No effects of long-term sildenafil treatment on ocular functions

Purpose Sildenafil is a new and effective oral medication for the treatment of erectile dysfunction. The purpose of this study was to assess the long-term effects of sildenafil on visual acuity, color vision, intraocular pressure (IOP), electroretinography (ERG), blue-on-yellow and white-on-white Humphrey visual field (HVF), and tear functions. Methods Ten impotent patients ingested 50 mg of sildenafil one or more times a week for a minimum of 3 months. Ten age-matched subjects without any ophthalmological disorders other than refractive problems served as controls. Visual acuity (Snellen), color discrimination (Ishihara), and a slit-lamp examination were performed on the patients. Cotton thread and Schirmer I tests and tear break-up time were applied to random eyes of all subjects. IOP was measured in both eyes of the patients by Goldmann applanation tonometry. Both eyes of each subject were tested with white-on-white (fastpac 30-2, size 3 stimulus) followed by blue-on-yellow (fastpac 30-2, size 5 stimulus) HVF analyzer. ERG in scotopic (dark-adapted) condition was performed with unipolar corneal electrodes and rod response was recorded. Results In comparison with control, no clinically or statistically significant differences were detected in the patients ingesting sildenafil with regard to the visual acuity, color discrimination, IOP, mean deviation, cotton thread and Schirmer I tests, tear break-up time, amplitude, and implicit time of b-wave. Conclusion Long-term treatment with sildenafil did not produce any significant abnormality on ocular functions. Repeated exposures of ocular tissues to therapeutic doses of sildenafil are unlikely to impair their functions. The authors do not have any significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes, unlabeled, unapproved, or investigative products or devices.     

Comparison of the inferior oblique weakening by disinsertion or disinsertion-resection and tucking in the patient with infantile esotropia

The effectiveness of disinsertion vs disinsertion-resection and tucking procedure of the inferior oblique muscle for infantile esotropia was studied. Preoperative muscle overaction scores were +3.2±0.6 and +3.3±0.48 for the two groups, respectively. Postoperatively, there was +0.52 average score in five Group I cases, whereas there were none in Group 2. We conclude that the disinsertion-resection and tucking procedure is more effective than simple disinsertion. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which include unlabeled, unapproved, or investigative products or devices.     

Tear Film and Ocular Surface Evaluation in Gestational Diabetes Mellitus

Background: Dry eye syndrome is one of the complaints of diabetic patients. The aim of the present study was to evaluate the tear functions in pregnant women with gestational diabetes mellitus (GDM) using tests: Schirmer, tear break-up time (TBUT), and tear film osmolarity (TFO) tests and the Ocular Surface Disease Index score (OSDI). Methods: Pregnant women with GDM (Group 1, n=46) and healthy pregnant women (Group 2, n=36) were enrolled. Initially, all participants were asked to answer the OSDI and then they underwent a detailed ophthalmic examination including Schirmer, TBUT, and TFO tests. The individuals with ocular or systemic disorders that might affect the tear function tests and who were using topical medications were excluded. Results: The results of Schirmer, TBUT, TFO tests and OSDI scores were 11.20±4.93 mm, 5.59±2.16 sec, 309.65±14.80 mOsm/L, and 9.59 ± 9.69 in Group 1, respectively, and 12.33±5.33 mm, 5.67±2.68 sec, 308.36±16.00 mOsm/L, and 10.62±8.66 in Group 2, respectively. There was no significant difference in any of the tear function tests and OSDI scores between the study groups (p>0.05). Conclusion: GDM seems to have no negative effects on tear function tests. This may be due to a lack of duration of hyperglycemia long enough to affect the tear function tests of pregnant women.     

Effects of topical metranidazole in ocular rosacea

Purpose To determine the indirect ocular effects of facially applied metranidazole in rosacea. Methods In this prospective study, 20 patients with ocular rosacea and 10 normal reference subjects were involved. Ten patients with ocular rosacea were treated with topical metranidazole for 8 weeks and the other 10 patients with ocular rosacea were observed as controls. Study parameters included impression cytology from upper-bulbar conjunctiva (UBC) and inferonasal-interpalpebral conjunctiva (IPC), tear break-up time (TBUT), Schirmer tests, and ocular symptoms and signs. Results Both UBC and IPC of ocular rosacea patients before treatment showed Grade 1 or greater advanced changes in comparison with the normal eyes. After 8 weeks of facial metranidazole application, improvements in ocular signs and symptoms were observed. TBUT increased to 10.1±2.8 seconds from 6.4±2.7 seconds (p<0.01). Schirmer test values of treated patients and of normal subjects were statistically comparable (p>0.05). Conclusion Facial application of topical metranidazole had an indirect treating effect on ocular rosacea. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes, unlabeled, unapproved, or investigative products or devices.     

