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Duan Z, Yuan M, Liu Z, Pei W, Jiang K, Li L, Shen G. An Ultrasensitive Ti 3C 2T x MXene-based Soft Contact Lens for Continuous and Nondestructive Intraocular Pressure Monitoring. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2309785. [PMID: 38377279 DOI: 10.1002/smll.202309785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/08/2024] [Indexed: 02/22/2024]
Abstract
Wearable soft contact lens sensors for continuous and nondestructive intraocular pressure (IOP) monitoring are highly desired as glaucoma and postoperative myopia patients grow, especially as the eyestrain crowd increases. Herein, a smart closed-loop system is presented that combines a Ti3C2Tx MXene-based soft contact lens (MX-CLS) sensor, wireless data transmission units, display, and warning components to realize continuous and nondestructive IOP monitoring/real-time display. The fabricated MX-CLS device exhibits an extremely high sensitivity of 7.483 mV mmHg-1, good linearity on silicone eyeballs, excellent stability under long-term pressure-release measurement, sufficient transparency with 67.8% transmittance under visible illumination, and superior biocompatibility with no discomfort when putting the MX-CLS sensor onto the Rabbit eyes. After integrating with the wireless module, users can realize real-time monitoring and warning of IOP via smartphones, the demonstrated MX-CLS device together with the IOP monitoring/display system opens up promising platforms for Ti3C2Tx materials as the base for multifunctional contact lens-based sensors and continuous and nondestructive IOP measurement system.
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Affiliation(s)
- Zhongyi Duan
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing, 100081, P. R. China
| | - Miao Yuan
- State Key Laboratory of Integrated Optoelectronics Institute of Semiconductors, Chinese Academy of Sciences, Beijing, 100083, P. R. China
| | - Zhiduo Liu
- School of Physics, Beijing Institute of Technology, Beijing, 100081, P. R. China
| | - Weihua Pei
- State Key Laboratory of Integrated Optoelectronics Institute of Semiconductors, Chinese Academy of Sciences, Beijing, 100083, P. R. China
| | - Kai Jiang
- Faculty of Hepato-Pancreato-Biliary Surgery, Chinese PLA General Hospital, Institute of Hepatobiliary Surgery of Chinese PLA & Key Laboratory of Digital Hepatobiliary Surgery, Beijing, 100853, P. R. China
| | - La Li
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing, 100081, P. R. China
| | - Guozhen Shen
- School of Integrated Circuits and Electronics, Beijing Institute of Technology, Beijing, 100081, P. R. China
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Jiang Y, Cai Y, Zhang X, Chen L, Zhou X, Chen Y. A Two-Decade Bibliometric Analysis of Laser in Ophthalmology: From Past to Present. Clin Ophthalmol 2024; 18:1313-1328. [PMID: 38765459 PMCID: PMC11100493 DOI: 10.2147/opth.s458840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/26/2024] [Indexed: 05/22/2024] Open
Abstract
Background Laser therapy has been proven as an effective technique for managing ophthalmological disorders. To guide future research, we conducted a bibliometric analysis of laser applications in eye diseases from 1990 to 2022, aiming to identify key themes and trends. Methods We retrieved 3027 publications from the Web of Science Core Collection (WoSCC). Bibliometrix was used for science mapping of the literature, while VOSviewer and CiteSpace were applied to visualize co-authorship, co-citation, co-occurrence, and bibliographic coupling networks. Results From a co-citation reference network, we identified 52 distinct clusters. Our analysis uncovered three main research trends. The first trend revolves around the potential evolution of corneal laser surgery techniques, shifting from the treatment of refractive errors to broader applications in biomedical optics. The second trend illustrates the advancement of laser applications in treating a range of disorders, from retinal and ocular surface diseases to glaucoma. The third trend focuses on the innovative uses of established technologies. Conclusion This study offers significant insights into the evolution of laser applications in ophthalmology over the past 30 years, which will undoubtedly assist scientists in directing further research in this promising field.
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Affiliation(s)
- Yaping Jiang
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Yuying Cai
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Xin Zhang
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Li Chen
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Institute for Medical and Engineering Innovation, Eye & ENT Hospital, Fudan University; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, People’s Republic of China
| | - Yihui Chen
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
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Rajabpour M, Kangari H, Pesudovs K, Khorrami-Nejad M, Rahmani S, Mohaghegh S, Moradnejad S. Refractive error and vision related quality of life. BMC Ophthalmol 2024; 24:83. [PMID: 38388340 PMCID: PMC10885569 DOI: 10.1186/s12886-024-03350-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/15/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND To investigate and compare the vision-related quality of life (QOL) in different types of refractive error (RE). METHODS This cross-sectional study was performed on 200 subjects, categorized into four groups of 50 each, consisting of subjects with myopia, hyperopia, astigmatism, and emmetropia, the latter being the control group. The mean age of the participants was 23.88 ± 5.87 (range, 15 to 38: 110 females and 90 males). RE was defined as myopia, spherical equivalent (SE) < -0.25 diopters (D), hyperopia, SE > + 0.25 D, astigmatism, cylinder < -0.25 D, and emmetropia (-0.25 ≤ SE(D) ≤ + 0.25, cylinder ≥ -0.25). Groups are subdivided into very low magnitudes of RE (0.50 and 0.75) and significant RE (1.00 ≤). Vision-related QOL was assessed using the Persian version of the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). The NEI-VFQ was scored as visual function and socioemotional scales using Rasch analysis. RESULTS Corrected myopia, astigmatism, uncorrected myopia, and hyperopia had a lower vision-related QOL than emmetropes. (P < 0.001). Vision-related QOL in myopic subjects was lower than that in astigmatic participants. Very low myopes, who often do not use correction, had a significantly lower QOL than other groups. CONCLUSION Individuals with refractive errors experience a lower QOL score than those without. Notably, the adverse impact on QOL score is significantly greater in myopic cases, particularly very low myopia, compared to other refractive errors. Therefore, it is strongly recommended not to neglect managing very low myopia since it may improve participants' QOL.
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Affiliation(s)
- Mojtaba Rajabpour
- Department of Optometry, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Imam Hossein Square, Damavand Avenue, Opposite to Bouali Hospital, Tehran, 1616913111, Iran
| | - Haleh Kangari
- Department of Optometry, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Imam Hossein Square, Damavand Avenue, Opposite to Bouali Hospital, Tehran, 1616913111, Iran.
| | - Konrad Pesudovs
- School of Optometry and Vision Science, Medicine & Health, University of New South Wales, Kensington, NSW, Australia
| | - Masoud Khorrami-Nejad
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Optometry Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Rahmani
- Department of Optometry, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Imam Hossein Square, Damavand Avenue, Opposite to Bouali Hospital, Tehran, 1616913111, Iran
| | - Sahar Mohaghegh
- Department of Optometry, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Imam Hossein Square, Damavand Avenue, Opposite to Bouali Hospital, Tehran, 1616913111, Iran
| | - Shima Moradnejad
- Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Vought R, Vought V, Herzog I, Greenstein SA. EQIP Quality Assessment of Refractive Surgery Resources on YouTube. Semin Ophthalmol 2023; 38:768-772. [PMID: 37133414 DOI: 10.1080/08820538.2023.2209168] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE To evaluate the utility of EQIP as a novel tool for determining the quality of patient information on YouTube regarding refractive eye surgery. METHODS Three searches were conducted on YouTube using "PRK eye surgery", "LASIK eye surgery", and "SMILE eye surgery". 110 relevant videos were evaluated using the Ensuring Quality Information for Patients (EQIP) criteria. RESULTS The average EQIP score was 15.1 (moderate quality). On average, physician-authored videos scored significantly higher on questions 17 (p = .01), 18 (p = .001), 26 (p = .008), relating to author transparency and use of graphs/figures. Patient-authored videos scored significantly higher on questions 8 (p < .001), 9 (p < .001), 12 (p = .008), 16 (p = .02), and 21 (p = .0350). These questions addressed risks/benefits, quality of life and alert signs, date and video revisions, and personally addressing viewers. CONCLUSION EQIP was useful in identifying specific strengths and deficits in online refractive surgery patient education resources that were not evident from other screening tools. The quality of information on YouTube videos on refractive surgeries is average. Physician-authored videos could be improved by clarifying risks and quality of life issues. Quality evaluation of medical information is important for comprehensive online surgical education.
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Affiliation(s)
- Rita Vought
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Victoria Vought
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Isabel Herzog
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Steven A Greenstein
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
- Cornea and Laser Eye Institute - Hersh Vision Group, Teaneck, NJ, USA
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Geng C, Liu S, Wang J, Wang S, Zhang W, Rong H, Cao Y, Wang S, Li Z, Zhang Y. Targeting the cochlin/SFRP1/CaMKII axis in the ocular posterior pole prevents the progression of nonpathologic myopia. Commun Biol 2023; 6:884. [PMID: 37644183 PMCID: PMC10465513 DOI: 10.1038/s42003-023-05267-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 08/21/2023] [Indexed: 08/31/2023] Open
Abstract
Myopia is a major public health issue. However, interventional modalities for nonpathologic myopia are limited due to its complicated pathogenesis and the lack of precise targets. Here, we show that in guinea pig form-deprived myopia (FDM) and lens-induced myopia (LIM) models, the early initiation, phenotypic correlation, and stable maintenance of cochlin protein upregulation at the interface between retinal photoreceptors and retinal pigment epithelium (RPE) is identified by a proteomic analysis of ocular posterior pole tissues. Then, a microarray analysis reveals that cochlin upregulates the expression of the secreted frizzled-related protein 1 (SFRP1) gene in human RPE cells. Moreover, SFRP-1 elevates the intracellular Ca2+ concentration and activates Ca2+/calmodulin-dependent protein kinase II (CaMKII) signaling in a simian choroidal vascular endothelial cell line, and elicits vascular endothelial cell dysfunction. Furthermore, genetic knockdown of the cochlin gene and pharmacological blockade of SFRP1 abrogates the reduced choroidal blood perfusion and prevents myopia progression in the FDM model. Collectively, this study identifies a novel signaling axis that may involve cochlin in the retina, SFRP1 in the RPE, and CaMKII in choroidal vascular endothelial cells and contribute to the pathogenesis of nonpathologic myopia, implicating the potential of cochlin and SFRP1 as myopia interventional targets.
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Affiliation(s)
- Chao Geng
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300384, Tianjin, China
| | - Siyi Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300384, Tianjin, China
| | - Jindan Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300384, Tianjin, China
| | - Sennan Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300384, Tianjin, China
| | - Weiran Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300384, Tianjin, China
| | - Hua Rong
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300384, Tianjin, China
| | - Yunshan Cao
- Department of Cardiology, Gansu Provincial Hospital, Lanzhou University, 730000, Lanzhou, Gansu Province, China
| | - Shuqing Wang
- School of Pharmacy, Tianjin Medical University, 300070, Tianjin, China
| | - Zhiqing Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300384, Tianjin, China
| | - Yan Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300384, Tianjin, China.
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Gomes JAP, Azar DT, Baudouin C, Bitton E, Chen W, Hafezi F, Hamrah P, Hogg RE, Horwath-Winter J, Kontadakis GA, Mehta JS, Messmer EM, Perez VL, Zadok D, Willcox MDP. TFOS Lifestyle: Impact of elective medications and procedures on the ocular surface. Ocul Surf 2023; 29:331-385. [PMID: 37087043 DOI: 10.1016/j.jtos.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/10/2023] [Indexed: 04/24/2023]
Abstract
The word "elective" refers to medications and procedures undertaken by choice or with a lower grade of prioritization. Patients usually use elective medications or undergo elective procedures to treat pathologic conditions or for cosmetic enhancement, impacting their lifestyle positively and, thus, improving their quality of life. However, those interventions can affect the homeostasis of the tear film and ocular surface. Consequently, they generate signs and symptoms that could impair the patient's quality of life. This report describes the impact of elective topical and systemic medications and procedures on the ocular surface and the underlying mechanisms. Moreover, elective procedures performed for ocular diseases, cosmetic enhancement, and non-ophthalmic interventions, such as radiotherapy and bariatric surgery, are discussed. The report also evaluates significant anatomical and biological consequences of non-urgent interventions to the ocular surface, such as neuropathic and neurotrophic keratopathies. Besides that, it provides an overview of the prophylaxis and management of pathological conditions resulting from the studied interventions and suggests areas for future research. The report also contains a systematic review investigating the quality of life among people who have undergone small incision lenticule extraction (SMILE). Overall, SMILE refractive surgery seems to cause more vision disturbances than LASIK in the first month post-surgery, but less dry eye symptoms in long-term follow up.
