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1.

Purpose

This meta-analysis aims to evaluate the differences in performance of posterior capsular opacification (PCO) between hydrophobic acrylic intraocular lens (IOLs) and hydrophilic acrylic IOLs.

Setting

Tianjin Medical University, Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin, China.

Design

Systematic review of randomized controlled trials (RCTs) or meta-analysis.

Methods

An electronic literature search was performed using the PubMed, EMBASE and Cochrane Library database before May in 2013 to identify prospective RCTs comparing hydrophobic acrylic IOLs and hydrophilic acrylic IOLs in patients after phacoemulsification with IOL implantation with a follow-up time of at least 1 year. Pertinent studies were selected by meeting predefined criteria and reviewed systematically by meta-analysis. The PCO scores and YAG capsulotomy rate, as indicator of PCO, were measured and discussed in a meta-analysis. Standardized mean differences (SMD), relative risk ratio (RR), and the pooled estimates were computed according to a random effect model or fixed effect model.

Results

Nine prospective RCTs involving 861 eyes were included in the current meta-analysis. The hydrophobic acrylic IOLs were favored and the pooled SMD of PCO severity was1.72 (95% confidence interval (CI), 0.20 to 1.23, P = 0.0002) and 1.79 (95% CI, 0.95 to 2.64, P<0.0001) with 1-year follow-up and 2-year follow-up respectively. The pooled RR of Nd:YAG laser capsulotomy rates at postoperative 2-year follow-up was 6.96 (95% CI, 3.69 to 13.11, P<0.00001) comparing hydrophilic acrylic IOLs with hydrophobic acrylic IOLs.

Conclusions

Compared with hydrophilic acrylic IOLs, the hydrophobic acrylic IOLs showed superior reduction in rates of PCO and laser capsulotomy in 2-year follow-up. More RCTs with standard methods for longer follow-up are needed to validate the association.  相似文献   

2.
目的:总结Nd:YAG激光治疗人工晶体(intraocular lens,IOL)植入术后后囊膜混浊(posterioc rcapsular opacification,PCO)的疗效和并发症,探讨此类手术临床应用的技巧与适用范围。方法:在不散瞳的条件下,应用Nd:YAG激光切开瞳孔区后囊膜混浊。结果:患者术后视力改善显著,术后并发症有眼压升高、AI晶体损伤、出血及玻璃体疝形成。结论:Nd:YAG激光治疗人工晶体植入术后晶体后囊膜混浊效果显著,严格掌握适应症以及熟练的手术技巧是获得最佳疗效的关键。  相似文献   

3.
目的:研究眼内应用浓度为5mg/ml的吉西他滨(GEM)对于后囊膜混浊的抑制作用。方法:12只(24眼)实验动物随机分为A、B二组,A组为治疗组,B组为对照组。所有的实验动物均进行晶状体囊外摘除+人工晶体植入术。A组术中应用5mg/ml吉西他滨溶液作水分离;B组术中应用平衡盐溶液作水分离。术后定期观察角膜水肿,评价PCO及进行角膜内皮细胞分析。结果:术后第1天,第3天,第7天两组角膜水肿的例数均无差异。术后第二周,两组后囊膜发现不同程度混浊,第四周后囊膜混浊程度分级,对照组中央后囊明显混浊;角膜内皮细胞分析显示两组的角膜内皮数量明显低于术前,比较两组的角膜内皮数量减少量无统计学意义。结论:实验显示眼内应用5mg/ml吉西他滨后囊膜混浊程度较对照组明显轻。尽管眼内应用有导致眼内组织毒性反应的可能性,但通过用药方法的改进和保护措施的加强是可以有效避免或减轻的,因此吉西他滨是一种有潜力的预防后发性白内障的侯选药物。  相似文献   

4.
目的:探讨经多西紫杉醇修饰的人工晶体对眼组织相容性的影响。方法:按照随机数字表法将32 只日本大耳兔分为两组: 实验组通过手术植入表面经多西紫杉醇修饰处理后的疏水性人工晶体,对照组植入疏水性人工晶体。比较两组人工晶体亲水角、 术后24 小时光耀斑块计数以及人工晶体周围组织炎症浸润数。结果:实验组的亲水角小于对照组,差异有统计学意义(P<0.05)。 实验组光耀斑块计数低于对照组,差异有统计学意义(P<0.05)。实验组家兔人工晶体周围组织炎症浸润计数低于对照组,差异有 统计学意义(P<0.05)。结论:人工晶体表面经多西紫杉醇修饰后,其亲水性、与眼组织的组织相容性增加,且可缓解光耀斑炎症感 染和降低并发症的发生,有重要的临床参考价值。  相似文献   

5.

