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Rafizadeh SM, Sonbolestan SA, Zeidabadinejad H, Abtahi MA. Blepharoptosis and corneal epithelial thickness alterations, is there any relation? BMC Ophthalmol 2024; 24:282. [PMID: 38997644 PMCID: PMC11241861 DOI: 10.1186/s12886-024-03556-w] [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: 12/29/2023] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND To compare the epithelial thickness map of ptotic eyes of blepharoptosis patients with contralateral non- ptotic eyes. METHODS Unilateral blepharoptosis patients were enrolled consecutively. Patients were underwent full ophthalmologic examination and their demographic data such as age and gender and specific ptosis findings e.g. the cause and duration, MRD-1, and levator palpebralis superioris function were registered. Anterior segment imaging for epithelial thickness measurements was done using the Avanti RTVue-XR platform. The corneal epithelial thickness maps of ptotic and non-ptotic eyes were compared. RESULTS 44 patients with unilateral blepharoptosis were included in the study. 27 (61.4%) of them were female and 17 (38.6%) cases were male. The mean of the patients' ages was 24.40 ± 15.16 years. Ptotic eyes had significantly thinner superior (p = 0.000), superior-temporal (p = 0.000) and superior-nasal (p = 0.005) sectors of the cornea and slightly thicker corneal epithelium (CE) in the inferior-nasal sector. The correlation of difference of superior-inferior CE was evaluated with different parameters including patient's age (p = 0.457), type of blepharoptosis (p = 0.786), duration of blepharoptosis (p = 0.477) and MRD1 (p = 0.248), but no correlation was found. CONCLUSIONS This study revealed that lid position in blepharoptosis may have effects on the corneal epithelial thickness map. Because of the lower position of upper eyelid, a thinning effect on superior corneal sectors may happen.
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Affiliation(s)
- Seyed Mohsen Rafizadeh
- Department of oculo-facial plastic and reconstructive Surgery, Eye Research Center, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Sonbolestan
- Department of oculo-facial plastic and reconstructive Surgery, Eye Research Center, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Haniyeh Zeidabadinejad
- Farabi Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Ali Abtahi
- Department of cornea and anterior segment, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Arslan N, Kocamis SI, Bilgic AA, Acar M, Kesimal B. Evaluation of dry eye disease and corneal epithelial mapping in patients with lower eyelid ectropion. Int Ophthalmol 2024; 44:18. [PMID: 38324126 DOI: 10.1007/s10792-024-02966-5] [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: 04/27/2023] [Accepted: 12/04/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE To evaluate the corneal epithelial mapping, ocular surface parameters and their relationship with each other in lower eyelid ectropion patients according to severity. METHODS This retrospective study included 48 lower eyelid ectropion patients and 63 healthy individuals as control group. Ocular surface and tear functions were evaluated with ocular surface staining score, tear film break-up time (BUT), non-invasive tear break-up time (NIBUT) and ocular surface disease index (OSDI). Meibography scores and corneal epithelial thickness (CET) mapping were evaluated. The lower eyelid ectropion was classified and divided into subgroups as follows: mild, moderate and severe. RESULTS There was no significant differences between the groups for age and gender. Compared to controls, CET was significantly thinner at inferior (p = 0.047) and inferior nasal quadrants (p = 0.023) in the ectropion patients. Lower BUT and NIBUT, higher OSDI scores and higher ocular surface staining were observed in the ectropion patients. In the subgroups determined according to the severity of ectropion, ocular surface damage was found to be significantly higher as the severity of ectropion increased (p < 0.05). CONCLUSION Patients with lower eyelid ectropion had worse ocular surface findings and more ocular complaints. Furthermore, the inferior and inferior nasal CETs were thinner in patients with lower ectropion.
