Visual Outcomes of Pupilloplasty in Ocular Trauma and Iatrogenic Damage

Purpose: To report the visual outcomes of different techniques for iris pupilloplasty in eyes after traumatic and iatrogenic damage. Methods: 70 consecutive eyes with posttraumatic (80%) and postoperative (20%) iris damage were included. According to the preoperative diagnosis, the eyes were divided into three groups: mydriasis (50%), partial iris defects (24%), and iridodialysis (26%). Multiple techniques were performed: the Siepser slip-knot technique, the “lasso” technique, and suturing to the sclera. These techniques were combined in some cases. Results: The best improvement of visual acuity was found for the Siepser slip-knot technique with a median of 0.7 (SD ± 0.83) before surgery and 0.52 logMAR (SD ± 0.65) after surgery with regard to the surgical technique, and for mydriasis with a median of 0.7 (SD ± 0.75) before surgery and 0.52 logMAR (SD ± 0.49) after surgery with regard to preoperative diagnosis. Pupilloplasty was combined with additional surgery (corneal suturing, secondary intraocular lens implantation, anterior or pars plana vitrectomy) in 80% of cases. Apart from corneal suturing, all additional procedures ensured improvement in visual acuity. Conclusions: The slip-knot technique was the only suturing technique that resulted in a significant improvement in visual acuity. Other surgical procedures are usually needed in the majority of cases that undergo pupilloplasty, and they also give visual gain

Immunological aspects of the tumor microenvironment and epithelial-mesenchymal transition in gastric carcinogenesis

Infection with Helicobacter pylori, a Gram-negative, microaerophilic pathogen often results in gastric cancer in a subset of affected individuals. This explains why H. pylori is the only bacterium classified as a class I carcinogen by the World Health Organization. Several studies have pinpointed mechanisms by which H. pylori alters signaling pathways in the host cell to cause diseases. In this article, the authors have reviewed 234 studies conducted over a span of 18 years (2002–2020). The studies investigated the various mechanisms associated with gastric cancer induction. For the past 1.5 years, researchers have discovered new mechanisms contributing to gastric cancer linked to H. pylori etiology. Alongside alteration of the host signaling pathways using oncogenic CagA pathways, H. pylori induce DNA damage in the host and alter the methylation of DNA as a means of perturbing downstream signaling. Also, with H. pylori, several pathways in the host cell are activated, resulting in epithelial-to-mesenchymal transition (EMT), together with the induction of cell proliferation and survival. Studies have shown that H. pylori enhances gastric carcinogenesis via a multifactorial approach. What is intriguing is that most of the targeted mechanisms and pathways appear common with various forms of cancer

Vitrectomy Combined with Cataract Surgery for Retinal Detachment Using a Three-Dimensional Viewing System

Purpose: To evaluate the results of a pars plana vitrectomy (PPV) combined with cataract surgery for primary rhematogenous retinal detachment (RD) using a three-dimensional (3D) viewing system and a conventional microscope (CM). Methods: Medical reports of 82 patients were retrospec-tively reviewed: 26 patients were operated on with 3D and 56 patients were operated on with CM. The main outcome measures were visual acuity, duration of the surgery, and the rate of postoperative complications. Results: No statistically significant differences in pre-and postoperative visual acuity were found between both groups. There was significant improvement in the visual acuity in both groups. The best postoperative visual acuity was achieved with SF6 gas tamponade, followed by C3F8 gas and silicone oil in both groups. The duration of the surgery (60 min vs. 55 min) and the rate of postoperative complications (15% vs. 14%) were similar in both groups. Conclusions: The similar postoperative visual acuity and rate of complications detected using 3D and CM indicate that the 3D viewing system may be advantageous in the treatment of rhematogenous RD with PPV combined with cataract surgery, i.e., a complex procedure involving both anterior and posterior segment manipulations

Antioxidant status in the vitreous of eyes with rhegmatogenous retinal detachment with and without proliferative vitreoretinopathy, macular hole and epiretinal membrane

