Glaucoma filtration surgery(GFS)stands as the most effective intervention for reducing intraocular pressure,a critical component in glaucoma management.Despite its pivotal role,the scarring of the filtration bleb rema...Glaucoma filtration surgery(GFS)stands as the most effective intervention for reducing intraocular pressure,a critical component in glaucoma management.Despite its pivotal role,the scarring of the filtration bleb remains the primary impediment to successful GFS outcomes.Perioperative utilization of antimitotics,while frontline in combating fibrosis and modulating the wound healing process,carries the risk of vision-threatening complications.Given the complexity of the wound healing cascade and the potential insufficiency of targeting a single molecule,there is an imperative to expand therapeutic modalities through combination therapies.This review offers a comprehensive elucidation of the fibrogenesis post-GFS,a synthesis unprecedented in the available literature,and aims to inform the broadening of therapeutic strategies for GFS.展开更多
Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected fro...Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected from March 2023 to February 2024 in the hospital.Their clinical characteristics and treatment effects were observed and their causes were analyzed.Results:After the operations,the eyes with choroidal detachment after glaucoma surgery had 2 cases of true microphthalmos,6 cases of advanced glaucoma,and 2 cases of glaucoma secondary to vitreoretinal surgery.The postoperative manifestations were persistent shallow anterior chamber,the formation of anterior chamber,and then suddenly became shallow or disappeared.Meanwhile,the intraocular pressure was lower than 6 mmHg.Ultrasound and funduscopic examination showed that the choroid and retina were partially elevated,and the choroidal detachment recovered after treatment.Conclusion:Choroidal detachment is one of the common postoperative complications in glaucoma,especially in some special types of refractory glaucoma.Adequate perioperative management before surgery,cautious and delicate operation during surgery,and close observation and treatment after surgery can obviously decrease the occurrence and damage.展开更多
AIM:To propose a novel glaucoma surgery for rebalancing translaminar pressure difference.METHODS:Three non-human primates with normal eyes and two with laser-induced glaucoma underwent the novel surgical procedure.Can...AIM:To propose a novel glaucoma surgery for rebalancing translaminar pressure difference.METHODS:Three non-human primates with normal eyes and two with laser-induced glaucoma underwent the novel surgical procedure.Cannulation of the subarachnoid space was performed after completion of routine vitrectomy steps.An XEN 45 implant was inserted into the created puncture to communicate between the vitreous body and subarachnoid space.Intraocular pressure(IOP),fundus photography,and spectral-domain optical coherence tomography were assessed at baseline and regular intervals during follow-up.RESULTS:All operated eyes showed IOP reduction in the first postoperative month.Two(2/3)normal eyes and one(1/2)glaucomatous eye maintained lower IOP until 18mo after operation.The XEN 45 implant remained positioned through the lamina cribrosa in all normal eyes but was not detected in two glaucomatous eyes.Complications observed in this study included retinal vascular bleeding in 1/3 normal eyes and XEN implant dislocation in all 2 glaucomatous eyes.CONCLUSION:Subarachnoid space cannulation and mini-shunt implantation may contribute to IOP reduction,possibly by rebalancing translaminar pressure difference and enhancing aqueous humor drainage.The development of a suitable mini-shunt requires further investigation.展开更多
Dear Editor,We present the reported case of steroid-induced glaucoma(SIG)treated by trabeculectome tunneling trabeculoplasty(3T).The 3T procedure is a new minimally invasive glaucoma surgery designed to protect and en...Dear Editor,We present the reported case of steroid-induced glaucoma(SIG)treated by trabeculectome tunneling trabeculoplasty(3T).The 3T procedure is a new minimally invasive glaucoma surgery designed to protect and enhance the function of the trabecular meshwork(TM)while reducing resistance to outflow of atrial fluid^([1]).A 20-year-old male patient experienced an elevation in intraocular pressure(IOP)and subsequently progressed to SIG after continuously using tobramycin-dexamethasone eyedrops for one year.Trabeculotomy of the right eye was performed.展开更多
AIM:To develop a 5-fluorouracil(5-FU)mesoporous poly(lactic)acid(PLA)delivery system for glaucoma filtration surgery suitable for a single subconjunctival implantation.METHODS:The 5-FU was infiltration-loaded into mes...AIM:To develop a 5-fluorouracil(5-FU)mesoporous poly(lactic)acid(PLA)delivery system for glaucoma filtration surgery suitable for a single subconjunctival implantation.METHODS:The 5-FU was infiltration-loaded into mesoporous PLA.In vitro and in vivo release experiments and ocular toxicology evaluation of the formulation were performed.The antiproliferative effect of this 5-FU-PLA tablet after glaucoma filtration surgery in rabbits was evaluated.Pathology,immunohistochemistry,and Western blot were used to further validate the inhibitory effect of this sustained release system.RESULTS:Various drug formulations were tested,and two 5-FU-PLA tablets,namely 1.5P15(5-FU 1.5 mg+PLA 15000 Da)and 2.5P15(5-FU 2.5 mg+PLA 15000 Da),had the most suitable release profiles in vitro.Further in vivo studies confirmed the safety and sustained-release profiles of both drugs.Both 5-FU-PLA tablets,relative to the free drugs,significantly inhibited tissue proliferation after glaucoma filtration and improved surgical success.Western blot showed that transforming growth factor-β(TGF-β)and connective tissue growth factor(CTGF)were inhibited by 5-FU after filtration surgery,with the effects of the 5-FU-PLA tablets being more lasting.CONCLUSION:The tested 5-FU-PLA tablets provide a sustained release of 5-FU,which may be used for a single subconjunctival implantation to inhibit proliferation after filtration surgery.展开更多
Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow ...Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.展开更多
Dear Editor,We present the reported case of repetitive bilateral suprachoroidal expulsive hemorrhage(SEH)after anti-glaucoma surgeries.SEH is a rare but potentially devastating complication of intraocular surgery.Long...Dear Editor,We present the reported case of repetitive bilateral suprachoroidal expulsive hemorrhage(SEH)after anti-glaucoma surgeries.SEH is a rare but potentially devastating complication of intraocular surgery.Long-term ocular hypertension,high myopia,older age,arterial sclerosis,and aphakia have been reported as preoperative risk factors for developing SEH^([1]).The prognosis for the visual acuity is poor without proper management.A suggested time for surgical drainage is said to be 10-14d when the hemorrhagic clot begins to liquefy^([2]).展开更多