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Affiliation(s)
- Nese Arslan
- Department of Ophthalmology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Sucattin Ilker Kocamis
- Department of Ophthalmology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ahmet Alp Bilgic
- Department of Ophthalmology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
| | - Mutlu Acar
- Department of Ophthalmology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Bedia Kesimal
- Department of Ophthalmology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Abtahi MA, Beheshtnejad AH, Latifi G, Akbari-Kamrani M, Ghafarian S, Masoomi A, Sonbolastan SA, Jahanbani-Ardakani H, Atighechian M, Banan L, Nouri H, Abtahi SH. Corneal Epithelial Thickness Mapping: A Major Review. J Ophthalmol 2024; 2024:6674747. [PMID: 38205099 PMCID: PMC10776199 DOI: 10.1155/2024/6674747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/27/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
The corneal epithelium (CE) is the outermost layer of the cornea with constant turnover, relative stability, remarkable plasticity, and compensatory properties to mask alterations in the underlying stroma. The advent of quantitative imaging modalities capable of producing epithelial thickness mapping (ETM) has made it possible to characterize better the different patterns of epithelial remodeling. In this comprehensive synthesis, we reviewed all available data on ETM with different methods, including very high-frequency ultrasound (VHF-US) and spectral-domain optical coherence tomography (SD-OCT) in normal individuals, corneal or systemic diseases, and corneal surgical scenarios. We excluded OCT studies that manually measured the corneal epithelial thickness (CET) (e.g., by digital calipers) or the CE (e.g., by confocal scanning or handheld pachymeters). A comparison of different CET measuring technologies and devices capable of producing thickness maps is provided. Normative data on CET and the possible effects of gender, aging, diurnal changes, refraction, and intraocular pressure are discussed. We also reviewed ETM data in several corneal disorders, including keratoconus, corneal dystrophies, recurrent epithelial erosion, herpes keratitis, keratoplasty, bullous keratopathy, carcinoma in situ, pterygium, and limbal stem cell deficiency. The available data on the potential role of ETM in indicating refractive surgeries, planning the procedure, and assessing postoperative changes are reviewed. Alterations in ETM in systemic and ocular conditions such as eyelid abnormalities and dry eye disease and the effects of contact lenses, topical medications, and cataract surgery on the ETM profile are discussed.
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Affiliation(s)
| | | | - Golshan Latifi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sadegh Ghafarian
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Masoomi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Laleh Banan
- Sunshine Coast University Hospital, Brisbane, Queensland, Australia
| | - Hosein Nouri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Hossein Abtahi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Carreira P, Loureiro T, Carreira AR, Gouveia-Moraes F, Cardoso A, Sampaio A, Campos P, Rodrigues-Barros S, Machado I, Campos N. The Effect of Upper Eyelid Blepharoplasty on Corneal Tomography and Epithelial Profile. Clin Ophthalmol 2023; 17:3801-3807. [PMID: 38105910 PMCID: PMC10725641 DOI: 10.2147/opth.s426034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Upper tarsal mechanical forces influence corneal epithelial thickness profile, which could modulate corneal astigmatism. Upper eyelid blepharoplasty reduces upper tarsal strength and may have an impact on ocular surface. The aim of this study is to evaluate the effect of upper eyelid blepharoplasty on corneal epithelial thickness profile, astigmatism and aberrations. Methods Patients with dermatochalasis underwent bilateral upper eyelid blepharoplasty. Anterior segment optical coherence tomography (AS-OCT) (Zeiss Cirrus 5000 HD-OCT) and Pentacam (Oculus, Wetzlar Germany) were performed before surgery and in the 8th postoperative week. Corneal epithelial thickness, keratometry, aberrations and asphericity were considered for statistical purposes. Only right eyes were considered. A p-value lower than 0.05 was considered significant. Results Thirty eyes of 30 patients were included. The degree of astigmatism did not change after surgery (0.95D vs 0.83D, p=0.23). The difference between preoperative and postoperative steepest axis was 3.1° (p=0.04) with a tendency to change toward the vertical meridian. Mean epithelial thickness was higher in the inferior region both pre- and postoperatively and did not change. ET in the superior octant was lower (42 µm vs 45 µm, p<0.01) and the difference between inferior and superior octants (I-S) was higher (7 µm vs 3 µm, p<0.001) before surgery. There were no statistically significant changes in corneal aberrations (p=0.52) and asphericity (p=0.41) after surgery. Conclusion Our results support that upper tarsus pressure influences epithelial thickness profile and, consequently, the corneal steepest keratometry. These results lead us to postulate that upper eyelid blepharoplasty may influence biometric and keratometric measurements.