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Affiliation(s)
- José Alvaro P Gomes
- Dept. of Ophthalmology and Visual Sciences, Federal University of Sao Paulo/Paulista School of Medicine (UNIFESP/EPM), Sao Paulo, SP, Brazil.
| | - Dimitri T Azar
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Christophe Baudouin
- Quinze-Vingts National Eye Hospital & Vision Institute, IHU FOReSIGHT, Paris, France
| | - Etty Bitton
- Ecole d'optométrie, Université de Montréal, Montréal, Canada
| | - Wei Chen
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | | | - Pedram Hamrah
- Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Ruth E Hogg
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Belfast, UK
| | | | | | | | | | - Victor L Perez
- Foster Center for Ocular Immunology, Duke University Eye Center, Durham, NC, USA
| | - David Zadok
- Shaare Zedek Medical Center, Affiliated to the Hebrew University, School of Medicine, Jerusalem, Israel
| | - Mark D P Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Lan G, Twa MD, Song C, Feng J, Huang Y, Xu J, Qin J, An L, Wei X. In vivo corneal elastography: A topical review of challenges and opportunities. Comput Struct Biotechnol J 2023; 21:2664-2687. [PMID: 37181662 PMCID: PMC10173410 DOI: 10.1016/j.csbj.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023] Open
Abstract
Clinical measurement of corneal biomechanics can aid in the early diagnosis, progression tracking, and treatment evaluation of ocular diseases. Over the past two decades, interdisciplinary collaborations between investigators in optical engineering, analytical biomechanical modeling, and clinical research has expanded our knowledge of corneal biomechanics. These advances have led to innovations in testing methods (ex vivo, and recently, in vivo) across multiple spatial and strain scales. However, in vivo measurement of corneal biomechanics remains a long-standing challenge and is currently an active area of research. Here, we review the existing and emerging approaches for in vivo corneal biomechanics evaluation, which include corneal applanation methods, such as ocular response analyzer (ORA) and corneal visualization Scheimpflug technology (Corvis ST), Brillouin microscopy, and elastography methods, and the emerging field of optical coherence elastography (OCE). We describe the fundamental concepts, analytical methods, and current clinical status for each of these methods. Finally, we discuss open questions for the current state of in vivo biomechanics assessment techniques and requirements for wider use that will further broaden our understanding of corneal biomechanics for the detection and management of ocular diseases, and improve the safety and efficacy of future clinical practice.
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Affiliation(s)
- Gongpu Lan
- Guangdong-Hong Kong-Macao Intelligent Micro-Nano Optoelectronic Technology Joint Laboratory, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, Guangdong 528000, China
- Weiren Meditech Co., Ltd., Foshan, Guangdong 528000, China
| | - Michael D Twa
- College of Optometry, University of Houston, Houston, TX 77204, United States
| | - Chengjin Song
- Guangdong-Hong Kong-Macao Intelligent Micro-Nano Optoelectronic Technology Joint Laboratory, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, Guangdong 528000, China
| | - JinPing Feng
- Institute of Engineering and Technology, Hubei University of Science and Technology, Xianning, Hubei 437100, China
| | - Yanping Huang
- Guangdong-Hong Kong-Macao Intelligent Micro-Nano Optoelectronic Technology Joint Laboratory, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, Guangdong 528000, China
- Weiren Meditech Co., Ltd., Foshan, Guangdong 528000, China
| | - Jingjiang Xu
- Guangdong-Hong Kong-Macao Intelligent Micro-Nano Optoelectronic Technology Joint Laboratory, School of Physics and Optoelectronic Engineering, Foshan University, Foshan, Guangdong 528000, China
- Weiren Meditech Co., Ltd., Foshan, Guangdong 528000, China
| | - Jia Qin
- Weiren Meditech Co., Ltd., Foshan, Guangdong 528000, China
| | - Lin An
- Weiren Meditech Co., Ltd., Foshan, Guangdong 528000, China
| | - Xunbin Wei
- Biomedical Engineering Department, Peking University, Beijing 100081, China
- International Cancer Institute, Peking University, Beijing 100191, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
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Yao L, Zhang M, Wang D, Zhao Q, Wang S, Bai H. Small Incision Lenticule Extraction (SMILE) and Laser in Situ Keratomileusis (LASIK) Used to Treat Myopia and Myopic Astigmatism: A Systematic Review and Meta-analysis of Randomized Clinical Trials. Semin Ophthalmol 2023; 38:283-293. [PMID: 35912896 DOI: 10.1080/08820538.2022.2107399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSES The purpose of this meta-analysis is to systematically compare the safety, efficacy, and predictability of small incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK). METHODS This study covered the data searched from the PubMed, the EMBASE and the Cochrane Library. The Cochrane Handbook was also referred to as evaluating the quality of the included studies. In addition, this meta-analysis was performed using Revman 5.4 software. RESULTS A total of 11 randomized controlled trails (RCTs) were included. The proportion of eyes with refraction within ±0.5D was higher in LASIK group compared with SMILE group (RR, 0.91; 95% CI, 0.83 to 0.99; p = .04). The spherical aberration (SA) was smaller in SMILE group compared with LASIK group (RR, -0.12; 95% CI, -0.23 to -0.01; p = .04). There were no significant differences between two groups with regard to final mean refractive spherical equivalent (SE) (MD, -0.04; 95% CI, -0.12 to 0.03; p = .22), proportion of eyes losing one or more lines of corrected distance visual acuity (CDVA) (RR, 1.14; 95% CI, 0.58 to 2.27; p = .70), proportion of eyes with uncorrected distance visual acuity (UCVA) of 20/20 or better (RR, 0.99; 95% CI, 0.94 to 1.05; p = .71), postoperative mean logMAR UCVA (MD, 0.01; 95% CI, -0.00 to 0.03; p = .13), postoperative refraction within ±1.0D (RR, 1.00; 95% CI, 0.98 to 1.02; p = .60), postoperative astigmatism within ±0.25, 0.5 and 1.0D (RR, 0.80, 0.99, 1.00; 95% CI, 0.35 to 1.83, 0.94 to 1.05, 0.98 to 1.02; p = .60, 0.86, 0.87), postoperative higher order aberrations (HOAs) (RR, 0.00; 95% CI, -0.16 to 0.16; p = .99). CONCLUSION For predictability, LASIK was superior to SMILE. There were comparably safety and efficacy for the correction of myopia and myopic astigmatism in SMILE and LASIK. SA was smaller after SMILE than after LASIK.
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Affiliation(s)
- Lin Yao
- Qingdao Aier Eye Hospital, Qingdao, SD, China
| | | | | | - Qian Zhao
- Qingdao Aier Eye Hospital, Qingdao, SD, China
| | | | - Haiqing Bai
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, SD, China
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Madrid-Costa D, Fernández-Vega-Cueto L, Azor-Morón JA, Vega F, Millán MS, Alfonso JF. Beam-Shaping Extended Depth of Focus Intraocular Lens: Optical Assessment With Corneas of Increasing Spherical Aberration. J Refract Surg 2023; 39:95-102. [PMID: 36779468 DOI: 10.3928/1081597x-20221215-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE To assess the optical quality and halo formation of a beam-shaping extended depth-of-focus (EDOF) intraocular lens (IOL) (AcrySof IQ Vivity; Alcon Laboratories, Inc) with corneas of long-range spherical aberration (SA) such as those resulting from myopic laser ablations. METHODS The optical quality of the EDOF IOL and a reference monofocal IOL was evaluated with three corneas (A, B, and C, with SA =+0.135, +0.290, +0.540 µm, respectively, for a 5.15-mm pupil at the IOL plane). The through-focus modulation transfer function area (MTFa) curves were obtained between -5.00 and +2.00 diopters (D) defocus range. The halo was also assessed with the three corneas. RESULTS Through-focus MTFa curves for a 4.5-mm IOL pupil showed a slight decrease in the maximum MTFa value provided by the EDOF IOL compared to the monofocal IOL in the three corneal situations (A: 45.9 vs 38.6 units; B: 41.1 vs 33.1 units, and C: 26.9 vs 23.8 units). For the 3.0-mm pupil, the EDOF IOL also had lower maximum MTFa than the monofocal IOL; however, the depth-of-focus increased to -2.20 D. With corneas A and B, the halo induced was of low energy with both IOLs. With cornea C, the EDOF IOL created a much larger and intense halo. CONCLUSIONS The EDOF IOL provided a good distance optical performance and an extended range of focus of approximately 2.00 D, with a halo of low intensity when evaluated with a corneal SA similar to the one induced by a low to moderate myopic ablation. With a high myopic ablation, the halo induced would be of considerable size and energy. [J Refact Surg. 2023;39(2):95-102.].
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In Vivo Evaluation of the Effects of SMILE with Different Amounts of Stromal Ablation on Corneal Biomechanics by Optical Coherence Elastography. Diagnostics (Basel) 2022; 13:diagnostics13010030. [PMID: 36611322 PMCID: PMC9818797 DOI: 10.3390/diagnostics13010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/18/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
This work aims to depth-resolved quantitatively analyze the effect of different stromal ablation amounts on the corneal biomechanical properties during small incision lenticule extraction (SMILE) using optical coherence elastography (OCE). A 4.5-MHz ultrasonic transducer was used to excite elastic waves in the corneal tissue. The OCE system combined with the antisymmetric Lamb wave model was employed to achieve a high-resolution, high-sensitivity, and depth-resolved quantitative detection of the corneal Young's modulus. Eighteen rabbits were randomly divided into three groups; each group had six rabbits. The first and second groups underwent -3D and -6D SMILE surgeries, and the third group was the control group, respectively. Young's modulus of the corneal cap and residual stromal bed (RSB) were both increased after SMILE, which shared the stress under intraocular pressure (IOP). Furthermore, the Young's modulus of both the corneal cap and RSB after 3D SMILE group were significantly lower than that in the -6D group, which indicated that the increases in the post-operative corneal Young's modulus were positively correlated with the amount of stromal ablation. The OCE system for quantitative spatial characterization of corneal biomechanical properties can provide useful information on the extent of safe ablation for SMILE procedures.
