combination with collagen crosslinking for keratoconus

Purpose: To compare visual outcomes, corneal astigmatism, and keratometric readings in patients with progressive keratoconus undergoing intrastromal corneal ring implantation (ICRSI) only and in combination with ultraviolet A riboflavin mediated corneal collagen crosslinking (CXL).Methods: In this retrospective comparative study, there were 2 groups of keratoconus patients. Group 1 consisted of only ICRSI patients. Group 2 consisted of combined ICRSI-CXL patients. Preoperative and postoperative uncorrected distance visual acuity (UCDVA) and best-corrected distance visual acuity (BCDVA), spherical error, cylindrical error; and mean keratometty were compared.Results: The study evaluated 166 eyes of 121 patients with a mean age of 24.74 years. The UCDVA improved from 0.24 to 0.37 in group 1 and from 0.24 to 0.42 in group 2 at the last visit. The BCDVA improved from 0.34 to 0.62 in group 1 and from 0.31 to 0.67 in group 2. Spherical error decreased from -5.05 D to -1.65 D in group 1 and from -4.82 D to -1.52 D in group 2. Cylindrical error decreased from -6.06 D to -3.47 D in group 1 and from -5.66 D to -3.20 D in group 2. Mean keratometry values decreased from 51.89 D to 47.96 D in group 1 and from 50.89 D to 46.91 D in group 2. p Value was >0.05 in group comparisons. Ring explantation due to corneal melting was applied in 3 eyes.Conclusions: Both combined ICRSI-CXL and ICRSI-only groups experienced favorable outcomes, without statistical difference in any studied effect of both treatment strategies

Development of a novel experimental In vitro model of isothiocyanate-induced apoptosis in human malignant melanoma cells

Background: Isothiocyanates are constituents of cruciferous vegetables which have been associated with reduced cancer risk partially through their ability to induce apoptosis in malignant cells including melanoma. Materials and Methods: We have utilized human malignant melanoma (A375), epidermoid carcinoma (A431) and immortalized keratinocyte (HaCaT) cells exposed to various isothiocyanates, under different experimental conditions. Results: An experimental in vitro model utilizing low isothiocyanate concentrations (0.1-5 μM for 48 h with all treatments being refreshed after 24h) was shown to be (i) most efficient in exerting an anti-cancer effect when compared to higher concentrations (5-100 μM for 24 or 48 h added as a single bolus) and (ii) specific to A375 cells while A431 and HaCaT cells remained unaffected. Such effect involved the activation of several caspases including (iii) initiator caspases 8, 9, 4 (indicating the involvement of intrinsic, extrinsic and endoplasmic reticulum-based pathways) and (iv) effector caspases 3, 7 and 6. Conclusion: Utilization of low isothiocyanate concentrations (under the conditions described herein) exerts an anti-cancer effect specific to human malignant melanoma cells thus providing a therapeutic basis for their utilization in management of the disease

Ectopic Pancreatic Tissue Adherent to the External Gallbladder Wall

Heterotopic pancreatic tissue can be found in the gastrointestinal tract, with the stomach and small bowel being the most common sites of localization. The gallbladder is seldom affected. Here, we report 2 cases of ectopic pancreas within the fatty tissue adherent to the organ wall. Both cases concerned young women (31 and 36 years old) who were treated with a laparoscopic cholecystectomy due to persistent abdominal symptoms thought to be related to chronic cholecystitis. Pathological examination revealed the presence of ectopic pancreatic tissue type 1

Lighting standards revisited: Introduction of a mathematical model for the assessment of the impact of illuminance on visual acuity

