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Rhee MK, Zakher M, Najac M, Arias H, Jo J, Gorham R, Moadel K. Comparing Intracanalicular and Topical Steroid Use in Patients Undergoing Pterygium Surgery. Eye Contact Lens 2024; 50:183-188. [PMID: 38305478 PMCID: PMC10953680 DOI: 10.1097/icl.0000000000001075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVE The study received funding from Ocular Therapeutix, Inc., Bedford, MA.We undertook this study to compare the efficacy of intracanalicular dexamethasone 0.4 mg with topical prednisolone acetate (PA) 1% in controlling postoperative pain and inflammation in patients undergoing pterygium surgery. METHODS This was an open-label, prospective, interventional, nonrandomized comparative trial. Thirty patients were assigned to one of the following groups: Group A [intracanalicular insert of 0.4 mg dexamethasone placed into upper and lower puncta during the procedure, followed by at postoperative month 1 visit institution of topical PA 1% twice daily × 2 weeks then once daily × 2 weeks] or Group B [nonintervention group with institution on postoperative day 1 topical PA 1% every 2 hours × 2 weeks then four times per day × 2 weeks then twice daily × 2 weeks then once daily × 2 weeks]. RESULTS Fifteen cases and 15 controls were enrolled. There was no statistical difference in patient-reported pain or satisfaction between the case and control groups at 1 day; 1 week; and 1, 3, and 6 months postoperatively. There was no significant difference in time to an ocular hyperemia score of 0 between the two groups. There was no difference in the rate of corneal reepithelialization and recurrence rate (two controls). Nine eyes had transient ocular hypertension (seven cases and two controls). CONCLUSION Intracanalicular dexamethasone 0.4 mg may reduce the medication burden for patients who need prolonged postoperative steroid therapy as is routine in the setting of pterygium surgery. It is a safe and effective alternative to PA 1% drops alone for postoperative control of pain and inflammation in pterygium surgery.
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Affiliation(s)
- Michelle K. Rhee
- Department of Ophthalmology (M.K.R., J.J.), Icahn School of Medicine at Mount Sinai, New York, NY; Elmhurst Hospital (M.K.R.), Mount Sinai Services, New York, NY; Department of Ophthalmology (M.Z.), New York Eye and Ear Infirmary of Mount Sinai, New York, NY; Lewis Katz School of Medicine at Temple University (M.N.), Philadelphia, PA; Moadel Medicine (H.A., K.M.), New York, NY; and Ektropia Solutions LLC (R.G.), Laguna Beach, CA
| | - Meena Zakher
- Department of Ophthalmology (M.K.R., J.J.), Icahn School of Medicine at Mount Sinai, New York, NY; Elmhurst Hospital (M.K.R.), Mount Sinai Services, New York, NY; Department of Ophthalmology (M.Z.), New York Eye and Ear Infirmary of Mount Sinai, New York, NY; Lewis Katz School of Medicine at Temple University (M.N.), Philadelphia, PA; Moadel Medicine (H.A., K.M.), New York, NY; and Ektropia Solutions LLC (R.G.), Laguna Beach, CA
| | - Michael Najac
- Department of Ophthalmology (M.K.R., J.J.), Icahn School of Medicine at Mount Sinai, New York, NY; Elmhurst Hospital (M.K.R.), Mount Sinai Services, New York, NY; Department of Ophthalmology (M.Z.), New York Eye and Ear Infirmary of Mount Sinai, New York, NY; Lewis Katz School of Medicine at Temple University (M.N.), Philadelphia, PA; Moadel Medicine (H.A., K.M.), New York, NY; and Ektropia Solutions LLC (R.G.), Laguna Beach, CA
| | - Harold Arias
- Department of Ophthalmology (M.K.R., J.J.), Icahn School of Medicine at Mount Sinai, New York, NY; Elmhurst Hospital (M.K.R.), Mount Sinai Services, New York, NY; Department of Ophthalmology (M.Z.), New York Eye and Ear Infirmary of Mount Sinai, New York, NY; Lewis Katz School of Medicine at Temple University (M.N.), Philadelphia, PA; Moadel Medicine (H.A., K.M.), New York, NY; and Ektropia Solutions LLC (R.G.), Laguna Beach, CA
| | - Jace Jo
- Department of Ophthalmology (M.K.R., J.J.), Icahn School of Medicine at Mount Sinai, New York, NY; Elmhurst Hospital (M.K.R.), Mount Sinai Services, New York, NY; Department of Ophthalmology (M.Z.), New York Eye and Ear Infirmary of Mount Sinai, New York, NY; Lewis Katz School of Medicine at Temple University (M.N.), Philadelphia, PA; Moadel Medicine (H.A., K.M.), New York, NY; and Ektropia Solutions LLC (R.G.), Laguna Beach, CA
| | - Richard Gorham
