AIM: To estimate the effects of human umbilical vein (HUV) implanted under the sclera of glaucoma model on intraocular pressure (IOP) lowering and to investigate its related mechanisms METHODS: A total of 20 human umb...AIM: To estimate the effects of human umbilical vein (HUV) implanted under the sclera of glaucoma model on intraocular pressure (IOP) lowering and to investigate its related mechanisms METHODS: A total of 20 human umbilical veins (HUV) were collected from healthy fetus umbilical core. After the establishment of glaucoma model in rabbits, human freeze-dried umbilical vein was implanted under the sclera during NPDS, while for control group, sclerostomy was performed without implant. The formation of the filtration bleb and TOP were detected every 24 hours before surgery and on day 3, 7, 10 and 14 after surgery. Handheld pen-type Tono-pen II tonometer was used to measure TOP after topical anesthesia treatment. Each measurement has three duplicates. The incision recovery, filtration, conjunctiva congestion and anterior chamber inflammation were observed everyday after surgery. RESULTS: IOP was decreased dramatically with less inflammation than traditional sclerostomies with the application of HUV. The significant differences of IOP between the NPDS with and without HUV implant groups were shown up from 10 days after surgery. The average TOP in NPDS without HUV implant was 14.25mmHg, while for NPDS with HUV implant group, it was 12.30mmHg. This structure of filtration bleb, which allowed the aqueous humor to leave the eye, was formed for any type of surgery. However, 1-2 weeks later, filtration bleb was still Existed in the group of sclerostomy with HUV implant and more stable than that of the surgery without HUV implant. Histological observations were performed on day 3, 7 and 14 after surgery. For the eyes under sclerostomy with HUV implant, HUV lumina was shown up on 3 days after surgery with few fibroblast cells near the sclera. On 7 days after surgery, HUV lumina was stably maintained but with obvious fibroblast cells and inflammatory cell. On 14 days after surgery, HUV lumina was still clearly observed but with scarring formation, which suggests that the IOP lowering effects might result from an effective drainage structure formation. CONCLUSION: HUV might be an alternative material to make the drainage pathway for non-penetrating deep sclerostomy.展开更多
AIM: To experimentally compare the external sclerostomy produced using a femtosecond laser with that made by a surgical knife and to evaluate the healing patterns, efficacy and technical advantages of femtosecond lase...AIM: To experimentally compare the external sclerostomy produced using a femtosecond laser with that made by a surgical knife and to evaluate the healing patterns, efficacy and technical advantages of femtosecond laser sclerostomy. METHODS: In a prospective randomized, controlled, masked-observer study, 10 pigmented rabbits underwent external sclerostomy with a femtosecond laser in the right eye; 10 additional rabbits underwent sclerostomy with a surgical superblade in the right eye. Clinical characteristics, which included bleb morphology and intraocular pressure, were recorded for 1 month after surgery. Six additional rabbits underwent external femtosecond laser sclerostomy in the right eye and mechanical sclerostomy in the left eye and were killed at day 14 after surgery. Histologic staining, immunohistochemistry and scanning electron microscopy were subsequently performed to assess the morphology of the filtering fistula. The titanium-sapphire femtosecond laboratory laser was operating at a repetition rate of 1 kHz, 0.4 mJ pulse energy, a central wavelength of 800nm and a pulse duration of 50 femtoseconds. Mann-Whitney and Kaplan-Meier tests were used for statistical analysis. RESULTS: Successful complete sclerostomy was achieved in each laser-treated eye which was hit only once by the laser. The laser treated time was approximately 15s-16s. In the laser-treated group (n =16), 2 eyes (12%) developed mild hyphema at the site of entry and 8 eyes (50%) showed transient edema in the corneal periphery adjacent to the laser impact zone. The differences between the groups in duration of function blebs and pressure reduction were statistically significant (P=0.025 and 0.016, respectively). The success rate of the laser-treated group was significantly higher than the knife group (P=0.005). Histologically, the subconjunctival connective tissue was loosely arranged with partially patent sclerostomy in the laser-treated eyes at postoperative day 14. This contrasted with the completely scarred sclerostomy tract in the knife group. The mean numbers of fibroblasts and new vessels as well as the amount of new collagen deposition at bleb site were significantly decreased in the laser group (P= 0.045, 0.013 and 0.036, respectively). CONCLUSION: The current study demonstrates that external femtosecond laser sclerostomy may offer a safe and effective alternative for the minimally invasive surgical management of glaucoma.展开更多
AIM: To investigate the clinical characteristics of idiopathic uveal effusion syndrome(IUES) and to identify effective surgical modalities for its treatment.METHODS: This retrospective analysis included clinical data ...AIM: To investigate the clinical characteristics of idiopathic uveal effusion syndrome(IUES) and to identify effective surgical modalities for its treatment.METHODS: This retrospective analysis included clinical data of 33 eyes from 26 patients with IUES at Beijing Tongren Hospital. Records of eye examinations, ocular ultrasound, ocular ultrasound biomicroscopy(UBM), and follow-up surgical treatment were reviewed and analyzed.RESULTS: Of 26 patients, 17(65.4%) were male and 9(34.6%) were female. The average age of disease onset was 46.8 y(range: 22-64 y). Seven patients(26.9%) showed retinal detachment in both eyes at presentation. B-ultrasound showed the presence of retinal detachment in one eye or both eyes. All patients had binocular ciliary leakage and detachment. Eyes with retinal detachment underwent four-quadrantic partial-thickness sclerectomy and sclerostomy. Subretinal fluid resolution was achieved within 6 mo. Recurrence was observed in three eyes and was resolved with re-operation.CONCLUSION: Ophthalmic ultrasound and UBM, among others, can be helpful in the diagnosis of IUES. Sclerectomy and sclerostomy are surgical modalities that can successfully treat the disease. Some patients may experience recurrence after surgery;reoperation remains safe and effective for them. Long-term follow-up is essential in such settings.展开更多
