Background:To evaluate the effect of three different combinations of tip designs and infusion systems in torsional phacoemulsification(INFINITI and CENTURION)in patients with cataract.According to the manufacturer,two...Background:To evaluate the effect of three different combinations of tip designs and infusion systems in torsional phacoemulsification(INFINITI and CENTURION)in patients with cataract.According to the manufacturer,two unique improvements in the Centurion are:active fluid dynamic management system and use of an intrepid balanced tip.The study specifically aimed to evaluate the beneficial effects,if any,of change in tip design and infusion system individually and in combination on both per-operative parameters as well as endothelial health over 6 months.Methods:One hundred and twenty six consenting patients of grade 4.0-6.9 senile cataract were randomized into three groups for phacoemulsification:Group A(n=42):Gravity fed infusion system and 45° Kelman miniflared ABS phaco tip;Group B(n=42):intraocular pressure(IOP)based infusion system and 45° Kelman miniflared ABS phaco tip;Group C(n=42):IOP based infusion system and 45° Intrepid balanced phaco tip.The cumulative dissipated energy(CDE),estimated fluid usage(EFU)and total aspiration time(TAT)were compared peroperatively.The endothelial parameters were followed up postoperatively for six months.Results:The three arms were matched for age(p=0.525),gender(p=0.96)and grade of cataract(p=0.177).Group C was associated with significant reductions in CDE(p=0.001),EFU(p<0.0005)as well as TAT(p=0.001)in comparison to the other groups.All three groups had comparable baseline endothelial cell density(p=0.876)and central corneal thickness(p=0.561).On post-operative evaluation,although all groups were comparable till 3 months,by 6 months,the percentage losses in endothelial cell density were significantly lower in group C as compared to the other groups.Conclusions:Use of an IOP based phacoemulsification system in association with use of the Intrepid balanced tip reduces the CDE,EFU and TAT in comparison to a gravity fed system with a mini flared tip or IOP based system with a mini flared tip while also providing better endothelial preservation thus favouring the use of an I展开更多
Gene therapies,despite of being a relatively new therapeutic approach,have a potential to become an important alternative to current treatment strategies in glaucoma.Since glaucoma is not considered a single gene dise...Gene therapies,despite of being a relatively new therapeutic approach,have a potential to become an important alternative to current treatment strategies in glaucoma.Since glaucoma is not considered a single gene disease,the identified goals of gene therapy would be rather to provide neuroprotection of retinal ganglion cells,especially,in intraocular-pressure-independent manner.The most commonly reported type of vector for gene delivery in glaucoma studies is adeno-associated virus serotype 2 that has a high tro pism to retinal ganglion cells,res ulting in long-term expression and low immunogenic profile.The gene thera py studies recruit inducible and genetic animal models of optic neuropathy,like DBA/2J mice model of high-tension glaucoma and the optic nerve crush-model.Reported gene therapy-based neuroprotection of retinal ganglion cells is targeting specific genes translating to growth factors(i.e.,brain derived neurotrophic factor,and its receptor TrkB),regulation of apoptosis and neurodegeneration(i.e.,Bcl-xl,Xiap,FAS system,nicotinamide mononucleotide adenylyl transferase 2,Digit3 and Sarm1),immunomodulation(i.e.,Crry,C3 complement),modulation of neuroinflammation(i.e.,e rythropoietin),reduction of excitotoxicity(i.e.,Com KIlα)and transcription regulation(i.e.,Max,Nrf2).On the other hand,some of gene therapy studies focus on lowering intra ocular pressure,by impacting genes involved in both,decreasing aqueous humor production(i.e.,aquaporin 1),and increasing outflow facility(i.e.,COX2,prostaglandin F2a receptor,RhoA/RhoA kinase signaling pathway,MMP1,Myocilin).The goal of this review is to summarize the current stateof-art and the direction of development of gene therapy strategies for glaucomatous neuropathy.展开更多
Dear Editor,Glaucoma is a multifunctional neurodegenerative disease and is the leading cause of irreversible blindness. It is characterized by progressive loss of retinal ganglion cells and their axons leading to visu...Dear Editor,Glaucoma is a multifunctional neurodegenerative disease and is the leading cause of irreversible blindness. It is characterized by progressive loss of retinal ganglion cells and their axons leading to visual field defects.展开更多
