Publications by authors named "Tommaso Bacci"

18 Publications

  • Page 1 of 1

Diagnostic & Therapeutic Challenges.

Retina 2020 Dec 18;Publish Ahead of Print. Epub 2020 Dec 18.

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http://dx.doi.org/10.1097/IAE.0000000000003088DOI Listing
December 2020

Uncertainty Quantification of Film Cooling Performance of an Industrial Gas Turbine Vane.

Entropy (Basel) 2019 Dec 22;22(1). Epub 2019 Dec 22.

Department of Industrial Engineering, University of Florence, Via S. Marta 3, 50139 Firenze, Italy.

Computational Fluid Dynamics (CFD) results are often presented in a deterministic way despite the uncertainties related to boundary conditions, numerical modelling, and discretization error. Uncertainty quantification is the field studying how these phenomena affect the numerical result. With these methods, the results obtained are directly comparable with the experimental ones, for which the uncertainty related to the measurement is always shown. This work presents an uncertainty quantification approach applied to CFD: the test case consists of an industrial prismatic gas turbine vane with standard film cooling shaped holes system on the suction side only. The vane was subject of a previous experimental test campaign which had the objective to evaluate the film cooling effectiveness through pressure-sensitive paint technique. CFD analyses are conducted coherently with the experiments: the analogy between heat and mass transfer is adopted to draw out the adiabatic film effectiveness, solving an additional transport equation to track the concentration of CO used as a coolant fluid. Both steady and unsteady simulations are carried out: the first one using a RANS approach with k-ω SST turbulence model the latter using a hybrid LES-RANS approach. Regarding uncertainty quantification, three geometrical input parameters are chosen: the hole dimension, the streamwise inclination angle of the holes, and the inlet fillet radius of the holes. Polynomial-chaos approach in conjunction with the probabilistic collocation method is used for the analysis: a first-order polynomial approximation was adopted which required eight evaluations only. RANS approach is used for the uncertainty quantification analysis in order to reduce the computational cost. Results show the confidence interval for the analysis as well as the probabilistic output. Moreover, a sensitivity analysis through Sobol's indices was carried out which prove how these input parameters contribute to the film cooling effectiveness, in particular, when dealing with the additive manufacturing process.
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http://dx.doi.org/10.3390/e22010016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516432PMC
December 2019

Exudative non-neovascular age-related macular degeneration.

Graefes Arch Clin Exp Ophthalmol 2021 May 26;259(5):1123-1134. Epub 2020 Nov 26.

Vitreous Retina Macula Consultants of New York, 950 Third Ave., New York, NY, 10022, USA.

Purpose: To describe the clinical and multimodal imaging (MMI) features of age-related macular degeneration (AMD) eyes presenting with intraretinal exudation and no evidence of neovascularization or structural alterations of native retinal vessels.

Methods: This was a retrospective review of the MMI and electronic health records for 3 consecutive patients presenting with unilateral exudative non-neovascular age-related macular degeneration. MMI included confocal color fundus photography (CFP), fundus autofluorescence (FAF), fluorescein angiography (FA), spectral domain optical coherence tomography (SD-OCT), swept-source optical coherence tomography angiography (SS-OCTA), and spectral domain optical coherence tomography angiography (SD-OCTA). Dense B-scan OCTA (DB-OCTA) patterns and implemented image post-processing were used to improve spatial resolution in the OCTA analysis and remove projection artifacts.

Results: Three eyes of 3 patients (1 male and 2 females, ages 72-87) developed intraretinal fluid (IRF) producing retinal edema during regular follow-up for non-neovascular AMD. FA, SS-OCTA, and DB-OCTA demonstrated no evidence of macular neovascularization or discrete retinal vascular abnormalities that could explain the IRF accumulation. Two eyes received intravitreal anti-VEGF therapy and demonstrated prompt resolution of IRF with periodic recurrences over time.

Conclusion: Exudative non-neovascular AMD is a novel clinical phenotype characterized by the presence of non-neovascular intraretinal exudation producing macular edema. Differentiating this condition from other manifestations of AMD requires appropriate use of MMI. Further study is needed to assess the clinical impact and optimal management of exudative non-neovascular AMD.
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http://dx.doi.org/10.1007/s00417-020-05021-yDOI Listing
May 2021

Vitreous incarceration in sutured vs non-sutured sclerotomies after 25-gauge macular surgery.

