To explore whether pyroptosis, an inflammatory type of programmed cell death, participates in the initiation and progression of myopia, and to further elucidate its regulatory role in scleral remodeling.

Scleral tissues from form-deprivation myopia (FDM) mouse models were subjected to transcriptome sequencing to screen inflammatory and cell death-related molecular characteristics. Differentially expressed gene analysis and pathway enrichment analysis were adopted to identify pyroptosis-related signaling pathways. Meanwhile, human scleral fibroblasts were treated with complement component 3a (C3a) to construct an in vitro inflammatory cell model. Western blot, immunofluorescence staining, lactate dehydrogenase (LDH) release assay and transmission electron microscopy were applied to detect extracellular matrix (ECM) alterations and the expression levels of core pyroptosis markers including NOD-like receptor family pyrin domain-containing protein 3 (NLRP3), caspase-1 and N-terminal gasdermin D (GSDMD-N).

Transcriptomic results revealed that inflammatory response, immune regulation, and pyroptosis-related pathways were significantly enriched in myopic scleral tissues, accompanied by synchronous activation of inflammasome signaling. In vitro inflammatory intervention downregulated the expression of type Ⅰ collagen and upregulated matrix metalloproteinase-2 (MMP-2), suggesting aggravated ECM degradation. The levels of interleukin-1β (IL-1β), interleukin-18 (IL-18), cell membrane permeability, as well as NLRP3, caspase-1, and GSDMD-N were obviously increased in activated fibroblasts. Immunofluorescence and ultrastructural observations further confirmed gasdermin protein-mediated cell membrane damage and typical pyroptotic morphological changes.

In vivo animal experiments and in vitro cellular studies collectively verify that the activation of inflammasome-caspase-1-GSDMD signaling axis is involved in myopia-related scleral remodeling. Pyroptosis acts as a key mechanistic bridge linking inflammatory response and scleral structural weakening, which offers novel molecular targets for the intervention and suppression of myopia progression.

To explore the effect of wearing bandage contact lenses(BCL) on the clinical symptoms and quality of life of patients after small incision lenticule extraction (SMILE).

Patients with myopic or myopic astigmatism who underwent SMILE in Peking Union Medical College Hospital from Januaryto May 2019 were collected. According to the postoperative treatment methods, they were divided into the study group and the control group. The study group wore BCL immediately after SMILE, while the control group wore transparent eye patches routinely. BLC or the transparent eye patch was removed on the first day after surgery. The severity and duration of postoperative pain, photophobia, tearing, blurred vision and other clinical symptoms, the impact of pain on quality of life, postoperative uncorrected visual acuity, non-contact intraocular pressure, spherical equivalent, overall surgical satisfaction were compared between the two groups. Meanwhile, BCL adverse reactions was recorded.

Severity scores of pain [0.2(0, 1.1) vs. 1.1(0.5, 2.1), P=0.007] and photophobia [1.0(0, 2.0) vs. 2.0(0.8, 2.3), P=0.032] as well as the duration of pain [0(0, 1.0) h vs. 2.0(0, 6.3) h, P=0.014] and photophobia [0(0, 1.0) h vs. 2.0(0, 4.3) h, P=0.006] at 24 h after surgery were significantly lower in the study group than those in the control group. There were no significant differences in the severity scores and duration of tears and blurred vision at 24 h postoperatively between the two groups(all P > 0.05). At 24 h after SMILE, the effects of pain on activity, sleep and the relationship with others were lower in the study group than those in the control group(all P < 0.05). At 7 d postoperatively, the score of overall satisfaction to the surgery of the study group was not significantly different from that of the control group[10.0(9.0, 10.0) vs. 10.0(9.0, 10.0), P=0.617]. There were no significant differences in postoperative uncorrected visual acuity, non-contact intraocular pressure, and spherical equivalent on days 1, 2, and 7 days after SMILE between the two groups (all P > 0.05). BCL related adverse effects (bulbar conjunctival hyperemia) occurred in two patients. The symptoms gradually improved after BCL removal, and the postoperative uncorrected visual acuity recovered to the best-corrected preoperative visual acuity at 7 d after surgery.

The application of BCL after SMILE can reduce the degree and duration of postoperative pain and photophobia, and improve the postoperative quality of life to a certain extent.