AIM:To present a case series of rapid-onset neovascular glaucoma(NVG)accompanied by vitreous haemorrhage(VH)following cataract surgery in diabetic patients,and to evaluate the efficacy of pars plana vitrectomy(PPV)com...AIM:To present a case series of rapid-onset neovascular glaucoma(NVG)accompanied by vitreous haemorrhage(VH)following cataract surgery in diabetic patients,and to evaluate the efficacy of pars plana vitrectomy(PPV)combined with Ahmed glaucoma valve(AGV)implantation.METHODS:This is a retrospective,single-center,consecutive case series.All patients underwent 23-gauge PPV with AGV implantation 2–3d after intravitreal ranibizumab injection(IVR).The minimum postoperative follow-up period lasted 12mo.The primary outcome measures included bestcorrected visual acuity(BCVA),intraocular pressure(IOP),and topical hypotensive medications.RESULTS:Fifteen diabetic patients(age,46–81y)with rapid-onset NVG and VH following uncomplicated phacoemulsification were included.The median time to the initial NVG diagnosis following cataract surgery was within 4wk.After PPV combined with AGV implantation,the mean BCVA(logMAR)improved from 1.9(range:1.0 to 2.6)preoperatively to 1.2(range:0.2 to 2.6)at the final follow-up.Baseline BCVA and the presence of diabetic nephropathy(DN)were significantly associated with the final BCVA in the multiple regression model.The mean postoperative IOP at all follow-up visits was significantly reduced compared to baseline.At the final follow-up,9 patients required one or two topical ocular hypotensive medications,while the other 6 needed not.Success was achieved in 87%,and the reoperation rate was 20%.The majority of NVG cases(9/15)were primarily attributed to the rapid progression of proliferative diabetic retinopathy.However,a notable subset(6 eyes)was complicated retinal vein occlusion or carotid artery occlusion.CONCLUSION:PPV combined with AGV implantation after adjuvant IVR for rapid-onset NVG with VH following diabetic cataract surgery is one of the safe and effective treatments.Baseline BCVA and preexisting DN may be potential indicators for visual outcomes.展开更多
AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current resea...AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current research international trends and hot topics in this area.METHODS:Bibliometric analysis was conducted on 9128 articles in the Web of Science Core Collection(WoSCC;Clarivate)database.Quantitative and qualitative analysis was employed using VOSviewer(v1.6.18),Pajek(v1.0.0.0),and CiteSpace(v6.1.R2)software.RESULTS:The 9128 papers relating to glaucoma treatment were published from April 2013 to April 2023,of which 7482 articles(82%)were original research articles and 1464(18%)were review articles.The United States(2867)and Johns Hopkins University(166)were the most productive country and institution,respectively,but the University College London had the highest h-index(54).The Journal of Glaucoma was the most productive and Ophthalmology had the highest h-index compared with other journals.The Keywords of interest included treatment surgery,cyclophotocoagulation,minimally invasive glaucoma surgery(MIGS),trabeculectomy,baerveldt,epidemiology,medication adherence,nanoparticle,optical coherence tomography(OCT),gene therapy,and artificial intelligence(AI).Glaucoma surgery appeared as a current research hotspot through the analysis of keywords.CONCLUSION:This study provides insights into the research trends and potential research hotspots in the treatment of glaucoma.This will help researchers to evaluate research policies and to promote international cooperation.展开更多
AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glauc...AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).METHODS:This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023,and 45 eyes underwent goniotomy combined with phacoemulsification,and 15 eyes underwent goniotomy as a stand-alone procedure.Postoperatively,intraocular pressure(IOP)and the number of medications were collected at 1,3,6,and 12 mo.The side effects of surgery were recorded 1 d,1 wk,and 1,3,6,and 12 mo postoperatively.The primary outcomes were a reduction in IOP of at least 20%from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively.The secondary outcome was surgical success,defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.RESULTS:At the end of 1 a,78%of patients achieved both a>20%reduction in IOP and a reduction in the number of medications used.Overall success was achieved in 63%of patients.Microhyphaema was the most common complication,none of the patients experienced a complication requiring surgical intervention.CONCLUSION:Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG,and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.展开更多
The development of pancreatic surgery in China has progressed remarkably over 7 decades.China initiated its pancreatic surgery journey in the 1950s,marked by the first pancreaticoduodenectomy performed by Zeng Xianjiu...The development of pancreatic surgery in China has progressed remarkably over 7 decades.China initiated its pancreatic surgery journey in the 1950s,marked by the first pancreaticoduodenectomy performed by Zeng Xianjiu in 1951.Early progress was hindered by technological limitations and fragmented practices,but the establishment of academic platforms such as the National Pancreatic Disease Symposia in the 1980s catalyzed standardized research and interdisciplinary collaboration.In 2006,Zhang Shengdao spearheaded China’s first Guidelines for the Diagnosis and Treatment of Severe Acute Pancreatitis.The 21st century has seen remarkable progress in pancreatic surgery,marked by the China-specific treatment guidelines,technological breakthroughs in laparoscopic and robotic surgical systems,and the increasing centralization of pancreatic surgery in high-volume medical centers.These synergistic advancements have collectively propelled a paradigm shift in contemporary cancer care.By 2022,China Pancreas Data Center reported a postoperative mortality rate of 0.4% and 3-year survival rates of 43% for resected pancreatic cancer,rivaling global benchmarks.China has also emerged as a leader in minimally invasive pancreatic surgery,with advancements in laparoscopic and robotic pancreatic surgery.Academic growth paralleled clinical progress:the Chinese Pancreatic Association,established in 2022,fosters global collaboration,evidenced by its 2024 annual conference attracting over 10,000 participants.Through technological innovation,centralized care models,and international partnerships,China continues to redefine its role in advancing pancreatic surgery.展开更多
