Pub Date : 2022-06-01DOI: 10.1097/ICL.0000000000000902
P. Maharana, Gunjan Saluja, Sridevi Nair, R. Vijay, Ritu Nagpal, Nishat Hussain, R. Sinha, T. Agarwal, N. Sharma, J. Titiyal
Purpose: To report the clinical profile and treatment outcomes of patients with culture-positive Acremonium keratitis. Methods: This is a retrospective observational study. Medical records of all patients treated in a tertiary eye hospital for culture positive infective keratitis from March 2016 to February 2021 were screened, of which those positive for Acremonium species on fungal culture were reviewed. Demographic details, clinical presentation, clinical course, treatment given, total follow-up duration, time taken for ulcer to heal, scar size, and final visual acuity in the last follow-up were recorded. Results: Fifty three cases of fungal keratitis caused by Acremonium species were identified, 22 females and 31 males, with average age of 46.39±18.64 years. The mean duration of symptoms being 54.47±50 days. Only five patients had a history of trauma with vegetative matter. Clinical presentation of patients showed a large number of variations, with 2 patients presenting as peripheral ulcerative keratitis and 1 with epithelial plaque. The mean visual acuity of patients at presentation was 2.43±0.46 logMAR units. Thirty-three of 53 patients presented with perforated corneal ulcer and underwent penetrating keratoplasty; 20 patients were medically managed on topical voriconazole 1%, natamycin 5%, and oral voriconazole. The mean duration of healing of epithelial defect was 95±60.62 days (range 60–165 days). Conclusion: Acremonium keratitis has a long and indolent course. A prolonged combination therapy of natamycin and voriconazole seems to be effective in the management. A delay in the diagnosis of Acremonium keratitis often leads to clinical worsening requiring keratoplasty.
{"title":"Clinical Profile and Treatment Outcomes of Patients With Acremonium Species Positive Keratitis Managed in a Tertiary Eye Care Center","authors":"P. Maharana, Gunjan Saluja, Sridevi Nair, R. Vijay, Ritu Nagpal, Nishat Hussain, R. Sinha, T. Agarwal, N. Sharma, J. Titiyal","doi":"10.1097/ICL.0000000000000902","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000902","url":null,"abstract":"Purpose: To report the clinical profile and treatment outcomes of patients with culture-positive Acremonium keratitis. Methods: This is a retrospective observational study. Medical records of all patients treated in a tertiary eye hospital for culture positive infective keratitis from March 2016 to February 2021 were screened, of which those positive for Acremonium species on fungal culture were reviewed. Demographic details, clinical presentation, clinical course, treatment given, total follow-up duration, time taken for ulcer to heal, scar size, and final visual acuity in the last follow-up were recorded. Results: Fifty three cases of fungal keratitis caused by Acremonium species were identified, 22 females and 31 males, with average age of 46.39±18.64 years. The mean duration of symptoms being 54.47±50 days. Only five patients had a history of trauma with vegetative matter. Clinical presentation of patients showed a large number of variations, with 2 patients presenting as peripheral ulcerative keratitis and 1 with epithelial plaque. The mean visual acuity of patients at presentation was 2.43±0.46 logMAR units. Thirty-three of 53 patients presented with perforated corneal ulcer and underwent penetrating keratoplasty; 20 patients were medically managed on topical voriconazole 1%, natamycin 5%, and oral voriconazole. The mean duration of healing of epithelial defect was 95±60.62 days (range 60–165 days). Conclusion: Acremonium keratitis has a long and indolent course. A prolonged combination therapy of natamycin and voriconazole seems to be effective in the management. A delay in the diagnosis of Acremonium keratitis often leads to clinical worsening requiring keratoplasty.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"2014 1","pages":"272 - 275"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73991114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-17DOI: 10.1097/ICL.0000000000000900
Dawn Y. Lam, H. Wagner, Aaron B. Zimmerman, B. Rosner, Beth T. Kinoshita, Chandra V Mickles, G. Mitchell, M. Moreno, K. Richdale
