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Rabinowitz J, Kinnear N, O'Callaghan M, Hennessey D, Shafi F, Fuller A, Ibrahim M, Lane T, Adshead J, Vasdev N. Systematic review of the ophthalmic complications of robotic-assisted laparoscopic prostatectomy. J Robot Surg 2024; 18:46. [PMID: 38240959 DOI: 10.1007/s11701-023-01771-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 11/20/2023] [Indexed: 01/23/2024]
Abstract
This study aims to review ophthalmic injuries sustained during of robotic-assisted laparoscopic prostatectomy (RALP). A search of Medline, Embase, Cochrane and grey literature was performed using methods registered a priori. Eligible studies were published 01/01/2010-01/05/2023 in English and reported ophthalmic complications in cohorts of > 100 men undergoing RALP. The primary outcome was injury incidence. Secondary outcomes were type and permanency of ophthalmic complications, treatments, risk factors and preventative measures. Nine eligible studies were identified, representing 100,872 men. Six studies reported rates of corneal abrasion and were adequately homogenous for meta-analysis, with a weighted pooled rate of 5 injuries per 1000 procedures (95% confidence interval 3-7). Three studies each reported different outcomes of xerophthalmia, retinal vascular occlusion, and ophthalmic complications unspecified in 8, 5 and 2 men per 1000 procedures respectively. Amongst identified studies, there were no reports of permanent ophthalmic complications. Injury management was poorly reported. No significant risk factors were reported, while one study found African-American ethnicity protective against corneal abrasion (0.4 vs. 3.9 per 1000). Variables proposed (but not proven) to increase risk for corneal abrasion included steep Trendelenburg position, high pneumoperitoneum pressure, prolonged operative time and surgical inexperience. Compared with standard of care, occlusive eyelid dressings (23 vs. 0 per 1000) and foam goggles (20 vs. 1.3 per 1000) were found to reduce rates of corneal abrasion. RALP carries low rates of ophthalmic injury. Urologists should counsel the patient regarding this potential complication and pro-actively implement preventative strategies.
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Affiliation(s)
| | - Ned Kinnear
- Lister Hospital, Coreys Mill Ln, Stevenage, SG1 4AB, UK.
- Flinders Medical Centre, Adelaide, Australia.
| | - Michael O'Callaghan
- Flinders Medical Centre, Adelaide, Australia
- Flinders University, Adelaide, Australia
- University of Adelaide, Adelaide, Australia
| | | | - Fariha Shafi
- Lister Hospital, Coreys Mill Ln, Stevenage, SG1 4AB, UK
| | | | | | - Timothy Lane
- Lister Hospital, Coreys Mill Ln, Stevenage, SG1 4AB, UK
| | - James Adshead
- Lister Hospital, Coreys Mill Ln, Stevenage, SG1 4AB, UK
| | - Nikhil Vasdev
- Lister Hospital, Coreys Mill Ln, Stevenage, SG1 4AB, UK
- University of Hertfordshire, Hatfield, UK
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Ren S, Tu R, Xu L, Gu Y, Fan Q, Wang Q, Zhu M, Yin S, Pang C, Zhao D, Yang K. A high body mass index strengthens the association between the time of eye rubbing and keratoconus in a Chinese population: a case control study. BMC Public Health 2023; 23:2032. [PMID: 37853356 PMCID: PMC10585765 DOI: 10.1186/s12889-023-16937-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 10/09/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Although body mass index (BMI) and eye rubbing are linked to an increased risk of keratoconus (KC), the interactive effect of eye rubbing and BMI on KC is largely unknown. This study aimed to evaluate the independent and interactive effects of BMI and eye rubbing on KC and to further explore the role of environmental factors on the occurrence of KC. METHODS A total of 621 individuals (291 KC patients and 330 control individuals) were enrolled in this hospital‑based study on KC patients in Central China after individuals missing BMI data were excluded. BMI was calculated as weight in kilograms divided by the square of height in meters. Data on eye rubbing was recorded through face-to-face interviews. Generalized linear regression models were used to analyze associations among BMI, eye rubbing and KC. Interaction plots were used to describe the interactive effects of BMI and eye rubbing on KC. RESULTS The β and 95% confidence interval (CI) were 0.923 (0.112, 1.733) (p = 0.026) and 3.356 (1.953, 4.759) (p < 0.001), respectively, for the effect of each 10 kg/m2 increase in BMI and each 1 min increase in eye rubbing on KC. The interaction of BMI and eye rubbing were positively correlated with KC (p < 0.001). CONCLUSION These findings suggested that a high BMI aggravated the negative effect of eye rubbing on KC, implying that individuals with a high BMI may be more susceptible to exposure to eye rubbing, which is related to an increased risk of KC.
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Affiliation(s)
- Shengwei Ren
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Runqi Tu
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Liyan Xu
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Yuwei Gu
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Qi Fan
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Qing Wang
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Meng Zhu
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Shanshan Yin
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Chenjiu Pang
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Dongqing Zhao
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China
| | - Kaili Yang
- Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, China.
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do Prado PR, Silveira RCCP, Vettore MV, Fossum M, Vabo GL, Gimenes FRE. Nursing interventions to prevent corneal injury in critically ill sedated and mechanically ventilated patients: A systematic review of interventions. Intensive Crit Care Nurs 2023; 78:103447. [PMID: 37172465 DOI: 10.1016/j.iccn.2023.103447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/15/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To identify the effectiveness of interventions to prevent corneal injury in critically ill, sedated, and mechanically ventilated patients. RESEARCH METHODOLOGY A systematic review of intervention studies was conducted in the following electronic databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Embase, Latin American and Caribbean Literature in Health Sciences, LIVIVO, PubMed, Scopus and Web of Science, and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Study selection and data extraction were performed by two independent reviewers. Quality assessment of the randomized and non-randomized studies was performed using the Risk of Bias (RoB 2.0) and ROBINS-I Cochrane tools, respectively, and the Newcastle-Ottawa Scale for cohort studies. The certainty of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. RESULTS 15 studies were included. Meta-analysis showed that the risk of corneal injury in the lubricants group was 66% lower (RR = 0.34; 95 %CI: 0.13-0.92) than in the eye-taping group. The risk of corneal injury in the polyethylene chamber was 68% lower than in the eye ointment group (RR = 0.32; 95 %CI 0.07-1.44). The risk of bias was low in most of the studies included and the certainty of the evidence was evaluated. CONCLUSIONS The most effective interventions to prevent corneal injury in critically ill sedated mechanically ventilated, who have compromised blinking and eyelid closing mechanisms, are ocular lubrication, preferably gel or ointment, and protection of the corneas with a polyethylene chamber. IMPLICATIONS FOR CLINICAL PRACTICE Critically ill, sedated, and mechanically ventilated patients who have compromised blinking and eyelid closing mechanisms must receive interventions to prevent corneal injury. Ocular lubrication, preferably gel or ointment, and protection of the corneas with a polyethylene chamber were the most effective interventions to prevent corneal injury in critically ill, sedated, and mechanically ventilated patients. A polyethylene chamber must be made commercially available for critically ill, sedated, and mechanically ventilated patients.
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Affiliation(s)
- Patrícia Rezende do Prado
- Federal University of Acre, Rio Branco, Acre, Brazil; Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
| | | | - Mario Vianna Vettore
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway.
| | - Mariann Fossum
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway.
| | - Grete Lund Vabo
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway.
| | - Fernanda Raphael Escobar Gimenes
- Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, São Paulo, Brazil.
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Ridelman E, Teitelbaum A, Craig A, Segar S, Bohra L, Shanti C. Ocular Complications of Facial Burns in the Pediatric Population. J Burn Care Res 2023; 44:1110-1116. [PMID: 37094885 DOI: 10.1093/jbcr/irad048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Indexed: 04/26/2023]
Abstract
Pediatric ocular burns carry a risk of permanent vision impairment. This study identifies risk factors that place these patients at high risk of permanent visual complications. A retrospective review was conducted in our academic urban pediatric burn center. All 300 patients under 18 years of age admitted from January 2010 to December 2020 with periorbital or ocular thermal injuries were included. Variables analyzed included patient demographics, burn characteristics, ophthalmology consultation, ocular exam findings, follow up time period, and early and late ocular complications. Etiologies of burn injuries were as follows: 112 (37.5%) scald, 80 (26.8%) flame, 35 (11.7%) contact, 31 (10.4%) chemical, 28 (9.4%) grease, and 13 (4.3%) friction. Overall, 207 (70.9%) patients with ocular burns received an ophthalmology consult. Of these patients, 61.5% had periorbital cutaneous burns and 39.8% had corneal injuries, and only 61 (29.5%) presented for a follow-up visit. Ultimately, six had serious ocular sequelae, including ectropion, entropion, symblepharon, and corneal decompensation. While thermal burns involving the ocular surface and eyelid margins are relatively infrequent overall, they carry a small risk of serious to long-term sequelae. Recognizing those at greatest risk, and initiating appropriate early intervention is critical.
