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Bu Q, Zhu H, Cao G, Gong G, Su Y, Ge Q, Zhu W, Li Z, Pan X. Targeting mechanics-induced trabecular meshwork dysfunction through YAP-TGFβ Ameliorates high myopia-induced ocular hypertension. Exp Eye Res 2024; 241:109853. [PMID: 38453038 DOI: 10.1016/j.exer.2024.109853] [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: 10/25/2023] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 03/09/2024]
Abstract
High myopia is a risk factor for primary open angle glaucoma (POAG). The pathological mechanism of high myopia induced POAG occurrence is not fully understood. In this study, we successfully established the guinea pig model of ocular hypertension with high myopia, and demonstrated the susceptibility of high myopia for the occurrence of microbead-induced glaucoma compared with non-myopia group and the effect of YAP/TGF-β signaling pathway in TM pathogenesis induced by high myopia. Moreover, we performed stretching treatment on primary trabecular meshwork (TM) cells to simulate the mechanical environment of high myopia. It was found that stretching treatment disrupted the cytoskeleton, decreased phagocytic function, enhanced ECM remodeling, and promoted cell apoptosis. The experiments of mechanics-induced human TM cell lines appeared the similar trend. Mechanically, the differential expressed genes of TM cells caused by stretch treatment enriched YAP/TGF-β signaling pathway. To inhibit YAP/TGF-β signaling pathway effectively reversed mechanics-induced TM damage. Together, this study enriches mechanistic insights of high myopia induced POAG susceptibility and provides a potential target for the prevention of POAG with high myopia.
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Affiliation(s)
- Qianwen Bu
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 271016, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China
| | - Hai Zhu
- Department of Urology, Qingdao Municipal Hospital Affiliated to Qingdao Medical College of Qingdao University, Qingdao, Shandong, 266071, China
| | - Guangliang Cao
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 271016, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China
| | - Ganyu Gong
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, 271016, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China
| | - Ying Su
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China
| | - Qingshu Ge
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China
| | - Wei Zhu
- Department of Pharmacology, School of Pharmacy, Qingdao University, Qingdao, Shandong, 266021, China
| | - Zongyi Li
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China.
| | - Xiaojing Pan
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, Shandong, 266071, China.
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Zhang Q, Zhao J, Wang S, Deng S, Su P. A Mechanical Evaluation of a Robot-Assisted Cutting Cornea Based on Force Response. MICROMACHINES 2023; 14:1634. [PMID: 37630170 PMCID: PMC10457903 DOI: 10.3390/mi14081634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
The aim of this paper is to propose laws of trephine operation based on a robot-assisted cutting cornea in order to obtain better microsurgical effects for keratoplasty. Using a trephine robot integrated with a microforce sensor and a handheld trephine manipulator, robotic and manual experiments were performed, with porcine corneas as the test subjects. The effect of trephine operational parameters on the results reflected by the biomechanical response is discussed, and the parameters include linear velocity, rotating angle, and angular velocity. Using probability density functions, the distributions of the manual operational parameters show some randomness, and there is a large fluctuation in the trephine force during the experiments. The biomechanical response shows regular trends in the robotic experiments even under different parameters, and compared to manual trephination, the robot may perform the operation of trephine cornea cutting more stably. Under different operational parameters, the cutting force shows different trends, and the optimal initial parameters that result in better trephine effects can be obtained based on the trends. Based on this derived law, the operational parameters can be set in robotic trephination, and surgeons can also be specially trained to achieve a better microsurgical result.
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Affiliation(s)
- Qinran Zhang
- School of Electromechanical Engineering, Beijing Information Science and Technology University, Beijing 100192, China; (Q.Z.); (J.Z.); (S.W.)
| | - Jingyu Zhao
- School of Electromechanical Engineering, Beijing Information Science and Technology University, Beijing 100192, China; (Q.Z.); (J.Z.); (S.W.)
| | - Sikai Wang
- School of Electromechanical Engineering, Beijing Information Science and Technology University, Beijing 100192, China; (Q.Z.); (J.Z.); (S.W.)
| | - Shijing Deng
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Peng Su
- School of Electromechanical Engineering, Beijing Information Science and Technology University, Beijing 100192, China; (Q.Z.); (J.Z.); (S.W.)
