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1.
Yael Kusne M&#x;hamed Temkit Nandita Khera Dharmendra R. Patel Joanne F. Shen 《The ocular surface》2017,15(4):784-788
Purpose
Dry eye symptoms greatly impact patients' quality of life in ocular graft-versus-host disease (oGVHD). Various ocular surface changes have been reported in oGVHD, including meibomian gland atrophy (MGA) and clinical conjunctival scarring or subepithelial fibrosis (CSEF). The relationships between CSEF, MGA, and other ocular surface changes in oGVHD were examined.Methods
Charts of 21 consecutive GVHD patients examined by a single ophthalmologist were retrospectively reviewed. International Chronic Ocular Graft-vs-Host-Disease Consensus Group (ICCG) scores were calculated for each patient using previously published methods. The severity of CSEF by slit lamp examination and MGA by infrared meibography were also assessed for each patient. Infrared meibography images were analyzed using ImageJ to determine percent of MGA. Pearson correlation coefficients were calculated using SAS Studio 9.3 (SAS Institute, Cary, NC).Results
In the 42 eyes, no significant correlations were identified among the variables examined (CSEF score, ICCG score, MGA). Further examination revealed asymmetric ocular findings in 20 of 21 patients. Analysis of the more severe eye alone (n = 21) revealed a weakly positive correlation between ICCG score and CSEF (r = 0.54; p = 0.01). No other statistically significant correlations were found.Conclusions
Clinical CSEF may be an important sign of GVHD impact on the ocular surface and may be relevant in oGVHD severity assessment. Though meibomian glands and conjunctiva are in close proximity, MGA did not correlate with clinical CSEF findings. Some ocular GVHD patients may present with asymmetrical ocular findings, with one eye displaying more severe pathological changes and symptoms despite the systemic nature of GHVD. Further studies are needed to examine these findings. 相似文献2.
Sridevi Nair Murugesan Vanathi Manoranjan Mahapatra Tulika Seth Jasbir Kaur T. Velpandian Alok Ravi Jeewan Singh Titiyal Radhika Tandon 《The ocular surface》2018,16(3):352-367
Aim
To analyze tear cytokines levels and their correlation to ocular surface parameters in allogenic hematopoietic stem cell transplants (allo-HSCT) patients.Methods
Prospective longitudinal study of allo-HSCT patients and controls for ocular surface evaluation (OSDI, TBUT, Schirmer's test, staining scores), tear biochemical analysis for protein, cytokines [IL-10, IL-12, IL-2, IL-4, IL-6, IL-17, interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, VEGF], MMPs [MMP 2, 9, 7, 13, 10 and chemokine (IL-8)], & VEGF on three consecutive follow up visits (at three monthly interval) was done.Results
Of 24 post allo-HSCT patients (19 males, 5 females) & 12 controls (mean age 34.3 + 5.8 years) enrolled, 20 patients [mean age 33.4 + 7.77 years; mean time of recruitment of 5.2 + 2.12 months following alloHSCT] who completed three consecutive follow up visits were included for analysis. Ocular GVHD (oGVHD) was seen in 8 patients (33.3%). Tears biochemical analysis showed elevated levels of interferon γ, IL 6, IL 8, IL 10, IL 12AP70, IL 17A, MMP 9 and VEGF in oGVHD eyes as compared to non-oGVHD & control eyes. Non-oGVHD eyes showed elevated tear MMP 7 and MMP 9 as compared to healthy controls. Tear protein levels were significantly decreased in oGVHD eyes and were equivocal in nonGVHD and control eyes. TBUT and ocular staining scores to correlate best with tear interleukins and MMPs.Conclusion
Evaluation of levels of tear VEGF, total protein & MMP 9 can be of significance in identifying oGVHD in post alloHSCT patients. 相似文献3.
