Corneal Epithelial Healing Time Research Articles

Different Thicknesses of Acellular Porcine Corneal Stroma on Prognosis of Fungal Corneal Ulcers Treated by Lamellar Keratoplasty: A Five-Year Retrospective Study.

To compare the prognosis and efficacy of acellular porcine corneal stroma (APCS) with different thicknesses for the treatment of fungal corneal ulcers by lamellar keratoplasty (LKP). A total of 52 patients who underwent LKP with APCS for the treatment of fungal corneal ulcers were included in this retrospective study. Patients were divided into 2 groups according to the different thicknesses of APCS (0.30 ± 0.05 mm, L2 group, n = 20; 0.40 ± 0.05 mm, L3 group, n = 32). Observation indicators included best corrected visual acuity, graft transparency, corneal neovascularization, ocular irritation symptoms, corneal epithelial healing time, graft survival, central corneal thickness at 1 year after surgery, and postoperative complications. Compared with the L3 group, the L2 group had better postoperative best corrected visual acuity and graft transparency (P < 0.001), less corneal neovascularization (P < 0.001), and lower incidence of complications (P < 0.05). There were significant differences in ocular irritation symptoms between the 2 groups (P < 0.05) at 3 and 6 months postoperatively, which might be related to the higher recurrence rate and graft rejection rate in the L3 group. The comparison of postoperative epithelial healing time also showed significant differences in 2 groups (P < 0.01). The 1-year survival rate was up to 63.5% in both groups, with no significant difference (P < 0.05). However, the risk of transplantation was less in the L2 group. Both APCS thicknesses could provide adequate central corneal thickness at 1 year after surgery (P > 0.05). APCS was safe and effective in the treatment of fungal corneal ulcers by LKP. Thinner grafts should be preferred for LKP for fungal corneal ulcers to reduce the risk of grafting.

Effects of injectable platelet-rich fibrin (i-PRF) on pterygium surgery with conjunctival autograft.

To investigate the effects of subconjunctival injectable platelet-rich fibrin (i-PRF) injection on healing and complication rates after pterygium surgery with conjunctival autograft. This retrospective and comparative study evaluated 31 eyes that received i-PRF injections under the donor and graft conjunctiva following pterygium surgery, while 34 eyes did not receive i-PRF after the pterygium surgery. The patients' follow-up period was for 12months. Postoperative recurrence, epithelial healing time, postoperative pain score, graft edema, and sliding of the graft (need for re-suturation) data were evaluated. For the 12months after surgery, one eye (3.2%) in the i-PRF group had developed corneal recurrence, and five eyes (14.7%) in the non-i-PRF group had developed recurrence. The mean corneal epithelial healing time was 2.96 ± 0.70days in the i-PRF group and 3.58 ± 0.70days in the non-i-PRF group (p = 0.001). The mean healing time of the donor conjunctiva epithelium was 3.84 ± 0.70days in the i-PRF group, whereas it was 4.44 ± 0.74days in the non-i-PRF group (p = 0.006). The mean postoperative pain score was 4.45 ± 1.52 in the i-PRF group and 5.08 ± 1.40 in the non-i-PRF group. In the non-i-PRF group, three cases (8.8%) required re-suturation, whereas, in the i-PRF group, no one required re-suturation. Thanks to its platelets-derived growth factors, i-PRF can be a safe and effective adjuvant therapy for faster healing of conjunctival autograft and in the prevention of recurrence.

Risk factors for corneal epithelial wound healing: Can sex play a role?

To determine if sex is associated with corneal epithelial wound healing time in patients with persistent corneal epithelial defects (PCEDs). Retrospective case series on patients with PCED from November 2014 to January 2019. Records of 127 patients with diagnosis of PCED were reviewed. Patients with an epithelial defect that lasted more than two weeks in the absence of an active corneal infection were included. Main outcome was corneal epithelial wound healing time. 55 patients (29 males) with a mean age of 65.3 ± 16.5 years were included. No difference was found between female and male patients in terms of risk factors, age, treatment strategies or intervals between visits (median of 15 days in females and 12 days in males; p = 0.24). Median duration of the PCED was 51 days (IQR 32-130), with a median number of 5 clinical visits (IQR 4-8). Female patients had significantly longer healing times (p = 0.004) and a corresponding increase in the number of clinical visits (median of 7 visits vs. 5 clinical visits in males, p = 0.012). Results from this study suggest female patients with PCED might have a longer corneal epithelial wound healing duration and may therefore require earlier intervention.

