Break-up Time Research Articles

Evaluation of cyclosporine 0.05% and artificial tears for the management of dry eye disease following cataract surgery: a randomized controlled trial.

To compare the effects of cyclosporine 0.05% and artificial tears on dry eye disease following cataract surgery. This prospective, double-masked, randomized clinical trial enroled 60 eyes of 60 eligible cataract patients who completed the study. Patients were randomized to receive either cyclosporine 0.05% or artificial tear four times daily for 1 month following cataract surgery. Clinical assessments included refraction, corrected distance visual acuity, tear break-up time (TBUT), Schirmer's test, and the visual analogue scale (VAS). An independent sample t-test was used to compare the means of the variables between the two groups. Mean patient age was 64.15±9.17 (range, 45-90), of which 53% (n=32) were female. There was no significant difference in mean age (P=0.308) between the two groups. One month postoperatively, the cyclosporine 0.05% group had a significantly higher TBUT value (P=0.004). Schirmer's result (P=0.095) and the VAS questionnaire scores (P=0.374) did not show a statistically significant difference between the two groups. There was no significant difference in the visual outcomes (P>0.05). Cyclosporine 0.05% was superior to artificial tears in improving tear stability after cataract surgery in the management of immediate postoperative dry eye. It may provide a more effective therapeutic option for the management of dry eye symptoms in the clinical setting.

Role of Vitamin D3 Supplementation in the Treatment of Dry Eye Syndrome

Purpose: The aim of this study was to evaluate the role of vitamin D3 supplementation in treating non-Sjogren dry eye (NSDE) patients compared to the conventional treatment with artificial tears. Study Design: Non-randomized controlled Trial. Place and duration of study: Rural Health Centre (RHC) Buchaal Kalan from September 2021 to July 2022 Methods: This study allocated 108 patients with NSDE and hypovitaminosis D via two-arm parallel assignment. The sample was divided into two groups by non-probability purposive sampling. Group 1 received conventional treatment as artificial tears 4 times/day and group 2 was given oral vitamin D3 supplementation of 6000 IU daily along with artificial tears for a period of 90 days. The impact of oral vitamin D3 supplementation on NSDE was assessed by comparing means of ocular parameters of both groups over time. Tear break-up time (TBUT) in seconds and Schirmer’s test (ST) score in millimeters were primary outcome measures. The ocular surface disease index (OSDI) score and numerical pain rating scale (NPRS) were secondary outcome measures. Results: The mean age of patients in group 1 and group 2 was 34.98±8.64 and 34.87±8.79 respectively. Similarly, the mean serum 25 (OH) D level was 15.03±3.27 in group 1 and 14.93±3.26 in group 2. Results showed that OSDI and NPRS scores were decreased in both groups, however, TBUT and ST scores were improved in group 2. Conclusion: Oral vitamin D3 supplementation may serve as a new treatment option for NSDE patients having hypovitaminosis D.

Effect of Isotretinoin Treatment on Tear-Film Status and Ocular Surface Disease Index Score in Patients with Acne Vulgaris

Purpose: To determine tear film stability, tear secretion, volume, and dry eye symptoms according to the duration of isotretinoin use in treating acne vulgaris. Materials and Methods: In this cross-sectional comparison study, dry eye measurements were taken for 60 participants from patients who were diagnosed with acne vulgaris and were treated with isotretinoin from the dermatology clinic at Tishreen University Hospital-Lattakia during the period 2022-2023. The sample was examined before using isotretinoin, after a month and a half, and after three months. The sample underwent eye examinations that included the Schirmer 1 test, a tear film break-up time (BUT) examination using a slit lamp device, and Ocular Surface Disease Index (OSDI). Results: We noticed an increase in the intensity of dry eye as the duration of use increased, with statistically significant differences regarding the mean values of the tear film breakdown time (BUT) test, as it became less with the increase in the duration of isotretinoin (p=0.0001). The OSDI also showed an increase in the intensity of dryness as the duration of isotretinoin use increased, with statistically significant differences (p=0.0001). The Schirmer1 decreased as the duration of isotretinoin increased, with statistically insignificant differences regarding the mean values of the Schirmer1 test, as it became less as the duration of isotretinoin increased (p=0.07). Conclusion: The intensity of dry eye increases with the increasing duration of isotretinoin use in treating acne vulgaris in a statistically significant manner.

