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Zhao L, Duan H, Ma B, Yang T, Zhou Y, Liu Y, Chen J, Chen Y, Qi H. Impact of Topical 0.05% Cyclosporine A Eye Drops on Post-Femtosecond-Assisted Laser In Situ Keratomileusis Ocular Surface Recovery: A Randomized Clinical Trial. Eye Contact Lens 2024; 50:348-356. [PMID: 38865592 PMCID: PMC11265643 DOI: 10.1097/icl.0000000000001103] [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: 04/12/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVES To investigate the effect of topical 0.05% cyclosporine A (CsA) eye drops as an adjunct to conventional therapy in maintaining post-femtosecond-assisted laser in situ keratomileusis (FS-LASIK) ocular surface stability. METHODS Sixty-six patients (eyes) undergoing FS-LASIK were randomized into 2 groups: 33 patients (eyes) in group I (conventional treatment group) and 33 patients (eyes) in group II (CsA group). Conventional treatments include topical levofloxacin, fluorometholone, and artificial tears. Group II received topical 0.05% CsA eye drops twice daily for three months in addition to conventional treatment. Ocular Surface Disease Index (OSDI), numerical rating scale (NRS), tear break-up time (TBUT), Schirmer I test (SIt), corneal fluorescein staining (CFS), conjunctival lissamine green (LG) staining, corneal sensitivity, and corneal nerve morphology were measured. In addition, tear inflammatory cytokine levels were measured using the Luminex assay. Follow-up was performed preoperatively and 1 and 3 months postoperatively. RESULTS In the CsA group, OSDI, TBUT, LG, corneal sensitivity, and corneal nerve fiber total branch density recovered better than in the conventional treatment group. As for tear inflammatory cytokines, interferon (INF) -γ, interleukin (IL)-10, and IL-6 levels were significantly higher in the conventional treatment group as compared with the CsA group. In addition, no significant differences in NRS, SIt, and CFS scores were observed between the two groups. CONCLUSION In conclusion, 0.05% CsA eye drops is a useful adjunct to conventional treatment for restoring the ocular surface stability after corneal refractive surgery and is more potent in sustaining anti-inflammatory effects.
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Affiliation(s)
- Lu Zhao
- Department of Ophthalmology (L.Z., H.D., B.M., Y.Z., Y.L., Y.C., H.Q.), Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China; Department of Ophthalmology (T.Y.), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; and Institute of Medical Technology (J.C., H.Q.), Peking University Health Science Center, Beijing, China
| | - Hongyu Duan
- Department of Ophthalmology (L.Z., H.D., B.M., Y.Z., Y.L., Y.C., H.Q.), Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China; Department of Ophthalmology (T.Y.), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; and Institute of Medical Technology (J.C., H.Q.), Peking University Health Science Center, Beijing, China
| | - Baikai Ma
- Department of Ophthalmology (L.Z., H.D., B.M., Y.Z., Y.L., Y.C., H.Q.), Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China; Department of Ophthalmology (T.Y.), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; and Institute of Medical Technology (J.C., H.Q.), Peking University Health Science Center, Beijing, China
| | - Tingting Yang
- Department of Ophthalmology (L.Z., H.D., B.M., Y.Z., Y.L., Y.C., H.Q.), Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China; Department of Ophthalmology (T.Y.), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; and Institute of Medical Technology (J.C., H.Q.), Peking University Health Science Center, Beijing, China
| | - Yifan Zhou
- Department of Ophthalmology (L.Z., H.D., B.M., Y.Z., Y.L., Y.C., H.Q.), Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China; Department of Ophthalmology (T.Y.), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; and Institute of Medical Technology (J.C., H.Q.), Peking University Health Science Center, Beijing, China
| | - Yilin Liu
- Department of Ophthalmology (L.Z., H.D., B.M., Y.Z., Y.L., Y.C., H.Q.), Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China; Department of Ophthalmology (T.Y.), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; and Institute of Medical Technology (J.C., H.Q.), Peking University Health Science Center, Beijing, China
| | - Jiawei Chen
- Department of Ophthalmology (L.Z., H.D., B.M., Y.Z., Y.L., Y.C., H.Q.), Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China; Department of Ophthalmology (T.Y.), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; and Institute of Medical Technology (J.C., H.Q.), Peking University Health Science Center, Beijing, China
| | - Yueguo Chen
- Department of Ophthalmology (L.Z., H.D., B.M., Y.Z., Y.L., Y.C., H.Q.), Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China; Department of Ophthalmology (T.Y.), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; and Institute of Medical Technology (J.C., H.Q.), Peking University Health Science Center, Beijing, China
| | - Hong Qi
- Department of Ophthalmology (L.Z., H.D., B.M., Y.Z., Y.L., Y.C., H.Q.), Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China; Department of Ophthalmology (T.Y.), Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; and Institute of Medical Technology (J.C., H.Q.), Peking University Health Science Center, Beijing, China
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Lazreg S, Hosny M, Ahad MA, Sinjab MM, Messaoud R, Awwad ST, Rousseau A. Dry Eye Disease in the Middle East and Northern Africa: A Position Paper on the Current State and Unmet Needs. Clin Ophthalmol 2024; 18:679-698. [PMID: 38464499 PMCID: PMC10924846 DOI: 10.2147/opth.s436027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/24/2024] [Indexed: 03/12/2024] Open
Abstract
In the Middle East and Northern Africa (MENA), dry eye disease (DED) is often misdiagnosed or overlooked. This review summarizes a series of conversations with ophthalmologists in the region around a variety of climatic, lifestyle, and iatrogenic factors that contribute to specific features of DED in the MENA region. These considerations are further classified by patient lifestyle and surgical choices. All statements are based on discussions and formal voting to achieve consensus over three meetings. Overall, a deeper understanding of the disease characteristics of DED specific to MENA can better guide local eyecare practitioners on appropriate management and follow-up care. Additionally, population-based studies and patient and physician education on ocular surface diseases, together with the use of culturally appropriate and language-specific questionnaires can help ease the public health burden of DED in this region.