Purpose

To objectively compare the optical quality and the intraocular scattering after implantation of the posterior chamber phakic implantable collamer lens (Visian ICL™, STAAR Surgical) with and without a central artificial hole for moderate to high ametropia.

Methods

This retrospective study comprised 28 eyes of 28 consecutive patients undergoing Hole ICL implantation (mean age ± standard deviation, 30.3±5.8 years), and 24 age-matched eyes of 24 patients undergoing conventional ICL implantation (age, 30.4±6.1 years). We quantitatively assessed the postoperative values of MTF cutoff frequency, Strehl ratio, objective scattering index (OSI), and OQAS values (OVs), using an Optical Quality Analysis System™. We compared these postoperative variables between the two groups.

Results

The mean MTF cutoff frequency, Strehl ratio, OSI, OV100%, OV 20%, and OV9%, were 26.21±8.32 cycles/degree, 0.16±0.04, 1.16±0.57, 0.87±0.28, 0.80±0.35, and 0.80±0.33, respectively, 3 months after Hole ICL implantation. We found no significant differences in the MTF cutoff frequency (Mann Whitney U test, p = 0.59), the Strehl ratio (p = 0.82), the OSI (p = 0.63), or the OVs at contrasts of 100% (p = 0.58), 20% (p = 0.40), and 9% (p = 0.87), between the two groups.

Conclusions

Both Hole ICL and conventional ICL implantation provides an excellent optical performance including intraocular scattering. Newly developed Hole ICL implantation appears to be essentially equivalent in the optical quality variables to conventional ICL implantation, suggesting that the presence of the central artificial hole does not significantly affect the optical quality and the intraocular scattering after surgery.  相似文献   

6.

Purpose

To analyze the level of human inflammatory immune mediators in the intraocular fluid aspirated from foldable capsular vitreous body (FCVB) filled-eyes during FCVB removal surgery, 3 months after implantation.

Methods

8 samples of intra-FCVB fluids (n = 8) were collected from 8 FCVB filled patients in our previous FCVB exploratory clinical trial. The intra-FCVB fluids were aspirated from the FCVB filled-eyes during the FCVB removal surgeries at the third month. For the control groups, the vitreous fluids were collected from patients with idiopathic macular hole (n = 9) or rhegmatogenous retinal detachment (n = 6) during pars plana vitrectomy. A multiplex immunoassay was used to determine levels of 9 cytokines (IL-1β, IL-2, IL-6, IL-8, IL-10, IL-17, TNF-α, IFN-γ and VEGF) in these samples. The VEGF level of some intra-FCVB fluids (n = 6) were re-tested using enzyme-linked immunosorbent assay (ELISA).

Results

In the intra-FCVB fluids, 9 cytokines concentrations of most samples (n = 5) measured by Multiplex immunoassay showed low values, except for Patient 02, 06, and 09. The VEGF concentrations of some intra-FCVB fluids (n = 6) tested by ELISA were in accordance with Multiplex immunoassay results. For all eight patients (n = 8), the concentrations of IL-1β, IL-2, IL-6, TNF-α, IFN-γ and VEGF were slightly higher as compared to the idiopathic macular hole control group. While, the concentrations of IL-8, IL-10, and IL-17 were not statistically significant different compared with the idiopathic macular hole control samples. Most cytokines concentrations (IL-2, IL-6, IL-8, IL-10, IL-17, TNF-α, IFN-γ, VEGF) were not statistically significant different compared to the rhegmatogenous retinal detachment control group except IL-1β.

