Effects of SMILE Surgery on Intraocular Pressure, Central Corneal Thickness, Axial Length, Peripapillary Retinal Nerve Fiber Layer, and Macular Ganglion Cell Complex Thickness

Purpose. To evaluate the change in intraocular pressure (IOP), central corneal thickness (CCT), axial length, peripapillary retinal nerve fiber layer (RNFL) thickness, and macular ganglion cell complex (GCC) thickness after small incision lenticule extraction (SMILE) surgery. Methods. This prospective observational study was conducted in Espace Nouvelle Vision, Ophthalmological Clinic, Paris, France. Fifty eyes of 25 patients were enrolled in this study and underwent SMILE surgeries. IOP, central corneal thickness (CCT), axial length (AL), peripapillary RNFL thickness, and macular GCC thickness were measured before and at 3 months after SMILE. Results. The mean preoperative spherical equivalent was −3.15 ± 1.50 diopters (D), and the mean postoperative value was 0.15 ± 0.28 D. After SMILE surgery, IOP decreased from 15.03 ± 2.79 mmHg to 11.02 ± 2.73 mmHg and 10.02 ± 2.21 mmHg at 1 and 3 months, respectively (P<0.01 for both comparisons). The mean decrease in measured IOP as a function of ablation depth was 0.065 ± 0.031 mmHg/μm. CCT decreased from 545.98 ± 26.61 μm to 478.40 ± 30.26 μm after SMILE surgery (P<0.01). AL decreased from 24.80 ± 0.84 mm to 24.70 ± 0.83 mm (P<0.01). There was no statistically significant change in mean peripapillary RNFL or mean GCC thickness after SMILE surgery. Conclusions. SMILE surgery modified IOP measurement, CCT, and AL but did not change peripapillary RNFL and macular GCC thicknesses. The postoperative drop in measured IOP might be explained by the decreased CCT. An accurate re-evaluation of AL should be performed before cataract surgery among post-SMILE patients

Effects of benzalkonium chloride on THP-1 differentiated macrophages in vitro.

PURPOSE: To characterize the effects of benzalkonium chloride (BAK) in THP-1 differentiated cells in vitro. METHODS: Macrophages were obtained after differentiation of THP-1 cells, a human monocytic leukemia cell line. Macrophages were exposed for 24 h to 33 nM (10(-5)%) benzalkonium chloride (BAK), 10 nM dinitrochlorobenzene (DNCB), 100 ng/mL lipopolysaccharide (LPS), 5 ng/mL tumor necrosis factor alpha (TNF-α) or phosphate buffered saline (PBS) as controls. The expression of CD11b, CD11c, CD33 and CD54 was evaluated using immunohistochemistry and flow cytometry (FCM). Phagocytosis function was analyzed using carboxylate-modified fluorescent microspheres and quantified by FCM. Migration was evaluated in cocultures with conjunctival epithelial cells. Cytokine production was detected and quantified in culture supernatants using a human cytokine array. RESULTS: Stimulation of THP-1-derived macrophages with a low concentration of BAK increased CD11b and CD11c expression and decreased CD33. Macrophages exposed to BAK, LPS and TNF-α had increased phagocytosis. In contrast to LPS, BAK and TNF-α increased macrophage migration. Cytokines in supernatants of macrophages exposed to BAK revealed an increased release of CCL1, CCL4/MIP-1β, TNF-α, soluble CD54/ICAM-1 and IL-1β. CONCLUSION: In vitro, BAK has a direct stimulating effect on macrophages, increasing phagocytosis, cytokine release, migration and expression of CD11b and CD11c. Long-term exposure to low concentrations of BAK should be considered as a stimulating factor responsible for inflammation through macrophage activation

Long term effect of phacoemulsification on intraocular pressure in patients with medically controlled primary open-angle glaucoma

International audienceBACKGROUND: The effect of cataract surgery on IOP in patients with primary open-angle glaucoma (POAG) is a subject of debate. We investigated the effect of cataract surgery by phacoemulsification on intraocular pressure (IOP) in patients with medically POAG .METHODS: Seventy eyes of 40 POAG patients undergoing cataract surgery by phacoemulsification were retrospectively evaluated. All patients had their POAG medically controlled without prior glaucoma surgery. Baseline demographics and clinical characteristics were recorded. IOP and the number of glaucoma medications were evaluated before and for 1 year after cataract surgery. We analyzed IOP variations from baseline with a Student t-test for a paired sample. We used a Pearson correlation coefficient and linear regression to study the relation between IOP change from baseline and preoperative characteristics.RESULTS: One year after phacoemulsification, IOP decreased by a mean 1.15 ± 3 mmHg (6.8 ± 18.1%) (P = 0.01) and the number of glaucoma medications remained unchanged with a difference of - 0.1 ± 0.43 (P = 0.09). Higher preoperative IOP was associated with a greater IOP decrease after 1 year of follow-up (P  30 mmHg, respectively. One year after cataract surgery, 75.7% of the POAG eyes maintained the same number of glaucoma medications while 17.1% had a decrease and 7.2% of the eyes required adding glaucoma medications.CONCLUSION: Cataract surgery by phacoemulsification in eyes with medically controlled POAG resulted at 1 year in a very small IOP decrease without a change in the number of glaucoma medications. A drop in IOP should not be expected after performing phacoemulsification alone in POAG patients