Combined trabeculotomy-trabeculectomy as a first surgical procedure for primary congenital glaucoma

Early surgical results (mean follow-up=163 days) following combined trabeculotomy-trabeculectomy as a first surgical procedure for 20 consecutive cases in 14 children with primary congenital glaucoma were retrospectively examined. Mean pretreatment intraocular pressure was 25.55±9.58 mmHg, decreasing to 14.55±6.15 mmHg following treatment. Primary combined trabeculotomy-trabeculectomy was a useful initial procedure to control intraocular pressure in primary congenital glaucoma. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which include unlabeled, unapproved, or investigative products or devices.     

Repeatability of the phenol-red thread and tear thinning time tests for tear film function

Reliable tear function tests are required both in clinical practice and for research. Between-sessions repeatability of the phenol-red thread and tear thinning time tests was assessed for 17 young normal Caucasian subjects on two consecutive days. A single phenol-red thread result and the mean of three tear thinning times were recorded on each day. The minimum phenol-red thread result was 11 mm, and the 68 per cent and 95 per cent confidence intervals for repeatability were ± 5 mm and ± 10 mm, respectively. We propose diagnostic criteria of less than 11 mm for low tear secretion and less than 16 mm for a borderline result, based on the 68 per cent confidence interval. A level of measurement effect on repeatability of tear thinning time was present (Spearman's rho = 0.79, p = 0.002), with longer times showing greater variability: this relationship was eliminated by logarithmic data transformation. The tear thinning time test was not sufficiently reliable for clinical use; for a result of 15 seconds, there was 95 per cent confidence that subsequent times would lie between 57 and three seconds. We recommend further investigation into the use of log scales for tear stability tests.     

Autologous rectal mucosal grafts on the conjunctiva of healthy rabbits

We evaluated the feasibility and viability of 10×5 mm autologous rectal mucosal grafts on the superior bulbar conjuctival surface of 25 albino rabbits. After enucleation, histopathological studies revealed a mean goblet cell count of 190 cells per ×400 field and squamous cell metaplasia did not exceed 20%. Rectal mucosa transplantation into the conjuctiva of healthy rabbit’s eyes is possible. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Effect of pterygium excision by limbal conjunctival auotografting on tear function tests

We investigated the effects of pterygium excision using the limbal conjunctival autografting technique on the tear function tests in 14 eyes of 13 patients. Since no difference was found in the Schirmer and tear break-up time tests at one and six months postoperative vs preoperative pterygium excision does not affect tear function test results during short-term follow up. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which include unlabeled, unapproved, or investigative products or devices.     

Are high-water-content contact lenses safe?

We examined the role of tear secretion on contact lens water content during selection. Tear secretion was estimated using Schirmers tests. High-water-content contact lenses compromised the tear film more than low-water-content contact lenses, hence they should not be advised in low or marginal Schirmers test cases. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which include unlabeled, unapproved, or investigative products or devices.     

Estimating intraocular pressure using a glass rod

Four masked examiners studied the usefulness of the glass-rod for estimating intraocular pressure (IOP) in a living, anesthetized rabbit eye manometrically set to 135 different random values. With training, the average error in IOP estimation improved from 7.42±5.56 mmHg to 5.13±4.48 mmHg. Gentle palpation of the corneal apex with a glass-rod provides tactile and visual clues that may assist in estimating the IOP. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which include unlabeled, unapproved, or investigative products or devices.     

