Tear Film Function Research Articles

Evaluation of Tear Film Functions Preoperatively and Postoperatively in Cases with Pterygium: A Case Control Study

Evaluation of Tear Film Functions Preoperatively and Postoperatively in Cases with Pterygium: A Case Control Study

Tear Film Instability and Meibomian Gland Dysfunction Correlate with the Pterygium Size and Thickness Pre- and Postexcision in Patients with Pterygium.

Purpose This study aimed to evaluate the effects of excision on dry eye and meibomian gland dysfunction (MGD) in individuals with pterygium, before and after surgery. It also aimed to investigate how these effects correlate with the size and thickness of the pterygium. Subjects and Methods 63 eyes from 63 patients with primary nasal pterygium and 45 eyes from 45 healthy volunteers without ocular pathologies were enrolled in this study. 63 eyes from 63 patients underwent pterygium surgery. ImageJ software was used to calculate the pterygium size based on images of the anterior segments. Anterior segment spectral domain optical coherence tomography (SD-OCT) was performed preoperatively to measure the thickness of the pterygium 1 mm anterior to the nasal scleral spur. The ocular surface disease index (OSDI), Schirmer I Test (SIT), and MGD grade were used to evaluate the eyes, and the eyes were imaged using the noninvasive keratograph average tear film breakup time (NIBUTav), tear meniscus height (TMH), meiboscore, and lipid layer grading tools of the Oculus® Keratograph 5M, preoperatively and at 1, 3, and 6 months postoperatively. Results The OSDI, NIBUTav, lid margin abnormality, meiboscore, and lipid layer grading values differed significantly in the pterygium patients in comparison with the controls (p < 0.01 for all scores). However, the SIT and TMH values were unchanged between the two groups (all p > 0.05). Multivariate regression analysis demonstrated that the NIBUTav, meiboscore, and lipid layer grading score was significantly correlated with the pterygium parameters, such as size and thickness. The postoperative OSDI, NIBUTav, lid margin abnormality, and lipid layer grading values improved significantly (p < 0.05 for all scores). The SIT, TMH, and meiboscore results did not differ significantly between the pre- and postoperative values (p > 0.05). Among the conventional and automated indexes, at 1 month postoperatively, SIT and TMH were significantly correlated with the pterygium parameters, but no correlation was observed at 3 and 6 months postoperatively. The OSDI, NIBUTav, meiboscore, and lipid layer grading values at 1, 3, and 6 months postoperatively were significantly correlated with the pterygium parameters. Conclusion Abnormal tear film and meibomian gland (MG) function improved following pterygium excision in the patients with primary pterygium, which was associated with uncomfortable ocular symptoms. Pterygium parameters, such as size and thickness, correlated with the dry eye and MGD indexes in patients pre- and postoperatively, potentially offering a novel strategy for clinical implementation of pterygium excision surgery.

The Impact of Bilateral Subepithelial Corneal Infiltrates on Tear Film After Epidemic Keratoconjunctivitis.

To evaluate the effect of corneal subepithelial infiltrates (SEIs) on tear film function and best-corrected visual acuity (BCVA) after persistent epidemic keratoconjunctivitis (EKC) and to compare the findings with controls. In this prospective, cross-sectional study, 38 patients with EKC and 42 healthy volunteers were enrolled. While patients with SEIs after EKC made up groups 1a (first involved eye) and 1b (second involved eye), healthy controls made up group 2. Best-corrected visual acuity, corneal subepithelial infiltrate scoring (CSIS), Fantes score, tear breakup time (TBUT), Schirmer test, and ocular surface disease index (OSDI) scores were measured. The Oxford grading system was used to score corneal staining. The mean Fantes score was 1.8±0.8 for group 1a and 1.3±1.1 for group 1b (P=0.03). The mean CSIS was 2.9±1.3 for group 1a and 1.9±1.7 for group 1b (P=0.005). But there was no significant difference in terms of the mean BCVA, TBUT, Schirmer, OSDI, and Oxford grading (P=0.66, 0.9, 0.9, 0.9, and 1.0, respectively) between group 1a and group 1b. The mean BCVA, TBUT, Schirmer, and OSDI values were worse in group 1a and group 1b in comparison to group 2 (P=0.001). We showed that the first involved eyes of patients with SEIs may be affected more significantly, but this difference may not have a clinical reflection on the difference in tear film functions between two eyes. However, compared with the healthy eyes, tear film function and BCVA were equally compromised in both eyes of the patients with SEIs irrelevant to the involved eye.