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Affiliation(s)
| | - Mohamed Hosny
- Refractive and Cornea Service, Cairo University Hospitals, Cairo, Egypt
| | - Muhammad A Ahad
- Department of Ophthalmology, Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Mazen M Sinjab
- Dr Sulaiman Al Habib Hospital, DHCC, Dubai, United Arab Emirates
| | - Riadh Messaoud
- Department of Ophthalmology, Tahar SFAR University Hospital, Mahdia, Tunisia
| | - Shady T Awwad
- Department of Ophthalmology, American University of Beirut - Medical Center, Beirut, Lebanon
| | - Antoine Rousseau
- Department of Ophthalmology, Bicêtre Hospital, Paris-Saclay University, Le Kremlin-Bicêtre, France
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Cañones-Zafra R, Abad JP, Castellanos M, Muñiz C, Sideroudi H, Teus MA. Comparison of Two Topical Lubricants on the Corneal Surface Recovery and Patient Discomfort After Photorefractive Keratectomy. Ophthalmol Ther 2024; 13:397-407. [PMID: 37996630 PMCID: PMC10776532 DOI: 10.1007/s40123-023-00847-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/25/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION This study aimed to compare the effect of two preservative-free (PF) artificial tears, one containing carboxymethylcellulose (CMC) (control group) vs another containing hyaluronic acid and hydroxypropyl guar (HA + HP-guar) (study group), on the healing of the corneal epithelium and the ocular discomfort after bilateral photorefractive keratectomy (PRK) surgery. METHODS A total of 68 patients that were scheduled to have PRK to correct myopia were randomized into two groups: 34 patients (68 eyes) in the study group and 34 patients (68 eyes) in the control group. Ocular examinations were performed on postoperative days 1, 4, 7, 30, and 90, evaluating the diameter of the de-epithelized cornea, the fluorescein staining using the Oxford scale, the tear film osmolarity and stability (tear breakup time), and the pain using visual analog scale (VAS). RESULTS On postoperative day 4, 97% of the study eyes vs 84.4% of the control eyes were completely re-epithelized (p = 0.01). Less ocular pain was observed on postoperative day 3 in the study group (5.0 (3.0-6.0) vs 6.0 (3.5-7.0), p = 0.03). No differences were observed beyond postoperative day 7 in the healing of the corneal epithelium, non-invasive Keratograph breakup time (NIKBUT), and the self-perceived ocular discomfort between the two groups. CONCLUSION The current study shows faster healing of the corneal epithelium and less ocular pain and discomfort in the first days after PRK with the use of topical lubricants containing HA + HP-guar compared to conventional CMC artificial tears, probably due to the different trophic effect of the aforementioned tears on the corneal epithelial cells. TRIAL REGISTRATION EudraCT No. 2020-003488-25.
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Affiliation(s)
- Rafael Cañones-Zafra
- Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- Clínica Novovisión, Madrid, Spain
| | | | | | | | - Haris Sideroudi
- Democritus University of Thrace, Moshonission 29, 68100, Alexandroupolis, Greece.
| | - Miguel A Teus
- Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
- Clínica Novovisión, Madrid, Spain
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Ichikawa K, Ichikawa K, Yamamoto N, Horai R. Flexural and Cell Adhesion Characteristic of Phakic Implantable Lenses. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1282. [PMID: 37512093 PMCID: PMC10385999 DOI: 10.3390/medicina59071282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: In this study, we aimed to compare the physical properties of hole-implantable collamer lenses (H-ICLs) and implantable phakic contact lenses (IPCLs) and investigate their flexural and cell adhesion characteristics. Materials and Methods: Transverse compression load to achieve lens flexion and static Young's modulus were measured in H-ICLs and IPCLs using designated equipment. Load was measured both with and without restraining the optic section of the lenses. Adhesion of iHLEC-NY2 cells to the lens surfaces was examined using phase-contrast microscopy, and cell proliferation activity was evaluated using WST-8 assay. Results: The H-ICL showed a greater tendency for transverse compression load compared to IPCL, while the IPCL showed a higher Young's modulus with respect to the force exerted on the center of the anterior surface of the optic section. The joint between the optic section and haptic support in the IPCL was found to mitigate the effects of transverse compression load. Both lens types showed minimal cell adhesion. Conclusions: Our findings indicate that H-ICLs and IPCLs exhibit distinct physical properties and adhesive characteristics. The IPCL demonstrated higher Young's modulus and unique structural features, while the H-ICL required greater transverse compression load to achieve the flexion required to tuck the haptic supports into place behind the iris to fix the lens. The observed cell non-adhesive properties for both lens types are promising in terms of reducing complications related to cell adhesion. However, further investigation and long-term observation of IPCL are warranted to assess its stability and potential impact on the iris. These findings contribute to a better understanding of the performance and potential applications of H-ICLs and IPCLs in ophthalmology.