翼状胬肉切除联合角膜缘干细胞移植术前术后的泪膜变化

目的：探讨翼状胬肉切除联合角膜缘干细胞移植手术前、术后泪膜功能的变化。方法：对24例24眼翼状胬肉患者行逆向胬肉切除联合自体角膜缘干细胞移植术,分别于术前1d;术后1,2mo行Schirmer试验和泪膜破裂时间（BUT）检查,比较各时间点上泪膜的稳定性。结果：患者24例术前1d;术后1,2mo SchirmerⅠ试验分别为15.5±7.81,15.76±7.39,16.00±8.05mm,BUT分别为8.15±3.611,10.05±3.03,10.50±4.26s,术前术后BUT差异具有统计学意义（P〈0.05）,Schirmer试验术后与术前比较无明显变化（P〉0.05）。结论：翼状胬肉切除联合角膜缘干细胞移植可以恢复眼表的形态及泪膜功能的稳定性。     

地夸磷索钠联合玻璃酸钠改善配戴角膜塑形镜后的泪膜稳定性

目的：探究地夸磷索钠滴眼液联合玻璃酸钠滴眼液对改善角膜塑形镜配戴后的泪膜稳定性的作用。

方法：前瞻性研究。选取2022-03/08于安徽爱尔眼科医院门诊就诊的初次配戴角膜塑形镜患者82例82眼(均取右眼数据),根据随机数字表法分为玻璃酸钠组(玻钠组)30眼、地夸磷索钠组(地夸组)24眼和地夸磷索钠联合玻璃酸钠组(联合组)28眼,各组患者均配戴同一品牌的角膜塑形镜。每位患者分别在配戴角膜塑形镜前,配戴后1 d,1 wk,1 mo进行非接触式泪膜破裂时间(NIBUT)、非接触式泪河高度(NITMH)和脂质层厚度检查,并记录患者是否有角膜点染。

结果：联合组与地夸组治疗1 mo的NITMH与NIBUT较配戴前升高(均P<0.05)。配戴1 mo,联合组的NIBUT和NITMH分别为19.74±3.29 s和0.30±0.05 mm,均优于地夸组(NIBUT：16.09±2.98 s,NITMH：0.22±0.08 mm)和玻钠组(NIBUT：15.67±3.90 s,NITMH：0.22±0.04 mm)(均P<0.01)。各组间脂质层厚度均无明显差异(均P>0.05)。各组患者角膜点染发生率无明显区别(P>0.05)。

结论：地夸磷索钠滴眼液联合玻璃酸钠滴眼液在配戴角膜塑形镜后1 mo对改善NIBUT和NITMH有更佳的效果,有效提高配戴角膜塑形镜患者的泪膜稳定性。     

Phacoemulsification with Viscodissection in Posterior Polar Cataract: Minimizing Risk of Posterior Capsule Tear

We retrospectively evaluated the efficacy of viscodissection in decreasing the risk of posterior capsule tear during phacoemulsification surgery in 23 eyes with posterior polar cataract. Eyes were randomly assigned to two groups prior to emulsification: cortical viscodissection (Group 1) or non-viscodissection (Group 2). The visual acuities similarly improved in all eyes in the two groups. Posterior capsule tear occurred in one eye in Group 1 and five eyes in Group 2 (p < 0.05). On the basis of these results, the viscodissection technique was safer and more efficient than the non-dissection technique. Drs. Taskapili, Gulkilik, Kocabora, and Ozsutcu are from the Vakif Gureba Education Hospital, Istanbul, Turkey. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices. The authors demonstrated that the viscodissection technique was safer and more efficient than the non-dissection technique during phacoemulsification surgery for posterior polar cataract.     

Tear film measurements in four different ethnic groups: Malay, Chinese, Indian and Nigerian

AIM: To compare the non-invasive tear film break-up time (NIBUT), tear break up time (TBUT), basal tear secretion (BTS) and blink rate in four ethnic groups: Malay, Chinese, Indian and Nigerian. METHODS: Totally 120 healthy (61 males and 59 females) subjects (without dry eye symptoms and ocular surface disorder) with the age 20 to 39 years were recruited; 30 were Malays, 30 were Chinese, 31 were Indians and 29 were Nigerians. Based on McMonnies questionnaire and clinical examination, normal subjects were selected. NIBUT, TBUT, BTS were assessed in only one eye (right) of each subject and blink rate was also assessed. RESULTS: There was significant difference in the NIBUT, TBUT, BTS and blink rate among 4 different ethnic groups (P=0.018, 0.001, 0.011, and 0.004 respectively). No statistically significant difference of NIBUT, TBUT, BTS and blink rate was found between the genders among different ethnic groups. Indian had higher median for NIBUT (10±6s), TBUT (7±5s) and BTS (20±20 mm) than other races. Chinese had lower median for NIBUT (7.5±4s) and TBUT (4±2s) while Malay had for BTS (9.5±16 mm) among the groups. There was no significant correlation of blink rate with NIBUT (r=-0.119, P=0.195), TBUT (r=-0.086, P=0.352), and BTS (r=-0.123, P=0.180) respectively. CONCLUSION: The tear-film measurement values are variability in four ethnic groups.     

