AIM:To evaluate the mid-term effects of topical latanoprost 0.005%on vessel density(VD)of the bulbar conjunctiva using anterior segment optical coherence tomography angiography(OCTA).METHODS:Thirty-four eyes of 21 pat...AIM:To evaluate the mid-term effects of topical latanoprost 0.005%on vessel density(VD)of the bulbar conjunctiva using anterior segment optical coherence tomography angiography(OCTA).METHODS:Thirty-four eyes of 21 patients and 18 eyes of 9 healthy subjects were recruited as the treatment and control groups,respectively.The treatment group was instructed to apply generic latanoprost 0.005%once daily at night,while the control group received no medication.Anterior segment OCTA was performed on all eyes at baseline,3wk,and 12wk after initiation of latanoprost.The superficial bulbar conjunctival VD was measured in the superior,inferior,temporal,and nasal quadrants.A linear mixed model was used to compare the change in the VD between groups.RESULTS:The change in the VD was not different between groups in temporal,and nasal quadrants at 3-week and 12-week time points.The VD in the superior bulbar conjunctiva was significantly increased after 12wk(P=0.029)while the change from baseline after 3wk was not different between groups(P=0.218).After adjustment for age and gender superior hemi(P=0.006)and center(P=0.016)of the inferior quadrant of bulbar conjunctiva showed increased VD after 12wk.CONCLUSION:The trend of changes in the superior and inferior conjunctival VD is increased following topical latanoprost administration and these changes can be quantified using anterior segment OCTA.展开更多
AIM:To isolate and identify the conjunctival microbiota of cataract patients and analyze the associated influencing factors.METHODS:This study recruited 216 participants(216 eyes)from April 2022 to July 2022.Under the...AIM:To isolate and identify the conjunctival microbiota of cataract patients and analyze the associated influencing factors.METHODS:This study recruited 216 participants(216 eyes)from April 2022 to July 2022.Under the condition of no antibiotic use prior to cataract surgery,sterile swabs were used to collect samples from the lower conjunctival sac.Bacterial cultures were then conducted,followed by species identification through 16S rDNA gene sequencing.Clinical factors associated with positive or negative bacterial isolation rates were analyzed,including age,gender,meibomian gland dysfunction(MGD),history of hypertension,history of diabetes,history of cancer,history of infectious diseases and the habit of wearing masks.RESULTS:Among the 216 eyes,78 eyes yielded isolates,with an isolation rate of 36.11%,detecting a total of 122 strains.Gram-positive rods accounted for 49.18%(60 strains),gram-positive cocci accounted for 45.08%(55 strains),gram-negative bacteria accounted for 4.92%(6 strains),and fungi accounted for 0.82%(1 strain).This study found that the most abundant genera in the conjunctival sac were Corynebacterium(42.62%),Staphylococcus(31.15%),Micrococcus(9.84%),Acinetobacter(4.10%),and Bacillus(3.28%).Furthermore,age(P=0.006),gender(P=0.039),diabetes(P=0.003),history of infectious diseases(P=0.02),and duration of mask replacement(P<0.001)were important factors influencing the positive bacterial culture of the conjunctival microbiota.Although hypertensive patients exhibited a higher isolation rate of conjunctival bacteria,it did not reach statistical significance,and the history of cancer did not affect the isolation rate of the conjunctival microbial community in cataract patients before surgery.CONCLUSION:Potential changes are observed in the conjunctival microbiota among a sample of middleaged and elderly individuals from Beijing,China.Notably,an increased isolation rate of Corynebacterium and Micrococcus is detected,suggesting a possible change in the microbial balance that requires further investigation and attention from the ophthalmological community.Advanced age,female gender,MGD,diabetes,a recent history of infectious diseases,and inadequate mask-wearing habits are potentially significant factors associated with the conjunctival microbiota.These factors should be considered in the development of strategies to prevent perioperative infections in cataract surgery patients.展开更多
Objective:To develop a survival prediction model for primary conjunctival malignant tumors.Methods:Detailed information on cases diagnosed with primary conjunctival malignant tumors from 2000 to 2019 was collected fro...Objective:To develop a survival prediction model for primary conjunctival malignant tumors.Methods:Detailed information on cases diagnosed with primary conjunctival malignant tumors from 2000 to 2019 was collected from SEER database.Subsequently,cases meeting the inclusion criteria were randomly assigned to either the development group(1,216 cases)or validation group(608 cases).Relevant risk factors affecting overall survival(OS)were identified using Cox proportional hazards regression analysis.A nomogram was constructed to predict the 1-year,3-year,and 5-year survival rates.The concordance index(C index)was calculated to assess the predictive power of the model.Receiver operating characteristic curves(ROC curves)and calibration curves were plotted.The area under the curve(AUC)was measured.Decision curve analysis(DCA)was also applied.Results:The overall survival rate was 77.8%.Statistically significant differences in the survival time distribution were observed among groups based on age(P<0.001),histology(P<0.001),and stage(P=0.01).According to the multivariate analysis,patients with lymphoma,younger age,and localized lesions exhibited better survival outcomes.The C-index of the constructed model was 0.79.In the training group,the AUC values for predicting 1-year,3-year,and 5-year mortality were 0.824,0.796,and 0.815,respectively.In the validation group,age corresponding AU values were 0.750,0.820,and 0.838.The DCA results demonstrated a significant advantage of the model,while the calibration plots indicated that the predicted OS was in good agreement with the actual OS in both groups.Conclusions:This study presents a satisfying survival prediction model for malignant conjunctival tumors.展开更多
AIM:To investigate the outcome of combined anterior corneal elastic sublaminectomy,conjunctival flap,and prosthetic eyepiece for ocular atrophy following foldable capsular vitreous body(FCVB)implantation in severe tra...AIM:To investigate the outcome of combined anterior corneal elastic sublaminectomy,conjunctival flap,and prosthetic eyepiece for ocular atrophy following foldable capsular vitreous body(FCVB)implantation in severe trauma.METHODS:This study conducted a retrospective analysis of 38 patients who underwent conjunctival flap coverage followed by prosthetic eyepiece fitting after developing ocular atrophy secondary to FCVB surgery.Anterior corneal elastic sublaminectomy combined with conjunctival coverage was performed on the FCVBimplanted atrophic eyes.Prosthetic lenses were fitted after complete healing of the stroma and conjunctiva and suture removal.Corneal irritation,eyeball protrusion,axial length,lid height,cosmetic satisfaction,and pain numerical rating scale scores were observed before the conjunctival flap covering and after the prosthetic eyepiece surgery.RESULTS:The ocular protrusion was 11 mm preoperatively and 14 mm postoperatively,with the difference being statistically significant(Z=-5.459,P<0.001).The ocular axis length was 20.82±0.94 mm in the experimental group and 23.57±0.33 mm in the control group,showing a statistically significant difference(t=-20.207,P<0.05).The lid height was 6 mm in the experimental group and 9 mm in the control group,a difference that was statistically significant(Z=-5.326,P<0.001).The appearance satisfaction score was 1 in the experimental group and 4 in the control group,with this difference being statistically significant(Z=-5.447,P=0.001).Regarding the pain numerical rating scale score,the ranges were 0-2 in the experimental group and 0 in the control group.No discomfort was reported after wearing the prosthetic eyepiece,and the difference was not statistically significant(Z=-1.100,P>0.05).There was no statistically significant difference between pre-and post-treatment satisfaction.CONCLUSION:A conjunctival flap covering and a prosthetic eyepiece after FCVB postoperative atrophy can reduce the number of surgeries,alleviate patients’economic burdens,satisfy patients’psychological eyeball retention requirements,and provide better cosmetic efficacies for patients desiring eyeball retention or silicone-oil dependence.展开更多