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Affiliation(s)
- Elika Ridelman
- Department of Surgery, Division of Pediatric Surgery, Children's Hospital of Michigan/Wayne State University, Detroit, Michigan, USA
| | - Abigail Teitelbaum
- Department of Surgery, Division of Pediatric Surgery, Children's Hospital of Michigan/Wayne State University, Detroit, Michigan, USA
| | - Annmarie Craig
- Department of Surgery, Division of Pediatric Surgery, Children's Hospital of Michigan/Wayne State University, Detroit, Michigan, USA
| | - Sharmila Segar
- Department of Surgery, Division of Pediatric Surgery, Children's Hospital of Michigan/Wayne State University, Detroit, Michigan, USA
| | - Lisa Bohra
- Department of Surgery, Division of Pediatric Surgery, Children's Hospital of Michigan/Wayne State University, Detroit, Michigan, USA
| | - Christina Shanti
- Department of Surgery, Division of Pediatric Surgery, Children's Hospital of Michigan/Wayne State University, Detroit, Michigan, USA
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Jayaraj S, Samanta R, Agrawal A, Shrestha S. Multimodal imaging and management of multiple retained corneal bee stingers. BMJ Case Rep 2023; 16:e255939. [PMID: 37336628 PMCID: PMC10314465 DOI: 10.1136/bcr-2023-255939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Affiliation(s)
- Sreeram Jayaraj
- Ophthalmology, All India Institute of Medical Sciences - Rishikesh, Dehradun, Uttarakhand, India
| | - Ramanuj Samanta
- Ophthalmology, All India Institute of Medical Sciences - Rishikesh, Dehradun, Uttarakhand, India
| | - Ajai Agrawal
- Ophthalmology, All India Institute of Medical Sciences - Rishikesh, Dehradun, Uttarakhand, India
| | - Sandhya Shrestha
- Ophthalmology, All India Institute of Medical Sciences - Rishikesh, Dehradun, Uttarakhand, India
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Bright MR, White LD, Concha Blamey SI, Endlich Y, Culwick MD. Perioperative corneal abrasions: A report of 42 cases from the webAIRS database. Anaesth Intensive Care 2023; 51:63-71. [PMID: 36065127 DOI: 10.1177/0310057x221099032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Corneal abrasions are an uncommon complication of anaesthesia. The aim of this study was to identify potential risk factors, treatment and outcomes associated with corneal abrasions reported to the web-based anaesthesia incident reporting system (webAIRS), a voluntary de-identified anaesthesia incident reporting system in Australia and New Zealand, from 2009 to 2021. There were 43 such cases of corneal abrasions reported to webAIRS over this period. The most common postoperative finding was a painful eye. Common features included older patients, individuals with pre-existing eye conditions, general anaesthesia and procedures longer than 60 minutes. Most cases were treated with a combination of lubricating eye drops or aqueous antibiotic eye drops. The findings indicate that patients who sustain a perioperative corneal abrasion can be reassured that in many cases it will heal within 48 hours, but they should seek earlier review if symptoms persist or deteriorate. None of the cases in this series resulted in permanent harm. Well established eye protective measures are important to utilise throughout the perioperative period, including the time until the patient has recovered in the post-anaesthesia care unit.
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Affiliation(s)
- Matthew R Bright
- Department of Anaesthesia, Royal Brisbane and Women's Hospital, Herston, Australia
- Faculty of Medicine, University of Queensland, Australia
| | - Leigh D White
- Department of Anaesthesia and Perioperative Medicine, Sunshine Coast Hospital and Health Service, Birtinya, Australia
| | - Sandra I Concha Blamey
- Department of Anaesthesia, Royal Brisbane and Women's Hospital, Herston, Australia
- Faculty of Medicine, University of Queensland, Australia
| | - Yasmin Endlich
- Department of Anaesthesia, 1062Royal Adelaide Hospital, Adelaide, Australia
- Faculty of Medicine, The University of Adelaide, Adelaide, Australia
| | - Martin D Culwick
- Department of Anaesthesia, Royal Brisbane and Women's Hospital, Herston, Australia
- Faculty of Medicine, University of Queensland, Australia
- Australian and New Zealand Tripartite Anaesthesia Data Committee, Melbourne, Australia
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García-Onrubia L, Stanojcic N, Bhogal M. P-15 Utilising endothelial migration to perform deep anterior lamellar keratoplasty in eyes with deep posterior corneal scarring typically treated with penetrating keratoplasty. BMJ Open Ophthalmol 2022; 7:A4-A5. [PMID: 36161814 DOI: 10.1136/bmjophth-2022-bcm.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
UNLABELLED *Correspondence - Luis García-Onrubia: luis.garciaonrubia@gstt.nhs.uk PURPOSE: To describe a novel technique for deep anterior lamellar keratoplasty (DALK) in patients central corneal perforation and deep scarring making conventional DALK (Melles or Big Bubble) unviable. A posterior Descemet's membrane (DM) skirt has provided an adequate scaffold for the migration of the host endothelial cells. METHODS AND ANALYSIS A case report. A 32-year-old male with previous hydrops developed severe corneal scarring with a break in DM visible on OCT scanning. A modified DALK procedure was perform consisting of a 400µm, 8.5mm Anterior lamellar cap with a 4.5mm posterior lamellar disc, denuded of endothelial cells and containing a DM skirt.Initially, manual dissection of the and anterior 400µm of corneal stroma was performed using a modified Melles technique. The residual posterior lamellar was assessed and found to have significant residual scarring. A central 4mm optical window was performed through the posterior lamellar over the visual axis.The donor tissue was cut using a 350µm microkeratome head. The anterior cap was trephined to 8.5mm and set aside. The posterior lamellar was placed in a punch block, and the endothelial was removed using a silicone tipped cannula. The removal of endothelial cells was confirmed using trypan blue dye. A posterior lamellar graft with a 4.0mm stromal bed and a 4.5mm DM skirt was fashion using a peeling and double punch technique. The posterior lamellar graft was inserted into the optical window such that the DM skirt provided a bridge to the donor corneal endothelium. The anterior cap was sutured with a double continuous suture of 10-0 monofilament nylon. An inferior peripheral iridotomy was created, and an air bubble filling the anterior chamber was left at the end of the case. RESULTS The preoperative visual acuity (VA) was hand movements. Full attachment of the posterior lamellar was seen at all time-points from week one onwards. Central corneal pachymetry continued to reduce for 12 weeks. One year after the operation, with sutures in, the best spectacle-corrected VA was 6/12. The corneal graft was clear, and no rejection episodes occurred. Endothelial cell repopulation of the donor DM could be observed with specular microscopy. CONCLUSION The presence of DM promotes endothelial migration and healing. Modifications to traditional DALK surgery, in which DM is used to promote endothelial healing, are a viable alternative to penetrating keratoplasty. This method eliminates the risk of allograft endothelial rejection and allows a 'regenerative' for DALK to be used, offering a new modality of treatment in patients with healthy reserves of endothelial cells and deep posterior lamellar scarring.
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Affiliation(s)
- Luis García-Onrubia
- Department of Ophthalmology, St. Thomas' Hospital, London, UK
- King's College, London, UK
| | - Nick Stanojcic
- Department of Ophthalmology, St. Thomas' Hospital, London, UK
- King's College, London, UK
| | - Maninder Bhogal
- Department of Ophthalmology, St. Thomas' Hospital, London, UK
- King's College, London, UK
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Hou A, Jin ML, Goldman D. The Protective Effects of Soft Contact Lenses for Contact Sports: A Novel Porcine Model for Corneal Abrasion Biomechanics. Eye Contact Lens 2022; 48:228-230. [PMID: 35220351 DOI: 10.1097/icl.0000000000000894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to determine whether soft contact lenses provide protection for the corneal surface. METHODS Fresh porcine eyes were inflated to intraocular pressures of 11 to 22 mm Hg and secured to a Styrofoam head. Newton meters affixed with artificial acrylic nails were placed at angles of 0°, 45°, and 90° from a porcine corneal surface. The force of impact was recorded at which corneal abrasions were induced. The experiment was repeated with Senofilcon A and Lotrafilcon A soft contact lenses placed upon porcine eyes. RESULTS The mean forces required to induce a corneal abrasion with force at 0°, 45°, and 90° from corneal surface were 11±5.09, 9.18±2.76, and 7.72±2.61 Newtons, respectively. With soft contact lens barrier, the maximum measurable force of 50 Newtons could not produce a corneal abrasion. CONCLUSION The force required to create corneal abrasions varies depending on the angle of the force vector. The use of contact lenses can withstand a minimum of five times the average force needed to create corneal abrasions.