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Affiliation(s)
| | - Kei Ichikawa
- Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan
- General Aoyama Hospital, Toyokawa 441-0103, Aichi, Japan
| | - Naoki Yamamoto
- Support Office for Bioresource Research, Translational Research Headquarters, Fujita Health University, Toyoake 470-1192, Aichi, Japan
| | - Rie Horai
- Chukyo Eye Clinic, Nagoya 456-0032, Aichi, Japan
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Oliveira TGV, da Fonseca JBR, Criado GG, Sena NB, Ambrósio R. Avaliação do conhecimento sobre cirurgia refrativa por meio de questionário eletrônico. REVISTA BRASILEIRA DE OFTALMOLOGIA 2023. [DOI: 10.37039/1982.8551.20230006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
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Tamimi A, Sheikhzadeh F, Ezabadi SG, Islampanah M, Parhiz P, Fathabadi A, Poudineh M, Khanjani Z, Pourmontaseri H, Orandi S, Mehrabani R, Rahmanian M, Deravi N. Post-LASIK dry eye disease: A comprehensive review of management and current treatment options. Front Med (Lausanne) 2023; 10:1057685. [PMID: 37113611 PMCID: PMC10126282 DOI: 10.3389/fmed.2023.1057685] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/14/2023] [Indexed: 04/29/2023] Open
Abstract
Laser-assisted in situ keratomileusis (LASIK) is a unique corneal stromal laser ablation method that uses an excimer laser to reach beneath corneal dome-shaped tissues. In contrast, surface ablation methods, such as photorefractive keratectomy, include removing epithelium and cutting off the Bowman's layer and the stromal tissue of the anterior corneal surface. Dry eye disease (DED) is the most common complication after LASIK. DED is a typical multi-factor disorder of the tear function and ocular surface that occurs when the eyes fail to produce efficient or adequate volumes of tears to moisturize the eyes. DED influences quality of life and visual perception, as symptoms often interfere with daily activities such as reading, writing, or using video display monitors. Generally, DED brings about discomfort, symptoms of visual disturbance, focal or global tear film instability with possible harm to the ocular surface, the increased osmolarity of the tear film, and subacute inflammation of the ocular surface. Almost all patients develop a degree of dryness in the postoperative period. Detection of preoperative DED and committed examination and treatment in the preoperative period, and continuing treatments postoperatively lead to rapid healing, fewer complications, and improved visual outcomes. To improve patient comfort and surgical outcomes, early treatment is required. Therefore, in this study, we aim to comprehensively review studies on the management and current treatment options for post-LASIK DED.
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Affiliation(s)
- Atena Tamimi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Sajjad Ghane Ezabadi
- Students’ Scientific Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Peyman Parhiz
- Student Research Committee, Zahedan Medical Sciences Branch, Islamic Azad University, Zahedan, Iran
| | - Amirhossein Fathabadi
- Student Research Committee, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Zahra Khanjani
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Pourmontaseri
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
- Bitab Knowledge Enterprise, Fasa University of Medical Sciences, Fasa, Iran
| | - Shirin Orandi
- Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Mehrabani
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohammad Rahmanian
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Niloofar Deravi,
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Moshirfar M, Brown AH, Sulit CA, Corbin WM, Ronquillo YC, Hoopes PC. Corneal Refractive Surgery Considerations in Patients with Cystic Fibrosis and Cystic Fibrosis Transmembrane Conductance Regulator-Related Disorders. Int Med Case Rep J 2022; 15:647-656. [PMID: 36388243 PMCID: PMC9656410 DOI: 10.2147/imcrj.s381078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022] Open
Abstract
This article discusses common ocular manifestations of cystic fibrosis (CF) and cystic fibrosis transmembrane conductance regulator-related disorders (CFTR-RD). A structured approach for assessing and treating patients with CF/CFTR-RD seeking corneal refractive surgery is proposed, as well as a novel surgical risk scoring system. We also report two patients with various manifestations of CFTR dysfunction who presented for refractive surgery and the outcomes of the procedures. Surgeons seeking to perform refractive surgery on patients with CF/CFTR-RD should be aware of mild to severe clinical manifestations of CFTR dysfunction. Specific systemic and ocular manifestations of CF include chronic obstructive pulmonary disease (COPD), bronchiectasis, recurrent pulmonary infections, CF-related diabetes and liver disease, pancreatic insufficiency, conjunctival xerosis, night blindness, meibomian gland dysfunction (MGD), and blepharitis. Corneal manifestations include dry eye disease (DED), punctate keratitis (PK), filamentary keratitis (FK), xerophthalmia, and decreased endothelial cell density and central corneal thickness. Utilization of the appropriate review of systems (ROS) and screening tests will assist in determining if the patient is a suitable candidate for refractive surgery, as CF/CFTR-RD can impact the health of the cornea. Collaboration with other medical professionals who care for these patients is encouraged to ensure that their CF/CFTR-RD symptoms are best controlled via systemic and other treatment options. This will assist in reducing the severity of their ocular manifestations before and after surgery.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT, USA
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA
- Utah Lions Eye Bank, Murray, UT, USA
| | - Alex H Brown
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Christian A Sulit
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Wyatt M Corbin
- Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA
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Packer M. Refractive surgery current status: expanding options. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2108405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Mark Packer
- Packer Research Associates, 1400 Bluebell Ave., Boulder, CO 80302 USA
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Thin-Flap Laser In Situ Keratomileusis-Associated Dry Eye: A Comparative Study Between Femtosecond Laser and Mechanical Microkeratome-Assisted Laser In Situ Keratomileusis. Eye Contact Lens 2021; 48:20-26. [PMID: 34644283 DOI: 10.1097/icl.0000000000000850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess and compare postlaser in situ keratomileusis (LASIK) dry eye after LASIK with planned thin flaps created by a femtosecond laser (FS) and mechanical microkeratome (MK). METHODS Patients were stratified according to the flap creation technique into FS and MK groups with planned 100 μm flap thickness in all eyes. Dry eye parameters including tear film break-up time (TBUT), Schirmer I test, ocular surface disease index (OSDI), and lower tear meniscus height and area (tear meniscus height [TMH] and tear meniscus area [TMA]) were assessed before surgery and at 3 and 6 months after surgery. RESULTS The study included 102 eyes of 55 patients (52 eyes underwent FS-LASIK/50 eyes underwent MK-LASIK). The preoperative characteristics including age, gender, and spherical equivalents were similar in both groups (P>0.05). The difference in postoperative flap thickness was statistically significant (P<0.05). In each group, dry eye parameters showed a statistically significant worsening (P value<0.001) at 3 months with later significant improvement at 6 months but did not return to baseline. The mean TBUT, Schirmer I, and lower TMH and TMA were statistically higher, and the mean OSDI was statistically lower in FS-LASIK than the MK-LASIK group at both 3 and 6 months (P value<0.001). The depth of ablation had a statistically significant correlation with Schirmer I at 6 months and OSDI at both 3 and 6 months post-LASIK (P<0.05). CONCLUSION The use of femtosecond laser technology in performing thin-Flap LASIK eye surgeries has improved the outcome of post-LASIK dry eye when compared with the mechanical microkeratome.