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Sullivan KM, Ko E, Kim EM, Ballance WC, Ito JD, Chalifoux M, Kim YJ, Bashir R, Kong H. Extracellular Microenvironmental Control for Organoid Assembly. TISSUE ENGINEERING. PART B, REVIEWS 2022; 28:1209-1222. [PMID: 35451330 PMCID: PMC9836674 DOI: 10.1089/ten.teb.2021.0186] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/04/2022] [Indexed: 01/22/2023]
Abstract
Organoids, which are multicellular clusters with similar physiological functions to living organs, have gained increasing attention in bioengineering. As organoids become more advanced, methods to form complex structures continue to develop. There is evidence that the extracellular microenvironment can regulate organoid quality. The extracellular microenvironment consists of soluble bioactive molecules, extracellular matrix, and biofluid flow. However, few efforts have been made to discuss the microenvironment optimal to engineer specific organoids. Therefore, this review article examines the extent to which engineered extracellular microenvironments regulate organoid quality. First, we summarize the natural tissue and organ's unique chemical and mechanical properties, guiding researchers to design an extracellular microenvironment used for organoid engineering. Then, we summarize how the microenvironments contribute to the formation and growth of the brain, lung, intestine, liver, retinal, and kidney organoids. The approaches to forming and evaluating the resulting organoids are also discussed in detail. Impact statement Organoids, which are multicellular clusters with similar physiological function to living organs, have been gaining increasing attention in bioengineering. As organoids become more advanced, methods to form complex structures continue to develop. This review article focuses on recent efforts to engineer the extracellular microenvironment in organoid research. We summarized the natural organ's microenvironment, which informs researchers of key factors that can influence organoid formation. Then, we summarize how these microenvironmental controls significantly contribute to the formation and growth of the corresponding brain, lung, intestine, liver, retinal, and kidney organoids. The approaches to forming and evaluating the resulting organoids are discussed in detail, including extracellular matrix choice and properties, culture methods, and the evaluation of the morphology and functionality through imaging and biochemical analysis.
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Affiliation(s)
- Kathryn M. Sullivan
- Department of Bioengineering, and University of Illinois at Urbana−Champaign, Urbana, Illinois, USA
| | - Eunkyung Ko
- Department of Bioengineering, and University of Illinois at Urbana−Champaign, Urbana, Illinois, USA
| | - Eun Mi Kim
- Department of Chemical and Biomolecular Engineering, University of Illinois at Urbana−Champaign, Urbana, Illinois, USA
| | - William C. Ballance
- Department of Chemical and Biomolecular Engineering, University of Illinois at Urbana−Champaign, Urbana, Illinois, USA
| | - John D. Ito
- Department of Chemical and Biomolecular Engineering, University of Illinois at Urbana−Champaign, Urbana, Illinois, USA
| | - Madeleine Chalifoux
- Department of Chemical and Biomolecular Engineering, University of Illinois at Urbana−Champaign, Urbana, Illinois, USA
| | - Young Jun Kim
- Environmental Safety Group, Korea Institute of Science and Technology (KIST–Europe), Saarbrucken, Germany
| | - Rashid Bashir
- Department of Bioengineering, and University of Illinois at Urbana−Champaign, Urbana, Illinois, USA
| | - Hyunjoon Kong
- Department of Chemical and Biomolecular Engineering, University of Illinois at Urbana−Champaign, Urbana, Illinois, USA
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Sun Y, Hong Y, Rong X, Ji Y. Presbyopia-Correcting Intraocular Lenses Implantation in Eyes After Corneal Refractive Laser Surgery: A Meta-Analysis and Systematic Review. Front Med (Lausanne) 2022; 9:834805. [PMID: 35479941 PMCID: PMC9035540 DOI: 10.3389/fmed.2022.834805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To assess the efficacy, safety, and predictability of presbyopia-correcting intraocular lenses (IOLs) in cataract patients with previous corneal refractive surgery. Methods A systematic literature search was performed to identify studies evaluating the clinical outcomes of presbyopia-correcting IOLs implantation in cataract surgery after laser refractive surgery. Outcomes were efficacy, safety and predictability parameters. Results The authors identified 13 studies, involving a total of 128 patients and 445 eyes. Presbyopia-correcting IOLs were effective at improving distance, intermediate and near visual acuity aftercataract surgery. The proportion of post-laser surgery eyes with uncorrected distance visual acuity (UDVA) ≥ 20/25 was 0.82 [95% confidence interval (CI), 0.74-0.90] and the pooled rates of spectacle independence at near, intermediate, and far distances were 0.98 (95% CI, 0.94-1.00), 0.99 (95% CI, 0.95-1.00) and 0.78 (95% CI, 0.65-0.94) respectively. The percentage of participants who suffered from halos and glare was 0.40 (95% CI, 0.25-0.64) and 0.31 (95% CI, 0.16-0.60), respectively. The predictability had a percentage of 0.66 (95% CI, 0.57-0.75) and 0.90 (95% CI, 0.85-0.96) of eyes within ±0.5 diopters (D) and ±1.0 D from the targeted spherical equivalent. Conclusions Presbyopia-correcting IOLs provide satisfactory results in terms of efficacy, safety and predictability in patients with previous corneal refractive surgery, but have a higher risk of photopic side effects such as halos and glare.
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Affiliation(s)
- Yang Sun
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- National Health Commission (NHC) Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yingying Hong
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- National Health Commission (NHC) Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xianfang Rong
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- National Health Commission (NHC) Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yinghong Ji
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- National Health Commission (NHC) Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- *Correspondence: Yinghong Ji
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13
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Menon J. Refractive Corneal surgeries: A Review. KERALA JOURNAL OF OPHTHALMOLOGY 2022. [DOI: 10.4103/kjo.kjo_21_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Epithelial cells removed in advanced surface ablation (ASA) surgery can be used as a source of corneal samples to perform in vitro studies. Exp Eye Res 2021; 214:108878. [PMID: 34871567 DOI: 10.1016/j.exer.2021.108878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/17/2021] [Accepted: 11/30/2021] [Indexed: 11/22/2022]
Abstract
Human corneal epithelial cells are needed to study corneal pathophysiology in vitro. Due to the limitations of cell lines, the use of primary cells is highly desirable, but the scarcity of human tissues, along with ethical issues, make it difficult to accomplish all required experiments. In advanced surface ablation (ASA), the central corneal epithelium is removed and discarded. We hypothesized that ASA samples could be used to perform in vitro assays. In this study, 29 samples from patients undergoing ASA were recovered in supplemented DMEM/F12 culture medium, RIPA buffer, or RLT lysis buffer. The first aim was to determine whether cells could be maintained in culture. Although with the explant technique, tissue pieces did not attach to the culture surface, after disaggregation, cells showed high viability (90.0 ± 6.0%), attached to plates, and remained viable for up to 14 days. The second aim was to elucidate if ASA samples could be used to study protein or gene expression. Cytokeratin-3, ZO-1, Ki67, and E-cadherin protein expression were confirmed by immunofluorescence. Total protein (485.8 ± 115.8 μg) was isolated from cells in RIPA buffer, and GAPDH was detected by Western blotting, indicating that samples are adequate for protein studies. RNA (9.0 ± 3.6 μg) was isolated from samples in RLT lysis buffer, and GAPDH gene expression was studied by PCR, confirming that samples were also suitable for gene expression studies. These results suggest that samples obtained from corneal surface ablation procedures may constitute a valuable source of human cells to accomplish in vitro studies.
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15
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Current Challenges Supporting School-Aged Children with Vision Problems: A Rapid Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11209673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many children have undetected vision problems or insufficient visual information processing that may be a factor in lower academic outcomes. The aim of this paper is to contribute to a better understanding of the importance of vision screening for school-aged children, and to investigate the possibilities of how eye-tracking (ET) technologies can support this. While there are indications that these technologies can support vision screening, a broad understanding of how to apply them and by whom, and if it is possible to utilize them at schools, is lacking. We review interdisciplinary research on performing vision investigations, and discuss current challenges for technology support. The focus is on exploring the possibilities of ET technologies to better support screening and handling of vision disorders, especially by non-vision experts. The data orginate from a literature survey of peer-reviewed journals and conference articles complemented by secondary sources, following a rapid review methodology. We highlight current trends in supportive technologies for vision screening, and identify the involved stakeholders and the research studies that discuss how to develop more supportive ET technologies for vision screening and training by non-experts.
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Sankaridurg P, Tahhan N, Kandel H, Naduvilath T, Zou H, Frick KD, Marmamula S, Friedman DS, Lamoureux E, Keeffe J, Walline JJ, Fricke TR, Kovai V, Resnikoff S. IMI Impact of Myopia. Invest Ophthalmol Vis Sci 2021; 62:2. [PMID: 33909036 PMCID: PMC8083082 DOI: 10.1167/iovs.62.5.2] [Citation(s) in RCA: 129] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/26/2020] [Indexed: 01/15/2023] Open
Abstract
The global burden of myopia is growing. Myopia affected nearly 30% of the world population in 2020 and this number is expected to rise to 50% by 2050. This review aims to analyze the impact of myopia on individuals and society; summarizing the evidence for recent research on the prevalence of myopia and high myopia, lifetime pathological manifestations of myopia, direct health expenditure, and indirect costs such as lost productivity and reduced quality of life (QOL). The principal trends are a rising prevalence of myopia and high myopia, with a disproportionately greater increase in the prevalence of high myopia. This forecasts a future increase in vision loss due to uncorrected myopia as well as high myopia-related complications such as myopic macular degeneration. QOL is affected for those with uncorrected myopia, high myopia, or complications of high myopia. Overall the current global cost estimates related to direct health expenditure and lost productivity are in the billions. Health expenditure is greater in adults, reflecting the added costs due to myopia-related complications. Unless the current trajectory for the rising prevalence of myopia and high myopia change, the costs will continue to grow. The past few decades have seen the emergence of several novel approaches to prevent and slow myopia. Further work is needed to understand the life-long impact of myopia on an individual and the cost-effectiveness of the various novel approaches in reducing the burden.
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Affiliation(s)
- Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia
| | - Nina Tahhan
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia
| | - Himal Kandel
- Save Sight Institute, Sydney Medical School, The University of Sydney, New South Wales, Australia
| | - Thomas Naduvilath
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia
| | - Haidong Zou
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
| | - Kevin D. Frick
- Johns Hopkins Carey Business School, Baltimore, Maryland, United States
| | - Srinivas Marmamula
- Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - David S. Friedman
- Glaucoma Center of Excellence, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Ecosse Lamoureux
- Duke - NUS Medical School, Singapore; Singapore Eye Research Institute, Singapore
| | - Jill Keeffe
- Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Jeffrey J. Walline
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | | | - Vilas Kovai
- Health Promotion Service, Population Health, Liverpool Hospital, SWSLHD, Health - New South Wales, New South Wales, Australia
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia
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Chou CC, Shih PJ, Lin HC, Chen JP, Yen JY, Wang IJ. Changes in Intraocular Pressure after Transepithelial Photorefractive Keratectomy and Femtosecond Laser In Situ Keratomileusis. J Ophthalmol 2021; 2021:5592195. [PMID: 33777445 PMCID: PMC7972855 DOI: 10.1155/2021/5592195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/22/2021] [Accepted: 02/28/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate the changes in intraocular pressure (IOP) and biomechanically corrected IOP (bIOP) in patients undergoing transepithelial photorefractive keratectomy (TPRK) and femtosecond laser in situ keratomileusis (FS-LASIK) and to determine the effects of preoperative biomechanical factors on IOP and bIOP changes after FS-LASIK and TPRK. DESIGN A retrospective comparative study. METHODS We retrospectively investigated the IOP and corneal biomechanical changes in 93 eyes undergoing FS-LASIK and 104 eyes undergoing TPRK in a clinical setting. Preoperative and postoperative data on ophthalmic and Corvis ST examinations, in vivo Young's modulus, and noncontact tonometry were analyzed. Marginal linear regression models with generalized estimating equations were used for intragroup and intergroup comparisons of IOP and bIOP changes. RESULTS In the univariate model, IOP reduction after FS-LASIK was 2.49 mmHg higher than that after TPRK. In addition, bIOP reduction after FS-LASIK was 1.85 mmHg higher than that after TPRK. In the multiple regression model, we revealed that IOP reduction after FS-LASIK was 1.75 mmHg higher than that after TPRK. Additionally, bIOP reduction after FS-LASIK was 1.64 mmHg higher than that after TPRK. Postoperative changes in bIOP were less than those in IOP. In addition, Young's modulus and CBI had no significant effect on postoperative IOP and bIOP changes. We establish a biomechanically predictive model using the available data to predict postoperative IOP and bIOP changes after TPRK and FS-LASIK. CONCLUSIONS Reductions in IOP and bIOP after FS-LASIK were 1.75 mmHg and 1.64 mmHg, respectively, more than those after TPRK, after adjustment for confounders. We revealed that the type of refractive surgery and peak distance (PD) were significant predictors of postoperative IOP and bIOP changes. By contrast, depth of ablation showed a significant effect on only IOP changes.