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Affiliation(s)
- Andrew Hou
- Department of Ophthalmology, Henry Ford Hospital, Detroit, MI
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Bayar SA, Öztürker ZK, Yılmaz G. Clinical characteristics and outcomes of ocular injuries in pediatric patients. ULUS TRAVMA ACIL CER 2022; 28:654-661. [PMID: 35485471 PMCID: PMC10442986 DOI: 10.14744/tjtes.2021.54524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/18/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Childhood eye injuries are one of the most common causes of acquired unilateral blindness. In this study, our purpose was to investigate the demographics, etiology, and outcome of pediatric patients with ocular injury. METHODS The charts of children with ocular trauma who presented to Baskent University Hospitals, between January 1, 2017 and December 31, 2019 were retrospectively reviewed. All patients who were under 16 years of age were included. Data were collected on age, sex, time of trauma, injury type, associated injuries, treatments, visual impairment, intraocular pressure (IOP), and ophthalmic sequelae. Ocular traumas were classified according to the Birmingham Eye Trauma Terminology (BETT) system. RESULTS A total of 21 patients were identified. Male-female ratio was 13/8. The mean age of the patients was 8.5±3.4 years. Mean post-treatment follow-up was 8.2±4.3 months. Injury was unilateral in all cases (10 right eye, 11 left eye). Fifteen patients (71.4%) had open globe, and 6 (28.5%) had closed globe injury. Type of injury was rupture in 7 cases, perforation in 5, penetration in 4, and intraocular foreign body in 4. A total of 5 cases were documented to have retinal detachment during the follow-up. Sharp injuries were documented in 11 (64.7%) cases, and blunt in 6 (35.2%). The most frequent finding was hyphema in blunt injury, and corneal laceration in perforating injury. Five patients had choroidal hemorrhage, 3 had commotio retinae, 2 had intravitreal hemorrhage, 1 had subhyaloidal hemorrhage, 1 had macular hole, and 1 had optic nerve avulsion. Lens aspiration was performed in 12 (57.1%) cases, and 2 of them had intraocular lens implantation. In children whose initial vision was able to be taken, 4 had no light perception, 7 had light perception-counting fingers, and 5 had best-corrected visual acuity of 0.05-0.3. At final visit, 61.9% of patients had a VA of 0.05-0.8. Corneal scar or leucoma was observed in 14 (66.6%) cases at last visit. One eye was enucleated due to post-traumatic endophthalmitis that did not respond to treatment. At final visit, IOP <6 mmHg was identified in 2 cases and >21 mmHg in 4. CONCLUSION Anterior segment damage is the main cause of visual morbidity in pediatric ocular trauma. Injuries with sharp objects occur twice as often as blunt trauma and reduce vision with residual corneal scarring in about two-thirds of patients. Under-standing the pattern of eye injuries is useful in determining the strategies required to protect children's eye health.
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Affiliation(s)
- Sezin Akça Bayar
- Department of Ophthalmology, Başkent University Ankara Hospital, Ankara-Turkey
| | | | - Gürsel Yılmaz
- Department of Ophthalmology, Başkent University Ankara Hospital, Ankara-Turkey
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Ben Ishai M, Schaap Fogler M, Ehrlich R, Geffen N, Gal-Or O, Bahar I, Dotan G. Ocular Trauma Caused by Confetti Cannons. Isr Med Assoc J 2021; 23:703-707. [PMID: 34811985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Eye trauma is an unfortunate and often preventable cause of vision loss. Confetti cannons are common causes of injury. Awareness of ocular hazards of confetti cannons remains low because of limited reports describing ophthalmic injuries following their use. OBJECTIVES To describe outcomes of ocular trauma caused by confetti cannons and to increase recognition of their ocular risks. METHODS A retrospective analysis was conducted of eye injuries caused by confetti cannons presenting to a single medical center between 2016 and 2020. Data collected included age, gender, eye injured, ocular damage, visual outcome, and details of surgeries performed. RESULTS Overall, six consecutive patients (2 males, mean age 19.5 ± 9.74 years) were identified and studied. In all patients only one eye was injured (3 right eyes) during a private celebration, most commonly (n=5) to a bystander while in the vicinity of a cannon operated by someone else. Most common eye injuries included corneal erosion (n=4), traumatic hyphema (n=4), and retinal edema (n=3). Mean initial logMAR visual acuity in the injured eye was 0.73 ± 0.18, improving to 0.25 ± 0.16 at the final visit (P = 0.125). Two patients underwent eye surgery due to their trauma: one to repair globe penetration and another to undergo intravitreal injection of tissue plasminogen activator and C3F8 for submacular hemorrhage, followed 8 months later by intravitreal bevacizumab injection for choroidal neovascularization. CONCLUSIONS Confetti cannons pose hazards that can cause severe ocular trauma resulting in permanent vision loss. Increasing awareness of device hazards is necessary to prevent eye injuries.
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Affiliation(s)
- Meydan Ben Ishai
- Department of Ophthalmology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Schaap Fogler
- Department of Ophthalmology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rita Ehrlich
- Department of Ophthalmology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noa Geffen
- Department of Ophthalmology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Orly Gal-Or
- Department of Ophthalmology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Irit Bahar
- Department of Ophthalmology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gad Dotan
- Ophthalmology Unit, Schneider Children's Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Goswami DG, Mishra N, Kant R, Agarwal C, Croutch CR, Enzenauer RW, Petrash MJ, Tewari-Singh N, Agarwal R. Pathophysiology and inflammatory biomarkers of sulfur mustard-induced corneal injury in rabbits. PLoS One 2021; 16:e0258503. [PMID: 34637469 PMCID: PMC8509852 DOI: 10.1371/journal.pone.0258503] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/28/2021] [Indexed: 01/01/2023] Open
Abstract
Sulfur mustard (SM) is a cytotoxic, vesicating, chemical warfare agent, first used in 1917; corneas are particularly vulnerable to SM exposure. They may develop inflammation, ulceration, neovascularization (NV), impaired vision, and partial/complete blindness depending upon the concentration of SM, exposure duration, and bio-physiological conditions of the eyes. Comprehensive in vivo studies have established ocular structural alterations, opacity, NV, and inflammation upon short durations (<4 min) of SM exposure. In this study, detailed analyses of histopathological alterations in corneal structure, keratocytes, inflammatory cells, blood vessels, and expressions of cyclooxygenase (COX)-2, matrix metalloproteinase (MMP)-9, vascular endothelial growth factor (VEGF), and cytokines were performed in New Zealand white rabbits, in a time-dependent manner till 28 days, post longer durations (5 and 7 min) of ocular SM exposure to establish quantifiable endpoints of injury and healing. Results indicated that SM exposure led to duration-dependent increases in corneal thickness, opacity, ulceration, epithelial-stromal separation, and epithelial degradation. Significant increases in NV, keratocyte death, blood vessels, and inflammatory markers (COX-2, MMP-9, VEGF, and interleukin-8) were also observed for both exposure durations compared to the controls. Collectively, these findings would benefit in temporal delineation of mechanisms underlying SM-induced corneal toxicity and provide models for testing therapeutic interventions.