Conclusions

The FCVB had sufficient porosity to allow cytokines to pass through. This study first discovered that the FCVB possesses favorable permeability of proteins in the human eye.  相似文献   

7.
目的:探讨超声乳化白内障吸除术(Phaco)、人工晶状体植入术(IOL)联合小梁切除术(TBL)治疗原发性闭角型青光眼(PACG)伴厚晶状体白内障的临床疗效和安全性。方法:将82例(98眼)原发性闭角型青光眼伴厚晶状体白内障患者随机分为A组(41例52眼)和B组(41例46眼),A组行Phaco+IOL+TBL治疗,B组单纯行TBL治疗,比较两组的手术前后眼压、最佳矫正视力、中央前房深度(ACD)、小梁虹膜角(TIA)、房角开放距离500(AOD500)及小梁睫状体距离(TCPD)的变化、视力提高率及并发症的发生情况。结果:两组术后眼压均较术前显著降低,且A组的降低幅度显著高于B组(P0.05);两组术后最佳矫正视力均显著提高,且A组显著高于B组(P0.05);A组术后视力提高率为86.54%,显著高于B组的32.61%(P0.05);两组术后ACD、TIA、AOD500及TCPD均显著提高,且A组显著高于B组(P0.05);A组手术并发症发生率为5.77%,显著低于B组的17.39%(P0.05)。结论:超声乳化白内障摘除术、人工晶状体植入术联合小梁切除术治疗PACG伴厚晶状体白内障的疗效较单用小梁切除术更好,且安全性更高。  相似文献   

8.
Three methods of antiserum production have been compared. One of these consistently gave rise to greater homologous quellung titres and was used routinely. A modification of this method using vaccines consisting of washed, killed suspensions of type strains resulted in no significant increase in titres or decrease in cross-reactions. Considerable differences were found between the homologous quellung titres and cross-reactions of antisera prepared in the same laboratory on different occasions.  相似文献   

9.
In wild-type lenses from various species, an intracellular hydrostatic pressure gradient goes from ∼340 mmHg in central fiber cells to 0 mmHg in surface cells. This gradient drives a center-to-surface flow of intracellular fluid. In lenses in which gap-junction coupling is increased, the central pressure is lower, whereas if gap-junction coupling is reduced, the central pressure is higher but surface pressure is always zero. Recently, we found that surface cell pressure was elevated in PTEN null lenses. This suggested disruption of a feedback control system that normally maintained zero surface cell pressure. Our purpose in this study was to investigate and characterize this feedback control system. We measured intracellular hydrostatic pressures in mouse lenses using a microelectrode/manometer-based system. We found that all feedback went through transport by the Na/K ATPase, which adjusted surface cell osmolarity such that pressure was maintained at zero. We traced the regulation of Na/K ATPase activity back to either TRPV4, which sensed positive pressure and stimulated activity, or TRPV1, which sensed negative pressure and inhibited activity. The inhibitory effect of TRPV1 on Na/K pumps was shown to signal through activation of the PI3K/AKT axis. The stimulatory effect of TRPV4 was shown in previous studies to go through a different signal transduction path. Thus, there is a local two-legged feedback control system for pressure in lens surface cells. The surface pressure provides a pedestal on which the pressure gradient sits, so surface pressure determines the absolute value of pressure at each radial location. We speculate that the absolute value of intracellular pressure may set the radial gradient in the refractive index, which is essential for visual acuity.  相似文献   

10.
The control over the crystallinity of chitosan and chitosan/ovalbumin films can be achieved via an appropriate balance of the hydrophilic/hydrophobic interactions during the film formation process, which then controls the release kinetics of ovalbumin. Chitosan films were prepared by solvent casting. The presence of the anhydrous allomorph can be viewed as a probe of the hydrophobic conditions at the neutralization step. The semicrystalline structure, the swelling behavior of the films, the protein/chitosan interactions, and the release behavior of the films were impacted by the DA and the film processing parameters. At low DAs, the chitosan films neutralized in the solid state corresponded to the most hydrophobic environment, inducing the crystallization of the anhydrous allomorph with and without protein. The most hydrophilic conditions, leading to the hydrated allomorph, corresponded to non-neutralized films for the highest DAs. For the non-neutralized chitosan acetate (amorphous) films, the swelling increased when the DA decreased, whereas for the neutralized chitosan films, the swelling decreased. The in vitro release of ovalbumin (model protein) from chitosan films was controlled by their swelling behavior. For fast swelling films (DA?=?45%), a burst effect was observed. On the contrary, a lag time was evidenced for DA?=?2.5% with a limited release of the protein. Furthermore, by blending chitosans (DA?=?2.5% and 45%), the release behavior was improved by reducing the burst effect and the lag time. The secondary structure of ovalbumin was partially maintained in the solid state, and the ovalbumin was released under its native form.  相似文献   

