Tear hyperosmolarity is a central hallmark of dry eye disease, and perpetuates a vicious cycle of ocular surface inflammation and tear film instability. The measurement of tear osmolarity and inter-ocular variability forms part of the global consensus dry eye diagnostic criteria recommended by the Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II). This investigator-masked diagnostic accuracy study sought to evaluate the discriminative ability and optimal thresholds for tear osmolarity and interocular variability in detecting other dry eye signs and symptoms. The study received institutional ethics committee approval and conformed to the tenets of the Declaration of Helsinki. Participants were required to be 16 years or older, with no ophthalmic surgical procedures in the 3 months preceding study participation. Written consent was provided by 866 participants, satisfying diagnostic accuracy power calculations (sample size ≥ 814, estimated prevalence = 40%, anticipated sensitivity = 70%, confidence level = 95%, absolute precision = 5%, power = 80%). The 5-Item Dry Eye Questionnaire and Ocular Surface Disease Index dry eye questionnaires were administered, and right eye ocular surface parameters (Oculus Keratograph 5M) assessed. An independent observer measured tear osmolarity from both eyes (TearLab Osmometer), and the higher reading and inter-ocular difference was recorded. The presence of nonosmolar dry eye signs and symptoms was determined according to the TFOS DEWS II diagnostic criteria (Table 1). The discriminative ability of osmolarity measurements in detecting other dry eye signs and symptoms was determined by the area under the receiver operating characteristic curve (C-statistic) and compared using the paired DeLong test. Youden-optimal diagnostic cut-off sensitivity and specificity values were then calculated. The discriminative ability of tear osmolarity (C-statistic = 0.82; 95% confidence interval [CI], 0.79-0.85) was greater than inter-ocular variability (C-statistic = 0.68; 95% CI, 0.65-0.72; P < 0.0001), although both were significantly greater than chance (both P < 0.0001). The optimal diagnostic cut-off for tear osmolarity was ≥308 mOsm/L,
{"title":"Diagnostic profile of tear osmolarity and inter‐ocular variability for dry eye disease","authors":"M. Wang, S. Ormonde, A. Muntz, J. Craig","doi":"10.1111/ceo.13688","DOIUrl":"https://doi.org/10.1111/ceo.13688","url":null,"abstract":"Tear hyperosmolarity is a central hallmark of dry eye disease, and perpetuates a vicious cycle of ocular surface inflammation and tear film instability. The measurement of tear osmolarity and inter-ocular variability forms part of the global consensus dry eye diagnostic criteria recommended by the Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II). This investigator-masked diagnostic accuracy study sought to evaluate the discriminative ability and optimal thresholds for tear osmolarity and interocular variability in detecting other dry eye signs and symptoms. The study received institutional ethics committee approval and conformed to the tenets of the Declaration of Helsinki. Participants were required to be 16 years or older, with no ophthalmic surgical procedures in the 3 months preceding study participation. Written consent was provided by 866 participants, satisfying diagnostic accuracy power calculations (sample size ≥ 814, estimated prevalence = 40%, anticipated sensitivity = 70%, confidence level = 95%, absolute precision = 5%, power = 80%). The 5-Item Dry Eye Questionnaire and Ocular Surface Disease Index dry eye questionnaires were administered, and right eye ocular surface parameters (Oculus Keratograph 5M) assessed. An independent observer measured tear osmolarity from both eyes (TearLab Osmometer), and the higher reading and inter-ocular difference was recorded. The presence of nonosmolar dry eye signs and symptoms was determined according to the TFOS DEWS II diagnostic criteria (Table 1). The discriminative ability of osmolarity measurements in detecting other dry eye signs and symptoms was determined by the area under the receiver operating characteristic curve (C-statistic) and compared using the paired DeLong test. Youden-optimal diagnostic cut-off sensitivity and specificity values were then calculated. The discriminative ability of tear osmolarity (C-statistic = 0.82; 95% confidence interval [CI], 0.79-0.85) was greater than inter-ocular variability (C-statistic = 0.68; 95% CI, 0.65-0.72; P < 0.0001), although both were significantly greater than chance (both P < 0.0001). The optimal diagnostic cut-off for tear osmolarity was ≥308 mOsm/L,","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82294957","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}
Cannabis is the most consumed illicit drug worldwide. As more countries consider bills that would legalize adult use of cannabis, health care providers, including eye care professionals (ophthalmologists, optometrists), will need to recognize ocular effects of cannabis consumption in patients. There are only 20 studies on the eyelid effects of cannabis usage as a medical treatment or a recreational drug. These include ptosis induction, an “eyelid tremor” appearance and blepharospasm attenuation. Six articles describe how adequately dosed cannabis regimens could be promising medical treatments for blepharospasm induced by psychogenic factors. Fourteen articles report eyelid tremors in intoxicated drivers and ptosis as a secondary effect in cannabinoid animal experimental models. The exact mechanism of cannabinoids connecting cannabis to the eyelids is unclear. Further studies should be conducted to better understand the cannabinoid system in relation to the eyelid and eventually develop new, effective and safe therapeutic targets derived from cannabis.