Supplemental Digital Content is Available in the Text. Objectives: To determine if targeted education can influence the behaviors and scores of soft contact lens (SCL) wearers via the Contact Lens Risk Survey (CLRS). Methods: This was a multicenter, prospective, case–control study. Cases were symptomatic red eye SCL wearers (age, 18–39 years), and controls were age , sex, and site matched. Participants completed the CLRS and were provided targeted patient education at three time points: baseline, one, and six months. Change in scores and behaviors were analyzed using the Wilcoxon signed rank test. Results: Forty-one cases and 71 controls were analyzed. The mean risk score (mean±SE) from baseline to follow-up improved (reduced) for all participants (−1.96±0.73; P=0.01), mostly driven by the improvement among cases (−2.55±1.32; P=0.05). Case subjects reported a decrease in frequency of wearing lenses while showering (−0.32±0.07; P<0.0001), discarding lens solution (−0.13±0.06; P=0.03), and rinsing lenses with tap water (−0.19±0.08; P=0.02) after targeted education. Conclusions: Targeted patient education can influence some behaviors of SCL wearers, especially those who experienced a red eye event. Further study is needed to determine how to improve other risk behaviors and whether these changes are sustained long term.
{"title":"Change in Risk Score and Behaviors of Soft Contact Lens Wearers After Targeted Patient Education","authors":"Dawn Y. Lam, H. Wagner, Aaron B. Zimmerman, B. Rosner, Beth T. Kinoshita, Chandra V Mickles, G. Mitchell, M. Moreno, K. Richdale","doi":"10.1097/ICL.0000000000000900","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000900","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Objectives: To determine if targeted education can influence the behaviors and scores of soft contact lens (SCL) wearers via the Contact Lens Risk Survey (CLRS). Methods: This was a multicenter, prospective, case–control study. Cases were symptomatic red eye SCL wearers (age, 18–39 years), and controls were age , sex, and site matched. Participants completed the CLRS and were provided targeted patient education at three time points: baseline, one, and six months. Change in scores and behaviors were analyzed using the Wilcoxon signed rank test. Results: Forty-one cases and 71 controls were analyzed. The mean risk score (mean±SE) from baseline to follow-up improved (reduced) for all participants (−1.96±0.73; P=0.01), mostly driven by the improvement among cases (−2.55±1.32; P=0.05). Case subjects reported a decrease in frequency of wearing lenses while showering (−0.32±0.07; P<0.0001), discarding lens solution (−0.13±0.06; P=0.03), and rinsing lenses with tap water (−0.19±0.08; P=0.02) after targeted education. Conclusions: Targeted patient education can influence some behaviors of SCL wearers, especially those who experienced a red eye event. Further study is needed to determine how to improve other risk behaviors and whether these changes are sustained long term.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"50 1","pages":"347 - 354"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83272852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-17DOI: 10.1097/ICL.0000000000000904
Tingting Yang, B. Ma, Jianyang Xie, Yifan Zhou, Rongjun Liu, H. Duan, Yitian Zhao, H. Qi
Objectives: To investigate ocular surface alterations and in vivo confocal microscopic characteristics of the cornea in dry eye disease (DED) with contact lens wear (CLW). Methods: Sixty participants were divided into three groups: DED with CLW (n=20), DED without CLW (n=20), and normal control (n=20). Ocular surface parameters were evaluated. Basal tears and in vivo confocal microscopy images of the cornea were collected. Multiplex bead analysis was used to assess interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, nerve growth factor (NGF), and substance P (SP) in tears. Nerve morphology and dendritic cell density in corneal subbasal nerve images were calculated. Results: The DED with CLW group showed significantly higher ocular surface staining scores (P=0.022) and higher levels of IL-1β, NGF, and SP in tears (P=0.014, P=0.004 and P=0.025) than the DED without CLW group. Corneal dendritic cell density in the DED with CLW group was significantly higher than that in the normal controls (P=0.001) and DED without CLW group (P=0.043). Tear cytokine levels of IL-1β, NGF, and SP were correlated with ocular surface parameters in the DED with CLW group. Moreover, the years of CLW were positively correlated with corneal dendritic cell density (r=0.527, P=0.017) and negatively correlated with corneal nerve density (r=−0.511, P=0.021). Conclusions: Patients with DED with CLW showed greater epithelial damage, elevated inflammatory cytokines and neuromediators in tears, and higher corneal dendritic cell density than patients with DED without CLW. The immune and nervous systems may be involved in contact lens–related DED.