Examining Tear Film Dynamics Using the Novel Tear Film Imager.

The purpose of this study was to examine Tear Film Imager (TFI, AdOM, Israel) generated parameters across controls and dry eye (DE) subgroups and examine the changes in TFI parameters with contact lens (CL) placement. The retrospective study (n = 48) was conducted at the Miami Veterans Hospital. Symptoms were assessed through validated questionnaires and signs of tear function by tear break-up time and Schirmer scores. Participants were grouped as 1) healthy, 2) evaporative, 3) aqueous deficient, and 4) mixed DE based on tear function. Seventeen individuals had a baseline scan and a repeat scan following CL placement. Descriptives were compared across groups and over time. The median age was 27 years, 74% self-identified as White, 45% as male, and 51% as Hispanic. Subjects in the aqueous deficiency category had lower muco-aqueous layer thickness (MALT) (2672 vs. 3084 nm) but higher lipid layer thickness (47.5 vs. 38.3 nm), lipid break-up time (4.4 vs. 2 seconds), and interblink interval (13.9 vs. 5.4 seconds) compared with the evaporative group. Subjects in the evaporative group had the highest MALT values (3084 vs. 2988, 2672, 3053 nm) compared with healthy, aqueous-deficient, and mixed groups. Symptoms were not significantly correlated with TFI parameters. CL placement significantly decreased MALT values (2869 → 2175 nm, P = 0.001). The TFI provides unique information regarding the dynamic function of the tear film not captured by clinical examination. TFI generated metrics demonstrate a thinner aqueous layer in individuals with aqueous deficiency but highlight a thicker aqueous layer in those with evaporative DE.

End-of-day assessment of asymptomatic versus highly symptomatic soft contact lens wearers.

To investigate differences in key clinical parameters between asymptomatic and highly symptomatic soft contact lens (CL) wearers after 14 h of wear. In this pilot investigation, Phase 1 identified asymptomatic (CLDEQ-8 score ≤ 7) and highly symptomatic (CLDEQ-8 score ≥ 20) subjects after fitting with nelfilcon A CLs. Phase 2 investigated the following over a single nelfilcon A CL-wearing day (14 ± 2 h): blinking characteristics, tear meniscus height (TMH), non-invasive tear break-up time (NIBUT), tear film osmolarity and eyelid margin staining. Parameters for the two groups were compared using linear mixed models and post-hoc testing. The relationship between comfort scores and the clinical parameters was also investigated. Overall, 161 and 42 subjects were enrolled into Phase 1 and 2, respectively. Twenty-five asymptomatic and 17 symptomatic subjects completed Phase 2. Lower eyelid TMH was decreased after 14 h in symptomatic compared with asymptomatic subjects (least square mean [LSM] difference -0.04 mm, 95% CI: -0.07, -0.01). Osmolarity was lower in symptomatic than in asymptomatic subjects at fitting (LSM difference -9.89, 95% CI: -18.91, -0.86). Upper eyelid margin staining was greater after 14 h in symptomatic than in asymptomatic subjects (LSM difference 0.53, 95% CI: 0.01, 1.05) and greater after 14 h than baseline in the symptomatic group (LSM difference 0.61, 95% CI: 0.16, 1.07). There was a significant relationship between comfort and upper eyelid margin staining (r = -0.40, 95% CI: -0.63, -0.11) and blink rate (r = -0.31, 95% CI: -0.57, -0.003). The potential parameters most effective in differentiating asymptomatic from symptomatic wearers were upper eyelid margin staining and lower TMH. The parameter with the strongest relationship to comfort was upper eyelid margin staining, where higher comfort scores were associated with lower levels of staining.