The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which...The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.展开更多
Globally,glaucoma stands as a primary cause of irreversible blindness,marked by intricate pathophysiological processes in which neuroinflammation plays a pivotal role.As the principal immune cells within the central n...Globally,glaucoma stands as a primary cause of irreversible blindness,marked by intricate pathophysiological processes in which neuroinflammation plays a pivotal role.As the principal immune cells within the central nervous system,microglia play a dual function in the progression of glaucoma.Under standard physiological states,microglia safeguard the retina by offering neurotrophic support and removing cellular debris.In the pathological progression of glaucoma,microglia become activated and release significant levels of inflammatory factors,resulting in retinal ganglion cell injury,cell death,and impaired neuroregeneration.This review focuses on examining the dual functions of microglia in glaucoma,evaluating their influence on retinal neurodegeneration and repair,and suggesting that modulating microglial activity could serve as a promising therapeutic strategy.Understanding the mechanisms of microglial action in glaucoma is crucial for unveiling the complex pathophysiological processes of the disease and developing new therapeutic strategies.展开更多
AIM:To investigate the etiology and clinical characteristics of hospitalized secondary glaucoma(SG)patients in northwestern China.METHODS:A cross-sectional study was conducted involving SG patients hospitalized betwee...AIM:To investigate the etiology and clinical characteristics of hospitalized secondary glaucoma(SG)patients in northwestern China.METHODS:A cross-sectional study was conducted involving SG patients hospitalized between July 2024 and January 2025.Clinical data were collected,including medical history,best-corrected visual acuity(BCVA),intraocular pressure(IOP),slit-lamp examination,gonioscopic findings,and fundus examination.Demographic characteristics,etiological factors,and treatment modalities were analyzed.RESULTS:A total of 67 patients(82 eyes)were enrolled,aged 7 to 90y.Males accounted for 54.0%(36/67),and 22.4%(15/67)of patients had bilateral involvement.The predominant etiologies of SG were neovascular glaucoma(NVG;25.4%),traumatic glaucoma(23.9%),uveitic glaucoma(20.9%),and lens-induced glaucoma(14.9%),collectively accounting for 85.1%of all cases.The peak age-specific incidence occurred in the 50-59 years age group(32.8%,22/67),while NVG was prevalent across the 40-79 years age range.IOP of the 82 affected eyes was stratified into five severity tiers:22-29 mm Hg(15 eyes,18.3%),30-39 mm Hg(14 eyes,17.1%),40-49 mm Hg(13 eyes,15.9%),50-59 mm Hg(20 eyes,24.4%),and≥60 mm Hg(20 eyes,24.4%).The overall mean IOP was 45.2±12.3 mm Hg,indicating a significant pathological elevation.Surgical intervention was required in 46.3%of cases,predominantly for NVG,lensinduced glaucoma,and traumatic glaucoma—conditions prone to rapid IOP elevation.The etiologies with the highest surgical intervention rates were malignant glaucoma,pigmentary glaucoma,lens-induced glaucoma,and NVG.In contrast,uveitic glaucoma cases were primarily managed with targeted anti-inflammatory therapy,which effectively controlled IOP in the early disease stages and potentially obviated the need for surgery.CONCLUSION:This study identifies NVG,traumatic glaucoma,uveitic glaucoma,and lens-induced glaucoma as the four leading etiologies of SG in Northwestern China.These findings emphasize the critical need for targeted prevention strategies and evidence-based health education programs among high-risk populations.Implementation of such initiatives will improve early detection,enable ophthalmologists to deliver timely therapeutic interventions,and ultimately reduce preventable vision loss in this region.展开更多
AIM:To identify early biomarkers associated with glaucomatous visual field(VF)progression in patients with normal-tension glaucoma(NTG).METHODS:This study included patients were divided into two groups based on diseas...AIM:To identify early biomarkers associated with glaucomatous visual field(VF)progression in patients with normal-tension glaucoma(NTG).METHODS:This study included patients were divided into two groups based on disease progression status.Tear samples were collected for proteomic analysis.Dataindependent acquisition(DIA)mass spectrometry combined with bioinformatic analyses was performed to identify and validate potential protein biomarkers for NTG progression.Additionally,differentially expressed proteins(DEPs)were evaluated using mediating effect models and receiver operating characteristic(ROC)curve analysis.RESULTS:A total of 19 patients(20 eyes)with NTG participated in this study,including 10 patients(4 males and 6 females;10 eyes)in the progression group with mean age of 67.70±9.03y and 10 patients(4 males and 6 females;10 eyes)in the non-progression group with mean age of 68.60±7.58y.A total of 158 significantly differentially expressed proteins were detected.UniProt database annotation identified 3 upregulated proteins and 12 downregulated proteins.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis showed that these DEPs were mainly enriched in pathways such as oocyte meiosis.Gene Ontology(GO)enrichment analysis revealed functional clusters related to cellular processes.Weighted gene coexpression network analysis(WGCNA)indicated that the core proteins were primarily involved in the neurodegenerationmultiple diseases pathway and cellular processes.Mediating effect analysis identified PRDX4(L)as a potential protein biomarker.ROC curve analysis showed that GNAI1 had the largest area under the curve(AUC=0.889).CONCLUSION:This study identifies 15 differentially expressed proteins in the tear fluid of NTG patients,including PRDX4(L).PRDX4(L)plays a key role in oxidative stress.展开更多
Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive ca...Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive cardiothoracic surgery in our hospital from June 2024 to December 2024 were selected as the research objects.They were divided into the light anesthesia group(n=45)and the deep anesthesia group(n=44).The vital signs at different intraoperative nodes and perioperative stress status of the two groups were compared.Results:Before lesion resection and after surgery,the mean arterial pressure and heart rate of the deep anesthesia group were lower than those of the light anesthesia group,with statistically significant differences.Conclusion:In thoracoscopic minimally invasive cardiothoracic surgery,deep anesthesia can effectively control the patient’s surgical stress response,but the postoperative awakening time is longer;patients under light anesthesia have a shorter awakening time,but the intraoperative stress response is obvious.展开更多