Comparison of tear index and tear film function between type 2 diabetic patients and normal subjects

Objective To compare the tear related indexes of patients with type-2 diabetes and the healthy subjects, analyze the functions of tear film of these two groups and provide significant theoretical evidences for the causes of the increased prevalence of dry eye in patients with type-2 diabetes and their pathogenesis. Methods A case-control study was designed.During the epidemiological investigation of dry eye in communities, 79 patients with diabetes and 74 normal healthy subjects were randomly selected as participants in this case-contol study.Dry eye tests including tear film break-up time (BUT), SchirmerⅠtest (SⅠt) and corneal fluorescein staining were performed.The tears were collected to detect mucoprotein-5AC (MUC-5AC), matrix metalloproteinase 9 (MMP-9), receptor of advanced glycation endproducts (RAGEs) and the content of insulin.The diagnosis standard referred to Experts Consensus on Clinical Diagnosis and Treatment of Dry Eye published in 2013.The study was followed the Declaration of Helsinki.This study protocol was approved by Medical Ethics Committee of the Shanghai General Hospital, Shanghai Jiaotong University(No.2016KY005), and written informed consent was obtained from all subjects. Results There were significant differences between 79 diabetes patients and 74 normal healthy subjects in the value of BUT, SⅠt and corneal fluorescein staining (all at P<0.05). The value of BUT and SⅠt in patients with diabetes were lower than those in the control group, while the corneal fluorescein staining scores of patients were higher than those of normal healthy subjects, with significant differences (P<0.05). In addition, compared with normal healthy subjects, the diabetic patients were higher in the value of MMP-9 and RAGEs, but lower in the content of insulin and MUC-5AC, with significant differences (P<0.05). There were significant differences in gender, diabetes duration, MMP-9, and MUC-5AC between the dry and non-dry eyes in the diabetic group (P<0.05). Women were more likely to develop dry eyes with a significant difference (t=4.35, P=0.04). The duration of diabetes in dry eye group was higher than that in non-dry eye group, with a significant difference (t=2.56, P=0.01); the value of MMP-9 in dry eye group was (1 052.37±157.68)pg/ml, which was significantly higher than that in non-dry eye group ([459.11±258.67]pg/ml)(t=11.92, P<0.01); the value of MUC-5AC in dry eye group was (867.83±121.82)pg/ml, which was significantly lower than in non-dry eye group ([972.93±153.52] pg/ml)(t=-3.30, P<0.01). There was no statistical difference in age and insulin between the two groups.Pearson correlation analysis showed that MMP-9 was negatively correlated with BUT (r=-0.349, P<0.01), and positively correlated with corneal fluorescein staining (r=0.181, P=0.026). MUC-5AC was positively correlated with SⅠt (r=0.367, P<0.01). Conclusions Dry eye prevalence is significantly related with the decrease in MUC-5AC and the increase in MMP-9 in community-based diabetic patients. Key words: Diabetes mellitus; Tear index detection; Tear film function; Dry eye

Evaluation of Meibomian Glands Dysfunction in Type Two Diabetic Patients

Background: Diabetes Mellitus is one of the most common leading causes of blindness. Cataract and retinopathy are wellknown as ocular complications of diabetes, problems involving the ocular surface; dry eyes in particular, have been reported in diabetic patients. Aim of the Work: to evaluate Meibomian glands function in patients with type 2 diabetes Mellitus. Materials and Methods: this prospective observational study compared changes in Meibomian glands and tear film function in type 2 diabetic patients with non-diabetic patients. It included 20 eyes of 11 patients with type two diabetes mellitus and 20 eyes of 11 healthy non-diabetic controls. Meibomian glands function was evaluated by grading of Meibomian gland loss by meibography. Tear film function was assessed by dry eye questionnaire, measuring tear breakup time (TBUT), the Schirmer I test & corneal and Conjunctival fluorescein staining. Results: dry eye questionnaire results were significantly higher scoring in diabetic group comparing with non-diabetic. TBUT was significantly lower in diabetic, especially with longer diabetic duration, comparing with normal control. Schirmer 1 test, corneal and conjunctival fluorescein staining, was significantly higher in diabetic patients compared with normal control. Meibography showed significant high scoring in diabetic patients that represent significant decrease in Meibomian gland number compared with controls. Conclusion: our data suggest that type 2 diabetes predisposes to various changes on the ocular surface Meibomian gland dysfunction (MGD) in type 2 diabetic patients is more severe compared with nondiabetic patients. It should be noted at an early stage and treated appropriately in order to prevent more severe eye complications. Therefore, close attention should be paid to the ocular surface, especially in long-term diabetes mellitus. Further studies are needed to increase the sample size and include fluctuations in blood sugar as a key factor in studying the ocular surface.