APPLICATION OF AUTOLOGOUS SERUM EYE DROPS AFTER PTERYGIUM SURGERY

Objective: To compare the corneal epithelium healing time and post-operative pain after pterygium surgery with and without he use of autologous serum drops.&#x0D; Study Design: Comparative cross-sectional study.&#x0D; Place and Duration of Study: Eye Department, Combined Military Hospital Quetta, from Jan to Aug 2019.&#x0D; Methodology: Twenty patients were included in this study and divided into two groups. All patients underwent pterygium excision with conjunctival autograft. Fourteen of them were instilled with autologous serum drops while 14 were given lubricants postoperatively until corneal epithelium healed completely. Corneal epithelium healing time, visual analog scale for postoperative pain assessment, conjunctival inflammation and recurrences were evaluated. Patients were followed up for 6 months.&#x0D; Results: For corneal epithelial healing, 1 (7.14%) patient showed complete healing on day 2 while 7 (50%) showed healing on day 3 and 6 (42.86%) on day 4. While in non-autologous serum drops group 7 (50%) showed complete healing on day 4 while 4 (28.57%) showed healing on day 5 and 3 (21.43%) on day 6. The mean corneal healing time of autologous serum drops group was 3.36 ± 0.63 days and that of non-autologous serum drops group was 4.71 ± 0.83 days. Patients of autologous serum drops group also experienced significantly less pain as compared to the non-autologous serum drops group. While the recurrence rate and conjunctival inflammation in the two groups was found to be of equal degree.&#x0D; Conclusion: Patients who used autologous serum eye drops post operatively experienced less pain and their corneal epithelium healed earlier than the.......

Clinical Outcomes of Aberration-Free All Surface Laser Ablation (ASLA) vs. Aberration-Free ASLA Assisted by Smart Pulse Technology in High Myopia: A One-Year Follow-Up Study.

Purpose To compare the clinical outcomes of aberration-free all surface laser ablation (ASLA) with and without the use of smart pulse technology (SPT) in high myopia. Methods This study retrospectively analyzed 138 eyes (138 patients, only the right eye was selected) treated for high myopia (spherical equivalent ≥−6.00 diopters) using aberration-free ASLA (non-SPT group; 85 eyes) and aberration-free ASLA assisted by SPT (SPT group; 53 eyes). Examinations such as visual acuity, refraction, and haze were performed before the 12-month follow-up. Corneal epithelial healing time was assessed in the first postoperative day. Visual acuity and refraction examination were performed at 7 days and 1, 3, 6, and 12 months postoperatively. Corneal haze was evaluated in 1, 3, 6, and 12 months. Safety, efficacy, and corneal wavefront aberrations were assessed 12 months after the treatment. Results At 12 months postoperatively, 60% versus 40% of eyes achieved 20/16 Snellen lines or better, and 92% versus 82% of eyes achieved 20/20 Snellen lines or better visual acuity in the SPT and the non-SPT groups, respectively. The average postoperative epithelial healing time was 3.75 ± 1.00 days in the SPT group and 3.73 ± 1.30 days in the non-SPT group (P ≥ 0.05). The safety and the efficacy index of the SPT group were better than those of the non-SPT group in the follow-ups. The attempted spherical equivalent before the surgery and the achieved spherical equivalent at 12 months were comparable between the two groups. Regarding the aberrations, the results of Coma 90° in the SPT group were better than those in the non-SPT group (P ≤ 0.05), but the increase of RMS HOAs (root mean square higher order aberrations), Coma 0°, and spherical aberration postoperatively had no statistical difference between the two groups (P ≥ 0.05). Conclusions: Both aberration-free ASLA with and without SPT showed favorable safety, effectiveness, and predictability within 12 months for high myopia. And, ASLA using SPT might have potential advantages in the long-term visual quality.

