糖尿病性眼表病变的临床研究

目的本研究通过对糖尿病患者眼表病变进行临床观测,旨在探讨糖尿病眼表并发症发生的可能机制,以寻找检测和控制糖尿病眼部并发症的可行方法。方法选取2型糖尿病患者25例,50眼为病例组;非糖尿病健康体检者(性别、年龄匹配)25例,50眼为对照组。对所有实验对象进行角膜敏感度测定、基础泪液分泌试验、泪膜破裂时间、角膜荧光素染色、结膜虎红染色及眼底血管荧光造影检查。所有实验结果量化后,通过SPSS10.0统计分析软件进行数据分析。结果糖尿病患者角膜敏感度下降、BUT值缩短、SchirmerI试验值下降、角膜荧光素染色阳性率增加、结膜粘膜退变及坏死细胞增多,与对照组均有显著差异(P<0.05),且随糖尿病视网膜病变的程度加重而加重。糖尿病患者角膜敏感度的下降以周边角膜更显著。结论糖尿病患者眼表泪膜稳定性显著下降,是引起干眼症的主要原因。对糖尿病患者进行常规的角膜敏感度测定、基础泪液分泌试验、泪膜破裂时间、角膜荧光素染色等检查,有利于糖尿病性眼表病变的早期发现及治疗。     

长期使用青光眼药物对眼表的影响

目的 探讨长期使用青光眼药物对患者眼表的影响.方法 收集局部使用青光眼药物3个月以上的患者65例108只眼,分为单种药物使用组(A组)和多种药物使用组(B组);另收集正常对照组(c组)25例25只眼.对所有观察对象进行泪膜破裂时间测定(BUT)、基础泪液分泌试验(ST)、角膜上皮荧光素染色、结膜上皮虎红染色以及结膜印迹细胞(IC)检查.结果 正常对照组BUT(12.25±5.40)s,ST(11.65±4.66)mm,A组BUT(6.97±4.87)8 9ST(7.19±5.36)mm,明显低于正常对照组(BUT P=0.000;STP=0.001). B组BUT(4.81±2.45)s,显著短于正常对照组(P=0.000)和A组(P=0.008);ST(5.20±2.97)mm,显著少于正常对照组(P=0.000)和A组(P=0.026).A组和B组的角膜荧光素染色评分和结膜虎红染色评分显著高于正常对照组.与正常对照组相比,A组和B组IC评分2-3级所占比例明显增高,结膜上皮表现出鳞状上皮化趋势.结论 长期使用青光眼药物会导致患者泪膜稳定性下降、泪液分泌减少,角膜上皮荧光素染色增多,结膜上皮杯状细胞减少、上皮细胞呈鳞状上皮化等泪膜、角膜和结膜的损伤.     

人工泪液治疗儿童干眼症的疗效观察

目的:观察人工泪液治疗儿童干眼症的疗效及安全性.方法:对58例116眼经泪膜破裂时间(tear break-up time,BUT)、泪液分泌试验(Schirmer Ⅰ test,SⅠt)、泪河高度、角膜荧光染色、睑板腺功能检查方法确诊为干眼症的儿童患者进行人工泪液治疗,疗程为1 mo,复查时再次行上述检查,对各观察指标进行统计分析.结果:儿童于眼症患者58例116眼治疗前BUT为6.03±1.19s,SⅠt为7.67±2.32mm/5min,泪河高度为0.20±0.02mm,角膜荧光染色为1.02±0.13分,睑板腺功能评分为2.45 ±0.86分.其中31例62眼为脂质缺乏型干眼、20例40眼为水液缺乏型干眼、7例14眼为其他类型.根据其分型,给予相应的人工泪液治疗,治疗1mo后患者的临床症状明显改善,BUT为13.72±1.83s,SIt为12.38±3.64mm/5min,泪河高度为0.36±0.08mm,角膜荧光染色为0.03±0.24分,睑板腺功能评分为1.57±0.93分.各观察指标与治疗前相比,差异具有统计学意义(P＜0.05).所有患者在治疗期间均未出现任何不良反应.结论:利用人工泪液治疗儿童干眼是安全、有效的.     

