Formation Of Bleb Research Articles

Bleb Needling Procedure in Juvenile Open Angle Glaucoma (JOAG) for Failed Bleb in Trabeculectomy

Introduction : JOAG is less responsive to medications and often requires surgical therapy. The main choice of surgery is trabeculectomy. One of its success rates is determined by the formation of bleb. Failed bleb causes an increase in IOP. To repair the bleb, bleb needling can be performed as a simple procedure.
 Case Illustration : A 7-year-old boy came with a chief complaint of pain accompanied by redness of the left eye. The patient was diagnosed with JOAG and had underwent trabeculectomy with mitomycin-C (MMC) 3 months ago on the right eye and 2 months ago on the left eye with complete success surgery. On physical examination, intraocular pressure (IOP) was 12 mmHg / 29 mmHg with flat bleb on the left eye. Visual acuity on the right eye was 3/10 with cc C-2.00 X 0° ? 7/10 while on the left eye was light perception without possible refractive correction. Timolol maleate and latanoprost eye drops were given for 2 weeks but the IOP remained high. Therefore, the patient underwent bleb needling with 5- Fluorouracil (5-FU) on the left eye. Post-operatively, the IOP was 12 mmHg without antiglaucoma medication.
 Discussion : Failure of the trabeculectomy bleb can occur due to fibrotic proliferation as part of the wound healing response. Studies stated 5-FU bleb needling provide clinically significant IOP lowering and minimal complication. Reduced IOP post needling and formation of bleb indicate successful needling.
 Conclusion : Bleb is an important indicator of a success trabeculectomy surgery. Bleb needling with 5-FU could be considered as effective and safe procedure after trabeculectomy failure.

The impact of technique of conjunctive wound suturing during sinus trabeculectomy on the formation of the filter bleb and the hypotensive efficiency of the operation

Purpose. To study how filtration blebs change in the postoperative period after applying the innovative patented suture during sinus trabeculectomy (STE).Material and methods. 105 patients (105 eyes) with primary open-angle glaucoma were randomized into 2 gender and age matched groups. In group 1, the conjunctival wound was sutured with separate continuous sutures on the conjunctiva and the Tenon's capsule. In group 2, the wound was sealed according to an innovative method. Before surgery, patients underwent a comprehensive examination, including visometry, tonometry, perimetry, and retinal tomography. In the postoperative period (1 day, 1, 2 weeks, 1, 3, 6 and 12 months after the STE), the changes of filtration blebs characteristics were assessed using the Würzburg bleb classification score (WBCS).Results. In group 2, one day after the surgery, IOP showed a decrease 0.8 mm Hg greater than in group 1. One month after surgery, the decrease was 1.5 mm Hg greater. The difference in IOP levels between the study groups persisted for up to 1 year (with a significant difference of 3.6 mm Hg after 3 months, and 3.8 mm Hg after 1 year, p = 0.001). The development of intraoperative and early postoperative complications was generally comparable. In group 1, an additional suture sealing was required in 11 8 % of cases due to external filtration. In group 2, no additional sutures were required (p = 0.01). The two groups revealed differences in the degree of vascularization of the conjunctiva and in the presence of conjunctival microcysts, as well as in the degree of encapsulation (p < 0.001) Group 2 treated by the innovative suturing technique showed better results.Conclusion. The innovative method of applying a sealing suture after STE quickens the normalization of the main characteristics of filtration blebs in comparison with the control group within 1 year after the intervention.

Geometrical and Hemodynamic Characteristic Changes of Small Anterior Communicating Artery Aneurysms during Follow-ups in a Retrospective Analysis.