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Affiliation(s)
- Chien-Chih Chou
- Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po-Jen Shih
- Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Hung-Chou Lin
- Dr. Lin's Eye Clinic and Laser Vision Correction Center, Taoyuan, Taiwan
| | - Jun-Peng Chen
- Biostatistics Task Force of Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jia-Yush Yen
- Department of Mechanical Engineering, National Taiwan University, Taipei, Taiwan
| | - I-Jong Wang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
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Wilson SM, Handan Tezel F. Adsorption separation of CF4, O2, CO2, and COF2 from an excimer gas mixture. Sep Purif Technol 2021. [DOI: 10.1016/j.seppur.2020.117659] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Shetty R, Lalgudi VG, Kaweri L, Choudhary U, Chabra A, Gupta K, Khamar P. Customized laser vision correction for irregular cornea post-refractive surgery. Indian J Ophthalmol 2020; 68:2867-2879. [PMID: 33229662 PMCID: PMC7856932 DOI: 10.4103/ijo.ijo_2793_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Ablation-related complications following the refractive procedures are a major challenge for a refractive surgeon, considering the elective nature of the procedure. The use of topography-guided customized ablation has revolutionized the management of irregular corneas postrefractive surgery. This preferred practice highlights various hurdles encountered while managing cases of decentered ablation, small ablation zones, and planning a cataract surgery in patients with irregular corneas. It will give insight to the refractive surgeon on the planning of corneal regularization on various modern-day refractive platforms available, such as the WaveLight® EX-500 (Alcon Laboratories, Inc., Fort Worth, TX, USA), Schwind Amaris 1050 (Peramis; SCHWIND eye-tech-solutions, Kleinostheim, Germany), and Technolas Teneo 317 model 2 excimer laser (Bausch & Lomb, Rochester, NY, USA). The algorithmic approach outlined will enable the refractive surgeon to choose between the wavefront optomized and the topography-guided ablations.
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Affiliation(s)
- Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
| | | | - Luci Kaweri
- Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Urvija Choudhary
- Consultant Refractive, Cornea and Cataract, Rajas Eye Hospital and Retina Research Centre, Indore, Madhya Pradesh, India
| | - Aishwariya Chabra
- Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Krati Gupta
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Pooja Khamar
- Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India
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Ang M, Farook M, Htoon HM, Mehta JS. Randomized Clinical Trial Comparing Femtosecond LASIK and Small-Incision Lenticule Extraction. Ophthalmology 2020; 127:724-730. [DOI: 10.1016/j.ophtha.2019.09.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/02/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022] Open
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21
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Duru Z, Duru N, Ulusoy DM. Effects of senofilcon A and lotrafilcon B bandage contact lenses on epithelial healing and pain management after bilateral photorefractive keratectomy. Cont Lens Anterior Eye 2020; 43:169-172. [DOI: 10.1016/j.clae.2019.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/14/2019] [Accepted: 08/19/2019] [Indexed: 11/30/2022]
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22
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Xiong R, Luan J, Kang S, Ye C, Singamaneni S, Tsukruk VV. Biopolymeric photonic structures: design, fabrication, and emerging applications. Chem Soc Rev 2020; 49:983-1031. [PMID: 31960001 DOI: 10.1039/c8cs01007b] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Biological photonic structures can precisely control light propagation, scattering, and emission via hierarchical structures and diverse chemistry, enabling biophotonic applications for transparency, camouflaging, protection, mimicking and signaling. Corresponding natural polymers are promising building blocks for constructing synthetic multifunctional photonic structures owing to their renewability, biocompatibility, mechanical robustness, ambient processing conditions, and diverse surface chemistry. In this review, we provide a summary of the light phenomena in biophotonic structures found in nature, the selection of corresponding biopolymers for synthetic photonic structures, the fabrication strategies for flexible photonics, and corresponding emerging photonic-related applications. We introduce various photonic structures, including multi-layered, opal, and chiral structures, as well as photonic networks in contrast to traditionally considered light absorption and structural photonics. Next, we summarize the bottom-up and top-down fabrication approaches and physical properties of organized biopolymers and highlight the advantages of biopolymers as building blocks for realizing unique bioenabled photonic structures. Furthermore, we consider the integration of synthetic optically active nanocomponents into organized hierarchical biopolymer frameworks for added optical functionalities, such as enhanced iridescence and chiral photoluminescence. Finally, we present an outlook on current trends in biophotonic materials design and fabrication, including current issues, critical needs, as well as promising emerging photonic applications.
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Affiliation(s)
- Rui Xiong
- School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, GA 30332-0245, USA.
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23
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Duru N, Altunel O, Sırakaya E, Küçük B. Comparison of the balafilcon A and samfilcon A lenses on postoperative pain control and epithelial healing time after photorefractive keratectomy: a contralateral eye study. Lasers Med Sci 2020; 35:1955-1960. [PMID: 32125536 DOI: 10.1007/s10103-020-02985-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/14/2020] [Indexed: 11/28/2022]
Abstract
To compare the effects of balafilcon A and samfilcon A silicone hydrogel bandage contact lenses on postoperative pain control and epithelial healing time after photorefractive keratectomy (PRK). Seventy-four eyes of 37 patients who underwent bilateral PRK were included in this randomized clinical trial study. In the end of the surgery, a balafilcon A lens was used in one eye and a samfilcon A lens was used in the fellow eye randomly. Pain, blurred vision, epiphora, photophobia, and foreign body sensation were assessed on the first and third postoperative day using a visual analogue scale (0 = no ocular pain or discomfort, 10 = highest level of ocular pain and discomfort). For balafilcon A and samfilcon A lenses, mean scores for pain were 6.22 ± 2.81 and 3.11 ± 2.90 on first postoperative day (p < 0.001) and 1.57 ± 1.65 and 0.68 ± 0.85 on third postoperative day (p = 0.001), respectively; mean scores for foreign body sensation were 6.11 ± 2.53 and 3.19 ± 2.72 on first postoperative day (p < 0.001) and 3.16 ± 1.92 and 1.35 ± 1.43 on third postoperative day (p < 0.001), also respectively; and mean scores for epiphora were 6.46 ± 2.64 and 5.46 ± 3.40 on first postoperative day (p = 0.007) and 1.68 ± 1.60 and 1.32 ± 1.31 on third postoperative day (p = 0.065), again respectively. No significant difference in blurred vision or photophobia emerged between the lenses on first and third postoperative day after PRK. On the third postoperative day, reepithelialization was complete in 83.7% of eyes with the balafilcon A lens and 89.1% of eyes fitted with the samfilcon A lens. Wearing samfilcon A lenses after photorefractive keratectomy can significantly manage pain, decrease foreign body sensation on first and third postoperative day, and reduce epiphora on first postoperative day.
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Affiliation(s)
- Necati Duru
- Department of Ophthalmology, Kayseri City Education and Research Hospital, Kayseri, Turkey.
| | - Orhan Altunel
- Department of Ophthalmology, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Ender Sırakaya
- Department of Ophthalmology, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Bekir Küçük
- Department of Ophthalmology, Kayseri City Education and Research Hospital, Kayseri, Turkey
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[Refractive surgery for children with developmental delay : Indications, techniques and results]. Ophthalmologe 2020; 117:199-209. [PMID: 31940059 DOI: 10.1007/s00347-019-01032-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Visual stimulation and communication with the surroundings are crucial factors for childhood development. In children with intellectual disability the developmental delay can be exacerbated by visual impairment leading to visual autism. Uncorrected refractive error is one of the leading causes of visual impairment and spectacles are the gold standard for treatment. For some children with developmental delay or intellectual disability, the fitting and wearing of spectacles can be impossible due to severe craniofacial malformations, poor neck control or involuntary head movements. In these cases, if wearing contact lenses is also impossible the refractive error remains untreated and the child visually impaired. In certain situations cornea-based laser refractive surgery or lens-based refractive surgery can treat these refractive errors to enable better unaided visual acuity and therefore enhanced stimulation and integration of these developmentally delayed children. This article describes and discusses the indications, technical aspects and results of refractive surgery for children with developmental delay and intellectual disability.
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Zhang H, Sun Z, Li L, Sun R, Zhang H. Comparison of intraocular pressure measured by ocular response analyzer and Goldmann applanation tonometer after corneal refractive surgery: a systematic review and meta-analysis. BMC Ophthalmol 2020; 20:23. [PMID: 31924174 PMCID: PMC6954592 DOI: 10.1186/s12886-019-1288-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 12/27/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Accurate measurement of intraocular pressure (IOP) after corneal refractive surgery is of great significance to clinic, and comparisons among various IOP measuring instruments are not rare, but there is a lack of unified analysis. Although Goldmann Applanation Tonometer (GAT) is currently the internationally recognized gold standard for IOP measurement, its results are severely affected by central corneal thickness (CCT). Ocular Response Analyzer (ORA) takes certain biomechanical properties of cornea into account and is supposed to be less dependent of CCT. In this study, we conducted the meta-analysis to systematically assess the differences and similarities of IOP values measured by ORA and GAT in patients after corneal refractive surgery from the perspective of evidence-based medicine. METHODS The authors searched electronic databases (MEDLINE, EMBASE, Web of science, Cochrane library and Chinese electronic databases of CNKI and Wanfang) from Jan. 2005 to Jan. 2019, studies describing IOP comparisons measured by GAT and ORA after corneal refractive surgery were included. Quality assessment, subgroup analysis, meta-regression analysis and publication bias analysis were applied in succession. RESULTS Among the 273 literatures initially retrieved, 8 literatures (13 groups of data) with a total of 724 eyes were included in the meta-analysis, and all of which were English literatures. In the pooled analysis, the weighted mean difference (WMD) between IOPcc and IOPGAT was 2.67 mmHg (95% CI: 2.20~3.14 mmHg, p < 0.0001), the WMD between IOPg and IOPGAT was - 0.27 mmHg (95% CI: - 0.70~0.16 mmHg, p = 0.2174). In the subgroup analysis of postoperative IOPcc and IOPGAT, the heterogeneity among the data on surgical procedure was zero, while the heterogeneity of other subgroups was still more than 50%. The comparison of the mean difference of pre- and post-operative IOP (∆IOP) was: mean-∆IOPg > mean-∆IOPGAT > mean-∆IOPcc. CONCLUSIONS IOPcc, which is less dependent on CCT, may be more close to the true IOP after corneal refractive surgery compared with IOPg and IOPGAT, and the recovery of IOPcc after corneal surface refractive surgery may be more stable than that after lamellar refractive surgery.
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Affiliation(s)
- Hui Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, 100069, China
| | - Zhengtao Sun
- School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China
| | - Lin Li
- School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China.,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, 100069, China
| | - Ran Sun
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Haixia Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China. .,Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, 100069, China. .,School of Engineering, University of Liverpool, Liverpool, UK.
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Spadea L, Giovannetti F. Main Complications of Photorefractive Keratectomy and their Management. Clin Ophthalmol 2019; 13:2305-2315. [PMID: 31819355 PMCID: PMC6885542 DOI: 10.2147/opth.s233125] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 11/06/2019] [Indexed: 11/23/2022] Open
Abstract
Photorefractive keratectomy (PRK) was the first surface ablation procedure introduced for the treatment of refractive errors and has been proven to be effective and safe. In some cases, however, the patient may not be totally satisfied with the final result and retreatment may be necessary. We performed a literature review to describe the main conditions that may arise following PRK that may require retreatment and new promising techniques to allow customized and effective treatments for patients. There is currently no gold standard for retreatment of residual refractive error after PRK. The surgeon must take into account the patient's history and type of problem when choosing the most appropriate technique. LASIK and PRK are the main options. Haze can be treated with good results with phototherapeutic keratectomy and mytomicin C. High order aberrations and decentration may be addressed with topographically-guided excimer photoablation or with wavefront-guided PRK.