Percentage of cytotoxicity of PMA differentiated THP-1 exposed to reagents.

<p>Cell viability of PMA differentiated THP-1 was measured using an Annexin V/7-aminoactinomycin D (7-AAD) double staining in flow cytometry. We tested the 24 hours exposure to benzalkonium chloride (BAK), dinitrochlorobenzen (DNCB), lipopolysaccharide (LPS), tumor necrosis factor alpha (TNF-α) and phosphate buffered saline (PBS) for control. For each reagent, a panel of 4 different concentrations was tested. Grades of toxicity were separated in early apoptosis, late apoptosis, necrosis and total cytotoxicity. Results are expressed in percentage ± standard deviation (SD). Results with statistical differences (<i>P</i><0.05) compared to PBS are presented in bold.</p

Fluorescence microscopy images of carboxylate microspheres in non-differentiated THP-1 cells and in macrophages.

<p>An increased carboxylate microspheres (red) concentration is observed in macrophages (B) than in non-differentiated THP-1 cells (A). Nuclei are stained in blue (DAPI). Magnification used was ×400. Bar : 20 µm.</p

Light microscopy and fluorescence microscopy images of non-differentiated and differentiated THP-1 cells.

<p>Non-differentiated THP-1 cells (A) display a round shape and a nonadherent pattern while differentiated THP-1 cells (B) display a dendritic shape and an adherent pattern at light microscopy (×400), black scale bar : 10 µm. Fluorescence microscopy images (×200) showing CD11c expression by non-differentiated THP-1 cells (C) and differentiated THP-1 cells (D). Nuclei are stained in blue (DAPI) and CD11c is stained in red phycoerythrin (PE), white scale bar : 20 µm. A significantly increased CD11c expression was observed on differentiated THP-1 cells.</p

Quantification of carboxylate-modified fluorescent microspheres in non-differentiated THP-1 cells and macrophages.

<p>Macrophages had a higher level of phagocytosis (48.3±3%) (<i>P</i><0.0001, +) as compared to non-differentiated THP-1 cells (5.1±0.6%). Increased phagocytosis was observed after 24-h exposure to benzalkonium chloride (BAK) (<i>P</i> = 0.015, *), lipopolysaccharide (LPS) (<i>P</i><0.0001, #) or tumor necrosis factor alpha (TNF-α) (<i>P</i> = 0.03, §) as compared to macrophages exposed to phosphate buffered saline (PBS). Errors bars represent standard deviation.</p

Flow cytometry analysis of phenotypic changes of macrophages after various stimulatory substances.

<p>A: expression of CD11b : the expression of CD11b increased after benzalkonium chloride (BAK) stimulation (<i>P</i> = 0.033, *) as compared to phosphate buffered saline (PBS). B: expression of CD11c : the expression of CD11c increased with BAK (<i>P</i> = 0.005, *), DNCB (<i>P</i> = 0.004, #), lipopolysaccharide (LPS) (<i>P</i> = 0.035, §) or tumor necrosis factor alpha (TNF-α) (<i>P</i> = 0.033, +) as compared to PBS. C: expression of CD54 : the expression increased under LPS stimulation (<i>P</i> = 0.007, *) as compared to PBS. D: expression of CD33 : a decreased expression of CD33 was observed when exposed to BAK (<i>P</i> = 0.003, *) as compared to PBS. Errors bars represent standard deviation.</p

Evaluation of migration rates of non-differentiated THP-1 cells and PMA differentiated macrophages.

<p>The migration rate was higher when macrophages were exposed to benzalkonium chloride (BAK) (16.2±2.1%, <i>P</i> = 0.001,*), lipopolysaccharide (LPS) (15.1%±4.7%, <i>P</i> = 0.004, §) or tumor necrosis factor alpha (TNF-α) (29.9±4.7%, <i>P</i><0.0001, #) as compared to macrophages exposed to phosphate buffered saline (PBS). Migration was significantly higher when macrophages were exposed to TNF-α as compared to BAK (<i>P</i> = 0.004). Migration was measured in coculture with conjunctival cells except for column 2. Errors bars represent standard deviation.</p