Eye (Lond) 2020 Oct 27. Epub 2020 Oct 27.

Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.

Objectives: To study the patterns of vitreous incarceration in sutured vs non-sutured sclerotomies in patients subjected to 25-gauge macular surgery.

Methods: A prospective study of 135 eyes affected by epiretinal membrane or macular hole. Vitreal disposition was evaluated via ultrasound biomicroscopy (UBM) at the sclerotomy sites between 30 and 40 days after surgery, once the tamponade had completely disappeared.

Results: In total, 349 sclerotomies (86.2%) of 99 patients were non-sutured while 56 sclerotomies (13.8%) of 36 patients were sutured at the end of the surgical procedure. Among the 36 patients with sutured sclerotomies, 15 out of 36 (41.6%) had at least two sclerotomies sutured. All the sclerotomy sites were evaluated (405 sclerotomies). Sclerotomy suture was significantly associated with a less aggressive pattern of vitreal incarceration (OR: 0.16, 95% CI: 0.07-0.35, p < 0.001). Compared to preoperative values, day 1 post operative IOP was not significantly different in patients with sutured sclerotomies, while patients with non-sutured sclerotomies had a significantly lower day 1 post operative IOP.

Conclusions: In 25-gauge macular surgery, UBM evaluation documented a higher rate of postoperative vitreous incarceration in the non-sutured sclerotomies, confirming the previously postulated role of the residual vitreous, left at the end of the surgery, in closing the sclerotomy site.
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http://dx.doi.org/10.1038/s41433-020-01234-xDOI Listing
October 2020

MicroRNA Expression in the Aqueous Humor of Patients with Diabetic Macular Edema.

Int J Mol Sci 2020 Oct 3;21(19). Epub 2020 Oct 3.

Ophthalmology Unit of the Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy.

We identified and compared secreted microRNA (miRNA) expression in aqueous humor (AH) and plasma samples among patients with: type 2 diabetes mellitus (T2D) complicated by non-proliferative diabetic retinopathy (DR) associated with diabetic macular edema (DME) (DME group: 12 patients); T2D patients without DR (D group: 8 patients); and non-diabetic patients (CTR group: 10 patients). Individual patient AH samples from five subjects in each group were profiled on TaqMan Low Density MicroRNA Array Cards. Differentially expressed miRNAs identified from profiling were then validated in single assay for all subjects. The miRNAs validated in AH were then evaluated in single assay in plasma. Gene Ontology (GO) analysis was conducted. From AH profiling, 119 mature miRNAs were detected: 86 in the DME group, 113 in the D group and 107 in the CTR group. miRNA underexpression in the DME group was confirmed in single assay for let-7c-5p, miR-200b-3p, miR-199a-3p and miR-365-3p. Of these four, miR-199a-3p and miR-365-3p were downregulated also in the plasma of the DME group. GO highlighted 54 validated target genes of miR-199a-3p, miR-200b-3p and miR-365-3p potentially implied in DME pathogenesis. Although more studies are needed, miR-200b-3p, let-7c-5p, miR-365-3p and miR-199a-3p represent interesting molecules in the study of DME pathogenesis.
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http://dx.doi.org/10.3390/ijms21197328DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7582592PMC
October 2020

Heat Shock Protein 90 Involvement in the Development of Idiopathic Epiretinal Membranes.

Invest Ophthalmol Vis Sci 2020 07;61(8):34

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Purpose: This work was aimed to further characterize cells of idiopathic epiretinal membranes (iERMs). We wanted to determine the contribution of 90-kDa heat shock protein (HSP90) to sustain the transforming growth factor-β (TGF-β)-mediated signal transduction pathway in iERM.

Methods: Immunofluorescence and confocal microscopy were carried out on deplasticized sections from 36 epiretinal membranes processed for electron microscopy and on frozen sections from five additional samples with antibodies against α-smooth muscle actin (αSMA), vimentin, glial fibrillary acidic protein (GFAP), SMAD2, HSP90α, type-II TGF-β1 receptor (TβRII), type-I collagen, and type-IV collagen. In addition, Müller MIO-M1 cells were transfected with HSP90 and challenged with TGF-β1.