Effects of Amniotic Membrane Transplantation in Ocular Burns: A Meta-Analysis

<i>Background: </i>Ocular burns is a serious eye injury with a high rate of blindness, efforts should be made to eliminate the serious complications, prevent from lifelong disability, and improve emergency interventions and treatment.<i> Objective: </i>To evaluate the effectiveness of amniotic membrane transplantation (AMT) in ocular burns. <i>Methods:</i> The following electronic databases were searched: PubMed, Web of Science, and Cochrane Library. With the keyword “amniotic membrane” and “ocular burn”. No limitation of year, language, gender, age, nationality, etc. Animal trials, patients with other ocular surface diseases, and amniotic membrane transplantation combined with other surgeries were excluded. We evaluated the corneal epithelium healing time (CEHT), tear break-up time (TBUT), Schirmer test (ST), corneal neovascularization, the formation of symblepharon, and lid abnormalities after conventional treatment (CT) and AMT. The differences were tested by referring to the Cochrane Handbook. Pooled estimates were determined with RevMan software, version 5.3. <i>Results:</i> 5 studies with 310 eyes of 282 participants suffering from ocular burns were included. There was no significant difference between CT and AMT among the following outcomes: CEHT, TBUT, ST, formation of symblepharon, and lid abnormalities, except the extent of corneal neovascularization, which was less in patients treated with AMT (RR 0.81; 95% CI 0.68, 0.96; I² = 40%, p = 0.02). <i>Conclusions:</i> Compared to CT, AMT does not show better advantages in promoting epithelial healing, improving tear film status, and preventing complications such as symblepharon formation and eyelid abnormalities except reducing corneal neovascularization.

Comparative Study on the Efficacy of Frozen Amniotic Membrane Transplantation and Lamellar Keratoplasty in the Treatment of Mooren Ulcer.

To compare of the clinical efficacy of frozen amniotic membrane transplantation (AMT) and lamellar keratoplasty (LKP) in the treatment of Mooren ulcer. Forty patients (42 eyes) with Mooren's ulcer in our hospital from January 2010 to January 2019 were divided into frozen AMT group (20 eyes) and LKP group (22 eyes). Comparative observation of post-operative best corrected visual acuity (BCVA), corneal epithelial healing time, corneal epithelialization time, ulcer healing, corneal transparency, corneal graft transparency, neovascularization and original disease recurrence were observed. The average BCVA at post-operative 6 and 12 months in LKP group were significantly lower than AMT group (P < 0.05). The ulcer healing rates in LKP group (63.6) were significantly higher than AMT group (30) (P < 0.05). The corneal epithelialization time of LKP group were 9.55 ± 1.26 days. The corneal epithelial healing time of AMT group were 13.50 ± 2.21 days. Nine cases were corneal graft transparency grade 0, and 13 cases were grade I. Three eyes in AMT group were corneal transparency grade 0, 7 were grade I and 10 were grade II. Corneal neovascularization were observed in 3 eyes in AMT group and 4 eyes in LKP group. The original disease recurrence rates in LKP group (50) were significantly higher than AMT group (20) (P < 0.05). Four cases of primary corneal transplantation failure were observed in LKP group. Lamellar keratoplasty group obtained significantly better BCVA during follow-up and faster healing time than the frozen AMT group while frozen AMT group had lower original disease recurrence rates than LKP group.

Experimental study of riboflavin-ultraviolet A collagen crosslinking for the treatment of alkali-induced corneal burns in rabbits

Objective To evaluate the efficacy of riboflavin-ultraviolet A (UVA) collagen crosslinking (CXL) combined with drugs for the treatment of alkali-induced corneal burns in rabbits. Methods Prospective experimental study.The corneas of left eyes of 40 healthy New Zealand rabbits were established alkali burn model. All rabbits were randomly divided into 4 groups: the model group, drugs treatment group, crosslinking group and combined group, with 10 cases in each group. The model goup received no treatments. The drug goup received drug treatment. Riboflavin-UVA collagen crosslinking was appied in crosslinking group and the combined group received CXL combined with drug treatment. Therapeutic efficacy of each group were compared at 1 and 3 months after operation. Results The corneal epithelial healing time in the model group, drug group, cross-linking group and combined group were (32.9±5.8 ), (12.8±2.3), (25.9±3.2 ) and (10.7±2.5 )days, respectively. The difference were statistically significant among the four groups (F=67.647, P=0.000) . The corneal turbidity score of combined group was the lowest among the 4 groups, followed by the drug group, and the score of model group was the heaviest (F=6.446, P=0.001). The number of inflammatory cells were (162.6±33.3), (46.0±21.3 ), (87.9±7.5)and (8.3±6.5)cells respectively under single confocal microscopy field of vision ( 400 μm×400 μm). The difference among the 4 groups was statistically significant (χ2=36.040, P=0.000). The corneal collagen fibers with pathological examination in the combined group were the thickest and densely arranged, followed by crosslinking group. Conclusion The efficacy of drug combined with cross-linking for the treatment of corneal alkali burn in rabbits is better than that of simple drug therapy or simple corneal collagen cross-linking. Key words: Riboflavin-ultraviolet A; Collagen; Crosslinking; Burn, alkali, coreal

