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Yang F, Cheng H, Zhao S, Huang Y. The effect of incomplete blinking rate on corneal epithelial remodeling after trans-PRK surgery: a six-month study. Front Med (Lausanne) 2024; 10:1305461. [PMID: 38259844 PMCID: PMC10800622 DOI: 10.3389/fmed.2023.1305461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Purpose To evaluate the impact of incomplete blink rate on corneal epithelial thickness after transepithelial photorefractive keratectomy (Trans-PRK) surgery. Methods Trans-PRK patients were divided into two groups based on preoperative incomplete blinking rates, namely rates ≤0.5 (41 right eyes, group A) and rates >0.5 (65 right eyes, group B). We used anterior segment optical coherence tomography to measure the corneal epithelial thickness (CET) and lipiview to measure the number of blinks, incomplete blinking rate, and lipid layer thickness (LLT). Results In both groups, CET decreased at 1 week and 1 month, and the thicknesses in the IT, T, and ST regions exceeded the preoperative levels. Three months after Trans-PRK, the thickness exceeded the preoperative levels and continued to increase during subsequent follow-ups. The blinking times and LLT in both groups decreased at 1 week and gradually increased but did not return to preoperative levels. Group A maintained an incomplete blinking rate of over 0.5 at all postoperative periods. The incomplete blinking rate of group B remained above 0.5 postoperatively, although there was an improvement compared with preoperative rates. Both groups showed a correlation between changes in CET and incomplete blinking rate. There was a correlation between changes in LLT and the incomplete blinking rate after surgery. Conclusion Both groups showed uneven corneal epithelia thickening, which became more pronounced approaching the peripheral areas. In addition, changes in CET after surgery were positively correlated with the incomplete blinking rate in both patient groups. There was a negative correlation between postoperative LLT and incomplete blinking rate.
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Affiliation(s)
| | | | | | - Yue Huang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
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Khodaparast M, Ambrósio R, Ahmadzadeh H, Khorrami-Nejad M, Mohammadzadeh M, Azizi S, Mohammadi SF, Hashemian H. Evaluation of the effect of artificial tears on corneal epithelial thickness changes after photorefractive keratectomy. Indian J Ophthalmol 2024; 72:66-72. [PMID: 38131572 PMCID: PMC10841771 DOI: 10.4103/ijo.ijo_1354_23] [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: 05/24/2023] [Revised: 07/30/2023] [Accepted: 08/12/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE This study aimed to evaluate the corneal epithelial thickness changes after photorefractive keratectomy (PRK) and the impact of long-term artificial tear usage on epithelial thickness changes in these patients. METHODS This study was performed on 71 patients (142 eyes) without dry eye disease who received PRK for myopic refractive correction. The corneal epithelial thickness profile was obtained before, one, three, and six months after surgery using anterior segment optical coherence tomography. Patients were randomly divided into two groups: group A, who received preservative-free artificial tears post-surgery, and group B, who did not receive artificial tears. RESULTS The epithelial thickness decreased universally in the first month and then increased in the 3- and 6-month follow-ups. Group A had a significantly thicker epithelium in central, paracentral, and midperipheral zones compared with group B in the 3-month follow-up. In the 6-month follow-up, no significant differences were detected between groups. At the last follow-up, the central, paracentral, and midperipheral zone epithelial thicknesses in all patients were significantly higher than preoperative values, but peripheral zone thickness only increased to preoperative values. CONCLUSIONS Patients using artificial tears showed a faster thickening, especially in the central and paracentral zones, but there were no significant differences between the two groups in the final follow-up. Artificial tear usage may increase the rate of the epithelial remodeling process in post-PRK patients without significantly altering the final epithelial thickness profile. Further studies are warranted to evaluate the influence of different factors on epithelial remodeling.