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Dan Z, Xiao-fei H, Yue Z, Guang Y, Xie-he K, Cui-hong Z, Jue H, Yan-ting Y, Jie L, Xiao-peng M. Effects of auricular point sticking on dry eye in myopia patients after SMILE surgery: a prospective randomized controlled clinical trial. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2021. [DOI: 10.1007/s11726-021-1238-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bianchi GR. PRESBYOPIA MANAGEMENT WITH DIFFRACTIVE PHAKIC POSTERIOR CHAMBER IOL. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2021; 76:211-219. [PMID: 33499642 DOI: 10.31348/2020/30] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate safety and refractive efficiency after posterior chamber diffractive implantable phakic contact lens (IPCL) surgery. MATERIAL AND METHODS A prospective non-randomized case-series study was performed on 54 myopic eyes of 27 patients who had undergone diffractive IPCL surgery. Corneal endothelial cell density (ECD), central corneal thickness (CCT), intra-ocular pressure (IOP), vault, uncorrected distance (UDVA), spherical equivalent (SE) and defocus curve, were all evaluated twelve months after surgery. The presence of cataracts was evaluated by slit-lamp during a postoperative follow-up. RESULTS Mean age was 47 ± 2.62 years-old. Mean SE decreased, from -5.95 ± 2.56 D in a pre-operative stage, to -0.25 ± 0.25 D twelve months after surgery. Achieved UDVA was 20/20 in 24.1% of all cases, 20/25 in 74.1% of them, and 20/32 in all remaining cases. No eyes suffered lost lines of vision. The binocular defocus curve was 0.06 ± 0.05 logMAR for a -3.0 D of defocus; 0.11 ± 0.04 logMAR for a -1.5 D of defocus, and 0.08 ± 0.03 logMAR for a 0 D of defocus. Twelve months after surgery, mean ECD had decreased by 1.43 %, whereas mean CCT had increased by 0.06 %, without any significant statistical difference (p = 0.28 and p = 0.93 respectively). No difference (p: 0.86) in the vault was observed at 6 months vs.12 months, as well as between IOP measurements (p = 0.22). There were no non-intra or postoperative complications, and, specifically, no cataracts developed either. CONCLUSIONS Diffractive IPCL was implanted safely. Corneal endothelial CD, CCT, vault, and IOP remained stable twelve months after surgery. Visual acuity for distance, intermediate and near sight were achieved without spectacles.
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Cochener B, Cassan A, Omiel L. Prevalence of meibomian gland dysfunction at the time of cataract surgery. J Cataract Refract Surg 2019; 44:144-148. [PMID: 29587971 DOI: 10.1016/j.jcrs.2017.10.050] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/13/2017] [Accepted: 10/31/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the incidence of meibomian gland dysfunction and quantify subjective dry-eye symptoms in cataract surgery candidates. SETTING Brest University Hospital, Brest, France. DESIGN Prospective case series. METHODS Patients having cataract surgery between November 2015 and June 2016 completed the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire. Lipid layer thickness and partial blink rate measurements as well as gland structure assessment were performed using the Lipiview Ocular Surface Interferometer. A slitlamp examination determined tear breakup time; the quantity and quality of the meibomian gland secretion were determined using the Meibomian Gland Evaluator. RESULTS The study comprised 342 eyes of 180 patients. The mean lipid layer thickness was 72.5 nm ± 19.91 (SD). In patients with a SPEED score lower than 8, the mean lipid layer thickness was 77.5 ± 19.48 nm. In patients with a SPEED score of 8 or higher, the mean lipid layer thickness was 58.5 ± 19.58 nm. The difference in lipid layer thickness between SPEED score groups was statistically significant (P < .05). Fifty-two percent of patients had meibomian gland dysfunction, and 56% had meibomian gland atrophy equal to or more than Arita grade 1. Meibomian gland function correlated significantly with lipid layer thickness, symptoms, age, and gland atrophy (P < .05). CONCLUSIONS The incidence of meibomian gland dysfunction was high in patients presenting for cataract surgery. Fifty percent of patients with meibomian gland dysfunction were asymptomatic. Correct criteria and meibomian function and structure assessment are critical to diagnosis. Comprehensive preoperative testing should routinely include evaluation of meibomian function.