Nest predation and climate change as drivers of alternative reproductive tactics in a migratory species

Alternative reproductive tactics enable individuals to choose a reproductive tactic relative to their status and prevailing environmental conditions in a way that increases their fitness. For example, females in many avian species show phenotypic plasticity and employ alternative reproductive tactics to cope with changes in predation risk and climate. Conspecific brood parasitism (CBP), in which females lay eggs in nests of conspecifics, is one example of such behaviour. It has been proposed that when prospects for successful nesting are low and/or costs of reproduction are high, females employ tactics of low effort such as non‐breeding and parasitic laying. When environmental conditions are ideal and prospects for success high, females can increase their reproductive effort above typical nesting by laying parasitic eggs prior to initiating their own nest. Here, I used this flexible life‐history strategy concept and long‐term (1994‒2022) population level data of the common goldeneye Bucephala clangula to study how the rate of parasitic laying varies in relation to variation in nest predation risk and in the timing and length of the breeding season, the latter being measured by the timing of ice breakup. Nest predation rate in the previous year and timing of ice breakup interactively affected parasitic laying, the rate of parasitic laying being particularly high in years with late ice breakup and high nest predation rate in the previous year. Furthermore, the proportion of predated eggs was lower in parasitized nests than in non‐parasitized nests, while the opposite was true for the proportion of eggs that failed in other way. As a consequence, the final number of young produced per nest was higher for parasitized nests. The findings of this study show that changes in environmental conditions affect the dynamics of alternative reproductive tactics in goldeneyes, with consequences to population level reproductive output.

Dry eye symptoms are prevalent in moderate-severe COVID-19, while SARS-COV-2 presence is higher in mild COVID-19: Possible ocular transmission risk of COVID-19

PurposeTo evaluate the correlation between dry eye symptoms and coronavirus disease 2019 (COVID-19) infection and to assess the real-time reverse transcription–polymerase chain reaction (RT‒PCR) of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from the conjunctival swab. MethodsA prospective observational case series study was conducted of all suspected and confirmed COVID-19 patients from Dr. Cipto Mangunkusumo Hospital (RSCM) and the Universitas Indonesia Hospital (RSUI). On the first day of the visit (day 0), systemic clinical symptoms and naso-oropharyngeal (NO) RT‒PCR results will classify all subjects as non-, suspected, or confirmed (mild, moderate, and severe) COVID-19. In all patients, we determined the dry eye symptoms based on the Ocular Surface Disease Index (OSDI) and followed up 7(day 7) and 14 days (day 14) after the first visit. When it was technically possible, we also examined the objective dry eye measurements: tear meniscus height (TMH), noninvasive Keratograph® break-up time (NIKBUT), and ocular redness. Additionally, we took conjunctival swab samples for SARS-CoV-2 RT-PCR in all patients. ResultsThe OSDI scores for 157 patients decreased across days 0, 7, and 14 (median (interquartile range): 2.3 (0–8), 0 (0–3), and 0 (0-0), p value < 0.0001 (D0 vs D14). The moderate-severe COVID-19 group had a higher OSDI score than the other groups at median D0 (15.6 vs 0–2.3), p value < 0.0001 and this pattern was consistently seen at follow-up D7 and D14. However, dry eye complaints were not correlated with the three objective dry eye measurements in mild-moderate COVID-19 patients. NO RT‒PCR results were positive in 32 (20.4%) patients, namely, 13 and 19 moderate-severe and mild COVID-19 patients, respectively. Positive RT‒PCR results were observed in 7/157 (4.5%) conjunctival swab samples from 1 in non-COVID-19 group and 6 in mild group. ConclusionIn the early phase of infection, COVID-19 patients experience dry eye symptoms, which have no correlation with objective dry eye measurements. SARS-CoV-2 in conjunctival swab samples can be detected in patients with normal-to-mild COVID-19, which shows the risk of ocular transmission.