Small intracranial aneurysms have a low risk of rupture. However, ruptured anterior communicating artery (ACoA) aneurysms are usually smaller in clinical practice. The retrospective study aimed to investigate the geometrical and hemodynamic changes of small unruptured ACoA aneurysms during serial follow-ups. We retrospectively collected patients with small unruptured ACoA aneurysms that were not repaired, who had serial follow-ups from the Electronic Medical Record System in four tertiary hospitals. The geometrical parameters of ACoA aneurysms were measured using a three-dimensional reconstructed model. Intra-aneurysmal hemodynamic parameters were computed using a high-resolution computational fluid dynamics model. Geometrical and hemodynamic changes of the aneurysms were evaluated at each follow-up. Five patients with small unruptured ACoA aneurysms that were not repaired were identified and included in this analysis. Aneurysms rupture occurred in two patients with aneurysm growth. The formation and enlargement of an irregular bleb at the aneurysm neck or dome were observed before the rupture. Ruptured aneurysms showed high wall shear stress (WSS) in the high inflow zone of aneurysm neck while low WSS and high oscillatory shear index (OSI) in the flow-recirculating region of aneurysm dome. Three unruptured aneurysms maintained a stable morphology and a physiological level of WSS. Aneurysm growth, low WSS, and high OSI at the dome and/or high WSS at the neck potentially contribute to the rupture of small ACoA aneurysms. These aneurysms should be considered for the treatment regardless of the small size.

Confocal Microscopy and Anterior Segment Optical Coherence Tomography Imaging of the Ocular Surface and Bleb Morphology in Medically and Surgically Treated Glaucoma Patients: A Review.

Glaucoma patients often suffer from ocular surface disease (OSD) caused by the chronic administration of topical anti-glaucoma medications, especially in cases of long-term therapy with preserved or multiple drugs. Additionally, glaucoma surgery may determine ocular surface changes related to the formation and location of the filtering bleb, the application of anti-mitotic agents, and the post-operative wound-healing processes within the conjunctiva. Recently, several studies have evaluated the role of advanced diagnostic imaging technologies such as in vivo confocal microscopy (IVCM) and anterior segment-optical coherence tomography (AS-OCT) in detecting microscopic and macroscopic features of glaucoma therapy-related OSD. Their clinical applications are still being explored, with recent particular attention paid to analyzing the effects of new drug formulations and of minimally invasive surgical procedures on the ocular surface status. In this review, we summarize the current knowledge about the main changes of the ocular surface identified at IVCM and AS-OCT in glaucoma patients under medical therapy, or after surgical treatment.

Sea Hare Hydrolysate-Induced Reduction of Human Non-Small Cell Lung Cancer Cell Growth through Regulation of Macrophage Polarization and Non-Apoptotic Regulated Cell Death Pathways.

Sea hare-derived compounds induce macrophage activation and reduce asthmatic parameters in mouse models of allergic asthma. These findings led us to study the role of sea hare hydrolysates (SHH) in cancer pathophysiology. SHH treatment-induced M1 macrophage activation in RAW264.7 cells, peritoneal macrophages, and THP-1 cells, as did lipopolysaccharide (LPS) (+ INF-γ), whereas SHH reduced interleukin (IL)-4 (+IL-13)-induced M2 macrophage polarization. In addition, SHH treatment inhibited the actions of M1 and M2 macrophages, which have anticancer and pro-cancer effects, respectively, in non-small cell lung cancer cells (A549 and HCC-366) and tumor-associated macrophages (TAMs). Furthermore, SHH induced G2/M phase arrest and cell death in A549 cells. SHH also downregulated STAT3 activation in macrophages and A549 cells, and the down-regulation was recovered by colivelin, a STAT3 activator. SHH-induced reduction of M2 polarization and tumor growth was blocked by colivelin treatment. SHH-induced cell death did not occur in the manner of apoptotic signaling pathways, while the death pattern was mediated through pyroptosis/necroptosis, which causes membrane rupture, formation of vacuoles and bleb, activation of caspase-1, and secretion of IL-1β in SHH-treated A549 cells. However, a combination of SHH and colivelin blocked caspase-1 activation. Z-YVAD-FMK and necrostatin-1, pyrotosis and necroptosis inhibitors, attenuated SHH’s effect on the cell viability of A549 cells. Taken together, SHH showed anticancer effects through a cytotoxic effect on A549 cells and a regulatory effect on macrophages in A549 cells. In addition, the SHH-induced anticancer effects were mediated by non-apoptotic regulated cell death pathways under STAT3 inhibition. These results suggest that SHH may be offered as a potential remedy for cancer immunotherapy.

