Father Waclaw Szuniewicz(1891-1963) was a skilled ophthalmic surgeon, missionary, and teacher. For several years he worked in China, afterwards in the United States and in Brazil. The aim of the paper is to present th...Father Waclaw Szuniewicz(1891-1963) was a skilled ophthalmic surgeon, missionary, and teacher. For several years he worked in China, afterwards in the United States and in Brazil. The aim of the paper is to present the unanalyzed issues of Szuniewicz’s research regarding corneal refractive surgery. Szuniewicz performed experiments on changing the corneal curvature with anterior, posterior and full-thickness incisions. The results of modifying the anterior and posterior corneal curvature were satisfactory, however, diminished significantly within months after surgery. Corneal band resections were superior in terms of efficacy, however, such an intervention commonly led to complications in animal studies. Szuniewicz’s work was not published during his life. Nevertheless, as a result of strong impact of his personality and ideas, he is frequently considered as a pioneer of corneal refractive surgery.展开更多
AIM:To evaluate the refractive and long-term outcome of eyes filled with silicone oil(SO)undergoing phacoemulsification cataract surgery(PCS).METHODS:This retrospective study evaluated patients with SO tamponade who w...AIM:To evaluate the refractive and long-term outcome of eyes filled with silicone oil(SO)undergoing phacoemulsification cataract surgery(PCS).METHODS:This retrospective study evaluated patients with SO tamponade who were scheduled for PCS.RESULTS:Subjects(n=26)were followed for 29.5±13.9 mo after cataract surgery.The median spherical equivalent refraction(SER)was+5.3 D[interquartile range(IQR)+2.9 to+6.7]before PCS,and+3.4 D(IQR+2.0 to+4.4)after PCS.Within the follow-up period retinal reattachment after SO removal was achieved in 15 out of 26 eyes(57.7%).In 13 eyes assessment of refraction after SO-removal was possible,and showed a myopic shift of-4.6 D(IQR-2.9 to-7.3)in the SER.After SO removal,5 of the 13 eyes(38.5%)were within±1.0 D of the target refraction,while 9 out of the 13 eyes(69.2%)were within±2.0 D.CONCLUSION:In our study,the refraction after PCS for eyes filled with SO manifested low predictability,as did the myopic shift following SO removal.A significant percentage of the eyes that underwent SO administration required a long-term tamponade.展开更多
AIM: To compare the results of in vivo human high resolution image registration studies of the eye during accommodation to the predictions of mathematical and finite element models of accommodation. METHODS: Data from...AIM: To compare the results of in vivo human high resolution image registration studies of the eye during accommodation to the predictions of mathematical and finite element models of accommodation. METHODS: Data from published high quality image registration studies of pilocarpine induced accommodative changes of equatorial lens radius(ELR) and central lens thickness(CLT) were statistically analyzed. RESULTS: The mean changes in ELR and CLT were 6.76 μm/diopter and 6.51 μm/diopter, respectively. The linear regressions, reflecting the association between ELR and accommodative amplitude(AAELR) was: slope=6.58 μm/diopter, r^2=0.98, P<0.0001 and between CLT and AACLT was: slope=6.75 μm/diopter, r^2=0.83, P<0.001. On the basis of these relationships, the CLT slope and the AAELR were used to predict the measured change in ELR(ELRpredicted). There was no statistical difference between ELRpredicted and the measured ELR as demonstrated by a Student's paired t-test: P=0.96 and linear regression analysis: slope=0.97, r^2=0.98, P<0.00001.CONCLUSION: Image registration with invariant positional references demonstrates that ELR and CLT equivalently minimally increase ~7.0 μm/diopter during accommodation. The small equivalent increases in ELRand CLT are associated with a large accommodative amplitude. These findings are consistent with the predictions of mathematical and finite element models that specified the stiffness of the lens nucleus is the same or greater than the lens cortex and that accommodation involves a small force(<5 g).展开更多
1.Introduction Ophthalmology focuses on relating structural changes to function and disease.From biomicroscopy,ophthalmoscopy and fundus photography,to electroretinography and visual evoked potentials the clinical pur...1.Introduction Ophthalmology focuses on relating structural changes to function and disease.From biomicroscopy,ophthalmoscopy and fundus photography,to electroretinography and visual evoked potentials the clinical purpose is to objectively assess visual function.However,these techniques are macroscopic and only grossly related to visual acuity.With the development of optical coherence tomography(OCT)in vivo histological resolution of the retina has become routine.展开更多