Frequency of dry eye syndrome in patients with multiple sclerosis: A cross-sectional case-control study

Introduction: Demyelination of the nerve fibers of the central nervous system is a main pathology of multiple sclerosis (MS), in which inflammation plays a major role. Studies have shown that inflammation is the leading cause of dry eye disorder. To investigate the association between inflammation and both diseases, we aimed to estimate the prevalence of dry eye syndrome (DES) in MS patients and its correlation with the severity of the disease and disability status. Methods: We enrolled 100 MS patients randomly and 100 healthy controls. DES was evaluated by Dry Eye questionnaire and Scoring System (DESS), tear break-up time (TBUT), tear meniscus height (TMH), and Schirmer 1 &amp; 2 tests in subjects. Furthermore, the leading disability in MS was assessed by a clinician (neurology professor) using the related questionnaire (Expanded Disability Status Scale). Results: According to the TBUT, THM, and Schirmer tests, the number of subjects with abnormal results was significantly higher in the MS group than in the control group. The severity of DES measured by the DESS was also higher in the MS group compared to control group. Also, there was a significant relationship between increasing disability and abnormal dry eye tests, especially in MS patients with EDSS scores&gt;4. Conclusion: The present study highlights the importance of considering dry eye disorder in MS patients as a possible consequence of inflammation. Also, our results suggested a significant relationship between dry eye disorder and the EDSS scores.

Dry Eye-Like Ocular Surface Dysfunction in Post-Vitreoretinal Surgery Eyes

Objective: Dry eye is associated with reduced QoL and with the relevant social and economic costs. We evaluated the prevalence of dry eye signs and symptoms in a group of patients who underwent vitreoretinal surgery for epiretinal membrane removal for at least 6 months. Method: Fourty-one consecutive patients were enrolled. Ocular surface symptoms were evaluated using a structured form and a Visual Analogue Scale (VAS). Blink completeness, Break-Up Time (BUT), fluorescein and lissamine green staining and thickness of the lower tear meniscus were also assessed. Lissamine green staining was used to evaluate the mucocutaneous junction. Results: Symptoms were present up to 1 year from surgery in 80% of population. Foreign body and burning sensations were reported by 14 (34.1%) and 11 (26.8%) patients. Blinking was incomplete in 36.8% of patients; eyelid mucocutaneous junction was abnormal in 68.3% of patients. Mild or moderate eyelid injection were reported by 29 (70.7%) and 12 (21.3%) patients; moderate and peri-keratic hyperemia were reported by 22 (53.7%) and 15 (36.6%) patients. Only 26.2% of patients showed a normal BUT (&gt;10 s). Corneal sensitivity was absent in 4 patients (9.8%) and strongly decreased in 2 patients (7.3%). The lower tear meniscus was &lt;0.2 mm in 21 patients (51.2%). Fluorescein staining of the cornea was positive in 56% of patients. Conclusion: Patients who underwent vitreoretinal surgery showed, in the long-term, signs and symptoms of ocular surface dysfunction (dry eye) with a frequency that is more than double the expected frequency of the disease.

Machine learning-based prediction of tear osmolarity for contact lens practice.

This study addressed the utilisation of machine learning techniques to estimate tear osmolarity, a clinically significant yet challenging parameter to measure accurately. Elevated tear osmolarity has been observed in contact lens wearers and is associated with contact lens-induced dry eye, a common cause of discomfort leading to discontinuation of lens wear. The study explored machine learning, regression and classification techniques to predict tear osmolarity using routine clinical parameters. The data set consisted of 175 participants, primarily healthy subjects eligible for soft contact lens wear. Various clinical assessments were performed, including symptom assessment with the Ocular Surface Disease Index and 5-Item Dry Eye Questionnaire (DEQ-5), tear meniscus height (TMH), tear osmolarity, non-invasive keratometric tear film break-up time (NIKBUT), ocular redness, corneal and conjunctival fluorescein staining and Meibomian glands loss. The results revealed that simple linear regression was insufficient for accurate osmolarity prediction. Instead, more advanced regression models achieved a moderate level of predictive power, explaining approximately 32% of the osmolarity variability. Notably, key predictors for osmolarity included NIKBUT, TMH, ocular redness, Meibomian gland coverage and the DEQ-5 questionnaire. In classification tasks, distinguishing between low (<299 mOsmol/L), medium (300-307 mOsmol/L) and high osmolarity (>308 mOsmol/L) levels yielded an accuracy of approximately 80%. Key parameters for classification were similar to those in regression models, emphasising the importance of NIKBUT, TMH, ocular redness, Meibomian glands coverage and the DEQ-5 questionnaire. This study highlights the potential benefits of integrating machine learning into contact lens research and practice. It suggests the clinical utility of assessing Meibomian glands and NIKBUT in contact lens fitting and follow-up visits. Machine learning models can optimise contact lens prescriptions and aid in early detection of conditions like dry eye, ultimately enhancing ocular health and the contact lens wearing experience.