Evaluation of Meibomian Glands Dysfunction in Type Two Diabetic Patients

Background: Diabetes Mellitus is one of the most common leading causes of blindness. Cataract and retinopathy are wellknown as ocular complications of diabetes, problems involving the ocular surface; dry eyes in particular, have been reported in diabetic patients. Aim of the Work: to evaluate Meibomian glands function in patients with type 2 diabetes Mellitus. Materials and Methods: this prospective observational study compared changes in Meibomian glands and tear film function in type 2 diabetic patients with non-diabetic patients. It included 20 eyes of 11 patients with type two diabetes mellitus and 20 eyes of 11 healthy non-diabetic controls. Meibomian glands function was evaluated by grading of Meibomian gland loss by meibography. Tear film function was assessed by dry eye questionnaire, measuring tear breakup time (TBUT), the Schirmer I test & corneal and Conjunctival fluorescein staining. Results: dry eye questionnaire results were significantly higher scoring in diabetic group comparing with non-diabetic. TBUT was significantly lower in diabetic, especially with longer diabetic duration, comparing with normal control. Schirmer 1 test, corneal and conjunctival fluorescein staining, was significantly higher in diabetic patients compared with normal control. Meibography showed significant high scoring in diabetic patients that represent significant decrease in Meibomian gland number compared with controls. Conclusion: our data suggest that type 2 diabetes predisposes to various changes on the ocular surface Meibomian gland dysfunction (MGD) in type 2 diabetic patients is more severe compared with nondiabetic patients. It should be noted at an early stage and treated appropriately in order to prevent more severe eye complications. Therefore, close attention should be paid to the ocular surface, especially in long-term diabetes mellitus. Further studies are needed to increase the sample size and include fluctuations in blood sugar as a key factor in studying the ocular surface.

Observation of pranprofen to prevent dry eyes after cataract surgery

Objective To observe the preventive effect of pranoprofen on the dry eye after phacoemulsification. Methods The data of 300 eyes of 245 cases with cataract who received phacoemulsification from Jan.2017 to Jan.2018 in Changxing County People’s Hospital were selected and analyzed retrospectively.According to random number table, all cases were divided into two groups. The hyaluronate group, 150 eyes of 123 cases, were treated with sodium hyaluronate eye drops at 3 days before operation and 1 day after operation.And the pranoprofen group, 150 eyes of 122 cases, were treated with pranprofen eye drops combind with sodium hyaluronate eye drops. The ocular inflammation were observed and compared between the two groups. Results At 30 days after operation the tumor necrosis factor-a(TNF-a), interleukin -6(IL-6), high sensitive C-reactive(hs-CRP) and corneal fluorescence staining(FL), aningeresting, foreign body sensation, pain and fatigue scores in pranoprofen group and hyaluronate group were significantly lower than those in 3 days preoperatively.At 30 days after operation the TNF-a, IL-6, hs-CRP and FL, dryness, foreign body sensation, pain and fatigue scores in pranoprofen group were significantly lower than those in hyaluronate group.At 30 days after operation the basic tear secretion test and tear film rupture time in pranprofen group and hyaluronate group were significantly higher than those at 3 days preoperatively. At 30 days after operation the basic tear secretion test and tear film rupture time in pranoprofen group were significantly higher than those in hyaluronate group, the difference were statistically significant (P<0.05). No adverse reaction in two group occurred. Conclusion Pranprofen can effectively amelionate the ocular inflammation and tear film function after phacoemulsification, and it has the good preventive effect on dry eye, and it is safety. Key words: Pranoprofen; Cataract; Phacoemulsification; Dry eye; Prevention