AIM:To assess and compare the conjunctival bacterial flora in patients with congenital ptosis(CP)to that of healthy individuals.METHODS:The study included 38 patients with CP and 42 healthy control subjects.Conjunctiv...AIM:To assess and compare the conjunctival bacterial flora in patients with congenital ptosis(CP)to that of healthy individuals.METHODS:The study included 38 patients with CP and 42 healthy control subjects.Conjunctival cultures were collected using a cotton-tipped swab applied to the inferior conjunctival fornix.The samples were inoculated into blood agar,eosin methylene blue agar,chocolate agar for bacteria,and Sabouraud dextrose agar medium for fungi.RESULTS:The culture positivity rate was 68.4%in CP and 47.6%in the control group(P<0.001).Additionally,there was a significant difference in culture positivity between the eyes of patients with unilateral ptosis(P=0.039).In the CP group,the most common found microorganism was Staphylococcus epidermidis at 23.67%,followed by Haemophilus species at 21.04%,and Corynebacterium species at 15.78%.In the control group,Staphylococcus epidermidis and Corynebacterium species were both the most commonly isolated microorganisms,each accounting for 19.04%.More than one species of bacteria was grown in the cultures of 36.84%and 23.80%of the CP and control subjects,respectively.Gram-negative bacteria were more common in CP than in control subjects(P=0.031).CONCLUSION:Culture positivity is significantly higher in the ptotic eyes of CP.Potentially pathogenic microorganisms are more frequently isolated from the CP group compared with the healthy control group.展开更多
In this case report it describes a novel technique using indocyanine green gel for the surgical excision of conjunctival lymphangiectasia(CL).CL was found on the nasal side of left eye in a 50-year-old male.Surgical e...In this case report it describes a novel technique using indocyanine green gel for the surgical excision of conjunctival lymphangiectasia(CL).CL was found on the nasal side of left eye in a 50-year-old male.Surgical excision of the entire cystic lesion with an intact cyst wall was completed with the assistance of an indocyanine green(ICG)gel.No sutures were used throughout the entire procedure.Subsequent post operative follow-up was uneventful.Herein,we report a novel technique used to facilitate the identification and complete removal of an intraocular cystic lesion ensuring an intact cyst wall.展开更多
Uveal and conjunctival melanomas are relatively rare tumors;nonetheless,they pose a significant risk of mortality for a large number of affected individuals.The pathogenesis of melanoma at different sites is very simil...Uveal and conjunctival melanomas are relatively rare tumors;nonetheless,they pose a significant risk of mortality for a large number of affected individuals.The pathogenesis of melanoma at different sites is very similar,however,the prognosis for patients with ocular melanoma remains unfavourable,primarily due to its distinctive genetic profile and tumor microenvironment.Regardless of considerable advances in understanding the genetic characteristics and biological behaviour,the treatment of uveal and conjunctival melanoma remains a formidable challenge.To enhance the prospect of success,collaborative efforts involving medical professionals and researchers in thefields of ocular biology and oncology are essential.Current data show a lack of well-designed randomized clinical trials and limited benefits in current forms of treatment for these tumors.Despite advancements in the development of effective melanoma therapeutic strategies,all current treatments for uveal melanoma(UM)and conjunctival melanoma(CoM)remain unsatisfactory,resulting in a poor long-term prognosis.Ongoing trials offer hope for positive outcomes in advanced and metastatic tumors.A more comprehensive understanding of the genetic and molecular abnormalities involved in the development and progression of ocular melanomas opens the way for the development of personalized therapy,with various potential therapeutic targets currently under consideration.Increased comprehension of the molecular pathogenesis of UM and CoM and their specificities may aid in the development of new and more effective systemic therapeutic agents,with the hope of improving the prognosis for patients with metastatic disease.展开更多
AIM:To determine the efficacy and safety of pedicled conjunctival lacrimal duct reconstruction in the treatment of severe obstruction of superior and inferior lacrimal canaliculi with conjunctivochalasis.METHODS:This ...AIM:To determine the efficacy and safety of pedicled conjunctival lacrimal duct reconstruction in the treatment of severe obstruction of superior and inferior lacrimal canaliculi with conjunctivochalasis.METHODS:This study was per formed as a retrospective analysis of patients who received conjunctival dacryocystorhinostomy with pedicled conjunctival flap reconstruction combined with tube intubation due to severe superior and inferior lacrimal canalicular obstruction with conjunctivochalasis from January 2019 to October 2019.The clinical data included the degree of preoperative epiphora and postoperative relief,preoperative examination of lacrimal duct computed tomography and ultrasound biomicroscopy,postoperative evaluation of lacrimal duct function by chloramphenicol taste and fluorescein dye disappearance test,etc.Syringing was carried out to determine the reconstruction and patency of the lacrimal duct.RESULTS:All 9 patients(9 eyes)had severe canalicular obstruction with conjunctivochalasis.The patients included 4 males and 5 females aged between 47–65y with an average age of 52.2±6.7y.At 3mo follow-up,the tube was removed and the patients were followed for a further 3mo.After tube removal,6 patients showed no epiphora.These patients also had positive chloramphenicol tastes and normal fluorescein dye disappearance test results.Two patientshad epiphora.Also,syringing showed partial patency of the reconstructed lacrimal duct.One patient had no improvement in epiphora with negative chloramphenicol taste and fluorescein dye disappearance test results and obstruction of the reconstructed lacrimal duct.The total effective rate of the operation was 8/9,with no serious complications.CONCLUSION:Pedicled conjunctival lacrimal duct reconstruction conjunctival dacryocystorhinostomy is safe and effective for superior and inferior canalicular obstruction with conjunctivochalasis.展开更多
AIM： To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques： combined conjunctival autograft and overlay amniotic membrane transplantation （CAT with AMT）, conjuncti...AIM： To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques： combined conjunctival autograft and overlay amniotic membrane transplantation （CAT with AMT）, conjunctival autograft transplantation （CAT） alone and amniotic membrane transplantation （AMT） alone. METHODS： In this retrospective study, 142 eyes of 142 pterygium patients （104 primary, 38 recurrent）who underwent CAT （group A）, AMT （group B） or CAT with AMT （group C） respectively following surgical excision were reviewed and compared based on the recurrences and post-operative complications. RESULTS： The number of recurrence post-surgery were 17 （9 from primary, 8 from recurrent; the same description below）, 18 （10, 8） and 2 （1, 1） in groups A, B, and C respectively; dry eyes were 22 （16, 6）, 27 （18, 9） and 7 （3, 4）; conjunctival inflammations were 30 （17, 13）, 27 （16, 11） and 11 （6, 5）. Patients in group C （either pdmary or recurrent or both） mainly showed significantly better results than those in group A or B （P〈0.05） regarding above-mentioned clinical effects. CONCLUSION： Combined CAT and overly AMT have significantly lower rates of recurrence and postoperative complications for primary and recurrent pterygium surgery than CAT or AMT alone.展开更多