Application effect of cross-linked sodium hyaluronate in trabeculectomy

Objective To evaluate the clinical effects of application of cross-linked sodium hyaluronate during trabeculectomy. Methods The data of 120 eyes of 120 patients who received trabeculectomy from Jan.2017 to Apr.2017 were analyzed retrospectively. All cases were randomly divided into 2 groups. The clinical trial group, 64 eyes of 64 patients, received cross-linked hyaluronate in the trabeculectomy. And the control group, 56 eyes of 56 patients, only received trabeculectomy. Results At 18 months postoperatively, the difference in postoperative visual acuity was statistically significant between the two groups. The mean intraocular pressure were (14.04±1.33)mmHg (1 mmHg = 0.133 kPa)in clinical trial group and (18.18±1.35)mmHg in control group at 18 months postoperatively, the difference in intraocular pressure was not statistically significant between the two groups. Nun-functional filtering bleb occurred in 3 eyes of the trial group and 20 eyes of the control group. The difference was statistically significant between the two groups(P<0.05). Conclusion Application of cross-linked sodium hyaluronate during trabeculectomy can promote formation of filtering bleb after trabeculectomy, and the intraocular pressure is satisfactorily controlled. Key words: Cross-linked sodium hyaluronate; Trabeculectomy; Glaucoma

Losartan Attenuates Scar Formation in Filtering Bleb After Trabeculectomy.

To examine the effects of losartan on scar formation after trabeculectomy and on fibrotic changes of human Tenon's fibroblasts (HTFs). Trabeculectomy was performed on New Zealand rabbits. They were randomized to receive one of the following treatments: 0.9% normal saline, mitomycin-C, or one of the three doses of losartan. Bleb morphology, IOP, and histopathology examination were performed. Primary cultured HTFs were treated with losartan or vehicle, with or without angiotensin II (Ang II). Cell proliferation was assessed by Cell Counting Kit-8 assay, and cell migration was detected by scratch wound and transwell assay. Transdifferentiation was evaluated through the expression of α-smooth muscle actin (α-SMA) by immunofluorescence, real-time PCR, and Western blot. The expression of fibronectin (FN) was evaluated by real-time PCR and Western blot. An amount of 5 mg/mL of losartan subconjunctival injection significantly decreased IOP postoperatively and attenuated wound healing of the filtering bleb in the rabbit model. Immunostaining results showed less myofibroblast and collagen deposition around the bleb area in the losartan-treated eyes. Losartan (10-5 M) in vitro significantly attenuated Ang II's stimulatory effects on proliferation and migration of HTFs. Expressions of α-SMA and FN in these cells were also decreased by losartan pretreatment. Losartan attenuates scar formation of filtering bleb after trabeculectomy likely via decreasing proliferation, migration, transdifferentiation, and extracellular matrix deposition of Tenon's fibroblasts. These results indicate that losartan may be an effective therapeutic agent in preventing bleb scar formation and in improving surgical outcome after trabeculectomy.

Effects of Honghua preserved amniotic membrane on scar healing in experimental glaucoma surgery.

To investigate the efficacy and safety of Honghua preserved amniotic membrane (AM) for preventing scar formation of the filtering bleb in a rabbit model of glaucoma trabeculectomy surgery. Totally 36 rabbits (36 eyes) were randomly divided into 3 groups: the experimental group (ocular trabeculectomy in combination with Honghua preserved AM transplantation), the control group (ocular trabeculectomy surgery in combination with AM implantation), and the blank group (single trabeculectomy). Clinical observations [including intraocular pressure (IOP), filtering blebs and complications], Masson-Trichrome staining, real-time quantitative reverse transcription-polymerase chain reaction (real-time PCR), Western blot were performed on different time points (D1, D7, D14, D21 and D56) after the surgery. After operated for 14d, there were statistically significant differences in the filtering blebs compared to the situation before operation (P<0.05), whereas no statistically difference on that among three groups (P>0.05). After 21d, the IOP of experimental group was lowest (P<0.05). There was significant difference between control group and blank group (P<0.05). On postoperative D14, the mean number of fibroblasts in the experimental group was significantly lower (40.6±10.2) compared to those in the control group (54.4±10.8) and blank group (68.2±11.6) (P<0.05, respectively). The mean numbers of the macrophage in the experimental and control groups were respcitively significantly lower versus the blank group (P<0.05, P<0.05, respectively). Compared to that in blank group, the level of transforming growth factor-β (TGF-β1) expression in sclera and conjunctival areas was reduced in the experimental and control groups on protein and mRNA level (P<0.05), but not significant difference between these two groups (P>0.05). The trabeculectory surgery with Honghua preserved AM can control IOP, sustain the functional filtration bleb, inhibit the proliferation of fibroblasts and open the filtrating pathway on the rabbit glaucoma models.