Cataract is the leading cause of visual impairment,and posterior capsular opacification(PCO)is the most common long-term complication of modern cataract surgery,which can cause severe visual impairment after surgery.T...Cataract is the leading cause of visual impairment,and posterior capsular opacification(PCO)is the most common long-term complication of modern cataract surgery,which can cause severe visual impairment after surgery.The proliferation,migration,and epithelial-mesenchymal transition(EMT)of residual lens epithelial cells(LECs)stimulated by growth factors and cytokines,are the key pathological mechanisms involved in the development of PCO.This study demonstrated that non-steroidal anti-inflammatory drug(NSAID),bromfenac,was capable of effectively inhibiting cell migration,overexpression of EMT markers,such as fibronectin(FN),matrix metalloproteinase 2(MMP2),α-smooth muscle actin(α-SMA),and transcription factor Snail,and extracellular signal-regulated kinase(ERK)/glycogen synthase kinase-3β(GSK-3β)signaling induced by transforming growth factor-β2(TGF-β2)in vitro.The inhibitory effect of bromfenac on TGF-β2-induced EMT was also verified on a primary lens epithelial cell model using human anterior capsules.Furthermore,based on ultrasonic spray technology,we developed a drug-eluting intraocular lens(IOL)using poly(lactic-co-glycolic acid)(PLGA)with sustained bromfenac release ability for the prevention of PCO development.In the rabbit models of cataract surgery,bromfenac-eluting IOL exhibited remarkable PCO prevention and inflammation suppression effects with excellent biocompatibility.In conclusion,bromfenac can inhibit TGF-β2-induced cell migration and the EMT of LECs via ERK/GSK-3β/Snail signaling.The present study offers a novel approach for preventing PCO through PLGA-based drug sustained-release IOLs.展开更多
Background:Enhanced depth-of-focus intraocular lenses(EDOF IOL)have filled the gap between monofocal and multifocal intraocular implants with optical qualities of monofocal lenses and usually minor dysphotopsias typic...Background:Enhanced depth-of-focus intraocular lenses(EDOF IOL)have filled the gap between monofocal and multifocal intraocular implants with optical qualities of monofocal lenses and usually minor dysphotopsias typical for multifocal lenses.The purpose of this study was to evaluate visual outcomes after bilateral implantation of a new EDOF IOL in patients with requirements for perfect near and intermediate vision.Methods:The study included 15 patients(29 eyes as one was amblyopic)with bilateral implantation of LUXSMART EDOF IOL(Bausch&Lomb)with a targeted myopia(between-0.25 and-0.50D)in both eyes.Monocular corrected and uncorrected visual acuity for far,intermediate and near as well as refractive outcomes were evaluated at 1,3,6 and 12 months after the surgery.Additionally,binocular visual acuity,contrast sensitivity and defocus curve were measured at the final follow-up visit.At 12 months’visit patients completed a questionnaire evaluating patient satisfaction,spectacle independence and presence of dysphotopsias.Results:Binocular uncorrected visual acuities at 12 month’s visit were 0.13±0.16,0.06±0.08,0.07±0.09 and 0.15±0.09 logMAR for far distance,80 cm,66 cm and 40 cm respectively.Corrected binocular visual acuities at 12 months were 0.00±0.00,0.05±0.07,0.05±0.06,0.13±0.16 respectively for distance,80 cm,66 cm and 40 cm.Automated refraction spherical equivalent at 12 months’visit stood at-0.70±0.48D,which was 0.46D less than calculated biometric target,however spherical equivalent of subjective refraction at 12 months equaled–0.49±0.46D,which was closer to preoperative biometric target.Defocus curve had gentle shape without peaks typical for monofocal IOLs.Binocular contrast sensitivity results were superior to average results for that age group and equaled 1.78±0.16 logMAR without correction and 1.81±0.13 logMAR with correction.Spectacle independence for near and intermediate distances was achieved in all patients and for far distance in 73.3%of patients.Burdensome dysphotopsias were not reported in any case.Conclusions:EDOF IOLs targeted bilaterally at low myopia can provide excellent near and intermediate visual acuity and independence of any optical correction in majority of cases.This approach can be used in selected patients who are focused on stationary activities.展开更多