Purpose
To evaluate long-term ocular surface clinical signs and symptoms response to therapy in patients with chronic ocular GVHD.Methods
Retrospective review and data modeling. We reviewed the records of post-bone marrow transplantation patients who were newly diagnosed with ocular GVHD and initiated therapy, and analyzed changes in symptoms (Ocular Surface Disease Index [OSDI]; Symptom Assessment in Dry Eye [SANDE]) and signs (corneal fluorescein staining [CFS]; Schirmer test). We used a LOESS technique to fit a model in function of data variations and obtain a predictive value of the scores progression over time.Results
The records of 123 patients who were followed-up for over 2 years (up to 62 months) were reviewed. The median baseline scores recorded were: OSDI 52 units, SANDE 62.2 units, CFS 2.0 Oxford units, and Schirmer 4?mm. After six months of follow up, scores improved for OSDI (?18.6 units, p?=?0.007), SANDE (23.7 units, p?=?0.01), and CFS (?0.7 Oxford units, p?<?0.001). Data analysis showed that after a 2-year follow up the three parameters continued to improve: OSDI -13.67 units (27% reduction), SANDE -17.55 units (28%), CFS -1.1 units (54%), but Schirmer test scores progressively worsened ?1.2?mm (22%).Conclusion
In patients with ocular GVHD symptoms and corneal fluorescein staining improved after initiation of treatment, meanwhile Schirmer scores declined progressively. This indicates that appropriate treatment in chronic ocular GVHD can lead to mid- and long-term improvements in symptoms and corneal epitheliopathy; however, sustained reduction in Schirmer test scores suggests chronic tear production impairment. 相似文献4.
Albert Y. Cheung Brad M. Genereux Brittney Dautremont Amit Govil Edward J. Holland 《The ocular surface》2018,16(3):294-300
Purpose
To report the clinical features, management, and outcomes of patients with ocular surface damage secondary to Roman candle explosion accidents.Methods
Retrospective, noncomparative, interventional case series of 11 patients with Roman candle explosion-related ocular surface injuries referred to the Cincinnati Eye Institute between 2007 and 2016.Results
Eleven patients (10 male, 1 female, mean age 22.4 years) sustained unilateral ocular surface injuries with presenting visual acuity ranging from count fingers to light perception. All patients had severe limbal stem cell deficiency with total ocular surface failure. Eight eyes received a conjunctival-limbal autograft (CLAU) with a keratolimbal allograft (KLAL), 1 eye received a living related-conjunctival limbal allograft (lr-CLAL) with a KLAL, and 2 eyes received a CLAU with lr-CLAL. Nine eyes underwent subsequent penetrating keratoplasty, and 7 eyes had reconstructive eyelid surgery. Nine eyes demonstrated improved visual acuity at last follow-up; seven eyes demonstrated a stable ocular surface at last follow-up. Nonadherence was noted in 7 patients, either with poor adherence with post-operative treatment or poor follow-up; this portended a worse visual result.Conclusions
Roman candle-related accidents can lead to severe ocular surface injury. Despite total ocular surface failure, these eyes can achieve good postoperative visual results following limbal stem cell transplantation and subsequent keratoplasty with appropriate compliance. 相似文献5.
Aaron B.C. Wong Michael T.M. Wang Kevin Liu Zak J. Prime Helen V. Danesh-Meyer Jennifer P. Craig 《The ocular surface》2018,16(3):289-293
Purpose
To assess tear film parameters, ocular surface characteristics, and dry eye symptomology in patients receiving topical anti-glaucoma medications.Methods
Thirty-three patients with a diagnosis of open angle glaucoma or ocular hypertension, receiving unilateral topical anti-glaucoma medication for at least 6 months, were recruited in a cross-sectional, investigator-masked, paired-eye comparison study. Tear film parameters, ocular surface characteristics, and dry eye symptomology of treated and fellow eyes were evaluated and compared.Results
The mean?±?SD age of the participants was 67?±?12 years, and the mean?±?SD treatment duration was 5.3?±?4.4 years. Treated eyes had poorer non-invasive tear film breakup time (p?=?0.03), tear film osmolarity (p?=?0.04), bulbar conjunctival hyperaemia (p?=?0.04), eyelid margin abnormality grade (p?=?0.01), tear meniscus height (p?=?0.03), and anaesthetised Schirmer value (p?=?0.04) than fellow eyes. There were no significant differences in dry eye symptomology, meibomian gland assessments, and ocular surface staining between treated and fellow eyes (all p?>?0.05).Conclusions
Adverse changes in tear film stability, tear osmolarity, conjunctival hyperaemia, and eyelid margins were observed in treated eyes. This suggests that inflammatory mechanisms may be implicated in the development of dry eye in patients receiving long term topical anti-glaucoma therapy. 相似文献6.