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Affiliation(s)
- Mehdi Khodaparast
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Renato Ambrósio
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, Brazil
- Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
- Brazilian Study Group of Artificial Intelligence and Corneal Analysis - BrAIN, Rio de Janeiro and Maceió, Brazil
- Department of Ophthalmology, Federal University the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Hooman Ahmadzadeh
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khorrami-Nejad
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Mohammadzadeh
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Azizi
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Farzad Mohammadi
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hesam Hashemian
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Carreira AR, Rodrigues-Barros S, Silva JC, de Almeida MF, Machado I, Cardoso JN, Campos N. Tobacco effects on ocular surface, meibomian glands, and corneal epithelium and the benefits of treatment with a lipid-based lubricant. Graefes Arch Clin Exp Ophthalmol 2023; 261:171-184. [PMID: 35881199 DOI: 10.1007/s00417-022-05778-4] [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: 03/22/2022] [Revised: 07/10/2022] [Accepted: 07/19/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE Our aim was to evaluate the ocular surface in chronic smokers and to assess the benefit of sodium hyaluronate (SH) versus semi-fluorinated alkane (SFA) eyedrops on tear film, meibomian glands, and corneal epithelial thickness (CET). METHODS This prospective randomized single-blinded study included smokers, who applied one eyedrop of Hyabak® on one eye (SH group) and one eyedrop of EvoTears® on the fellow eye (SFA group) 4 times daily for 2 months, and age-matched non-smokers. Ocular surface parameters, including tear film break-up time (TBUT) test and corneal fluorescein staining (CFS) score, lipid layer thickness (LLT), meibography (LipiView®), and CET measurements (Zeiss Cirrus HD-5000®), were assessed at baseline and after treatment. RESULTS Seventy-eight eyes were included in the smokers group (39 in the SH subgroup and 39 in the SFA subgroup) and 42 eyes in the control group. At baseline, the smokers group had a higher prevalence of dry eye (100% vs 0%, p < 0.001) and of meibomian gland dysfunction (MGD) and lower CET measurements than controls (p < 0.05). TBUT, CFS, and LLT (controls vs SFA group: 64.02 ± 1.87 nm vs 49.56 ± 4.33 nm, p = 0.05) improved in the SFA subgroup after treatment, but not in the SH subgroup, and became equivalent to those of controls. Prevalence of dry eye decreased in the smokers group after treatment (controls vs SH group vs SFA group: 0% vs 12.82% vs 16.26%, p > 0.05). Meibomian gland morphological parameters and CET did not improve after treatment (p < 0.05). CONCLUSIONS Smoking is associated with dry eye, MGD, and corneal epithelial thinning that seem to be only partially reversible with topical lubricants, preferably SFA.
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Affiliation(s)
- Ana Rita Carreira
- Ophthalmology Department, Hospital Garcia de Orta, E.P.E, Avenida Torrado da Silva, 2805-267, Almada, Portugal.
| | - Sandra Rodrigues-Barros
- Ophthalmology Department, Hospital Garcia de Orta, E.P.E, Avenida Torrado da Silva, 2805-267, Almada, Portugal
| | - Júlia Cunha Silva
- Pneumology Department, Hospital Garcia de Orta, E.P.E, Avenida Torrado da Silva, 2805-267, Almada, Portugal
| | | | - Inês Machado
- Ophthalmology Department, Hospital Garcia de Orta, E.P.E, Avenida Torrado da Silva, 2805-267, Almada, Portugal
| | - João Nobre Cardoso
- Ophthalmology Department, Hospital Garcia de Orta, E.P.E, Avenida Torrado da Silva, 2805-267, Almada, Portugal
| | - Nuno Campos
- Ophthalmology Department, Hospital Garcia de Orta, E.P.E, Avenida Torrado da Silva, 2805-267, Almada, Portugal
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Hynnekleiv L, Magno M, Vernhardsdottir RR, Moschowits E, Tønseth KA, Dartt DA, Vehof J, Utheim TP. Hyaluronic acid in the treatment of dry eye disease. Acta Ophthalmol 2022; 100:844-860. [PMID: 35514082 PMCID: PMC9790727 DOI: 10.1111/aos.15159] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/05/2022] [Accepted: 04/18/2022] [Indexed: 12/31/2022]
Abstract
Dry eye disease (DED) is a highly prevalent and debilitating condition affecting several hundred million people worldwide. Hyaluronic acid (HA) is a naturally occurring glycosaminoglycan commonly used in the treatment of DED. This review aims to critically evaluate the literature on the safety and efficacy of artificial tears containing HA used in DED treatment. Literature searches were conducted in PubMed, including MEDLINE, and in Embase via Ovid with the search term: "(hyaluronic acid OR hyaluronan OR hyaluronate) AND (dry eye OR sicca)". A total of 53 clinical trials are included in this review, including eight placebo-controlled trials. Hyaluronic acid concentrations ranged from 0.1% to 0.4%. Studies lasted up to 3 months. A broad spectrum of DED types and severities was represented in the reviewed literature. No major complications or adverse events were reported. Artificial tears containing 0.1% to 0.4% HA were effective at improving both signs and symptoms of DED. Two major gaps in the literature have been identified: 1. no study investigated the ideal drop frequency for HA-containing eyedrops, and 2. insufficient evidence was presented to recommend any specific HA formulation over another. Future investigations assessing the optimal drop frequency for different concentrations and molecular weights of HA, different drop formulations, including tonicity, and accounting for DED severity and aetiology are essential for an evidence-based, individualized approach to DED treatment.