不同手术方式对翼状胬肉患者泪液功能的影响

目的:探讨不同手术方式对翼状胬肉患者泪液功能的影响及其可能机制。方法:翼状胬肉患者50例50眼,随机分成两组,A组30例30眼行翼状胬肉切除联合带蒂结膜瓣移植术,B组20例20眼行翼状胬肉切除联合自体角膜缘干细胞移植术,分别于术前和术后1,3mo检查泪膜破裂时间(BUT)、SchirmerI试验、角结膜荧光素染色(CFS)、泪液羊齿状物试验(TFT),采用眼表疾病指数(OSDI)评价胬肉及胬肉切除术后泪液功能变化对患者生活质量的影响,并作统计学分析。结果:两组术后1moBUT缩短、CFS增多、OSDI变高、泪液羊齿结晶形成较差,和术前比较差异有显著意义(P<0.05),而术后1moSchirmerI和术前比较差异无显著意义。两组术后3moBUT,SchirmerI,CFS,OSDI,TFT和术前比较差异无显著意义。术后1moB组BUT较A组长,CFS较A组少,OSDI较A组高,泪液羊齿结晶形成较A组良好,差异有显著意义(P<0.05),而术后1mo两组SchirmerI比较差异均无显著意义。术后3mo两组BUT,SchirmerI,CFS,OSDI,TFT比较差异均无显著意义。结论:翼状胬肉切除术后早期对泪膜功能有影响,术后3mo泪膜功能恢复至术前水平。行翼状胬肉切除联合自体角膜缘干细胞移植术后早期对泪膜功能的影响小于翼状胬肉切除联合带蒂结膜瓣移植术。     

提上睑肌缩短术后睑球粘连合并球结膜脱垂的矫治

提上睑肌缩短术后穹窿部结膜下垂是常见的并发症 ,但是睑球粘连合并角膜缘处球结膜下垂却极为少见 ,近遇一例 ,指导如下。1　病例介绍患者 ,女性 ,2 0岁 ,学生。自幼右眼上睑不能抬起。术前检查 :右上睑缘遮角膜 4ｍｍ ,提上睑肌力 4ｍｍ ,Ｂｅｌｌ征( ) ,诊断为右眼先天性单纯性上睑下垂。于 4年前在外院行右眼提上睑肌缩短术 ,术中切除提上睑肌 2 2ｍｍ。术后首次检查 :平视时 ,上睑缘平角膜上缘 ,较对侧高 1ｍｍ ,睑裂宽11ｍｍ ,闭目时暴露结膜 5ｍｍ ,眼球运动良好 ,无复视 ,Ｂｅｌｌ征 ( )。给予 0 3%环丙沙星眼水点右眼 ,夜间涂抗生…     

不同切口方式白内障摘除对泪膜稳定性的影响

目的:探讨不同方式小切口白内障摘除及人工晶状体植入术后泪膜稳定性的变化。方法:随机抽取2004-07/2005-07我院行小切口白内障摘除术的老年性白内障患者96例102眼,分3组。A:透明角膜切口组30例32眼;B:巩膜隧道切口组35例(38眼);C:角膜缘切口组31例(32眼);平均年龄(65.2±11.5)岁。检测术前1d,术后1,7,14,30d的泪膜破裂时间(breakuptime,BUT)、基础泪液分泌试验(SchirmerItest,Sit)、角膜荧光素染色积分(fluorescenceintegral,FI),下睑中央泪河高度。结果:与术前相比,透明角膜切口组术后1dBUT明显缩短;Sit,下睑中央泪河高度和角膜荧光素染色程度明显增高,差异均有显著性意义;7d时SIt,14d时下睑中央泪河高度,30d时BUT、角膜荧光素染色积分恢复至术前水平。巩膜隧道切口组术后1d仅BUT明显缩短,SIt明显增高(P<0.05),下睑中央泪河高度、角膜荧光素染色积分无明显变化;术后7d时BUT已恢复至术前水平。角膜缘切口组,4项检测指标与术前比较,差异无显著意义。结论:透明角膜切口行白内障摘除术显著降低泪膜的稳定性,巩膜隧道切口行白内障摘除术轻微影响泪膜的稳定性,而角膜缘切口行白内障摘除术对泪膜影响最小。     