AIM: To study the clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. METHODS:A retrospect...AIM: To study the clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. METHODS:A retrospective study was done to 10 patients (10 eyes) who had accepted removal of the necrotic corneal tissue combined with conjunctival flap covering surgery for fungal keratitis,the diagnosis by corneal scraping and smear examination or confocal microscopy check hyphae. Local and systemic antifungal therapy more than one week for all patients, corneal ulcer enlarge or no shrink. Slit lamp microscope examination the diameter of corneal ulcer about 2mm-4mm. Anterior segment optical coherence tomography (AS-OCT)examine the depth of corneal ulcer between 1/3-1/2, infiltrate corneal stroma about 20um-80um,the diameter of corneal ulcer about 3mm-6mm.Type-B ultrasonic exclusion endophthalmitis. Complete removal lesions until transparent of stoma, make conjunctival flap equal or greater than ulcer 1mm nearby conjunctiva. Continued antifungal therapy. The vision, fungal recurrence, conjunctival flap rollback or desquamate were analysed. ' RESULTS:Ten patients had success done this surgery, the corneal ulcer was not enlarge and healing afteroperation. 7 cases were bridging conjunctival flap and 3cases were single conjunctival flap. Preoperation vision above 0.1 had 8 cases,7 cases had vision above 0.1 one week after surgery, while 1 cases vision droped from 0.3 to 0.05.There was not recurrent for fungal,2 cases conjunctival flap rollback:1 case was bridging and 1case was single flap, no conjunctival flap desquamate. CONCLUSION: It is safe and effective to perform removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis which werenot sensitive or aggravate for antifungal drugs.展开更多
AIM: To report a procedure and results of a two-stage operation to manage intractable extensive orbital implant exposure with a large conjunctival defect which was difficult to treat with dermis fat grafts due to repe...AIM: To report a procedure and results of a two-stage operation to manage intractable extensive orbital implant exposure with a large conjunctival defect which was difficult to treat with dermis fat grafts due to repeated graft necrosis. METHODS: A retrospective chart review of four patients who had extensive orbital implant exposures with large conjunctival defects and had past histories of repeated autologous or preserved dermis graft failures was done. As a first-stage operation, the problematic pre-existing orbital implants were removed and autologous dermis fat grafts alone were performed on the defect area. Four months later, new orbital implants were secondarily inserted after confirmation of graft survival. The size of the conjunctival defects and state of the extraocular muscles were checked preoperatively. Success of the operations and complications were investigated.RESULTS: The mean size of the conjuctival defects was 17.3mm×16.0mm, and the mean time from the initial diagnosis of orbital implant exposure to implant removal and autologous dermis fat graft was 20.8 months. After implant removal and autologous dermis fat graft, no graft necrosis was observed in any patients. Also, implant exposure or fornix shortening was not observed in any patients after new orbital implant insertion. CONCLUSION: The secondary insertion of a new orbital implant after pre-existing implant removal and preceding dermis fat graft is thought to be an another selective management of intractable orbital implant exposure in which dermis fat grafts persistently fail.展开更多
AIM: To investigate the resistance to bacterial adhesion of materials used in oculoplastic surgery, particularly materials used in the manufacture of orbital implants.METHODS: Seven organisms of conjunctival flora(two...AIM: To investigate the resistance to bacterial adhesion of materials used in oculoplastic surgery, particularly materials used in the manufacture of orbital implants.METHODS: Seven organisms of conjunctival flora(two strains of Staphylococcus epidermidis and one strain each of Staphylococcus aureus, Staphylococcus hominis, Corynebacterium amycolatum, Acinetobacter calcoaceticus, and Serratia marcescens) were selected. A lactic acid bacterium(Lactobacillus rhamnosus) was also included as positive control because of its well-known adhesion ability. Eight materials used to make oculoplastic prostheses were selected(glass, steel, polytetrafluoroethylene, polymethylmethacrylate, silicone from orbital implants, commercial silicone, porous polyethylene, and semismooth polyethylene). Materials surfaces and biofilms developed by strains were observed by scanning electron microscopy. Kinetics of growth and adhesion of bacterial strains were determined by spectrophotometry. Each strain was incubated in contact with plates of the different materials. After growth, attached bacteria were re-suspended and colony-forming units(CFUs) were counted. The number of CFUs per square millimetre of material was statistically analyzed.RESULTS: A mature biofilm was observed in studied strains except Staphylococcus hominis, which simply produced a microcolony. Materials showed a smooth surface on the microbial scale, although steel exhibited 1.0-μm-diameter grooves. Most organisms showed significant differences in adhesion according to the material. There were also significant differences in thetotal number of CFUs per square millimetre from each material(P=0.044). CFU counts were significantly higher in porous polyethylene than in silicone from orbital implants(P=0.038).CONCLUSION: Silicone orbital implants can resist microbial colonization better than porous polyethylene implants.展开更多
AIM： To investigate the effect of long-term use of topically administered latanoprost on conjunctival thickness（CT） and conjunctival epithelium thickness（CET） in the patients with glaucoma. METHODS： A series of...AIM： To investigate the effect of long-term use of topically administered latanoprost on conjunctival thickness（CT） and conjunctival epithelium thickness（CET） in the patients with glaucoma. METHODS： A series of 106 glaucomatous patients were included. Of the 106 eyes, 55 eyes were treated with latanoprost eye drops once a day（latanoprost group）, while 51 eyes were treated with carteolol hydrochloride eye drops（carteolol group）. All the included patients completed a 2-year follow-up. CT and CET were measured with optical coherence tomography（OCT） in all patients at presentation and at 2-year visit, respectively. Statistical analysis was then performed to compare the change in CT and CET. RESULTS： At presentation, there was no difference in CET（t=0.400, P=0.689） or CT（t=1.14, P=0.259） between the two groups. No significant difference was found in CET（61.65±5.35 μm at baseline, 60.36±6.36 μm at 2-year follow-up, respectively; t=1.977, P=0.0531）, while there was a significant decrease in CT from 201.45±14.99 μm at baseline to 167.81±14.57 μm at 2-year visit（t=14.1407, P〈0.001） in the latanoprost group. At 2-year follow-up, no statistically difference was found in CET（62.24±5.27 μm; t=1.086, P=0.282） or CT（201.23±12.45 μm; t=1.44, P=0.154） compared to it at baseline（CET： 61.23±5.42 μm; CT： 198.76±13.68 μm, respectively） in the carteolol group. CONCLUSION： A significant decrease in conjunctival thickness is found in glaucoma patients treated with long-term topical latanoprost; its potential effect on the outcome of filtration surgery should be considered.展开更多
AIM:To examine the effects of sulforaphane on fibrotic changes of transforming growth factor(TGFβ2)induced human conjunctival fibroblast(HCon Fs).METHODS:HCon Fs were cultured and divided into control,TGFβ2(1 ng/m L...AIM:To examine the effects of sulforaphane on fibrotic changes of transforming growth factor(TGFβ2)induced human conjunctival fibroblast(HCon Fs).METHODS:HCon Fs were cultured and divided into control,TGFβ2(1 ng/m L),sulforaphane and TGFβ2+sulforaphane groups.Cell viability and apoptosis were detected using the MTT and Apo Tox-Glo Triplex assay.Cell migration was detected using scratch and Transwell assay.Real-time quantitative PCR method was used to evaluate m RNA expression of TGFβ2,matrix metalloproteinase-2(MMP2),myosin light chain kinase(MYLK),integrinαV,integrinα5,fibronectin 1 andα-smooth muscle actin(α-SMA).The protein expression ofα-SMA,p-PI3 K,PI3 K,p-Akt,and Akt were detected by Western blot.RESULTS:The proliferation of HCon Fs was significantly(P<0.05)suppressed by sulforaphane compared to control cells with the increase of the concentration and treatment time.Cell proliferation after 48 h incubation was significantly reduced with 100μmol/L sulforaphane treatment by 17.53%(P<0.05).The Transwell assay showed sulforaphane decreased cell migration by 18.73%compared with TGFβ2-induced HCon F(P<0.05).TGFβ2-induced the increasing expression of fibronectin,type I collagen andα-SMA,and the phosphorylation of PI3 K and Akt were all significantly suppressed by sulforaphane pretreatment.CONCLUSION:Sulforaphane inhibits proliferation,migration,and synthesis of the extracellular matrix in HCon Fs,and inhibiting the PI3 K/Akt signaling pathway.Sulforaphane could be a potential therapeutic drug for prevention of scar formation in filtering bleb after trabeculectomy.展开更多