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Affiliation(s)
- Pedro Carreira
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Tomás Loureiro
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Rita Carreira
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Filipe Gouveia-Moraes
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Cardoso
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Audrey Sampaio
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Paul Campos
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Sandra Rodrigues-Barros
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Ines Machado
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
| | - Nuno Campos
- Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal
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Amatu JB, Baudouin C, Trinh L, Labbé A, Buffault J. [Corneal epithelial biomechanics: Resistance to stress and role in healing and remodeling]. J Fr Ophtalmol 2023; 46:287-299. [PMID: 36759249 DOI: 10.1016/j.jfo.2022.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 09/29/2022] [Accepted: 09/29/2022] [Indexed: 02/10/2023]
Abstract
The corneal epithelium is one of the first tissue barriers of the eye against the environment. In recent years, many studies provided better knowledge of its healing, its behavior and its essential role in the optical system of the eye. At the crossroads of basic science and clinical medicine, the study of the mechanical stresses applied to the cornea makes it possible to learn the behavior of epithelial cells and better understand ocular surface disease. We describe herein the current knowledge about the adhesion systems of the corneal epithelium and their resistance to mechanical stress. We will also describe the involvement of these mechanisms in corneal healing and their role in epithelial dynamics. Adhesion molecules of the epithelial cells, especially hemidesmosomes, allow the tissue cohesion required to maintain the integrity of the corneal epithelium against the shearing forces of the eyelids as well as external forces. Their regeneration after a corneal injury is mandatory for the restoration of a healthy epithelium. Mechanotransduction plays a significant role in regulating epithelial cell behavior, and the study of the epithelium's response to mechanical forces helps to better understand the evolution of epithelial profiles after refractive surgery. A better understanding of corneal epithelial biomechanics could also help improve future therapies, particularly in the field of tissue engineering.
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Affiliation(s)
- J-B Amatu
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28, rue de Charenton, 75012 Paris, France.
| | - C Baudouin
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28, rue de Charenton, 75012 Paris, France; Institut de La Vision, Sorbonne Université, Inserm, CNRS, IHU FOReSIGHT, 17, rue Moreau, 75012 Paris, France; Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, University of Versailles Saint-Quentin-en-Yvelines, Boulogne-Billancourt, France
| | - L Trinh
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28, rue de Charenton, 75012 Paris, France
| | - A Labbé
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28, rue de Charenton, 75012 Paris, France; Institut de La Vision, Sorbonne Université, Inserm, CNRS, IHU FOReSIGHT, 17, rue Moreau, 75012 Paris, France; Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, University of Versailles Saint-Quentin-en-Yvelines, Boulogne-Billancourt, France
| | - J Buffault
- Department of Ophthalmology III, CHNO des Quinze-Vingts, IHU FOReSIGHT, 28, rue de Charenton, 75012 Paris, France; Institut de La Vision, Sorbonne Université, Inserm, CNRS, IHU FOReSIGHT, 17, rue Moreau, 75012 Paris, France; Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, University of Versailles Saint-Quentin-en-Yvelines, Boulogne-Billancourt, France
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El-Shahed A, El-Shahed R, Gaballah K. Epithelial thickness mapping: mechanical photorefractive keratectomy versus transepithelial photorefractive keratectomy. DELTA JOURNAL OF OPHTHALMOLOGY 2022. [DOI: 10.4103/djo.djo_48_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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