(1) Background: The aim of the study was to test the hypothesis that the antioxidant status in the vitreous body of eyes, which had been vitrectomized due to rhegmatogenous retinal detachment (RRD) with or without proliferative vitreoretinopathy (PVR), is higher than in eyes vitrectomized due to other retinal diseases. (2) Methods: four patient groups were analyzed: 22 eyes of patients with RRD without PVR, 27 eyes with RRD and PVR, 22 eyes with macular hole (MH) and 10 eyes with epiretinal membrane (ERM). Spectrophotometric methods were used to determine the total antioxidant status (TAS) values as well as superoxide dismutase (SOD) and glutathione reductase (GR) activities in the vitreous fluid samples. (3) Results: no significant differences in TAS values and antioxidant enzyme activities were observed among patient with RRD with and without PVR and with MH and ERM. The longer the duration of RRD leading to PVR and better postoperative visual acuity, the higher the TAS level. No significant differences were found between “macula on” and “macula off” subgroups within the RRD group and the RRD combined with PVR group. (4) Conclusions: The preliminary results do not support the thesis that the antioxidant status of vitrectomized eyes is different in patients with RRD with or without PVR in comparison to patients with MH and ERM. In patients with RRD, PVR presence and detached macula do not affect the values of TAS, SOD and GR in the vitreous fluid. The duration of the disease influences TAS in the vitreous in eyes with RRD complicated with PVR

Formation and structure of ionomer complexes from grafted polyelectrolytes

We discuss the structure and formation of Ionomer Complexes formed upon mixing a grafted block copolymer (poly(acrylic acid)-b-poly(acrylate methoxy poly(ethylene oxide)), PAA21-b-PAPEO14) with a linear polyelectrolyte (poly(N-methyl 2-vinyl pyridinium iodide), P2MVPI), called grafted block ionomer complexes (GBICs), and a chemically identical grafted copolymer (poly(acrylic acid)-co-poly(acrylate methoxy poly(ethylene oxide)), PAA28-co-PAPEO22) with a linear polyelectrolyte, called grafted ionomer complexes (GICs). Light scattering measurements show that GBICs are much bigger (~70–100 nm) and GICs are much smaller or comparable in size (6–22 nm) to regular complex coacervate core micelles (C3Ms). The mechanism of GICs formation is different from the formation of regular C3Ms and GBICs, and their size depends on the length of the homopolyelectrolyte. The sizes of GBICs and GICs slightly decrease with temperature increasing from 20 to 65 °C. This effect is stronger for GBICs than for GICs, is reversible for GICs and GBIC-PAPEO14/P2MVPI228, and shows some hysteresis for GBIC-PAPEO14/P2MVPI43. Self-consistent field (SCF) calculations for assembly of a grafted block copolymer (having clearly separated charged and grafted blocks) with an oppositely charged linear polyelectrolyte of length comparable to the charged copolymer block predict formation of relatively small spherical micelles (~6 nm), with a composition close to complete charge neutralization. The formation of micellar assemblies is suppressed if charged and grafted monomers are evenly distributed along the backbone, i.e., in case of a grafted copolymer. The very large difference between the sizes found experimentally for GBICs and the sizes predicted from SCF calculations supports the view that there is some secondary association mechanism. A possible mechanism is discussed

Vertical and Horizontal M-Charts and Microperimetry for Assessment of the Visual Function in Patients after Vitrectomy with ILM Peeling due to Stage 4 Macular Hole

Purpose. To examine the relationship between the morphological and functional results in eyes after pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling due to stage 4 full-thickness macular hole (FTMH). Methods. The study included 22 eyes that underwent successful PPV due to FTMH. Both vertical metamorphopsia (VM) and horizontal metamorphopsia (HM) were determined using type 2 M-charts, as well as best-corrected visual acuity (BCVA), microperimetry, and optical coherence tomography (OCT) were performed before PPV and 1 and 6 months postoperatively. Results. A significant improvement of BCVA and metamorphopsia scores measured by M-charts in particular periods before surgery, 1 and 6 months after PPV, was observed. The VM scores were consistently higher than the HM scores at all assessment times. There was a correlation found between VM and BCVA and microperimetry parameters before surgery. The macular sensitivity (MS) as well as macular integrity index increased from 1 month to 6 months after PPV and were correlated with postoperative visual acuity (VA). There was a correlation found between the hole diameter and MS and P2 parameter 6 months after PPV. There was a correlation found between mean duration of symptoms of FTMH and VA and VM score. Conclusions. VM scores seem to correlate better than HM scores with preoperative BCVA, microperimetry parameters, and duration of symptoms of the FTMH. VM scores are higher after PPV than HM scores in patients with stage 4 of the FTMH. This trial is registered with NCT03701542