睑板腺功能障碍患者96例的诊疗分析

目的：探讨睑板腺功能障碍( meibomian gland dysfunction, MGD)患者的诊疗方法,为临床治疗提供依据。
　　方法：回顾性分析2012-07/2014-06在长江大学附属第一医院眼科门诊诊治的MGD患者96例192眼,裂隙灯显微镜下进行睑缘形态和功能的检查、泪膜破裂时间( BUT)、泪液分泌试验( SIt)检查,并进行清洁睑缘、睑板腺按摩、挤压睑板、人工泪液及抗生素和激素等综合治疗。结果：睑缘、睑脂排出情况平均评分分别为3.02±0.78,1.90±0 .76。所有患者BUT均异常,平均为4.3±1.9 s;84眼SIt正常,32眼5mm/5min　　结论：MGD患者可引起干眼常见症状,通过睑板腺裂隙灯检查、BUT及SIt检查,可对患者进行及时、准确的诊断和积极治疗。     

翼状胬肉不同手术方法患者泪液功能的临床分析

目的探讨两种不同手术方式治疗翼状胬肉对泪液功能的影响及影响因素。方法选取翼状胬肉患者40例(40只眼)随机分成两组:A组20个病人(20只眼)翼状胬肉切除联合冻干羊膜移植术;B组20个病人(20只眼)翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术。术前,术后1mo,术后3mo行泪膜破裂时间(BUT)、泪液分泌试验(SchirmerI)、角膜荧光素染色(CSF),评价翼状胬肉及翼状胬肉切除术后泪膜功能变化对患者生活质量的影响。结果两组病人术后1moBUT缩短,角膜荧光素染色增多,差异有统计学意义(p<0.05),而术后SchirmerI与术前相比无统计学意义,两组术后3moBUT,SchirmerI,CFS与术前相比无统计学意义,翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术组术后早期泪膜稳定性优于翼状胬肉切除联合冻干羊膜移植术,差异具有统计学意义(p<0.05)。结论翼状胬肉切除术早期对泪膜功能有影响。翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术早期对泪膜的影响小于翼状胬肉切除联合冻干羊膜移植术。     

结膜松弛症眼表和泪液的改变

目的研究结膜松弛症患者泪液和眼表的改变。方法结膜松弛症患者23例（46眼）及年龄和性别与受试者匹配的健康志愿者15例（30眼）。所有研究对象进行裂隙灯检查、泪膜破裂时间检查,角膜荧光素染色和基础泪液分泌试验。同时进行结膜印迹细胞学检查,评价杯状细胞密度。结果结膜松弛症患者泪膜破裂时间为（3．5±1．3）s,明显较健康对照组的（8．3±1．1）S缩短（P〈0．05）;结膜松弛症患者角膜荧光素染色得分为（1．66±2．1）点,明显高于健康对照组的（0．79±1．0）点;结膜松弛症患者结膜杯状细胞密度为（580±406）个／mm^2,明显低于健康对照的（1102±356）个／mm^2（P〈0．05）。两者的泪液分泌量无明显差别。结论结膜松弛症患者存在明显的眼表和泪液损害,包括泪膜破裂时间缩短,角膜荧光素染色增加和杯状细胞减少。（中国眼耳鼻喉科杂志,2010,10：87—89）     

糖皮质激素治疗睑板腺功能障碍的临床研究

目的:探讨糖皮质激素对睑板腺功能障碍的治疗作用。方法:睑板腺功能障碍患者45例90眼,随机分为3组(各15例30眼),对照组采用抗生素滴眼液和睑板腺局部物理治疗,在对照组的治疗基础上,泪液组加用人工泪液,激素组加用人工泪液及糖皮质激素滴眼液,分别于治疗前和治疗后1wk行症状和睑缘评分、泪膜破裂时间(tear film break-up time,BUT)、角膜荧光素染色(corneal fluorescein staining,CFS)和泪液分泌试验检查(SchirmerⅠtest,SⅠt),对比分析各组检测指标。结果:各组基线值无统计学差异(P>0.05);治疗后1wk,对照组症状、睑缘评分以及CFS和基线值比较差异有显著意义(P<0.05),BUT和SⅠt则无统计学差异(P>0.05);泪液组和激素组症状评分、BUT,CFS,SⅠt、睑缘评分均较基线值显著改善,差异有统计学意义(P<0.05);激素组各指标和对照组、泪液组比较均有显著差异(P<0.05)。结论:糖皮质激素可显著改善睑板腺功能障碍患者的症状和体征,治疗效果优于单纯应用抗生素或人工泪液。     

Supratarsal triamcinolone injection in the treatment of superior limbic keratoconjunctivitis