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Affiliation(s)
- Leopoldo Spadea
- Eye Clinic, Policlinico Umberto 1, Department of Sensory Organs, "La Sapienza" University of Rome, Rome, Italy
| | - Francesca Giovannetti
- Eye Clinic, Policlinico Umberto 1, Department of Sensory Organs, "La Sapienza" University of Rome, Rome, Italy
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Kim TI, Alió Del Barrio JL, Wilkins M, Cochener B, Ang M. Refractive surgery. Lancet 2019; 393:2085-2098. [PMID: 31106754 DOI: 10.1016/s0140-6736(18)33209-4] [Citation(s) in RCA: 164] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/29/2018] [Accepted: 12/11/2018] [Indexed: 01/19/2023]
Abstract
Refractive surgery has evolved beyond laser refractive techniques over the past decade. Laser refractive surgery procedures (such as laser in-situ keratomileusis), surface ablation techniques (such as laser epithelial keratomileusis), and photorefractive keratectomy have now been established as fairly safe procedures that produce excellent visual outcomes for patients with low-to-moderate amounts of ametropia. Additionally, a broader selection of options are now available to treat a wider range of refractive errors. Small incision lenticule extraction uses a femtosecond laser to shape a refractive lenticule, which is removed through a small wound. The potential advantages of this procedure include greater tectonic strength and less dry eye. In the future, intracorneal implants could be used to treat hyperopia or presbyopia. Phakic intraocular implants and refractive lens exchange might be useful options in carefully selected patients for correcting high degrees of ametropia. Thus, physicians are now able to provide patients with the appropriate refractive corrective option based on the individual's risk-benefit profile.
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Affiliation(s)
- Tae-Im Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Jorge L Alió Del Barrio
- Cornea, Cataract and Refractive Surgery Unit, Research & Development Department VISSUM Innovation Alicante, Alicante, Spain; Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain
| | - Mark Wilkins
- Department of Ophthalmology, Moorfields Eye Hospital, London, UK
| | - Beatrice Cochener
- Department of Ophthalmology, University Hospital Morvan, Brest, France
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology and Visual Science, Duke-NUS Graduate Medical School, Singapore.
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Predictive factors for efficacy and safety in refractive surgery for myopia. PLoS One 2018; 13:e0208608. [PMID: 30550575 PMCID: PMC6294382 DOI: 10.1371/journal.pone.0208608] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 11/20/2018] [Indexed: 11/19/2022] Open
Abstract
Purpose To evaluate the predictive factors for safety and efficacy in laser refractive surgery for myopia Setting A singular refractive surgery center, at a University-affiliated tertiary medical center. Design Retrospective cohort study Methods Study population—A total 8,775 eyes having laser refractive laser procedures for myopia (in4,623 patients). Observation procedures–Using a prospective database of refractive procedures performed over the span of 13 years, variables such as gender, age, type of surgery, date of surgery, pre-operative corneal thickness and Spherical Equivalent (SEQ) were evaluated. Main outcome measures—Proportion of patients with Safety index higher than 0.85 and Efficacy index higher than 0.80. Results 91.9% and 86.0% of all evaluated eyes were above the safety and efficacy cut-off levels, respectively. Younger age was significantly correlated with safety and efficacy indices above the cut-off levels (p<0.001). Male gender was significantly correlated with efficacy above the cut-off level (p<0.001). Myopic eyes with lower SEQ were associated with both safety (p = 0.002) and efficacy (p<0.001) indices above the cut-offs. The surgical procedure was found to significantly affect the outcome only using univariate analysis: Safety was higher in Photorefractive Keratectomy (PRK), while Efficacy was higher in Laser Assisted In Situ Keratomileusis (LASIK) (p<0.001, respectively) but no difference was found using multivariate analysis. Safety index above the cut-off level increased over the years (p<0.001). Conclusions Efficacy in refractive surgery for myopia is correlated with younger age, male gender and low myopia. Safety is correlated with younger age, low myopia and increases over the years. Multivariate analysis found no differences between PRK and LASIK regarding safety and efficacy.
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You S, Sun Y, Chaney EJ, Zhao Y, Chen J, Boppart SA, Tu H. Slide-free virtual histochemistry (Part I): development via nonlinear optics. BIOMEDICAL OPTICS EXPRESS 2018; 9:5240-5252. [PMID: 30460125 PMCID: PMC6238939 DOI: 10.1364/boe.9.005240] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/16/2018] [Accepted: 09/13/2018] [Indexed: 05/18/2023]
Abstract
Histochemistry is a microscopy-based technology widely used to visualize the molecular distribution in biological tissue. Recent developments in label-free optical imaging has demonstrated the potential to replace the conventional histochemical labels/markers (fluorescent antibodies, organic dyes, nucleic acid probes, and other contrast agents) with diverse optical interactions to generate histochemical contrasts, allowing "virtual" histochemistry in three spatial dimensions without preparing a microscope slide (i.e. labor-intensive sample preparation). However, the histochemical information in a label-free optical image has often been rather limited due to the difficulty in simultaneously generating multiple histochemical contrasts with strict spatial co-registration. Here, in the first part (Part I) of this two-part series study, we develop a technique of slide-free virtual histochemistry based on label-free multimodal multiphoton microscopy, and simultaneously generate up to four histochemical contrasts from in vivo animal and ex vivo human tissue. To enable this functionality, we construct and demonstrate a robust fiber-based laser source for clinical translation and phenotype a wide variety of vital cells in unperturbed mammary tissue.
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Affiliation(s)
- Sixian You
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Yi Sun
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Eric J Chaney
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Youbo Zhao
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Jianxin Chen
- Fujian Provincial Key Laboratory for Photonics Technology, Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Normal University, Fuzhou, 350007, China
| | - Stephen A Boppart
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Department of Electrical and Computer Engineering, Carle-Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Haohua Tu
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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Biocompatible and Implantable Optical Fibers and Waveguides for Biomedicine. MATERIALS 2018; 11:ma11081283. [PMID: 30044416 PMCID: PMC6117721 DOI: 10.3390/ma11081283] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/20/2018] [Accepted: 07/21/2018] [Indexed: 11/17/2022]
Abstract
Optical fibers and waveguides in general effectively control and modulate light propagation, and these tools have been extensively used in communication, lighting and sensing. Recently, they have received increasing attention in biomedical applications. By delivering light into deep tissue via these devices, novel applications including biological sensing, stimulation and therapy can be realized. Therefore, implantable fibers and waveguides in biocompatible formats with versatile functionalities are highly desirable. In this review, we provide an overview of recent progress in the exploration of advanced optical fibers and waveguides for biomedical applications. Specifically, we highlight novel materials design and fabrication strategies to form implantable fibers and waveguides. Furthermore, their applications in various biomedical fields such as light therapy, optogenetics, fluorescence sensing and imaging are discussed. We believe that these newly developed fiber and waveguide based devices play a crucial role in advanced optical biointerfaces.
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Artini W, B Riyanto S, Hutauruk JA, D Gondhowiardjo T, Kekalih A. Predictive Factors for Successful High Myopia Treatment Using High-Frequency Laser- In-Situ Keratomileusis. Open Ophthalmol J 2018; 12:214-225. [PMID: 30123384 PMCID: PMC6062894 DOI: 10.2174/1874364101812010214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 05/18/2018] [Accepted: 07/05/2018] [Indexed: 11/22/2022] Open
Abstract
Aim To evaluate the predictive factors of LASIK procedure for high myopia with or without astigmatism using a combination of high-frequency femtosecond-assisted LASIK followed by an excimer laser. Methods This study was a retrospective interventional case series study to evaluate myopic eyes undergoing high platform LASIK with FEMTO LDV Z2 intervention, followed by WaveLight®EX500 excimer laser machine. Subjects were divided into 2 groups: high myopia (SE of -6.01 to -9.00 D) and very high myopia (SE of -9.01 D or higher). Myopic eyes (Spherical Equivalent/SE) less than -13 D were included in this study. Visual Acuity (VA) was evaluated 1 day and 60 days after the procedure. Predictive factors, such as age, degree of sphere, degree of astigmatism, keratometric reading and axial length were analyzed to detect any influences affecting the final VA results. Results A total of 316 myopia eyes underwent intervention, mean age: 25.3±3.8 years. Target treatment was achieved in 96.1% of patients with high myopia and 69.9% of patients with very high myopia. High degree of sphere and astigmatism constitutes an important factor influencing final VA. Conclusion Modern machines provide a more promising efficacy and success of LASIK procedure in high myopia: important predictive factors were a high degree of sphere and astigmatism for achieving the optimal final outcome.
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Affiliation(s)
- Widya Artini
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Kirana Hospital, Jakarta, Indonesia.,Jakarta Eye Center Menteng Jakarta, Jakarta, Indonesia
| | | | | | - Tjahjono D Gondhowiardjo
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Kirana Hospital, Jakarta, Indonesia.,Jakarta Eye Center Menteng Jakarta, Jakarta, Indonesia
| | - Aria Kekalih
- Community Medicine Department, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Heng Wong MY, Tan NYQ, Sabanayagam C. Time trends, disease patterns and gender imbalance in the top 100 most cited articles in ophthalmology. Br J Ophthalmol 2018; 103:18-25. [PMID: 30002071 DOI: 10.1136/bjophthalmol-2018-312388] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/05/2018] [Accepted: 06/17/2018] [Indexed: 11/03/2022]
Abstract
We analysed the 100 top cited articles in ophthalmology to identify and characterise the most influential articles of the past four decades. Two independent investigators searched the Scopus database to determine the 100 most frequently cited articles in ophthalmology (T100-Eye) and general non-ophthalmology journals (T100-Gen) published from 1975 to December 2017. The T100-Eye list consisted of 83 original articles and 17 reviews, and the number of citations ranged from 582 to 2833. Seventy-eight of these articles were published in three journals alone (impact factor (IF): 5.05-8.2), led by the Archives of Ophthalmology The T100-Gen list consisted of 84 original articles and 16 reviews and the number of citations ranged from 358 to 3272. Forty-five of these articles were published in four journals alone (IF: 9.66-72.41). In both lists, majority of the first authors were from the USA (T100-Eye, n=80; T100-Gen, n=66), and were men (n=76 in T100-Eye; n=72 in T100-Gen). With regard to the article type, in the T100-Eye, among the 83 original research articles, most were randomised controlled trials (n=26) or clinical observational studies related to description of a new condition or new management (n=26). In the T100-Gen, of the 84 original research articles, many were clinical observational studies (n=27) or basic science research (n=26). In both lists, the most frequently examined diseases were age-related macular degeneration, diabetic retinopathy and glaucoma. Our analysis reveals landmark articles, trends and medical advancements in ophthalmology over the past four decades. It also highlights gender disparity and influence of the USA in seminal ophthalmic research.