Results: Double and triple labeling experiments showed that a variable number of TβRII+ cells were present in 94.1% of tested iERMs and they were mostly GFAP-/αSMA+/vimentin+/HSP90α+. In almost half of the cases these cells contained type-I collagen, suggesting their involvement in matrix deposition. HSP90 overexpressing MIO-M1 cells challenged with TGF-β1 showed increased levels of TβRII, SMAD2, SMAD3, and phosphor-SMAD2. Nuclear SMAD2 staining could be observed in HSP90α+ cells on frozen sections of iERMs.

Conclusions: Cells in iERMs that express TβRII are also HSP90α+ and show the antigenic profile of myofibroblast-like cells as they are GFAP-/αSMA+/vimentin+. HSP90α-overexpressing MIO-M1 cells challenged with TGF-β1 showed an increased activation of the SMAD pathway implying that HSP90α might play a role in sustaining the TGF-β1-induced fibrotic response of iERM cells.
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http://dx.doi.org/10.1167/iovs.61.8.34DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425702PMC
July 2020

Bacillary Layer Detachment in Bilateral Diffuse Uveal Melanocytic Proliferation Masquerading as Neovascular AMD.

Ophthalmic Surg Lasers Imaging Retina 2020 07;51(7):413-417

Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare and unusual paraneoplastic ocular syndrome with generally poor prognosis. The authors present a case of BDUMP in a patient with bladder cancer, examined with current multimodal imaging. In the clinical setting with drusen and exudative macular detachments, the fundus simulated neovascular age-related macular degeneration, warranting standard-of-care therapy. The imaging actually showed the typical manifestations of BDUMP, but also newly recognized, associated manifestations, including the bacillary layer detachment, a gravitating retinal detachment, and multifocal choroidal hyperpermeability, but no evidence of neovascularization. Recognition of these associated manifestations is of value in appreciating the pathophysiology of this paraneoplastic disorder. Based on the imaging, the correct diagnosis was possible along with a better understanding of the nature of the clinical features in the posterior fundus. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:413-417.].
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http://dx.doi.org/10.3928/23258160-20200702-07DOI Listing
July 2020

Novel Multimodal Imaging and Volume Rendering of Type 3 Macular Neovascularization.

Retina 2020 Oct;40(10):e55-e57

Vitreous Retina Macula Consultants of New York, New York, New York.

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http://dx.doi.org/10.1097/IAE.0000000000002892DOI Listing
October 2020

High-Resolution OCT Angiography Features of an Early Type 3 Neovascularization.

Ophthalmology 2020 07;127(7):887

Vitreous Retina Macula Consultants of New York, New York, New York; Department of Ophthalmology, New York University School of Medicine, New York, New York.

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http://dx.doi.org/10.1016/j.ophtha.2020.03.036DOI Listing
July 2020

Retinal Vasculitis and Intraocular Inflammation after Intravitreal Injection of Brolucizumab.

Ophthalmology 2020 10 25;127(10):1345-1359. Epub 2020 Apr 25.

Bascom Palmer Eye Institute, University of Miami Leonard M. Miller School of Medicine, Miami, Florida.

Purpose: To evaluate features and outcomes of eyes with retinal vasculitis and intraocular inflammation (IOI) after intravitreal injection (IVI) of brolucizumab 6 mg/0.05 ml for treatment of neovascular age-related macular degeneration.

Design: Retrospective case series.

Participants: Fifteen eyes from 12 patients identified from 10 United States centers.

Methods: Review of patient demographics, ophthalmologic examination results, and retinal imaging findings.

Main Outcome Measures: Baseline and follow-up visual acuity (VA), prior anti-vascular endothelial growth factor (VEGF) injections, clinical presentation, retinal findings, fluorescein angiography results, and treatment strategies.

Results: The number of previous anti-VEGF IVIs ranged between 2 and 80 in the affected eye before switching to brolucizumab. Retinal vasculitis and IOI were diagnosed at a mean of 30 days after brolucizumab IVI. Mean VA before brolucizumab IVI was 0.426 logarithm of the minimum angle of resolution (logMAR; Snellen equivalent, 20/53) and VA at diagnosis of retinal vasculitis was 0.981 logMAR (Snellen equivalent, 20/191; range, 20/25-20/1600; P = 0.008). All affected eyes showed IOI with variable combinations of focal or elongated segmental sheathing and discontinuity of small and large retinal arteries, sclerotic arteries, regions of vascular nonperfusion, cotton-wool spots, Kyrieleis plaques, irregular venous caliber with dilated and sclerotic segments, perivenular hemorrhages, and foci of phlebitis. Fluorescein angiography revealed delayed retinal arterial filling, retinal vascular nonperfusion, and variable dye leakage from affected vessels and the optic nerve. Systemic evaluation for embolic causes was unrevealing in 2 patients, and 3 patients showed negative laboratory assessment for uveitis. Treatment consisted of various combinations of corticosteroids (systemic, intravitreal, and topical), and 2 eyes underwent vitrectomy without improvement in vision. After a mean follow-up of 25 days, mean VA was 0.833 logMAR (Snellen equivalent, 20/136), which was reduced compared with baseline (P = 0.033).

