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Travé-Huarte S, Wolffsohn JS. Sutureless Dehydrated Amniotic Membrane (Omnigen) Application Using a Specialised Bandage Contact Lens (OmniLenz) for the Treatment of Dry Eye Disease: A 6-Month Randomised Control Trial. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:985. [PMID: 38929602 PMCID: PMC11205730 DOI: 10.3390/medicina60060985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 06/07/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: Dry Eye Disease (DED) is a chronic condition characterised by tear film instability and ocular surface disruption, significantly impacting patients' quality of life. This study aimed to provide top-level clinical evidence for the long-term efficacy of dehydrated amniotic membrane (dAM, Omnigen®) delivered via a specialised bandage contact lens (sBCL, OmniLenz) for managing moderate-to-severe DED. Materials and Methods: This randomised controlled trial (NCT04553432) involved 93 participants with moderate-to-severe DED, randomised to receive a 1-week bilateral treatment of either dAM (17 mm diameter with 6 mm central 'window') applied under a sBCL or sBCL alone. Participants were assessed at baseline and followed up at 1, 3, and 6 months post-treatment. Outcomes included changes in symptomatology, tear film and ocular surface measurements, and in vivo confocal microscopy imaging of corneal nerve parameters and corneal dendritic cell (CDC) counts. Results: The dAM-sBCL group demonstrated a 65% reduction in OSDI scores at 6 months (p < 0.001), with 88% of participants showing improvement at 1 month. Corneal staining was significantly reduced in both groups. dAM-sBCL provided significant improvements in corneal nerve parameters at 1 month, with sustained positive trends at 3 months. Additionally, dAM-sBCL significantly reduced mature CDC counts, suggesting an anti-inflammatory effect. Conclusions: Treatment with dAM-sBCL for just 1 week significantly and rapidly improved dry eye symptoms as well as ocular surface signs for at least 3 months. It also enhanced corneal nerve health while reducing activated/mature corneal inflammatory cell numbers, presenting a safe and promising new treatment for moderate-to-severe DED.
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Affiliation(s)
- Sònia Travé-Huarte
- College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK;
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Travé-Huarte S, Wolffsohn JS. Bilateral Sutureless Application of Human Dehydrated Amniotic Membrane with a Specialised Bandage Contact Lens for Moderate-to-Severe Dry Eye Disease: A Prospective Study with 1-Month Follow-Up. Clin Ophthalmol 2024; 18:1329-1339. [PMID: 38765455 PMCID: PMC11100494 DOI: 10.2147/opth.s458715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/28/2024] [Indexed: 05/22/2024] Open
Abstract
Purpose To assess changes in symptoms and ocular surface signs following a bilateral sutureless treatment of dehydrated amniotic membrane (dAM) under a specialised bandage contact lens (sBCL) in patients with moderate-to-severe dry eye disease (DED). Patients and Methods In this prospective pre-post interventional study, 35 patients diagnosed with moderate-to-severe DED, with an Ocular Surface Disease Index (OSDI) score >30 on current treatment, were enrolled. Assessments were conducted at baseline (day -30), after 30 days run-in with no additional treatment (day 0 - control), and 30 days post sBCL+dAM treatment (day 30 - treatment). Intervention involved two successive bilateral 4-5 day sutureless applications of dAM (17mm diameter, with a 6 mm central aperture, Omnigen® VIEW) under an 18mm sBCL (OmniLenz®). Symptomatology and ocular signs were measured using OSDI, Dry Eye Questionnaire-5 (DEQ-5), Symptom Assessment iN Dry Eye (SANDE), and other ocular surface health indicators including non-invasive breakup time, corneal and conjunctival staining, and lid wiper epitheliopathy length and width (LWE). Results While symptomatology remained stable during the 30-day no-treatment run-in, 1-month post-dAM treatment, there was a significant reduction in OSDI scores (from 55.8 to 32.3, p<0.001), DEQ-5 (from 14.6 to 10.0, p<0.001), SANDE frequency (from 65.2 to 43.6, p<0.001), and SANDE severity (from 59.8 to 41.1, p<0.001). Additionally, there was a notable decrease in the width of LWE staining, from grade 2 (50-75% of the lid wiper) to grade 1 (25-50% of the lid wiper) (p=0.011). Conclusion A bilateral 8-10-day treatment duration with dAM applied with sBCL demonstrated a 31 to 42% improvement in symptomatology and a decrease in ocular surface signs of mechanical stress. This innovative bilateral treatment approach offers a promising treatment modality for patients with refractory moderate-to-severe DED.