Degeneration of Corneal Sensation and Innervation in Patients with Facial Paralysis: A Cross-Sectional Study Using in Vivo Confocal Microscopy

ABSTRACTPurpose: Facial paralysis (FP) leads to diverse periocular complications which threats visual acuity and affects corneal nerve functionally and morphologically. This study aims to summarize the clinical ophthalmic outcomes, corneal sensation, and morphological alterations of subbasal nerve and dendritic cells (DCs) in patients with facial paralysis.Methods: We performed a cross-sectional study of 48 consecutive patients with facial paralysis at one tertiary hospital. Forty-eight healthy participants were enrolled as controls. The images of corneal nerves and epithelial DCs were detected by in vivo confocal microscopy (IVCM). Each patient received thorough ophthalmic examination, tear film function tests, corneal fluorescence staining and Cochet-Bonnet esthesiometry test. Clinical and morphologic data were compared with controls.Results: Forty patients (83.3%) showed corneal injuries from punctate epithelial defects to corneal ulcers and scars. Visual impairment and eyelid malposition were observed. Corneal sensitivity remarkably decreased (25.1 ± 23.8 mm) in the affected eyes and was correlated to diminished subbasal nerve density (P = .019, r = 0.387). Numbers of corneal main nerve trunks and branches were significantly reduced (P < .0001) while DCs were increased (P < .0001) in patients with FP when compared with controls. Nerve fiber density showed inverse association with DC density (P = .019, r = −0.389).Conclusions: Ocular complications including corneal erosions, loss of corneal sensation, visual impairment and eyelid malposition have largely affected patients with facial paralysis. Morphological changes of diminished corneal subbasal nerve and increased DCs were detected by IVCM. Corneal epithelial defect, corneal opacity, corneal sensation, dendritic cell density are factors associated with corneal subbasal nerve density. Patients with FP are suggested to have complete ophthalmic evaluation and early instruction on ocular prevention.

Human Meibum Cholesteryl and Wax Ester Variability With Age, Sex, and Meibomian Gland Dysfunction.

PurposeRelationships between tear film lipid (TFL) layer composition, structure, and function could provide insight into the etiology of dry eye. The molar ratio of cholesteryl ester (CE)/wax ester (WE) was measured in meibum from normal donors (Mn) and compared with meibum from donors with meibomian gland dysfunction (MMGD).MethodsCE/WE was measured using nuclear magnetic resonance spectroscopy.ResultsCE/WE was distributed into two populations with 81% distributed near 0.55 and 19% near 0.3. CE/WE were higher in donors 13 to 19 years old compared with donors 1 to 12 years old and 20 to 88 years old. CE/WE for MMGD was 30% lower, 0.34 ± 0.04, compared with Mn, 0.49 ± 0.04. There were no sex differences in CE/WE. There were no significant racial differences between the CE/WE ratios for Asians and Caucasians. The CE/WE ratio was higher for blacks and lower for Hispanics compared to Caucasians. Due to the small number sampled, confirmation of the later racial results is needed. The packing of CE and WE in the TFL layer was proposed.ConclusionsAlthough MMGD contains much less CE than Mn, factors other than the CE content, such as the levels of saturation and/or proteins, may be responsible for the higher order of MMGD. In addition to saturation, CE could contribute to the increase in order of Mn between 0 and 20 years of age. Observed changes in the meibum content of CE alone is not likely to influence tear film stability.

Dynamic assessment of the tear film muco-aqueous and lipid layers using a novel tear film imager (TFI)

PurposeThe objective of the study was to assess a new technology, the tear film imager (TFI), which can dynamically image the muco-aqueous and lipid layers.MethodsProspective pilot case series of individuals...

The Influence of Overnight Orthokeratology on Ocular Surface and Meibomian Gland Dysfunction in Teenagers with Myopia.