Conclusions: Retinal vasculitis and IOI after brolucizumab IVI are characterized by variable occlusion of large or small retinal arteries, or both, and perivenular abnormalities. It may span from peripheral vasculitis to occlusion of large retinal arteries around the optic nerve or macula with severe vision loss. A high index of suspicion is required because vitreous cells may obscure visualization of retinal details.
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http://dx.doi.org/10.1016/j.ophtha.2020.04.017DOI Listing
October 2020

Vitreomacular interface alterations following peripheral laser retinopexy: Interface changes after laser.

Eur J Ophthalmol 2020 Sep 20;30(5):941-947. Epub 2019 Sep 20.

Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.

Aim: To demonstrate the morphological outcomes of macular hole following prophylactic peripheral laser retinopexy (PPLR).

Methods: Our retrospective case-control analysis included 92 eyes, 55 in the laser group and 37 in the non-laser group. Fifty-five patients were subjected to prophylactic peripheral laser retinopexy in preparation for pars plana vitrectomy for macular hole, with and without vitreomacular adhesion (laser group). Before and after prophylactic peripheral laser retinopexy, we evaluated any changes in vitreomacular anatomy by optical coherence tomography. Optical coherence tomography changes were also analyzed in the visits preceding pars plana vitrectomy in 37 macular hole eyes not subjected to prophylactic peripheral laser retinopexy (non-laser group).

Results: In the laser group, 7 out of 55 eyes (12.7%) showed macular hole closure (6 out of 18 macular hole eyes with vitreomacular adhesion (33.3%) and 1 out of 37 eyes without vitreomacular adhesion (2.7%)), while no patients showed macular hole closure in the non-laser group (p < 0.05). The mean width of the seven closed macular hole was 191.4 µm (range: 59-282 µm). In all except one of the six macular hole eyes with vitreomacular adhesion, the macular hole closed without vitreomacular adhesion release. In our analysis of the patient subgroup with vitreomacular adhesion, we observed a release of vitreomacular adhesion in 3 out of 18 eyes (16.6%) in the laser group and in 1 out of 13 eyes (7.6%) in the non-laser group (p > 0.05).

Conclusion: These findings support a possible beneficial role for prophylactic peripheral laser retinopexy in selected individuals with macular hole.
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http://dx.doi.org/10.1177/1120672119876547DOI Listing
September 2020

Long-term evaluation of corneal sub-basal nerve recovery after photorefractive keratectomy and influence of pars plana vitrectomy.

J Cell Physiol 2019 05 11;234(5):7459-7466. Epub 2018 Nov 11.

Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, Pennsylvania.

The corneal sub-basal nerve (SBN) plexus is destroyed during photorefractive keratectomy (PRK) and its recovery is still a matter of debate. In vivo confocal microscopy (IVCM) was used to evaluate SBN plexus in 23 patients at a distance of 10-25 years (mean 15.6 years) from myopic PRK. Because 8 out of the 23 PRK patients underwent pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment, IVCM was also performed on those patients 6 months after PPV. Thirteen patients matched for age and myopia served as controls (non-PRK). SBN plexus was markedly reduced after PRK compared with non-PRK eyes and showed a slow, continuous but incomplete recovery up to the end of our follow-up (range 10-25 years). PRK and non-PRK eyes showed a marked reduction in SBN density 6 months after PPV, thus demonstrating a detrimental effect exerted by PPV on SBN plexus.
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http://dx.doi.org/10.1002/jcp.27504DOI Listing
May 2019

Publisher Correction: TGF-β concentrations and activity are down-regulated in the aqueous humor of patients with neovascular age-related macular degeneration.

Sci Rep 2018 Jun 29;8(1):10141. Epub 2018 Jun 29.