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Affiliation(s)
| | - Albane Cassan
- From the University Hospital of Brest, Brest, France
| | - Laura Omiel
- From the University Hospital of Brest, Brest, France
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Advanced Technology IOL Cataract Surgery Optimized for Pre-existing Corneal Disease. CURRENT OPHTHALMOLOGY REPORTS 2018. [DOI: 10.1007/s40135-018-0188-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Baudouin C, Rolando M, Benitez Del Castillo JM, Messmer EM, Figueiredo FC, Irkec M, Van Setten G, Labetoulle M. Reconsidering the central role of mucins in dry eye and ocular surface diseases. Prog Retin Eye Res 2018; 71:68-87. [PMID: 30471351 DOI: 10.1016/j.preteyeres.2018.11.007] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 11/16/2018] [Accepted: 11/21/2018] [Indexed: 01/16/2023]
Abstract
Mucins are key actors in tear film quality and tear film stability. Alteration of membrane-bound mucin expression on corneal and conjunctival epithelial cells and/or gel-forming mucin secretion by goblet cells (GCs) promotes in ocular surface diseases and dry eye disease (DED). Changes in the mucin layer may lead to enhanced tear evaporation eventually contributing to tear hyperosmolarity which has been associated with ocular surface inflammation. Inflammatory mediators in turn may have a negative impact on GCs differentiation, proliferation, and mucin secretion. This sheds new light on the position of GCs in the vicious circle of DED. As contributor to ocular surface immune homeostasis, GC loss may contribute to impaired ocular surface immune tolerance observed in DED. In spite of this, there are no tools in routine clinical practice for exploring ocular surface mucin deficiency/dysregulation. Therefore, when selecting the most appropriate treatment options, there is a clear unmet need for a better understanding of the importance of mucins and options for their replacement. Here, we comprehensively revisited the current knowledge on ocular surface mucin biology, including functions, synthesis, and secretion as well as the available diagnostic tools and treatment options to improve mucin-associated homeostasis. In particular, we detailed the potential link between mucin dysfunction and inflammation as part of the uncontrolled chronic inflammation which perpetuates the vicious circle in DED.
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Affiliation(s)
- Christophe Baudouin
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, University Versailles Saint Quentin en Yvelines, Paris, France.
| | - Maurizio Rolando
- Ocular Surface & Dry Eye Center, ISPRE Ophthalmics, Genoa, Italy
| | | | | | - Francisco C Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary and Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, UK
| | - Murat Irkec
- Department of Ophthalmology, Hacettepe Faculty of Medicine, Ankara, Turkey
| | | | - Marc Labetoulle
- Hôpital Bicêtre, APHP, South Paris University, Ophthalmology, Le Kremlin-Bicêtre, France
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Anitua E, de la Fuente M, Muruzabal F, Sánchez-Ávila RM, Merayo-Lloves J, Azkargorta M, Elortza F, Orive G. Differential profile of protein expression on human keratocytes treated with autologous serum and plasma rich in growth factors (PRGF). PLoS One 2018; 13:e0205073. [PMID: 30312303 PMCID: PMC6193583 DOI: 10.1371/journal.pone.0205073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/17/2018] [Indexed: 11/22/2022] Open
Abstract
Purpose The main objective of this study is to compare the protein expression of human keratocytes treated with Plasma rich in growth factors (PRGF) or autologous serum (AS) and previously induced to myofibroblast by TGF-β1 treatment. Methods Blood from healthy donor was collected and processed to obtain AS and PRGF eye drops. Blood derivates were aliquoted and stored at -80°C until use. Keratocyte cells were pretreated for 60 minutes with 2.5 ng/ml TGF-β1. After that, cells were treated with PRGF, AS or with TGF-β1 (control). To characterize the proteins deregulated after PRGF and AS treatment, a proteomic approach that combines 1D-SDS–PAGE approach followed by LC–MS/MS was carried out. Results Results show a catalogue of key proteins in close contact with a myofibroblastic differentiated phenotype in AS treated-cells, whereas PRGF-treated cells show attenuation on this phenotype. The number of proteins downregulated after PRGF treatment or upregulated in AS-treated cells suggest a close relationship between AS-treated cells and cytoskeletal functions. On the other hand, proteins upregulated after PRGF-treatment or downregulated in AS-treated cells reveal a greater association with processes such as protein synthesis, proliferation and cellular motility. Conclusion This proteomic analysis helps to understand the molecular events underlying AS and PRGF-driven tissue regeneration processes, providing new evidence that comes along with the modulation of TGF-β1 activity and the reversion of the myofibroblastic phenotype by PRGF.