Michael T.M. Wang Leslie Tien Alicia Han Jung Min Lee Dabin Kim Maria Markoulli Jennifer P. Craig 《The ocular surface》2018,16(4):424-429
Purpose
To investigate the influence of blinking on tear film parameters, ocular surface characteristics, and dry eye symptomology.Methods
A total of 154 participants were recruited in an age, gender and ethnicity-matched cross-sectional study, of which 77 exhibited clinically detectable incomplete blinking, and 77 did not. Blink rate, dry eye symptomology, tear film parameters, and ocular surface characteristics were assessed in a single clinical session.Results
Overall, a higher proportion of participants exhibiting incomplete blinking fulfilled the TFOS DEWS II dry eye diagnostic criteria (64% versus 44%, p?=?0.02), with an odds ratio (95% CI) of 2.2 (1.2–4.2) times. Participants exhibiting incomplete blinking had higher Ocular Surface Disease Index scores (18?±?13 versus 12?±?9, p?=?0.01), and greater levels of meibomian gland dropout (41.3?±?15.7% versus 27.5?±?14.1%, p?<?0.001). Furthermore, poorer tear film lipid layer thickness, non-invasive tear film stability, expressed meibum quality, eyelid notching, and anterior blepharitis grades were also observed in those exhibiting incomplete blinking (all p?<?0.05). Blink frequency did not correlate significantly with any ocular surface parameters (all p?>?0.05).Conclusions
Incomplete blinking was associated with a two-fold increased risk of dry eye disease. The greater levels of meibomian gland dropout, as well as poorer expressed meibum quality and tear film lipid layer thickness, observed would suggest that incomplete blinking may predispose towards the development of evaporative dry eye. 相似文献7.
Arthur Ferrero Seydou Alassane Christine Binquet Lionel Bretillon Niyazi Acar Louis Arnould Aurore Muselier-Mathieu Cécile Delcourt Alain M. Bron Catherine Creuzot-Garcher 《The ocular surface》2018,16(1):112-119
Purpose
To estimate the prevalence of dry eye disease (DED) in the elderly and to describe systemic and ocular factors associated with DED in a population-based study, the Montrachet (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases) study.Methods
Dry eye symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. A self-reported history of dry eye symptoms and artificial tear use were also recorded. Every participant underwent an ophthalmic evaluation, which included the Schirmer test without anesthesia (Schirmer I), tear film breakup time (TFBUT) measurement, and fluorescein corneal staining evaluation.Results
A total of 1045 subjects were included in the study. The mean age was 82.2 ± 3.8 years. The prevalence of DED according to symptoms, signs, or both was 34.4% [95% confidence interval ({CI)} 31.5–37.2], 34.5% [95% CI 31.6–37.3] and 13.0% [95% CI 10.9–15.0], respectively. Compared with men, women were more likely to self-report DED and artificial tear use, more often displayed an OSDI >22, and more often suffered from subjective and definite DED. In multivariate analysis, associated factors with definite DED were an educational level of short secondary school (to age 15 years), best-corrected visual acuity <20/60, dark iris color, systemic hypertension, and anxiolytic agent and antihistamine eye drop use.Conclusion
Dry eye disease is a major ophthalmologic condition with a high prevalence among the elderly. We report well-documented factors associated with DED and new associations deserving further investigation. 相似文献8.