AIM:To perform a bibliometric analysis of publications focusing on inflammatory mechanisms in glaucoma,thereby comprehensively understanding the current research status and identifying potential frontier directions fo...AIM:To perform a bibliometric analysis of publications focusing on inflammatory mechanisms in glaucoma,thereby comprehensively understanding the current research status and identifying potential frontier directions for future studies.METHODS:A systematic search was conducted in the Web of Science Core Collection(WoSCC)database to retrieve relevant literature published from January 1,2000,to August 31,2025(data accessed on September 12,2025).Multiple data visualization tools were employed to conduct in-depth analyses of the included publications,covering aspects such as publication quantity and quality,evolutionary trends of research hotspots,keyword cooccurrence networks,and collaborative patterns among countries/regions,institutions,and authors.RESULTS:A total of 3381 articles related to glaucoma inflammation were extracted from WoSCC.The analysis showed that the USA had the highest research output in this field(29.04%,n=982),followed by China(18.40%,n=622)and UK(6.01%,n=203).Based on citation frequency and burst intensity,the USA also ranked as the most influential country.Baudouin C and Sun X were identified as the most productive authors,while Journal of Glaucoma and Investigative Ophthalmology&Visual Science were the journals with the highest number of published relevant articles.Additionally,keyword analysis revealed that“neuroinflammation”,“retinal ganglion cells(RGCs)”,“pathophysiology”,and“traditional Chinese medicine”are emerging research hotspots in the field of immuneinflammatory responses in glaucoma.CONCLUSION:This study presents a comprehensive bibliometric overview of research on glaucoma-related inflammation,indicating that this field has received extensive scientific attention with a steady upward trend in research activity.Furthermore,it establishes a theoretical basis for the development of neuroinflammation-targeted therapeutic strategies for glaucoma and emphasizes the necessity of strengthening interdisciplinary collaboration to promote the clinical translation of research findings.展开更多
AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and ...AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and randomized controlled trial was conducted.Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group.In GM group,the range of peripheral anterior synechiae(PAS)was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation(PEI).PAS was separated only under a microscope.After separating the closed angle of 360°by this method,we used a surgical gonioscope to confirm the PAS range.If any remaining PAS was present,we would separate them with an iris repositor under the direct gonio-lens until angle of 360°was reopened.In GG group,PAS was separated under direct gonioscopy after PEI until angle of 360°was reopened.The range of residual PAS after GSLs was the primary outcome.Intraoperative complications(hyphema),intraocular pressure(IOP)and anti-glaucoma medication usage after operation were the secondary outcomes.RESULTS:Sixty eyes were included,each group comprising 30 eyes.The average age[GM group:66.3±6.8y(12 males),GG group:67.6±8.9y(7 males),P=0.550],the baseline IOP(GM group:29.6±11.5 mm Hg,GG group:32.4±12.2 mm Hg,P=0.366)and the average initial PAS extent(GM group:8.9±2.6h,GG group:9.4±2.5h,P=0.425)were similar in the two groups.In GM group,the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL.In GG group,the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL.The PAS after PEI was significantly reduced compared to the preoperative PAS in both groups(all P<0.001).The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference(P<0.001).Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy.The difference of hyphema grade between the two groups was statistically significant(P=0.019).CONCLUSION:PEI alone can not open 360°of angle completely.PEI+GSL significantly reduced PAS range.But for patients with CACG,GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.展开更多
Interaction between Müller cells and microglia aggravates neuroinflammation,resulting in retinal ganglion cell(RGC)death in glaucoma.Here,we investigated how tumor necrosis factor-alpha(TNF-α)produced by activat...Interaction between Müller cells and microglia aggravates neuroinflammation,resulting in retinal ganglion cell(RGC)death in glaucoma.Here,we investigated how tumor necrosis factor-alpha(TNF-α)produced by activated microglia mediates the crosstalk between Müller cells and microglia and impacts RGC injury in a chronic ocular hypertension(COH)glaucoma model.In COH retinas,elevated TNF-αinduced the activation of Müller cells and microglia,and recruited microglia to the ganglion cell layer.Co-culture with Müller cells enhanced TNF-α-induced microglial activation,migration,and proliferation.Both in vivo and in vitro experiments confirmed that chemokine C-C motif ligand 2(CCL2),primarily released from Müller cells,mediated the TNF-α-induced effects on microglia in COH retinas.Knockdown of CCL2 attenuated RGC damage and vision loss.Our results demonstrate that TNF-αreleased from microglia induces the secretion of CCL2 from Müller cells,thus inducing microglial activation and migration,exacerbating retinal neuroinflammation and RGC injury in glaucoma.展开更多
With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Lap...With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC.展开更多
基金Supported by Hospital Level Project of the Eye Hospital of China Academy of Chinese Medical Sciences(No.GSP5-40)Internal Project of the Eye Hospital of China Academy of Chinese Medical Sciences(No.1011632).
文摘Glaucoma filtration surgery(GFS)stands as the most effective intervention for reducing intraocular pressure,a critical component in glaucoma management.Despite its pivotal role,the scarring of the filtration bleb remains the primary impediment to successful GFS outcomes.Perioperative utilization of antimitotics,while frontline in combating fibrosis and modulating the wound healing process,carries the risk of vision-threatening complications.Given the complexity of the wound healing cascade and the potential insufficiency of targeting a single molecule,there is an imperative to expand therapeutic modalities through combination therapies.This review offers a comprehensive elucidation of the fibrogenesis post-GFS,a synthesis unprecedented in the available literature,and aims to inform the broadening of therapeutic strategies for GFS.