Background:It is possible that preservative-free eye drops can be contaminated.The aim of this study was to assess the incidence of microbial contamination of preservative-free hospital-prepared anti-infective eye dro...Background:It is possible that preservative-free eye drops can be contaminated.The aim of this study was to assess the incidence of microbial contamination of preservative-free hospital-prepared anti-infective eye drops and investigate factors that contribute to contamination.This finding may help to raise awareness of this problem to medical healthcare staff and patients in order to prevent the transmission of microorganisms from eye drops to the patients through treatment of pre-existing eye diseases.Methods:Two hundred and ninety-five eye drop bottles were collected from patients attending Rajavithi Hospital Ophthalmologic outpatient and inpatient department,including both those used by patients at home and those administered in the hospital by medical staff.Samples were taken from the tips of droppers and bottles,and the residual fluid inside the bottles was then cultivated onto different culture plates.The culture results were identified and analyzed according to various factors related to both individual users and the bottles.Results:Seven different types of eye drops were collected and 71(24.06%)of the 295 bottles were contaminated.Vancomycin eye drops were the most contaminated.Twenty-six different types of pathogens were identified,most frequently mold(42.98%),and the amount of contamination was higher in tips than in residual fluid inside the bottle.There was no statistically significant difference in contamination between patients used eye drops collected in outpatient units(32.14%)and medical staff used eye drops collected in inpatient settings(23.22%).The only factor that was statistically significant was the number of eye drops used per person.We found that samples from patients who used only up to 2 eye drops suffered contamination(42.8%)more than those from their counterparts who used at least 3(22.18%),P¼0.02.Conclusions:Of these preservative-free hospital preparations anti-infective eye drops,24.06%were contaminated.The number of eye drops used per person was statistically significant in triggering contamination.There is a possibility of number of eyedrops use person may trigger contamination.展开更多
文摘Father Waclaw Szuniewicz(1891-1963) was a skilled ophthalmic surgeon, missionary, and teacher. For several years he worked in China, afterwards in the United States and in Brazil. The aim of the paper is to present the unanalyzed issues of Szuniewicz’s research regarding corneal refractive surgery. Szuniewicz performed experiments on changing the corneal curvature with anterior, posterior and full-thickness incisions. The results of modifying the anterior and posterior corneal curvature were satisfactory, however, diminished significantly within months after surgery. Corneal band resections were superior in terms of efficacy, however, such an intervention commonly led to complications in animal studies. Szuniewicz’s work was not published during his life. Nevertheless, as a result of strong impact of his personality and ideas, he is frequently considered as a pioneer of corneal refractive surgery.
文摘AIM:To evaluate the refractive and long-term outcome of eyes filled with silicone oil(SO)undergoing phacoemulsification cataract surgery(PCS).METHODS:This retrospective study evaluated patients with SO tamponade who were scheduled for PCS.RESULTS:Subjects(n=26)were followed for 29.5±13.9 mo after cataract surgery.The median spherical equivalent refraction(SER)was+5.3 D[interquartile range(IQR)+2.9 to+6.7]before PCS,and+3.4 D(IQR+2.0 to+4.4)after PCS.Within the follow-up period retinal reattachment after SO removal was achieved in 15 out of 26 eyes(57.7%).In 13 eyes assessment of refraction after SO-removal was possible,and showed a myopic shift of-4.6 D(IQR-2.9 to-7.3)in the SER.After SO removal,5 of the 13 eyes(38.5%)were within±1.0 D of the target refraction,while 9 out of the 13 eyes(69.2%)were within±2.0 D.CONCLUSION:In our study,the refraction after PCS for eyes filled with SO manifested low predictability,as did the myopic shift following SO removal.A significant percentage of the eyes that underwent SO administration required a long-term tamponade.