- Department of Ophthalmology (M.K.R., J.J.), Icahn School of Medicine at Mount Sinai, New York, NY; Elmhurst Hospital (M.K.R.), Mount Sinai Services, New York, NY; Department of Ophthalmology (M.Z.), New York Eye and Ear Infirmary of Mount Sinai, New York, NY; Lewis Katz School of Medicine at Temple University (M.N.), Philadelphia, PA; Moadel Medicine (H.A., K.M.), New York, NY; and Ektropia Solutions LLC (R.G.), Laguna Beach, CA
| | - Ken Moadel
- Department of Ophthalmology (M.K.R., J.J.), Icahn School of Medicine at Mount Sinai, New York, NY; Elmhurst Hospital (M.K.R.), Mount Sinai Services, New York, NY; Department of Ophthalmology (M.Z.), New York Eye and Ear Infirmary of Mount Sinai, New York, NY; Lewis Katz School of Medicine at Temple University (M.N.), Philadelphia, PA; Moadel Medicine (H.A., K.M.), New York, NY; and Ektropia Solutions LLC (R.G.), Laguna Beach, CA
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Abstract
The fibrocyte, which was first described in 1994, is a type of circulating mesenchymal progenitor cell in the peripheral blood. Fibrocytes play important roles in chronic inflammation, wound healing, tissue remodeling, and fibrosis. Emerging evidence indicates that fibrocytes are involved in a wide variety of ocular disorders associated with inflammation and fibrosis. In this review, we summarize recent advances regarding the general characteristic profile of fibrocytes, molecular mechanisms underlying the fibrocyte recruitment to target tissues, their differentiation into fibroblasts, and the potential role of fibrocytes in ocular disease. Given the critical role of fibrocytes in ocular disorders, fibrocytes may serve as a promising pharmaceutical target in the development of novel therapeutic strategies to treat ocular inflammation and fibrosis.
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Affiliation(s)
- Feng Zhang
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan Province, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, 410011, Hunan Province, China
| | - Ke Liu
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan Province, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, 410011, Hunan Province, China
| | - Han Zhao
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan Province, China.,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, 410011, Hunan Province, China
| | - Yan He
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan Province, China. .,Hunan Clinical Research Center of Ophthalmic Disease, Changsha, 410011, Hunan Province, China.
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Changes in cytokines in tears after endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction. Eye (Lond) 2014; 28:600-7. [PMID: 24577250 DOI: 10.1038/eye.2014.33] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 01/13/2014] [Indexed: 01/11/2023] Open
Abstract
PURPOSE We attempted to compare the cytokine composition of tears between primary acquired nasolacrimal duct (NLD) obstruction and normal controls. We investigated the changes in cytokines in tears after endoscopic endonasal dacryocystorhinostomy (DCR). PATIENTS AND METHODS Eighteen patients underwent endonasal DCR, with seven patients undergoing bilateral DCR, resulting in twenty-five DCRs in total. Eleven contralateral un-operated eyes were used as normal controls. Silicone stents were removed 3 months after surgery. Tear samples were collected from all eyes before surgery, and at 1 month, 2 months, 3 months, and 4 months after surgery. The level of interleukin (IL)-1β, IL-2, IL-6, IL-10, transforming growth factor (TGF)-β2, fibroblast growth factor (FGF)-2, and vascular endothelial growth factor (VEGF) in the tears was measured. RESULTS The concentrations of IL-2, IL-6, IL-10, VEGF, and FGF-2 were significantly higher in eyes with NLD obstruction than controls before surgery (P=0.006, 0.018, 0.002, 0.048, and 0.039, respectively). Most inflammatory cytokines (IL-1β, IL-2, IL-6, VEGF, and FGF-2) were higher in the tears of the DCR group compared with the controls during the postoperative follow-up, but then rapidly decreased to the level of the controls after removal of the silicone stent. The recurred eyes showed a higher level of TGF-β2 and FGF-2 in tears compared with the eyes that showed good surgical results (P<0.005 and <0.005, respectively). CONCLUSION The tear levels of inflammatory cytokines were higher in eyes with NLD obstruction than controls. The changes in cytokine level during the postoperative period showed the importance of cytokine analysis in understanding wound healing after DCR.
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