Prospective study on amelioration of pterygium combined with free autogenous conjunctival flap transplantation for the treatment of 45 patients with primary pterygium

Objective To explore the application effect of amelioration of pterygium combined with free autogenous conjunctival flap transplantation in patients with primary pterygium. Methods 90 cases (90 eyes) of primary pterygium treated in our hospital were grouped according to random number table. 45 cases in control group were treated with traditional pterygium excision, and 45 cases in observation group were treated with pterygium combined with free autogenous conjunctival flap transplantation. The operative condition (length of operation, incision size, blood loss during operation, healing time of corneal epithelium), the effect of operation and corneal astigmatism [corneal dispersion (CAD)], naked eye [uncorrected visual acuity (UCVA)] and tear film rupture time [break up time (BUT)] before and after operation were observed and compared. The incidence of complications, recurrence rate and quality of life (SF-36) before and after operation were compared between the two groups. Results The incision size, operative time, intraoperative blood loss and corneal epithelial healing time in the observation group were smaller than those in the control group (P 0.05). The complication rate in the observation group was 2.22% (1/45), which was lower than that in the control group 17.78% (8/45) (P<0.05). The recurrence rate of the observation group was 2.22% (1/45), which was lower than that of the control group 17.78%(8/45) (P<0.05). 3 months after operation, the SF-36 scores of the two groups were all higher than those before operation, and the SF-36 score of the observation group was higher than that of the control group 3 months after operation (P<0.05). Conclusions Free autogenous conjunctival flap transplantation combined with amelioration of pterygium can improve corneal astigmatism and visual function of the patients with primary pterygium, and promote corneal epithelial healing, with small incision, less bleeding and longer operation, which can reduce the incidence of postoperative complications and the recurrence rate, and help to improve the quality of life of the patients. Key words: Pterygium; Ophthalmologic surgical procedures; Conjunctiva; Transplantation, autologous

Bandage contact lenses for the treatment of acute ocular chemical injuries

Objective To observe the application efficacy of bandage contact lens(BCL) for the treatment of acute ocular chemical injuries. Methods Prospective case-control study. Seventy-seven eyes of 50 patients with ocular chemical injuries were randomly divided into 2 groups: observation group, 39 eyes of 25 patients and control group, 38 eyes of 25 patients. All patients were treated with routine anti-inflammatory and reparative treatment after emergency treatment. The observation group received normal treatment combined with BCL.The changes in corneal epithelial, symptom scores, corneal epithelial healing time and complications after treatment were observed and recorded. Results All BCLs were successfully fit patients of observation group, no any related complication occurred. The scores of symptoms and corneal fluorescence staining in observation group were significantly lower than those in the control group at 1, 3 and 7 days after treatment(all P<0.05). The difference of scores of the two groups were not significant between before and 14 days after treatment (P=0.311). The average time of corneal epithelial healing in observation group was (2.670±0.982) days and (5.870±1.711 )days in the control group, the difference was statistically significant between the two groups(t=-10.769, P<0.05). Conclusion Application of BCL for the treatment of acute ocular chemical injuries is effective for shorting the time of re-epithelialization and reducing postoperative pain. Key words: Bandage, contact lens, cornea; Injuries, chemical, ocular

Observation on the efficacy and labratory analysis of tear of two methods for extraction of corneal foreign body due to chestnut eye injury