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Affiliation(s)
- Matthew Yu Heng Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Anglo-Chinese School (Independent), Singapore
| | - Nicholas Y Q Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore .,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Heus P, Verbeek JH, Tikka C. Optical correction of refractive error for preventing and treating eye symptoms in computer users. Cochrane Database Syst Rev 2018; 4:CD009877. [PMID: 29633784 PMCID: PMC6494484 DOI: 10.1002/14651858.cd009877.pub2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Computer users frequently complain about problems with seeing and functioning of the eyes. Asthenopia is a term generally used to describe symptoms related to (prolonged) use of the eyes like ocular fatigue, headache, pain or aching around the eyes, and burning and itchiness of the eyelids. The prevalence of asthenopia during or after work on a computer ranges from 46.3% to 68.5%. Uncorrected or under-corrected refractive error can contribute to the development of asthenopia. A refractive error is an error in the focusing of light by the eye and can lead to reduced visual acuity. There are various possibilities for optical correction of refractive errors including eyeglasses, contact lenses and refractive surgery. OBJECTIVES To examine the evidence on the effectiveness, safety and applicability of optical correction of refractive error for reducing and preventing eye symptoms in computer users. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; Embase; Web of Science; and OSH update, all to 20 December 2017. Additionally, we searched trial registries and checked references of included studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-randomised trials of interventions evaluating optical correction for computer workers with refractive error for preventing or treating asthenopia and their effect on health related quality of life. DATA COLLECTION AND ANALYSIS Two authors independently assessed study eligibility and risk of bias, and extracted data. Where appropriate, we combined studies in a meta-analysis. MAIN RESULTS We included eight studies with 381 participants. Three were parallel group RCTs, three were cross-over RCTs and two were quasi-randomised cross-over trials. All studies evaluated eyeglasses, there were no studies that evaluated contact lenses or surgery. Seven studies evaluated computer glasses with at least one focal area for the distance of the computer screen with or without additional focal areas in presbyopic persons. Six studies compared computer glasses to other types of glasses; and one study compared them to an ergonomic workplace assessment. The eighth study compared optimal correction of refractive error with the actual spectacle correction in use. Two studies evaluated computer glasses in persons with asthenopia but for the others the glasses were offered to all workers regardless of symptoms. The risk of bias was unclear in five, high in two and low in one study. Asthenopia was measured as eyestrain or a summary score of symptoms but there were no studies on health-related quality of life. Adverse events were measured as headache, nausea or dizziness. Median asthenopia scores at baseline were about 30% of the maximum possible score.Progressive computer glasses versus monofocal glassesOne study found no considerable difference in asthenopia between various progressive computer glasses and monofocal computer glasses after one-year follow-up (mean difference (MD) change scores 0.23, 95% confidence interval (CI) -5.0 to 5.4 on a 100 mm VAS scale, low quality evidence). For headache the results were in favour of progressive glasses.Progressive computer glasses with an intermediate focus in the upper part of the glasses versus other glassesIn two studies progressive computer glasses with intermediate focus led to a small decrease in asthenopia symptoms (SMD -0.49, 95% CI -0.75 to -0.23, low-quality evidence) but not in headache score in the short-term compared to general purpose progressive glasses. There were similar small decreases in dizziness. At medium term follow-up, in one study the effect size was not statistically significant (SMD -0.64, 95% CI -1.40 to 0.12). The study did not assess adverse events.Another study found no considerable difference in asthenopia between progressive computer glasses and monofocal computer glasses after one-year follow-up (MD change scores 1.44, 95% CI -6.95 to 9.83 on a 100 mm VAS scale, very low quality evidence). For headache the results were inconsistent.Progressive computer glasses with far-distance focus in the upper part of the glasses versus other glassesOne study found no considerable difference in number of persons with asthenopia between progressive computer glasses with far-distance focus and bifocal computer glasses after four weeks' follow-up (OR 1.00, 95% CI 0.40 to 2.50, very low quality evidence). The number of persons with headache, nausea and dizziness was also not different between groups.Another study found no considerable difference in asthenopia between progressive computer glasses with far-distance focus and monofocal computer glasses after one-year follow-up (MD change scores -1.79, 95% CI -11.60 to 8.02 on a 100 mm VAS scale, very low quality evidence). The effects on headaches were inconsistent.One study found no difference between progressive far-distance focus computer glasses and trifocal glasses in effect on eyestrain severity (MD -0.50, 95% CI -1.07 to 0.07, very low quality evidence) or on eyestrain frequency (MD -0.75, 95% CI -1.61 to 0.11, very low quality evidence).Progressive computer glasses versus ergonomic assessment with habitual (computer) glassesOne study found that computer glasses optimised for individual needs reduced asthenopia sum score more than an ergonomic assessment and habitual (computer) glasses (MD -8.9, 95% CI -16.47 to -1.33, scale 0 to 140, very low quality evidence) but there was no effect on the frequency of eyestrain (OR 1.08, 95% CI 0.38 to 3.11, very low quality evidence).We rated the quality of the evidence as low or very low due to risk of bias in the included studies, inconsistency in the results and imprecision. AUTHORS' CONCLUSIONS There is low to very low quality evidence that providing computer users with progressive computer glasses does not lead to a considerable decrease in problems with the eyes or headaches compared to other computer glasses. Progressive computer glasses might be slightly better than progressive glasses for daily use in the short term but not in the intermediate term and there is no data on long-term follow-up. The quality of the evidence is low or very low and therefore we are uncertain about this conclusion. Larger studies with several hundreds of participants are needed with proper randomisation, validated outcome measurement methods, and longer follow-up of at least one year to improve the quality of the evidence.
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Affiliation(s)
- Pauline Heus
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityCochrane NetherlandsRoom Str. 6.131PO Box 85500UtrechtNetherlands3508 GA
| | - Jos H Verbeek
- Finnish Institute of Occupational HealthCochrane Work Review GroupTYÖTERVEYSLAITOSFinlandFI‐70032
| | - Christina Tikka
- Finnish Institute of Occupational HealthCochrane Work Review GroupTYÖTERVEYSLAITOSFinlandFI‐70032
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Abstract
PURPOSE OF REVIEW Given the popularity of keratorefractive surgery, and an aging populous of patients who have undergone these procedures, there is an increasing need for updated management protocols. This is particularly relevant for patients with chronic progressive diseases such as glaucoma, due to the variety of related diagnostic and management challenges inherent to these diseases. Here, we will review the current literature to provide an update on the management of patients with glaucoma who are undergoing, or have had laser ablative refractive surgery. Preoperative testing and eligibility considerations, intraoperative factors, and postoperative observation and follow-up will be discussed. RECENT FINDINGS Intraoperative intraocular pressure (IOP) rise during flap creation is associated with low risk of acute complications, and furthermore do not appear to have significant long term effects. Modern technologies have improved our ability to determine accurate IOP after refractive surgery despite postoperative changes in corneal architecture. Furthermore, advances in structural imaging allow for earlier detection of even subtle glaucomatous nerve damage. SUMMARY Although glaucoma remains a relative contraindication to refractive surgery, it is a safe procedure for many patients with appropriate perioperative management and follow-up. Advancements in diagnostic modalities have allowed for earlier detection of glaucomatous disease, and subsequent earlier intervention when appropriate. Standardized diagnostic algorithms and rigorous perioperative assessment are critical to safe management of glaucoma patients undergoing refractive corneal surgery.
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Kandel H, Khadka J, Lundström M, Goggin M, Pesudovs K. Questionnaires for Measuring Refractive Surgery Outcomes. J Refract Surg 2017; 33:416-424. [DOI: 10.3928/1081597x-20170310-01] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/18/2017] [Indexed: 11/20/2022]
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Peyman A, Dastborhan Z, Peyman M. Astigmatic treatment with photorefractive keratectomy: Investigations of non-keratometric ocular astigmatism. J Curr Ophthalmol 2017; 29:98-102. [PMID: 28626818 PMCID: PMC5463002 DOI: 10.1016/j.joco.2016.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/28/2016] [Accepted: 12/06/2016] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the effect of non-keratometric ocular astigmatisms on visual and refractive outcomes after photorefractive keratectomy (PRK) for correction of myopic astigmatisms. METHODS Seventy one eyes of 36 subjects were enrolled in this study. Patients underwent PRK for treatment of myopia. Subjects were evaluated for refractive error, keratometry, and visual acuity before and six months after surgery. Pre- and post-op non-keratometric astigmatisms were calculated by vectorial analysis of the difference between the corneal plane refractive astigmatism and keratometric astigmatism. Astigmatic analysis explored the contribution of non-keratometric astigmatisms. RESULTS The pre-op spherical equivalent (SE) was -6.27 ± 1.48 with 1.16 ± 1.02 diopters of corneal plane refractive astigmatism and 1.44 ± 0.47 diopters keratometric astigmatism. Post-op values were -0.60 ± 0.85, 0.56 ± 0.47, and 1.06 ± 0.57, respectively, 6 months after surgery. Pre- and post-op non-keratometric astigmatisms were 0.76 ± 0.41 and 0.76 ± 0.46, respectively, (P = 0.976) with significant correlation (r = 0.37, P = 0.002). Pre-op non-keratometric astigmatisms correlated to the pre-op SE (r = -0.25, P = 0.04). Pre-op non-keratometric astigmatisms had significant correlation with keratometric difference vector of astigmatic correction (r = 0.369, P = 0.002). Post-op non-keratometric astigmatisms correlated to keratometric induced astigmatism (r = 0.334, P = 0.006), keratometric index of success (r = 0.571, P < 0.001), and post-op keratometric astigmatism (r = 0.736, P < 0.001). CONCLUSIONS Higher or lower non-keratometric ocular astigmatisms did not have any effect on refractive and visual outcome after PRK. PRK effectively corrected total refractive astigmatism through correction of keratometric astigmatism and additional adjustment to compensate for non-keratometric ocular astigmatisms.
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Affiliation(s)
- Alireza Peyman
- Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Dastborhan
- Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Peyman
- Department of Ophthalmology, Faculty of Medicine Building, University of Malaya, Kuala Lumpur, Malaysia
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Kandel H, Khadka J, Goggin M, Pesudovs K. Impact of refractive error on quality of life: a qualitative study. Clin Exp Ophthalmol 2017; 45:677-688. [PMID: 28370795 DOI: 10.1111/ceo.12954] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 02/27/2017] [Accepted: 03/24/2017] [Indexed: 11/28/2022]
Abstract
IMPORTANCE This study qualitatively explores the impact of refractive error on adults, particularly after correction. BACKGROUND The study aimed to explore the impact of refractive error on quality of life. DESIGN Cross-sectional; in-depth telephone and face-to-face semistructured interviews; qualitative study with inductive and deductive processes. PARTICIPANTS Forty-eight adults with refractive error (including presbyopia) were recruited from the Flinders Vision, the Ashford Advanced Eye Care and among Flinders University staff and students, in South Australia. METHODS The interviews were audio-recorded, transcribed verbatim, coded and analysed using thematic analysis. MAIN OUTCOME MEASURES Themes and categories RESULTS: The median age of the participants was 49 years (min: 22 years; max: 76 years). Most of them were female: (29; 59%). Most of them (36; 75.0%) had myopia followed by hyperopia (12; 25.0%). Twenty-two (45.8%) participants had astigmatism. Similarly, 23 (47.9%) of them were presbyopes. Most of the participants (39; 81.3%) wore glasses; 17 (35.4%) used contact lenses, and 17 (35.4%) had undergone refractive surgery. A total of 2367 comments were coded. Thematic analysis resulted into six themes that informed about quality of life issues in people with refractive error. Concerns about cosmetic appearance, personal health and safety, difficulties in day-to-day activities and inconveniences rendered in daily life were identified as the most important themes. CONCLUSIONS AND RELEVANCE The findings of this study enrich the understanding on the issues important in people with refractive error. The quality of life issues identified will be used to develop a refractive error-specific item bank.