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Affiliation(s)
- Eduardo Anitua
- BTI—Biotechnology Institute, Vitoria-Gasteiz, Spain
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria-Gasteiz, Spain
- * E-mail: (GO); (EA)
| | - María de la Fuente
- BTI—Biotechnology Institute, Vitoria-Gasteiz, Spain
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria-Gasteiz, Spain
| | - Francisco Muruzabal
- BTI—Biotechnology Institute, Vitoria-Gasteiz, Spain
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria-Gasteiz, Spain
| | | | - Jesús Merayo-Lloves
- Instituto Universitario Fernández-Vega, Universidad de Oviedo, Oviedo, Spain
| | - Mikel Azkargorta
- Proteomics Platform, CIC bioGUNE, CIBERehd, ProteoRed-ISCIII, Bizkaia Science and Technology Park, Derio, Spain
| | - Felix Elortza
- Proteomics Platform, CIC bioGUNE, CIBERehd, ProteoRed-ISCIII, Bizkaia Science and Technology Park, Derio, Spain
| | - Gorka Orive
- BTI—Biotechnology Institute, Vitoria-Gasteiz, Spain
- University Institute for Regenerative Medicine and Oral Implantology—UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria-Gasteiz, Spain
- NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, Vitoria-Gasteiz, Spain
- Biomedical Research Networking Centre in Bioengineering, Biomaterials, and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain
- * E-mail: (GO); (EA)
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El Ameen A, Majzoub S, Vandermeer G, Pisella PJ. [Influence of cataract surgery on Meibomian gland dysfunction (French translation of the article)]. J Fr Ophtalmol 2018; 41:526-535. [PMID: 29887409 DOI: 10.1016/j.jfo.2017.11.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/22/2017] [Accepted: 11/09/2017] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the influence of cataract surgery on meibomian gland dysfunction, in particular on postoperative functional symptoms. PATIENTS AND METHODS Thirty patients who underwent cataract surgery were included in the study. A clinical examination (OSDI questionnaire, measurement of tear break up time [TBUT], corneal staining, meibomian gland expressibility test) and a paraclinical evaluation (loss of Meibomius glands [LMG] measured using ImageJ on meibography, conjunctival redness and non-invasive tear break up time [NIK-BUT]) were performed preoperatively and at 1 month and 3 months after phacoemulsification. RESULTS TBUT and meibomian gland expressibility were worsened at 1 month and 3 months postoperatively (P<0.05). LMG was significantly more important for the upper eyelid and the mean at 1 month (33.1±15.2 P=0.02; 28.5±15.6 P=0.025, respectively) and 3 months postoperatively (36.5±17.4 P=0.0005; 31.2±17.4 P=0.0002, respectively) than preoperative values (29.4±15.3; 26±15, respectively). There was a significant correlation between LMG on the upper eyelid preoperatively and the OSDI score at 1 month postoperatively (R=0.37; P=0.05). CONCLUSION The meibomian gland loss in the upper eyelid is associated with an increased postoperative ocular discomfort score. Alterations in the meibomian gland expressibility and TBUT persist for up to 3 months postoperatively suggesting a direct role of cataract surgery by an obstructive mechanism.
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Affiliation(s)
- A El Ameen
- Service d'ophtalmologie du CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
| | - S Majzoub
- Service d'ophtalmologie du CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - G Vandermeer
- Service d'ophtalmologie du CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - P-J Pisella
- Service d'ophtalmologie du CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France
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El Ameen A, Majzoub S, Vandermeer G, Pisella PJ. Influence of cataract surgery on Meibomian gland dysfunction. J Fr Ophtalmol 2018; 41:e173-e180. [PMID: 29778280 DOI: 10.1016/j.jfo.2018.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the influence of cataract surgery on Meibomian gland dysfunction, in particular on postoperative functional symptoms. PATIENTS AND METHODS Thirty patients who underwent cataract surgery were included in the study. A clinical examination (OSDI questionnaire, measurement of tear break-up time (TBUT), corneal staining, Meibomian gland expression test) and a paraclinical evaluation (Meibomian gland loss [MGL] measured using ImageJ on Meibography, conjunctival hyperemia and non-invasive keratograph break-up time [NIK-BUT]) were performed preoperatively and at 1month and 3months after phacoemulsification. RESULTS TBUT and Meibomian gland expressibility were worsened at 1month and 3months postoperatively (P<0.05). MGL was significantly higher for the upper eyelid and the mean at 1month (33.1±15.2, P=0.02; 28.5±15.6, P=0.025, respectively) and 3months postoperatively (36.5±17.4, P=0.0005; 31.2±17.4, P=0.0002, respectively) than preoperative values (29.4±15.3; 26±15, respectively). There was a significant correlation between MGL on the upper eyelid preoperatively and the OSDI score at 1month postoperatively (R=0.37; P=0.05). CONCLUSION Meibomian gland loss in the upper eyelid is associated with an increased early postoperative ocular discomfort score. Alterations in Meibomian gland expressibility and TBUT persist for up to 3months postoperatively, suggesting a direct role of cataract surgery by an obstructive mechanism.
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Affiliation(s)
- A El Ameen
- Service d'ophtalmologie, CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
| | - S Majzoub
- Service d'ophtalmologie, CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - G Vandermeer
- Service d'ophtalmologie, CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - P-J Pisella
- Service d'ophtalmologie, CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France
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Gomes JAP, Azar DT, Baudouin C, Efron N, Hirayama M, Horwath-Winter J, Kim T, Mehta JS, Messmer EM, Pepose JS, Sangwan VS, Weiner AL, Wilson SE, Wolffsohn JS. TFOS DEWS II iatrogenic report. Ocul Surf 2017; 15:511-538. [PMID: 28736341 DOI: 10.1016/j.jtos.2017.05.004] [Citation(s) in RCA: 258] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 05/02/2017] [Indexed: 01/04/2023]
Abstract
Dry eye can be caused by a variety of iatrogenic interventions. The increasing number of patients looking for eye care or cosmetic procedures involving the eyes, together with a better understanding of the pathophysiological mechanisms of dry eye disease (DED), have led to the need for a specific report about iatrogenic dry eye within the TFOS DEWS II. Topical medications can cause DED due to their allergic, toxic and immuno-inflammatory effects on the ocular surface. Preservatives, such as benzalkonium chloride, may further aggravate DED. A variety of systemic drugs can also induce DED secondary to multiple mechanisms. Moreover, the use of contact lens induces or is associated with DED. However, one of the most emblematic situations is DED caused by surgical procedures such as corneal refractive surgery as in laser-assisted in situ keratomileusis (LASIK) and keratoplasty due to mechanisms intrinsic to the procedure (i.e. corneal nerve cutting) or even by the use of postoperative topical drugs. Cataract surgery, lid surgeries, botulinum toxin application and cosmetic procedures are also considered risk factors to iatrogenic DED, which can cause patient dissatisfaction, visual disturbance and poor surgical outcomes. This report also presents future directions to address iatrogenic DED, including the need for more in-depth epidemiological studies about the risk factors, development of less toxic medications and preservatives, as well as new techniques for less invasive eye surgeries. Novel research into detection of early dry eye prior to surgeries, efforts to establish appropriate therapeutics and a greater attempt to regulate and oversee medications, preservatives and procedures should be considered.