OUR FIRST EXPERIENCE OF THE APPLICATION OF EX-PRESS SHUNT IN COMBINATION WITH HEMOSTATIC SPONGE IN OBSTINATE GLAUCOMA SURGERY

On the clinical case the article presents our first experience of the use of Ex-Press shunt in combination with hemostatic sponge in obstinate (resistant) glaucoma surgery, which requires a special approach to the choice of means and methods of treatment because of the low efficiency of conventional methods. The technology of the surgery distinguishes with its minimal invasiveness, absence of necessity in scleroticectomy or iridectomy, provides reliable and consistent normalization of intraocular pressure. Good conditions for the formation of a consistent filtering bleb are created in combination with the use of gelatinous hemostatic sponge, because the processes of formation of conjunctival and scleral as well as scleral adherences in the area of surgical interference are prevented. The use of a sponge reduces the possibility of haemorrhagic intraoperative and postoperative complications, and significantly reduces the period of post-operative ocular hypotony.

Impact of application of bio-amniotic membrane immersed in 5-fluorouracil solution in trabeculectomy on rabbit retina.

Background:To observe the impact of application of bio-amniotic membrane immersed in 5-fluorouracil solution in trabeculectomy on the retina in a rabbit model.Materials and Methods:Healthy white New Zealand rabbits were randomly assigned into three groups with 20 in each group. Bio-amniotic membranes of 4 × 5 mm immersed in either physiological saline/water for 10 min, or 25 mg/mL 5-fluorouracil solution for 5 and 10 min, respectively, were applied on rabbit eyes during trabeculectomy. At 7, 14, 21, and 28 days of postoperation, five rabbits from each group were examined with electroretinogram (ERG). After being examined for eye pressure and bleb morphology, rabbits were sacrificed by air embolism and their retinas were collected and examined by transmission electron microscopy (TEM). In addition, 5-fluorouracil amount in bio-amniotic membranes was measured using high-performance liquid chromatography.Results:Each bio-amniotic membrane could absorb 59.004 μg and 75.828 μg 5-fluorouracil after being immersed in 5-fluorouracil solution for 5 and 10 min, respectively. Application of these bio-amniotic membranes in trabeculectomy could promote the formation of well-functioning bleb and maintain intraocular pressure, although it had no effect on retina structures as examined with ERG and TEM.Conclusion:Application of 5-FU soaked bio-amniotic membrane in rabbit eye trabeculectomy is effective and safe.

Developmental regulation of locomotive activity in Xenopus primordial germ cells

Primordial germ cells (PGCs) arise in the early embryo and migrate toward the future gonad through species-specific pathways. They are assumed to change their migration properties dependent on their own genetic program and/or environmental cues, though information concerning the developmental change in PGC motility is limited. First, we re-examined the distribution of PGCs in the endodermal region of Xenopus embryos at various stages by using an antibody against Xenopus Daz-like protein, and found four stages of migration, namely clustering, dispersing, directionally migrating and re-aggregating. Next, we isolated living PGCs at each stage and directly examined their morphology and locomotive activity in cell cultures. PGCs at the clustering stage were round in shape with small blebs and showed little motility. PGCs in both the dispersing and the directionally migrating stages alternated between the locomotive phase with an elongated morphology and the pausing phase with a rugged morphology. The locomotive activity of the elongated PGCs was accompanied by the persistent formation of a large bleb at the leading front. The duration of the locomotive phase was shortened gradually with the transition from the dispersing stage to the directionally migrating stage. At the re-aggregating stage, PGCs became round in shape and showed no motility. Thus, we directly showed that the locomotive activity of PGCs changes dynamically depending upon the migrating stage. We also showed that the locomotion and blebbing of the PGCs required F-actin, myosin II activity and RhoA/Rho-associated protein kinase (ROCK) signaling.