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Affiliation(s)
- Himal Kandel
- NHMRC Centre for Clinical Eye Research, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Jyoti Khadka
- NHMRC Centre for Clinical Eye Research, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Michael Goggin
- University of Adelaide/South Australian Institute of Ophthalmology, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Konrad Pesudovs
- NHMRC Centre for Clinical Eye Research, Flinders University of South Australia, Adelaide, South Australia, Australia
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Abstract
PURPOSE To determine the demographic and refractive characteristics of excimer laser refractive surgery candidates in Iran. METHODS This was a cross-sectional study between 2010 and 2014. All information was collected from 28 centers randomly selected from 12 provinces. Then, for each season of the year, one week was chosen through simple random selection, and within each week, 3 days were again chosen randomly. All excimer laser surgical procedures performed during these 3 days were identified by training staff, and data were extracted from patient charts. RESULTS A total of 14,569 charts were reviewed; 67.5% of the subjects were female and the rest were male. Of the total surgeries, 18.6% had been done in 2010 which reached to 19.1% in 2014. The mean age of people receiving refractive surgery showed an upward trend (P<0.001) and female patients were significantly younger than male patients (P<0.001). The 25 to 39 years age group received the highest number of surgeries (31.9% of the total) and there was a significant association with gender (P<0.001). The most common refractive error was compound myopic astigmatism with a prevalence of 79.3%. In 2010, 33.3% of the performed surgeries were covered by insurance policies, and this decreased to 30.2% in 2014 (P<0.001). CONCLUSION Women with compound myopic astigmatism in the age range of 25 and 35 years are the most frequent users of excimer laser refractive surgery. Less than one-third of laser refractive surgeries are covered by insurance policies. Therefore, proper planning for improving services to this group must be given priority.
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Abstract
Light and optical techniques have made profound impacts on modern
medicine, with numerous lasers and optical devices being currently used in
clinical practice to assess health and treat disease. Recent advances in
biomedical optics have enabled increasingly sophisticated technologies —
in particular those that integrate photonics with nanotechnology, biomaterials
and genetic engineering. In this Review, we revisit the fundamentals of
light–matter interactions, describe the applications of light in
imaging, diagnosis, therapy and surgery, overview their clinical use, and
discuss the promise of emerging light-based technologies.
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Affiliation(s)
- Seok Hyun Yun
- Wellman Center for Photomedicine, Massachusetts General Hospital, 65 Landsdowne Street, Cambridge, MA 02139, USA.,Department of Dermatology, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115.,Harvard-MIT Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Sheldon J J Kwok
- Wellman Center for Photomedicine, Massachusetts General Hospital, 65 Landsdowne Street, Cambridge, MA 02139, USA.,Harvard-MIT Health Sciences and Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
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Lellouch J, Saad A, Guilbert E, Gatinel D. [Evaluation of vision quality after laser vision correction in healthcare professionals]. J Fr Ophtalmol 2016; 39:849-858. [PMID: 27865691 DOI: 10.1016/j.jfo.2016.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 09/02/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE Healthcare professionals require good quality of vision. The main objective of this study is to evaluate the satisfaction and vision quality after laser vision correction in healthcare professionals. METHODS This is a monocentric retrospective study. An online 25-question survey was sent to ametropic physicians, surgeons and nurses who underwent corneal refractive surgery with laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between July 2012 and February 2016. Questionnaire responses were recorded anonymously by the internet survey site. These patients' pre- and postoperative data were analyzed. RESULTS In total, 2491 laser vision corrections were performed during this time frame. One hundred and fifty-eight patients were healthcare providers; 131 received the survey, and 111 responded. Ninety-nine were surgeons, 60 were medical physicians, and 32 were nurses. Ninety-one percent reported that they were satisfied with their postoperative vision quality, 63.9% even reported an improvement in their quality of vision compared with their corrected preoperative vision, 92.8% reported that they would have the procedure again, and 94.6% would recommend the procedure to a family member or a patient. Visual outcomes showed high levels of efficacy and predictability. CONCLUSION While healthcare professionals require good quality of vision, those who had undergone laser vision correction reported the same satisfaction as the general population and would recommend the procedure to their family, friends and patients.
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Affiliation(s)
- J Lellouch
- Fondation ophtalmologique Adolphe de Rothschild, 29, rue Manin, 75019 Paris, France
| | - A Saad
- Fondation ophtalmologique Adolphe de Rothschild, 29, rue Manin, 75019 Paris, France
| | - E Guilbert
- Fondation ophtalmologique Adolphe de Rothschild, 29, rue Manin, 75019 Paris, France
| | - D Gatinel
- Fondation ophtalmologique Adolphe de Rothschild, 29, rue Manin, 75019 Paris, France.
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Sasse AC, Shajari M, Kohnen T. Influence of blurred vision, accommodation, and target laser settings on eye movements during LASIK. J Cataract Refract Surg 2016; 42:1424-1430. [PMID: 27839596 DOI: 10.1016/j.jcrs.2016.07.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 07/19/2016] [Accepted: 07/22/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To analyze the influence of blurred vision, accommodation, and target laser settings on eye movements during laser in situ keratomileusis (LASIK). SETTING Department of Ophthalmology, Goethe University, Frankfurt, Germany. DESIGN Prospective randomized study. METHODS Participants had simulated LASIK treatment. They were instructed to focus on the fixation light; the treatment laser was blocked, and all other settings were applied according to standard LASIK treatments. To simulate blurred vision a 0.0 diopter (D) soft contact lens received a 5.0 D myopia laser treatment and was then applied to the participant's eye. To diminish accommodation, a second lens that had a refraction of the patient's spherical equivalent, plus 3.0 D to compensate for accommodation, was used. There were 4 treatment modalities as follows: (1) blurred lens with target laser on, (2) blurred lens with target laser turned off, (3) +3.0 D lens with target laser on, and (4) +3.0 D lens with target laser turned off. Lateral and torsional eye movements were recorded. Fourier analysis was used to obtain temporal power spectra from dynamic eye movements. The Fn criterion was set as the frequency below which n% of eye movements in the cohort occurred (n = 95%, 80%, and 50%). RESULTS The study comprised 11 eyes of 11 participants. There was 1 significant difference between the eye movements based on measurement modalities. In 1 variable in the y-axis, there was movement that showed a significant difference in the F80 criterion. CONCLUSION Surgical circumstances such as blurred vision, accommodation, and target light had little influence on eye movements during LASIK. FINANCIAL DISCLOSURE Proprietary or commercial disclosures are listed after the references.
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Affiliation(s)
- Anna Christina Sasse
- From the Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt, Germany
| | - Mehdi Shajari
- From the Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt, Germany
| | - Thomas Kohnen
- From the Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt, Germany.
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Pinheiro FI, Araújo-Filho I, Meneses do Rego AC, Pereira de Azevedo E, Tabosa do Egito ES, Oréfice F, Alves de Souza Lima Filho A. New drug delivery system for corneal administration of mitomycin-C. J Cataract Refract Surg 2016; 42:1216-23. [PMID: 27531299 DOI: 10.1016/j.jcrs.2016.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/29/2016] [Accepted: 04/29/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE To develop a new corneal release system to deliver optimum amounts of mitomycin-C (MMC) during the perioperative period of photorefractive keratectomy (PRK). SETTING Ophthalmos S/A, São Paulo, Brazil. DESIGN Experimental study. METHODS An in vitro experimental design was developed for studying a new MMC delivery system at a drug concentration of 0.02%. Whatman sterile filter paper disks with a diameter of 8.0 mm were impregnated with MMC solution. After drying, the disks were placed on agar plates seeded with Staphylococcus epidermidis; this was followed by instillation of a drop of sterile water. After 1 minute, the disks were removed and the plates were incubated for 48 hours at 35°C. The mean volume of the drops delivered from regular eyedrop bottles was determined, and the inhibition zone (in millimeters) was correlated with the amount of MMC loaded onto the disks. RESULTS Analysis of the inhibition zones produced by MMC indicated that 16 μg was the optimum dose to be incorporated in the disks. The mean volume of a drop delivered from eyedrop bottles was 37.7 μL. One minute after the application of a single drop of a balanced salt solution, the system released an adequate concentration of MMC for PRK. CONCLUSION A new delivery system for MMC was successfully developed for application during photorefractive keratectomy. FINANCIAL DISCLOSURE Dr. de Souza Lima Filho is the managing director of Ophtalmos S/A. Drs. de Souza Lima Filho, Irochima Pinheiro, and Oréfice have exclusive rights to intellectual property of this invention secured by a patent application filed with the Instituto Nacional da Propriedade Industrial.
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Affiliation(s)
- Francisco Irochima Pinheiro
- From the Graduate Program in Biotechnology (Pinheiro, Araújo-Filho, Rego, Azevedo), Potiguar University, the Laboratory of Dispersed Systems (Tabosa do Egito), Federal University of Rio Grande do Norte, Natal-RN, the Division of Uveitis, Brazilian Center for Visual Sciences (Oréfice), Belo Horizonte-MG, Ophthalmos S/A (Lima Filho), and the Department of Ophthalmology (Lima Filho), Federal University of São Paulo (USP), São Paulo, Brazil
| | - Irami Araújo-Filho
- From the Graduate Program in Biotechnology (Pinheiro, Araújo-Filho, Rego, Azevedo), Potiguar University, the Laboratory of Dispersed Systems (Tabosa do Egito), Federal University of Rio Grande do Norte, Natal-RN, the Division of Uveitis, Brazilian Center for Visual Sciences (Oréfice), Belo Horizonte-MG, Ophthalmos S/A (Lima Filho), and the Department of Ophthalmology (Lima Filho), Federal University of São Paulo (USP), São Paulo, Brazil.
| | - Amalia Cinthia Meneses do Rego
- From the Graduate Program in Biotechnology (Pinheiro, Araújo-Filho, Rego, Azevedo), Potiguar University, the Laboratory of Dispersed Systems (Tabosa do Egito), Federal University of Rio Grande do Norte, Natal-RN, the Division of Uveitis, Brazilian Center for Visual Sciences (Oréfice), Belo Horizonte-MG, Ophthalmos S/A (Lima Filho), and the Department of Ophthalmology (Lima Filho), Federal University of São Paulo (USP), São Paulo, Brazil
| | - Eduardo Pereira de Azevedo
- From the Graduate Program in Biotechnology (Pinheiro, Araújo-Filho, Rego, Azevedo), Potiguar University, the Laboratory of Dispersed Systems (Tabosa do Egito), Federal University of Rio Grande do Norte, Natal-RN, the Division of Uveitis, Brazilian Center for Visual Sciences (Oréfice), Belo Horizonte-MG, Ophthalmos S/A (Lima Filho), and the Department of Ophthalmology (Lima Filho), Federal University of São Paulo (USP), São Paulo, Brazil
| | - Eryvaldo Socrates Tabosa do Egito
- From the Graduate Program in Biotechnology (Pinheiro, Araújo-Filho, Rego, Azevedo), Potiguar University, the Laboratory of Dispersed Systems (Tabosa do Egito), Federal University of Rio Grande do Norte, Natal-RN, the Division of Uveitis, Brazilian Center for Visual Sciences (Oréfice), Belo Horizonte-MG, Ophthalmos S/A (Lima Filho), and the Department of Ophthalmology (Lima Filho), Federal University of São Paulo (USP), São Paulo, Brazil
| | - Fernando Oréfice
- From the Graduate Program in Biotechnology (Pinheiro, Araújo-Filho, Rego, Azevedo), Potiguar University, the Laboratory of Dispersed Systems (Tabosa do Egito), Federal University of Rio Grande do Norte, Natal-RN, the Division of Uveitis, Brazilian Center for Visual Sciences (Oréfice), Belo Horizonte-MG, Ophthalmos S/A (Lima Filho), and the Department of Ophthalmology (Lima Filho), Federal University of São Paulo (USP), São Paulo, Brazil
| | - Acácio Alves de Souza Lima Filho
- From the Graduate Program in Biotechnology (Pinheiro, Araújo-Filho, Rego, Azevedo), Potiguar University, the Laboratory of Dispersed Systems (Tabosa do Egito), Federal University of Rio Grande do Norte, Natal-RN, the Division of Uveitis, Brazilian Center for Visual Sciences (Oréfice), Belo Horizonte-MG, Ophthalmos S/A (Lima Filho), and the Department of Ophthalmology (Lima Filho), Federal University of São Paulo (USP), São Paulo, Brazil
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Outcomes of a Management Strategy in Eyes with Corneal Irregularity and Cataract. BIOMED RESEARCH INTERNATIONAL 2016; 2016:8497858. [PMID: 27563677 PMCID: PMC4987472 DOI: 10.1155/2016/8497858] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/28/2016] [Indexed: 11/18/2022]
Abstract
Purpose. To evaluate the outcomes of a management strategy in patients with irregular corneas and cataract. Methods. Six eyes of four patients presented for cataract surgery with irregular corneas following corneal refractive surgery. Topoguided ablation regularised the cornea, followed by phacoemulsification and intraocular lens implantation. Zonal keratometric coefficient of variation (ZKCV) measured structural changes and visual quality metrics measured functional improvement. Results. The mean duration after corneal refractive surgery was 7.83 ± 2.40 years. The logmar uncorrected distance visual acuity (0.67 ± 0.25) and the corrected distance visual acuity (0.38 ± 0.20) improved to 0.34 ± 0.14 and 0.18 ± 0.10, respectively. The changes in the standard deviations of the zonal keratometry values and the ZKCV were statistically significant in the 2, 3, and 4 mm zones. The changes in the Strehl ratio (ANOVA p = 0.043) were also statistically significant. Conclusions. Corneal regularisation followed by phacoemulsification resulted in lower residual refractive error with improved visual quality metrics. This strategy is a viable option in patients with symptomatic cataracts and irregular corneas.