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Affiliation(s)
- José Alvaro P Gomes
- Dept. of Ophthalmology and Visual Sciences, Federal University of Sao Paulo/Paulista School of Medicine (UNIFESP/EPM), São Paulo, SP, Brazil.
| | - Dimitri T Azar
- University of Illinois College of Medicine, Chicago, IL, USA
| | | | - Nathan Efron
- School of Optometry and Vision Science, Queensland University of Technology, Queensland, Australia
| | - Masatoshi Hirayama
- Department of Ophthalmology, School of Medicine, Keio University, Tokyo, Japan
| | | | - Terry Kim
- Duke University School of Medicine, Durham, NC, USA; Duke University Eye Center, Durham, NC, USA
| | | | - Elisabeth M Messmer
- Department of Ophthalmology, Ludwig-Maximilians-University (LMU), Munich, Germany
| | - Jay S Pepose
- Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Steven E Wilson
- Cole Eye Institute, The Cleveland Clinic, Cleveland, OH, USA
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Zhang X, M VJ, Qu Y, He X, Ou S, Bu J, Jia C, Wang J, Wu H, Liu Z, Li W. Dry Eye Management: Targeting the Ocular Surface Microenvironment. Int J Mol Sci 2017; 18:E1398. [PMID: 28661456 PMCID: PMC5535891 DOI: 10.3390/ijms18071398] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 06/19/2017] [Accepted: 06/24/2017] [Indexed: 12/24/2022] Open
Abstract
Dry eye can damage the ocular surface and result in mild corneal epithelial defect to blinding corneal pannus formation and squamous metaplasia. Significant progress in the treatment of dry eye has been made in the last two decades; progressing from lubricating and hydrating the ocular surface with artificial tear to stimulating tear secretion; anti-inflammation and immune regulation. With the increase in knowledge regarding the pathophysiology of dry eye, we propose in this review the concept of ocular surface microenvironment. Various components of the microenvironment contribute to the homeostasis of ocular surface. Compromise in one or more components can result in homeostasis disruption of ocular surface leading to dry eye disease. Complete evaluation of the microenvironment component changes in dry eye patients will not only lead to appropriate diagnosis, but also guide in timely and effective clinical management. Successful treatment of dry eye should be aimed to restore the homeostasis of the ocular surface microenvironment.
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Affiliation(s)
- Xiaobo Zhang
- Eye Institute of Xiamen University, Xiamen 361102, China.
- Medical College of Xiamen University, Xiamen 361102, China.
- Xiamen University affiliated Xiamen Eye Center, Xiamen 361102, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, China.
| | - Vimalin Jeyalatha M
- Eye Institute of Xiamen University, Xiamen 361102, China.
- Medical College of Xiamen University, Xiamen 361102, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, China.
| | - Yangluowa Qu
- Eye Institute of Xiamen University, Xiamen 361102, China.
- Medical College of Xiamen University, Xiamen 361102, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, China.
| | - Xin He
- Eye Institute of Xiamen University, Xiamen 361102, China.
- Medical College of Xiamen University, Xiamen 361102, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, China.
| | - Shangkun Ou
- Eye Institute of Xiamen University, Xiamen 361102, China.
- Medical College of Xiamen University, Xiamen 361102, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, China.
| | - Jinghua Bu
- Eye Institute of Xiamen University, Xiamen 361102, China.
- Medical College of Xiamen University, Xiamen 361102, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, China.
| | - Changkai Jia
- Eye Institute of Xiamen University, Xiamen 361102, China.
- Medical College of Xiamen University, Xiamen 361102, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, China.
| | - Junqi Wang
- Eye Institute of Xiamen University, Xiamen 361102, China.
- Medical College of Xiamen University, Xiamen 361102, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, China.
| | - Han Wu
- Eye Institute of Xiamen University, Xiamen 361102, China.
- Medical College of Xiamen University, Xiamen 361102, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, China.
| | - Zuguo Liu
- Eye Institute of Xiamen University, Xiamen 361102, China.
- Medical College of Xiamen University, Xiamen 361102, China.
- Xiamen University affiliated Xiamen Eye Center, Xiamen 361102, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, China.
| | - Wei Li
- Eye Institute of Xiamen University, Xiamen 361102, China.
- Medical College of Xiamen University, Xiamen 361102, China.
- Xiamen University affiliated Xiamen Eye Center, Xiamen 361102, China.
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen 361102, China.
