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Taiwan Journal of Ophthalmology 2023Femtosecond laser (FSL) applications in corneal surgery have increased since its inception. Corneal surgery has undergone a tremendous transformation thanks to the... (Review)
Review
Femtosecond laser (FSL) applications in corneal surgery have increased since its inception. Corneal surgery has undergone a tremendous transformation thanks to the introduction of FSL technology. This laser makes precise, three-dimensional incisions while causing minimal damage to surrounding tissue. This review updates and summarizes current and upcoming FSL applications in corneal surgery, current commercially available FSL, and its respective applications. Refractive surgery applications include laser keratomileusis flaps, refractive corneal lenticule extraction such as small incision lenticule extraction, astigmatic keratotomy, intracorneal ring segments tunnels for keratoconus including corneal allogenic intrastromal ring segments, and presbyopia treatments with intrastromal pockets for corneal inlays and intrastromal incisions (INTRACOR). Keratoplasty applications include penetrating keratoplasty trephination; superficial and deep anterior lamellar keratoplasty trephination, lamellar dissection, and tunnel creation; posterior lamellar keratoplasty donor and recipient preparation; Bowman layer transplantation donor, and recipient preparation; and stromal keratophakia. Other applications include conjunctival graft preparation in pterygium surgery, and keratopigmentation (corneal tattooing). FSL is a surgical instrument widely used in corneal surgery because it improves reproducibility and safety in many procedures.
PubMed: 38089509
DOI: 10.4103/tjo.TJO-D-23-00083 -
Beyoglu Eye Journal 2023To evaluate the efficiency and safety of autologous blood-assisted, sutureless conjunctival autograft surgery in the management of pterygium.
OBJECTIVES
To evaluate the efficiency and safety of autologous blood-assisted, sutureless conjunctival autograft surgery in the management of pterygium.
METHODS
This study included the eyes of 124 patients who were divided into two groups. Group 1 consisted of 62 patients who received autologous blood-assisted, sutureless conjunctival autograft, and Group 2 consisted of 62 patients who underwent conventional sutured conjunctival autograft surgery. The primary outcome measure was graft stability, and the secondary outcome measures were postoperative immediate patient comfort and recurrence rates at 12 months.
RESULTS
The mean duration of surgery was significantly shorter in Group 1 (9.84±2.64 min) than in Group 2 (17.90±4.42 min) (p<0.001). The postoperative pain visual analog scale score was significantly lower in Group 1 (p<0.001). The postoperative complications included graft loss in four patients in Group 1 and recurrence of pterygium in six patients in Group 2.
CONCLUSION
The autologous blood-assisted, sutureless conjunctival autograft technique seems superior to the conventional sutured autograft technique in terms of postoperative patient comfort, lower recurrence rates, and shorter duration of surgery.
PubMed: 38089071
DOI: 10.14744/bej.2023.26878 -
Oman Journal of Ophthalmology 2023The recurrence rate plays a key role in using various treatments of pterygium. This study assessed the effectiveness of argon laser therapy before the excision of...
BACKGROUND
The recurrence rate plays a key role in using various treatments of pterygium. This study assessed the effectiveness of argon laser therapy before the excision of pterygium on the recurrence rate.
MATERIALS AND METHODS
The eyes ( = 60) of patients ( = 30) were divided into two groups based on the treatment. All eyes had undergone pterygium excision with the bare sclera technique. Three weeks before surgery, an argon laser was applied to 30 eyes. Patients have been followed up for 1 year, and the progression of pterygium has been evaluated at days 1, 7, 14, and 30, and then, every 2 months until month 6 and then every 3 months until month 12. Recurrence was defined as more than 1 mm growth of pterygium from the limbus.
RESULTS
In the group with adjuvant argon laser therapy, the mean size of pterygium was 3.7 ± 0.47 mm before surgery and 2.3 ± 0.98 after 12 months ( = 0.001). These were 3.8 ± 0.43 mm and 2.4 ± 1 mm in the other group ( = 0.001). The recurrence of the pterygium was 76% (23/30) in the group treated with an argon laser and 90% (27/30) in another group ( = 0.16). There was no correlation between pterygium sizes before surgery and the pterygium recurrence rate in both eyes ( = 0.272 [right] and 0.916 [left]).
CONCLUSION
Argon laser therapy on pterygium before surgery cannot decrease its recurrence rate, but its application gives a good vision and clarifies the surgery's target area.
PubMed: 38059099
DOI: 10.4103/ojo.ojo_59_23 -
Oman Journal of Ophthalmology 2023
PubMed: 38059093
DOI: 10.4103/ojo.ojo_240_23 -
Cureus Dec 2023Lichen planus is a chronic inflammatory disorder affecting skin and mucosal surfaces. There are multiple variants of lichen planus described in the literature. We report...