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Affiliation(s)
- Sònia Travé-Huarte
- Optometry and Vision Science Research Group, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, College of Health and Life Sciences, Aston University, Birmingham, UK
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Chen D, Xu D, Wu X, Wang J, Sheng S, Yu X, Lin X, Liu L, Ge X, Zhao H, Xu W. The efficacy of bandage contact lens in relieving the aggravation of dry eye disease after complicated cataract or/and IOL surgery. BMC Ophthalmol 2024; 24:141. [PMID: 38549070 PMCID: PMC10976755 DOI: 10.1186/s12886-024-03385-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 03/07/2024] [Indexed: 04/01/2024] Open
Abstract
PURPOSE In the present study, we aimed to evaluate the efficacy of the bandage contact lens (BCLs) in the treatment of dry eye disease (DED) after complicated cataract or/and intraocular lens (IOL) surgery. METHODS In this retrospective, single-centered, observational study, we collected data from 69 patients who underwent complicated cataract or/and IOL surgery. Of these, 35 cases wore their own BCLs immediately after the operation, while the other 34 cases did not have their own BCLs and were instead covered with gauze. The Ocular Surface Disease Index (OSDI) questionnaire, slit-lamp microscope examination, keratograph analysis, and Schirmer I test were measured at baseline, 1 week and 1 month postoperatively. RESULTS In the BCL group, the score of the OSDI questionnaire was significantly decreased at 1 week and 1 month postoperatively compared with baseline levels (P = 0.000, collectively). Moreover, the fluorescein staining score of the BCL group was remarkably decreased 1-week and 1-month postoperatively compared with the non-BCL group (P = 0.000 and P = 0.000, respectively). Furthermore, the redness score of the BCL group was also better compared with the non-BCL group at 1 week and 1 month postoperatively (P = 0.014 and P = 0.004, respectively). CONCLUSIONS Complicated cataract or/and IOL surgery would intensify the DED. Early application of BCLs postoperatively improved patients' comfort and alleviated dry eye-related symptoms and signs. Furthermore, this mechanism might involve the acceleration of corneal epithelial healing, the alleviation of ocular stress response and the stabilization of the tear film. TRIAL REGISTRATION Trial registration ClinicalTrials, NCT04120389. Registered 10 October 2019-retrospectively registered.
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Affiliation(s)
- Dan Chen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Dejian Xu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
- Lemolight Ophthalmology Hospital, Hangzhou, Zhejiang, China
| | - Xingdi Wu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Jingwen Wang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Siting Sheng
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Xuewen Yu
- Department of Ophthalmology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Xueqi Lin
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lirui Liu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Xian Ge
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
- Jianyang Eye Hospital of Jianhu County, Jiangsu, China
| | - Huiling Zhao
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Wen Xu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China.