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Tanbakouee E, Ghoreishi M, Aghazadeh-Amiri M, Tabatabaee M, Mohammadinia M. Photorefractive keratectomy for patients with preoperative low Schirmer test value. J Curr Ophthalmol 2016; 28:176-180. [PMID: 27830200 PMCID: PMC5093774 DOI: 10.1016/j.joco.2016.06.002] [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: 03/17/2016] [Revised: 06/01/2016] [Accepted: 06/01/2016] [Indexed: 11/04/2022] Open
Abstract
Purpose To compare dry eye signs and symptoms between patients with preoperative low and normal Schirmer test after Photorefractive keratectomy (PRK). Methods In this prospective, nonrandomized, comparative case series, 76 eyes of 76 patients were preoperatively categorized into two groups according to selected criteria for characterization of tear film status: the low Schirmer test value (STV) group and the normal STV group. For the tear function assessment, we performed a Schirmer test with and without anesthesia, tear break-up time (TBUT) test, and measurement dry eye symptoms using the Farsi translation of Ocular Surface Disease Index (OSDI) questionnaire pre- and 3 months post-operation. Results Postoperatively, the Schirmer and TBUT values were significantly lower in both groups than preoperatively (all p < 0.05). Deterioration in tear secretion was significantly greater in the low STV group (p = 0.012), but tear stability was more compromised in the normal STV group (p = 0.021). The changes in OSDI score were not significant between the two groups. Conclusion These results demonstrated that tear function deteriorates after PRK. Therefore, patients with low preoperative Schirmer test values should be thoroughly assessed for dry eye before proceeding with refractive surgery to eliminate postoperative complication.
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Affiliation(s)
- Elham Tanbakouee
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ghoreishi
- Ophthalmology Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Aghazadeh-Amiri
- Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Tabatabaee
- Department of Basic Sciences, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Abstract
FS-assisted LASIK has become the preferred method for LASIK flap creation due to the precision, accuracy, and reproducibility of the flap creation. Thinner, planar flaps may help prevent cases of post-LASIK ectasia and may have a superior refractive outcome. However, FS flap creation has several unique complications that require early recognition and optimal timely management for the best visual outcomes.
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Chan C, Lawless M, Sutton G, Versace P, Hodge C. Small incision lenticule extraction (SMILE) in 2015. Clin Exp Optom 2016; 99:204-12. [PMID: 27156103 DOI: 10.1111/cxo.12380] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 11/11/2015] [Accepted: 11/19/2015] [Indexed: 11/30/2022] Open
Abstract
Small incision lenticule extraction (SMILE) represents a recent addition to the refractive surgeon's range of procedures. Although there remains a number of similarities to existing techniques in terms of patient selection and treatment parameters, consideration is required to optimise patient outcomes and satisfaction. Here, we review the selection criteria, contraindications, indications and existing published safety and efficacy outcomes.
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Affiliation(s)
- Colin Chan
- Vision Eye Institute, Chatswood, New South Wales, Australia
| | - Michael Lawless
- Vision Eye Institute, Chatswood, New South Wales, Australia.,Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Gerard Sutton
- Vision Eye Institute, Chatswood, New South Wales, Australia.,Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | | | - Chris Hodge
- Vision Eye Institute, Chatswood, New South Wales, Australia.,University of New South Wales, Kensington, New South Wales, Australia
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Piñero-Llorens DP, Murueta-Goyena Larrañaga A, Hanneken L. Visual outcomes and complications of small-incision lenticule extraction: a review. EXPERT REVIEW OF OPHTHALMOLOGY 2016. [DOI: 10.1586/17469899.2016.1131610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Mondy P, Brama T, Fisher J, Gemelli CN, Chee K, Keegan A, Waller D. Sustained benefits of autologous serum eye drops on self-reported ocular symptoms and vision-related quality of life in Australian patients with dry eye and corneal epithelial defects. Transfus Apher Sci 2015; 53:404-11. [DOI: 10.1016/j.transci.2015.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Dry Eye Disease following Refractive Surgery: A 12-Month Follow-Up of SMILE versus FS-LASIK in High Myopia. J Ophthalmol 2015; 2015:132417. [PMID: 26649190 PMCID: PMC4662970 DOI: 10.1155/2015/132417] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 10/07/2015] [Accepted: 10/08/2015] [Indexed: 02/06/2023] Open
Abstract
Purpose. To compare dry eye disease following SMILE versus FS-LASIK. Design. Prospective, nonrandomised, observational study. Patients. 90 patients undergoing refractive surgery for myopia were included. 47 eyes underwent SMILE and 43 eyes underwent FS-LASIK. Methods. Evaluation of dry eye disease was conducted preoperatively and at 1, 3, 6, and 12 months postoperatively, using the Salisbury Eye Evaluation Questionnaire (SEEQ) and TBUT. Results. TBUT reduced following SMILE at 1 and 3 months (p < 0.001) and at 1, 3, and 6 months following FS-LASIK (p < 0.001). TBUT was greater following SMILE than FS-LASIK at 3, 6, and 12 months (p < 0.001, p < 0.001, and p = 0.009, resp.). SEEQ scores increased (greater symptoms) following SMILE at 1 month (p < 0.001) and 3 months (p = 0.003) and at 1, 3, and 6 months following FS-LASIK (p < 0.001). SMILE produced lower SEEQ scores (fewer symptoms) than FS-LASIK at 1, 3, and 6 months (p < 0.001). Conclusion. SMILE produces less dry eye disease than FS-LASIK at 6 months postoperatively but demonstrates similar degrees of dry eye disease at 12 months.
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Kreutzer TC, Dirisamer M, Priglinger S. ReLEx SMILE – Refraktive Lentikel Extraktion über Kleinschnittinzision. SPEKTRUM DER AUGENHEILKUNDE 2015. [DOI: 10.1007/s00717-015-0254-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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