超声乳化白内障摘除联合小梁切除术对眼表的影响

目的：采用Keratograph 5M眼表综合分析仪比较小梁切除术和超声乳化白内障摘除联合小梁切除术对眼表的影响。

方法：纳入原发性闭角型青光眼合并白内障患者62例62眼,按手术方式分为两组：小梁切除术组32例32眼,超声乳化白内障摘除联合小梁切除术组(青白联合手术组)30例30眼。运用Keratograph 5M评估术前,术后3d,1、 3mo的非侵入性首次泪膜破裂时间(NifBUT)、非侵入性平均泪膜破裂时间(NiaBUT)、泪河高度(TMH)和角膜荧光素染色评分(CFS)。

结果：术前两组患者眼表参数比较差异均无统计学意义(P>0.05)。术后3d青白联合手术组的NiaBUT、NifBUT、CFS、TMH最差,分别为10.13±1.48、12.59±1.96s、0.80±0.22分与0.31±0.02mm,变化幅度明显高于小梁切除组(均 P<0.05),术后1mo两组的各项指标均有所恢复,但直到术后3mo仍未完全恢复到术前水平。

结论：眼表综合分析仪可以客观、精确地用于评估抗青光眼手术后泪膜功能的变化。在术后3mo短期内超声乳化白内障摘除联合小梁切除术比单纯小梁切除术对眼表的影响更为严重,提示在此期间应加强对眼表的护理。     

Effects of diquafosol sodium in povidone iodine-induced dry eye model

AIM: To investigate the effects of diquafosol sodium (DQS) for dry eye model induced with povidone-iodine (PI) solution. METHODS: Ten Sprague Dawley rats as the control group. Thirty Sprague Dawley rats were used to establish the dry eye model with stimulation of 10 g/L PI for 14d, then divided rats into three groups: dry eye group with no treatment (DED group, n=10); phosphate buffer saline treated group (PBS group, n=10); diquafosol treated group (DQS group, n=10). Clinical changes were observed by tear production test, fluorescein staining, tear break-up time (TBUT) test, corneal confocal microscope and ocular surface comprehensive analyzer. Eyeballs were collected on day 10 of treatment for hematoxylin-eosin (HE), periodic acid-Schiff (PAS), and alcian blue staining. TUNEL assay, polymorphonuclear (PMN) and mucin 1 (MUC1) immunofluorescence were performed and corneal ultrastructural changes were detected by electron microscopy. RESULTS: Compared with DED and PBS groups, tear production (7.26±0.440 vs 4.07±0.474 mm; 7.26±0.440 vs 3.74±0.280 mm; all P<0.01) and TBUT (7.37±0.383s vs 1.49±0.260s; 7.37±0.383s vs 1.42±0.437s; all P<0.01) were significantly increased in DQS group. HE, PAS, and alcian blue staining and MUC1 immunofluorescence showed mucins and conjunctival goblet cells density (8.45±0.718 vs 5.21±0.813 cells/0.1 mm2; 8.45±0.718 vs 5.36±0.615 cells/0.1 mm2; all P<0.01) increased in DQS group. Confocal microscopy, PMN immunofluorescence and TUNEL staining showed inflammatory infiltration and corneal epithelial cells apoptosis decreased in DQS group. The increased number of microvilli in corneal epithelial and the recovered cell junction were observed in DQS group. CONCLUSION: PI instillation can induce goblet cells and mucin loss, epithelial cell apoptosis and inflammation, which are consistent with the pathological manifestations of dry eye. Diquafosol can repair the ocular surface damage caused by PI, reduce corneal inflammation, inhibit corneal epithelial cell apoptosis, promote mucin secretion and maintain tear film stability.     