Purpose: Primary objective of present study is to introduce a contemporary methodology for the lighting standards update addressing both normophakic and pseudophakic patients. Methods: For the sake of our study, we theoretically estimated the intraocular-to-crystalline lens iIluminance ratio (ICIR) and the intraocular lens (IOL) luminous efficiency function VIOL (λ) as a new lighting benefit metric. Then, in a sample of 24 pseudophakic patients (38 eyes) implanted with the trifocal diffractive IOL Panoptix (SG) and in a control group (CG) of 28 normophakic participants (50 eyes), uncorrected distance visual acuity (UDVA) was measured at illuminance of 550lx (optimal UDVA). Following dark adaptation, illuminance was gradually raised from 20 lx until illuminance level that the patient reached his/her optimal UDVA. This measured illuminance at this point was defined as the minimum required illuminance level (MRIL). MRIL and UDVA for illuminance levels between 20 and 550lx in SG were compared with the corresponding values in CG. MRIL calculation allowed the construction of a predictive mathematical model that estimates the impact of environmental lighting on UDVA. Results: ICIR for Panoptix eyes ranged from 54.00% to 55.99%. Both groups had significantly higher UDVA at 550lx compared to 20lx (p < 0.05). CG had significantly higher UDVA than SG at 20lx (7.20 letters, p = 0.045), while no significant difference was detected at 550lx (0.40 letters, p = 0.883). SG required significantly more illuminance than CG to maintain their UDVA (MRILSG= 191.05lx, MRILCG= 122lx, p = 0.007). Our predictive model suggests suboptimal UDVA in a series of lighting directives for normophakic and Panoptix eyes. Conclusion: This is the first study to introduce the VIOL(λ) as a new lighting benefit metric and a mathematical model that quantifies the impact of illuminance on UDVA in normo-phakic and pseudophakic patients. Clinicaltrials.gov Identifier: NCT04263636. © 2021 Labiris et al. php and incorporate t

Radial keratotomy for the optical rehabilitation of mild to moderate keratoconus: More than 5 years' experience

PURPOSE. To present the authors' long-term experience of radial keratotomy (RK) for the optical rehabilitation of patients with mild to moderate keratoconus-central corneal thickness of greater than 400 mu m and without apical scarring

Comparison of efficacy between low-fluence and half-dose verteporfin photodynamic therapy for chronic central serous chorioretinopathy

Zeynep Alkin,1 Irfan Perente,1 Abdullah Ozkaya,1 Dilek Alp,1 Alper Agca,1 Ebru Demet Aygit,1 Selcuk Korkmaz,2 Ahmet Taylan Yazici,1 Ahmet Demirok1 1Beyoglu Eye Training and Research Hospital, Istanbul, Turkey; 2Hacettepe University Faculty of Science, Department of Statistics, Ankara, Turkey Purpose: To compare the efficacy of low-fluence photodynamic therapy (PDT) and PDT with half-dose verteporfin in chronic central serous chorioretinopathy (CSC). Patients and methods: The medical records of 64 eyes from 60 patients with chronic CSC were retrospectively reviewed; 36 eyes received low-fluence PDT (25 J/cm2) and 28 eyes received half-dose verteporfin PDT (3 mg/m2). The primary outcome measure was the proportion of eyes with complete resolution of subretinal fluid. Secondary outcome measures were the changes in best corrected visual acuity (BCVA) and central foveal thickness, and the proportion of eyes that showed an increase of ≥5 letters in BCVA at the last visit. Results: The mean follow-up period was12.5±4.3 months and 13.1±4 months in the low-fluence group and half-dose group, respectively (P=0.568). Thirty-three eyes (91.6%) in the low-fluence group and 26 eyes (92.8%) in the half-dose verteporfin group showed complete resolution of subretinal fluid (P=0.703). BCVA increased by a mean of 7.4 letters and 4.8 letters in the low-fluence group and half-dose group, respectively (P=0.336). Seventeen eyes (52.8%) in the low-fluence group and 14 eyes (50%) in the half-dose group experienced a gain of ≥5 letters in BCVA (P=0.825). In the low-fluence and half-dose verteporfin group, the mean baseline central foveal thickness was 351±90 µm and 341±96 µm, and significantly decreased to 188±61 µm and 181±47 µm, respectively (P<0.01). Conclusion: Both treatments resulted in complete subretinal fluid resolution in most of the eyes, with significantly better visual acuity outcomes compared to baseline at the last visit. Keywords: low-fluence, half-dose verteporfin, photodynamic therapy, central serous chorioretinopath