AIMTo compare the conjunctival epithelial toxicities of three newer-generation fluoroquinolones without preservatives.METHODSIn a prospective, randomized, double blind comparative study, 47 eyes of 47 patients with a ...AIMTo compare the conjunctival epithelial toxicities of three newer-generation fluoroquinolones without preservatives.METHODSIn a prospective, randomized, double blind comparative study, 47 eyes of 47 patients with a primary pterygium were enrolled, and divided randomly into three groups (levofloxacin 0.5%, gatifloxacin 0.3%, and moxifloxacin 0.5%). After pterygium surgery with the same conjunctival autograft technique, each patient maintained a regimen with a randomly assigned fluoroquinolone eye drop. Patients were examined every other day after surgery until the epithelium had completely healed. Photos were taken and used to measure the area of residual epithelial defects. Conjunctival healing time and speed (initial defect area/healing time (mm<sup>2</sup>/d) compared in each group using Kruskal-Wallis tests.RESULTSThere were no significant differences in mean age, gender, and conjunctival defect size of the donor site between these groups. However, the mean of conjunctival healing time and speed were statistically different in each group. The mean of conjunctival epithelial healing time was 8.93±2.69d (levofloxacin group), 10.31±2.96d (gatifloxacin group), and 13.50±4.10d (moxifloxacin group), P=0.006. The mean conjuctival epithelial healing speed was 6.18±1.39 mm<sup>2</sup>/d (levofloxacin group), 5.52±1.68 mm<sup>2</sup>/d (gatifloxacin group), and 4.40±1.30 mm<sup>2</sup>/d (moxifloxacin group), P=0. 003.CONCLUSIONWithout the influence of preservatives, levofloxacin and gatifloxacin might be less toxic to the regeneration of conjunctival epithelial cells and cause a faster conjunctival wound healing relative to moxifloxacin.展开更多
AIM:To investigate whether the two-step strategy[conjunctival flap covering surgery(CFCS)combined with secondary deep anterior lamellar keratoplasty(DALK)]is effective for patients with high-risk fungal keratitis(FK)....AIM:To investigate whether the two-step strategy[conjunctival flap covering surgery(CFCS)combined with secondary deep anterior lamellar keratoplasty(DALK)]is effective for patients with high-risk fungal keratitis(FK).METHODS:In this noncomparative,retrospective case series,10 subjects(6 males,4 females)with a mean age of 56.5±7.1(range 47-72)y with high-risk FK undergone the two-step strategy were included.Reported outcome measures were healing of the corneal ulcer,recurrence of FK,reject reaction,improvement in best corrected visual acuity(BCVA)and relevant complications.RESULTS:The average diameter of corneal infiltrates was 7.50±0.39 mm,ranging from 6.94 to 8.13 mm.The mean depth of corneal infiltrates was 422.4±77.1μm,ranging from 350 to 535μm.The mean corneal thickness was 597.4±117.3μm,ranging from 458 to 851μm.Hypopyon and endothelial plaques were presented in all patients.The period between the two steps was 3.65±0.9(ranging from 3 to 5)mo.The graft diameter was 7.75±0.39 mm.At the last follow-up(average 9.25±3.39,ranging from 5.5 to 17mo),no fungal recurrence or graft rejection appeared,and all patients showed improvement of BCVA.One patient suffered from liver function impairment due to oral voriconazole for 4wk and recovered spontaneously after 1wk of drug withdrawal.CONCLUSION:The two-step strategy is safe and effective in the treatment of high-risk FK by transforming intentional therapeutic penetrating keratoplasty during acute infection to later optical DALK.It is a practical strategy,especially in areas lacking fresh donor corneas and eye bank services.展开更多
AIM:To explore the effects of alarmins produced by necrotic human conjunctival fibroblasts on the release of matrix metalloproteinases(MMPs)by human corneal fibroblasts(HCFs).METHODS:A necrotic cell supernatant(NHCS)w...AIM:To explore the effects of alarmins produced by necrotic human conjunctival fibroblasts on the release of matrix metalloproteinases(MMPs)by human corneal fibroblasts(HCFs).METHODS:A necrotic cell supernatant(NHCS)was prepared by subjecting human conjunctival fibroblasts to three cycles of freezing and thawing.The amounts of interleukin(IL)-1βand tumor necrosis factor(TNF)-αin NHCS were determined by enzyme-linked immunosorbent assays.HCFs exposed to NHCS or other agents in culture were assayed for the release of MMPs as well as for intracellular signaling by immunoblot analysis.The abundance of MMP m RNAs in HCFs was examined by reverse transcription and real-time polymerase chain reaction analysis.RESULTS:NHCS increased the release of MMP-1 and MMP-3 by HCFs as well as the amounts of the corresponding m RNAs in the cells.NHCS also induced activation of mitogen-activated protein kinase(MAPK)signaling pathways mediated by extracellular signal-regulated kinase(ERK),p38,and c-Jun NH2-terminal kinase(JNK)as well as elicited that of the nuclear factor(NF)-κB signaling pathway by promoting phosphorylation of the endogenous NF-κB inhibitor IκB-α.Inhibitors of MAPK and NF-κB signaling as well as IL-1 and TNF-αreceptor antagonists attenuated the NHCS-induced release of MMP-1 and MMP-3 by HCFs.Furthermore,IL-1βand TNF-αwere both detected in NHCS,and treatment of HCFs with these cytokines induced the release of MMP-1 and MMP-3 in a concentration-dependent manner.CONCLUSION:Alarmins,including IL-1βand TNF-α,produced by necrotic human conjunctival fibroblasts triggered MMP release in HCFs through activation of MAPK and NF-κB signaling.IL-1βand TNF-αare therefore potential therapeutic targets for the amelioration of corneal stromal degradation in severe ocular burns.展开更多
AIM:To explore the ocular features of corona virus disease(COVID)-19 and severe acute respiratory syndrome coronavirus(SARS-CoV)-2 detection in tears and conjunctival scrapes in non-severe COVID-19 patients.METHODS:Th...AIM:To explore the ocular features of corona virus disease(COVID)-19 and severe acute respiratory syndrome coronavirus(SARS-CoV)-2 detection in tears and conjunctival scrapes in non-severe COVID-19 patients.METHODS:This is a multicenter observational clinical study with no intervention conducted from Jan 25th to March 1st,2020.Clinical data and samples of tears and conjunctival scraping were collected in consecutive laboratory-confirmed,non-severe COVID-19 patients from three hospitals.COVID-19 virus was analyzed by real-time reverse transcriptase polymerase chain reaction(RT-PCR)kits.RESULTS:Totally 255 laboratory-confirmed,non-severe COVID-19 patients were recruited for ocular manifestation investigation.Of them,54.9%were females,with a mean age of 49.4 y.None of the patients has evidence of uveitis;11 patients(4.3%)complained of mild asthenopia;2(0.8%)had mild conjunctival congestion and serous secretion.Twenty-five of them had performed tears and conjunctival scrape for COVID-19 virus detection,with 4 yield possible positive results in the nucleoprotein gene.One of them were asymptomatic with normal chest CT and positive pharyngeal swab result.CONCLUSION:Ocular manifestations are neither common nor specific in non-severe COVID-19 patients.Meanwhile,COVID-19 virus nucleotides can be detected in the tears and conjunctival scrape samples,warranting further research on the transmissibility by the ocular route.展开更多
Dear Editor,I am Dr.Elias F Jarade from the Beirut Eye and ENT Specialist Hospital, Beirut, Lebanon. I write to describe a novel surgical technique in the management of chronic ocular graft-versus-host disease（GVHD）.
