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  • SLACK, Inc.  (4)
  • 1
    Online Resource
    Online Resource
    Evaluation of the Safety and Long-term Scleral Biomechanical Stability of UVA Cross-linking on Scleral Collagen in Rhesus Monkeys
    SLACK, Inc. ; 2020
    In:  Journal of Refractive Surgery Vol. 36, No. 10 ( 2020-10), p. 696-702
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 36, No. 10 ( 2020-10), p. 696-702
    Abstract: To investigate the changes of retinal and choroidal parameters, scleral biomechanical strength, and ocular histopathology after scleral ultraviolet-A (UVA) cross-linking (CXL) in rhesus monkeys eyes, and to evaluate the safety and long-term biomechanical stability of scleral CXL for preventing myopia from progressing further in clinic. METHODS: Six 3-year-old male rhesus monkeys (12 eyes) were randomized to receive UVA-CXL procedures applied on the superotemporal equatorial sclera. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) were used for examination before and 1 week and 1, 3, 6, and 12 months after CXL. The stress-strain behaviors of equatorial scleral strips were analyzed 12 months postoperatively by a biomaterial tester. Hematoxylin–eosin and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) staining were performed 12 months postoperatively. RESULTS: For central retinal thickness, choroidal thickness, and flow density of central retinal superficial vascular networks, no statistical difference was noted between CXL eyes and control eyes at 12 months postoperatively ( P 〉 .05). The biomechanical stability of sclera was increased. The scleral stress and Young modulus at 8% strain corresponded to 184% and 183%, respectively, of the control values at 12 months (each P 〈 .001). No retinal damage was detected on histology in scleral CXL eyes. There was no obvious difference between scleral CXL eyes and control eyes by hematoxylin–eosin and TUNEL staining ( P 〉 .05). CONCLUSIONS: Scleral CXL with riboflavin/UVA in rhesus monkey eyes could strengthen the biomechanical properties of scleral tissues and maintain the stability for 12 months postoperatively. The UVA-CXL on the sclera of rhesus monkey eyes seems to be effective and safe. [ J Refract Surg . 2020;36(10):696–702.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20200807-01
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2020
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Three-Step Treatment of Keratoconus and Post-LASIK Ectasia: Implantation of ICRS, Corneal Cross-linking, and Implantation of Toric Posterior Chamber Phakic IOLs
    SLACK, Inc. ; 2020
    In:  Journal of Refractive Surgery Vol. 36, No. 2 ( 2020-02), p. 104-109
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 36, No. 2 ( 2020-02), p. 104-109
    Abstract: To evaluate vision and corneal surface regularity after each step of a three-step surgical treatment of keratoconus and post–laser in situ keratomileusis (LASIK) ectasia (implantation of intracorneal ring segments [ICRS], corneal cross-linking [CXL] , and implantation of toric intraocular contact lenses [ICLs]). METHODS: Thirty-one eyes of 24 patients with moderate to severe keratoconus and post-LASIK ectasia (stages II and III of Amsler–Krumeich classification) were included. All eyes underwent all three steps. The time interval between ICRS implantation and CXL was 4 to 6 weeks, and ICL implantation was performed 6 to 8 months after CXL. Visual acuity, refraction, and corneal topometric indices were evaluated with the Pentacam system (index of surface variance [ISV], index of vertical asymmetry [IVA] , keratoconus index [KI], central keratoconus index [CKI] , index of height asymmetry [IHA], index of height decentration [IHD] , and corneal wavefront parameters [eg, higher order aberrations, spherical aberration, and coma]). RESULTS: Decimal uncorrected distance visual acuity (UDVA) improved from 0.13 ± 0.17 preoperatively to 0.69 ± 0.18 at 1 year, whereas corrected distance visual acuity (CDVA) improved from 0.56 ± 0.24 to 0.80 ± 0.18, respectively. The topometric indices ISV, IVA, KI, and IHD also improved significantly, whereas CKI and IHA showed no significant improvement. Higher order aberrations, spherical aberration, and coma improved significantly compared to baseline. CONCLUSIONS: The combined use of ICRS, CXL, and ICL implantation significantly improves visual acuity, higher order aberrations, and corneal shape in moderate and severe keratoconus and post-LASIK ectasia. [ J Refract Surg . 2020;36(2):104–109.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20191217-01
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2020