Effect of Regulated Type-2 Diabetes Mellitus on the Ocular Surface

The aim of this study was to see whether well-regulated Type-2 diabetes mellitus (DM) under than 10 years impacted meibography and tear film break-up time. DM (n=45) and normal subjects (n=45) were recruited. Two years’ mean glycated hemoglobin data were calculated as the regulation indicator. Eye examination followed by noninvasive tear break‑up time (NTBUT) measurement and then meibography were conducted. Regression analyses corrected for age and gender were used for comparisons between groups. Pearson correlation analysis was used to examine the linear relationship between NTBUT and meibomian gland loss to mean glycated hemoglobin. A value of p&lt;0.05 was considered statistically significant. The meiboscale comparisons within groups did not show any statistical difference. The mean meibomian gland loss comparisons between groups for the right lower eyelid (r=0.017, p=0.69), right upper eyelid (r=0.04 p=0.24), left lower eyelid (r=0.009, p=0.68) and left upper eyelid (r=0.027, p=0.13) were all similar. NTBUT for right and left eye were similar between groups (p=0.69 and p=0.36 respectively). Pearson’s correlation did not show any significant correlation between glycated hemoglobin, NTBUT and gland loss. In conclusion, it was found that patients with less than 10-year disease duration under DM regulation had similar ocular surfaces to normal subjects.

Efficacy of far infrared functional glasses in the treatment of meibomian gland dysfunction-related dry eye.

Meibomian gland dysfunction (MGD)-related dry eye disease (DED) is a significant subtype of DED. In this research, we investigate the effectiveness of far infrared (FIR) functional glasses in the treatment of MGD-related DED. According to the TFO DEWS II diagnostic criteria, 61 eyes with MGD-related DED were included. All participants wore functional FIR glasses throughout the day for a period of 4weeks and were followed up three times during the treatment. All subjects were followed up thoroughly in accordance with the DED clinical examination procedure. Ultimately, the treatment's impact was assessed. We found the Visual Analogue Scale and Ocular Surface Disease Index scores after FIR treatment were significantly lower than the baseline values (p<0.05). Compared with the baseline, fluorescein tear breakup time and corneal fluorescein staining score after FIR treatment were significantly improved (p<0.05). The eyelid margin signs, meibum quality, and meibomian gland expressibility after the 4-week treatment were significantly better than those at baseline (p<0.05). We can see that wearing the FIR functional glasses significantly relieves the symptoms and signs of patients. We believe FIR therapy could be considered as a new method of MGD-related DED.

Neuropathic Corneal Pain: Tear Proteomic and Neuromediator Profiles, Imaging Features, and Clinical Manifestations