Objective To investigate the efficacy and laboratory analysis of tear of two different treatment methods: fibrin glue and mechanical extraction of cornea chestnut thorn. Methods The data of 48 eyes of 48 patients with corneal foreign bodies due to chestnut eye injury were enrolled and analyzed retrospectively. Patients were randomly divided into 2 groups: fibrine glue group of 24 cases and mechanical extraction group of 24 cases. The fibrin glue group was covered with fibrin glue on the corneal surface, and the mechanical extraction group received chestnut thorn extraction under the microscope. The treatment time and the labratory analysis of tear after surgery were compared between the two groups during the healing process. Results The time of extraction of corneal foreign body was (11.5±4.0) min in the mechanical extraction group and (3.5±2.0) min in the fibrin glue group, the difference was statistically significant (t=9.771, P=0.021). The healing time of corneal epithelium was (14.5±2.1) d in the mechanical extraction group and (5.7±1.1) d in the fibrin glue group. The difference between the two groups was statistically significant (t=19.142, P=0.037). The differnce in ocular surface index, Schirmer I test and tear measuring height were statistilally significant between the two groups(all P 0.05). Corneal matrix edema subsided 1 week after surgery in fibrin glue group and corneal epithelium was healed completely, but in mechanical extraction group it was not healed, and corneal matrix edema was obvious. Conclusion The fibrin glue for the treatment of corneal foreign body caused by chestnut eye injury can reduce the operation time, beneficial to corneal healing.It is a safe and effective method. Key words: Ocular trauma; Corneal foreign body, chestnut thorn; Fibrin glue; Mechanical extraction; Labratory analysis of tear

Affecting factors of corneal epithelial healing following de-epithelized corneal collagen cross linking in keratoconus patients

Background Corneal collagen cross-linking (CXL) shows good clinical effects for keratoconus, and de-epithelized CXL appears to be benefit to the distribution and absorption of riboflavin in cornea stroma.However, de-epithelization of CXL will increase the infective risk and corneal healing time.It is very important to understand and control the affecting factors of corneal repair after de-epithelization of CXL. Objective This study was to evaluate the characteristics of corneal epithelial repair and analyze the relevant factors affecting corneal healing time after de-epithelized CXL. Methods A series-cases observational study was performed.De-epithelized CXL was performed on 77 eyes of 68 keratoconus patients in Shandong Eye Hospital from September 2013 to September 2015 under the approval of Ethic Committee of this hospital and informed consent of each patient.The age, corneal curvature, corneal thickness, breakup time of tear film (BUT), corneal front astigmatism (Astig) and epithelial healing time of the patients were recorded after surgery.The correlations between corneal epithelium healing time and above-mentioned factors were analyzed. Results De-epithelized CXL was smoothly finished in all the eyes.The corneal epithelium healing time was 2-12 days after surgery, with the average healing time 5 (4, 6) days.The mean age, thickness at corneal thinnest point, minimal cornea curvature (Kf), maximal corneal curvature (Ks), corneal average curvature (Km) and Astig was 22.00 (18.00, 25.00) years, 436 (412, 470)μm, 47.40 (44.70, 50.45)D, 52.10 (49.00, 54.55)D, 50.00 (47.15, 53.15)D and -3.30 (-5.45, 1.70)D, respectively.Spearman rank correlation analysis showed significant negative correlations between corneal epithelium healing time and BUT or the thickness at corneal thinnest point (BUT: rs=-0.334, P=0.003; corneal thickness: rs=-0.417, P=0.000), and the significant positive correlations were found between corneal epithelium healing time and Km, Kf and Ks (Km: rs=0.449, P=0.000; Kf: rs=0.300, P=0.008; Ks: rs=0.432, P=0.000). There were no considerable correlarions between corneal epithelium healing time and age or Astig (age: rs=0.023, P=0.845; Astig: rs=-0.190, P=0.098). Multiple linear regression analysis were carried out to study the dependent variable and independent factors.Because of the multiple co-linearity between variables, this paper corrects the model by using ridge regression.There is significant negative correlation between BUT, corneal thickness and corneal healing time, respectively(both at P<0.05), corneal curvature Km and Kf is positively correlated with corneal healing time (both at P<0.05). Conclusions The corneal thickness, Kf, Km, as well as BUT are influencing factors of epithelial healing after CXL. Key words: Keratoconus/therapy; Corneal stroma/chemistry; Collagen/chemistry; Photochemotherapy/methods; Biometry; Epithelium/cornea; Collagen cross-linking; Wound healing