9.
Janika Nättinen Antti Jylhä Ulla Aapola Amalia Enríquez-de-Salamanca José Pinto-Fraga Alberto López-Miguel María J. González-García Michael E. Stern Margarita Calonge Lei Zhou Matti Nykter Hannu Uusitalo Roger Beuerman 《The ocular surface》2018,16(1):84-92
Purpose
It was hypothesized that tear protein biomarkers could predict the effects of topical steroid treatment and desiccating stress in patients with dry eye disease (DED). To test this concept, a randomized, double-masked, controlled clinical trial with 41 patients was conducted.Methods
The patients were treated topically with either 0.1% fluorometholone (FML) or polyvinyl alcohol (PA). Tear samples were collected using 1 μl glass capillaries at recruitment into the study and after a 3-week treatment period, both before and after 2 h exposure to desiccating stress, in a controlled environment chamber. Relative quantification of tear proteins was conducted by NanoLC-MSTOF using sequential window acquisition of all theoretical mass spectra (SWATH). Ocular surface integrity (corneal and conjunctival staining and conjunctival hyperemia) was selected as the key DED-related sign and analyzed with proteomic data. Analysis of covariance (ANCOVA) and linear models were used to analyze the data with R.Results
758 proteins were identified and relatively quantified from each tear sample. Analysis revealed 9 differentially expressed proteins between FML and PA treatments after 3 weeks and 7 after desiccating stress (P < 0.05). We also identified several differentially expressed proteins at the initial collection, which could be used to predict changes of conjunctival and corneal staining and conjunctival hyperemia after FML treatment and after desiccating stress. These proteins include complement C3 (C3) and calmodulin like 5 (CALML5), which could also differentiate the severity of DED at baseline.Conclusions
The identified proteins could be further used as biomarkers to identify patients most benefiting from FML treatment. 相似文献10.
Shao Dan Zhang Jing Na He Tong Tong Niu Shan Shan Liu Chiu Yeung Chan Chun Yang Ren Chi Liu Chi Pui Pang Yang Qu Ruo Xi Li Hai Lin Wang 《The ocular surface》2018,16(1):70-76
Objective
To investigate the bacterial profile in the conjunctiva and meibomian glands in patients before penetrating ocular surgeries, and to compare the anti-bacterial efficacy of 0.5% levofloxacin and its combination with meibomian gland massage.Design
Hospital-based, case-control study.Participants
Two hundred and twenty-six eyes from 226 patients with non-infective ocular diseases and scheduled for penetrating ocular surgeries.Methods
Tested eyes were administered topical 0.5% levofloxacin (4 times daily) for 2 days. Among them, 91 eyes received meibomian gland massage before levofloxacin application. Samples from the conjunctival sac and meibomian glands were collected for aerobic and anaerobic cultures.Main outcome measures
Culture-positivity and bacterial strains.Results
Before treatment, aerobes and anaerobes were cultured from 38.5% and 11.0% of the conjunctival samples respectively, compared with 38.5% and 8.8% in the meibomian secretions respectively. Staphylococcus epidermidis and Propionibacterium acnes were the commonest isolated aerobe and anaerobe. Two-day application of levofloxacin reduced aerobic growth to 29.6% in the conjunctiva and 19.3% in the meibomian glands. It had no effect on the anaerobes in these regions (13.3% in the conjunctiva and 10.4% in the meibomian glands). Combined levofloxacin with meibomian gland massage further reduced aerobic growth to 19.8% in the conjunctiva and 11.0% in the meibomian glands. It also drastically decreased anaerobic growth in the meibomian glands (1.1%).Conclusions
Meibomian glands carrying considerable bacteria should be considered as a potential source of contamination in ocular surgery. Meibomian gland massage shows additional anti-bacterial effects to topical levofloxacin and could be recommended as a complementary preoperative prophylaxis. 相似文献11.