{"title":"Evaluation of Ocular Surface Characteristics in Dry Eye Disease With and Without Soft Contact Lens Wear: A Comparative Study","authors":"Tingting Yang, B. Ma, Jianyang Xie, Yifan Zhou, Rongjun Liu, H. Duan, Yitian Zhao, H. Qi","doi":"10.1097/ICL.0000000000000904","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000904","url":null,"abstract":"Objectives: To investigate ocular surface alterations and in vivo confocal microscopic characteristics of the cornea in dry eye disease (DED) with contact lens wear (CLW). Methods: Sixty participants were divided into three groups: DED with CLW (n=20), DED without CLW (n=20), and normal control (n=20). Ocular surface parameters were evaluated. Basal tears and in vivo confocal microscopy images of the cornea were collected. Multiplex bead analysis was used to assess interleukin (IL)-6, IL-1β, tumor necrosis factor (TNF)-α, nerve growth factor (NGF), and substance P (SP) in tears. Nerve morphology and dendritic cell density in corneal subbasal nerve images were calculated. Results: The DED with CLW group showed significantly higher ocular surface staining scores (P=0.022) and higher levels of IL-1β, NGF, and SP in tears (P=0.014, P=0.004 and P=0.025) than the DED without CLW group. Corneal dendritic cell density in the DED with CLW group was significantly higher than that in the normal controls (P=0.001) and DED without CLW group (P=0.043). Tear cytokine levels of IL-1β, NGF, and SP were correlated with ocular surface parameters in the DED with CLW group. Moreover, the years of CLW were positively correlated with corneal dendritic cell density (r=0.527, P=0.017) and negatively correlated with corneal nerve density (r=−0.511, P=0.021). Conclusions: Patients with DED with CLW showed greater epithelial damage, elevated inflammatory cytokines and neuromediators in tears, and higher corneal dendritic cell density than patients with DED without CLW. The immune and nervous systems may be involved in contact lens–related DED.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"23 1","pages":"377 - 383"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82476059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-17DOI: 10.1097/ICL.0000000000000901
D. Shin, Jeong Min Lee, Tae-im Kim, K. Y. Seo, K. Koh
Objective: To compare the difference in performance between the image-guided alignment system and the manual-marking method in the four-haptic hydrophobic monofocal toric intraocular lens (IOL). Methods: Medical records of patients who underwent cataract surgery with a four-haptic hydrophobic monofocal toric IOL implantation between May 2020 and April 2021 and with 3-month visit data available were investigated. Toric IOL misalignment, residual astigmatism, and mean prediction errors between the two groups were compared. Results: This study included 49 eyes of 44 patients (women: 68%; mean age: 67.2±7.0 [range: 47–82] years). Twenty-nine eyes of 26 patients were treated with toric IOL implantation using the image-guided system and 20 eyes of 18 patients were treated using the manual-marking method. No statistical differences were observed regarding the baseline characteristics of the two groups. Three months after the surgery, the misalignment of the toric IOL was significantly lower in the image-guided group (2.18°±0.65°, range: 1.26°–3.95°) than in the manual; marking group (4.72°±0.74°, range: 3.44°–6.21°; P<0.001). Conclusion: In comparison to the manual-marking method, the image-guided system reduced the misalignment of a four-haptic hydrophobic monofocal toric IOL.