University of Siena, Department of Biotechnology, Chemistry and Pharmacy, Siena, 53100, Italy.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.
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http://dx.doi.org/10.1038/s41598-018-28203-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6023889PMC
June 2018

Corneal Subbasal Nerve Density and Sensitivity After Pars Plana Vitrectomy Using Contact or Noncontact Wide-Angle Viewing Systems.

Cornea 2018 Sep;37(9):1130-1137

Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.

Purpose: To assess corneal subbasal nerve density (SBND) and corneal sensitivity (CS) after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD) without intraoperative 360-degree laser treatment using contact or noncontact panoramic viewing systems.

Methods: This is a prospective study of 34 eyes affected by RRD, which underwent PPV using contact (18 eyes) and noncontact (16 eyes) panoramic viewing systems; 12 eyes which underwent scleral buckling, and 17 eyes which underwent cataract surgery. SBND and CS were assessed before surgery and 3 and 6 months postoperatively by in vivo confocal microscopy and Cochet-Bonnet esthesiometry.

Results: Compared with baseline values, at 6 months, SBND and CS decreased in both contact PPV (SBND preoperative value: 19.1 ± 3.7 mm/mm; SBND postoperative value: 3.5 ± 1.3 mm/mm; CS preoperative value: 5.1 ± 0.5 cm; CS postoperative value: 1.5 ± 0.4 cm) and in noncontact PPV groups (SBND preoperative value: 19.5 ± 3.8 mm/mm; SBND postoperative value: 8.7 ± 2.3 mm/mm; CS preoperative value: 5.3 ± 0.5 cm; CS postoperative value: 2.5 ± 0.7 cm) (P < 0.001 for all comparisons). SBND reduction was greater in the contact PPV group than in the noncontact PPV group (P < 0.001). By contrast, the scleral buckling and cataract surgery group values were unchanged (P > 0.1 for all comparisons). In multivariate analysis, no significant effect was found for cataract surgery associated with PPV, pseudophakia, surgical time, intraocular pressure, or for laser in horizontal sectors for PPV groups. SBND was highly correlated with CS (r = 0.93).

Conclusions: A contact viewing system reduces SBND after PPV more than a noncontact system does.
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http://dx.doi.org/10.1097/ICO.0000000000001656DOI Listing
September 2018

TGF-β concentrations and activity are down-regulated in the aqueous humor of patients with neovascular age-related macular degeneration.

Sci Rep 2018 05 23;8(1):8053. Epub 2018 May 23.

University of Siena, Department of Biotechnology, Chemistry and Pharmacy, Siena, 53100, Italy.

Controversy still exists regarding the role of the TGF-β in neovascular age-related macular degeneration (nAMD), a major cause of severe visual loss in the elderly in developed countries. Here, we measured the concentrations of active TGF-β1, TGF-β2, and TGF-β3 by ELISA in the aqueous humor of 20 patients affected by nAMD, who received 3 consecutive monthly intravitreal injections of anti-VEGF-A antibody. Samples were collected at baseline (before the first injection), month 1 (before the second injection), and month 2 (before the third injection). The same samples were used in a luciferase-based reporter assay to test the TGF-β pathway activation. Active TGF-β1 concentrations in the aqueous humor were below the minimum detectable dose. Active TGF-β2 concentrations were significantly lower at baseline and at month 1, compared to controls. No significant differences in active TGF-β3 concentration were found among the sample groups. Moreover, TGF-β pathway activation was significantly lower at baseline compared to controls. Our data corroborate an anti-angiogenic role for TGF-β2 in nAMD. This should be considered from the perspective of a therapy using TGF-β inhibitors.
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http://dx.doi.org/10.1038/s41598-018-26442-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5966430PMC
May 2018

CD93 as a Potential Target in Neovascular Age-Related Macular Degeneration.

J Cell Physiol 2017 Jul 30;232(7):1767-1773. Epub 2016 Nov 30.

Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy.