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Affiliation(s)
- Leif Hynnekleiv
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of OphthalmologyHaukeland University HospitalBergenNorway,Department of Twin Research & Genetic EpidemiologyKing's College LondonSt Thomas' HospitalLondonUK
| | - Morten Magno
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of Ophthalmology and EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands,Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
| | | | - Emily Moschowits
- Department of Medical BiochemistryOslo University HospitalOsloNorway
| | - Kim Alexander Tønseth
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
| | - Darlene A. Dartt
- Schepens Eye Research Institute/Massachusetts Eye and EarDepartment of OphthalmologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Jelle Vehof
- Department of Twin Research & Genetic EpidemiologyKing's College LondonSt Thomas' HospitalLondonUK,Department of Ophthalmology and EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands,Department of OphthalmologyVestfold Hospital TrustTønsbergNorway
| | - Tor P. Utheim
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of OphthalmologySørlandet Hospital ArendalArendalNorway,Department of OphthalmologyStavanger University HospitalOsloNorway,Department of OphthalmologyVestre Viken HospitalDrammenNorway
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Reinstein DZ, Archer TJ, Vida RS. Epithelial thickness mapping for corneal refractive surgery. Curr Opin Ophthalmol 2022; 33:258-268. [PMID: 35779050 DOI: 10.1097/icu.0000000000000867] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW As more devices become available that offer corneal epithelial thickness mapping, this is becoming more widely used for numerous applications in corneal refractive surgery. RECENT FINDINGS The epithelial thickness profile is nonuniform in the normal eye, being thinner superiorly than inferiorly and thinner temporally than nasally. Changes in the epithelial thickness profile are highly predictable, responding to compensate for changes in the stromal curvature gradient, using the eyelid as an outer template. This leads to characteristic changes that can be used for early screening in keratoconus, postoperative monitoring for early signs of corneal ectasia, and for determining whether further steepening can be performed without the risk of apical syndrome following primary hyperopic treatment. Compensatory epithelial thickness changes are also a critical part of diagnosis in irregular astigmatism as these partially mask the stromal surface irregularities. The epithelial thickness map can then be used to plan a trans-epithelial PRK treatment for cases of irregularly irregular astigmatism. Other factors can also affect the epithelial thickness profile, including dry eye, anterior basement membrane dystrophy and eyelid ptosis. SUMMARY Epithelial thickness mapping is becoming a crucial tool for refractive surgery, in particular for keratoconus screening, ectasia monitoring, hyperopic treatment planning, and therapeutic diagnosis and treatment.