{"title":"Efficacy of the Image-Guided Alignment System for a Four-Haptic Hydrophobic Monofocal Toric Intraocular Lens","authors":"D. Shin, Jeong Min Lee, Tae-im Kim, K. Y. Seo, K. Koh","doi":"10.1097/ICL.0000000000000901","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000901","url":null,"abstract":"Objective: To compare the difference in performance between the image-guided alignment system and the manual-marking method in the four-haptic hydrophobic monofocal toric intraocular lens (IOL). Methods: Medical records of patients who underwent cataract surgery with a four-haptic hydrophobic monofocal toric IOL implantation between May 2020 and April 2021 and with 3-month visit data available were investigated. Toric IOL misalignment, residual astigmatism, and mean prediction errors between the two groups were compared. Results: This study included 49 eyes of 44 patients (women: 68%; mean age: 67.2±7.0 [range: 47–82] years). Twenty-nine eyes of 26 patients were treated with toric IOL implantation using the image-guided system and 20 eyes of 18 patients were treated using the manual-marking method. No statistical differences were observed regarding the baseline characteristics of the two groups. Three months after the surgery, the misalignment of the toric IOL was significantly lower in the image-guided group (2.18°±0.65°, range: 1.26°–3.95°) than in the manual; marking group (4.72°±0.74°, range: 3.44°–6.21°; P<0.001). Conclusion: In comparison to the manual-marking method, the image-guided system reduced the misalignment of a four-haptic hydrophobic monofocal toric IOL.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"30 1","pages":"396 - 402"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78862557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-07DOI: 10.1097/ICL.0000000000000899
Cristina Cagliari, P. Schor, Luiz Formentin, C. Lipener, M. S. dos Santos, Helena Oliveira, José Ney de Carvalho Raulino Junior, D. de Freitas
Supplemental Digital Content is Available in the Text. Objective: To verify corneal alterations in patients with keratoconus who wear scleral contact lenses (ScCLs), focusing on corneal endothelial assessment. Methods: Scleral contact lenses were fitted in 22 patients with keratoconus. During a 90-day follow-up, patients were assessed in three visits: at baseline, after 30 days, and after 90 days. Patients underwent visual acuity measurement, slitlamp biomicroscopy of the anterior segment, specular microscopy of the corneal endothelium, corneal pachymetry, measurement of the clearance between the cornea and the lens, and follow-up of ectasia. Results: Variables related to endothelial morphology and pachymetry values did not change significantly over time. Central clearance measurements decreased in the 90-day period. No progression of corneal ectasia was observed, neither were infectious or inflammatory processes in the same period. Conclusion: Daily wear of ScCLs in patients with keratoconus was not associated with adverse effects on the cornea or endothelium over a period of 90 days nor was there evidence of disease progression. Central clearance values diminished over that period, but the significance of this observation remains unclear.
{"title":"Corneal Response to Scleral Contact Lens Wear in Keratoconus","authors":"Cristina Cagliari, P. Schor, Luiz Formentin, C. Lipener, M. S. dos Santos, Helena Oliveira, José Ney de Carvalho Raulino Junior, D. de Freitas","doi":"10.1097/ICL.0000000000000899","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000899","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Objective: To verify corneal alterations in patients with keratoconus who wear scleral contact lenses (ScCLs), focusing on corneal endothelial assessment. Methods: Scleral contact lenses were fitted in 22 patients with keratoconus. During a 90-day follow-up, patients were assessed in three visits: at baseline, after 30 days, and after 90 days. Patients underwent visual acuity measurement, slitlamp biomicroscopy of the anterior segment, specular microscopy of the corneal endothelium, corneal pachymetry, measurement of the clearance between the cornea and the lens, and follow-up of ectasia. Results: Variables related to endothelial morphology and pachymetry values did not change significantly over time. Central clearance measurements decreased in the 90-day period. No progression of corneal ectasia was observed, neither were infectious or inflammatory processes in the same period. Conclusion: Daily wear of ScCLs in patients with keratoconus was not associated with adverse effects on the cornea or endothelium over a period of 90 days nor was there evidence of disease progression. Central clearance values diminished over that period, but the significance of this observation remains unclear.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"24 1","pages":"322 - 327"},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84490339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1097/ICL.0000000000000882
Melinda Thomas De Jesus, J. Paugh, C. van de Pol, Alan Sasai, William R Ridder, A. Nguyen