基金Key Research and Development Program of Hubei Province(Project No.:2021BCA125)。
文摘Purpose:To summarize and analyze the clinical features and management of postoperative choroidal detachment in glaucoma.Methods:Ten cases of choroidal detachment that occurred after glaucoma surgery were collected from March 2023 to February 2024 in the hospital.Their clinical characteristics and treatment effects were observed and their causes were analyzed.Results:After the operations,the eyes with choroidal detachment after glaucoma surgery had 2 cases of true microphthalmos,6 cases of advanced glaucoma,and 2 cases of glaucoma secondary to vitreoretinal surgery.The postoperative manifestations were persistent shallow anterior chamber,the formation of anterior chamber,and then suddenly became shallow or disappeared.Meanwhile,the intraocular pressure was lower than 6 mmHg.Ultrasound and funduscopic examination showed that the choroid and retina were partially elevated,and the choroidal detachment recovered after treatment.Conclusion:Choroidal detachment is one of the common postoperative complications in glaucoma,especially in some special types of refractory glaucoma.Adequate perioperative management before surgery,cautious and delicate operation during surgery,and close observation and treatment after surgery can obviously decrease the occurrence and damage.
文摘AIM:To propose a novel glaucoma surgery for rebalancing translaminar pressure difference.METHODS:Three non-human primates with normal eyes and two with laser-induced glaucoma underwent the novel surgical procedure.Cannulation of the subarachnoid space was performed after completion of routine vitrectomy steps.An XEN 45 implant was inserted into the created puncture to communicate between the vitreous body and subarachnoid space.Intraocular pressure(IOP),fundus photography,and spectral-domain optical coherence tomography were assessed at baseline and regular intervals during follow-up.RESULTS:All operated eyes showed IOP reduction in the first postoperative month.Two(2/3)normal eyes and one(1/2)glaucomatous eye maintained lower IOP until 18mo after operation.The XEN 45 implant remained positioned through the lamina cribrosa in all normal eyes but was not detected in two glaucomatous eyes.Complications observed in this study included retinal vascular bleeding in 1/3 normal eyes and XEN implant dislocation in all 2 glaucomatous eyes.CONCLUSION:Subarachnoid space cannulation and mini-shunt implantation may contribute to IOP reduction,possibly by rebalancing translaminar pressure difference and enhancing aqueous humor drainage.The development of a suitable mini-shunt requires further investigation.
基金Supported by Sichuan Provincial Administration of Traditional Chinese Medicine(No.2024MS471)。
文摘Dear Editor,We present the reported case of steroid-induced glaucoma(SIG)treated by trabeculectome tunneling trabeculoplasty(3T).The 3T procedure is a new minimally invasive glaucoma surgery designed to protect and enhance the function of the trabecular meshwork(TM)while reducing resistance to outflow of atrial fluid^([1]).A 20-year-old male patient experienced an elevation in intraocular pressure(IOP)and subsequently progressed to SIG after continuously using tobramycin-dexamethasone eyedrops for one year.Trabeculotomy of the right eye was performed.
基金Supported by the National Natural Science Foundation of China(No.82301211)Beijing Natural Science Foundation(No.J230028).
文摘AIM:To develop a 5-fluorouracil(5-FU)mesoporous poly(lactic)acid(PLA)delivery system for glaucoma filtration surgery suitable for a single subconjunctival implantation.METHODS:The 5-FU was infiltration-loaded into mesoporous PLA.In vitro and in vivo release experiments and ocular toxicology evaluation of the formulation were performed.The antiproliferative effect of this 5-FU-PLA tablet after glaucoma filtration surgery in rabbits was evaluated.Pathology,immunohistochemistry,and Western blot were used to further validate the inhibitory effect of this sustained release system.RESULTS:Various drug formulations were tested,and two 5-FU-PLA tablets,namely 1.5P15(5-FU 1.5 mg+PLA 15000 Da)and 2.5P15(5-FU 2.5 mg+PLA 15000 Da),had the most suitable release profiles in vitro.Further in vivo studies confirmed the safety and sustained-release profiles of both drugs.Both 5-FU-PLA tablets,relative to the free drugs,significantly inhibited tissue proliferation after glaucoma filtration and improved surgical success.Western blot showed that transforming growth factor-β(TGF-β)and connective tissue growth factor(CTGF)were inhibited by 5-FU after filtration surgery,with the effects of the 5-FU-PLA tablets being more lasting.CONCLUSION:The tested 5-FU-PLA tablets provide a sustained release of 5-FU,which may be used for a single subconjunctival implantation to inhibit proliferation after filtration surgery.
基金Supported by the National Key Research and Development Program(No.2019YFC1710200)the Shandong Province Pharmaceutical Technology Development Project(No.202107020970).
文摘Dear Editor,The latest Visian implantable collamer lens(ICL)with a central port design(Aquaport;model V4c)obviates the necessity for preoperative laser iridotomy or intraoperative iridectomy by allowing the free flow of the aqueous humor between the sides of the intraocular lens.The design of Aquaport can also eliminate the complications associated with iridotomy and iridectomy.Therefore,the V4c ICL has the potential to significantly reduce the risk of pupillary block compared to its predecessors.
基金Supported by National Natural Science Foundation of China(No.82171087No.82201228)+1 种基金Natural Science Foundation of Hunan Province(No.2024JJ6570)the Scientific Research Launch Project for new employees of the Second Xiangya Hospital of Central South University.
文摘Dear Editor,We present the reported case of repetitive bilateral suprachoroidal expulsive hemorrhage(SEH)after anti-glaucoma surgeries.SEH is a rare but potentially devastating complication of intraocular surgery.Long-term ocular hypertension,high myopia,older age,arterial sclerosis,and aphakia have been reported as preoperative risk factors for developing SEH^([1]).The prognosis for the visual acuity is poor without proper management.A suggested time for surgical drainage is said to be 10-14d when the hemorrhagic clot begins to liquefy^([2]).
基金Supported by Shanghai Municipal Health Commission(No.202140183).