PURPOSE: To evaluate the efficacy of supratarsal triamcinolone injection in the treatment of superior limbic keratoconjunctivitis (SLK). METHODS: Forty eyes of 20 patients were diagnosed with SLK. All eyes with long-standing severe ocular irritation unresponsive to topical steroid and artificial tears were treated with supratarsal triamcinolone injection in addition to ongoing treatment of dry eye. Objective tarsal conjunctiva inflammation, bulbar conjunctiva, cornea staining, and subjective symptom gradings were performed before and after 2 weeks of therapy. All patients underwent laboratory evaluations of underlying systemic abnormalities. RESULTS: All 40 eyes responded well to treatment and had long-term (average, 7.8 months) improvement of irritation and dry sensation and improvement of inflammation and staining of conjunctiva and cornea. Fourteen patients (70%) had associated autoimmune diseases. There were no irreversible complications related to this therapy. CONCLUSIONS: Supratarsal triamcinolone injection effectively and rapidly resolved symptoms and signs associated with SLK. It is helpful as primary or adjunctive therapy for SLK.     

Comparative sensitivity of fluorescent antibody staining of conjunctival scrapings and irradiated McCoy cell culture for the diagnosis of hyperendemic trachoma.

The sensitivity of an indirect fluorescent antibody (FA) staining technique for detecting chlamydial inclusions in scrapings from the whole conjunctiva (upper tarsus, upper fornix, and lower lid) was compared with the sensitivity of culture in irradiated McCoy cells for the diagnosis of hyperendemic trachoma. In a group of 211 patients with various grades of active trachoma from the Bandar Abbas area of Southern Iran 42 patients were positive for chlamydiae by either method. There was little difference between the rates of positivity of FA staining of the scrapings from the whole conjunctiva (28 positives) and culture in irradiated McCoy cells (32 positives). In the patients included in this study chlamydial inclusions were detected in 15 eyes by examination of FA stained scrapings taken from the upper tarsal conjunctiva, whereas inclusions were detected in 40 eyes by the additional examination of scrapings taken from the upper fornix and lower lid (P less than 0.001). The examination of FA stained scrapings taken from the whole conjunctiva and spread as a single but larger smear may provide a satisfactory alternative to cell culture methods for the diagnosis of trachoma, particularly for field studies when cell culture facilities are not available.     

Orbicularis oculi muscle stripping and tarsal fixation for recurrent entropion

This prospective study highlights the result of a new technique for correction of recurrent lower lid entropion. The technique was designed to address the aetiological factors involved based on the pre- and per-operative findings. MATERIAL AND METHODS. 37 eyelids of 31 consecutive patients with recurrent entropion were enrolled. Under local anaesthesia, a horizontal incision was made at the lower border of the tarsus, involving the total width of the lower eyelid. Anterior lamellar (skin and orbicularis oculi muscle - OOM) inferior to the incision was dissected towards the orbital rim. An ellipse of the excess overriding OOM and overlying skin inferior to the incision was excised. The OOM was fixed to the lower border of the tarsus with three to four 6/0 Vicryl subcutaneous sutures. Skin was repaired with 6/0 silk sutures, which were removed five days post-operatively. Five cases underwent horizontal lid shortening and 15 had preaponeurosis fat sculpting in addition. RESULTS. 37 procedures were performed on 31 patients (23 M & 8 F). The mean age was 76.5 yrs. (range 63-90). The patients had had one to four (mean = 1.7) previous surgeries. All patients had OOM override. Fifteen had significant preaponeurosis fat prolapse. Lower lid laxity was not identified in all cases, in some due to previous lid surgery. There was no evidence of lower lid retractor laxity in the majority of cases. After a mean follow-up time of 18 months (5-36) there were three recurrences. One underwent further tarsal fixation and the other two had horizontal lid shortening with a favourable outcome. CONCLUSIONS. Excision of overriding OOM and tarsal fixation for recurrent entropion is simple and effective. Its success is due to direct tackling of the aetiological factors.     