Fibrin glue coating of the surgical surfaces may facilitate formation of a successful bleb in trabeculectomy surgery

Trabeculectomy is commonly conducted when medical therapy fails to control intraocular pressure (IOP). The success of trabeculectomy for the treatment of glaucoma depends on the wound-healing response at the subconjunctival filtering bleb site. Postoperative scar formation is a serious problem in this surgery. Current strategies to counteract scarring include local antimetabolite treatment, which is associated with severe side effects, limiting its application. Therefore, additional means to safely modulate wound healing are desirable. In ophthalmic surgery, fibrin glue is used mainly for sealing and hemostatics purpose. Fibrin glue coating of tenon face of conjunctiva, scleral surface, reverse face of scleral flap and scleral bed with insoluble fibrin glue can halt both ooze bleeding and vascular leakage. By retarding the first step of wound healing, less postoperative inflammation may occur. Additionally aqueous humor flows through a fibrin glue coated interface. Therefore, we hypothesize that fibrin glue coating of the surgical surfaces in trabeculectomy surgery may yield less subconjunctival fibrosis and more successful bleb. To the best of our knowledge, no basic research has yet been performed regarding fibrin glue coating for halting the vascular leakage and easing the aqueous drainage into subconjunctival space in glaucoma surgery.

IOP-lowering effects for the application of human umbilical vein in non-penetrating deep sclerostomy in rabbits.

To estimate the effects of human umbilical vein (HUV) implanted under the sclera of glaucoma model on intraocular pressure (IOP) lowering and to investigate its related mechanisms A total of 20 human umbilical veins (HUV) were collected from healthy fetus umbilical core. After the establishment of glaucoma model in rabbits, human freeze-dried umbilical vein was implanted under the sclera during NPDS, while for control group, sclerostomy was performed without implant. The formation of the filtration bleb and IOP were detected every 24 hours before surgery and on day 3, 7, 10 and 14 after surgery. Handheld pen-type Tono-pen II tonometer was used to measure IOP after topical anesthesia treatment. Each measurement has three duplicates. The incision recovery, filtration, conjunctiva congestion and anterior chamber inflammation were observed everyday after surgery. IOP was decreased dramatically with less inflammation than traditional sclerostomies with the application of HUV. The significant differences of IOP between the NPDS with and without HUV implant groups were shown up from 10 days after surgery. The average IOP in NPDS without HUV implant was 14.25mmHg, while for NPDS with HUV implant group, it was 12.30mmHg. This structure of filtration bleb, which allowed the aqueous humor to leave the eye, was formed for any type of surgery. However, 1-2 weeks later, filtration bleb was still existed in the group of sclerostomy with HUV implant and more stable than that of the surgery without HUV implant. Histological observations were performed on day 3, 7 and 14 after surgery. For the eyes under sclerostomy with HUV implant, HUV lumina was shown up on 3 days after surgery with few fibroblast cells near the sclera. On 7 days after surgery, HUV lumina was stably maintained but with obvious fibroblast cells and inflammatory cell. On 14 days after surgery, HUV lumina was still clearly observed but with scarring formation, which suggests that the IOP lowering effects might result from an effective drainage structure formation. HUV might be an alternative material to make the drainage pathway for non-penetrating deep sclerostomy.

Argon laser suture lysis following glaucoma filtering surgery – A short introduction to the procedure

Abstract Background Trabeculectomy is the most commonly performed glaucoma filtering surgery. The success of the outcome of an operation to reduce the intraocular pressure (IOP) is dependent on postoperative wound modulation by antimetabolite therapy and by flow regulation of the filtering bleb, which can be achieved by argon laser suture lysis. Methods and case report Postoperative IOP controls, examination of bleb formation and bleb massage can lead to the decision to perform up to four argon laser suture lyses in order to reduce IOP and enhance aqueous humor flow and bleb formation. The procedure is described here in a case report. Conclusion After glaucoma filtering surgery, argon laser suture lysis is an effective tool for postoperative regulation of aqueous humor flow and formation of the filtration bleb to guarantee the success of surgery.