文摘AIM:To present a case series of rapid-onset neovascular glaucoma(NVG)accompanied by vitreous haemorrhage(VH)following cataract surgery in diabetic patients,and to evaluate the efficacy of pars plana vitrectomy(PPV)combined with Ahmed glaucoma valve(AGV)implantation.METHODS:This is a retrospective,single-center,consecutive case series.All patients underwent 23-gauge PPV with AGV implantation 2–3d after intravitreal ranibizumab injection(IVR).The minimum postoperative follow-up period lasted 12mo.The primary outcome measures included bestcorrected visual acuity(BCVA),intraocular pressure(IOP),and topical hypotensive medications.RESULTS:Fifteen diabetic patients(age,46–81y)with rapid-onset NVG and VH following uncomplicated phacoemulsification were included.The median time to the initial NVG diagnosis following cataract surgery was within 4wk.After PPV combined with AGV implantation,the mean BCVA(logMAR)improved from 1.9(range:1.0 to 2.6)preoperatively to 1.2(range:0.2 to 2.6)at the final follow-up.Baseline BCVA and the presence of diabetic nephropathy(DN)were significantly associated with the final BCVA in the multiple regression model.The mean postoperative IOP at all follow-up visits was significantly reduced compared to baseline.At the final follow-up,9 patients required one or two topical ocular hypotensive medications,while the other 6 needed not.Success was achieved in 87%,and the reoperation rate was 20%.The majority of NVG cases(9/15)were primarily attributed to the rapid progression of proliferative diabetic retinopathy.However,a notable subset(6 eyes)was complicated retinal vein occlusion or carotid artery occlusion.CONCLUSION:PPV combined with AGV implantation after adjuvant IVR for rapid-onset NVG with VH following diabetic cataract surgery is one of the safe and effective treatments.Baseline BCVA and preexisting DN may be potential indicators for visual outcomes.
基金Suppotred by Tianjin Key Medical Discipline Construction Project(No.TJYXZDXK-3-004A-2).
文摘AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current research international trends and hot topics in this area.METHODS:Bibliometric analysis was conducted on 9128 articles in the Web of Science Core Collection(WoSCC;Clarivate)database.Quantitative and qualitative analysis was employed using VOSviewer(v1.6.18),Pajek(v1.0.0.0),and CiteSpace(v6.1.R2)software.RESULTS:The 9128 papers relating to glaucoma treatment were published from April 2013 to April 2023,of which 7482 articles(82%)were original research articles and 1464(18%)were review articles.The United States(2867)and Johns Hopkins University(166)were the most productive country and institution,respectively,but the University College London had the highest h-index(54).The Journal of Glaucoma was the most productive and Ophthalmology had the highest h-index compared with other journals.The Keywords of interest included treatment surgery,cyclophotocoagulation,minimally invasive glaucoma surgery(MIGS),trabeculectomy,baerveldt,epidemiology,medication adherence,nanoparticle,optical coherence tomography(OCT),gene therapy,and artificial intelligence(AI).Glaucoma surgery appeared as a current research hotspot through the analysis of keywords.CONCLUSION:This study provides insights into the research trends and potential research hotspots in the treatment of glaucoma.This will help researchers to evaluate research policies and to promote international cooperation.
文摘AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).METHODS:This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023,and 45 eyes underwent goniotomy combined with phacoemulsification,and 15 eyes underwent goniotomy as a stand-alone procedure.Postoperatively,intraocular pressure(IOP)and the number of medications were collected at 1,3,6,and 12 mo.The side effects of surgery were recorded 1 d,1 wk,and 1,3,6,and 12 mo postoperatively.The primary outcomes were a reduction in IOP of at least 20%from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively.The secondary outcome was surgical success,defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.RESULTS:At the end of 1 a,78%of patients achieved both a>20%reduction in IOP and a reduction in the number of medications used.Overall success was achieved in 63%of patients.Microhyphaema was the most common complication,none of the patients experienced a complication requiring surgical intervention.CONCLUSION:Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG,and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.
文摘The development of pancreatic surgery in China has progressed remarkably over 7 decades.China initiated its pancreatic surgery journey in the 1950s,marked by the first pancreaticoduodenectomy performed by Zeng Xianjiu in 1951.Early progress was hindered by technological limitations and fragmented practices,but the establishment of academic platforms such as the National Pancreatic Disease Symposia in the 1980s catalyzed standardized research and interdisciplinary collaboration.In 2006,Zhang Shengdao spearheaded China’s first Guidelines for the Diagnosis and Treatment of Severe Acute Pancreatitis.The 21st century has seen remarkable progress in pancreatic surgery,marked by the China-specific treatment guidelines,technological breakthroughs in laparoscopic and robotic surgical systems,and the increasing centralization of pancreatic surgery in high-volume medical centers.These synergistic advancements have collectively propelled a paradigm shift in contemporary cancer care.By 2022,China Pancreas Data Center reported a postoperative mortality rate of 0.4% and 3-year survival rates of 43% for resected pancreatic cancer,rivaling global benchmarks.China has also emerged as a leader in minimally invasive pancreatic surgery,with advancements in laparoscopic and robotic pancreatic surgery.Academic growth paralleled clinical progress:the Chinese Pancreatic Association,established in 2022,fosters global collaboration,evidenced by its 2024 annual conference attracting over 10,000 participants.Through technological innovation,centralized care models,and international partnerships,China continues to redefine its role in advancing pancreatic surgery.
文摘The year 2025 marked a significantmilestone for Laparoscopic,Endoscopic and Robotic Surgery(LERS)—we have awarded our first Impact Factor of 2.0 released by the Journal Citation Reports from Clarivate Analytics,which ranks in the second quartile in the surgery category.This remarkable achievement,which reflects LERS’s steadily increasing influencein the area of surgery,would not be possible without the peer reviewer’s invaluable contributions.On behalf of the Editorial Board and Editorial Office,we would express our sincere appreciation to the following reviewers,who reviewed at least one paper with rigorous and insightful comments.We sincerely hope to engage further with them,either as esteemed reviewers or outstanding authors,in 2026 and beyond.
基金supported by the Deutsche Forschungsgemeinschaft(DFG)with grants PR1569/1-1 and PR 1569/1-3(to VP).