Supplemental Digital Content is Available in the Text. Objectives: This study evaluated whether swimming goggle wear contributes to meibomian gland (MG) atrophy or functional change. Methods: Subjects included minimal goggle wear experience (normal subjects) and maximal goggle wear experience (competitive swimmers). Principal outcome measures were meiboscore and percent MG area remaining percent gland area remaining [PGAR]). Clinical tests included symptoms, tear meniscus height, lipid layer thickness, fluorescein tear breakup time, corneal and conjunctival staining, lower lid margin signs, gland secretion quality, Schirmer I, and meibography. Results: Forty-two age-matched, and sex-matched subjects completed the study (25 normal subjects and 17 goggle-wearing swimmers). Tear breakup time was significantly shorter in goggle wearers (P=0.016, Mann–Whitney U). Differences in meibography, symptoms, and other clinical dry eye workup parameters were not statistically significant (all P values >0.05). Regression analysis indicated that sex, tear breakup time, and meiboscore statistically impacted PGAR. Conclusions: There was no apparent difference in MG morphology and function between goggle-wearing swimmers and nongoggle-wearing control subjects in this study sample. Although swimming goggles have been documented as having adverse effects on the periorbital tissues, mechanical forces from long-term swimming goggle wear may not impact MG morphology or function. The tarsal plate likely plays a protective role for the MGs from external mechanical friction from swimming goggles.
{"title":"A Pilot Study of the Effects of Swimming Goggles on Meibomian Glands","authors":"Melinda Thomas De Jesus, J. Paugh, C. van de Pol, Alan Sasai, William R Ridder, A. Nguyen","doi":"10.1097/ICL.0000000000000882","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000882","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Objectives: This study evaluated whether swimming goggle wear contributes to meibomian gland (MG) atrophy or functional change. Methods: Subjects included minimal goggle wear experience (normal subjects) and maximal goggle wear experience (competitive swimmers). Principal outcome measures were meiboscore and percent MG area remaining percent gland area remaining [PGAR]). Clinical tests included symptoms, tear meniscus height, lipid layer thickness, fluorescein tear breakup time, corneal and conjunctival staining, lower lid margin signs, gland secretion quality, Schirmer I, and meibography. Results: Forty-two age-matched, and sex-matched subjects completed the study (25 normal subjects and 17 goggle-wearing swimmers). Tear breakup time was significantly shorter in goggle wearers (P=0.016, Mann–Whitney U). Differences in meibography, symptoms, and other clinical dry eye workup parameters were not statistically significant (all P values >0.05). Regression analysis indicated that sex, tear breakup time, and meiboscore statistically impacted PGAR. Conclusions: There was no apparent difference in MG morphology and function between goggle-wearing swimmers and nongoggle-wearing control subjects in this study sample. Although swimming goggles have been documented as having adverse effects on the periorbital tissues, mechanical forces from long-term swimming goggle wear may not impact MG morphology or function. The tarsal plate likely plays a protective role for the MGs from external mechanical friction from swimming goggles.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"41 1","pages":"169 - 174"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88845235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-03DOI: 10.1097/ICL.0000000000000858
Ilayda Korkmaz, M. Palamar, S. Eğrilmez, A. Yağcı, Ozlem Barut Selver
Objectives: To report 10 years of pediatric ocular chemical burn experience in a tertiary eye care center in Turkey. Methods: Thirty-three patients aged 18 years and younger who presented with ocular chemical burn between 2011 and 2021 were enrolled. Demographic data and clinical characteristics of patients were reviewed. Limbal stem cell deficiency (LSCD) stage was assessed according to LSCD working group's staging system. The initial and final best-corrected visual acuities were recorded. Results: The mean age was 10.4±5.5 (0.25–18) years with an F/M ratio of 12/21. Eleven (33.3%) of the patients were injured with acid and 5 (15.1%) with alkaline. The most common causative agent was nail polish remover (n=7, 21.2%), followed by cologne (n=5, 15.1%) and hand sanitizer (n=4, 12.1%). The severity of burn was ≥grade 4 in 20 patients (60.6%). Chemical injury resulted in LSCD in 18 patients (54.5%). Surgery was performed (LSCD ≥Stage 2 B) in 13 patients (39.3%); limbal stem cell transplantation (LSCT) (n=11), staged amniotic membrane transplantation, and symblepharon release (n=2). Penetrating keratoplasty after LSCT was performed in three of 11 patients. The mean follow-up time was 31.9±28.6 months (6–102.33) after the surgery. Conclusions: In pediatric population, accurate diagnosis and management of ocular chemical burns are challenging. Although the severity of burn and consequently LSCD rate seems to be high in children, comparative studies in a larger population are still needed.