Effects of optimal nursing in improving postoperative complications of Epi-LASIK

Objective To investigate effects of optimal nursing in improving postoperative complications of epipolis laser in situ ketatomileusis (Epi-LASIK) . Methods A total of 80 patients (160 eyes) with myopia undergoing Epi-LASIK operation in our hospital from June 2010 to May 2014 were included in the study. Control group contained 40 patients from June 2010 to August 2012 and received routine nursing, while observation group contained 40 patients from September 2012 to May 2014 and were given additional optimal nursing. Postoperative pain symptoms, healing time of corneal epithelium and corneal haze (Haze) were compared between two groups. Results After 1 day and 3 days post operation, the scores of pain of patients in observation group were significant lower than those of control group (P<0.05) . Average healing time of corneal epithelium of patients in observation group (5.05±0.58) days was shorter than control group (5.59±0.98) days. The difference was statistically significant (P<0.05) . After 1, 3 and 6 months, incidence rate of Haze in observation group was significantly lower than control group (P<0.05) . Conclusions Optimal nursing effectively prevents and reduces postoperative complications of Epi-LASIK. Key words: Nursing care; Pain; Epithelium, corneal; Epi-LASIK

The analysis of cases with eye injury caused by mineral spirits

Objective To analyze the treatment and prevention of eye injury caused by mineral spirits vapour. Methods Ten eyes of 6 cases with eye injury caused by mineral spirits vapour were given saline thoroughly rinsing the conjunctival sac. Nine eyes of 5 cases received corneal epithelial curettage combined with bandage contact lens; one eye of 1 case was underwent amniotic membrane transplantation first, and then accepted the combined surgery. The changes of endothelial cells were observed postoperatively. Results Except 2 eyes of 1 case with corneal endothelial decompensation, 8 eyes of 5 patients were cured. Their corneal fluorescein staining not colored, and restore transparency, no clouds form, vision returned to normal and corneal endothelial cells without significant change. Conclusion Mineral spirits vapour can induce corneal epithelial degeneration and endothelial damage. Corneal epithelial scrape combined with bandage contact lens is effective treatment for mineral spirits injury and can significantly shorten the healing time of corneal epithelium. Key words: Mineral spirits, volatile; Corneal injury , chemical burn; Treatment

The application of ultrasound biomicroscopy in pterygium surgery

Objective To observe the guidance role of ultrasound biomicroscope (UBM) examination results for pterygium operation. Methods Eighty-five eyes of 85 cases with primary pterygium were randomly divided into clinical trial group, 46 eyes, using UBM examination results for guiding the pterygium operation; and the control group, 39 eyes, in which traditional pterygium operation was performed. The operation time, postoperative corneal epithelium healing time, patient comfort and recurrence rate between the two groups were compared. Results The conjunctival flap of patients in the two groups healed well. The operation time of the trial group and the control group were (23.06±1.87) minutes and (30.63 ± 2.43) minutes. The difference was statisially significant (t=5.46, P=0.000); The healing time of corneal epithelium were (2.13 ± 0.37) days in trial group and (2.87 ± 0.41) days in control group and the difference was statisially significant (t=4.91, P=0.002); The scores of postoperative discomfort were 0.89±0.39 in trial group and 2.43±0.74 in control group and the difference was statisially significant (t=3.13, P=0.025). The follow-up time was 6 months, and there was no recurrence being found. Conclusion Preoperative UBM examination of pterygium can effectively identify corneal infiltration and adhesion of pterygium, which is conductive to better removal of pterygium head. Key words: Pterygium; Ultrasound biomicroscopy; Stem cell transplantation

Comparation of effectiveness of silicone hydrogel contact lens and hydrogel contact lens in patients after LASEK.

To conduct a comparative study of effectiveness of silicone hydrogel contact lens and hydrogel contact lens, which are used in patients after laser-assisted subepithelial keratomileusis (LASEK). Sixty-three patients (121 eyes) with a spherical equivalent ≤-5.0 D were chosen after undergoing LASEK in 2012 at Guangdong General Hospital. They were randomly divided into 2 groups. The silicone hydrogel group included 32 cases (61 eyes) that wore silicone hydrogel contact lenses for 4-6d after the operation, while the hydrogel group included 31 cases (60 eyes) who wore hydrogel contact lenses for 4-6d after the operation. Patients' self-reported postoperative symptoms (including pain, photophobia, tears, and foreign body sensation) were evaluated. The healing time of the corneal epithelium, the visual acuity of patients without contact lens after epithelial healing, and the incidence of delayed corneal epithelial shedding were also assessed. The follow-up time was 1mo. Postoperative symptoms were milder in the silicone hydrogel group than in the hydrogel group. There were significant differences in pain, foreign body sensation, and photophobia between the 2 groups (P<0.05), although there was no significant difference in postoperative tearing (P>0.05). The healing time of the corneal epithelium in the silicone hydrogel lens group was markedly shorter than that in the hydrogel group (4.07±0.25 vs 4.33±0.82d, t=2.43, P=0.02). Visual acuity without contact lenses after healing of the corneal epithelium was better in the silicone hydrogel group compared with the hydrogel group (χ (2)=7.76, P=0.02). There was no significant difference in the occurrence of delayed corneal epithelial shedding between the 2 groups (P>0.05). Patients with LASEK using silicon hydrogel contact lenses had less discomfort and shorter corneal epithelial healing time compared with those using hydrogel contact lenses, suggesting that silicon hydrogel contact lenses may be considered to be a better choice of bandage contact lens after LASEK.

