Background Different diagnostic and grading systems of conjunctivochalasis have resulted in apparent disparity between the prevalence rates of recent population-based studies.This study aimed to investigate the dispar...Background Different diagnostic and grading systems of conjunctivochalasis have resulted in apparent disparity between the prevalence rates of recent population-based studies.This study aimed to investigate the disparity between 4-level system cited from Meller and Tseng in 1998 （abbreviated here as Meller＇s system） and 5-level system modified from Meller＇s system cited from Zhang and associates （abbreviated here as Zhang＇s system） regarding the diagnosis and the patients＇ preferences for the treatment of conjunctivochalasis in the general population.Methods A total of 546 senile residents living in the Guiyangyuan community of Shanghai,China,participated in the study.The diagnostic criteria for conjunctivochalasis were based on two diagnostic grading systems：Meller＇s system and Zhang＇s system,which was modified from Meller＇s system.The participants＇ preference regarding medical treatment for conjunctivochalasis was determined according to the response to a question.One year later,a follow-up interview determines whether the patient had undergone surgery for conjunctivochalasis.Results With Meller＇s system,398 participants were confirmed as having conjunctivochalasis,and the prevalence rate was 72.89％.According to Zhang＇s system,only 213 participants were diagnosed as having conjunctivochalasis,and the prevalence rate was 39.01％.A total of 109 eyes underwent medical treatment or surgery for conjunctivochalasis in the following year,including eight eyes that were diagnosed as grade Ⅱ and 101 eyes that were diagnosed as grade Ⅲ according to Meller＇s system and five eyes that were diagnosed as grade Ⅰ,55 eyes that were diagnosed as grade Ⅱ,31 eyes that were diagnosed as grade Ⅲ,and 18 eyes that were diagnosed as grade Ⅳ according to Zhang＇s system.Conclusion Diagnoses of conjunctivochalasis using Zhang＇s system are more consistent with patient requests and the medical treatment strategies used than diagnoses made using Meller＇s system.展开更多
AIM：To investigate the expression of matrix metalloproteinases 1 and 3（MMP-1 and MMP-3） and their tissue inhibitors of metalloproteinases 1 and 3（ TIMP-1 and TIMP-3） in the conjunctiva of eyes with conjunctivocha...AIM：To investigate the expression of matrix metalloproteinases 1 and 3（MMP-1 and MMP-3） and their tissue inhibitors of metalloproteinases 1 and 3（ TIMP-1 and TIMP-3） in the conjunctiva of eyes with conjunctivochalasis（CCh）.METHODS：The conjunctival tissue was obtained from the CCh patients and controls,the MMPs/TIMPs expression concentration was determined by enzyme-linked immunosorbent assay（ELISA） and immunofluorescence staining.The expression levels of MMPs/TIMPs in the CCh fibroblasts were determined by analyzing its concentration in the cellular supernatant that was abstracted from the in vitro cultured CCh fibroblasts.RESULTS：MMP-1 and MMP-3 levels determined by ELISA were both significantly higher in the CCh group than that in the control group（P= 0.042,0.022,respectively）,so was the levels of TIMP-1（P= 0.010）.No significant difference in the expression of TIMP-3 in conjunctiva was found between the two groups（P= 0.298）.The expression of MMP-1 and MMP-3 were both up-regulated significantly in the CCh group（P= 0.040,0.001,respectively） on immunofluorescence staining.MMP-1 and MMP-3 expression in the fibroblasts were both significantly higher in the CCh group than that in the control group（P= 0.027,0.001,respectively）,while neither the TIMP-1 nor TIMP-3 expression was significantly different between the two groups（P= 0.421,0.237,respectively）.CONCLUSION：The overexpression of MMP-1 and MMP-3 in conjunctival tissue and fibroblasts may play an important role in the pathogenesis and development of CCh.展开更多
Background The crescent excision of the inferior bulbar conjunctiva has been advised as a surgical procedure in the management of conjunctivochalasis refractory to medical treatments. However, it is difficult for this...Background The crescent excision of the inferior bulbar conjunctiva has been advised as a surgical procedure in the management of conjunctivochalasis refractory to medical treatments. However, it is difficult for this procedure to design how much conjunctival tissue should be excised. This study aimed to present a quantitative Iocator for conjunctiva resection and evaluate its effect on the treatment of conjunctivochalasis （CCh）. Methods Poly β-hydroxyethyl methacrylate resin/β-hydroxyethyl methacrylate （HEMA, water gel） was used as the material to make the quantitative Iocator which was designed to suit the specific patient. Forty-six patients with bilateral symptomatic CCh were included in this prospective study. Of the patients, while the right eye underwent the popularly used crescent-shaped conjunctiva resection （group I）, the left eye was treated with conjunctiva resection assisted by the quantitative Iocator （group II）. International Ocular Surface Disease Index （OSDI）, scores of remnant conjunctiva fold, complications and conjunctival cut healing, height of tear meniscus, tear break-up time （BUT）, and time of surgery were evaluated. Tasting chloromycetin test （TCT） was used to evaluate how the lacrimal duct worked. Results OSDI in group II （8.82±2.36） was significantly lower than that in group I （14.67±2.21） （t=12.22, P 〈0.01）. The amount of conjunctiva fold remaining in group II was less than that in group I. Scores of remnant conjunctiva fold in group I were significantly higher than those in group II （t=31.85, P 〈0.01）. While evaluation scores of conjunctival cut healing in group I were lower than those in group II, scores of complication in group I were significantly higher than those in group II at 8 weeks after surgery （t=89.60, P 〈0.01）. There was no significant difference in eyes with normal BUT （X^2=0.031, P=0.985） between the two groups, as the case was in eyes with positive TCT （X^2=0.14, P=0.930） and in eyes with normal height o展开更多