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Affiliation(s)
- Dinesh G. Goswami
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Neha Mishra
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Rama Kant
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Chapla Agarwal
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Claire R. Croutch
- Medical Countermeasures Division, MRIGlobal, Kansas City, Missouri, United States of America
| | - Robert W. Enzenauer
- Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Mark J. Petrash
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Neera Tewari-Singh
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Rajesh Agarwal
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
- * E-mail:
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12
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Mangan MS. Direct Corneal Injury During Radiofrequency-Assisted Upper Blepharoplasty. Dermatol Surg 2021; 47:1146-1147. [PMID: 33867460 DOI: 10.1097/dss.0000000000003037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Mehmet Serhat Mangan
- Division of Ophthalmic Plastic and Reconstructive Surgery, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Institute, University of Health Sciences, Istanbul, Turkey
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13
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Affiliation(s)
| | - Sonal Tuli
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville
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Gupta Y, Viswanath S. Retained cilia in anterior chamber in repaired post-traumatic corneal laceration. BMJ Case Rep 2021; 14:e241447. [PMID: 33541976 PMCID: PMC7868175 DOI: 10.1136/bcr-2020-241447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 02/06/2023] Open
Affiliation(s)
- Yogita Gupta
- Ophthalmology, All India Institute of Medical Sciences, New Delhi, India
| | - Shilpa Viswanath
- Department of Ophthalmology (RP Centre), All India Institute of Medical Sciences, New Delhi, India
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15
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Abstract
This 75-year-old woman had phacomorphic angle closure, dense nuclear sclerosis, deep set eye, miotic pupil and tight corneal wound during phacoemulsification. Phacoemulsification wound burn was noted at the end of surgery. Tenon was harvested from the inferior conjunctiva, placed over the gape and anchored by two radial corneoscleral 10-0 nylon. Ten days later, anterior optical coherence tomography showed good wound apposition and sutures were removed with visual recovery to 20/25 (6/7.5) without astigmatism.
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Affiliation(s)
- Hana A Mansour
- Ophthalmology, American University of Beirut Faculty of Medicine, Beirut, Lebanon
| | - Ahmad M Mansour
- Ophthalmology, American University of Beirut Faculty of Medicine, Beirut, Lebanon
- Ophthalmology, Rafic Hariri University Hospital, Lebanon
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16
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Chlasta-Twardzik E, Nowińska A, Wylęgała E. Corneal complication after femtosecond laser-assisted cataract surgery: A case report. Medicine (Baltimore) 2021; 100:e24013. [PMID: 33466143 PMCID: PMC7808488 DOI: 10.1097/md.0000000000024013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 12/03/2020] [Indexed: 01/05/2023] Open
Abstract
RATIONALE The femtosecond laser LDV Z 8 is unique, and the only femtosecond laser used in ophthalmic microsurgery, which is characterized by low-energy near-infrared (1030 nm) femtosecond single pulses in the nano-Joule range and a very high repetition rate in the MHz range. To the best of our knowledge, this is the first description of unintentional partial corneal incision in the anterior part of a stroma by the femtosecond laser. PATIENT CONCERNS A 79-year-old patient was referred to our clinic for cataract surgery. On admission, we diagnosed mature cataract of the left eye and pseudophakic of the right eye. The patient was qualified for the Femtosecond Laser-Assisted Cataract Surgery (FLACS). Unexpectedly during FLACS procedure after lens fragmentation the surgeon observed unexpected paracentral incision in the cornea. DIAGNOSIS The corneal incision line between 4 to 8 o'clock was observed. In vivo confocal microscopy was performed to assess the morphology and depth of the corneal wound. The corneal incision covered the epithelium, Bowman's membrane and stroma of the cornea reached a depth of 336 um. INTERVENTIONS The patient was under increased ophthalmologic controls; follow up with typical ophthalmic examinations and confocal microscopy was performed. OUTCOMES In 2-year follow-up period, this complication had no effect on postoperative visual function, the patient had no visual problems and obtained the final BCVA 5/5. There is no dislocation of the lens in 2 years follow-up. LESSONS Low pulse energy and high pulse frequency in the LDV Z8 causes a low traumatization of tissues. In a 2-year follow-up, the corneal incision line could be observed on the slit lamp examination without long-term visual consequences of this complication. In our opinion, the most likely cause of this complication was human error and lack of communication between medical personnel. The operation team should be alert and great caution must be exercised during the procedure and check the laser settings parameters carefully each time.
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Yadavalli T, Koganti R, Shukla D. Infection-Induced Porcine Ex Vivo Corneal Wound Model to Study the Efficacy of Herpes Simplex Virus-1 Entry and Replication Inhibitors. Methods Mol Biol 2021; 2193:183-196. [PMID: 32808270 DOI: 10.1007/978-1-0716-0845-6_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Corneal infections by viruses and bacteria can result in ocular surface defects, ulcers, or wounds. Herpes simplex virus type-1 (HSV-1) is a human virus with global seroprevalence in the range of 60-90%. While the virus more commonly causes mucocutaneous lesions including ulcers on the face and mouth, it is also a leading cause of infection-associated blindness. In this chapter, we discuss an in-depth protocol required to evaluate corneal damage due to HSV-1 infection using porcine models of ex vivo infection. Our methods can be adapted to study similar infections caused by other viruses and bacteria.
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Affiliation(s)
- Tejabhiram Yadavalli
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Raghuram Koganti
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Deepak Shukla
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA.
- Department of Microbiology and Immunology, University of Illinois at Chicago, Chicago, IL, USA.
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Abstract
A murine model of corneal epithelial wounding can be performed using simple injury and imaging methods. Here, we describe the creation of a central corneal epithelial defect using mechanical debridement under ophthalmic microscopic visualization. Subsequent monitoring with vital dye application and slit-lamp bio microscopy (slit-lamp) is described in detail.
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Affiliation(s)
- Dhara Shah
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Vinay Kumar Aakalu
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA.
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Fei X, Cai Y, Lin F, Huang Y, Liu T, Liu Y. Amniotic fluid mesenchymal stem cells repair mouse corneal cold injury by promoting mRNA N4-acetylcytidine modification and ETV4/JUN/CCND2 signal axis activation. Hum Cell 2021; 34:86-98. [PMID: 33010000 PMCID: PMC7788028 DOI: 10.1007/s13577-020-00442-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/21/2020] [Indexed: 11/29/2022]
Abstract
Severe corneal injury is one of the main causes of loss of visual function. Mesenchymal stem cells (MSCs) have the ability to repair damaged cells in vivo. The present study aimed to explore whether MSCs could function as a cell therapy tool to replace traditional methods to treat corneal injury. CD44 + /CD105 + mesenchymal stem cells isolated from mouse amniotic fluid (mAF-MSCs) were injected into mice after cryoinjury to induce corneal endothelial cell injury. Histopathological assays indicated that mAF-MSCs could promote the growth of corneal epithelial cells, reduce keratitis, and repair the corneal damage caused by low temperature. cDNA microarray analysis revealed that the mAF-MSCs affected the expression patterns of mRNAs related to cell proliferation and differentiation pathways in the mice after transplantation. The results of quantitative real-time PCR and western blotting revealed that NAT12, NAT10, and the ETV4/JUN/CCND2 signaling axis were elevated significantly in the mAF-MSC-transplantation group, compared with those in the phosphate-buffered saline-treated groups. High performance liquid chromatography-mass spectroscopy results revealed that mAF-MSCs could promote mRNA N4-acetylcytidine (ac4C) modification and high expression of N-acetyltransferase in the eyeballs. RNA immunoprecipitation-PCR results showed that a specific product comprising Vegfa, Klf4, Ccnd2, Jun, and Etv4 mRNA specific coding region sites could be amplified using PCR from complexes formed in mAF-MSC-transplanted samples cross-linked with anti-ac4C antibodies. Thus, mouse amniotic fluid MSCs could repair the mouse corneal cold injury by promoting the ETV4/JUN/CCND2 signal axis activation and improving its stability by stimulating N4-acetylcytidine modification of their mRNAs.
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Affiliation(s)
- Xinfeng Fei
- Department of Ophthalmology, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, 100 Haining Road, Shanghai, 200080, China
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, 200080, China
| | - Yuying Cai
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, 200080, China
- National Clinical Research Center for Eye Diseases, Shanghai General Hospital, Shanghai, 200080, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai, 200080, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai General Hospital, Shanghai, 200080, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai General Hospital, Shanghai, 200080, China
| | - Feng Lin
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, 200080, China
- National Clinical Research Center for Eye Diseases, Shanghai General Hospital, Shanghai, 200080, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai, 200080, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai General Hospital, Shanghai, 200080, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai General Hospital, Shanghai, 200080, China
| | - Yongyi Huang
- School of Environmental and Chemical Engineering, Shanghai University, Shanghai, 200444, China
| | - Te Liu
- Shanghai Geriatric Institute of Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Building C, 365 Xiangyang Road, Shanghai, 200031, China.
| | - Yan Liu
- Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, 200080, China.
- National Clinical Research Center for Eye Diseases, Shanghai General Hospital, Shanghai, 200080, China.
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai, 200080, China.
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai General Hospital, Shanghai, 200080, China.
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai General Hospital, Shanghai, 200080, China.