文摘Background:To evaluate the effect of three different combinations of tip designs and infusion systems in torsional phacoemulsification(INFINITI and CENTURION)in patients with cataract.According to the manufacturer,two unique improvements in the Centurion are:active fluid dynamic management system and use of an intrepid balanced tip.The study specifically aimed to evaluate the beneficial effects,if any,of change in tip design and infusion system individually and in combination on both per-operative parameters as well as endothelial health over 6 months.Methods:One hundred and twenty six consenting patients of grade 4.0-6.9 senile cataract were randomized into three groups for phacoemulsification:Group A(n=42):Gravity fed infusion system and 45° Kelman miniflared ABS phaco tip;Group B(n=42):intraocular pressure(IOP)based infusion system and 45° Kelman miniflared ABS phaco tip;Group C(n=42):IOP based infusion system and 45° Intrepid balanced phaco tip.The cumulative dissipated energy(CDE),estimated fluid usage(EFU)and total aspiration time(TAT)were compared peroperatively.The endothelial parameters were followed up postoperatively for six months.Results:The three arms were matched for age(p=0.525),gender(p=0.96)and grade of cataract(p=0.177).Group C was associated with significant reductions in CDE(p=0.001),EFU(p<0.0005)as well as TAT(p=0.001)in comparison to the other groups.All three groups had comparable baseline endothelial cell density(p=0.876)and central corneal thickness(p=0.561).On post-operative evaluation,although all groups were comparable till 3 months,by 6 months,the percentage losses in endothelial cell density were significantly lower in group C as compared to the other groups.Conclusions:Use of an IOP based phacoemulsification system in association with use of the Intrepid balanced tip reduces the CDE,EFU and TAT in comparison to a gravity fed system with a mini flared tip or IOP based system with a mini flared tip while also providing better endothelial preservation thus favouring the use of an I
基金supported by Medical University of Silesia research grants,No.PCN-1-129/N/2/O(to AS)。
文摘Gene therapies,despite of being a relatively new therapeutic approach,have a potential to become an important alternative to current treatment strategies in glaucoma.Since glaucoma is not considered a single gene disease,the identified goals of gene therapy would be rather to provide neuroprotection of retinal ganglion cells,especially,in intraocular-pressure-independent manner.The most commonly reported type of vector for gene delivery in glaucoma studies is adeno-associated virus serotype 2 that has a high tro pism to retinal ganglion cells,res ulting in long-term expression and low immunogenic profile.The gene thera py studies recruit inducible and genetic animal models of optic neuropathy,like DBA/2J mice model of high-tension glaucoma and the optic nerve crush-model.Reported gene therapy-based neuroprotection of retinal ganglion cells is targeting specific genes translating to growth factors(i.e.,brain derived neurotrophic factor,and its receptor TrkB),regulation of apoptosis and neurodegeneration(i.e.,Bcl-xl,Xiap,FAS system,nicotinamide mononucleotide adenylyl transferase 2,Digit3 and Sarm1),immunomodulation(i.e.,Crry,C3 complement),modulation of neuroinflammation(i.e.,e rythropoietin),reduction of excitotoxicity(i.e.,Com KIlα)and transcription regulation(i.e.,Max,Nrf2).On the other hand,some of gene therapy studies focus on lowering intra ocular pressure,by impacting genes involved in both,decreasing aqueous humor production(i.e.,aquaporin 1),and increasing outflow facility(i.e.,COX2,prostaglandin F2a receptor,RhoA/RhoA kinase signaling pathway,MMP1,Myocilin).The goal of this review is to summarize the current stateof-art and the direction of development of gene therapy strategies for glaucomatous neuropathy.
基金supported by the National Natural Science Foundation of China (81470635, 81600725)Beijing Natural Science Foundation (7162037)Beijing Tongren Hospital Affiliated to Capital Medical University research foundation (2015-YJJ-ZZL-003)
文摘Dear Editor,Glaucoma is a multifunctional neurodegenerative disease and is the leading cause of irreversible blindness. It is characterized by progressive loss of retinal ganglion cells and their axons leading to visual field defects.