文摘AIM: To compare the results of in vivo human high resolution image registration studies of the eye during accommodation to the predictions of mathematical and finite element models of accommodation. METHODS: Data from published high quality image registration studies of pilocarpine induced accommodative changes of equatorial lens radius(ELR) and central lens thickness(CLT) were statistically analyzed. RESULTS: The mean changes in ELR and CLT were 6.76 μm/diopter and 6.51 μm/diopter, respectively. The linear regressions, reflecting the association between ELR and accommodative amplitude(AAELR) was: slope=6.58 μm/diopter, r^2=0.98, P<0.0001 and between CLT and AACLT was: slope=6.75 μm/diopter, r^2=0.83, P<0.001. On the basis of these relationships, the CLT slope and the AAELR were used to predict the measured change in ELR(ELRpredicted). There was no statistical difference between ELRpredicted and the measured ELR as demonstrated by a Student's paired t-test: P=0.96 and linear regression analysis: slope=0.97, r^2=0.98, P<0.00001.CONCLUSION: Image registration with invariant positional references demonstrates that ELR and CLT equivalently minimally increase ~7.0 μm/diopter during accommodation. The small equivalent increases in ELRand CLT are associated with a large accommodative amplitude. These findings are consistent with the predictions of mathematical and finite element models that specified the stiffness of the lens nucleus is the same or greater than the lens cortex and that accommodation involves a small force(<5 g).
文摘1.Introduction Ophthalmology focuses on relating structural changes to function and disease.From biomicroscopy,ophthalmoscopy and fundus photography,to electroretinography and visual evoked potentials the clinical purpose is to objectively assess visual function.However,these techniques are macroscopic and only grossly related to visual acuity.With the development of optical coherence tomography(OCT)in vivo histological resolution of the retina has become routine.
基金This study was supported by the National Natural Science Foundation of China(Grant Nos.82070939,22005265,81870641,and 81800809)the National Key R&D Program of China(No.2018YFC1106104)+1 种基金Key Research and Development Project of Zhejiang Province of China(No.2020C03035)and the Joint Funds of the Zhejiang Provincial Natural Science Foundation of China(Grant No.LBY21E030002).
文摘Cataract is the leading cause of visual impairment,and posterior capsular opacification(PCO)is the most common long-term complication of modern cataract surgery,which can cause severe visual impairment after surgery.The proliferation,migration,and epithelial-mesenchymal transition(EMT)of residual lens epithelial cells(LECs)stimulated by growth factors and cytokines,are the key pathological mechanisms involved in the development of PCO.This study demonstrated that non-steroidal anti-inflammatory drug(NSAID),bromfenac,was capable of effectively inhibiting cell migration,overexpression of EMT markers,such as fibronectin(FN),matrix metalloproteinase 2(MMP2),α-smooth muscle actin(α-SMA),and transcription factor Snail,and extracellular signal-regulated kinase(ERK)/glycogen synthase kinase-3β(GSK-3β)signaling induced by transforming growth factor-β2(TGF-β2)in vitro.The inhibitory effect of bromfenac on TGF-β2-induced EMT was also verified on a primary lens epithelial cell model using human anterior capsules.Furthermore,based on ultrasonic spray technology,we developed a drug-eluting intraocular lens(IOL)using poly(lactic-co-glycolic acid)(PLGA)with sustained bromfenac release ability for the prevention of PCO development.In the rabbit models of cataract surgery,bromfenac-eluting IOL exhibited remarkable PCO prevention and inflammation suppression effects with excellent biocompatibility.In conclusion,bromfenac can inhibit TGF-β2-induced cell migration and the EMT of LECs via ERK/GSK-3β/Snail signaling.The present study offers a novel approach for preventing PCO through PLGA-based drug sustained-release IOLs.