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Stati G, Sancilio S, Basile M, Angelini A, Di Pietro R. Curcuma longa aqueous extract: A potential solution for the prevention of corneal scarring as a result of pterygium surgical excision (Review). Int J Mol Med 2020; 46:1951-1957. [PMID: 33125502 DOI: 10.3892/ijmm.2020.4738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/30/2020] [Indexed: 02/05/2023] Open
Abstract
Curcumin has been used since ancient times as a treatment for a wide range of pathologies. For centuries, it has been considered to be an effective aid for common human diseases. Curcuma longa has been reported to possess various beneficial properties and actions, including anti‑inflammatory, proapoptotic, antiangiogenic and cortisone‑like actions. Pterygium is a degenerative disorder of the conjunctiva indicative of a strong inflammatory condition that requires surgical treatment, which often results in disfiguring sclerocorneal scars. The delay in the healing of superficial corneal wounds caused by topical administration of light‑cortisone results in improved restoration of corneal functions and anatomy compared with physiological healing processes. The present review is focused on the medicinal properties of curcumin, the main component of Curcuma longa extract, in particular its strong cortisone‑like effect, and its potential use for the prevention and treatment of sclerocorneal scars resulting from pterygium surgical excision.
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Affiliation(s)
- Gianmarco Stati
- Department of Medicine and Ageing Sciences, d'Annunzio University of Chieti‑Pescara, I‑66100 Chieti, Italy
| | - Silvia Sancilio
- Department of Medicine and Ageing Sciences, d'Annunzio University of Chieti‑Pescara, I‑66100 Chieti, Italy
| | - Mariangela Basile
- Department of Medicine and Ageing Sciences, d'Annunzio University of Chieti‑Pescara, I‑66100 Chieti, Italy
| | - Antonio Angelini
- Department of Medicine and Ageing Sciences, d'Annunzio University of Chieti‑Pescara, I‑66100 Chieti, Italy
| | - Roberta Di Pietro
- Department of Medicine and Ageing Sciences, d'Annunzio University of Chieti‑Pescara, I‑66100 Chieti, Italy
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21
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Oliveira RF, Ferreira GA, Ghanem VC, Corrêa-Dantas PE, Ghanem RC. Transepithelial Surface Ablation With Mitomycin C for the Treatment of Chronic Central Corneal Scars Following Adenoviral Keratoconjunctivitis. J Refract Surg 2020; 36:55-61. [PMID: 31917852 DOI: 10.3928/1081597x-20191203-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 11/27/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess visual and refractive outcomes and recurrence rates of subepithelial infiltrates after corneal surface ablation with mitomycin C (MMC) 0.02% for the treatment of chronic corneal scars following epidemic keratoconjunctivitis and to compare these results with a control group receiving only medical treatment. METHODS This was a retrospective case series enrolling patients with central corneal scars following epidemic keratoconjunctivitis. Patients were divided into two groups: (1) control with clinical follow-up and refractive correction with glasses or rigid gas-permeable contact lenses when necessary and (2) transepithelial phototherapeutic keratectomy (PTK) with MMC 0.02%, combined with photorefractive keratectomy (PRK) in selected cases (treatment group). Signs and symptoms, corrected distance visual acuity (CDVA) in logMAR units, manifest and cycloplegic refraction, and depth of the corneal opacities were assessed. RESULTS Thirty-five eyes of 27 patients (11 men [40.7%] and 16 women [59.3%]) were enrolled, with a mean follow-up of 54.4 ± 19.7 and 27.5 ± 22.8 months in the control and treatment groups, respectively. Mean improvement in CDVA was 0.13 ± 0.17 logMAR (P = .007) in the control group and 0.29 ± 0.24 logMAR (P = .001) in the treatment group. Intergroup comparison showed a greater improvement in the treatment group (P = .041). Mean hyperopic shift induced in the treatment group was +0.46 ± 1.20 diopters. The recurrence rate of subepithelial infiltrates was 77.7% in the control group and 11.7% in the treatment group throughout the follow-up (54.4 ± 19.7 and 27.5 ± 22.8 months, respectively). CONCLUSIONS Corneal surface ablation with MMC 0.02% was efficient in treating corneal scars following adenoviral epidemic keratoconjunctivitis, with greater visual improvement in comparison to clinical treatment and a decreased rate of infiltrate recurrence. [J Refract Surg. 2020;36(1):55-61.].
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Negishi K, Masui S, Torii H, Nishi Y, Tsubota K. Refractive stability of a new single-piece hydrophobic acrylic intraocular lens and corneal wound repair after implantation using a new automated intraocular lens delivery system. PLoS One 2020; 15:e0238366. [PMID: 32877454 PMCID: PMC7467255 DOI: 10.1371/journal.pone.0238366] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/15/2020] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To investigate refractive stability and characterize corneal incision repair up to 3 months after implantation of a new hydrophobic acrylic intraocular lens (IOL) with hydroxyethylmethacrylate using a new automated IOL delivery system. METHODS This prospective case series included 50 eyes of 50 patients undergoing phacoemulsification and implantation of the Clareon® CNA0T0 IOL using the AutonoMe® automated delivery system in the Department of Ophthalmology, Keio University School of Medicine. The clinical data were collected from 46 eyes of 46 patients preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively. Endothelial-side incision gaping, posterior incision retraction, and Descemet's membrane detachment were recorded as present or absent using anterior-segment optical coherence tomography postoperatively. RESULTS The uncorrected distance and corrected distance visual acuities improved and stabilized 1 week postoperatively. The anterior chamber depth was stable from 1 week postoperatively. The subjective refraction was stable from 1 day postoperatively. Descemet's membrane detachments and endothelial-side wound gaping were seen in 19 (41.3%) eyes and 34 (73.9%) eyes 1 day postoperatively and decreased gradually. Posterior incision retraction was seen in eight eyes (17.4%) on day 1 and increased to 19 eyes (41.3%) 3 months postoperatively. CONCLUSIONS The Clareon IOL had excellent refractive stability from day 1 postoperatively. The AutonoMe automated delivery system enables safe IOL implantation through a 2.4-mm corneal incision, although the wound required longer than 1 month to heal postoperatively.
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Affiliation(s)
- Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- * E-mail:
| | - Sachiko Masui
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yasuyo Nishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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23
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Chang YC, Lee YC. Traumatic laser in situ keratomileusis flap dislocation with epithelial ingrowth, Propionibacterium acnes infection, and diffuse lamellar keratitis: A case report. Medicine (Baltimore) 2020; 99:e19257. [PMID: 32150061 PMCID: PMC7478497 DOI: 10.1097/md.0000000000019257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Traumatic flap dislocation might occur anytime after laser in situ keratomileusis (LASIK), but it is rarely concomitantly complicated with epithelial ingrowth, infectious keratitis, and diffuse lamellar keratitis altogether. Here we report a case of traumatic LASIK flap inversion with epithelial ingrowth, Propionibacterium acnes infection, and diffuse lamellar keratitis. PATIENT CONCERNS A 42-year-old man receiving bilateral LASIK surgery 10 years ago complained of right eye pain for 6 days after twig injury. Temporal flap inversion with epithelial ingrowth and dense infiltration at the interface were noted. DIAGNOSES Traumatic LASIK flap inversion with epithelial ingrowth, Propionibacterium acnes infection and diffuse lamellar keratitis. INTERVENTIONS Removal of corneal epithelium around the flap inversion site, flap lifting, scraping of epithelial ingrowth, removal of the dense infiltrate, alcohol soaking, interface irrigation with antibiotics, and flap reposition were performed. Diffuse lamellar keratitis was noted postoperatively. Culture of the infiltrate revealed P acnes. The infiltrate subsided and the cornea cleared up under topical antibiotics and steroid. OUTCOMES The visual acuity returned to 20/20. No recurrent epithelial ingrowth or infiltrate was noted during the follow-up. LESSONS This is the first report of Propionibacterium acnes keratitis after traumatic flap inversion. Although epithelial ingrowth, infectious keratitis, and diffuse lamellar keratitis all developed after the flap inversion, early recognition and proper intervention lead to a good result without sequels.