文摘Globally,glaucoma stands as a primary cause of irreversible blindness,marked by intricate pathophysiological processes in which neuroinflammation plays a pivotal role.As the principal immune cells within the central nervous system,microglia play a dual function in the progression of glaucoma.Under standard physiological states,microglia safeguard the retina by offering neurotrophic support and removing cellular debris.In the pathological progression of glaucoma,microglia become activated and release significant levels of inflammatory factors,resulting in retinal ganglion cell injury,cell death,and impaired neuroregeneration.This review focuses on examining the dual functions of microglia in glaucoma,evaluating their influence on retinal neurodegeneration and repair,and suggesting that modulating microglial activity could serve as a promising therapeutic strategy.Understanding the mechanisms of microglial action in glaucoma is crucial for unveiling the complex pathophysiological processes of the disease and developing new therapeutic strategies.
基金Supported by the National Natural Science Foundation of China(No.82070964,No.82571210)Shaanxi Science Fund for Distinguished Young Scholars(No.2022JC-60)+3 种基金the International Scientific and Technological Cooperation Projects(No.2024GH-YBXM-20)the Open Research Funds of the State Key Laboratory of Ophthalmology(No.83000-32030002)Education Department of Shaanxi Provincial Government for Youth Innovation Team Research Program Project(No.23JP151,No.23JP150)General Projects of Hospital-level Research Topics in the Second Affiliated Hospital of Xi’an Medical University(No.22KY0111).
文摘AIM:To investigate the etiology and clinical characteristics of hospitalized secondary glaucoma(SG)patients in northwestern China.METHODS:A cross-sectional study was conducted involving SG patients hospitalized between July 2024 and January 2025.Clinical data were collected,including medical history,best-corrected visual acuity(BCVA),intraocular pressure(IOP),slit-lamp examination,gonioscopic findings,and fundus examination.Demographic characteristics,etiological factors,and treatment modalities were analyzed.RESULTS:A total of 67 patients(82 eyes)were enrolled,aged 7 to 90y.Males accounted for 54.0%(36/67),and 22.4%(15/67)of patients had bilateral involvement.The predominant etiologies of SG were neovascular glaucoma(NVG;25.4%),traumatic glaucoma(23.9%),uveitic glaucoma(20.9%),and lens-induced glaucoma(14.9%),collectively accounting for 85.1%of all cases.The peak age-specific incidence occurred in the 50-59 years age group(32.8%,22/67),while NVG was prevalent across the 40-79 years age range.IOP of the 82 affected eyes was stratified into five severity tiers:22-29 mm Hg(15 eyes,18.3%),30-39 mm Hg(14 eyes,17.1%),40-49 mm Hg(13 eyes,15.9%),50-59 mm Hg(20 eyes,24.4%),and≥60 mm Hg(20 eyes,24.4%).The overall mean IOP was 45.2±12.3 mm Hg,indicating a significant pathological elevation.Surgical intervention was required in 46.3%of cases,predominantly for NVG,lensinduced glaucoma,and traumatic glaucoma—conditions prone to rapid IOP elevation.The etiologies with the highest surgical intervention rates were malignant glaucoma,pigmentary glaucoma,lens-induced glaucoma,and NVG.In contrast,uveitic glaucoma cases were primarily managed with targeted anti-inflammatory therapy,which effectively controlled IOP in the early disease stages and potentially obviated the need for surgery.CONCLUSION:This study identifies NVG,traumatic glaucoma,uveitic glaucoma,and lens-induced glaucoma as the four leading etiologies of SG in Northwestern China.These findings emphasize the critical need for targeted prevention strategies and evidence-based health education programs among high-risk populations.Implementation of such initiatives will improve early detection,enable ophthalmologists to deliver timely therapeutic interventions,and ultimately reduce preventable vision loss in this region.
基金Supported by The Eye Hospital of Wenzhou Medical University(No.KYQD20220304)The Fifth Batch of Provincial Ten Thousand Personnel Program Outstanding Talents Funding(No.474092204)+1 种基金Innovative Talents and Teams(2024)-The Fifth Batch of Funding Funds for Scientific and Technological Innovation Leading Talents Under the Provincial Ten Thousand Personnel Program(No.4240924003G)The Key R&D Program of Zhejiang(No.2022C03112).
文摘AIM:To identify early biomarkers associated with glaucomatous visual field(VF)progression in patients with normal-tension glaucoma(NTG).METHODS:This study included patients were divided into two groups based on disease progression status.Tear samples were collected for proteomic analysis.Dataindependent acquisition(DIA)mass spectrometry combined with bioinformatic analyses was performed to identify and validate potential protein biomarkers for NTG progression.Additionally,differentially expressed proteins(DEPs)were evaluated using mediating effect models and receiver operating characteristic(ROC)curve analysis.RESULTS:A total of 19 patients(20 eyes)with NTG participated in this study,including 10 patients(4 males and 6 females;10 eyes)in the progression group with mean age of 67.70±9.03y and 10 patients(4 males and 6 females;10 eyes)in the non-progression group with mean age of 68.60±7.58y.A total of 158 significantly differentially expressed proteins were detected.UniProt database annotation identified 3 upregulated proteins and 12 downregulated proteins.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis showed that these DEPs were mainly enriched in pathways such as oocyte meiosis.Gene Ontology(GO)enrichment analysis revealed functional clusters related to cellular processes.Weighted gene coexpression network analysis(WGCNA)indicated that the core proteins were primarily involved in the neurodegenerationmultiple diseases pathway and cellular processes.Mediating effect analysis identified PRDX4(L)as a potential protein biomarker.ROC curve analysis showed that GNAI1 had the largest area under the curve(AUC=0.889).CONCLUSION:This study identifies 15 differentially expressed proteins in the tear fluid of NTG patients,including PRDX4(L).PRDX4(L)plays a key role in oxidative stress.
文摘Objective:To explore the relationship between anesthetic depth and surgical stress response in minimally invasive cardiothoracic surgery.Methods:A total of 89 patients who underwent thoracoscopic minimally invasive cardiothoracic surgery in our hospital from June 2024 to December 2024 were selected as the research objects.They were divided into the light anesthesia group(n=45)and the deep anesthesia group(n=44).The vital signs at different intraoperative nodes and perioperative stress status of the two groups were compared.Results:Before lesion resection and after surgery,the mean arterial pressure and heart rate of the deep anesthesia group were lower than those of the light anesthesia group,with statistically significant differences.Conclusion:In thoracoscopic minimally invasive cardiothoracic surgery,deep anesthesia can effectively control the patient’s surgical stress response,but the postoperative awakening time is longer;patients under light anesthesia have a shorter awakening time,but the intraoperative stress response is obvious.