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Xia L, Zhang J, Wu J, Yu K. Comparison of Corneal Biological Healing After Femtosecond LASIK and Small Incision Lenticule Extraction Procedure. Curr Eye Res 2016; 41:1202-8. [DOI: 10.3109/02713683.2015.1107590] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lei Xia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Jing Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
- Department of Ophthalmology, the East Area of Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, People’s Republic of China
| | - Junshu Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Keming Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People’s Republic of China
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Anitua E, Muruzabal F, de la Fuente M, Merayo J, Durán J, Orive G. Plasma Rich in Growth Factors for the Treatment of Ocular Surface Diseases. Curr Eye Res 2016; 41:875-82. [PMID: 26828610 DOI: 10.3109/02713683.2015.1104362] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE The purpose of this work is to describe and review the technology of plasma rich in growth factors (PRGF), a novel blood derivative product, in the treatment of ocular surface disorders. METHODS To demonstrate the importance of this technology in the treatment of ocular pathologies, a thorough review of the preclinical and clinical literature results obtained following use of the different therapeutic formulations of PRGF was carried out. A literature search for applications of PGRF plasma in the ophthalmology field was carried out using the PubMed database. RESULTS PRGF involves the use of patient's own biologically active proteins, growth factors, and biomaterial scaffolds for therapeutic purposes. This procedural technology is gaining interest in regenerative medicine due to its potential to stimulate and accelerate the tissue healing processes. The versatility and biocompatibility of this technology opens the door to a personalized medicine on ocular tissue regeneration. This review discusses the state of the art of the new treatments and technologies developed to promote ocular surface tissue regeneration. The standardized protocol that has been developed to source eye drops from PRGF technology is also described. The preclinical research, together with the most relevant clinical applications are summarized and discussed. CONCLUSIONS The preliminary results suggest that the use of PRGF to enhance ocular tissue regeneration is safe and efficient.
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Affiliation(s)
- Eduardo Anitua
- a Department of R&D , Biotechnology Institute (BTI) , Vitoria , Spain.,b Department of R&D , Fundación Eduardo Anitua , Vitoria , Spain
| | | | | | - Jesús Merayo
- c Fundación de Investigación Oftalmológica , Instituto Oftalmológico Fernández-Vega , Oviedo , Spain
| | - Juan Durán
- d Department of R&D , Instituto Clínico-Quirúrgico de Oftalmología , Bilbao , Spain.,e Department of Ophthalmology, School of Medicine and Dentistry, BioCruces Health Research Institute , University of the Basque Country , Leioa , Spain
| | - Gorka Orive
- a Department of R&D , Biotechnology Institute (BTI) , Vitoria , Spain.,b Department of R&D , Fundación Eduardo Anitua , Vitoria , Spain
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46
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Abstract
Techniques available for corneal lamellar refractive surgery are laser-assisted in situ keratomileusis (LASIK) using a microkeratome or femtosecond laser incision followed by excimer laser corneal ablation, and femtosecond laser-assisted refractive lenticule extraction (ReLEx). These treatments are nowadays considered to be safe and effective standard procedures for surgical correction of mild to moderate ametropia. Possible complications include too small or decentered optical zones, intraoperative flap cutting errors and postoperative inflammation (e.g. diffuse lamellar keratitis, DLK), epithelial or flap folds, epithelial ingrowths or iatrogenic ectasia. The occurrence of complications may be significantly reduced by compliance to corresponding standards of indication and treatment that are based on current scientific knowledge.
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Affiliation(s)
- T Kohnen
- Klinik für Augenheilkunde, Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
| | - M Remy
- Klinik für Augenheilkunde, Goethe-Universität Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland
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47
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Cumberland PM, Chianca A, Rahi JS. Laser refractive surgery in the UK Biobank study. J Cataract Refract Surg 2015; 41:2466-75. [DOI: 10.1016/j.jcrs.2015.05.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 04/23/2015] [Accepted: 05/20/2015] [Indexed: 11/28/2022]
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48
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Mohammadi SF, Nabovati P, Mirzajani A, Ashrafi E, Vakilian B. Risk factors of regression and undercorrection in photorefractive keratectomy: a case-control study. Int J Ophthalmol 2015; 8:933-7. [PMID: 26558204 DOI: 10.3980/j.issn.2222-3959.2015.05.14] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 01/30/2015] [Indexed: 11/02/2022] Open
Abstract
AIM To determine risk factors of regression and undercorrection following photorefractive keratectomy (PRK) in myopia or myopic astigmatism. METHODS A case-control study was designed in which eyes with an indication for re-treatment (RT) were defined as cases; primary criteria for RT indication, as assessed at least 9mo postoperatively, included an uncorrected distance visual acuity (UDVA) of 20/30 or worse and a stable refraction for more than 3mo. Additional considerations included optical quality symptoms and significant higher order aberrations (HOAs). Controls were chosen from the same cohort of operated eyes which had complete post-operative follow up data beyond 9mo and did not need RT. The cohort included patients who had undergone PRK by the Tissue-Saving (TS) ablation profile of Technolas 217z100 excimer laser (Bausch & Lomb, Rochester, NY, USA). Mitomycin C had been used in all of the primary procedures. RESULTS We had 70 case eyes and 158 control eyes, and they were comparable in terms of age, sex and follow-up time (P values: 0.58, 1.00 and 0.89, respectively). Pre-operative spherical equivalent of more than -5.00 diopter (D), intended optical zone (OZ) diameter of less than 6.00 mm and ocular fixation instability during laser ablation were associated with RT indications (all P values <0.001). These factors maintained their significance in the multiple logistic regression model with odd ratios of 6.12, 6.71 and 7.89, respectively. CONCLUSION Higher refractive correction (>-5.00 D), smaller OZ (<6.00 mm) and unstable fixation during laser ablation of PRK for myopia and myopic astigmatism were found to be strong predictors of undercorrection and regression.
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Affiliation(s)
- Seyed-Farzad Mohammadi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Payam Nabovati
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran ; Department of Optometry, School of Rehabilitation, Iran University of Medical Sciences, Tehran 1676666431, Iran
| | - Ali Mirzajani
- Department of Optometry, School of Rehabilitation, Iran University of Medical Sciences, Tehran 1676666431, Iran
| | - Elham Ashrafi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Banafsheh Vakilian
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
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Kim S, Park YW, Lee E, Park SW, Park S, Kim JW, Seong JK, Seo K. Air assisted lamellar keratectomy for the corneal haze model. J Vet Sci 2015; 16:349-56. [PMID: 25797296 PMCID: PMC4588021 DOI: 10.4142/jvs.2015.16.3.349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 03/07/2015] [Indexed: 11/20/2022] Open
Abstract
To standardize the corneal haze model in the resection depth and size for efficient corneal haze development, air assisted lamellar keratectomy was performed. The ex vivo porcine corneas were categorized into four groups depending on the trephined depth: 250 µm (G1), 375 µm (G2), 500 µm(G3) and 750 µm (G4). The stroma was equally ablated at the five measurement sites in all groups. Significant differences were observed between the trephined corneal depths for resection and ablated corneal thickness in G1 (p < 0.001). No significant differences were observed between the trephined corneal depth for resection and the ablated corneal thickness in G2, G3, and G4. The resection percentage was similar in all groups after microscopic imaging of corneal sections. Air assisted lamellar keratectomy (AK) and conventional keratectomy (CK) method were applied to six beagles, after which development of corneal haze was evaluated weekly until postoperative day 28. The occurrence of corneal haze in the AK group was significantly higher than that in the CK group beginning 14 days after surgery. Alpha-smooth muscle actin expression was significantly higher in the AK group (p < 0.001) than the CK group. Air assisted lamellar keratectomy was used to achieve the desired corneal thickness after resection and produce sufficient corneal haze.
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Affiliation(s)
- Soohyun Kim
- Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 151-742, Korea
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Anitua E, de la Fuente M, Muruzabal F, Riestra A, Merayo-Lloves J, Orive G. Plasma rich in growth factors (PRGF) eye drops stimulates scarless regeneration compared to autologous serum in the ocular surface stromal fibroblasts. Exp Eye Res 2015; 135:118-26. [PMID: 25708868 DOI: 10.1016/j.exer.2015.02.016] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 12/29/2014] [Accepted: 02/13/2015] [Indexed: 11/26/2022]
Abstract
Autologous serum (AS) eye drops was the first blood-derived product used for the treatment of corneal pathologies but nowadays PRGF arises as a novel interesting alternative to this type of diseases. The purpose of this study was to evaluate and compare the biological outcomes of autologous serum eye drops or Plasma rich in growth factors (PRGF) eye drops on corneal stromal keratocytes (HK) and conjunctival fibroblasts (HConF). To address this, blood from healthy donors was collected and processed to obtain autologous serum (AS) eye drops and plasma rich in growth factors (PRGF) eye drops. Blood-derivates were aliquoted and stored at -80°C until use. PDGF-AB, VEGF, EGF, FGFb and TGF-β1 were quantified. The potential of PRGF and AS in promoting wound healing was evaluated by means of proliferation and migration assays in HK and HConF. Fibroblast cells were induced to myofibroblast differentiation after treatment with 2.5ng/mL of TGF-β1. The capability of PRGF and AS to prevent and inhibit TGF-β1-induced differentiation was evaluated. Results showed significant higher levels of all growth factors analyzed in PRGF eye drops compared to AS. Moreover, PRGF eye drops enhanced significantly the biological outcomes of both HK and HConF, and reduced TGF-β1-induced myofibroblast differentiation in contrast to autologous serum eye drops (AS). In summary, these results suggest that PRGF exerts enhanced biological outcomes than AS. PRGF may improve the treatment of ocular surface wound healing minimizing the scar formation compared to AS. Results obtained herein suggest that PRGF protects and reverses the myofibroblast phenotype while promotes cell proliferation and migration.
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Affiliation(s)
- E Anitua
- Biotechnology Institute (BTI), Vitoria, Spain
| | | | - F Muruzabal
- Biotechnology Institute (BTI), Vitoria, Spain
| | - A Riestra
- Fundación de Investigación Oftalmológica, Instituto Oftalmológico Fernández-Vega, Oviedo, Spain
| | - J Merayo-Lloves
- Fundación de Investigación Oftalmológica, Instituto Oftalmológico Fernández-Vega, Oviedo, Spain
| | - G Orive
- Biotechnology Institute (BTI), Vitoria, Spain.
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