Andres S. Parra Bryan M. Roth Taylor M. Nguyen Li Wang Stephen C. Pflugfelder Zaina Al-Mohtaseb 《The ocular surface》2018,16(2):254-258
Purpose
To describe changes in visual acuity in patients fit with the Prosthetic Replacement of Ocular Surface Ecosystem (PROSE) with irregular corneas compared to those with ocular surface disease, as well as describe patient demographics and fitting indications for PROSE at an academic medical center.Methods
A retrospective chart review from 2010 to 2016 on a total of 825 eyes from 493 patients fitted with a PROSE lens, and grouped by etiology, either irregular cornea/dystrophy or ocular surface disease and associated sub-etiologies. We compared best corrected visual acuity (BCVA) before and after PROSE fitting.Results
The irregular cornea group (n?=?262 eyes) included corneal scar (n?=?57), dystrophy (n?=?17), post-operative corneal irregularity (n?=?70), and primary ectasia (n?=?118). The OSD group included 563 eyes. For all etiologies combined, mean BCVA prior to PROSE fitting compared to after improved by 0.28 logMAR (p?<?.001). In the irregular cornea group, the mean BCVA improved by 0.46 logMAR (p?<?.001), while the improvement in BCVA for the OSD group was 0.20 logMAR (p?<?.001). All etiologies in the irregular cornea group demonstrated improvement in BCVA (p?<?.05) with the exception of post-PRK (n?=?2). BCVA improvement was found for all sub-etiologies in the OSD subgroup (p?<?.05).Conclusions
PROSE treatment had a positive impact on visual acuity for a wide range of corneal irregularities and ocular surface disease, suggesting that PROSE lenses may offer improvements in visual acuity without risks inherent to surgery. 相似文献12.
Giuseppe Giannaccare Federico Bernabei Marco Pellegrini Mario Arpinati Francesca Bonifazi Mariarosaria Sessa Piera Versura Emilio Campos 《The ocular surface》2019,17(1):98-103
Purpose
To assess eyelid metrics in the setting of chronic ocular graft versus-host disease (oGVHD), and to further correlate them with hematological and ocular characteristics.Methods
Prospective case-control study conducted at a single tertiary-referred Center. The following eyelid tests were performed in oGVHD patients and control subjects: vertical lid pull; anterior/lower distraction; lateral/medial distraction; distance between lateral canthal angle and orbital rim; margin reflex distances (MRD) 1 and 2; duration of tarsus exposure; snap back. Correlations of eyelid metrics with hematological and ocular parameters in the oGVHD group were performed.Results
Twenty-seven patients with oGVHD and 27 healthy matched subjects were finally included. Significantly higher values of vertical lid pull, anterior/lower distraction, lateral/medial distraction, and distance between lateral canthal angle and orbital rim were found in the oGVHD group compared to controls (always p?<?0.02). Conversely, MRD1 was lower in oGVHD patients compared to controls (p?<?0.001). Duration of tarsus exposure and snap back test were pathological in a higher percentage in oGVHD group compared to controls (respectively 66.7 and 59.3% vs 33.3 and 25.9%; p?<?0.005). Vertical lid pull test was significantly higher in oGVHD patients with superior limbic keratoconjunctivitis (13.8?±?2.4 vs 10.9?±?2.4, p?=?0.010). Ocular GVHD patients with subtarsal fibrosis had a higher percentage of pathological values for duration of tarsus exposure test (77.3 vs 20.0%; p?=?0.014).Conclusions
The present study highlighted for the first time higher eyelid laxity in oGVHD patients. This intriguing association may add a further piece to the puzzle of clinical features occurring in the setting of oGVHD. 相似文献13.