文摘Background Different diagnostic and grading systems of conjunctivochalasis have resulted in apparent disparity between the prevalence rates of recent population-based studies.This study aimed to investigate the disparity between 4-level system cited from Meller and Tseng in 1998 （abbreviated here as Meller＇s system） and 5-level system modified from Meller＇s system cited from Zhang and associates （abbreviated here as Zhang＇s system） regarding the diagnosis and the patients＇ preferences for the treatment of conjunctivochalasis in the general population.Methods A total of 546 senile residents living in the Guiyangyuan community of Shanghai,China,participated in the study.The diagnostic criteria for conjunctivochalasis were based on two diagnostic grading systems：Meller＇s system and Zhang＇s system,which was modified from Meller＇s system.The participants＇ preference regarding medical treatment for conjunctivochalasis was determined according to the response to a question.One year later,a follow-up interview determines whether the patient had undergone surgery for conjunctivochalasis.Results With Meller＇s system,398 participants were confirmed as having conjunctivochalasis,and the prevalence rate was 72.89％.According to Zhang＇s system,only 213 participants were diagnosed as having conjunctivochalasis,and the prevalence rate was 39.01％.A total of 109 eyes underwent medical treatment or surgery for conjunctivochalasis in the following year,including eight eyes that were diagnosed as grade Ⅱ and 101 eyes that were diagnosed as grade Ⅲ according to Meller＇s system and five eyes that were diagnosed as grade Ⅰ,55 eyes that were diagnosed as grade Ⅱ,31 eyes that were diagnosed as grade Ⅲ,and 18 eyes that were diagnosed as grade Ⅳ according to Zhang＇s system.Conclusion Diagnoses of conjunctivochalasis using Zhang＇s system are more consistent with patient requests and the medical treatment strategies used than diagnoses made using Meller＇s system.
基金Supported by Shanghai Municipal Health and Family Planning Commission Project(No.20124108)Putuo District of Shanghai Independent Innovation Research Foundation(No.2013PTKW009)
文摘AIM：To investigate the expression of matrix metalloproteinases 1 and 3（MMP-1 and MMP-3） and their tissue inhibitors of metalloproteinases 1 and 3（ TIMP-1 and TIMP-3） in the conjunctiva of eyes with conjunctivochalasis（CCh）.METHODS：The conjunctival tissue was obtained from the CCh patients and controls,the MMPs/TIMPs expression concentration was determined by enzyme-linked immunosorbent assay（ELISA） and immunofluorescence staining.The expression levels of MMPs/TIMPs in the CCh fibroblasts were determined by analyzing its concentration in the cellular supernatant that was abstracted from the in vitro cultured CCh fibroblasts.RESULTS：MMP-1 and MMP-3 levels determined by ELISA were both significantly higher in the CCh group than that in the control group（P= 0.042,0.022,respectively）,so was the levels of TIMP-1（P= 0.010）.No significant difference in the expression of TIMP-3 in conjunctiva was found between the two groups（P= 0.298）.The expression of MMP-1 and MMP-3 were both up-regulated significantly in the CCh group（P= 0.040,0.001,respectively） on immunofluorescence staining.MMP-1 and MMP-3 expression in the fibroblasts were both significantly higher in the CCh group than that in the control group（P= 0.027,0.001,respectively）,while neither the TIMP-1 nor TIMP-3 expression was significantly different between the two groups（P= 0.421,0.237,respectively）.CONCLUSION：The overexpression of MMP-1 and MMP-3 in conjunctival tissue and fibroblasts may play an important role in the pathogenesis and development of CCh.
文摘Background The crescent excision of the inferior bulbar conjunctiva has been advised as a surgical procedure in the management of conjunctivochalasis refractory to medical treatments. However, it is difficult for this procedure to design how much conjunctival tissue should be excised. This study aimed to present a quantitative Iocator for conjunctiva resection and evaluate its effect on the treatment of conjunctivochalasis （CCh）. Methods Poly β-hydroxyethyl methacrylate resin/β-hydroxyethyl methacrylate （HEMA, water gel） was used as the material to make the quantitative Iocator which was designed to suit the specific patient. Forty-six patients with bilateral symptomatic CCh were included in this prospective study. Of the patients, while the right eye underwent the popularly used crescent-shaped conjunctiva resection （group I）, the left eye was treated with conjunctiva resection assisted by the quantitative Iocator （group II）. International Ocular Surface Disease Index （OSDI）, scores of remnant conjunctiva fold, complications and conjunctival cut healing, height of tear meniscus, tear break-up time （BUT）, and time of surgery were evaluated. Tasting chloromycetin test （TCT） was used to evaluate how the lacrimal duct worked. Results OSDI in group II （8.82±2.36） was significantly lower than that in group I （14.67±2.21） （t=12.22, P 〈0.01）. The amount of conjunctiva fold remaining in group II was less than that in group I. Scores of remnant conjunctiva fold in group I were significantly higher than those in group II （t=31.85, P 〈0.01）. While evaluation scores of conjunctival cut healing in group I were lower than those in group II, scores of complication in group I were significantly higher than those in group II at 8 weeks after surgery （t=89.60, P 〈0.01）. There was no significant difference in eyes with normal BUT （X^2=0.031, P=0.985） between the two groups, as the case was in eyes with positive TCT （X^2=0.14, P=0.930） and in eyes with normal height o