AIM:To evaluate the effectiveness of knock-down of heat shock protein 47(HSP47)on conjunctival bleb scarring in a rat model and its possible mechanism.METHODS:Male Sprague–Dawley rats were used for glaucoma filtratio...AIM:To evaluate the effectiveness of knock-down of heat shock protein 47(HSP47)on conjunctival bleb scarring in a rat model and its possible mechanism.METHODS:Male Sprague–Dawley rats were used for glaucoma filtration surgery(GFS)and were treated with either phosphate buffered solution,shControl,mitomycin C,or sh-HSP47 using a microsyringe immediately after GFS.The morphology of filtering blebs was observed postoperatively.The levels of HSP47 were analyzed at 2,5,8,and 11d after GFS via real‑time quantitative polymerase chain reaction(PCR)and Western blot.The silencing effect of HSP47,the expression of collagen I and III,and the potential signaling pathways of HSP47 during scarification were explored 11d post GFS.The protein levels of transforming growth factor-β1(TGF-β1),phospho-Smad2(pSmad2),phospho-Smad3(p-Smad3),and phospho-p38(p-p38)were also analyzed using Western blot.RESULTS:Sh-HSP47 treatment significantly prolonged the functional filtration bleb retention.The levels of HSP47 were increased significantly at 5,8,and 11d postoperatively compared to the control group(P<0.05,P<0.01,and P<0.001).The levels of HSP47 protein at day 11 postoperatively were significantly down-regulated after HSP47 silencing using sh-HSP47 adenovirus transfection(P<0.01).Expression levels of collagen I and III within the blebs were significantly reduced in the absence of HSP47(P<0.01).Moreover,the protein levels of TGF-β1,p-Smad2/3,and p-p38 were dramatically inhibited after treatment with sh-HSP47(P<0.01).CONCLUSION:The inhibitory effects of HSP47 knockdown on scarring after GFS have the potential to be an efficacious therapeutic option for the treatment of conjunctival bleb scarring.展开更多
文摘AIM:To evaluate the mid-term effects of topical latanoprost 0.005%on vessel density(VD)of the bulbar conjunctiva using anterior segment optical coherence tomography angiography(OCTA).METHODS:Thirty-four eyes of 21 patients and 18 eyes of 9 healthy subjects were recruited as the treatment and control groups,respectively.The treatment group was instructed to apply generic latanoprost 0.005%once daily at night,while the control group received no medication.Anterior segment OCTA was performed on all eyes at baseline,3wk,and 12wk after initiation of latanoprost.The superficial bulbar conjunctival VD was measured in the superior,inferior,temporal,and nasal quadrants.A linear mixed model was used to compare the change in the VD between groups.RESULTS:The change in the VD was not different between groups in temporal,and nasal quadrants at 3-week and 12-week time points.The VD in the superior bulbar conjunctiva was significantly increased after 12wk(P=0.029)while the change from baseline after 3wk was not different between groups(P=0.218).After adjustment for age and gender superior hemi(P=0.006)and center(P=0.016)of the inferior quadrant of bulbar conjunctiva showed increased VD after 12wk.CONCLUSION:The trend of changes in the superior and inferior conjunctival VD is increased following topical latanoprost administration and these changes can be quantified using anterior segment OCTA.
基金Supported by Capital Health Development Scientific Research Special Project(No.2024-2-40913).
文摘AIM:To isolate and identify the conjunctival microbiota of cataract patients and analyze the associated influencing factors.METHODS:This study recruited 216 participants(216 eyes)from April 2022 to July 2022.Under the condition of no antibiotic use prior to cataract surgery,sterile swabs were used to collect samples from the lower conjunctival sac.Bacterial cultures were then conducted,followed by species identification through 16S rDNA gene sequencing.Clinical factors associated with positive or negative bacterial isolation rates were analyzed,including age,gender,meibomian gland dysfunction(MGD),history of hypertension,history of diabetes,history of cancer,history of infectious diseases and the habit of wearing masks.RESULTS:Among the 216 eyes,78 eyes yielded isolates,with an isolation rate of 36.11%,detecting a total of 122 strains.Gram-positive rods accounted for 49.18%(60 strains),gram-positive cocci accounted for 45.08%(55 strains),gram-negative bacteria accounted for 4.92%(6 strains),and fungi accounted for 0.82%(1 strain).This study found that the most abundant genera in the conjunctival sac were Corynebacterium(42.62%),Staphylococcus(31.15%),Micrococcus(9.84%),Acinetobacter(4.10%),and Bacillus(3.28%).Furthermore,age(P=0.006),gender(P=0.039),diabetes(P=0.003),history of infectious diseases(P=0.02),and duration of mask replacement(P<0.001)were important factors influencing the positive bacterial culture of the conjunctival microbiota.Although hypertensive patients exhibited a higher isolation rate of conjunctival bacteria,it did not reach statistical significance,and the history of cancer did not affect the isolation rate of the conjunctival microbial community in cataract patients before surgery.CONCLUSION:Potential changes are observed in the conjunctival microbiota among a sample of middleaged and elderly individuals from Beijing,China.Notably,an increased isolation rate of Corynebacterium and Micrococcus is detected,suggesting a possible change in the microbial balance that requires further investigation and attention from the ophthalmological community.Advanced age,female gender,MGD,diabetes,a recent history of infectious diseases,and inadequate mask-wearing habits are potentially significant factors associated with the conjunctival microbiota.These factors should be considered in the development of strategies to prevent perioperative infections in cataract surgery patients.
文摘Objective:To develop a survival prediction model for primary conjunctival malignant tumors.Methods:Detailed information on cases diagnosed with primary conjunctival malignant tumors from 2000 to 2019 was collected from SEER database.Subsequently,cases meeting the inclusion criteria were randomly assigned to either the development group(1,216 cases)or validation group(608 cases).Relevant risk factors affecting overall survival(OS)were identified using Cox proportional hazards regression analysis.A nomogram was constructed to predict the 1-year,3-year,and 5-year survival rates.The concordance index(C index)was calculated to assess the predictive power of the model.Receiver operating characteristic curves(ROC curves)and calibration curves were plotted.The area under the curve(AUC)was measured.Decision curve analysis(DCA)was also applied.Results:The overall survival rate was 77.8%.Statistically significant differences in the survival time distribution were observed among groups based on age(P<0.001),histology(P<0.001),and stage(P=0.01).According to the multivariate analysis,patients with lymphoma,younger age,and localized lesions exhibited better survival outcomes.The C-index of the constructed model was 0.79.In the training group,the AUC values for predicting 1-year,3-year,and 5-year mortality were 0.824,0.796,and 0.815,respectively.In the validation group,age corresponding AU values were 0.750,0.820,and 0.838.The DCA results demonstrated a significant advantage of the model,while the calibration plots indicated that the predicted OS was in good agreement with the actual OS in both groups.Conclusions:This study presents a satisfying survival prediction model for malignant conjunctival tumors.
基金Supported by National Natural Science Foundation of China(No.82260210)General Project of Jiangxi Provincial Traditional Chinese Medicine Science and Technology Plan(No.2023B1368).
文摘AIM:To investigate the outcome of combined anterior corneal elastic sublaminectomy,conjunctival flap,and prosthetic eyepiece for ocular atrophy following foldable capsular vitreous body(FCVB)implantation in severe trauma.METHODS:This study conducted a retrospective analysis of 38 patients who underwent conjunctival flap coverage followed by prosthetic eyepiece fitting after developing ocular atrophy secondary to FCVB surgery.Anterior corneal elastic sublaminectomy combined with conjunctival coverage was performed on the FCVBimplanted atrophic eyes.Prosthetic lenses were fitted after complete healing of the stroma and conjunctiva and suture removal.Corneal irritation,eyeball protrusion,axial length,lid height,cosmetic satisfaction,and pain numerical rating scale scores were observed before the conjunctival flap covering and after the prosthetic eyepiece surgery.RESULTS:The ocular protrusion was 11 mm preoperatively and 14 mm postoperatively,with the difference being statistically significant(Z=-5.459,P<0.001).The ocular axis length was 20.82±0.94 mm in the experimental group and 23.57±0.33 mm in the control group,showing a statistically significant difference(t=-20.207,P<0.05).The lid height was 6 mm in the experimental group and 9 mm in the control group,a difference that was statistically significant(Z=-5.326,P<0.001).The appearance satisfaction score was 1 in the experimental group and 4 in the control group,with this difference being statistically significant(Z=-5.447,P=0.001).Regarding the pain numerical rating scale score,the ranges were 0-2 in the experimental group and 0 in the control group.No discomfort was reported after wearing the prosthetic eyepiece,and the difference was not statistically significant(Z=-1.100,P>0.05).There was no statistically significant difference between pre-and post-treatment satisfaction.CONCLUSION:A conjunctival flap covering and a prosthetic eyepiece after FCVB postoperative atrophy can reduce the number of surgeries,alleviate patients’economic burdens,satisfy patients’psychological eyeball retention requirements,and provide better cosmetic efficacies for patients desiring eyeball retention or silicone-oil dependence.