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Zheng Y, Zhai CB. Performance of Bandage Contact Lens in Patients Post-ocular Surgeries: A Systematic Literature Review. Eye Contact Lens 2023; 49:449-458. [PMID: 37816246 PMCID: PMC10734785 DOI: 10.1097/icl.0000000000001021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 10/12/2023]
Abstract
ABSTRACT This study systematically reviewed the performance of bandage contact lenses (BCL) such as lotrafilcon A, lotrafilcon B, senofilcon A, balafilcon A, and comfilcon A as postoperative treatment in different ocular surgeries. A systematic search of English and Chinese databases (from inception to December 2021) was conducted for studies reporting the efficacy of BCLs after ocular surgeries. Postoperative symptoms, corneal healing, and visual outcomes were studied. Overall, 38 studies were identified. Bandage contact lens was applied as a postoperative aid in corneal refractive, cataract, and vitrectomy surgeries. Most studies were on photorefractive keratectomy. Reduced postoperative symptoms were observed within 4 hr to 3 days, whereas re-epithelization of the cornea and healing was complete within 3 to 7 days after ocular surgeries except for vitrectomy. In a vitrectomy, greater comfort and improved corneal epithelium were observed on the seventh day after surgery. An improvement in dry eye symptoms was observed at 7 days with considerable benefits observed after 1 month of cataract surgery. These findings indicate that BCLs are effective for improving postoperative symptoms and facilitation of early visual rehabilitation with a wear time of 8 hr to 7 days depending on the type of ocular surgery.
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Affiliation(s)
- Yan Zheng
- Beijing Tongren Eye Center (Y.Z.), Beijing KEY Laboratory of Ophthalmology and Visual Science; and Beijing Tongren Hospital (C.-B.Z.), Capital Medical University, Beijing, China
| | - Chang-Bin Zhai
- Beijing Tongren Eye Center (Y.Z.), Beijing KEY Laboratory of Ophthalmology and Visual Science; and Beijing Tongren Hospital (C.-B.Z.), Capital Medical University, Beijing, China
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Palkovits S, Schlatter A, Ruiss M, Georgiev S, Zeilinger J, Pilwachs C, Findl O. Occurrence of Corneal Staining after Cataract Surgery with and without Chitosan-N-Acetylcysteine Eye Drops. Ophthalmic Res 2023; 66:1293-1299. [PMID: 37797590 PMCID: PMC10623390 DOI: 10.1159/000534291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 09/20/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION The objective of this study was to evaluate the prevalence of ocular surface damage assessed by corneal staining scores right after cataract surgery and whether it can be prevented using chitosan-N-acetylcysteine (C-NAC) eye drops. METHODS We included patients scheduled for routine cataract surgery. Each patient was randomly assigned to one of three groups. Patients in group 1 underwent routine cataract surgery with no additional eye drops. In group 2, patients received C-NAC eye drops after cataract surgery, and in group 3, C-NAC was applied both before and after surgery. Both groups continued the treatment once daily for 4 days. Ocular surface alteration was assessed using the National Eye Institute (NEI) score, and the visual analog scale (VAS) was used to evaluate subjective complaints. RESULTS Thirty-six patients were included in the final analyses. One hour after cataract surgery, a statistically significant increase in corneal fluorescein staining was observed in all groups, which decreased again after 1 week. There was no significant difference between the groups 1 h after cataract surgery, though a tendency toward lower NEI scores was observed during this time point in group 3. DISCUSSION Cataract surgery induced ocular surface staining and subjective complaints after 1 h. However, the increase in VAS score was small and probably not clinically relevant. The application of perioperative C-NAC eye drops did reduce the rate of corneal staining after cataract surgery in a clinically relevant manner.