基金Supported by the National Natural Science Foundation of China(No.82074500)Beijing Natural Science Foundation(No.7252273)+2 种基金CACMS Innovation Fund(No.CI2021A02605)Administration of Traditional Chinese Medicine of Zhejiang Province(No.2024ZR029)Science and Technology Program of Wenzhou City(No.Y2023210).
文摘AIM:To perform a bibliometric analysis of publications focusing on inflammatory mechanisms in glaucoma,thereby comprehensively understanding the current research status and identifying potential frontier directions for future studies.METHODS:A systematic search was conducted in the Web of Science Core Collection(WoSCC)database to retrieve relevant literature published from January 1,2000,to August 31,2025(data accessed on September 12,2025).Multiple data visualization tools were employed to conduct in-depth analyses of the included publications,covering aspects such as publication quantity and quality,evolutionary trends of research hotspots,keyword cooccurrence networks,and collaborative patterns among countries/regions,institutions,and authors.RESULTS:A total of 3381 articles related to glaucoma inflammation were extracted from WoSCC.The analysis showed that the USA had the highest research output in this field(29.04%,n=982),followed by China(18.40%,n=622)and UK(6.01%,n=203).Based on citation frequency and burst intensity,the USA also ranked as the most influential country.Baudouin C and Sun X were identified as the most productive authors,while Journal of Glaucoma and Investigative Ophthalmology&Visual Science were the journals with the highest number of published relevant articles.Additionally,keyword analysis revealed that“neuroinflammation”,“retinal ganglion cells(RGCs)”,“pathophysiology”,and“traditional Chinese medicine”are emerging research hotspots in the field of immuneinflammatory responses in glaucoma.CONCLUSION:This study presents a comprehensive bibliometric overview of research on glaucoma-related inflammation,indicating that this field has received extensive scientific attention with a steady upward trend in research activity.Furthermore,it establishes a theoretical basis for the development of neuroinflammation-targeted therapeutic strategies for glaucoma and emphasizes the necessity of strengthening interdisciplinary collaboration to promote the clinical translation of research findings.
基金Supported by the Program for Zhejiang Leading Talent of S&T Innovation(No.2021R52012)Key Research and Development Projects of Zhejiang Province(No.2022C03112).
文摘AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and randomized controlled trial was conducted.Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group.In GM group,the range of peripheral anterior synechiae(PAS)was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation(PEI).PAS was separated only under a microscope.After separating the closed angle of 360°by this method,we used a surgical gonioscope to confirm the PAS range.If any remaining PAS was present,we would separate them with an iris repositor under the direct gonio-lens until angle of 360°was reopened.In GG group,PAS was separated under direct gonioscopy after PEI until angle of 360°was reopened.The range of residual PAS after GSLs was the primary outcome.Intraoperative complications(hyphema),intraocular pressure(IOP)and anti-glaucoma medication usage after operation were the secondary outcomes.RESULTS:Sixty eyes were included,each group comprising 30 eyes.The average age[GM group:66.3±6.8y(12 males),GG group:67.6±8.9y(7 males),P=0.550],the baseline IOP(GM group:29.6±11.5 mm Hg,GG group:32.4±12.2 mm Hg,P=0.366)and the average initial PAS extent(GM group:8.9±2.6h,GG group:9.4±2.5h,P=0.425)were similar in the two groups.In GM group,the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL.In GG group,the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL.The PAS after PEI was significantly reduced compared to the preoperative PAS in both groups(all P<0.001).The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference(P<0.001).Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy.The difference of hyphema grade between the two groups was statistically significant(P=0.019).CONCLUSION:PEI alone can not open 360°of angle completely.PEI+GSL significantly reduced PAS range.But for patients with CACG,GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.
基金supported by the National Natural Science Foundation of China(32471057,32271043,82301215,and 82171047)the Shanghai Municipal Science and Technology Major Project(2018SHZDZX01)ZJLab,the Shanghai Center for Brain Science and Brain-Inspired Technology.
文摘Interaction between Müller cells and microglia aggravates neuroinflammation,resulting in retinal ganglion cell(RGC)death in glaucoma.Here,we investigated how tumor necrosis factor-alpha(TNF-α)produced by activated microglia mediates the crosstalk between Müller cells and microglia and impacts RGC injury in a chronic ocular hypertension(COH)glaucoma model.In COH retinas,elevated TNF-αinduced the activation of Müller cells and microglia,and recruited microglia to the ganglion cell layer.Co-culture with Müller cells enhanced TNF-α-induced microglial activation,migration,and proliferation.Both in vivo and in vitro experiments confirmed that chemokine C-C motif ligand 2(CCL2),primarily released from Müller cells,mediated the TNF-α-induced effects on microglia in COH retinas.Knockdown of CCL2 attenuated RGC damage and vision loss.Our results demonstrate that TNF-αreleased from microglia induces the secretion of CCL2 from Müller cells,thus inducing microglial activation and migration,exacerbating retinal neuroinflammation and RGC injury in glaucoma.
基金supported by National Key Research and Development Program of China(No.2023YFC2507406)National Natural Science Foundation of China(No.82300646)+6 种基金Beijing Natural Science Foundation(No.7232334)Beijing Municipal Administration of Hospitals Incubating Program(No.PX2024002,PX2020001)Capital Fund for Health Development Scientific Research(No.2024-2-2028)Beijing Municipal Science&Technology Commission AI+Health Collaborative Innovation Cultivation Project(No.Z241100007724004)Research Ward Excellence Program of Beijing Municipal Health Commission(No.BRWEP2024W162020100,BRWEP2024W162020112,BRWEP2024W162020114)Excellent Plan for Capital Medicine Scientific and Technological Innovation Achievement Transformation Promotion Plan(No.YC202401QX0824)Clinical Scientific Research Fund of Beijing Integrated Medical Association[No.ZHKY-2025-1869(B012)]。
文摘With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC.