Efficacy of commercially available topical cyclosporine A 0.05% in the treatment of meibomian gland dysfunction

OBJECTIVE: To investigate the efficacy of topical cyclosporine A 0.05% (tCsA) (Restasis, Allergan Pharmaceuticals) in the treatment of meibomian gland dysfunction (posterior blepharitis). METHODS: Thirty-three patients with symptomatic meibomian gland dysfunction were randomized in a prospective study to either tCsA or placebo (Refresh Plus preservative-free artificial tears), 2 times daily for 3 months. They were evaluated at baseline and at 1, 2, and 3 months for subjective symptoms and objective signs including meibomian gland inclusions, lid margin vascular injection, tarsal telangiectasis, fluorescein staining, tear breakup time, and Schirmer scores. RESULTS: Twenty-six patients completed the study. All patients were tested for ocular symptoms, lid margin vascularity, tarsal telangiectasis, meibomian gland inclusions, tear breakup time, and fluorescein staining. At the 3-month visit, the tCsA group showed a greater improvement in ocular symptoms than the placebo group, but this difference was not statistically significant. At the 3-month visit, several objective examination findings were statistically significantly (P < 0.05) improved in the tCsA group compared with the placebo group. These differences included lid margin vascular injection, tarsal telangiectasis, and fluorescein staining. The most significant finding (P = 0.001) was the greater decrease in the number of meibomian gland inclusions in the tCsA group compared with the placebo group. CONCLUSIONS: Topical CsA may be helpful in the treatment of meibomian gland dysfunction (posterior blepharitis). Topical CsA did not induce an improvement in the symptoms, but it did decrease the number of meibomian gland inclusions in patients with meibomian gland dysfunction.     

The histopathology of involutional ectropion and entropion

Objective: Involutional ectropion and entropion are characterized by excessive horizontal eyelid length, which is thought to be secondary to laxity of the medial and lateral canthal tendons and to the stretching of the tarsus. Histopathological features of the surgical eyelid specimens from patients with involutional ectropion and entropion were evaluated.Design: Prospective histopathological study.Participants: Eighteen full-thickness eyelid specimens from patients with involutional ectropion and entropion were obtained during horizontal eyelid shortening procedures performed at the Ministry of Health Ankara Training and Research Hospital.Methods: All specimens were fixed in 4% formaldehyde solution and sectioned sagittally. Hematoxylin-eosin, periodic acid-Schiff, and Masson's trichrome staining were done for all specimens. Histopathologic alterations of the tarsal plate, the palpebral portion of the orbicularis muscle, and the conjunctiva were examined.Results: The patients ranged in age from 60 to 80 years. The main histopathologic features of the ectropic eyelids included collagen degeneration and elastosis of the tarsal plate, increased amounts of adipose tissue in the distal tarsus, and subacute inflammation and epidermalization of the tarsal conjunctiva. Specimens from patients with involutional entropion generally had milder degrees of these histopathological features.Conclusions: The causes of the excessive horizontal length of the eyelid, which is thought to be secondary to laxity of the medial and lateral canthal tendons, may be collagen degeneration and elastosis of the tarsal plate and canthal tendons.     

Medical ectropion repair. A new procedure

The lazy-T procedure described by Smith corrects medial ectropion of the lower lid by combining a horizontal full-thickness shortening of the lid with excision of conjunctiva and tarsus inferior to the punctum to invert the lid. However, some cases of senile medial ectropion involve an element of vertical traction on the skin as well as horizontal lid laxity. A new procedure is described that makes use of skin gained from horizontal lower lid shortening in the form of a medially based transposition flap to produce vertical skin lengthening. It is useful to treat medial ectropions that have horizontal laxity along with cicatricial components and has successfully relieved this condition in eight patients.     

Effects of sequential artificial tear and cyclosporine emulsion therapy on conjunctival goblet cell density and transforming growth factor-beta2 production

PURPOSE: To evaluate the effects of sequential treatment with artificial tears and cyclosporine emulsion on conjunctival goblet cell density and production of transforming growth factor (TGF)-beta2 in patients with dry eye disease. METHODS: Patients with dry eye disease (N = 6) defined by an Ocular Surface Disease Index symptom score >or=25, Schirmer test 1 <10 mm, and corneal fluorescein and conjunctival lissamine green staining scores >or=3 were treated with artificial tears (Refresh Plus; Allergan, Irvine, CA) 4 times a day for 4 weeks, followed by 0.05% cyclosporine emulsion (Restasis; Allergan) twice a day for 12 weeks. Impression cytology was performed on the bulbar conjunctiva of both eyes at baseline, after artificial tear therapy, and after 6 and 12 weeks of cyclosporine therapy. Goblet cells were counted in 5 representative microscopic fields per membrane in those taken from the temporal and inferior bulbar conjunctiva of the worse eye, and membranes taken from the fellow eye were immunostained for TGF-beta2. RESULTS: There were no differences in mean goblet cell density between baseline and 4 weeks of artificial tears in the temporal and inferior bulbar specimens. After 6 weeks of cyclosporine emulsion, goblet cell density was significantly greater than baseline and artificial tears in the inferior bulbar conjunctiva (P < 0.01). After 12 weeks of cyclosporine emulsion, goblet cell density was significantly greater than baseline and artificial tears in both temporal and inferior bulbar sites (P < 0.01). The number of TGF-beta2-positive goblet cells was also noted to increase after 6 and 12 weeks of cyclosporine therapy (P < 0.001). CONCLUSIONS: Cyclosporine emulsion, but not artificial tears, increases goblet cell density and production of the immunoregulatory factor TGF-beta2 in the bulbar conjunctiva in patients with dry eye.     