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Affiliation(s)
| | - Yuan-Chieh Lee
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital
- Department of Ophthalmology and Visual Science
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
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24
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Thapa D, Cairns EA, Szczesniak AM, Kulkarni PM, Straiker AJ, Thakur GA, Kelly MEM. Allosteric Cannabinoid Receptor 1 (CB1) Ligands Reduce Ocular Pain and Inflammation. Molecules 2020; 25:E417. [PMID: 31968549 PMCID: PMC7024337 DOI: 10.3390/molecules25020417] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/16/2020] [Indexed: 01/08/2023] Open
Abstract
Cannabinoid receptor 1 (CB1) activation has been reported to reduce transient receptor potential cation channel subfamily V member 1 (TRPV1)-induced inflammatory responses and is anti-nociceptive and anti-inflammatory in corneal injury. We examined whether allosteric ligands, can modulate CB1 signaling to reduce pain and inflammation in corneal hyperalgesia. Corneal hyperalgesia was generated by chemical cauterization of cornea in wildtype and CB2 knockout (CB2-/-) mice. The novel racemic CB1 allosteric ligand GAT211 and its enantiomers GAT228 and GAT229 were examined alone or in combination with the orthosteric CB1 agonist Δ8-tetrahydrocannabinol (Δ8-THC). Pain responses were assessed following capsaicin (1 µM) stimulation of injured corneas at 6 h post-cauterization. Corneal neutrophil infiltration was also analyzed. GAT228, but not GAT229 or GAT211, reduced pain scores in response to capsaicin stimulation. Combination treatments of 0.5% GAT229 or 1% GAT211 with subthreshold Δ8-THC (0.4%) significantly reduced pain scores following capsaicin stimulation. The anti-nociceptive effects of both GAT229 and GAT228 were blocked with CB1 antagonist AM251, but remained unaffected in CB2-/- mice. Two percent GAT228, or the combination of 0.2% Δ8-THC with 0.5% GAT229 also significantly reduced corneal inflammation. CB1 allosteric ligands could offer a novel approach for treating corneal pain and inflammation.
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Affiliation(s)
- Dinesh Thapa
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Elizabeth A. Cairns
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | | | - Pushkar M. Kulkarni
- Department of Pharmaceutical Sciences, Northeastern University, Boston, MA 02115, USA
| | - Alex J. Straiker
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47405, USA
| | - Ganesh A. Thakur
- Department of Pharmaceutical Sciences, Northeastern University, Boston, MA 02115, USA
| | - Melanie E. M. Kelly
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
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25
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Affiliation(s)
- Michael Carl Chen
- Tenwek Hospital, Bomet, Bomet County, Kenya
- Penn State Eye Center, Hershey, Pennsylvania
- Penn State College of Medicine, Hershey, Pennsylvania
- Corresponding author: Michael Carl Chen, Tenwek Hospital, Bomet, Bomet County, Kenya.
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26
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Affiliation(s)
| | - Syed N Ahmed
- Eastbourne District General Hospital, Eastbourne, UK
| | - Yusra Khan
- Stoke Gifford Medical Centre, Bristol, UK
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27
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Langdon S, Johnson A, Sharma R. Debris Flow Syndrome: Injuries and Outcomes after the Montecito Debris Flow. Am Surg 2019; 85:1094-1098. [PMID: 31657301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
On January 9, 2018, a catastrophic debris flow devastated Montecito, California. A 30-foot wall of boulders, mud, and debris ran down the hillsides at 15 miles per hour injuring dozens and causing 21 prehospital deaths. A retrospective review was conducted of the victims from the debris flow presenting to Cottage Health. Injury patterns, procedures performed, complications, length of stay, and outcomes were analyzed. Twenty-four patients were evaluated; 15 were admitted. Of the patients admitted, the most common presenting symptoms were soft tissue injuries (100%), hypothermia (67%), craniofacial injuries (67%), corneal abrasions (53%), and orthopedic injuries (47%), as well as loss of an immediate family member during the incident (73%). Procedures included skin irrigation (93%), operative soft tissue debridement (47%), body orifice irrigation due to mud impaction (40%), and orthopedic repair of fractures and ligaments (40%). All survived to discharge. "Debris flow syndrome" can be defined as a pattern of injuries, including soft tissue injuries, hypothermia, craniofacial trauma, corneal abrasions, orthopedic injuries, and mud impaction. Managing the debris flow syndrome requires co-ordinated and specialized care.
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Lim IH, Alias R, Umapathy T, Samsudin A. Cultivated oral mucosal epithelial transplantation (COMET) and penetrating keratoplasty in long-standing severe ocular surface injury. Med J Malaysia 2019; 74:433-435. [PMID: 31649222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Ocular chemical injury is a true ophthalmic emergency requiring immediate medical intervention. Damages can be devastating and potentially resulting in blindness, corneal perforation and phthisis bulbi. We describe here a successful treatment outcome in a patient who sustained Roper-Hall Grade 4 injury to both eyes. Patient received medical therapy followed by serial ocular surgeries with eventual visual recovery in one eye from counting finger to 6/15 after a decade. In conclusion, after maximum medical therapy, a carefully planned serial surgeries of cultivated oral mucosal epithelial transplantation (COMET) and PK has proven beneficial for this patient with advanced limbal stem cell deficiency (LSCD).
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Affiliation(s)
- I H Lim
- Hospital Kuala Lumpur, Department of Ophthalmology, Cornea Unit, Kuala Lumpur, Malaysia.
| | - R Alias
- Hospital Kuala Lumpur, Department of Ophthalmology, Cornea Unit, Kuala Lumpur, Malaysia
| | - T Umapathy
- Hospital Kuala Lumpur, Department of Ophthalmology, Cornea Unit, Kuala Lumpur, Malaysia
| | - A Samsudin
- University of Malaya Medical Centre, Department of Ophthalmology, Kuala Lumpur, Malaysia
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Xiao C, Wu M, Liu J, Gu J, Jiao X, Lu D, He J, Lin C, Xue Y, Fu T, Wang H, Wang G, Yang X, Li Z. Acute tobacco smoke exposure exacerbates the inflammatory response to corneal wounds in mice via the sympathetic nervous system. Commun Biol 2019; 2:33. [PMID: 30701198 PMCID: PMC6345828 DOI: 10.1038/s42003-018-0270-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 12/17/2018] [Indexed: 12/18/2022] Open
Abstract
Exposure to tobacco smoke is a major public health concern that can also affect ophthalmic health. Based on previous work demonstrating the important role of the sympathetic nervous system (SNS) in corneal wound repair, we postulated that acute tobacco smoke exposure (ATSE) may act through the SNS in the impairment of corneal wound repair. Here we find that ATSE rapidly increases the markers of inflammatory response in normal corneal limbi. After an abrasion injury, ATSE exaggerates inflammation, impairs wound repair, and enhances the expression of nuclear factor-κB (NF-κB) and inflammatory molecules such as interleukin-6 (IL-6) and IL-17. We find that chemical SNS sympathectomy, local adrenergic receptor antagonism, NF-κB1 inactivation, and IL-6/IL-17A neutralization can all independently attenuate ATSE-induced excessive inflammatory responses and alleviate their impairment of the healing process. These findings highlight that the SNS may represent a major molecular sensor and mediator of ATSE-induced inflammation.
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Affiliation(s)
- Chengju Xiao
- International Ocular Surface Research Center, Institute of Ophthalmology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
| | - Mingjuan Wu
- International Ocular Surface Research Center, Institute of Ophthalmology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
| | - Jun Liu
- International Ocular Surface Research Center, Institute of Ophthalmology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
| | - Jianqin Gu
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Xinwei Jiao
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Dingli Lu
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
| | - Jingxin He
- International Ocular Surface Research Center, Institute of Ophthalmology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
- Department of Ophthalmology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Cuipei Lin
- International Ocular Surface Research Center, Institute of Ophthalmology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
- Department of Ophthalmology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Yunxia Xue
- International Ocular Surface Research Center, Institute of Ophthalmology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
| | - Ting Fu
- International Ocular Surface Research Center, Institute of Ophthalmology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
| | - Hanqing Wang
- International Ocular Surface Research Center, Institute of Ophthalmology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
| | - Guang Wang
- Department of Histology and Embryology, Jinan University Medical School, Guangzhou, China
| | - Xuesong Yang
- Department of Histology and Embryology, Jinan University Medical School, Guangzhou, China
| | - Zhijie Li
- International Ocular Surface Research Center, Institute of Ophthalmology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Jinan University, Guangzhou, China
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People’s Hospital, Henan University People’s Hospital, Zhengzhou, China
- Section of Leukocyte Biology, Department of Pediatrics, Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX USA
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Bu Y, Shih KC, Kwok SS, Chan YK, Lo ACY, Chan TCY, Jhanji V, Tong L. Experimental modeling of cornea wound healing in diabetes: clinical applications and beyond. BMJ Open Diabetes Res Care 2019; 7:e000779. [PMID: 31803484 PMCID: PMC6887488 DOI: 10.1136/bmjdrc-2019-000779] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/06/2019] [Accepted: 11/03/2019] [Indexed: 12/11/2022] Open
Abstract
Diabetes mellitus is the most common cause of blindness in working age populations worldwide. While much of the focus for public health has been on secondary prevention in sight-threatening diabetic retinopathy, the cornea, including its epithelium and nerves, represents a major site of damage by chronic hyperglycemia. On injury, the diabetic cornea exhibits a delayed wound-healing response, as well as an altered ocular surface immune response. This suggests a potential association between the dysfunctional wound healing response and altered inflammation on the ocular surface. However, the presence of potential confounders makes this association difficult to investigate in human epidemiological studies. Thus, we turn to animal diabetic models for a better understanding. In this review, 20 original studies, published between 2008 and 2018, describe in vivo and in vitro models of diabetic cornea disease. We compared different models of diabetic cornea wound healing and discussed the relative strengths and drawbacks of each model. A number of molecular and cellular components involved in the corneal wound healing response that are altered in the presence of diabetes have been identified in the reviewed studies. Particularly, altered corneal epithelial protein concentrations of lumician and occludin were detected in diabetic eyes compared with controls. Additionally, the importance of IL-1β in modulating the inflammatory response after corneal injury in patients with diabetes and controls was further elucidated. Meanwhile, abnormal P2×7 receptor localization and decreased corneal sub-basal nerve density in diabetic eyes were shown to contribute to altered corneal nerve signaling after injury and thus affecting the wound healing response. Finally, the discovery of the therapeutic effects of topically administered aloe vera, Serpine 1, Resolvin D1 (RvD1), pigment epithelium-derived factor (PEDF) and Pro-His-Ser-Arg-Asn in diabetic animal models of cornea epithelial and nerve injury provide encouraging evidence for the future availability of effective treatment for diabetic keratopathy.
