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Re-Evaluation of the Safety of Laser-Assisted Subepithelial Keratectomy

Open Journal of Ophthalmology 2014年第3期4卷 79-85页

作者： Yuji Kumano Yumi Soejima Shinichiro Numa Hiroyasu Matsui Ikuko Zushi Masahito Shigematsu Takaaki Matsui teruo nishida Department of Oral and Maxillofacial Surgery Saga University Saga Japan Ohshima Hospital of Ophthalmology Fukuoka Japan Zushi Eye Clinic Fukuoka Japan

Purpose: Additional analyses of outcomes of laser-assisted subepithelial keratectomy (LASEK) are still necessary to improve the safety of LASEK. Therefore, in our study, outcomes were assessed retrospectively in 561 eyes that underwent LASEK treatment. Methods: Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA) and residual spherical equivalent were analyzed at 3 and 6 months postoperatively. We assessed four subgroups based on the degree of preoperative myopia considering mean BSCVA and loss of two or more lines. Results: Mean UCVAs and BSCVAs were obtained at 3 and 6 months postoperatively (1.23/1.35 and 1.23/1.37, respectively). The mean predictability was within ±0.125 diopters. Conversely, the safety indexes were 0.94 and 0.96 respectively, and the efficacy indexes were 0.86 and 0.86 at 3 and 6 months postoperatively, respectively. 8.4% eyes and 5.2% eyes lost two or more lines of BSCVA at 3 and 6 months postoperatively, respectively. The mean BSCVAs of the high or ultra-high groups were significantly lower than those of the low or mild groups both 3 months and 6 months postoperatively. The incidence rates of losing two or more lines of BSCVA in the high or ultra-high myopia groups were significantly greater than in the low or mild groups at 3 months and 6 months postoperatively. Conclusion: LASEK predictably corrected myopia achieving >1.2 in UCVA and BSCVA. However, the safety and efficacy indexes were <1.0, which were related to the loss of two or more lines of BSCVA. Since the incidence rates of losing two or more lines of BSCVA were greater in the high or ultra-high myopia groups, we consider LASEK as more safely performed in patients with low to mild preoperative myopia.

关键词： BSCVA LASEK Loss of Two or More Lines Preoperative Myopia Re-Evaluation

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Regenerative medicine of cornea by cell sheet engineering using temperature-responsive culture surfaces

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Chinese Science Bulletin 2013年第35期58卷 4349-4356页

作者： UMEMOTO Terumasa YAMATO Masayuki nishida Kohji OKANO teruo Institute of Advanced Biomedical Engineering and Science Tokyo Women’s Medical University Tokyo 162-8666 Japan Department of Ophthalmology Osaka University Medical School Osaka 565-0871 Japan

Recently,regenerative medicine has been focused on as next-generation definitive therapies for several diseases or injuries for which there are currently no effective *** therapies have been rapidly developed through the effective fusion between different fields such as stem cell biology and *** far,we have proposed"cell sheet engineering"through our core technology that simply applies alterations of the temperature which allows regulation of the attachment or detachment of living cells on the culture surfaces grafted with the temperature-responsive polymer"poly(N-isoproplyacrylamide)".This technology enables us to construct bioengineered sheet-like tissues,termed"cell sheets",without the need of using biodegradable scaffolds and protease treatments that are traditionally ***,our carrier-free cell sheets not only are independent of the issues observed in conventional methods,but also showed further advantages in the reconstruction of the corneal epithelium or endothelium(*** of optical transparency and cell-cell interactions to host stroma in reconstructed tissues).Moreover,our approach does not have issues such as immune rejection or limited number of donors,due to the use of cell sheets derived from autologous limbal(in patients with unilateral disease)or oral mucosal epithelial cells(in patients with bilateral disorders).Indeed,we have successfully performed the clinical application for the reconstruction of ocular surfaces through the transplantation of our carrier-free corneal epithelial cell sheets,as evidenced by improved visual acuity as well as long-term maintenance of postoperative health conditions on ocular surfaces in all *** have also proposed a novel approach for the reconstruction of the corneal endothelium using corneal endothelial cell sheets by demonstrating its successful ***,our cell sheet engineering technique provides a breakthrough in the field of regenerative medicine appli

关键词：干细胞生物学角膜上皮表面重建再生医学调节温度工程化反应性角膜内皮细胞

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