11.
摘要目的:探讨超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼的的临床疗效。方法:将2007年8月-2012年8月入住我院的100例经诊断为白内障合并青光眼患者随机地均分为对照组与观察组,各为50例。对照组仅给予超声乳化人工晶状体植入术,观察组在此基础上给予联合小梁切除术进行治疗,比较两组治疗前后的视力、眼压、中央房前深度、房角开放状态变化、视野及并发症发生率。结果:(1)对照组患者术后1周、1个月及3个月视力均要高于术前,且术后1个月与3个月视力较术前差异具有统计学意义(P〈0.05);观察组患者术后1周、1个月及3个月均要明显高于术前,术后视力较术前均具有显著的统计学意义(P〈0.01),且与对照组术后相比,差异均具有统计学意义(P〈0.05)。(2)两组手术前后眼压、房角开放状态变化、中央前房深度及视野差异均具有统计学意义(P〈O.05,P〈O.01),且观察组术后较对照组术后差异均有统计学意义(P〈0.05)。(3)对照组并发症发生率为22.00%,明显高于观察组(8.00%),二者差异具有显著的统计学意义(P〈0.01)。结论:超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼,临床疗效显著,术后恢复快,并发症发生率低,应在临床上加以推广并应用。  相似文献   

12.
目的:使用Lenstar LS900测量仪对高度近视合并白内障患者进行术前测量,比较SRK/T、Haigis、Barrett Universal II公式的精确性。方法:选择2018年5月至2018年8月于我院行白内障超声乳化吸除及人工晶状体植入术的高度近视合并白内障患者40例(54只眼),根据眼轴的长度分为三组。使用Lenstar LS900对患者进行眼部生物测量,并计算由SRK/T、Haigis、Barrett Universal II公式预测的术后屈光度。将术后一个月得到的实际屈光度与各公式预测的屈光度进行比较分析,观察上述公式在不同眼轴长度组中的准确性。结果:组内各公式的比较:A组:Haigis公式与Barrett Universal II公式间的差异有统计学意义(P0.05),其他公式间比较差异无统计学意义(P0.05);B组:SRK/T公式与Haigis公式比较差异无统计学意义(P0.05),其他公式间比较差异有统计学意义(P0.05);C组:三个公式之间的差异均具有统计学意义(P0.05)。各公式组间比较:SRK/T公式和Haigis公式比较差异具有统计学意义(P0.05),Barrett Universal II公式组间比较差异无统计学意义(P0.05)。结论:Barrett Universal II公式用于高度近视白内障患者在各个眼轴长度的测量中表现出良好的准确性,且准确性不随眼轴的增长而下降。随着眼轴的增长,SRK/T公式的准确性逐渐下降,当AL30 mm时,Haigis公式的准确性优于SRK/T公式。  相似文献   

13.
For many protozoan parasites, one of the first events in the process of infection is attachment to the surface of host cells. This adhesion phase usually involves ligand-receptor interactions, and has stimulated interest in the biochemical characterization of those host cell and parasite surface components involved. In this article, Ali Ouaissi discusses the strategy employed by pathogens such as Trypanosoma cruzi, Trichomonas, Leishmania and Treponema pallidum, in binding to their host cells' fibronectin receptors. Two systems appear available - to bind to the dimeric cell surface fibronectin through the Arginine-Glycine-Aspartic acid (RGD) sequence that is not occupied by the host cell surface receptors, or to present a surface antigen representing a 'fibronectin-like' molecule containing the RGD sequence directly to the host cell fibronectin receptors.  相似文献   