Tear proteins of normal young Hong Kong Chinese

Background: Analysis of tear proteins is of diagnostic value for abnormal ocular conditions such as dry eye syndrome. Many studies of tear proteins have been performed on Caucasian subjects. However, little is known about these proteins in Chinese eyes. Methods: The total tear protein concentrations of 30 normal young Hong Kong Chinese were determined by the Bradford method and the modified Lowry method. Bovine serum albumin (BSA) and bovine immunoglobulin G (IgG) were both used as standards for each method. The tear protein patterns were determined by sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS-PAGE), and the concentrations of major tear proteins were quantified by scanning densitometry after SDS-PAGE. Results: The mean±SD total tear protein concentrations determined by the Bradford method, using BSA and IgG as standards, were 6.05±1.58 mg/ml and 11.48± 2.32 mg/ml respectively. The values determined by the modified Lowry method, using the same two standards, were 9.66±2.03 mg/ml and 7.53±1.80 mg/ml respectively. The mean±SD concentrations of major tear proteins were 2.73±0.82 mg/ml for lactoferrin, 0.021±0.028 mg/ml for human serum albumin, 2.89± 0.88 mg/ml for tear-specific prealbumin and 2.46±0.44 mg/ml for lysozyme. Conclusion: The results of total tear protein concentrations indicated that values obtained from different methods and different standards were not comparable. The tear protein patterns of our subjects were qualitatively similar to those reported for Caucasian subjects. However, the concentrations of the major proteins of our subjects were not in accordance with those reported previously. The main reason may be the large variability of method used. Received: 13 September 1999 Revised: 19 January 2000 Accepted: 25 January 2000     

阿奇霉素雾化熏蒸对睑板腺功能障碍的疗效评价

目的:评价阿奇霉素雾化熏蒸联合睑板腺按摩治疗睑板腺功能障碍(MGD)的有效性及安全性。方法:前瞻性研究。选择2019-01/06在本院的47例中、重度MGD患者进行阿奇霉素雾化熏蒸联合睑板腺按摩治疗。在基线、治疗1、3mo时分别记录患者眼表疾病指数问卷(OSDI)、非侵入式泪膜破裂时间(NI-BUT)、泪河高度以及睑板腺萎缩率。结果:治疗1mo的OSDI为21.43±13.14分、首次NI-BUT为9.03±6.09s、平均NI-BUT为9.72±4.05s、泪河高度为0.24±0.09mm,与基线相比有差异(均P<0.05);治疗3mo的OSDI为23.02±11.41分、首次NI-BUT为7.80±4.82s、平均NI-BUT为10.25±4.78s、泪河高度为0.24±0.09mm,与基线相比有差异(均P<0.05);治疗1mo与3mo OSDI、首次NI-BUT、平均NI-BUT和泪河高度均无差异(均P>0.05)。治疗前后的睑板腺萎缩率无差异(均P>0.05)。结论:阿奇霉素雾化熏蒸联合睑板腺按摩可有效改善中、重度MGD患者的临床症状,并且增加首次NI-BUT、平均NI-BUT和泪河高度。     

Association between tear film break up time and blink interval in visual display terminal users

AIM: To investigate the association between tear film break up time (TBUT) and blinking interval in visual display terminal (VDT) users. METHODS: Nine hundred and thirty VDT users underwent dry eye testing, and functional visual acuity (FVA) test. The blinking interval during FVA was compared with TBUT. Subjects with longer blinking interval than TBUT were considered as unstable tear film. Logistic regression analysis revealed the risk factors for unstable tear group. RESULTS: Among 930 workers, 858 subjects (92.3%) participated in this study. Almost 80% of the subjects were categorized into the unstable tear group. Unstable tear group has significantly lower Schirmer values and TBUT (17.5±11.6 vs 21.1±11.5 mm, 3.7±2.6 vs 5.7±2.7s, both P<0.001). There were no significant differences in epithelial staining or severity of symptoms. Logistic regression showed that over 40y was a risk for being unstable tear group [odds ratio (OR)=1.53; 95% confidence interval (CI)=1.06-2.20]. Contact lens use was protective factor for being in the unstable tear group (OR=0.37; 95%CI= 0.26-0.53). CONCLUSION: Subjects with shorter TBUT than blinking interval are prevalent among VDT users. Subjects over the age of 40 shows an increased risk for unstable tear film.