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Affiliation(s)
- Yashan Bu
- Department of Ophthalmology, University of Hong Kong, Hong Kong
| | | | - Sum Sum Kwok
- Department of Ophthalmology, University of Hong Kong, Hong Kong
| | - Yau Kei Chan
- Department of Ophthalmology, University of Hong Kong, Hong Kong
| | | | | | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Louis Tong
- Department of Ophthalmology, Singapore National Eye Centre, Singapore
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Chee RI, Eliott D, Chau FY. Surgical Management of an Externally Protruding, Perforating Intraocular Foreign Body. Ophthalmic Surg Lasers Imaging Retina 2018; 49:904-906. [PMID: 30457652 DOI: 10.3928/23258160-20181101-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Ru-ik Chee Felix Y. Chau In this case of a perforating eye injury by a 2-inch-long nail that went through the cornea, lens, and posterior eye wall, the authors describe a combined external, anterior, and posterior segment surgical approach that resulted in safe and successful removal of the foreign body. Initial external trimming of the protruding nail facilitated the use of a noncontact viewing system. Combined limbal and pars plana placement of the vitrectomy cannulas optimized access to both anterior and posterior intraocular structures. Most importantly, careful removal of potential sources of foreign body adhesion to intraocular structures prior to extraction likely increased the likelihood for a successful clinical outcome. Care was taken to remove as much of the vitreous as possible and to keep the eye formed. The patient recovered 20/25+2 vision with aphakic correction.
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Paschalis EI, Zhou C, Lei F, Scott N, Kapoulea V, Robert MC, Vavvas D, Dana R, Chodosh J, Dohlman CH. Mechanisms of Retinal Damage after Ocular Alkali Burns. Am J Pathol 2017; 187:1327-1342. [PMID: 28412300 PMCID: PMC5455067 DOI: 10.1016/j.ajpath.2017.02.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 02/06/2017] [Accepted: 02/14/2017] [Indexed: 01/01/2023]
Abstract
Alkali burns to the eye constitute a leading cause of worldwide blindness. In recent case series, corneal transplantation revealed unexpected damage to the retina and optic nerve in chemically burned eyes. We investigated the physical, biochemical, and immunological components of retinal injury after alkali burn and explored a novel neuroprotective regimen suitable for prompt administration in emergency departments. Thus, in vivo pH, oxygen, and oxidation reduction measurements were performed in the anterior and posterior segment of mouse and rabbit eyes using implantable microsensors. Tissue inflammation was assessed by immunohistochemistry and flow cytometry. The experiments confirmed that the retinal damage is not mediated by direct effect of the alkali, which is effectively buffered by the anterior segment. Rather, pH, oxygen, and oxidation reduction changes were restricted to the cornea and the anterior chamber, where they caused profound uveal inflammation and release of proinflammatory cytokines. The latter rapidly diffuse to the posterior segment, triggering retinal damage. Tumor necrosis factor-α was identified as a key proinflammatory mediator of retinal ganglion cell death. Blockade, by either monoclonal antibody or tumor necrosis factor receptor gene knockout, reduced inflammation and retinal ganglion cell loss. Intraocular pressure elevation was not observed in experimental alkali burns. These findings illuminate the mechanism by which alkali burns cause retinal damage and may have importance in designing therapies for retinal protection.
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MESH Headings
- Alkalies
- Animals
- Apoptosis/drug effects
- Apoptosis/physiology
- Burns, Chemical/drug therapy
- Burns, Chemical/etiology
- Burns, Chemical/metabolism
- Burns, Chemical/pathology
- Cornea/immunology
- Corneal Injuries/drug therapy
- Corneal Injuries/etiology
- Corneal Injuries/metabolism
- Corneal Injuries/pathology
- Disease Models, Animal
- Drug Evaluation, Preclinical/methods
- Eye Burns/drug therapy
- Eye Burns/etiology
- Eye Burns/metabolism
- Eye Burns/pathology
- Hydrogen-Ion Concentration
- Infliximab/pharmacology
- Infliximab/therapeutic use
- Mice, Inbred C57BL
- Mice, Knockout
- Neuroprotective Agents/pharmacology
- Neuroprotective Agents/therapeutic use
- Oxidation-Reduction
- Rabbits
- Receptors, Tumor Necrosis Factor, Type I/deficiency
- Receptors, Tumor Necrosis Factor, Type I/genetics
- Receptors, Tumor Necrosis Factor, Type II/deficiency
- Receptors, Tumor Necrosis Factor, Type II/genetics
- Retina/immunology
- Retina/injuries
- Retina/metabolism
- Retina/pathology
- Retinal Ganglion Cells/drug effects
- Retinal Ganglion Cells/pathology
- Sodium Hydroxide
- Tumor Necrosis Factor-alpha/antagonists & inhibitors
- Tumor Necrosis Factor-alpha/metabolism
- Uvea/metabolism
- Uveitis, Anterior/chemically induced
- Uveitis, Anterior/metabolism
- Uveitis, Anterior/pathology
- Uveitis, Anterior/prevention & control
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Affiliation(s)
- Eleftherios I Paschalis
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Boston Keratoprosthesis Laboratory, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts; Disruptive Technology Laboratory, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
| | - Chengxin Zhou
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Boston Keratoprosthesis Laboratory, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts; Disruptive Technology Laboratory, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Fengyang Lei
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Boston Keratoprosthesis Laboratory, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts; Disruptive Technology Laboratory, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Nathan Scott
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Boston Keratoprosthesis Laboratory, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts; Disruptive Technology Laboratory, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Vassiliki Kapoulea
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Boston Keratoprosthesis Laboratory, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts; Disruptive Technology Laboratory, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Marie-Claude Robert
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Boston Keratoprosthesis Laboratory, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts; Centre Hospitalier de l'Universite de Montreal, Hospital Notre-Dame, Montreal, Quebec, Canada
| | - Demetrios Vavvas
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Angiogenesis Laboratory, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Reza Dana
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - James Chodosh
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Disruptive Technology Laboratory, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Claes H Dohlman
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Boston Keratoprosthesis Laboratory, Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts
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Feng X, Pi L, Sriram S, Schultz GS, Gibson DJ. Connective tissue growth factor is not necessary for haze formation in excimer laser wounded mouse corneas. PLoS One 2017; 12:e0172304. [PMID: 28207886 PMCID: PMC5313228 DOI: 10.1371/journal.pone.0172304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 02/02/2017] [Indexed: 11/19/2022] Open
Abstract
We sought to determine if connective tissue growth factor (CTGF) is necessary for the formation of corneal haze after corneal injury. Mice with post-natal, tamoxifen-induced, knockout of CTGF were subjected to excimer laser phototherapeutic keratectomy (PTK) and the corneas were allowed to heal. The extent of scaring was observed in non-induced mice, heterozygotes, and full homozygous knockout mice and quantified by macrophotography. The eyes from these mice were collected after euthanization for re-genotyping to control for possible Cre-mosaicism. Primary corneal fibroblasts from CTGF knockout corneas were established in a gel plug assay. The plug was removed, simulating an injury, and the rate of hole closure and the capacity for these cells to form light reflecting cells in response to CTGF and platelet-derived growth factor B (PDGF-B) were tested and compared to wild-type cells. We found that independent of genotype, each group of mice was still capable of forming light reflecting haze in the cornea after laser ablation (p = 0.40). Results from the gel plug closure rate in primary cell cultures of knockout cells were not statistically different from serum starved wild-type cells, independent of treatment. Compared to the serum starved wild-type cells, stimulation with PDGF-BB significantly increased the KO cell culture’s light reflection (p = 0.03). Most interestingly, both reflective cultures were positive for α-SMA, but the cellular morphology and levels of α-SMA were distinct and not in proportion to the light reflection seen. This new work demonstrates that corneas without CTGF can still form sub-epithelial haze, and that the light reflecting phenotype can be reproduced in culture. These data support the possibilities of growth factor redundancy and that multiple pro-haze pathways exist.