Conjunctival vasculature patterns influencing the filtering bleb shape following trabeculectomy with limbal-based conjunctival flaps

To investigate the correlation between conjunctival vasculature factors and two types of functional bleb shape, cystic and diffuse, formed after trabeculectomy with limbal-based conjunctival flaps. Eighty-five eyes of glaucoma patients were consecutively enrolled. After 6 months, functioning blebs were classified as either cystic or diffuse. For each bleb type, the presence of neovascularized vessels in the dissected area (NVc) or the nondissected area (NVi), an avascular area (AVA), or a posterior tarsal artery (PTA) feeding the conjunctiva was analyzed. In 62 eyes with functioning blebs, there were 54 cystic and eight diffuse blebs. AVA was present in 96.3% of the cystic and 25.0% of the diffuse blebs. NVc was present in 100% of the cystic and 62.5% of the diffuse blebs, and NVi in 96.3% of the cystic and 12.5% of the diffuse blebs. A PTA was present in 87.5% of the diffuse blebs, but in only 3.7% of the cystic blebs. AVA, NVi, and NVc were significantly more frequent in cystic blebs, whereas a PTA was more frequent in diffuse blebs. The presence of a PTA in the blebs was negatively related to the presence of AVA, NVc, or NVi. Avoidance of damage to the PTA during conjunctival dissection might facilitate the formation of a diffuse filtration bleb. The conjunctival vasculature should be considered to avoid cystic avascular bleb formation in trabeculectomy with limbal-based flaps.

Amniotic membrane transplantation and releasable sutures with trabeculectomy for treatment of refractory glaucoma

目的 观察和分析在难治性青光眼手术中羊膜植入的临床效果.方法对入院治疗的连续病例36例(45眼)难治性青光眼,在小梁切除手术中联合羊膜植入并应用可松解缝线技术,术后观察其视力、前房、滤过泡和眼压等情况并进行统计分析.结果手术后平均随访(13.5±6.2)月,随访12月以上者66.67%.手术后6月的39眼平均眼压由术前(42.65±8.40)mmHg降至(17.60±5.16)mmHg,手术总成功率为89.74%;随访12月以上的30眼眼压由术前(41.95±7.18)mmHg降至(19.08±4.81)mmHg,手术总成功率为86.67%;手术前后眼压差异有统计学意义;随访12月以上功能性滤过泡占76.67%.未发现羊膜排斥反应或严重并发症.结论羊膜植入联合小梁切除手术并应用可松解缝线技术是治疗难治性青光眼安全和有效的手术方法。

Biotransformation of chlorpropham (CIPC) in isolated rat hepatocytes and xenoestrogenic activity of CIPC and its metabolites by in vitro assays