To investigate the tear proteomic and neuromediator profiles, in vivo confocal microscopy (IVCM) imaging features, and clinical manifestations in neuropathic corneal pain (NCP) patients. Cross-sectional study. Twenty NCP patients and twenty age-matched controls were recruited. All subjects were evaluated by corneal sensitivity, Schirmer's test, tear break-up time, corneal and ocular surface staining, Ocular Surface Disease Index and Ocular Pain Assessment Survey questionnaires, as well as IVCM examinations for corneal nerves, microneruomas, epithelial and dendritic cells. Tears were collected for neuromediator and proteomic analysis using enzyme-linked immunosorbent assay and data-independent acquisition mass spectrometry. Burning and sensitivity to light were the two most common symptoms in NCP. A total of 188 significantly dysregulated proteins, such as elevated metallothionein-2, creatine kinases B-type, vesicle-associated membrane protein 2, neurofilament light polypeptide, and myelin basic protein, were identified in the NCP patients. The top 10 dysregulated biological pathways in NCP include neurotoxicity, axonal signaling, wound healing, neutrophil degradation, apoptosis, thrombin signaling mitochondrial dysfunction, RHOGDI and P70S6K signaling pathways. Compared to controls, the NCP cohort presented with significantly decreased corneal sensitivity (P<0.001), decreased corneal nerve fiber length (P=0.003), corneal nerve fiber density (P=0.006), nerve fiber fractal dimension (P=0.033), as well as increased in corneal nerve fiber width (P=0.002), increased length, total area and perimeter of microneuromas (P<0.001, P<0.001, P=0.019), smaller corneal epithelial size (P=0.017), and higher nerve growth factor level in tears (p=0.006). These clinical manifestations, imaging features, and molecular characterizations would contribute to the diagnostics and potential therapeutic targets for NCP.

Role of Polyunsaturated Fatty Acids (PUFAs) and Eicosanoids on Dry Eye Symptoms and Signs.

Polyunsaturated fatty acids (PUFAs) generate pro- and anti-inflammatory eicosanoids via three different metabolic pathways. This study profiled tear PUFAs and their metabolites and examined the relationships with dry eye (DE) and meibomian gland dysfunction (MGD) symptoms and signs. A total of 40 individuals with normal eyelids and corneal anatomies were prospectively recruited. The symptoms and signs of DE and MGD were assessed, and tear samples (from the right eye) were analyzed by mass spectrometry. Mann-Whitney U tests assessed differences between medians; Spearman tests assessed correlations between continuous variables; and linear regression models assessed the impact of potential confounders. The median age was 63 years; 95% were male; 30% were White; and 85% were non-Hispanic. The symptoms of DE/MGD were not correlated with tear PUFAs and eicosanoids. DE signs (i.e., tear break-up time (TBUT) and Schirmer's) negatively correlated with anti-inflammatory eicosanoids (11,12-dihydroxyeicosatrienoic acid (11,12 DHET) and 14,15-dihydroxyicosatrienoic acid (14,15, DHET)). Corneal staining positively correlated with the anti-inflammatory PUFA, docosahexaenoic acid (DHA). MGD signs significantly associated with the pro-inflammatory eicosanoid 15-hydroxyeicosatetranoic acid (15-HETE) and DHA. Several relationships remained significant when potential confounders were considered. DE/MGD signs relate more to tear PUFAs and eicosanoids than symptoms. Understanding the impact of PUFA-related metabolic pathways in DE/MGD may provide targets for new therapeutic interventions.

Breaking bubbles across multiple time scales in turbulence

The familiar process of bubbles generated via breaking waves in the ocean is foundational to many natural and industrial applications. In this process, large pockets of entrained gas are successively fragmented by the ambient turbulence into smaller and smaller bubbles. The key question is how long it takes for the bubbles to reach terminal sizes for a given system. Despite decades of effort, the reported breakup time from multiple experiments differs significantly. Here, to reconcile those results, rather than focusing on one scale, we measure multiple time scales associated with the process through a unique experiment that resolves bubbles’ local deformation and curvature. The results emphasize that the scale separation among various time scales is controlled by the Weber number, similar to how the Reynolds number determines the scale separation in single-phase turbulence, but shows a distinct transition at a critical Weber number.