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  • 3
    Online Resource
    Online Resource
    Risk Evaluation of Human Corneal Stromal Lenticules From SMILE for Reuse
    SLACK, Inc. ; 2021
    In:  Journal of Refractive Surgery Vol. 37, No. 1 ( 2021-01), p. 32-40
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 37, No. 1 ( 2021-01), p. 32-40
    Abstract: To investigate the pathogenicity and immunogenicity of human corneal stromal lenticules from small incision lenticule extraction (SMILE). METHODS: Serological testing was completed prior to sample collection to rule out infectious diseases. Pathogens herpes simplex viruses (HSV) type 1 and type 2 were screened for by real-time fluorescent quantitative polymerase chain reaction, and bacteria, fungi, and Acanthamoeba from 128 lenticules of 64 patients were cultured. A total of 132 lenticules from 93 patients were randomly assigned to the fresh group, −78 °C anhydrous glycerol preservation group (glycerol group), and 0.1% sodium dodecyl sulfate decellularization group (SDS group) in pairs and detected by immunohistochemistry, Western blot, transmission electron microscopy, transmittance, and nanoindentation. RESULTS: The fresh lenticules were all negative for HSV-1, HSV-2, bacteria, fungi, and Acanthamoeba . HLA-I A/B/C and HLA-II DR antigens were all expressed in fresh lenticules but were clearly reduced after preservation at −78 °C in anhydrous glycerol or decellularization in 0.1% SDS. The collagen fibers of the lenticules in the fresh group were regularly arranged, and the keratocytes were intact. The fibers in the glycerol group were regularly arranged, and the integrity of keratocytes was destroyed. The fibers in the SDS group were disordered and had no cellular structure. The transmittance and Young's modulus were highest in the fresh group, lower in the glycerol group, and lowest in the SDS group. CONCLUSIONS: Risk of infection is low, but risk of rejection exists on the reuse of fresh human corneal stromal lenticules from SMILE. Anhydrous glycerol preservation at −78 °C is an ideal method for reducing antigens without damaging the structure and function of lenticules. [ J Refract Surg . 2021;37(1):32–40.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20201030-03
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2021
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  • 4
    Online Resource
    Online Resource
    Regional Biomechanical Properties of Human Sclera After Cross-linking by Riboflavin/Ultraviolet A
    SLACK, Inc. ; 2012
    In:  Journal of Refractive Surgery Vol. 28, No. 10 ( 2012-10), p. 723-728
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 28, No. 10 ( 2012-10), p. 723-728
    Abstract: To evaluate the biomechanical difference of human scleral collagen cross-linking (CXL) by comparing different riboflavin-instilling methods and different cross-linked regions (equatorial and posterior sclera). METHODS: Fifteen donor human eyes were randomly divided into five groups. One group, in which CXL was not applied, was designated as the control group. In the remaining four groups, 0.1% riboflavin solution was instilled on the scleral surface for 5, 10, 20, or 30 minutes, respectively, followed by 30 minutes of ultraviolet A irradiation. The equatorial and posterior scleral strips in each eye were dissected. Stress–strain measurements of all scleral strips were performed by a biomaterial tester. Young modulus was calculated at 8% strain. Data of the stress and Young modulus in different regions and groups were compared using one-way analysis of variance. RESULTS: Under a 1 mm/minute stretching, the sclera exhibited an exponential stress–strain behavior. The stress and modulus of equatorial and posterior sclera after CXL gradually increased with riboflavin instillation before surgery. No statistical difference was noted in the modulus between 20 and 30 minutes riboflavin infiltration after CXL ( P 〉 .05). At the same strain levels, equatorial sclera with and without CXL exhibited higher stress and Young modulus than that of posterior sclera. CONCLUSIONS: Equatorial and posterior human sclera may be enhanced by CXL with riboflavin/ultraviolet A irradiation. Equatorial scleral CXL may be a good choice for the treatment of progressive myopia. Because of its safety and efficacy, 20 minutes of riboflavin infiltration before CXL is recommended.
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20120921-08
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2012
    Location Call Number Limitation Availability
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