文摘AIM: To estimate the effects of human umbilical vein (HUV) implanted under the sclera of glaucoma model on intraocular pressure (IOP) lowering and to investigate its related mechanisms METHODS: A total of 20 human umbilical veins (HUV) were collected from healthy fetus umbilical core. After the establishment of glaucoma model in rabbits, human freeze-dried umbilical vein was implanted under the sclera during NPDS, while for control group, sclerostomy was performed without implant. The formation of the filtration bleb and TOP were detected every 24 hours before surgery and on day 3, 7, 10 and 14 after surgery. Handheld pen-type Tono-pen II tonometer was used to measure TOP after topical anesthesia treatment. Each measurement has three duplicates. The incision recovery, filtration, conjunctiva congestion and anterior chamber inflammation were observed everyday after surgery. RESULTS: IOP was decreased dramatically with less inflammation than traditional sclerostomies with the application of HUV. The significant differences of IOP between the NPDS with and without HUV implant groups were shown up from 10 days after surgery. The average TOP in NPDS without HUV implant was 14.25mmHg, while for NPDS with HUV implant group, it was 12.30mmHg. This structure of filtration bleb, which allowed the aqueous humor to leave the eye, was formed for any type of surgery. However, 1-2 weeks later, filtration bleb was still Existed in the group of sclerostomy with HUV implant and more stable than that of the surgery without HUV implant. Histological observations were performed on day 3, 7 and 14 after surgery. For the eyes under sclerostomy with HUV implant, HUV lumina was shown up on 3 days after surgery with few fibroblast cells near the sclera. On 7 days after surgery, HUV lumina was stably maintained but with obvious fibroblast cells and inflammatory cell. On 14 days after surgery, HUV lumina was still clearly observed but with scarring formation, which suggests that the IOP lowering effects might result from an effective drainage structure formation. CONCLUSION: HUV might be an alternative material to make the drainage pathway for non-penetrating deep sclerostomy.
基金National Natural Science Foundation ofChina (No.30772382 and No.81100701)the FundamentalResearch Funds for the Central Universities of China (No.2011JC044)
文摘AIM: To experimentally compare the external sclerostomy produced using a femtosecond laser with that made by a surgical knife and to evaluate the healing patterns, efficacy and technical advantages of femtosecond laser sclerostomy. METHODS: In a prospective randomized, controlled, masked-observer study, 10 pigmented rabbits underwent external sclerostomy with a femtosecond laser in the right eye; 10 additional rabbits underwent sclerostomy with a surgical superblade in the right eye. Clinical characteristics, which included bleb morphology and intraocular pressure, were recorded for 1 month after surgery. Six additional rabbits underwent external femtosecond laser sclerostomy in the right eye and mechanical sclerostomy in the left eye and were killed at day 14 after surgery. Histologic staining, immunohistochemistry and scanning electron microscopy were subsequently performed to assess the morphology of the filtering fistula. The titanium-sapphire femtosecond laboratory laser was operating at a repetition rate of 1 kHz, 0.4 mJ pulse energy, a central wavelength of 800nm and a pulse duration of 50 femtoseconds. Mann-Whitney and Kaplan-Meier tests were used for statistical analysis. RESULTS: Successful complete sclerostomy was achieved in each laser-treated eye which was hit only once by the laser. The laser treated time was approximately 15s-16s. In the laser-treated group (n =16), 2 eyes (12%) developed mild hyphema at the site of entry and 8 eyes (50%) showed transient edema in the corneal periphery adjacent to the laser impact zone. The differences between the groups in duration of function blebs and pressure reduction were statistically significant (P=0.025 and 0.016, respectively). The success rate of the laser-treated group was significantly higher than the knife group (P=0.005). Histologically, the subconjunctival connective tissue was loosely arranged with partially patent sclerostomy in the laser-treated eyes at postoperative day 14. This contrasted with the completely scarred sclerostomy tract in the knife group. The mean numbers of fibroblasts and new vessels as well as the amount of new collagen deposition at bleb site were significantly decreased in the laser group (P= 0.045, 0.013 and 0.036, respectively). CONCLUSION: The current study demonstrates that external femtosecond laser sclerostomy may offer a safe and effective alternative for the minimally invasive surgical management of glaucoma.
文摘AIM: To investigate the clinical characteristics of idiopathic uveal effusion syndrome(IUES) and to identify effective surgical modalities for its treatment.METHODS: This retrospective analysis included clinical data of 33 eyes from 26 patients with IUES at Beijing Tongren Hospital. Records of eye examinations, ocular ultrasound, ocular ultrasound biomicroscopy(UBM), and follow-up surgical treatment were reviewed and analyzed.RESULTS: Of 26 patients, 17(65.4%) were male and 9(34.6%) were female. The average age of disease onset was 46.8 y(range: 22-64 y). Seven patients(26.9%) showed retinal detachment in both eyes at presentation. B-ultrasound showed the presence of retinal detachment in one eye or both eyes. All patients had binocular ciliary leakage and detachment. Eyes with retinal detachment underwent four-quadrantic partial-thickness sclerectomy and sclerostomy. Subretinal fluid resolution was achieved within 6 mo. Recurrence was observed in three eyes and was resolved with re-operation.CONCLUSION: Ophthalmic ultrasound and UBM, among others, can be helpful in the diagnosis of IUES. Sclerectomy and sclerostomy are surgical modalities that can successfully treat the disease. Some patients may experience recurrence after surgery;reoperation remains safe and effective for them. Long-term follow-up is essential in such settings.