{"title":"Ten Years of Pediatric Ocular Chemical Burn Experience in a Tertiary Eye Care Center in Turkey","authors":"Ilayda Korkmaz, M. Palamar, S. Eğrilmez, A. Yağcı, Ozlem Barut Selver","doi":"10.1097/ICL.0000000000000858","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000858","url":null,"abstract":"Objectives: To report 10 years of pediatric ocular chemical burn experience in a tertiary eye care center in Turkey. Methods: Thirty-three patients aged 18 years and younger who presented with ocular chemical burn between 2011 and 2021 were enrolled. Demographic data and clinical characteristics of patients were reviewed. Limbal stem cell deficiency (LSCD) stage was assessed according to LSCD working group's staging system. The initial and final best-corrected visual acuities were recorded. Results: The mean age was 10.4±5.5 (0.25–18) years with an F/M ratio of 12/21. Eleven (33.3%) of the patients were injured with acid and 5 (15.1%) with alkaline. The most common causative agent was nail polish remover (n=7, 21.2%), followed by cologne (n=5, 15.1%) and hand sanitizer (n=4, 12.1%). The severity of burn was ≥grade 4 in 20 patients (60.6%). Chemical injury resulted in LSCD in 18 patients (54.5%). Surgery was performed (LSCD ≥Stage 2 B) in 13 patients (39.3%); limbal stem cell transplantation (LSCT) (n=11), staged amniotic membrane transplantation, and symblepharon release (n=2). Penetrating keratoplasty after LSCT was performed in three of 11 patients. The mean follow-up time was 31.9±28.6 months (6–102.33) after the surgery. Conclusions: In pediatric population, accurate diagnosis and management of ocular chemical burns are challenging. Although the severity of burn and consequently LSCD rate seems to be high in children, comparative studies in a larger population are still needed.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"15 1","pages":"175 - 179"},"PeriodicalIF":0.0,"publicationDate":"2021-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73216275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-01DOI: 10.1097/ICL.0000000000000672
R. Macedo-De-Araújo, A. Amorim-de-Sousa, Eef van der Worp, J. González-Méijome
PURPOSE To report the fitting aspects, clinical findings, and symptoms over 12 months of scleral lens (SL) wear. METHODS Sixty-nine patients with irregular cornea due to ectasia or surgical procedures (IC group) or regular corneas with high ametropia (RC group) completed the 12-month prospective follow-up period. Patients were evaluated at baseline, lens dispensing visit, 1 month, 3 months, 6 months, and 12 months for assessment of comfort, fitting aspects, and slitlamp findings. Comfort was assessed with the Ocular Surface Disease Index (OSDI) questionnaire and Dry Eye Questionnaire. Slitlamp evaluations comprised on-eye lens fitting (lens alignment and tear reservoir thickness) and anterior ocular surface health after removing the lens (edema, hyperemia, staining, and adverse events). RESULTS OSDI Scores were significantly reduced after 1 month of SL wear comparing to baseline (from 47.0±22.7-23.9±14.7 in IC group, P<0.001 and 27.0±16.1-17.0±13.7, P=0.029 in RC group, P<0.05), without statistical significant differences from 1 to 12 months. Tear reservoir thickness showed a significant reduction at V1m (122 μm on IC group and 126 μm in RC group, P<0.05), that continued over time until V12m (195 and 184 μm lower compared with Baseline (P<0.05, Wilcoxon). Hyperemia and staining were significantly higher after SL removal when compared with baseline (P<0.05), and maintained the same behavior over the 12 months. There were no severe adverse events during the entire follow-up period. CONCLUSIONS Comfort enhancement promoted by SL remained over the entire follow-up. Despite no severe adverse events recorded over the 12 months of follow-up, higher hyperemia and staining grades were found after SL removal when compared with no-lens condition.