Colm McAlinden Rongrong Gao Qinmei Wang Senmiao Zhu Jing Yang Ayong Yu Anthony J. Bron Jinhai Huang 《The ocular surface》2017,15(2):202-210
Purpose
To assess the psychometric properties of Chinese versions of the Ocular Comfort Index (OCI), Ocular Surface Disease Index (OSDI) and McMonnies questionnaires. Further, to assess the correlation between questionnaire scores and objective dry eye disease (DED) clinical tests.Methods
Translated versions of the OCI, OSDI and McMonnies questionnaires were completed in a random order by 238 participants with DED. Objective clinical tests included visual acuity (VA), fluorescein tear film break-up time (TBUT), corneal fluorescein staining, Schirmer I testing and meibomian gland grading. Rasch analysis was used to assess questionnaire psychometrics and spearman rank for correlations.Results
For the OCI, the person separation was 2.31, item infit and outfit statistics ranged from 0.74–1.14 and 0.75–1.32, respectively, and targeting 1.54 logits. For the OSDI, person separation was 0.94. None of the three subscales provided valid measurements based on Rasch analysis. For the McMonnies questionnaire, person separation was 1.17, item infit and outfit statistics ranged from 0.7 to 1.21 and 0.51–3.49, respectively. There were weak correlations between questionnaire scores and clinical tests. There were weak correlations between OSDI scores and VA, fluorescein TBUT, Schirmer I testing and corneal fluorescein staining. There were weak correlations between McMonnies scores and VA, fluorescein TBUT, Schirmer I testing, and corneal fluorescein staining and meibomian gland grading.Conclusions
The OCI questionnaire was the only questionnaire that provided valid measurement on the basis of Rasch analysis, although slight multidimensionality was found. There were weak correlations between OCI scores and fluorescein TBUT, Schirmer I testing, and corneal fluorescein staining. Due to this paradoxical disconnect between symptoms and signs and the repeatability of tests, the use of both subjective and objective markers in the clinical management of patients or as endpoints in clinical trials would appear prudent. 相似文献14.
Mohsen Bahmani Kashkouli Sayyed Amirpooya Alemzadeh Hossein Aghaei Farzad Pakdel Parya Abdolalizadeh Mahya Ghazizadeh Farideh Moradpasandi 《The ocular surface》2018,16(4):458-462
Purpose
To compare the subjective versus Objective dry eye disease (DED) in patients with moderate-severe thyroid eye disease (TED).Method
Included were the patients with moderate-severe TED and ≥18 years old. They completed the ocular surface disease index (OSDI) questionnaire and had Schirmer, Tear breakup time (TBUT), fluorescein staining, osmolarity, corneal aesthesiometry, and meibomian gland dysfunction (MGD) tests. Excluded were patients with history of any disease, surgery and or medications which might be affecting the ocular surface and incomplete tests results. Subjective DED was defined as OSDI score of ≥13 and objective as one abnormal sign (TBUT, Schirmer, Osmolarity, and Staining). Presence of both was defined as definite DED.Results
Included were 38 patients (74 eyes) with mean age of 40 years. Subjective DED was detected in 77%, objective in 89.2%, and definite in 67.7% of the eyes. Severe subjective and objective DED were found in 36.5% and 24.3% of the eyes, respectively. TBUT was the most frequent positive test (63.5%). MGD was observed in 56.8% of the eyes. Mean clinical activity score, palpebral fissure, rundle grading, proptosis, corneal aesthesiometry, and presence of MGD were not significantly different between the eyes with and without subjective, objective, or definite DED.Conclusion
Definite DED was found in more than 2/3 of the eyes with moderate-severe TED. While frequency of objective DED was higher, severe form of subjective DED was more frequent. No variable was significantly different between the eyes with and without subjective, objective and definite DED. 相似文献15.