文摘Background:Enhanced depth-of-focus intraocular lenses(EDOF IOL)have filled the gap between monofocal and multifocal intraocular implants with optical qualities of monofocal lenses and usually minor dysphotopsias typical for multifocal lenses.The purpose of this study was to evaluate visual outcomes after bilateral implantation of a new EDOF IOL in patients with requirements for perfect near and intermediate vision.Methods:The study included 15 patients(29 eyes as one was amblyopic)with bilateral implantation of LUXSMART EDOF IOL(Bausch&Lomb)with a targeted myopia(between-0.25 and-0.50D)in both eyes.Monocular corrected and uncorrected visual acuity for far,intermediate and near as well as refractive outcomes were evaluated at 1,3,6 and 12 months after the surgery.Additionally,binocular visual acuity,contrast sensitivity and defocus curve were measured at the final follow-up visit.At 12 months’visit patients completed a questionnaire evaluating patient satisfaction,spectacle independence and presence of dysphotopsias.Results:Binocular uncorrected visual acuities at 12 month’s visit were 0.13±0.16,0.06±0.08,0.07±0.09 and 0.15±0.09 logMAR for far distance,80 cm,66 cm and 40 cm respectively.Corrected binocular visual acuities at 12 months were 0.00±0.00,0.05±0.07,0.05±0.06,0.13±0.16 respectively for distance,80 cm,66 cm and 40 cm.Automated refraction spherical equivalent at 12 months’visit stood at-0.70±0.48D,which was 0.46D less than calculated biometric target,however spherical equivalent of subjective refraction at 12 months equaled–0.49±0.46D,which was closer to preoperative biometric target.Defocus curve had gentle shape without peaks typical for monofocal IOLs.Binocular contrast sensitivity results were superior to average results for that age group and equaled 1.78±0.16 logMAR without correction and 1.81±0.13 logMAR with correction.Spectacle independence for near and intermediate distances was achieved in all patients and for far distance in 73.3%of patients.Burdensome dysphotopsias were not reported in any case.Conclusions:EDOF IOLs targeted bilaterally at low myopia can provide excellent near and intermediate visual acuity and independence of any optical correction in majority of cases.This approach can be used in selected patients who are focused on stationary activities.
文摘Background:It is possible that preservative-free eye drops can be contaminated.The aim of this study was to assess the incidence of microbial contamination of preservative-free hospital-prepared anti-infective eye drops and investigate factors that contribute to contamination.This finding may help to raise awareness of this problem to medical healthcare staff and patients in order to prevent the transmission of microorganisms from eye drops to the patients through treatment of pre-existing eye diseases.Methods:Two hundred and ninety-five eye drop bottles were collected from patients attending Rajavithi Hospital Ophthalmologic outpatient and inpatient department,including both those used by patients at home and those administered in the hospital by medical staff.Samples were taken from the tips of droppers and bottles,and the residual fluid inside the bottles was then cultivated onto different culture plates.The culture results were identified and analyzed according to various factors related to both individual users and the bottles.Results:Seven different types of eye drops were collected and 71(24.06%)of the 295 bottles were contaminated.Vancomycin eye drops were the most contaminated.Twenty-six different types of pathogens were identified,most frequently mold(42.98%),and the amount of contamination was higher in tips than in residual fluid inside the bottle.There was no statistically significant difference in contamination between patients used eye drops collected in outpatient units(32.14%)and medical staff used eye drops collected in inpatient settings(23.22%).The only factor that was statistically significant was the number of eye drops used per person.We found that samples from patients who used only up to 2 eye drops suffered contamination(42.8%)more than those from their counterparts who used at least 3(22.18%),P¼0.02.Conclusions:Of these preservative-free hospital preparations anti-infective eye drops,24.06%were contaminated.The number of eye drops used per person was statistically significant in triggering contamination.There is a possibility of number of eyedrops use person may trigger contamination.