文摘AIM:To assess and compare the conjunctival bacterial flora in patients with congenital ptosis(CP)to that of healthy individuals.METHODS:The study included 38 patients with CP and 42 healthy control subjects.Conjunctival cultures were collected using a cotton-tipped swab applied to the inferior conjunctival fornix.The samples were inoculated into blood agar,eosin methylene blue agar,chocolate agar for bacteria,and Sabouraud dextrose agar medium for fungi.RESULTS:The culture positivity rate was 68.4%in CP and 47.6%in the control group(P<0.001).Additionally,there was a significant difference in culture positivity between the eyes of patients with unilateral ptosis(P=0.039).In the CP group,the most common found microorganism was Staphylococcus epidermidis at 23.67%,followed by Haemophilus species at 21.04%,and Corynebacterium species at 15.78%.In the control group,Staphylococcus epidermidis and Corynebacterium species were both the most commonly isolated microorganisms,each accounting for 19.04%.More than one species of bacteria was grown in the cultures of 36.84%and 23.80%of the CP and control subjects,respectively.Gram-negative bacteria were more common in CP than in control subjects(P=0.031).CONCLUSION:Culture positivity is significantly higher in the ptotic eyes of CP.Potentially pathogenic microorganisms are more frequently isolated from the CP group compared with the healthy control group.
文摘In this case report it describes a novel technique using indocyanine green gel for the surgical excision of conjunctival lymphangiectasia(CL).CL was found on the nasal side of left eye in a 50-year-old male.Surgical excision of the entire cystic lesion with an intact cyst wall was completed with the assistance of an indocyanine green(ICG)gel.No sutures were used throughout the entire procedure.Subsequent post operative follow-up was uneventful.Herein,we report a novel technique used to facilitate the identification and complete removal of an intraocular cystic lesion ensuring an intact cyst wall.
文摘Uveal and conjunctival melanomas are relatively rare tumors;nonetheless,they pose a significant risk of mortality for a large number of affected individuals.The pathogenesis of melanoma at different sites is very similar,however,the prognosis for patients with ocular melanoma remains unfavourable,primarily due to its distinctive genetic profile and tumor microenvironment.Regardless of considerable advances in understanding the genetic characteristics and biological behaviour,the treatment of uveal and conjunctival melanoma remains a formidable challenge.To enhance the prospect of success,collaborative efforts involving medical professionals and researchers in thefields of ocular biology and oncology are essential.Current data show a lack of well-designed randomized clinical trials and limited benefits in current forms of treatment for these tumors.Despite advancements in the development of effective melanoma therapeutic strategies,all current treatments for uveal melanoma(UM)and conjunctival melanoma(CoM)remain unsatisfactory,resulting in a poor long-term prognosis.Ongoing trials offer hope for positive outcomes in advanced and metastatic tumors.A more comprehensive understanding of the genetic and molecular abnormalities involved in the development and progression of ocular melanomas opens the way for the development of personalized therapy,with various potential therapeutic targets currently under consideration.Increased comprehension of the molecular pathogenesis of UM and CoM and their specificities may aid in the development of new and more effective systemic therapeutic agents,with the hope of improving the prognosis for patients with metastatic disease.
基金Supported by Dalian Medical Science Research Project (No.1811048)。
文摘AIM:To determine the efficacy and safety of pedicled conjunctival lacrimal duct reconstruction in the treatment of severe obstruction of superior and inferior lacrimal canaliculi with conjunctivochalasis.METHODS:This study was per formed as a retrospective analysis of patients who received conjunctival dacryocystorhinostomy with pedicled conjunctival flap reconstruction combined with tube intubation due to severe superior and inferior lacrimal canalicular obstruction with conjunctivochalasis from January 2019 to October 2019.The clinical data included the degree of preoperative epiphora and postoperative relief,preoperative examination of lacrimal duct computed tomography and ultrasound biomicroscopy,postoperative evaluation of lacrimal duct function by chloramphenicol taste and fluorescein dye disappearance test,etc.Syringing was carried out to determine the reconstruction and patency of the lacrimal duct.RESULTS:All 9 patients(9 eyes)had severe canalicular obstruction with conjunctivochalasis.The patients included 4 males and 5 females aged between 47–65y with an average age of 52.2±6.7y.At 3mo follow-up,the tube was removed and the patients were followed for a further 3mo.After tube removal,6 patients showed no epiphora.These patients also had positive chloramphenicol tastes and normal fluorescein dye disappearance test results.Two patientshad epiphora.Also,syringing showed partial patency of the reconstructed lacrimal duct.One patient had no improvement in epiphora with negative chloramphenicol taste and fluorescein dye disappearance test results and obstruction of the reconstructed lacrimal duct.The total effective rate of the operation was 8/9,with no serious complications.CONCLUSION:Pedicled conjunctival lacrimal duct reconstruction conjunctival dacryocystorhinostomy is safe and effective for superior and inferior canalicular obstruction with conjunctivochalasis.
基金Supported by Natural Science Foundation of Jiangsu Province(No.BK20141346)Nanjing Science and Technology Development Plan(No.201402001)
文摘AIM： To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques： combined conjunctival autograft and overlay amniotic membrane transplantation （CAT with AMT）, conjunctival autograft transplantation （CAT） alone and amniotic membrane transplantation （AMT） alone. METHODS： In this retrospective study, 142 eyes of 142 pterygium patients （104 primary, 38 recurrent）who underwent CAT （group A）, AMT （group B） or CAT with AMT （group C） respectively following surgical excision were reviewed and compared based on the recurrences and post-operative complications. RESULTS： The number of recurrence post-surgery were 17 （9 from primary, 8 from recurrent; the same description below）, 18 （10, 8） and 2 （1, 1） in groups A, B, and C respectively; dry eyes were 22 （16, 6）, 27 （18, 9） and 7 （3, 4）; conjunctival inflammations were 30 （17, 13）, 27 （16, 11） and 11 （6, 5）. Patients in group C （either pdmary or recurrent or both） mainly showed significantly better results than those in group A or B （P〈0.05） regarding above-mentioned clinical effects. CONCLUSION： Combined CAT and overly AMT have significantly lower rates of recurrence and postoperative complications for primary and recurrent pterygium surgery than CAT or AMT alone.
文摘AIM: To study the clinical observation of removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis. METHODS:A retrospective study was done to 10 patients (10 eyes) who had accepted removal of the necrotic corneal tissue combined with conjunctival flap covering surgery for fungal keratitis,the diagnosis by corneal scraping and smear examination or confocal microscopy check hyphae. Local and systemic antifungal therapy more than one week for all patients, corneal ulcer enlarge or no shrink. Slit lamp microscope examination the diameter of corneal ulcer about 2mm-4mm. Anterior segment optical coherence tomography (AS-OCT)examine the depth of corneal ulcer between 1/3-1/2, infiltrate corneal stroma about 20um-80um,the diameter of corneal ulcer about 3mm-6mm.Type-B ultrasonic exclusion endophthalmitis. Complete removal lesions until transparent of stoma, make conjunctival flap equal or greater than ulcer 1mm nearby conjunctiva. Continued antifungal therapy. The vision, fungal recurrence, conjunctival flap rollback or desquamate were analysed. ' RESULTS:Ten patients had success done this surgery, the corneal ulcer was not enlarge and healing afteroperation. 7 cases were bridging conjunctival flap and 3cases were single conjunctival flap. Preoperation vision above 0.1 had 8 cases,7 cases had vision above 0.1 one week after surgery, while 1 cases vision droped from 0.3 to 0.05.There was not recurrent for fungal,2 cases conjunctival flap rollback:1 case was bridging and 1case was single flap, no conjunctival flap desquamate. CONCLUSION: It is safe and effective to perform removal of the necrotic corneal tissue combined with conjunctival flap covering surgery under the guidance of the AS-OCT in treatment of fungal keratitis which werenot sensitive or aggravate for antifungal drugs.