Purpose
To perform a bibliometric analysis in the field of dry eye disease (DED) research to characterize the current international status of DED research and to identify the most effective actors (journals, countries, authors) involved in this field.Methods
Scientometric methods were used to evaluate global scientific production and development trends in DED research, using the Web of Science Core Collection.Results
The growth of the literature related to DED averaged 12.18% over the last 10 years. A total of 5522 original and review articles, published in 821 different journals, were identified. The USA was the most productive country with 34.53% of the overall articles studied and 46.10% of the overall citations. The Ocular Surface published a very high percentage of articles related to DED relative to the total number of articles published (31.87%). The most productive institutions and the most frequently cited articles were from the USA and Japan. A network visualization map for country collaboration revealed that most European countries developed most of their collaborations with countries belonging to their own continent, which was not the case for the USA or Japan. A total of 41,956 KeyWords Plus were found with an average of 7.6 (SD = 3.15) KeyWords Plus per article.Conclusions
This study provides a broad view of the current status and trends in DED research and may help clinicians, researchers and policy makers better understand this research field and predict its dynamic directions. 相似文献16.
Alireza Baradaran-Rafii Siamak Delfazayebaher Nasser Aghdami Ehsan Taghiabadi Shahram Bamdad Danial Roshandel 《The ocular surface》2017,15(4):789-794
Purpose
To evaluate the midterm outcomes of penetrating keratoplasty (PKP) after cultivated oral mucosal epithelial transplantation (COMET) in patients with bilateral total limbal stem cell deficiency (LSCD) due to chemical burn.Methods
In this prospective interventional nonrandomized case series, optical PKP was performed in patients with severe stromal opacity after successful COMET. Main outcome measures were stability of the ocular surface, visual acuity improvement and corneal graft survival.Results
Fourteen eyes of 14 patients with successful COMET were included. Time interval between PKP and COMET was 7.6 ± 1.3 months (6–9 months). Mean follow-up period was 28.2 ± 8 months (14–40 months, median 30 months). Epithelial healing was complete after 7 days in all eyes. Thirteen eyes had stable ocular surface without epithelial defect at final examination. The corneal surface had been covered by a transparent epithelium without significant neovascularization. Persistent epithelial defect developed in one eye 3 months after PKP which was considered as graft failure. Best-corrected visual acuity increased from 2.67 ± 0.08 LogMAR preoperatively to 0.64 ± 0.27 LogMAR after PKP (P < 0.001). Endothelial rejection occurred in four patients and was successfully managed by systemic and topical corticosteroids. Overall and rejection-free graft survival rates were 92.9 and 69.2%, respectively.Conclusion
PKP after COMET is a successful procedure which can be used to restore visual function in cases with bilateral total LSCD associated with severe stromal opacity due to chemical burns. 相似文献17.
Alessandro Lambiase Benjamin D. Sullivan Tannin A. Schmidt David A. Sullivan Gregory D. Jay Edward R. Truitt Alice Bruscolini Marta Sacchetti Flavio Mantelli 《The ocular surface》2017,15(1):77-87
Purpose
The objective of this clinical trial (NCT02507934) was to assess the efficacy and safety of recombinant human lubricin as compared to a 0.18% sodium hyaluronate (HA) eye drop in subjects with moderate dry eye disease (DED).Methods
DEWS Grade 2-3 subjects were randomized to use lubricin (N=19, 51.9 ± 11.8 years) or HA (N=20, 61.8 ± 13.3 years). After a saline washout period, subjects administered BID therapy for 7 days, followed by instillation as needed (2–6 drops per eye) for 7 days. Visual analog scale (VAS) including foreign body sensation, burning/stinging, itching, pain, sticky feeling, blurred vision and photophobia were primary outcomes, with secondary endpoints of corneal fluorescein staining, Schirmer test, tear film breakup time (TFBUT), eyelid and conjunctival erythema and number of instillations compared at day 14.Results
The primary endpoint was met. Lubricin supplementation achieved greater than a 72% reduction from baseline in foreign body sensation (P<.013), burning/stinging, pain, sticky feeling (P<.0432), blurred vision (P<.0013), and photophobia (P<.011) in at least one eye. Lubricin also showed significant improvement in fluorescein staining (OD/OS: 43.8%/50.0%, vs. 26.5%/23.3%, P<.0398, P<.0232), TFBUT (P<.010), SANDE frequency (P<.0435), eyelid erythema (P<.004), conjunctival erythema (P<.0013), and instillations (P<.04) as compared to HA. No treatment-related adverse events occurred during the investigation.Conclusions
Recombinant human lubricin was shown to produce significant improvement in both signs and symptoms of dry eye disease as compared to HA. 相似文献18.