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Affiliation(s)
- Dan Z Reinstein
- Reinstein Vision
- London Vision Clinic, London, UK
- Department of Ophthalmology, Columbia University Medical Center, New York, USA
- Sorbonne Université, Paris, France
- School of Biomedical Sciences, University of Ulster, Coleraine, UK
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Lin F, Mao X, Ma L, Liu H. An investigation into the effects of ocular nebulization combined with meibomian gland massage on ocular surface status and corneal higher-order aberrations for the treatment of meibomian gland dysfunction. Acta Ophthalmol 2022; 100:e681-e693. [PMID: 34331838 DOI: 10.1111/aos.14961] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 06/17/2021] [Indexed: 01/06/2023]
Abstract
PURPOSE To evaluate ocular surface status and corneal higher-order aberrations after a new ocular nebulization therapy combined with meibomian gland massage for the treatment of meibomian gland dysfunction (MGD). PATIENTS AND METHODS This prospective randomized study involved 38 patients diagnosed with MGD. Subjects were classified into two groups: the nebulization and meibomian gland massage group (or NB group, 14 patients, 28 eyes) and the eye drop group (or ED group, 24 patients, 48 eyes). Azithromycin solution and esculin and digitalis glycoside eye drops were tested in the therapy. Best-corrected visual acuity (BCVA) testing; noncontact tonometry; fundoscopy; the Ocular Surface Disease Index (OSDI) questionnaire; tear film assessment encompassing tear meniscus height (TMH) and non-invasive keratograph breakup time (NIKBUT); corneal fluorescein staining; the Schirmer I test (SIT); and anterior, posterior and total corneal aberrations were evaluated at 1 and 3 months after treatment. RESULTS At 3 months, the NB group showed significantly better improvement than the ED group in terms of TMH (0.23 ± 0.04 versus 0.19 ± 0.05, p = 0.002) and first breakup time (f-BUT; 7.42 ± 2.49 versus 5.53 ± 2.12, p = 0.001). The average breakup time (Av-BUT) of the NB group was significantly longer than that of the ED group at 1 month (9.52 ± 2.70 versus 8.02 ± 2.33, p = 0.013) and 3 months (5.53 ± 2.12 versus 8.35 ± 2.38, p = 0.018). Both groups achieved improvement in corneal fluorescein staining (CFS) and SIT results at 1 and 3 months (p < 0.05). At the 3-month follow-up, anterior corneal trefoil aberrations decreased significantly in the NB group (p = 0.008), and improvements in anterior corneal coma aberrations and posterior corneal higher-order aberrations (HOAs) were observed in the ED group (p < 0.05) over the 4 mm pupil zone. Over a 6 mm zone at 3 months, anterior, posterior and total trefoil aberrations as well as total HOAs were significantly decreased in the NB group (p < 0.05), while posterior HOAs and trefoil aberrations were found to be decreased in the ED group (p < 0.05). For individual Zernike terms, anterior and total corneal Z(3, -3) showed decreases over the 4 and 6 mm zones, while no improvement was detected in the NB group at 3 months. CONCLUSION In terms of comfort and visual quality, nebulization therapy combined with meibomian gland massage to deliver azithromycin solution and esculin and digitalis glycoside eye drops appears to be more effective in treating clinical symptoms and signs of MGD than simply applying esculin and digitalis glycoside eye drops.
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Affiliation(s)
- Fangyu Lin
- Department of Ophthalmology Shanghai East Hospital Tongji University School of Medicine Shanghai China
| | - Xinjie Mao
- Department of Ophthalmology Shanghai East Hospital Tongji University School of Medicine Shanghai China
- School of Ophthalmology and Optometry and Eye Hospital Wenzhou Medical University Wenzhou China
| | - Lirong Ma
- Department of Ophthalmology Shanghai East Hospital Tongji University School of Medicine Shanghai China
| | - Huiying Liu
- Department of Ophthalmology Shanghai East Hospital Tongji University School of Medicine Shanghai China
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Assessment of Corneal Epithelium Thickness in Glaucomatous Patients Undergoing Medical Treatment. J Glaucoma 2021; 30:44-49. [PMID: 32969915 DOI: 10.1097/ijg.0000000000001677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 09/03/2020] [Indexed: 11/25/2022]
Abstract
PRECIS Patients with glaucoma have reduced and irregular corneal epithelial thickness (CET) even if they do not report symptoms of dry eyes. The reduction of corneal epithelium affects equally the superior and inferior areas of the cornea. PURPOSE To evaluate CET parameters by means of anterior segment optical coherence tomography in glaucomatous patients undergoing medical treatment and compare them with CET parameters of controls. METHODS This was a cross-sectional study of 62 patients with primary open-angle or pseudoexfoliative glaucoma (study group) and 62 age-matched controls. Fourier-domain optical coherence tomography (RTVue) with a corneal adaptor module was used in the present study. Τhe pachymetry scan pattern was used to map the cornea and the software generated corneal thickness parameters were recorded. Simple comparisons between groups were performed and the correlations of CET parameters with parameters associated with medication use (treatment duration, number of medications and number of instillations) were assessed. RESULTS Mean age of the patients was 68±11.9 years in the glaucoma group and 65.5±8.5, years in the control group (P=0.17). Median number of instillations of medication was 2 (range, 1 to 6) for the glaucoma group. Central corneal thickness was 537.6±33.3 in the glaucoma group and 550.8±33.7 in the control group, respectively (P=0.028). The central CET was 48.8.±3.7 μm in the glaucoma group and 53.5±3.7 μm in the control group (P<0.001). Similarly, the average superior (2 to 7 mm) CET and the average inferior (2 to 7 mm) CET were almost equally reduced in the glaucoma group (45±4 vs. 49.6±3.3 μm, P<0.001 and 49±3.9 vs 53.5±3.7, P<0.001, respectively). No CET parameter was correlated with any of the treatment parameters. CONCLUSIONS Patients treated for glaucoma have uniformly reduced corneal epithelial thickness.