文摘AIM: To report a procedure and results of a two-stage operation to manage intractable extensive orbital implant exposure with a large conjunctival defect which was difficult to treat with dermis fat grafts due to repeated graft necrosis. METHODS: A retrospective chart review of four patients who had extensive orbital implant exposures with large conjunctival defects and had past histories of repeated autologous or preserved dermis graft failures was done. As a first-stage operation, the problematic pre-existing orbital implants were removed and autologous dermis fat grafts alone were performed on the defect area. Four months later, new orbital implants were secondarily inserted after confirmation of graft survival. The size of the conjunctival defects and state of the extraocular muscles were checked preoperatively. Success of the operations and complications were investigated.RESULTS: The mean size of the conjuctival defects was 17.3mm×16.0mm, and the mean time from the initial diagnosis of orbital implant exposure to implant removal and autologous dermis fat graft was 20.8 months. After implant removal and autologous dermis fat graft, no graft necrosis was observed in any patients. Also, implant exposure or fornix shortening was not observed in any patients after new orbital implant insertion. CONCLUSION: The secondary insertion of a new orbital implant after pre-existing implant removal and preceding dermis fat graft is thought to be an another selective management of intractable orbital implant exposure in which dermis fat grafts persistently fail.
基金Supported by the Dirección General de Investigación(SAF 2015-64306-R)the Junta de Castilla y León,Spain(LE283U14)
文摘AIM: To investigate the resistance to bacterial adhesion of materials used in oculoplastic surgery, particularly materials used in the manufacture of orbital implants.METHODS: Seven organisms of conjunctival flora(two strains of Staphylococcus epidermidis and one strain each of Staphylococcus aureus, Staphylococcus hominis, Corynebacterium amycolatum, Acinetobacter calcoaceticus, and Serratia marcescens) were selected. A lactic acid bacterium(Lactobacillus rhamnosus) was also included as positive control because of its well-known adhesion ability. Eight materials used to make oculoplastic prostheses were selected(glass, steel, polytetrafluoroethylene, polymethylmethacrylate, silicone from orbital implants, commercial silicone, porous polyethylene, and semismooth polyethylene). Materials surfaces and biofilms developed by strains were observed by scanning electron microscopy. Kinetics of growth and adhesion of bacterial strains were determined by spectrophotometry. Each strain was incubated in contact with plates of the different materials. After growth, attached bacteria were re-suspended and colony-forming units(CFUs) were counted. The number of CFUs per square millimetre of material was statistically analyzed.RESULTS: A mature biofilm was observed in studied strains except Staphylococcus hominis, which simply produced a microcolony. Materials showed a smooth surface on the microbial scale, although steel exhibited 1.0-μm-diameter grooves. Most organisms showed significant differences in adhesion according to the material. There were also significant differences in thetotal number of CFUs per square millimetre from each material(P=0.044). CFU counts were significantly higher in porous polyethylene than in silicone from orbital implants(P=0.038).CONCLUSION: Silicone orbital implants can resist microbial colonization better than porous polyethylene implants.
基金Supported by a grant from Putuo Hospital affiliated to Shanghai University of Traditional Chinese Medicine(No.2071301A)a fund program from Shanghai University of Traditional Chinese Medicine for incubation of doctor degree(No.B 201708/J-16-11)
文摘AIM： To investigate the effect of long-term use of topically administered latanoprost on conjunctival thickness（CT） and conjunctival epithelium thickness（CET） in the patients with glaucoma. METHODS： A series of 106 glaucomatous patients were included. Of the 106 eyes, 55 eyes were treated with latanoprost eye drops once a day（latanoprost group）, while 51 eyes were treated with carteolol hydrochloride eye drops（carteolol group）. All the included patients completed a 2-year follow-up. CT and CET were measured with optical coherence tomography（OCT） in all patients at presentation and at 2-year visit, respectively. Statistical analysis was then performed to compare the change in CT and CET. RESULTS： At presentation, there was no difference in CET（t=0.400, P=0.689） or CT（t=1.14, P=0.259） between the two groups. No significant difference was found in CET（61.65±5.35 μm at baseline, 60.36±6.36 μm at 2-year follow-up, respectively; t=1.977, P=0.0531）, while there was a significant decrease in CT from 201.45±14.99 μm at baseline to 167.81±14.57 μm at 2-year visit（t=14.1407, P〈0.001） in the latanoprost group. At 2-year follow-up, no statistically difference was found in CET（62.24±5.27 μm; t=1.086, P=0.282） or CT（201.23±12.45 μm; t=1.44, P=0.154） compared to it at baseline（CET： 61.23±5.42 μm; CT： 198.76±13.68 μm, respectively） in the carteolol group. CONCLUSION： A significant decrease in conjunctival thickness is found in glaucoma patients treated with long-term topical latanoprost; its potential effect on the outcome of filtration surgery should be considered.
基金Supported by National Natural Science Foundation of China(No.81700813)Beijing Municipal Administration of Hospitals Qingmiao Projects(No.QML20180205)the Priming Scientific Research Foundation for the Junior Researcher in Beijing Tongren Hospital。
文摘AIM:To examine the effects of sulforaphane on fibrotic changes of transforming growth factor(TGFβ2)induced human conjunctival fibroblast(HCon Fs).METHODS:HCon Fs were cultured and divided into control,TGFβ2(1 ng/m L),sulforaphane and TGFβ2+sulforaphane groups.Cell viability and apoptosis were detected using the MTT and Apo Tox-Glo Triplex assay.Cell migration was detected using scratch and Transwell assay.Real-time quantitative PCR method was used to evaluate m RNA expression of TGFβ2,matrix metalloproteinase-2(MMP2),myosin light chain kinase(MYLK),integrinαV,integrinα5,fibronectin 1 andα-smooth muscle actin(α-SMA).The protein expression ofα-SMA,p-PI3 K,PI3 K,p-Akt,and Akt were detected by Western blot.RESULTS:The proliferation of HCon Fs was significantly(P<0.05)suppressed by sulforaphane compared to control cells with the increase of the concentration and treatment time.Cell proliferation after 48 h incubation was significantly reduced with 100μmol/L sulforaphane treatment by 17.53%(P<0.05).The Transwell assay showed sulforaphane decreased cell migration by 18.73%compared with TGFβ2-induced HCon F(P<0.05).TGFβ2-induced the increasing expression of fibronectin,type I collagen andα-SMA,and the phosphorylation of PI3 K and Akt were all significantly suppressed by sulforaphane pretreatment.CONCLUSION:Sulforaphane inhibits proliferation,migration,and synthesis of the extracellular matrix in HCon Fs,and inhibiting the PI3 K/Akt signaling pathway.Sulforaphane could be a potential therapeutic drug for prevention of scar formation in filtering bleb after trabeculectomy.
文摘AIMTo compare the conjunctival epithelial toxicities of three newer-generation fluoroquinolones without preservatives.METHODSIn a prospective, randomized, double blind comparative study, 47 eyes of 47 patients with a primary pterygium were enrolled, and divided randomly into three groups (levofloxacin 0.5%, gatifloxacin 0.3%, and moxifloxacin 0.5%). After pterygium surgery with the same conjunctival autograft technique, each patient maintained a regimen with a randomly assigned fluoroquinolone eye drop. Patients were examined every other day after surgery until the epithelium had completely healed. Photos were taken and used to measure the area of residual epithelial defects. Conjunctival healing time and speed (initial defect area/healing time (mm<sup>2</sup>/d) compared in each group using Kruskal-Wallis tests.RESULTSThere were no significant differences in mean age, gender, and conjunctival defect size of the donor site between these groups. However, the mean of conjunctival healing time and speed were statistically different in each group. The mean of conjunctival epithelial healing time was 8.93±2.69d (levofloxacin group), 10.31±2.96d (gatifloxacin group), and 13.50±4.10d (moxifloxacin group), P=0.006. The mean conjuctival epithelial healing speed was 6.18±1.39 mm<sup>2</sup>/d (levofloxacin group), 5.52±1.68 mm<sup>2</sup>/d (gatifloxacin group), and 4.40±1.30 mm<sup>2</sup>/d (moxifloxacin group), P=0. 003.CONCLUSIONWithout the influence of preservatives, levofloxacin and gatifloxacin might be less toxic to the regeneration of conjunctival epithelial cells and cause a faster conjunctival wound healing relative to moxifloxacin.