14.
Antimicrobial action of nanomaterials is typically assigned to the nanomaterial composition, size and/or shape, whereas influence of complex corona stabilizing the nanoparticle surface is often neglected. We demonstrate sequential surface functionalization of tyrosine-reduced gold nanoparticles (AuNPsTyr) with polyoxometalates (POMs) and lysine to explore controlled chemical functionality-driven antimicrobial activity. Our investigations reveal that highly biocompatible gold nanoparticles can be tuned to be a strong antibacterial agent by fine-tuning their surface properties in a controllable manner. The observation from the antimicrobial studies on a gram negative bacterium Escherichia coli were further validated by investigating the anticancer properties of these step-wise surface-controlled materials against A549 human lung carcinoma cells, which showed a similar toxicity pattern. These studies highlight that the nanomaterial toxicity and biological applicability are strongly governed by their surface corona.  相似文献   

15.
ABSTRACT:?

Precise control of the architecture of multiple cells in culture and in vivo via precise engineering of the material surface properties is described as cell patterning. Substrate patterning by control of the surface physicochemical and topographic features enables selective localization and phenotypic and genotypic control of living cells. In culture, control over spatial and temporal dynamics of cells and heterotypic interactions draws inspiration from in vivo embryogenesis and haptotaxis. Patterned arrays of single or multiple cell types in culture serve as model systems for exploration of cell-cell and cell-matrix interactions. More recently, the patterned arrays and assemblies of tissues have found practical applications in the fields of Biosensors and cell-based assays for Drug Discovery. Although the field of cell patterning has its origins early in this century, an improved understanding of cell-substrate interactions and the use of microfabrication techniques borrowed from the microelectronics industry have enabled significant recent progress. This review presents the important early discoveries and emphasizes results of recent state-of-the-art cell patterning methods. The review concludes by illustrating the growing impact of cell patterning in the areas of bioelectronic devices and cell-based assays for drug discovery.  相似文献   

16.
王刚  胡蓉  舒平  杨璐舟  刘尧  黄丽 《生物磁学》2013,(36):7112-7115
目的:探讨超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼的临床疗效及安全性。方法:将100例白内障合并青光眼患者按照抽签法随机地均分为对照组与观察组,对照组给予单纯超声乳化人工晶状体植入术,观察组在此基础上给予联合小梁切除术进行治疗。比较两组治疗前后相关指标以及术后并发症发生率等。结果:(1)对照组治疗前后IOP、ACD及AL均无统计学差异,观察组治疗前后IOP与CAD差异具有统计学意义(P〈0.05,P〈0.01),但该组治疗前后AL无统计学差异;(2)两组术前与术后1周、1个月及3个月平均视野缺损值、平均模式标准差相比,差异均具有统计学意义,且观察组术后与对照组术后相比,差异均具有统计学意义;(3)对照组并发症发生率为20.00%,明显大于观察组(10.00%)。结论:超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼,疗效显著,不良反应发生率低,值得加以推广并应用。  相似文献   

17.
Streptococcus iniae causes severe septicemia and meningitis in farmed fish and is also occasionally zoonotic. Vaccination against S. iniae is problematic, with frequent breakdown of protection in vaccinated fish. The major protective antigens in S. iniae are the polysaccharides of the capsule, which are essential for virulence. Capsular biosynthesis is driven and regulated by a 21-kb operon comprising up to 20 genes. In a long-term study, we have sequenced the capsular operon of strains that have been used in autogenous vaccines across Australia and compared it with the capsular operon sequences of strains subsequently isolated from infected vaccinated fish. Intriguingly, strains isolated from vaccinated fish that subsequently become infected have coding mutations that are confined to a limited number of genes in the cps operon, with the remainder of the genes in the operon remaining stable. Mutations in strains in diseased vaccinated fish occur in key genes in the capsular operon that are associated with polysaccharide configuration (cpsG) and with regulation of biosynthesis (cpsD and cpsE). This, along with high ratios of nonsynonymous to synonymous mutations within the cps genes, suggests that immune response directed predominantly against capsular polysaccharide may be driving evolution in a very specific set of genes in the operon. From these data, it may be possible to design a simple polyvalent vaccine with a greater operational life span than the current monovalent killed bacterins.  相似文献   