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Abstract
PURPOSE To evaluate the intraexaminer repeatability and the interobserver reproducibility of manifest refraction. SETTING Tertiary referral center. DESIGN Retrospective study. METHODS Patients attending at least 2 preoperative refractions before undergoing subsequent refractive surgery were included. All manifest refractions were performed by 1 of 4 experienced optometrists using an automated phoropter according to a standard protocol. The first manifest refraction was performed after obtaining automated refraction and measuring the spectacles of the patient. The second refraction was typically refined from the first also considering wavefront refraction and tomography/topography. RESULTS The latest 2 manifest refractions of 1000 eyes obtained at 2 separate visits showed a mean pairwise absolute difference of 0.16 ± 0.19 diopter (D) (range 0 to 1.38 D) in spherical equivalent (SE). This SD was better than 0.25 D (the minimum measurement increment of refraction itself). The 95% limit of agreement (LoA) was within 0.50 D for sphere, cylinder, and SE. The SD of the astigmatism axis was approximately 10 degrees, and the 95% LoA was within 22 degrees (the difference in axis decreasing significantly with the measured cylinder magnitude). The SD for corrected distance visual acuity (CDVA) was half a Snellen line and the 95% LoA was within 1.5 lines (with increasing deviation with worse vision). There were no clinically meaningful differences in reproducibility (2 optometrists) compared with repeatability (same optometrist) in sphere, axis, and CDVA. CONCLUSIONS Reproducibility was 0.16 D irrespective whether refractions were performed by 1 or 2 different optometrists. Obtaining multiple refractions preoperatively might increase the predictability of surgery and decrease the enhancement rate.
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van Setten GB. Impact of Attrition, Intercellular Shear in Dry Eye Disease: When Cells are Challenged and Neurons are Triggered. Int J Mol Sci 2020; 21:E4333. [PMID: 32570730 PMCID: PMC7352662 DOI: 10.3390/ijms21124333] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/02/2020] [Accepted: 06/15/2020] [Indexed: 12/18/2022] Open
Abstract
The mechanical component in the pathophysiology of dry eye disease (DED) deserves attention as an important factor. The lubrication deficit induced impaired mechano-transduction of lid pressure to the ocular surfaces may lead to the dysregulation of homeostasis in the epithelium, with sensations of pain and secondary inflammation. Ocular pain is possibly the first sign of attrition and may occur in the absence of visible epithelial damage. Attrition is a process which involves the constant or repeated challenge of ocular surface tissues by mechanical shear forces; it is enhanced by the thinning of corneal epithelium in severe DED. As a highly dynamic process leading to pain and neurogenic inflammation, the identification of the impact of attrition and its potential pathogenic role could add a new perspective to the current more tear film-oriented models of ocular surface disease. Treatment of DED addressing lubrication deficiencies and inflammation should also consider the decrease of attrition in order to stimulate epithelial recovery and neural regeneration. The importance of hyaluronic acid, its molecular characteristics, the extracellular matrix and autoregulative mechanisms in this process is outlined. The identification of the attrition and recognition of its impact in dry eye pathophysiology could contribute to a better understanding of the disease and optimized treatment regimens.
