),postoperative visual symptoms(frequency,P=0.043;severity,P<0.001;bothersome,P=0.018),difficulty driving at night(P=0.001),andaccommodative amplitude(AMP,P=0.020).Multivariateanalysis confirmed that female sex(P=0.024),severityof visual symptoms(P=0.009),and difficulty driving atnight(P=0.006)were significantly associated with lowersatisfaction.The dissatisfied group showed higher rates ofstarbursts,double or multiple images,and high myopia,but lower age.The frequency,severity,and bothersome ofdistortion exhibited decreased with increasing age.CONCLUSION:Patient satisfaction 5y after SMILEand FS-LASIK is high and stable.Difficulty driving at night,sex,and severity of visual symptoms are important factorsinfluencing patient satisfaction.Special attention should bepaid to younger highly myopic female patients,particularlythose with starbursts and double or multiple images.It is crucial to monitor postoperative visual outcomesand provide patients with comprehensive preoperativecounseling to enhance long-term satisfaction.
基金Supported by Vision International Eye Missions-USA,“One Drop for All”,Italy,and Private Donors in the Netherlands.
文摘AIM:To ascertain the pattern of ocular morbidity in a population of primary school children in rural Kenya as it is a prerequisite for planning effective preventive and therapeutic strategies.METHODS:A cross-sectional survey of ocular symptoms and clinical eye examinations were performed in a sample of 35 rural primary schools in the semi-arid region of Kajiado West sub-county in S.W.Kenya,amongst a seminomadic tribe(Maasai).Students in Grades 1-8 were included.Visual acuity was measured using the Snellen“tumbling E”chart at 6 m.Children with symptoms of refractive error underwent non-cycloplegic refraction.RESULTS:A total of 2036 children(1084 males)between the ages of 4-20y were examined.Conjunctival actinic changes were present in 22%(442/2036).Nine cases were seen with a potential squamous carcinoma.No overt classical ocular signs of vitamin A deficiency were noted,although 181(8.9%)children complained of nyctalopia.Three hundred thirty-six(16.5%)children had a visual acuity worse than 6/12 in either eye,were unable to read N10 near text at 40 cm or had symptoms suggestive of refractive error.Refractive data led to an estimate of hyperopia of+1.00 D or more in 3.9%and of myopia of-0.50 D or more in either eye in 3.0%of the study population.CONCLUSION:Solar exposure-and dust-related conjunctival pathology is common.As this may develop into potentially sight-or even life-threatening conditions,it warrants further study,and preventive strategies may be needed.Complaints of nyctalopia were common and could suggest vitamin A deficiency.The prevalence of refractive errors is low in this rural African population.
文摘AIM:To describe the technique and the outcomes of manual Bowman layer and stroma transplant-onlay(BLST-o)for 2 cases of radial keratotomy(RK).METHODS:Two patients with visual fluctuations and corneal irregularity due to RK were offered manual BLST-o as an alternative to penetrating keratoplasty(PKP).Visual acuity,refraction,corneal topography,corneal aberrometry,and corneal optical coherence tomography(OCT)pre-and postoperative were analyzed.Histology was obtained for 1 case.RESULTS:Both patients had corneal anatomical and morphological improvement,with elimination of the visual fluctuations.In one case,a subsequent excimer laser treatment improved corneal shape further,thus improving vision.The other case,whereas initially improved,developed epithelial ingrowth following suture removal.The latter was explanted and had a xenogeneic implant.The explanted sample was sent for histology,showing a viable graft of Bowman layer and anterior stroma.CONCLUSION:Manual BLST-o is a potential option for the management of symptoms post RK.These grafts may facilitate subsequent treatments such as laser corrections,and may not preclude from other interventions after explantation.