18.
摘要 目的:探讨儿童先天性白内障发病的影响因素,并研究人工晶状体植入(IOL)术后屈光状态的变化。方法:选择2017年4月~2019年2月期间我院收治的先天性白内障患儿98例作为病例组,选取同期来我院小儿眼科体检的健康儿童80例作为对照组。采用单因素和多因素Logistic回归分析先天性白内障发病的影响因素。病例组患儿均进行先天性白内障摘除联合IOL植入术。术后病例组患儿均随访3年,比较术后1、2、3年屈光度、眼轴长度的变化量。结果:单因素分析结果显示,先天性白内障发病与性别、孕期先兆流产、并发妊娠期高血压、并发妊娠期糖尿病、并发甲亢或甲减、贫血无关(P>0.05)。先天性白内障发病与胎龄、出生体重、先天性白内障家族史、孕前2个月或孕期是否存在感染、缺血缺氧脑病有关(P<0.05)。多因素Logistic回归分析结果显示,胎龄<37周、出生体重<2500 g、有先天性白内障家族史、孕前2个月或孕期存在感染是导致先天性白内障发病的危险因素(P<0.05)。同一时间点比较,<2岁组术后眼轴长度增长量、屈光度变化大于2~6岁组和7~12岁组,且2~6岁组大于7~12岁组(P<0.05)。结论:胎龄<37周、出生体重<2500 g、有先天性白内障家族史、孕前2个月或孕期存在感染是导致先天性白内障发病的危险因素,此外,先天性白内障患儿接受IOL治疗后,IOL对患儿眼球发育影响较为轻微。  相似文献   

19.

Background

To systematically evaluate the visual performance of aspheric AcrySof IQ and spherical AcrySof Natural intraocular lens (IOL) after cataract surgery.

Methodology/Principal Findings

Potential randomized controlled trials (RCTs) that involved implanting AcrySof IQ and AcrySof Natural were searched from PubMed, Web of science, EMBASE, Chinese Science and Technology Periodicals Databases and Cochrane Central Register of Controlled Trials. The methodological quality of the studies was assessed by the Jadad method. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) of best-corrected visual acuity (BCVA), contrast sensitivity and spherical aberration were pooled using a random-effects model. Seven studies were identified and analyzed to compare AcrySof IQ (236 eyes) with AcrySof Natural (232 eyes) after phacoemulsification. There was no significant difference in postoperative BCVA between AcrySof IQ and AcrySof Natural (p =0.137) after a follow up of 3 months. For contrast sensitivity, these differences reached statistical significance under photopic conditions at two spatial frequencies (3 cycles per degree (cpd), 6 cpd, 12 cpd, and 18 cpd; p =0.022, p =0.017, p = 0.065, and p=0.191, respectively) and under mesopic conditions at three spatial frequencies (3 cpd, 6 cpd, 12 cpd, and 18 cpd; p =0.007, p =0.033, p =0.030, and p =0.080, respectively). Eyes with AcrySof IQ also had statistically significant less spherical aberration than eyes with AcrySof Natural (p<0.001). Sensitivity analysis showed that the results were relatively stable and reliable.

Conclusions/Significance

The overall findings indicate that AcrySof IQ with a modified aspheric surface induced significantly less spherical aberration than AcrySof Natural. Contrast sensitivity in eyes with AcrySof IQ is better than that in eyes with AcrySof Natural, especially under mesopic conditions.  相似文献   

20.
With regard to the fact that, in anchorage-dependent lens epithelial cells, DNA synthesis can be switched on and off by cell flattening and cell rounding, respectively, the state of the microfilaments has been followed by labelling actin with FL-phalloidin during cell-shape alterations. Cell flattening proved to be accompanied by both a structural organization of actin filaments into stress fibres and an enlargement of the area of the cell nucleus. Cell rounding, on the other hand, caused the microfilament bundles to disappear and the area of the nucleus to become smaller. From the time course of the inhibition of DNA synthesis by cytochalasin B, it was inferred that functionally intact microfilaments are required for the entrance of the cells into DNA synthesis but not for the maintenance of ongoing DNA synthesis. the assumption has been made that the tension, generated by microfilaments during cell spreading, will affect the state of the plasma membrane as well as the shape and the structure of the nucleus, which in turn seems to be preparatory for cells to enter the cycle.  相似文献   

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