{"title":"Clinical Findings and Ocular Symptoms Over 1 Year in a Sample of Scleral Lens Wearers.","authors":"R. Macedo-De-Araújo, A. Amorim-de-Sousa, Eef van der Worp, J. González-Méijome","doi":"10.1097/ICL.0000000000000672","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000672","url":null,"abstract":"PURPOSE\u0000To report the fitting aspects, clinical findings, and symptoms over 12 months of scleral lens (SL) wear.\u0000\u0000\u0000METHODS\u0000Sixty-nine patients with irregular cornea due to ectasia or surgical procedures (IC group) or regular corneas with high ametropia (RC group) completed the 12-month prospective follow-up period. Patients were evaluated at baseline, lens dispensing visit, 1 month, 3 months, 6 months, and 12 months for assessment of comfort, fitting aspects, and slitlamp findings. Comfort was assessed with the Ocular Surface Disease Index (OSDI) questionnaire and Dry Eye Questionnaire. Slitlamp evaluations comprised on-eye lens fitting (lens alignment and tear reservoir thickness) and anterior ocular surface health after removing the lens (edema, hyperemia, staining, and adverse events).\u0000\u0000\u0000RESULTS\u0000OSDI Scores were significantly reduced after 1 month of SL wear comparing to baseline (from 47.0±22.7-23.9±14.7 in IC group, P<0.001 and 27.0±16.1-17.0±13.7, P=0.029 in RC group, P<0.05), without statistical significant differences from 1 to 12 months. Tear reservoir thickness showed a significant reduction at V1m (122 μm on IC group and 126 μm in RC group, P<0.05), that continued over time until V12m (195 and 184 μm lower compared with Baseline (P<0.05, Wilcoxon). Hyperemia and staining were significantly higher after SL removal when compared with baseline (P<0.05), and maintained the same behavior over the 12 months. There were no severe adverse events during the entire follow-up period.\u0000\u0000\u0000CONCLUSIONS\u0000Comfort enhancement promoted by SL remained over the entire follow-up. Despite no severe adverse events recorded over the 12 months of follow-up, higher hyperemia and staining grades were found after SL removal when compared with no-lens condition.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88728148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-01DOI: 10.1097/ICL.0000000000000658
Xiaoxiao Zhang, J. Zeng, Zhou Zhai, Cong Li, Xiao Yang
PURPOSE To provide fitting guidelines with suggested powers and base curves (BCs) and diameters for initial rigid gas-permeable (RGP) contact lenses (CLs) selection for unilateral aphakic infants based on age. METHODS Records of 52 children (52 eyes) with RGP CLs to unilateral aphakia between 2014 and 2019 were evaluated. Refractive status was assessed by standard retinoscopy. The original BC and diameter were determined by keratometric readings and fluorescein pattern under sedation. Correlation analysis was performed between age and CLs parameters. Linear regression analysis was used to develop a model for estimating power with the help of infant's age. Subgroup analysis was performed by grouping the eyes into four groups according to age. Lens adjustments and adverse events were also evaluated. RESULTS The median age was 9.0 months (interquartile range [IQR], 5.25-13.0 months). The mean power and BC and diameter of the initial RGP CLs were 25.46±4.83 diopters, 7.57±0.40 mm, and 9.48±0.23 mm, respectively. All these parameters showed correlations with infant's age (Pearson r=-0.676, 0.367, and 0.497, respectively; P=0.000, 0.008, and 0.000, respectively). Regression analysis revealed that CL power =31.66 to 0.62×age (P<0.001). The median follow-up was 7.50 months (IQR, 3.0-11.0 months). Lens adjustments took about every 3 months before 1 year of age and every 5 months afterward (F=3.442; P=0.024). The RGP CLs provided ideal fit characteristics, and no severe lens-related adverse event occurred except only one patient had mild conjunctivitis. CONCLUSIONS Our empirical RGP CLs fitting philosophy presented that aphakic infant's age can be used to determine the initial lens if accurate biometry cannot be obtained initially.