Purpose The aim of this study was to investigate the effect of overnight orthokeratology (OOK) on ocular surface and meibomian gland dysfunction in teenagers with myopia. Methods A total of 59 subjects were recruited in this prospective study. The following tests were performed before and after 1, 3, 6, 12, and 24 months of OOK lens wear, including ocular surface disease index (OSDI) questionnaire, slit-lamp examination, and Keratograph 5M. Results No infectious keratitis occurred during the study. OSDI scores increased gradually and reached the maximum at 6 months of OOK wear (P < 0.001). The meniscus height was significantly increased at 1 and 3 months after the initiation of OOK (P=0.006, P=0.035). The corneal fluorescein staining at 1, 3, 6, 12, and 24 months after wearing OOK were all increased than the prewearing level with significant difference (P=0.014, P=0.036, P < 0.001, P < 0.001, and P=0.008, respectively). The first and the average tear film NIKBUT were all higher than the prewearing level, but there was no significant difference between every follow-up time points (P > 0.05). The lid margin abnormalities were significantly increased (P=0.003, P=0.038, and P=0.015) at 6, 12, and 24 months after the initiation of OOK. There was no significant difference in the meibomian gland orifice scores at each follow-up time points compared to the prewearing level (P > 0.05). The meibomian gland lipid secretion scores after wearing OOK were higher than those of the prewearing level, however, without statistically significant difference (P > 0.05). No significant differences of the degree of difficulty of lipid excretions were detected after the initiation of OOK (P > 0.05). There was no significant difference in meibomian gland dropout scores between all follow-up time points and the prewearing level (P=1.000). Conclusion OOK increased the symptoms of dry eye and decreased the function of tear film by affecting the meniscus height and BUT. OOK did not affect the function of meibomian glands.Clinical Study registration number: ChiCTR18000185708.

Tear Film Functions and Dry Eye Symptoms in Young Patients with Pterygium.

Objectives:This study was performed to evaluate the Schirmer II test (ST2) results, tear breakup time (TBUT) findings, and Ocular Surface Disease Index (OSDI) scores of pterygium patients under 30 years of age, and to compare the results with pterygium patients aged 30 years and older and healthy controls.Methods:Eighty-four eyes of 60 patients who had primary pterygium and were younger than 30 years of age (Group 1), 79 eyes of 53 patients who had primary pterygium and were 30 years of age and older (Group 2), and 64 eyes of 64 healthy controls (Group 3) were included in the study. The results of ST2 and TBUT tests and the OSDI questionnaire scores were recorded and compared.Results:Group 1 had lower TBUT values compared to Group 2 and the control group (p= 0.03 and p<0.001, respectively). Group 1 had lower ST2 values than the control group (p<0.001). There was no significant difference in the ST2 results between Group 1 and Group 2 (p=0.08). Group 1 had higher OSDI scores than the control group (p=0.003). There was no significant difference in the OSDI scores between Group 1 and Group 2 (p=0.7).Conclusion:The results indicated that young patients with pterygium had lower ST2 results, lower TBUT values, and higher OSDI scores compared to the control group, and lower TBUT values compared to older patients with pterygium. Tear film abnormality may be a factor in the pterygium pathogenesis, especially in young patients, and may increase the vulnerability of the ocular surface of young people to environmental factors, leading to pterygium formation.

Conjunctival Impression Cytology and Tear-Film Changes in Patients With Inflammatory Bowel Disease.

To evaluate the ocular surface changes and tear-film functions in patients with inflammatory bowel disease (IBD). The IBD group included 57 patients, and the control group included 29 healthy individuals. The Schirmer I test, tear breakup time (TBUT), corneal and conjunctiva fluorescent staining, and conjunctival impression cytology tests were performed to both groups. The rate of dry eye was 56.1% and 10.3% in the IBD and control groups, respectively, as assessed by the Schirmer I test (P<0.001). The rate of dry eye was 52.6% and 20.8% in the IBD and control groups, respectively through TBUT (P=0.004). The Ocular Surface Disease Index scores of the IBD group (15.25±7.31) were significantly higher than the control group (11.75±7.33) (P=0.039). According to the Oxford scheme, mild-to-moderate staining was 54.4% in the IBD group and 6.9% in the control group (P<0.001). Nelson Staging System showed that 69% of the IBD group had stage 2 or 3 impression cytology, whereas none of the control group had stage 2 or 3 impression cytology (P<0.001). Using the Schirmer I test, the rate of dry eye was 55.8% of the patients with IBD receiving 5-aminosalicylic acid (5-ASA) and 61.5% of the patients with IBD receiving both 5-ASA and azathioprine (P=0.485). Our study results showed that dry eye was 3 times higher in the IBD group than the control group. But, the duration of disease seems not to have effect on dry eye.