基金Supported by the National Natural Science Foundation of China(No.82171025No.82070934)+2 种基金the Fundamental Research Funds for the Central Universities(No.HUST:2019kfy XMBZ065)the Key Research and Development Program of Hubei Province(No.2021BCA146)the Clinical Research Foundation of Wuhan Union Hospital(No.2021xhlcyj03)。
文摘AIM:To investigate whether the two-step strategy[conjunctival flap covering surgery(CFCS)combined with secondary deep anterior lamellar keratoplasty(DALK)]is effective for patients with high-risk fungal keratitis(FK).METHODS:In this noncomparative,retrospective case series,10 subjects(6 males,4 females)with a mean age of 56.5±7.1(range 47-72)y with high-risk FK undergone the two-step strategy were included.Reported outcome measures were healing of the corneal ulcer,recurrence of FK,reject reaction,improvement in best corrected visual acuity(BCVA)and relevant complications.RESULTS:The average diameter of corneal infiltrates was 7.50±0.39 mm,ranging from 6.94 to 8.13 mm.The mean depth of corneal infiltrates was 422.4±77.1μm,ranging from 350 to 535μm.The mean corneal thickness was 597.4±117.3μm,ranging from 458 to 851μm.Hypopyon and endothelial plaques were presented in all patients.The period between the two steps was 3.65±0.9(ranging from 3 to 5)mo.The graft diameter was 7.75±0.39 mm.At the last follow-up(average 9.25±3.39,ranging from 5.5 to 17mo),no fungal recurrence or graft rejection appeared,and all patients showed improvement of BCVA.One patient suffered from liver function impairment due to oral voriconazole for 4wk and recovered spontaneously after 1wk of drug withdrawal.CONCLUSION:The two-step strategy is safe and effective in the treatment of high-risk FK by transforming intentional therapeutic penetrating keratoplasty during acute infection to later optical DALK.It is a practical strategy,especially in areas lacking fresh donor corneas and eye bank services.
基金Supported by the National Natural Science Foundation of China(No.81770889)the Natural Science Foundation of Guangdong Province(No.2018A030313428)。
文摘AIM:To explore the effects of alarmins produced by necrotic human conjunctival fibroblasts on the release of matrix metalloproteinases(MMPs)by human corneal fibroblasts(HCFs).METHODS:A necrotic cell supernatant(NHCS)was prepared by subjecting human conjunctival fibroblasts to three cycles of freezing and thawing.The amounts of interleukin(IL)-1βand tumor necrosis factor(TNF)-αin NHCS were determined by enzyme-linked immunosorbent assays.HCFs exposed to NHCS or other agents in culture were assayed for the release of MMPs as well as for intracellular signaling by immunoblot analysis.The abundance of MMP m RNAs in HCFs was examined by reverse transcription and real-time polymerase chain reaction analysis.RESULTS:NHCS increased the release of MMP-1 and MMP-3 by HCFs as well as the amounts of the corresponding m RNAs in the cells.NHCS also induced activation of mitogen-activated protein kinase(MAPK)signaling pathways mediated by extracellular signal-regulated kinase(ERK),p38,and c-Jun NH2-terminal kinase(JNK)as well as elicited that of the nuclear factor(NF)-κB signaling pathway by promoting phosphorylation of the endogenous NF-κB inhibitor IκB-α.Inhibitors of MAPK and NF-κB signaling as well as IL-1 and TNF-αreceptor antagonists attenuated the NHCS-induced release of MMP-1 and MMP-3 by HCFs.Furthermore,IL-1βand TNF-αwere both detected in NHCS,and treatment of HCFs with these cytokines induced the release of MMP-1 and MMP-3 in a concentration-dependent manner.CONCLUSION:Alarmins,including IL-1βand TNF-α,produced by necrotic human conjunctival fibroblasts triggered MMP release in HCFs through activation of MAPK and NF-κB signaling.IL-1βand TNF-αare therefore potential therapeutic targets for the amelioration of corneal stromal degradation in severe ocular burns.
基金Supported by the National Natural Science Foundation of China(No.81300798)Natural Science Foundation of Hunan Province(No.2018JJ3737)。
文摘AIM:To explore the ocular features of corona virus disease(COVID)-19 and severe acute respiratory syndrome coronavirus(SARS-CoV)-2 detection in tears and conjunctival scrapes in non-severe COVID-19 patients.METHODS:This is a multicenter observational clinical study with no intervention conducted from Jan 25th to March 1st,2020.Clinical data and samples of tears and conjunctival scraping were collected in consecutive laboratory-confirmed,non-severe COVID-19 patients from three hospitals.COVID-19 virus was analyzed by real-time reverse transcriptase polymerase chain reaction(RT-PCR)kits.RESULTS:Totally 255 laboratory-confirmed,non-severe COVID-19 patients were recruited for ocular manifestation investigation.Of them,54.9%were females,with a mean age of 49.4 y.None of the patients has evidence of uveitis;11 patients(4.3%)complained of mild asthenopia;2(0.8%)had mild conjunctival congestion and serous secretion.Twenty-five of them had performed tears and conjunctival scrape for COVID-19 virus detection,with 4 yield possible positive results in the nucleoprotein gene.One of them were asymptomatic with normal chest CT and positive pharyngeal swab result.CONCLUSION:Ocular manifestations are neither common nor specific in non-severe COVID-19 patients.Meanwhile,COVID-19 virus nucleotides can be detected in the tears and conjunctival scrape samples,warranting further research on the transmissibility by the ocular route.
文摘Dear Editor,I am Dr.Elias F Jarade from the Beirut Eye and ENT Specialist Hospital, Beirut, Lebanon. I write to describe a novel surgical technique in the management of chronic ocular graft-versus-host disease（GVHD）.
基金Supported by the National Natural Science Foundation of China(No.81500719)Shaanxi Science and Technology Project(No.2022SF-434)Xi’an Science and Technology Project(No.21YXYJ0044).
文摘AIM:To evaluate the effectiveness of knock-down of heat shock protein 47(HSP47)on conjunctival bleb scarring in a rat model and its possible mechanism.METHODS:Male Sprague–Dawley rats were used for glaucoma filtration surgery(GFS)and were treated with either phosphate buffered solution,shControl,mitomycin C,or sh-HSP47 using a microsyringe immediately after GFS.The morphology of filtering blebs was observed postoperatively.The levels of HSP47 were analyzed at 2,5,8,and 11d after GFS via real‑time quantitative polymerase chain reaction(PCR)and Western blot.The silencing effect of HSP47,the expression of collagen I and III,and the potential signaling pathways of HSP47 during scarification were explored 11d post GFS.The protein levels of transforming growth factor-β1(TGF-β1),phospho-Smad2(pSmad2),phospho-Smad3(p-Smad3),and phospho-p38(p-p38)were also analyzed using Western blot.RESULTS:Sh-HSP47 treatment significantly prolonged the functional filtration bleb retention.The levels of HSP47 were increased significantly at 5,8,and 11d postoperatively compared to the control group(P<0.05,P<0.01,and P<0.001).The levels of HSP47 protein at day 11 postoperatively were significantly down-regulated after HSP47 silencing using sh-HSP47 adenovirus transfection(P<0.01).Expression levels of collagen I and III within the blebs were significantly reduced in the absence of HSP47(P<0.01).Moreover,the protein levels of TGF-β1,p-Smad2/3,and p-p38 were dramatically inhibited after treatment with sh-HSP47(P<0.01).CONCLUSION:The inhibitory effects of HSP47 knockdown on scarring after GFS have the potential to be an efficacious therapeutic option for the treatment of conjunctival bleb scarring.