Rubens Belfort Neto Jordan Isenberg Alexandra G. Castillejos Renato Sant&#x;ana Andre O. Romano 《The ocular surface》2018,16(3):337-340
Purpose
To evaluate the safety and 1-year effect of pattern scanning laser photocoagulation treatment for pedunculated papillomatous and sessile conjunctival lesions in a low-resource setting with extremely limited operating room access.Methods
Adult patients with clinical diagnosis of conjunctival papilloma underwent complete ophthalmologic exam including anterior segment photography. After topical anesthesia and toluidine blue 1% instillation, the lesion was treated by pattern scanning photocoagulation using a duration time that varied from 20 to 100?ms and power from 600 to 1800?mW, treating the entire lesion surface with a 2?mm margin. Patients were examined weekly for a month then monthly and underwent retreatment as necessary.Results
Six patients and seven eyes that had clinically significant non-malignant pedunculated or sessile papillomatous lesions were treated. All lesions responded to treatment, with complete resolution after an average of 2.3 sessions. Procedures were well tolerated with only minor mild discomfort persisting up to two days post-treatment. Patients were followed for a mean follow-up time of 13 months with no recurrences reported.Conclusion
Short-term results of the pattern scanning laser photocoagulation approach, with toluidine blue for papillomatous conjunctival lesions are favorable with a 100% success rate in this cohort. This rate is comparable to surgical excision. This novel strategy proved to be a less resource intensive alternative that not only could demonstrate its usefulness in settings with chronic operating room shortages, but also in recurrent cases. Longer follow-ups with a larger sample size and cost-analysis are necessary to confirm our findings. 相似文献19.
Marwan Atallah Madhura Joag Anat Galor Guillermo Amescua Afshan Nanji Jianhua Wang Victor L. Perez Sander Dubovy Carol L. Karp 《The ocular surface》2017,15(4):688-695
Purpose
Coexistence of an ocular surface disease can mask the typical features of ocular surface squamous neoplasia (OSSN). The purpose of this study was to evaluate high resolution optical coherence tomography (HR-OCT) as an adjunct in the detection and differentiation of OSSN within coexisting ocular surface pathologies.Methods
Retrospective study of 16 patients with ocular surface disease and lesions suspicious for OSSN that were evaluated with HR-OCT. HR-OCT images of the lesions were taken to look for evidence of OSSN. Biopsies were performed in all cases, and the HR-OCT findings were compared to the histological results.Results
Of the 16 patients with OSSN and a coexisting ocular surface disease, 12 were found to have OSSN by HR-OCT and all were subsequently confirmed by biopsy. Two patients had OSSN with rosacea, one with pingueculum, two within pterygia, one with Salzmann’ nodular degeneration, six with limbal stem cell deficiency (LSCD)/scarring. In all 12 cases HR-OCT images revealed classical findings of hyper-reflective, thickened epithelium and an abrupt transition from normal to abnormal epithelium. OSSN was ruled out by HR-OCT in four cases (2 Salzmann's, 1 mucous membrane pemphigoid, and 1 LSCD). Negative findings were confirmed by biopsy. HR-OCT was used to follow resolution of the OSSN in positive cases, and it detected recurrence in 1 case.Conclusions
While histopathology is the gold standard in the diagnosis of OSSN, HR-OCT can be used to noninvasively detect the presence of OSSN in patients with coexisting ocular conditions. 相似文献20.
Jelle Vehof Nicole Sillevis Smitt-Kamminga Simone A. Nibourg Christopher J. Hammond 《The ocular surface》2018,16(2):242-248