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Affiliation(s)
- Stefan Palkovits
- VIROS - Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
| | - Andreas Schlatter
- VIROS - Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Manuel Ruiss
- VIROS - Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
| | - Stefan Georgiev
- VIROS - Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
| | - Johannes Zeilinger
- VIROS - Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
| | - Caroline Pilwachs
- VIROS - Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
| | - Oliver Findl
- VIROS - Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria
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Ling J, Chan BCL, Tsang MSM, Gao X, Leung PC, Lam CWK, Hu JM, Wong CK. Current Advances in Mechanisms and Treatment of Dry Eye Disease: Toward Anti-inflammatory and Immunomodulatory Therapy and Traditional Chinese Medicine. Front Med (Lausanne) 2022; 8:815075. [PMID: 35111787 PMCID: PMC8801439 DOI: 10.3389/fmed.2021.815075] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/27/2021] [Indexed: 12/19/2022] Open
Abstract
Dry eye is currently one of the most common ocular surface disease. It can lead to ocular discomfort and even cause visual impairment, which greatly affects the work and quality of life of patients. With the increasing incidence of dry eye disease (DED) in recent years, the disease is receiving more and more attention, and has become one of the hot research fields in ophthalmology research. Recently, with the in-depth research on the etiology, pathogenesis and treatment of DED, it has been shown that defects in immune regulation is one of the main pathological mechanisms of DED. Since the non-specific and specific immune response of the ocular surface are jointly regulated, a variety of immune cells and inflammatory factors are involved in the development of DED. The conventional treatment of DED is the application of artificial tears for lubricating the ocular surface. However, for moderate-to-severe DED, treatment with anti-inflammatory drugs is necessary. In this review, the immunomodulatory mechanisms of DED and the latest research progress of its related treatments including Chinese medicine will be discussed.
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Affiliation(s)
- Jiawei Ling
- Institute of Chinese Medicine and State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, Hong Kong, China
| | - Ben Chung-Lap Chan
- Institute of Chinese Medicine and State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, Hong Kong, China
| | - Miranda Sin-Man Tsang
- Institute of Chinese Medicine and State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, Hong Kong, China
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Xun Gao
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Ping Chung Leung
- Institute of Chinese Medicine and State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, Hong Kong, China
| | - Christopher Wai-Kei Lam
- Faculty of Medicine and State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Macau, Macau SAR, China
| | - Jiang-Miao Hu
- State Key Laboratory of Phytochemistry and Plant Resources in West China, Kunming Institute of Botany, Chinese Academy of Sciences, Kunming, China
| | - Chun Kwok Wong
- Institute of Chinese Medicine and State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants, The Chinese University of Hong Kong, Hong Kong, China
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
- Li Dak Sum Yip Yio Chin R & D Centre for Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Relationship between ocular surface disease and patient's satisfaction among cataract surgical patients in Nigeria. Int Ophthalmol 2021; 41:3163-3170. [PMID: 34021435 DOI: 10.1007/s10792-021-01881-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To determine the effect of clinical and cytological features of ocular surface disease on patient's satisfaction following small incision cataract surgery at a tertiary eye care centre. METHOD This is a prospective observational study of 70 consecutive consenting patients who underwent manual small incision cataract surgery(MSICS) at a tertiary eye care centre. All participants underwent ocular surface profile assessment using Schirmer I test (ST1), tear film break-up time (TBUT), conjunctival impression cytology (CIC) and ocular surface disease index (OSDI) at pre-operative visit, 1-week and 4-week post-operative visit. Patient's satisfaction with surgical outcome was evaluated at 6-week post-operative visit using a rating scale of 1 to 10. Data were analysed using IBM Statistical Package for the Social Sciences (SPSS) version 20.0 (IBM Corp., Armonk, NY USA). RESULTS The mean age was 68 ± 9.4 years with a male/female ratio of 1:1.1. The mean OSDI score decreased significantly (p < 0.001) from 33.1 ± 8.4 pre-operatively to 20.8 ± 7.4 four weeks after surgery. The TBUT was 12 ± 4.1 s pre-operatively, but significantly reduced to 11.2 ± 3.9 s (p < 0.001) at 4-week post-operative period. At 6 weeks, patients with normal CIC reduced from 53 (75.8%) pre-operatively to 8 (11.4%) (p < 0.001, z = - 7.24). Fifty percent of patients with severe post-operative ocular surface disease reported dissatisfaction with their surgical outcome (p = 0.024). CONCLUSION Manual small incision cataract surgery can significantly impair the ocular surface health profile of patients. The presence of ocular surface disease in patients pre-operatively can negatively impact their level of satisfaction with surgical outcome.
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