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Affiliation(s)
- Xiaodi Feng
- Institute of Wound Research, University of Florida, Gainesville, Florida, United States of America
| | - Liya Pi
- Department of Pediatrics, University of Florida, Gainesville, Florida, United States of America
| | - Sriniwas Sriram
- Department of Biomedical Engineering, University of Florida, Gainesville, Florida, United States of America
| | - Gregory S. Schultz
- Institute of Wound Research, University of Florida, Gainesville, Florida, United States of America
| | - Daniel J. Gibson
- Institute of Wound Research, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
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Øregaard JS, Tran TL, Paulsen JF, Bredgaard R. [Severe corneal scald after steam explosion]. Ugeskr Laeger 2016; 178:V05160338. [PMID: 27908314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Facial burns and scalds are common but the eyes are rarely affected. We present a case of a 40-year-old female patient with severe eye injury due to facial scald. Although initial examination in the emergency department did not reveal signs of serious injury, the patient was referred to the burns unit two days later due to suspicion of infection of the facial burns. She was found to have seriously impaired vision and was transferred to a department of ophthalmology. Examination revealed bilateral severe corneal injuries and bilateral limbal ischaemia, presumably leading to permanently impaired vision.
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Lennox M, Rizzo J, Lennox L, Rothman I. Subcorneal hematomas in excessive video game play. Cutis 2016; 97:35-38. [PMID: 26919354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report a case of subcorneal hematomas caused by excessive video game play in a 19-year-old man. The hematomas occurred in a setting of thrombocytopenia secondary to induction chemotherapy for acute myeloid leukemia. It was concluded that thrombocytopenia subsequent to prior friction from heavy use of a video game controller allowed for traumatic subcorneal hemorrhage of the hands. Using our case as a springboard, we summarize other reports with video game associated pathologies in the medical literature. Overall, cognizance of the popularity of video games and related pathologies can be an asset for dermatologists who evaluate pediatric patients.
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Affiliation(s)
- Maria Lennox
- School of Medicine and Biomedical Sciences, State University of New York at Buffalo, USA
| | - Jason Rizzo
- School of Medicine and Biomedical Sciences, State University of New York at Buffalo, USA
| | - Luke Lennox
- School of Medicine and Biomedical Sciences, State University of New York at Buffalo, USA
| | - Ilene Rothman
- Women & Children's Hospital of Buffalo, New York, USA
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Tosi GM, Baiocchi S, Balestrazzi A, Martone G, Marigliani D, Neri G, Caporossi T. Corneal Complications During and After Vitrectomy for Retinal Detachment in Photorefractive Keratectomy Treated Eyes. Medicine (Baltimore) 2015; 94:e2215. [PMID: 26683931 PMCID: PMC5058903 DOI: 10.1097/md.0000000000002215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
To evaluate the occurrence of late-onset corneal haze (LOCH) after vitrectomy for rhegmatogenous retinal detachment (RRD) in photorefractive keratectomy (PRK)-treated eyes. This observational cohort study comprised 13 eyes of 13 patients who underwent vitrectomy for RRD and who had been subjected to PRK years earlier. The occurrence of LOCH was evaluated together with all the preoperative, intraoperative, and postoperative factors that could affect final corneal status. LOCH developed in 2 eyes. Both patients had undergone PRK for high myopia--one 3 years and the other 9 years prior to RRD. Both patients presented with RRD due to giant retinal tear and were subjected to scleral buckle, 20-gauge vitrectomy, and silicone oil tamponade. Three months after vitrectomy and 1 month after silicone oil removal they both developed LOCH. During vitreoretinal surgery neither of the 2 patients needed mechanical epithelial debridement. Intraoperative epithelial debridement was performed in 2 of the other patients of the series, who had undergone previous PRK for high myopia and had clear corneas at presentation; in 1 of them this manoeuvre hampered intraoperative visualization. Follow-up after retinal detachment surgery ranged from 6 to 156 months (mean, 37.5 months). Subepithelial corneal scarring may be reactivated many years after PRK. In our series this happened after vitrectomy.
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Affiliation(s)
- Gian Marco Tosi
- From the Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, University of Siena, Siena (GMT, SB, AB, GM, DM, GN); and Ophthalmology Department, University of Florence, AOUC, Florence, Italy (TC)
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38
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Zhu Q, Hu Z, Sun X, Hu M, Liu H, Yang Z. [Transplanted vascular endothelial cells to replace corneal endothelial cells by improved anterior chamber injection]. Zhonghua Yan Ke Za Zhi 2014; 50:277-284. [PMID: 24931154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To observe form and function changes of vascular endothelial cells (VEC) which were transplanted to the posterior surface of rhesus monkey cornea without Descemet's Membrane by anterior chamber injection, explore the feasibility of transplanting VEC to treat corneal endothelial injury, and find new method of corneal endothelial cell transplantation. METHODS Cultured VEC to proliferate in vitro.Rhesus monkeys were randomly divided into two groups: Experimental group (6) and control group (6) according to a random number table. The experimental group:transplant the culured VEC to the posterior surface of rhesus monkey cornea without Descemet's membrane by anterior chamber injection. The control group:Tear out the Descemet's membrane by capsulotomy needle without VEC transplantation. A ultrasound apparatus was adopted to measure the postoperative thicknes of the cornea and Goldman intraocular pressure meter measuring intraocular pressure in the postoperative 7 days, 14 days, 30 days, 60 days, 90 days, organize the data and entered into the computer , applicated the software of SPSS 11.5 for data independent samples t-test and analysis of variance. The eyes were removed respectively in postoperative 30, 60, 90 days to do pathological HE dyeing and scanning electron microscopy (SEM) observation of VEC in the posterior surface of cornea graft. RESULTS Corneal transpareney:In the experimental observation period (3 months), the experimental group had better transparency than the control group with normal anterior chamber depth and without bullous keratopathy. And the corneal neovascularization was exist in the cornea graft in experimental group in the third month. After 3 months, the corneal thickness of experimental group (500 ± 14) µm was significantly lower than the control group (618 ± 11) µm, Corneal thickness values between experimental and control groups were statistically significant differences in changes (all P < 0.05, t-values were -3.256, -4.419, -12.896 postoperative 1, 2, 3 months). Changes of intraocular pressure difference between the experimental group and the control was not statistically significant (all P > 0.05, t-values were -1.179, -2.166, -2.536 postoperative 1, 2, 3 months). The pathological:the cell layer was visible in the posterior surface of cornea graft. The control group:can't find the cell sample structure.SEM:Experimental group showed that VEC with irregular shape uniformly distributed on the inner surface of cornea and growing well, a small amount of white blood cells can be seen between VEC, and part of cellular debris exist in the trabecular meshwork. Control group showed a fiber material without VEC. CONCLUSIONS Ultrasonic emulsification can established a repeatability and simple model of corneal endothelial injury in Rhesus monkeys.VEC can be transplanted to the corneal surface by Anterior chamber injection and the cells can grow on the surface and play a barrier role in maintaining the state of dehydration and transparency of the cornea to a certain extent. After transplantation, organizational structure and morphology of the anterior chamber angle does not produce pathological effects in the short term. Prompt that transplant the culured VEC to the posterior surface of rhesus monkey cornea without Descemet's Membrane by anterior chamber injection to substitute the function of the corneal endothelial cells may be a new idea for treatment of corneal endothelial damage.
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Affiliation(s)
- Qin Zhu
- Department of Ophthalmology, the Second People's Hospital of Yunnan Province, Kunming 650021, China
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