1. The metabolism and action of chlorpropham (isopropyl N-(3-chlorophenyl)carbamate; CIPC, a post-harvest agent) were studied in freshly isolated rat hepatocytes, and the oestrogen-like activity of CIPC and its metabolites was assessed by in vitro assays. The exposure of hepatocyte suspensions to CIPC caused concentration- (0.25–1.0 mM) and time- (0–3 h) dependent cell death, which was assessed by Trypan blue exclusion, accompanied by losses of cellular adenosine triphosphate and adenine nucleotide pools, and formation of cell bleb.2. CIPC at a weakly toxic level (0.25 or 0.5 mM) was metabolized to isopropyl N-(3-chloro-4-hydroxyphenyl)carbamate (4OH-CIPC) and subsequently to its glucuronide and sulfate conjugates (major metabolites) or alternatively to the minor metabolites 3-chloroaniline (3CA) and 3-chloroacetanilide. CIPC (0.25 mM) added to hepatocyte suspensions was distributed equally between hepatocytes and the extracellular medium during the incubation. The glucuronide rather than the sulfate conjugate of 4OH-CIPC predominantly increased in the medium with time, while the amount of unconjugated free 4OH-CIPC in the extracellular medium increased by approximately threefold compared with the amount in the cell fraction after 0.5 h and then decreased rapidly accompanied by increases in the conjugates. This indicates that unconjugated free 4OH-CIPC produced in hepatocytes was temporarily excreted in the extracellular medium and subsequently converted to the conjugates via re-influx into hepatocytes.3. Diethylstilbestrol (DES), bisphenol A (BPA) and 4-hydroxybenzoic acid butyl ester (butylparaben), which are known xenoestrogenic compounds, competitively displaced 17β-oestradiol bound to the oestrogen receptor-α (ERα) in a concentration-dependent manner; IC50 values of DES, BPA, butylparaben and its derivative 3-chloro-4-hydroxybenzoic acid butyl ester (3-chloro-butylparaben) were approximately 10−8, 10−5, 5 × 10−5 and 5 × 10−4 M, respectively. In contrast, neither CIPC nor 4OH-CIPC impaired the binding of 17β-oestradiol to ERα at concentrations ranging from 10−9 to 10−4 M, whereas at concentrations of >5 × 10−4 M, the binding affinity of 4OH-CIPC was greater than that of CIPC. In a proliferation assay of MCF-7 cells, CIPC, 4OH-CIPC and 3CA did not increase cell numbers at concentrations ranging from 10−9 to 10−5 M, but these compounds at a concentration of 10−4 M induced a considerable decrease in cell numbers relative to the control. The results suggest that even if CIPC is metabolized to 4OH-CIPC by hepatocytes, the chlorine adjacent to the 4-hydroxy group added to the intermediate as well as 3-chloro-butylparaben obstructs the appearance of oestrogen-like effects via an interaction between the intermediate and the ER.

Efficacy and safety of the Ahmed glaucoma valve implant in Chinese eyes with complicated glaucoma

AIMSTo evaluate the efficacy and safety of the Ahmed glaucoma valve implant in Chinese eyes with complicated glaucomas.METHODSThis retrospective study reviewed the final intraocular pressure, visual outcome, and incidence of...

Relationship between Formation of a Filtering Bleb and an Intrascleral Aqueous Drainage Route after Trabeculectomy:Evaluation Using Ultrasound Biomicroscopy

We evaluated the relationship between the development of filtering bleb and the thickness of the aqueous drainage route beneath the scleral flap in patients who had undergone trabeculectomy. The relationship between the postoperative intraocular pressure and the size of the filtering bleb was also studied. We studied 29 eyes of 21 patients who had been followed for at least 1 (mean 9.9) month after the trabeculectomy. Ultrasound biomicroscopy was used to examine the filtering bleb and aqueous drainage route beneath the scleral flap. The thickness of the aqueous drainage route beneath the center of the scleral flap was found to be correlated with the development of a filtering bleb (r = 0.391, p < 0.05). The size of the bleb was correlated with the intraocular pressure (r = –0.560, p < 0.05) which had not been treated with antiglaucoma medication during follow-up. Thus, preservation of the aqueous drainage route beneath the scleral flap probably influenced the development of a filtering bleb following trabeculectomy.

Laser Sclerostomy Ab Externo Using Mid Infrared Lasers

ABSTRACT An ab externo fistulizing procedure (sclerostomy) was performed in vivo in 48 rabbit eyes using a pulsed (20 µs and 200 µs) Holmium:YAG (Ho:YAG) laser (2120 nm) and a pulsed (200 µs) Erbium:YAG (ErYAG) laser (2940 nm). The laser energy was delivered via an infrared transmitting fiber in contact with the sclera, with the fiber inserted into a specially sharpened retractable cannula in order to guide it into the subconjunctival space. An additional optical fiberfiber coupling system was required for the Er-YAG laser. A patent fistula (200-micrometer diameter) with formation of a filtering bleb and marked intraocular pressure reduction was achieved in nearly all cases. Significant intraoperative or postoperative complications occurred only with the 20-microsecond Ho:YAG laser. Trauma to the conjunctiva was as minimal as in a subconjunctival injection. The Er.YAG laser created a smaller thermal damage zone at the fistula walls and required significantly less laser energy than the Ho-YAG laser.