In patients with age-related macular degeneration (AMD), choroidal neovascularization is the major cause of severe visual loss. In these patients, the persistence of neovascular growth despite vascular endothelial growth factor-A blockage needs the discovery of new endothelial cell targets. The glycoprotein CD93, highly expressed in activated endothelial cells, has been recently involved in the regulation of the angiogenic process both as transmembrane and soluble protein. Choroidal neovascular membranes from patients affected by AMD were examined by immunofluorescence using anti-CD93 and anti-von Willebrand factor antibodies. Blood vessels within intraocular and extraocular neoplasias were used as controls for CD93 expression. All choroidal neovascular membranes displayed strong CD93 staining in the von Willebrand factor-positive endothelial cells, consistently with the analyses showing a high colocalization coefficient in the blood vessels. Intraocular and extraocular tumor vessels showed similar results, whereas the normal choroid displayed blood vessels with only faint CD93 staining. Additionally, the concentration of soluble CD93 was determined in the aqueous humor of patients affected by naïve neovascular AMD by enzyme-linked immunosorbent assays. Age-matched cataract patients served as controls. Soluble CD93 was significantly increased in the aqueous humor of naïve neovascular AMD patients and tended to decrease after treatment with an antiangiogenic drug. In conclusion, both transmembrane and soluble CD93 are overexpressed in patients with neovascular AMD, indicating that CD93 may represent a potential new antiangiogenic target in the treatment of choroidal neovascularization. J. Cell. Physiol. 232: 1767-1773, 2017. © 2016 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/jcp.25689DOI Listing
July 2017

Impact of intraoperative topical hydroxypropyl methylcellulose 2% versus sodium hyaluronate 1.2% on corneal reepithelialization after intentional epithelial debridement during vitrectomy.

Cornea 2014 Sep;33(9):942-5

Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.

Purpose: The aim of this study was to assess the impact of the intraoperative use of topical hydroxypropyl methylcellulose (HPMC) 2% versus sodium hyaluronate 1.2% on corneal reepithelialization time and final corneal status after intentional epithelial debridement during vitrectomy for proliferative vitreoretinopathy.

Methods: Forty eyes of 40 patients were included in the study, divided into 2 groups of 20 eyes. HPMC 2% and sodium hyaluronate 1.2% were used as corneal protectors in the first and second group, respectively. Patients' charts were reviewed to determine any differences between the HPMC 2% and sodium hyaluronate 1.2% groups in relation to the preoperative, intraoperative, and postoperative factors that could impact postoperative corneal reepithelialization. Postoperative reepithelialization time and final corneal status were recorded.

Results: No significant between-group differences in preoperative, intraoperative, and postoperative factors were found. Reepithelialization time was significantly shorter in the sodium hyaluronate 1.2% group than in the HPMC 2% group, although reepithelialization was eventually achieved in every patient in both groups. Corneal sequelae were significantly more frequent in the HPMC 2% group than in the sodium hyaluronate 1.2% group.

Conclusions: The choice of the ophthalmic viscosurgical device for intraoperative corneal protection may significantly influence the postoperative corneal status after complicated retinal detachment.
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http://dx.doi.org/10.1097/ICO.0000000000000201DOI Listing
September 2014

F6H8 as an Intraoperative Tool and F6H8/Silicone Oil as a Postoperative Tamponade in Inferior Retinal Detachment with Inferior PVR.

J Ophthalmol 2014 2;2014:956831. Epub 2014 Jan 2.

Department of Ophthalmology, Catholic University Sacro Cuore-Policlinico A. Gemelli, Rome, Italy.

Purpose. To evaluate the effectiveness and safety of perfluorohexyloctane (F6H8) for intraoperative flattening of the retina and of F6H8/silicone oil (SO) 1000 cSt as a postoperative tamponade for inferior retinal detachment with inferior proliferative vitreoretinopathy. Methods. This is a retrospective review of 22 patients who underwent pars plana vitrectomy using F6H8 as an intraoperative tool to flatten the retina. At the end of the surgery a direct partial exchange between F6H8 and SO 1000 cSt was performed, tamponing the eye with different ratios of F6H8/SO (70/30, 60/40, 50/50, 40/30, and 30/70). Anatomical and functional results and complications were evaluated over the follow-up period (mean 22.63 months). Results. F6H8 was efficacious for intraoperative flattening of the retina. Twenty-one of the 22 patients achieved a complete retinal reattachment. Postoperative visual acuity (VA) ranged from light perception to 20/70, with 72% of patients obtaining VA better than 20/400. No emulsification/inflammation was observed whatever the ratio of F6H8/SO used. With higher ratios of F6H8/SO (70/30 and 60/40) cloudiness of the tamponade was observed. A transparent mixture was present with all the other ratios. Conclusions. The surgical technique adopted is very simple and safe. The optimal F6H8/SO ratio seems to be between 50/50 and 30/70.
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http://dx.doi.org/10.1155/2014/956831DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941958PMC
March 2014