The prospective randomized controlled study of primary pterygium surgery

Objective To study two different methods in treatment of primary pterygium surgery on corneal epithelial wound repair and the influence on the recurrence rate. Methods Used prospective controlled study, according to a number table 128 patients with 128 eyes were randomly divided into control group (64 cases), and observation group (64 cases). The two groups of patients underwent pterygium excision and limbal stem cell transplantation.The observation group (64 eyes) received 0.2 mg/mL mitomycin C of mitomycin-C(MMC) adjuvant therapy.Corneal epithelial wound repair speed was observed.The patients were followed up for 6-12 months, average 8.5months, the recurrence rate of pterygium was observed in the two groups. Results The grafts were smooth, and the conjunctival flap healed well in the two groups.The postoperative corneal epithelial healing time of the control group and the observation group were (2.13±0.37)d, (2.87±0.41)d, there was statistically significant difference (t=4.91, P 0.05). Conclusion There was no difference in recurrence rate between two kinds of pterygium surgical method, but the combined MMC can cause corneal epithelial healing delay. Key words: Pterygium; Limbal stem cell; Transplantation; Mitomycin C

Clinical comparison between brachytherapy of 0.5% loteprednol etabonate eye drops and long-term therapy of 0.1% fluorometholone eye drops after LASEK

Background Conventional corticosteroid therapy after laser epithelial keratomileusis (LASEK) is topical application of 0.1% fluorometholone eye drops for 4 months, but this therapy increases the ocular hypertension risk and leads to poor compliance in patients. It is necessary to explore a safe and effective brachytherapeutic drug. Objective This study was to compare the clinical outcomes between the brachytherapy of 0.5% loteprednol etabonate eye drops and the long-term therapy of 0.1% fluorometholone eye drops after LASEK. Methods Clinical data were retrospectively analyzed from 208 right eyes in 208 mild and moderate myopia patients who received LASEK at Peking University Third Hospital from 2009 to 2013. The eye drops of 0.5% loteprednol etabonate was used 6 times daily since operation day until postoperative day 5, and 4 times daily for a week, and then tapered for three consecutive weeks in 104 eyes of the loteprednol group after LASEK, and 0.1% fluorometholone eye drops was applied topically 4 times daily for initial one month and then tapered for three consecutive months in another 104 eyes in the fluorometholone group after LASEK. Corneal epithelial healing time was compared between the two groups by recording the wearing duration of corneal contact lens. Noncontact intraocular pressure (IOP) was detected and corrected 5 days, 2 weeks, 1 month and 3, 6 months after LASEK. Haze was scored based on the criteria of Cheng under the slit lamp microscope and apparently optometry was performed 1 month and 3, 6 months after LASEK. Results The number of eyes removed corneal contact lens in 5, 6 and 7 days after LASEK was not significantly different between the loteprednol group and the fluorometholone group (χ2=1.180, P=0.554). No considerable differences were seen in the eye numbers with the equivalent spherical lens (absolute value) ≤0.5 D in 1 month, 3 months and 6 months after LASEK (Z=-1.028, P=0.304; Z=-0.398, P=0.691; Z=-0.445, P=0.656). In the fifth days after surgery, the median corrected IOP was 13.52 mmHg and 13.12 mmHg in the loteprednol group and the fluorometholone group, respectively, showing a significant difference between them (Z=-1.985, P=0.047), but no significant differences were found in IOP in 2 weeks, 1 month and 3 months, 6 months after surgery between the two groups (all at P>0.05). IOP elevated (postoperative IOP-preoperative IOP≥5 mmHg) after LASEK in 5 eyes in the loteprednol group and 4 eyes in the fluorometholone group (χ2=0.116, P=0.733). In 1 month after surgery, the number of eyes in different grades of haze was significantly decreased in the loteprednol group compared with the fluorometholone group (χ2=13.506, P=0.009), however, there was no significant differences in haze grading in postoperative 3 months and 6 months between the two groups (χ2=2.199, P=0.699; χ2=1.154, P=0.562). Conclusions Brachytherapy of 0.5% loteprednol etabonate eye drops appears to have a similar effect in anti-inflammation and inhibition of haze to the long-term therapy of 0.1% fluorometholone eye drops after LASEK. Furthermore, topical application of 0.5% loteprednol etabonate eye drops dose not increase the risk of ocular hypertension. Key words: Adrenal cortex hormones/therapeutic use; Anti-inflammatory agents/therapeutic use; Keratomileusis, laser epithelial; Myopia/surgery; Postoperative complications/drug therapy; Loteprednol etabonate; Fluorometholone; Eye drops; Comparative study