Lichen planus is a chronic inflammatory disorder affecting skin and mucosal surfaces. There are multiple variants of lichen planus described in the literature. We report a case of inverse lichen planus in a healthy 50-year-old male who presented to our dermatology clinic with multiple violaceous to hyperpigmented patches affecting both axillae and groin for three months. A skin biopsy confirmed the diagnosis of lichen planus. The patient subsequently developed nail dystrophy affecting his fingernails consistent with nail lichen planus. Early recognition and treatment of nail lichen planus is important to prevent irreversible scarring.
PubMed: 38045628
DOI: 10.7759/cureus.49823 -
Indian Journal of Dermatology,... Oct 2023Background Isolated nail lichen planus (NLP) without mucocutaneous involvement is rare. Literature about the clinical profile and management is scarce. Aims/Objective We...
Background Isolated nail lichen planus (NLP) without mucocutaneous involvement is rare. Literature about the clinical profile and management is scarce. Aims/Objective We attempted to characterize the clinico-demographic profile and analyze the management outcome of patients with isolated nail lichen planus. Methods Records of 15 patients were evaluated, and their demographic profile, clinical features of the nail matrix and nail bed disease, onychoscopy findings, histopathological features, treatment given, and follow-up progress were analysed. Results Data from 15 patients were collected. The mean age of the patients was 28.6 ± 19.0 years (range 3.5 years to 56 years). The gender ratio was 0.8 with 7 males and 8 females. The average disease duration at presentation was 2.8 ± 2.6 years (6 months-9 years). The average number of nails involved was 16.4 ± 4.6 (8-20 nails). All 20 nails were involved in 9 (60%) patients. Nail matrix -involvement was seen in all, with onychorrhexis being the most common manifestation, which was seen in 11 (73.3%) patients. Nail bed involvement was seen in 11 (73.3%) patients, with onycholysis being the most common presentation. Severe nail disease was seen in 7 (46.7%) patients, and 5 (33.3%) had pterygium involving an average of 3.4 nails. Moderate to good improvement was observed in 9 (60%) patients after an average of 6.1 ± 2.4 (3-9) treatment sessions with intramuscular and intramatricial triamcinolone acetonide injection. Of these, 2/9 (22.2%) developed disease recurrence in a few nails after an interval of 1 and 1.5 years, respectively. Two patients achieved complete clinical cures that persisted beyond 2 years of follow-up. Limitations Retrospective nature of the series and the small sample size are the major limitations. Conclusion The risk of permanent disfigurement is high in NLP and calls for an early diagnosis and prompt treatment. Intralesional and intramuscular steroids are first-line therapeutic options depending upon the number of nails involved.
PubMed: 38031689
DOI: 10.25259/IJDVL_449_2023 -
Computational and Structural... 2023There is limited knowledge about the impact of circulating lipids and lipid-modifying drugs on pterygium development, with conflicting results reported. Our study aimed...
There is limited knowledge about the impact of circulating lipids and lipid-modifying drugs on pterygium development, with conflicting results reported. Our study aimed to address these questions by applying the Mendelian randomization (MR) approach. A two-step MR model was developed. In the first step, bidirectional two-sample MR was employed to establish the causal relationship between circulating lipids and pterygium risk. In the second step, drug-target MR analysis was conducted to assess the causal effect of proprotein convertase subtilisin/kexin type 9 (PCSK9) and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) inhibitors on pterygium outcomes. Genetically predicted low-density lipoprotein cholesterol (LDL-c) levels were found to be significantly associated with an increased risk of pterygium (Inverse variance weighted [IVW] odds ratio [OR] = 2.227; = 1.53 × 10). Similarly, higher total cholesterol (TC) levels exhibited a suggestive association with greater susceptibility to pterygium (IVW OR = 1.806; = 1.70 × 10). Through drug-target MR, a positive causal association was noted between HMGCR-mediated LDL-c levels and pterygium (IVW OR = 6.999; = 0.016), suggesting that statins may be effective in reducing pterygium risk. The present findings suggest that circulating TC and LDL-c are risk factors for pterygium. Additionally, the results indicate that HMGCR inhibitors, which lower LDL-c levels, have a potential protective effect on pterygium outcomes. Further research is warranted to elucidate the underlying mechanisms involved in pterygium pathogenesis, with a particular focus on cholesterol metabolism.
PubMed: 38022695
DOI: 10.1016/j.csbj.2023.11.002 -
Turkish Journal of Ophthalmology Dec 2023To determine the roles of small GTP-binding proteins Rac1, Rac2, and Rac3 expression in pterygial tissue and to compare these expressions with normal conjunctival tissue.
OBJECTIVES
To determine the roles of small GTP-binding proteins Rac1, Rac2, and Rac3 expression in pterygial tissue and to compare these expressions with normal conjunctival tissue.
