Achieving fast and secure wound closure without ocular foreign body sensation is highly desired in ophthalmologic surgery. Sutureless approaches using tissue adhesives are gaining popularity, but their practical use is limited by the difficulty in controlling adhesion time and satisfying safety standards without compromising adhesive performance. Herein, we report user-demand hydrogel-forming ocular glues based on multilength photo-crosslinkable hyaluronic acid (HA), achieving firm tissue adhesion under wet and dynamic conditions and possessing cornea-like optical transparency.The HA-based photocurable glue (HA photoglue) quickly seals wounds upon nontoxic low-energy light exposure (320-500 nm, < 5 s, < 1 J cm À2 ), and its mechanical and adhesive properties are improved by introducing short and long crosslinkable moieties into HA through one-step synthesis, forming multilength networks. Furthermore, the HA photoglue provides stable sealing in wet environments like ocular mucous surface, a clear vision with a light transmittance of more than 95% over the entire visible range, and a lubricating surface with minimal ocular sensation (generating less than 10% frictional force than suture groups). In a rabbit corneal incision model, the HA photoglue showed improved wound healing efficacy based on histological evaluation compared to control groups.
Background Endophthalmitis is a fatal ophthalmological emergency that needs prompt diagnosis and treatment. This study aimed to evaluate the clinical characteristics and investigate risk factors for the visual prognosis of the different types of endophthalmitis. Methods This retrospective study included 239 eyes diagnosed with endophthalmitis at the Pusan National University Hospital between January 2006 and December 2020. All patients were classified into six groups based on the etiology of endophthalmitis: post-cataract surgery, post-vitrectomy, post-glaucoma surgery, post-intravitreal injection, endogenous, and post-trauma. Demographics and clinical characteristics such as age, sex, laterality, initial symptoms, the interval between the primary causable event and diagnosis of endophthalmitis, initial and final visual acuity, management, and culture results were reviewed and statistically analyzed. Risk factors for poor visual prognosis were also analyzed according to the type of endophthalmitis. Results Of the 239 cases of endophthalmitis, the most common cause was post-cataract surgery, that occurs within two weeks post-surgery. Gram-positive Staphylococcus was cultured most frequently. Fusarium was characteristically cultured from delayed post-cataract surgery endophthalmitis (14 days–6 weeks post-surgery). Post-vitrectomy endophthalmitis occurred within 3.3 days post-surgery, but post-glaucoma surgery endophthalmitis developed a long period after surgery, averaging 2,742 days. Post-intravitreal injection endophthalmitis occurred most frequently following bevacizumab injection, and Staphylococcus was most commonly isolated. For endogenous endophthalmitis, the pyogenic liver abscess was the most common underlying disease, and Klebsiella was isolated most frequently. Post-traumatic endophthalmitis mostly occurred in young men. Advanced age and poor initial visual acuity were risk factors for poor visual prognosis (P = 0.041, odds ratio = 1.024 and P < 0.001, odds ratio = 3.904, respectively, using logistic regression analysis). Conclusion Advanced age and initial visual acuity were risk factors for poor visual prognosis in cases of endophthalmitis caused by various etiologies. Early diagnosis and treatment of endophthalmitis are required, especially in older patients.
Background: Postoperative intraretinal fluid (IRF) is reportedly associated with visual outcomes after epiretinal membrane (ERM) surgery. However, preoperative IRF is common, and persistent IRF would have different impact on visual function from postoperative newly developed IRF. Therefore, we aimed to investigate the incidence rate and clinical implications of perioperative IRF in ERM. Methods: Medical records of patients who underwent vitrectomy for idiopathic ERM between January 2014 and January 2017 were reviewed retrospectively. The incidence of IRF was analyzed using optical coherence tomography preoperatively and 1, 3, and 6 months postoperatively. On the basis of the presence or absence and the time of detection of IRF, patients were divided into three groups, namely preoperative IRF group, New IRF group, and IRF(−) group. Correlations of various parameters including age, sex, baseline visual acuity (VA), central subfield macular thickness, lens status, and surgical factors with IRF, along with the effect of IRF on VA, were evaluated. Results: This study included 155 eyes from 155 patients. Thirty-six (23.2%) and 49 (31.6%) eyes demonstrated preoperative and newly developed IRF, respectively. Seventy eyes (45.2%), which did not exhibit IRF during the study period, were assigned to the IRF(−) group. At baseline, the IRF(−) group showed a better VA than the other two groups. Postoperatively, VA improved significantly in all three groups. There was no difference in VA between the IRF(−) and new IRF groups at 6 months; however, the preoperative IRF group had significantly lower VA than the other two groups. Conclusion: IRF associated with ERM was frequently observed preoperatively and postoperatively, but it did not prevent postoperative vision improvement. Preoperative IRF was related to lower postoperative vision improvement.
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