Two different surgical procedures for treatment of pterygium

Objective To observe the effect of autologous corneal limbal stem cell transplantation (LCAT) with or without MMC for pterygium. Methods One hundred and twenty eyes of 120 cases of pterygium were selected in this study. The cases were numbered by the hospital case number and were divided into two groups according to the random number table. Patients in the control group were given LCAT treatment, and patients in the observation group were treated with LCAT+ MMC. The corneal epithelial healing time, recurrence rate and the effect on neovascuarization was observed. And the treatment effects between the two groups were compared. Results The total effective rates of observation group was 95.00%, which is better than that in control group (60.00%); the recurrence rates in observation group was 5.00%, which is better than that in control group (40.00%) (χ2=21.075, P=0.000). The eye irritation disappearance time, corneal epithelial healing time, and hospitalization time in observation group were (3.71±2.63) d, (4.12±1.31) d, and (13.61±2.43) d. That were not different form control group statistically (P>0.05). Infection occurred in 2 cases and sclera thinning occurred only 1 case of sclera thinning in control group and only 1 case of sclera thinning in observation group (t=17.905, P=0.000). Conclusion LCAT+ MMC in the treatment of pterygium can reduce the possibility of recurrence and tissue proliferation. Key words: Pterygium; Transplantation, stem cell, limbus; Mitomycin C

The evaluation of clinical efficacy of debridement and medication for fungal keratitis by means of confocal microscopy

Objective To evaluate the clinical efficacy of debridement and medication for fungal keratitis by means of confocal microscopy. Methods The data of 19 eyes of 19 patients who had plant injury history and had been diagnosed as fungal keratitis were analysed retrospectively. The patients were examined by laser confocal microscopy firstly, and then by corneal scraping test to find fungal hyphae. The detection rates of two different methods were compared. The 19 patients were randomly divided into treatment group (9 eyes) and control group (10 eyes), and patients of both groups received conventional corneal debridement and antifungal agents. After confirming the lesions without fungal hyphae by repeated laser confocal microscopy examination, patients in the treatment group received corticosteroid, combined with non-steroidal anti-inflammatory medicine; patients in the control group was only given antifungal eye drops. The average corneal epithelial healing time, BCVA were measured and compared between the two groups. And the changes of the number of inflammatory cells and corneal stromal cells recorded by laser confocal microscopy. Results In the 19 eyes, fungal hyphae were detected on 17 eyes by confocal laser scanning microscopy, and the positive rate was 89.4%. 16 eyes were detected by corneal scraping, and the positive rate was 84.2%. There was no statistically significant difference between them (χ2=0.230, P=0.631). The corneal epithelial healing time in treatment group was (12.1±2.4) d, and it was (15.1±3.2) d in control group, the difference was statistically significant (t=-2.290, P=0.035). The difference in the BCVA 1 week, 3 weeks, 1 month and 3 months after treatment between the two groups were statistically significant (P=0.0000~0.0020), the treatment group showed better BCVA. In the treatment group, after using corticosteroid combined with non-steroidal anti-inflamming medicine, the number of inflamming cell decreased significantly and the corneal stromal cells tended to be normal. Conclusion After debridement and no fungal hyphae confirmed by laser confocal microscopy, the corticosteroid can promote epithelial healing and reduce inflammation. Laser confocal microscopy is a fast, effective and non-invasive biopsy methods. It plays an important role in the diagnosis, treatment and research in fungal keratitis. Key words: Keratitis, fungal; Medicine; Debridement; Laser scanning confocal microscopy