Improvement of Clinical Findings, Meibography and Tear Film Parameters in Pediatric Ocular Rosacea Patients After a Standard Treatment Protocol

ABSTRACT Purpose The objective of this study was to illustrate the changes in ocular findings, meibography, and tear break-up time (TBUT) values in pediatric patients with ocular rosacea following a standardized treatment. Methods The study included consecutive patients diagnosed with ocular rosacea, referred to a tertiary hospital between 2021 and 2023. Each patient underwent biomicroscopic examinations, non-invasive TBUT assessments, corneal fluorescein staining (evaluated using the Oxford scoring system), and meibography. The standard treatment protocol involved warm compresses, eyelid hygiene, preservative-free sodium hyaluronate eye drops (administered four times daily), topical azithromycin 1.5% (twice daily for 3 days), topical steroids (loteprednol 0.5%, four times daily for 2 weeks), and either doxycycline 100 mg/day for 14 days or oral suspension of azithromycin 10 mg/kg for 3 days followed by an additional three-day course of treatment administered 10 days later (for patients above and below 14 years of age, respectively). Results The study included 18 patients, with 10 (55.5%) being female and 8 (44.4%) being male, with a mean age of 9.7 ± 4.5 years (range: 3–18). Four patients displayed cutaneous involvement. The treatments resulted in significant improvements in the Oxford scores, reduction in corneal neovascularization, and increased TBUT (p < 0.001, p = 0.016, p < 0.001, respectively). Meibomian gland loss area also significantly improved post-treatment (27.4 ± 6.7% vs 39.2 ± 13.4%, p = 0.001). Conclusion This study demonstrated that pediatric ocular rosacea patients may exhibit improved meibomian gland function, regression of corneal neovascularization, and enhanced tear film parameters following a standardized treatment protocol that includes both topical and systemic approaches.

Evaluating GlicoPro Tear Substitute Derived from Helix aspersa Snail Mucus in Alleviating Severe Dry Eye Disease: A First-in-Human Study on Corneal Esthesiometry Recovery and Ocular Pain Relief.

Background: To evaluate the effects of 10% GlicoPro tear substitute therapy in patients with severe dry eye disease (DED). Methods: In this prospective longitudinal study, 30 individuals receiving 10% GlicoPro four times daily for DED were evaluated. The ocular surface disease index (OSDI) questionnaire, average non-invasive break-up time (A-NIBUT), non-anesthetic and anesthetic corneal esthesiometry (CE), ocular pain, and the presence of conjunctivochalasis (CCH) were used as clinical endpoints. Treatment compliance using dosing diaries and AEs was assessed. Results: A significant improvement was observed in the clinical endpoints: the ΔOSDI questionnaire was -39.27 ± 13.22 [-65 to -15] points, ΔA-NIBUT was 3.10 ± 1.31 [1 to 5] s, Δnon-anesthetic CE was 14 ± 6.35 [5 to 25] mm, and Δanesthetic CE was 13 ± 5.35 [5 to 20] mm (p < 0.001 for all comparisons). Ocular pain was reduced in 92.5% of the patients at the end of the follow-up. However, there was no change in the presence of CCH. In addition, all the patients were fully compliant with the dosing and no AEs related to the use of the 10% GlicoPro tear substitute were reported. Conclusions: The 10% GlicoPro tear substitute has the potential to achieve beneficial effects in ocular surface treatments.

Diamond Bur Microblepharoexfoliation Combined with Intense Pulse Light and Meibomian Gland Expression for Evaporative Dry Eye: A Short-term Controlled Clinical Trial.