Total lid replacement by an autologous and homologous combination graft in emergencies

Report on 3 cases with total loss of a lid which required an "emergency lid" in order to protect the cornea. In all cases the tarsus was replaced by a strip of dura mater, the eye-lid skin by a free retroauricular graft. In all 3 cases the attempt was made to mobilize the levator and other adjacent tissue and fix them to the tarsus replacement. In one case the upper palpebral and bulbar conjunctiva was also replaced by 2 flaps of lip mucosa. In this case the lower half of the tarsal zone was rejected; however, the situation was mastered by tarsoconjunctival shifting of the lower lid with a free lid skin graft from the other eye. All "emergency lids" resulted in lid closure which protected the cornea sufficiently. The 2 patients in whom the upper lid was replaced had active lid movement of 3 to 4 mm.     

上方角膜缘角结膜炎9例临床分析

目的 分析上方角膜缘角结膜炎（superior limbic keratoconjunctivitis of Theodore,SLK）的临床表现及治疗的特点。设计  回顾性病例系列。研究对象 2013年1月至2015年12月北京同仁医院SLK患者9例。方法 回顾性分析患者的临床病历资料。主要指标 临床表现及治疗情况。结果 9例患者中女性7例（7/9）;平均年龄（40±12）岁;均双眼发病。9例患者裂隙灯下表现为上睑结膜乳头,上方球结膜梯形局限性充血,上方角膜缘新月形灰白色浸润,点簇状荧光素染色。9例中有2例甲状腺功能亢进,其中1例以眼部表现为首发。均眼局部给予人工泪液、低浓度糖皮质激素药物治疗,充血及浸润较重者给予绷带式角膜接触镜。平均治疗时间（4.4±3.7）个月,4例停药后复发,重复治疗全部治愈。结论SLK是一种慢性反复性、双眼发病的上方球结膜和上部角膜缘的炎症。局部低浓度糖皮质激素联合绷带式角膜接触镜治疗有效,但应结合全身病治疗,避免复发。（眼科,2017,26：52-55）     

Effect of gefarnate on the ocular surface in squirrel monkeys

PURPOSE: To investigate the ability of gefarnate (geranyl farnesylacetate) to stimulate goblet cell function in the primate eye after a mild alkali injury of the tarsal conjunctiva. METHODS: A bilateral injury was created on the conjunctival surface of the lower eye lid of squirrel monkeys by means of a 30-second application of a 4-mm diameter piece of filter paper wetted with 0.5% NaOH. Gefarnate drops (1%) were administered to one eye of each monkey and vehicle alone in the contralateral eye six times a day, 5 days a week for 4 weeks. Slit-lamp biomicroscopy, impression cytology staining of the ocular surface, fluorescein and rose bengal staining, and Western blot for mucin were performed before injury and weekly thereafter. Light microscopy was used to evaluate the lower conjunctiva. RESULTS: Topical application of gefarnate was not associated with any adverse ocular surface effects. Goblet cell repopulation after injury was significantly greater in the gefarnate-treated eyes compared with the vehicle-treated eyes. In the gefarnate-treated eyes, tear mucin content was significantly greater at 1 week after injury. Fluorescein staining was significantly reduced at 3 weeks after injury, and rose bengal staining was significantly reduced in the area of the wound at 2 weeks in the gefarnate-treated eyes compared with the vehicle-treated eyes; at other times, conjunctival staining in the two groups of eyes was not significantly different. CONCLUSIONS: Gefarnate promotes goblet cell repopulation and increases mucin production after a conjunctival injury. No adverse affects of the treatment were found. Thus, this agent may be useful in conditions that diminish goblet cell function.