MATERIALS AND METHODS
Seventy-eight patients with primary pterygium were enrolled. Healthy conjunctival graft specimens obtained during pterygium surgery were used as control tissue. The real-time polymerase chain reaction method on the BioMark HD dynamic array system was utilized in genomic mRNA for the gene expression analysis. Protein expressions were analyzed using western blot and immunohistochemical methods.
RESULTS
, and gene expressions in pterygial tissues were not markedly elevated when compared to the control specimens (p>0.05). As a very low level of gene expression was observed, further protein expression analysis was performed for the Rac2 and Rac3 proteins. Western blot and immunohistochemical analysis of Rac2 and Rac3 protein expression revealed no significant differences between pterygial and healthy tissues (p>0.05).
CONCLUSION
This is the first study to identify the contribution of Rac proteins in pterygium. Our results indicate that the small GTP-binding protein Rac may not be involved in pterygium pathogenesis.
Topics: Humans; Pterygium; Conjunctiva; rac GTP-Binding Proteins; Blotting, Western
PubMed: 38014881
DOI: 10.4274/tjo.galenos.2023.93765 -
Cell Stress & Chaperones Nov 2023The human muscle-type nicotinic acetylcholine receptor α1β1δε (nAChR) is a complex transmembrane receptor needed for drug screening for disorders like congenital...
The human muscle-type nicotinic acetylcholine receptor α1β1δε (nAChR) is a complex transmembrane receptor needed for drug screening for disorders like congenital myasthenic syndromes and multiple pterygium syndrome. Until today, most models are still using the nAChR from Torpedo californica electric ray. A simple reproducible cellular system expressing functional human muscle-type nAChR is still missing. This study addressed this issue and further tested the hypothesis that different chaperones, both biological and chemical, and posttranslational modification supporting substances as well as hypothermic incubation are able to increase the nAChR yield. Therefore, Gibson cloning was used to generate transfer plasmids carrying the sequence of nAChR or chosen biological chaperones to support the nAChR folding in the cellular host. Viral transduction was used for stable integration of these transgenes in Chinese hamster ovary cells (CHO). Proteins were detected with Western blot, in-cell and on-cell Western, and the function of the receptor with voltage clamp analysis. We show that the internalization of nAChR into plasma membranes was sufficient for detection and function. Additional transgenic overexpression of biological chaperones did result in a reduced nAChR expression. Chemical chaperones, posttranslational modification supporting substances, and hypothermic conditions are well-suited supporting applications to increase the protein levels of different subunits. This study presents a stable and functional cell line that expresses human muscle-type nAChR and yields can be further increased using the chemical chaperone nicotine without affecting cell viability. The simplified access to this model system should enable numerous applications beyond drug development. Graphical abstract created with http://biorender.com.
Topics: Cricetinae; Animals; Humans; Receptors, Nicotinic; Nicotinic Agonists; CHO Cells; Cricetulus; Cell Membrane; Muscles
PubMed: 38006565
DOI: 10.1007/s12192-023-01395-0 -
Indian Journal of Ophthalmology Dec 2023To compare the outcomes of pterygium surgery by using an inferior rotational autograft and a conventional superior conjunctival autograft.
PURPOSE
To compare the outcomes of pterygium surgery by using an inferior rotational autograft and a conventional superior conjunctival autograft.
METHODS
This was a prospective interventional comparative study of 85 eyes of patients who were divided into two groups of 45 and 40. Standard techniques of both procedures were performed by a single surgeon. Astigmatism, recurrence rates, time taken, and other complications were compared.
RESULTS
All the subjects were in the age group 53 ± 7.56 (40-74) years. Demographic data and type of pterygium were comparable in the two groups. In the rotational group, the preoperative astigmatism was - 2.14 ± 1.36 D, which decreased in 1 week to 1.42 ± 1.11 D, in 1 month to - 1.13 ± 0.99 D, in 3 months to 0.91 ± 0.72 D, and in 6 months to 0.81 ± 0.85 D (P < 0.05 each). Preoperative astigmatism in the conventional group was - 2.63 ± 1.47 D, which decreased to - 1.43 ± 1.04 D in 1 week, -1.18 ± 0.85 D in 1 month, -1.07 ± 0.81 D in 3 months, and - 1.01 ± 0.78 D in 6 months (P < 0.05 each). There was no significant difference between the groups in terms of astigmatism at any follow-up visit (P < 0.05). Complications like dellen, graft edema, and superficial vascularization were seen in both groups. The rotational group had one recurrence (2.86%). No recurrence was noted in the conventional group. None of the complication rates was significantly different between the two groups (P < 0.05).
CONCLUSION
Inferior rotational conjunctival autografting is a good technique for management of pterygium. It has a profile similar to that of conventional conjunctival autograft.
Topics: Humans; Middle Aged; Pterygium; Transplantation, Autologous; Autografts; Astigmatism; Prospective Studies; Conjunctiva; Sutures; Recurrence; Follow-Up Studies; Treatment Outcome
PubMed: 37991298
DOI: 10.4103/IJO.IJO_16_23