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Affiliation(s)
- Gysbert-Botho van Setten
- Department of Clinical Neuroscience (CNS), Karolinska Institutet, 11282 Stockholm, Sweden; ; Tel.: +46-8-672-3298
- St Eriks Eye Hospital, 11282 Stockholm, Sweden
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The Effect of Pharmacological Dilation on Calculation of Targeted and Ideal IOL Power Using Multivariable Formulas. Ophthalmol Ther 2020; 9:1-11. [PMID: 32462340 PMCID: PMC7406603 DOI: 10.1007/s40123-020-00261-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Indexed: 12/19/2022] Open
Abstract
Background To examine the effect of pharmacologic dilation on biometric parameters
measured by the Lenstar LS 900, and whether these changes affect the power of the
calculated intraocular lens (IOL) using multivariable formulas in an undilated versus
pharmacologically dilated state. Methods Prospective study of 98 phakic eyes from 53 patients. Axial length (AL),
central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT),
and keratometry (K) readings were measured. The first set of measurements was taken
prior to dilation. After dilation (pupil diameter ≥ 6.0 mm), a second set of
measurements was taken. The Barrett, Olsen, Hill-RBF, Haigis, SRK/T, and Holladay I
formulas were used to calculate IOL power before and after dilation. Two calculation
methods were used: method A used a commonly available IOL targeted to achieve
the lowest myopic spheroequivalent residual refraction; method B calculated ideal IOL
power for emmetropia. Results Statistically significant increases were seen in CCT (p < 0.01), ACD (p < 0.01), and AL (p < 0.01)
whereas a statistically significant decrease was seen in LT (p < 0.01) post dilation. Using method A, the percentage of eyes
which would have received an IOL with 0.5 D or 1.0 D of higher power, if
post-dilation measurements were used, were 25.5%, 30.6%, 20.4%, and 23.5% for
Barrett, Olsen, Hill-RBF, and Haigis, respectively. Using method B, only Haigis and
Olsen had a statistically significant increase in ideal IOL power. Conclusions Pharmacologic dilation can be associated with an increase in non-custom
IOL dioptric power when using multivariable formulas, which may lead to a myopic
surprise.
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Messner A, Fischak C, Pfister M, Schützenberger K, Garreis F, Paulsen F, Stegmann H, Aranha dos Santos V, Garhöfer G, Schmetterer L, Werkmeister RM. Characterization of dry eye disease in a mouse model by optical coherence tomography and fluorescein staining. BIOMEDICAL OPTICS EXPRESS 2019; 10:4884-4895. [PMID: 31565532 PMCID: PMC6757454 DOI: 10.1364/boe.10.004884] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 06/10/2023]
Abstract
A custom-built ultrahigh-resolution optical coherence tomography (UHR-OCT) system and fluorescein staining were employed for investigation of a scopolamine induced dry eye mouse model. Acquired data was used to evaluate common and complementary findings of the two modalities. Central corneal thickness as measured by UHR-OCT increased significantly over the study period of 24 hours, from 89.0 ± 3.57 µm to 92.2 ± 4.07 µm. Both techniques were able to show corneal lesions with a large range of severity. Localized fluorescein staining was detected in 5% and diffuse staining in 45% of cases where no epithelial damage was visible with OCT. However, OCT revealed stromal defects in 6% and endothelial defects in 18% of the cases, which could not be visualized via fluorescein staining. Thus, while fluorescein staining widely detected defects of the corneal surface in a mouse model of dry eye disease, OCT non-invasively revealed additional information about defect depth and involvement of particular layers.
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Affiliation(s)
- Alina Messner
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Corinna Fischak
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Christian Doppler Laboratory for Ocular and Dermal Effects of Thiomers, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Martin Pfister
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Christian Doppler Laboratory for Ocular and Dermal Effects of Thiomers, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Institute of Applied Physics, Vienna University of Technology, Wiedner Hauptstraße 8-10, 1040 Vienna, Austria
| | - Kornelia Schützenberger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Christian Doppler Laboratory for Ocular and Dermal Effects of Thiomers, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Fabian Garreis
- Department of Functional and Clinical Anatomy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Friedrich Paulsen
- Department of Functional and Clinical Anatomy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Hannes Stegmann
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Christian Doppler Laboratory for Ocular and Dermal Effects of Thiomers, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Valentin Aranha dos Santos
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Leopold Schmetterer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Christian Doppler Laboratory for Ocular and Dermal Effects of Thiomers, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower Level 6, 169856, Singapore
- Institute for Health Technologies, Nanyang Technological University, Singapore
- Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - René M. Werkmeister
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
- Christian Doppler Laboratory for Ocular and Dermal Effects of Thiomers, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
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