Effects of femtosecond laser-assisted cataract surgery on dry eye.

The aim of this study was to investigate the effect of femtosecond laser-assisted cataract surgery (FLACS) on tear film and ocular surface function. Patients with age-related cataract who underwent phacoemulsification (phaco) in Air Force Aviation Medicine Research Institute Affiliation Hospital from January 2016 to December 2016 were randomly divided into two groups. Patients in experimental group (n=123, 150 eyes) received FLACS, while patients in phaco group (n=110, 150 eyes) underwent conventional coaxial micro-incision phaco and were implanted with foldable intraocular lens (IOL). Our results showed that there were no statistically significant differences in general conditions between the two groups. Ocular surface disease index (OSDI) and corneal fluorescein staining (CFS) scores of patients in both groups after operation were significantly increased compared with those before operation, but breakup time (BUT) and Schirmer's I test scores decreased significantly at 1 week after operation compared with those before operation and basically returned to preoperative baseline levels at 3 months after operation. CFS scores and OSDI in the FLACS group at 1 day and 1 week after operation were increased more significantly than those in the phaco group, but there were no statistically significant differences at 3 months after operation. The above results showed that the effect on ocular surface function in the FLACS group after operation was greater than that in the phaco group, and the dry eye symptoms in the FLACS group were more obvious after operation. Both FLACS and conventional phaco have certain effects on the ocular surface function of patients, and there are statistically significant differences only in the early stage. FLACS has greater effects on CFS and dry eye symptoms.

Evaluation of the tear film function in diabetic patients using the Keratograph 5M

Objective: To evaluate the tear film function of diabetic patients using the Keratograph 5M and to analyze its related factors. Methods: Case-control study. A total of 89 inpatients (174 eyes) diagnosed with diabetes in the Department of Endocrinology at our hospital were recruited. According to the fundus fluorescein angiography results, subjects were divided into two groups, diabetic retinopathy (DR) group and none-DR group. All subjects were examined for duration of diabetes, glycosylated hemoglobin, creatinine, 24-hour urinary protein, and 24-hour urinary microalbumin/urinary creatinine, and by electromyography. The Keratograph 5M was used to obtain the first and average tear film break-up time (BUTf and BUTav), tear meniscus height, the upper and lower meibomian gland loss scores. The data were analyzed by SPSS. Results: Compared to the non-DR group, the BUTf and the BUTav in the DR group were shorter [(8.42±4.71) s vs. (10.24±5.32) s, (11.20±5.25) s vs. (12.67±5.52) s; P=0.000]. There was no significant difference in the tear meniscus height between the three groups (P=0.067). The tear meniscus height were negatively related with glycosylated hemoglobin, and not related with duration of diabetes, 24-hour urinary microalbumin/urinary creatinine, creatinine, 24-h urinary protein, and electromyography results. As the duration of diabetic longer, the upper and lower meibomian gland loss scores added(Z=19.514, 15.342, P<0.05). Patients with EMG abnormal, the lower meibomian gland loss scores added(Z=-2.312, P<0.05). Conclusions: The Keratograph 5M can directly evaluate the tear film condition of diabetic patients.Diabetic patients with retinopathy and higher glycosylated hemoglobin tend to suffer tear film dysfunction. (Chin J Ophthalmol, 2018, 54:762-766).

Overview of benign and malignant lacrimal gland tumors.

