Sun Wei, Liu Jia, Li Jing, Wu Di, Wang Jing, Wang Ming-Wu, Zhang Jin-Song, Zhao Jiang-Yue
Department of Ophthalmology, the 4th Affiliated Hospital of China Medical University; Eye Hospital of China Medical University; Provincial Key Laboratory of Lens Research, Shenyang 110005, Liaoning Province, China.
Department of Ophthalmology and Vision Science, the University of Arizona College of Medicine, Tucson, AZ 85711-1824, USA.
Int J Ophthalmol. 2018 Mar 18;11(3):401-407. doi: 10.18240/ijo.2018.03.09. eCollection 2018.
To evaluate human lens epithelium cell apoptosis and epithelial to mesenchymal transition (EMT) induced by femtosecond laser in femtosecond laser assisted cataract surgery (FLACS).
Sixty cataract patients with N2 to N3 stage according to the LOCS III were enrolled in this study and divided into three groups randomly: FLACS1 group (cataract surgery by FLACS with LenSx), FLACS2 group (cataract surgery by FLACS with LensAR) and manual group (cataract surgery by phacoemulsification). Patients in two FLACS groups performed anterior capsulotomy by LenSx or LensAR laser system. Patients in the manual group were performed continuous curvilinear capsulorrhexis (CCC) manually. The anterior capsules were fixed right after moved out of eye. Hematoxylin-eosine staining, immunofluorescence staining and real-time PCR were performed in order to observe human lens epithelium cells changes after cataract surgery.
The capsule cutting edge was shown irregularity and roughness in two FLACS groups and smooth edge in manual capsulotomy by pathologic staining. Irregularities of the cell configuration with partly swollen and destroyed nuclei were observed in two FLACS groups. Femtosecond laser could induce a significantly higher cell apoptosis in human lens epithelium cell than manually performed CCC (<0.05). Lens epithelium cells apoptosis were correlated with femtosecond laser duration according to Pearson correlation analysis. Decreased N-cadherin expression, alpha-SMA and FSP-1 level in two FLACS groups showed the inhibition of cell EMT.
Femtosecond laser may affect the apoptosis and EMT of lens epithelium cells which are under the peeled central lens capsule.
评估飞秒激光辅助白内障手术（FLACS）中飞秒激光诱导的人晶状体上皮细胞凋亡及上皮-间质转化（EMT）。
选取60例根据LOCS III分级为N2至N3期的白内障患者，随机分为三组：FLACS1组（使用LenSx的飞秒激光白内障手术）、FLACS2组（使用LensAR的飞秒激光白内障手术）和手法组（超声乳化白内障手术）。两个飞秒激光组的患者通过LenSx或LensAR激光系统进行前囊切开术。手法组患者手动进行连续环形撕囊（CCC）。取出眼球后立即固定前囊。进行苏木精-伊红染色、免疫荧光染色和实时PCR，以观察白内障手术后人晶状体上皮细胞的变化。
病理染色显示，两个飞秒激光组的囊膜切割边缘不规则且粗糙，手法撕囊的边缘光滑。在两个飞秒激光组中观察到细胞形态不规则，部分细胞核肿胀和破坏。飞秒激光诱导的人晶状体上皮细胞凋亡明显高于手动进行的CCC（<0.05）。根据Pearson相关性分析，晶状体上皮细胞凋亡与飞秒激光持续时间相关。两个飞秒激光组中N-钙黏蛋白表达、α-平滑肌肌动蛋白和FSP-1水平降低，表明细胞EMT受到抑制。
飞秒激光可能影响剥脱的中央晶状体囊膜下人晶状体上皮细胞的凋亡和EMT。