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Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Poo-López A, Lisa C, Madrid-Costa D, Alfonso JF. Intrastromal Corneal Ring Segments Implantation After Deep Anterior Lamellar Keratoplasty for Astigmatism Correction: Mid-term and Long-term Follow-up. Cornea 2023; 42:962-969. [PMID: 36036677 DOI: 10.1097/ico.0000000000003110] [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: 03/23/2022] [Accepted: 06/11/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study was to assess the long-term outcomes of implanting intrastromal corneal ring segments (ICRSs) using a femtosecond laser for correcting astigmatism in patients who had previous deep anterior lamellar keratoplasty (DALK) throughout a 5-year follow-up period. METHODS This retrospective study included 40 eyes of 40 patients with previous DALK and astigmatism ≥3.00 D who underwent Ferrara-type ICRS implantation. The manifest refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuity (logMAR), and corneal topography were recorded preoperatively and at 6, 12, 36, and 60 months postoperatively. RESULTS The mean UDVA (logMAR scale) improved from 1.39 ± 0.55 preoperatively to 0.71 ± 0.37 at 6 months postoperatively ( P < 0.0001). The mean CDVA (logMAR) significantly improved from 0.36 ± 0.17 to 0.22 ± 0.12 at 6 months after surgery ( P < 0.0001). Both UDVA and CDVA remained unchanged throughout the follow-up ( P = 0.09). Postoperatively, no eyes lost lines of CDVA compared to preoperatively, and around 80% of the eyes gained lines of CDVA. The safety index remained stable at a value of 1.4 throughout the follow-up. The refractive cylinder decreased from -6.86 ± 2.62 D preoperatively to -2.33 ± 1.09D at 6 months postoperatively ( P < 0.0001), and subsequently, it was stable over the postoperative period ( P = 0.2). The maximum and minimum keratometry measurements significantly decreased after surgery and remained stable over the postoperative follow-up period ( P > 0.07). CONCLUSIONS This study shows the long-term viability of Ferrara-type ICRS implantation using a femtosecond laser as a surgical alternative for astigmatism correction in post-DALK eyes.
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Affiliation(s)
- Belén Alfonso-Bartolozzi
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain; and
| | - Luis Fernández-Vega-Cueto
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain; and
| | - Aranzazu Poo-López
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain; and
| | - Carlos Lisa
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain; and
| | - David Madrid-Costa
- Clinical and Experimental Eye Research Group (CEER), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Spain
| | - José F Alfonso
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain; and
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Choi JH, Jeng BH. Indications for keratoplasty in management of corneal ectasia. Curr Opin Ophthalmol 2022; 33:318-323. [PMID: 35779056 DOI: 10.1097/icu.0000000000000862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The current review aims to describe recent advancements in treatment of corneal ectasias and its effect on indications for corneal transplantation. RECENT FINDINGS The majority of patients affected by ectatic corneal disease use contact lenses to correct resulting astigmatism. Patients who are intolerant of contact lenses or cannot achieve acceptable vision through conservative measures could consider keratoplasty. However, continuing advancements in both nonsurgical and surgical treatments are either reducing or delaying the need for keratoplasty in patients affected by ectatic corneal disease. SUMMARY Corneal transplantation has been the mainstay of treatment for patients with advanced ectatic corneal disease. In the past decade, numerous improvements have been occurred to make contact lenses not only more effective for visual correction, but also more comfortable. Although corneal cross-linking is the only proven treatment known to prevent progression of disease, several other therapies show early potential for those in which cross-linking is contraindicated. Patients now have access to a wider range of therapies before considering keratoplasty.
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Affiliation(s)
- Jamie H Choi
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Zhao Y, Li Y, Hong J, Le Q, Xu J. Fourier-Domain Optical Coherence Tomographic Assessment of Changes in the Schlemm's Canal of Nonglaucomatous Subjects After Keratoplasty. Front Physiol 2021; 12:716117. [PMID: 34925051 PMCID: PMC8675085 DOI: 10.3389/fphys.2021.716117] [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: 05/28/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study aimed to evaluate the impact of keratoplasty on the in vivo anatomical structures in the Schlemm's canal (SC) of nonglaucomatous subjects using Fourier-domain optical coherence tomography (FD-OCT). Methods: Sixty-six nonglaucomatous eyes that underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), or triple surgery were enrolled in this prospective, comparative, observational study. The SC imaging was performed using FD-OCT before and after surgery in both the nasal and temporal quadrants. Patient demographics, SC parameters [e.g., cross-sectional area (CSA), meridional diameter of SC (MSC), sagittal diameter of SC (SSC), and circumference (CCF)], and the correlations between the variation of SC parameters and intraocular pressure (IOP) were analyzed. Results: The mean age of all subjects was 40.27 ± 18.97 years. Among all cases, the nasal, temporal, and mean MSC significantly decreased on the first day after surgery and then increased at 1 week (p = 0.04, 0.017, and 0.01, respectively). Temporal CSA (tCSA), temporal MSC (tMSC), and temporal circumference (tCCF) after PK (p = 0.017, 0.020, and 0.018, respectively) and nasal MSC (nMSC) after DALK (p = 0.025) decreased significantly on the first day after surgery. The shift in mean IOP was significantly correlated with the changes in tMSC (r = 0.341, p = 0.003) and CCF (r = 0.207, p = 0.048). Conclusion: SC had significant in vivo morphological changes in the early period after keratoplasty in nonglaucomatous eyes, accompanied with elevation of IOP. Early intervention might be necessary to prevent secondary glaucoma early after keratoplasty.
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Affiliation(s)
- Yujin Zhao
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yue Li
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jiaxu Hong
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Key Laboratory of Myopia, National Health and Family Planning Commission, Shanghai, China
| | - Qihua Le
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jianjiang Xu
- Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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