To assess the efficacy and safety of the combination of microblepharoexfoliation (MBE), intense pulse light (IPL) and meibomian gland expression (MGX) for treatment of meibomian gland dysfunction (MGD). This was a prospective, parallel-control trial conducted from April 2022 to January 2023. Participants were assigned to receive either three sessions of MBE-IPL-MGX treatment and home-based therapy (treatment group) or home-based therapy alone (control group). Outcome measures were assessed at baseline and after 2-month follow-up. Seventy eyes of 70 patients were enrolled. MBE-IPL-MGX treatment achieved better improvements than home-based therapy in ocular surface disease index (OSDI) and symptom assessment in dry eye (SANDE) scores, noninvasive tear film break-up time (NIBUT), lipid layer grade (LLG), loss area meibomian gland (LAMG) and meibomian gland yielding secretion score (MGYSS). The mean differences between the two groups were as follows: OSDI (- 11.23 ± 4.68 points, P < 0.001), SANDE (- 24.63 ± 13.41 points, P < 0.001), NIBUT (1.3 ± 1.57s, P = 0.033), LLG (0.4 ± 0.04 points, P = 0.003), LAMG (- 2.85 ± 1.69%, P = 0.023) and MGYSS (7.5 ± 2.32 points, P < 0.001). In addition, the increment (Δ) of MGYSS after MBE-IPL-MGX treatment was significantly higher in MGD grades 2 and 3 (all P < 0.001). MBE-IPL-MGX treatment is an effective and well-tolerated procedure that improves dry eye symptoms and signs as well as meibomian gland secretions in patients with MGD. In addition, this treatment is recommended for MGD grades 2 and 3.

The influence of some general diseases for changes on the ocular surface after trabeculectomy

BACKGROUND: By now, possible effects of diabetes mellitus and arterial hypertension on the ocular surface changes after trabeculectomy have not been evaluated. AIM: Analysis of the effects of arterial hypertension therapy and diabetes mellitus on the ocular surface changes after trabeculectomy. MATERIALS AND METHODS: The study group consisted of 443 patients, including those with arterial hypertension (179 patients), non insulin dependent compensated type 2 diabetes mellitus (25 patients) and their combination (53 persons), operated in 2016–2020 in the City Multifield Hospital No. 2, Saint-Petersburg, for primary open-angle noncompensated glaucoma and then observed for 6 to 24 months. The dynamics of ocular surface disease index (OSDI), tear film break-up time (TBUT), and amount of total tear production has been studied. RESULTS: The probability of the trabeculectomy success did not depend on the concomitant comorbidity. In contrast to intraocular pressure, the criteria for subjective and objective assessment of the ocular surface state were not subject to such obvious changes. In diabetic patients, the studied criteria have not changed compared to the baseline. CONCLUSIONS: The mentioned systemic diseases do not influence the state of the ocular surface in patients with glaucoma, and are not an independent risk factor for the failure of the IOP-lowering surgical procedure. The presence of diabetes mellitus prevents the accompanying a successful trabeculectomy regression of symptoms and clinical and functional signs of dry eye disease.

Efficacy and safety of trigeminal parasympathetic pathway stimulation for dry eye: A systematic review and meta-analysis.

This study aimed to investigate the efficacy and safety of trigeminal parasympathetic pathway (TPP) stimulation in the treatment of dry eye. A comprehensive search for randomized clinical trials was performed in seven databases (MEDLINE, Embase, CENTRAL, etc.) up to 28 February 2023. After screening the suitable studies, the data were extracted and transformed as necessary. Data synthesis and analysis were performed using Review Manager 5.4, and the risk of bias and quality of evidence were evaluated with the recommended tools. Fourteen studies enrolling 1714 patients with two methods (electrical and chemical) of TPP stimulation were included. Overall findings indicate that TPP stimulation was effective in reducing subjective symptom score (standardized mean difference [SMD], -0.45; 95% confidence interval [CI], -0.63 to -0.28), corneal fluorescence staining (mean difference [MD], -0.78; 95% CI, -1.39 to -0.18), goblet cell area (MD, -32.10; 95% CI, -54.58 to -9.62) and perimeter (MD, -5.90; 95% CI, -10.27 to -1.53), and increasing Schirmer's test score (SMD, 0.98; 95% CI, 0.65 to 1.31) and tear film break-up time (SMD, 0.57; 95% CI, 0.19 to 0.95). Compared to inactive or low-activity stimulation controls, it has a higher incidence of adverse events. Therefore, TPP stimulation may be an effective treatment for dry eye, whether electrical or chemical. Adverse events are relatively mild and tolerable. Due to the high heterogeneity and low level of evidence, the current conclusions require to be further verified.