The goal of this article is to review the key clinical and radiological features, treatment strategies, and prognosis of lacrimal gland tumors. Debulking of the orbital lobe of the lacrimal gland may offer improved control rates in dacryoadenitis without compromise of tear film function. Contrary to previous belief, careful biopsy of the lacrimal gland prior to excision does not appear to increase the risk of recurrence in cases with suspected pleomorphic adenoma. Low-dose radiation (4 Gy) in two 2-Gy fractions appears to be effective and well tolerated in indolent non-Hodgkin lymphoma of the ocular adnexa with high local control rate. Eye-sparing surgery for adenoid cystic carcinoma (ACC) leaving minimal or no tumor residual in the orbit followed by adjuvant radiation therapy or chemoradiotherapy may provide good local control and long-term survival outcomes. Intra-arterial chemotherapy has been found to decrease recurrence and improve survival in ACC and can also be used as part of an eye-sparing treatment strategy. The development of targeted drugs may offer palliation for patients with unresectable or metastatic disease in lacrimal gland carcinoma. This article offers an update on diagnosis, management, and prognosis of the major lacrimal gland lesions.

Effect of different incision phacoemulsification on corneal endothelial function and tear film function in senile cataract patients

Effect of different incision phacoemulsification on corneal endothelial function and tear film function in senile cataract patients

Protective effect of hydroxypropyl methyl cellulose on corneal epithelium during phacoemulsification

Objective To evaluate the protective effect of corneal protective agent (2% hydroxypropyl methyl cellulose, HPMC) on corneal epithelium intraoperative and early postoperative phacoemulsification. Methods The data of 328 eyes of 328 cases with cataract from Mar. 2017 to Aug. 2017 were analyzed retrospectively. All cases underwent phacoemulsification and intraocular lens implantation. They were randomly divided into HPMC group of 164 eyes and control group of 164 eyes. The HPMC group received corneal surface drops HPMC during operation. The control group only used balanced salt solution to wet cornea during operation. The tear break up time (TBUT), fluorescein staining, conjunctival lissamine green staining and Schirmer I test were observed at 1 day and 1 week after operation. Results One day after operation, the TBUT of two groups was less than that before surgery, the difference was statistically significant (P=0.012). The difference of TBUT at 1 week postoperatively was statistically significant between the two groups (P=0.009). The differences in the results of fluorescein staining, conjunctival lissamine green staining and Schirmer I test value were significant between the two groups (1 day postoperatively P=0.029, P=0.041, P=0.032; 1 week postoperatively: P=0.032, P=0.039, P=0.047). Conclusion Corneal protector has obvious protective effect on corneal epithelium during phacoemulsification. It will obviously improve the function of tear film after cataract surgery. It can effectively prevent the occurrence of corneal epithelial dysfunction. Key words: Corneal protective agent; Hydroxypropyl methyl cellulose; Phacoemulsification; Corneal epithelium

Evaluation of tear osmolarity and tear function in patients with Behçet’s syndrome

ObjectiveTo evaluate the effects of Behçet’s syndrome (BS) on tear osmolarity and tear film function tests. MethodsThirty patients with BS and 41 control subjects were enrolled in this study. Tear osmolarity was measured with an osmometer. Tear film function tests involved corneal fluorescein staining, tear film breakup time (TBUT), Schirmer’s 1 test, and an Ocular Surface Disease Index (OSDI) Questionnaire. ResultsThe patients with BS had significantly higher tear osmolarity (p = 0.000) and OSDI scores (p = 0.000) than the healthy controls. The TBUT (p = 0.000) and Schirmer’s 1 test (p = 0.033) results were significantly lower in the BS group, but the fluorescein staining results were not statistically different. A significant correlation was found between tear osmolarity, OSDI, and the activity of BS. ConclusionsBS is associated with hyperosmolarity of the tear film, which can damage the ocular surface and affect tear functions.

Investigating the effect of eye cosmetics on the tear film: current insights.

Eye cosmetics are frequently applied among female populations of all age groups around the world. However, the migration of cosmetic products across the eyelid margin has been reported, and this is thought to exacerbate tear film instability and symptoms of dry eye. Furthermore, numerous adverse effects and complications have also been reported with eye cosmetic wear, and the associated inflammatory responses may potentially increase the propensity toward ocular surface disease development. Prospective studies have demonstrated that eyeliner application at the inner eyelash line is associated with higher levels of tear film contamination and ocular discomfort than application at the outer periocular skin. A recent randomized trial also highlighted the potential for eye cosmetic wear to compromise the efficacy of lipid-based dry eye supplements. This review outlines the current evidence base and understanding regarding the periocular migration of eye cosmetic products, the effects of cosmetic product contamination on tear film function, and the use of dry eye treatments in eye cosmetic wearers.