{"title":"Rigid Gas-Permeable Contact Lenses Fitting Philosophy for Unilateral Aphakic Infants.","authors":"Xiaoxiao Zhang, J. Zeng, Zhou Zhai, Cong Li, Xiao Yang","doi":"10.1097/ICL.0000000000000658","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000658","url":null,"abstract":"PURPOSE\u0000To provide fitting guidelines with suggested powers and base curves (BCs) and diameters for initial rigid gas-permeable (RGP) contact lenses (CLs) selection for unilateral aphakic infants based on age.\u0000\u0000\u0000METHODS\u0000Records of 52 children (52 eyes) with RGP CLs to unilateral aphakia between 2014 and 2019 were evaluated. Refractive status was assessed by standard retinoscopy. The original BC and diameter were determined by keratometric readings and fluorescein pattern under sedation. Correlation analysis was performed between age and CLs parameters. Linear regression analysis was used to develop a model for estimating power with the help of infant's age. Subgroup analysis was performed by grouping the eyes into four groups according to age. Lens adjustments and adverse events were also evaluated.\u0000\u0000\u0000RESULTS\u0000The median age was 9.0 months (interquartile range [IQR], 5.25-13.0 months). The mean power and BC and diameter of the initial RGP CLs were 25.46±4.83 diopters, 7.57±0.40 mm, and 9.48±0.23 mm, respectively. All these parameters showed correlations with infant's age (Pearson r=-0.676, 0.367, and 0.497, respectively; P=0.000, 0.008, and 0.000, respectively). Regression analysis revealed that CL power =31.66 to 0.62×age (P<0.001). The median follow-up was 7.50 months (IQR, 3.0-11.0 months). Lens adjustments took about every 3 months before 1 year of age and every 5 months afterward (F=3.442; P=0.024). The RGP CLs provided ideal fit characteristics, and no severe lens-related adverse event occurred except only one patient had mild conjunctivitis.\u0000\u0000\u0000CONCLUSIONS\u0000Our empirical RGP CLs fitting philosophy presented that aphakic infant's age can be used to determine the initial lens if accurate biometry cannot be obtained initially.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87505064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-01DOI: 10.1097/ICL.0000000000000659
Suzanne W. Sherman, Christina Cherny, L. Suh
Acquired epithelial inclusion conjunctival bulbar cyst is a reported complication of scleral contact lens impingement commonly corrected with a diameter change or notch of the scleral contact lens. This case discusses an acquired epithelial inclusion conjunctival bulbar cyst due to microtrauma caused by prolonged scleral contact lens wear and corrected with a MicroVault.
{"title":"Epithelial Inclusion Cyst of the Bulbar Conjunctiva Secondary to Scleral Lens Impingement Managed With a MicroVault.","authors":"Suzanne W. Sherman, Christina Cherny, L. Suh","doi":"10.1097/ICL.0000000000000659","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000659","url":null,"abstract":"Acquired epithelial inclusion conjunctival bulbar cyst is a reported complication of scleral contact lens impingement commonly corrected with a diameter change or notch of the scleral contact lens. This case discusses an acquired epithelial inclusion conjunctival bulbar cyst due to microtrauma caused by prolonged scleral contact lens wear and corrected with a MicroVault.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88787204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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