{"title":"Association between cannabis and the eyelids: A comprehensive review","authors":"A. X. Nguyen, A. Wu","doi":"10.1111/ceo.13687","DOIUrl":"https://doi.org/10.1111/ceo.13687","url":null,"abstract":"Cannabis is the most consumed illicit drug worldwide. As more countries consider bills that would legalize adult use of cannabis, health care providers, including eye care professionals (ophthalmologists, optometrists), will need to recognize ocular effects of cannabis consumption in patients. There are only 20 studies on the eyelid effects of cannabis usage as a medical treatment or a recreational drug. These include ptosis induction, an “eyelid tremor” appearance and blepharospasm attenuation. Six articles describe how adequately dosed cannabis regimens could be promising medical treatments for blepharospasm induced by psychogenic factors. Fourteen articles report eyelid tremors in intoxicated drivers and ptosis as a secondary effect in cannabinoid animal experimental models. The exact mechanism of cannabinoids connecting cannabis to the eyelids is unclear. Further studies should be conducted to better understand the cannabinoid system in relation to the eyelid and eventually develop new, effective and safe therapeutic targets derived from cannabis.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"94 1","pages":"230 - 239"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85373903","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}
Ellen F Tyler, Stuti L Misra, C. McGhee, Jie Zhang
case, at the time of explanation the tissue appeared normal and there were no black particles visible. We suggest that the tissue reaction in our case was secondary to the remaining microscopic platinum particles following explanation. In 2016, a review of hypersensitivity reactions to implanted metal devices was performed with mention of cobalt, gold, copper, nickel and titanium causing hypersensitivity, but no specific mention of platinum. One described reaction was type IV hypersensitivity to cobalt-chromium particles acting as haptens to elicit immune responses manifesting as periprosthetic granulomatous pseudotumours. In conclusion, this case presents a rare complication of platinum chain eyelid implant used in the management of paralytic lagophthalmos.
{"title":"Corneal nerve plexus changes induced by Oxaliplatin chemotherapy and Ergothioneine antioxidant supplementation","authors":"Ellen F Tyler, Stuti L Misra, C. McGhee, Jie Zhang","doi":"10.1111/ceo.13685","DOIUrl":"https://doi.org/10.1111/ceo.13685","url":null,"abstract":"case, at the time of explanation the tissue appeared normal and there were no black particles visible. We suggest that the tissue reaction in our case was secondary to the remaining microscopic platinum particles following explanation. In 2016, a review of hypersensitivity reactions to implanted metal devices was performed with mention of cobalt, gold, copper, nickel and titanium causing hypersensitivity, but no specific mention of platinum. One described reaction was type IV hypersensitivity to cobalt-chromium particles acting as haptens to elicit immune responses manifesting as periprosthetic granulomatous pseudotumours. In conclusion, this case presents a rare complication of platinum chain eyelid implant used in the management of paralytic lagophthalmos.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82398979","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}
Mona S Awadalla, Ayub Qassim, Mark M. Hassall, T. Nugyen, J. Landers, J. Craig
Monitoring the results of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) using a home rebound tonometry.
选择性激光小梁成形术(SLT)对眼压(IOP)的影响。
{"title":"Using Icare HOME tonometry for follow‐up of patients with open‐angle glaucoma before and after selective laser trabeculoplasty","authors":"Mona S Awadalla, Ayub Qassim, Mark M. Hassall, T. Nugyen, J. Landers, J. Craig","doi":"10.1111/ceo.13686","DOIUrl":"https://doi.org/10.1111/ceo.13686","url":null,"abstract":"Monitoring the results of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) using a home rebound tonometry.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"5 1","pages":"328 - 333"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79490963","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}
1. Diamond EL, Dagna L, Hyman DM, et al. Consensus guidelines for the diagnosis and clinical management of Erdheim-Chester disease. Blood. 2014;124:483-492. 2. Wang F, Cao X, Niu N, et al. Multisystemic imaging findings in Chinese patients with Erdheim-Chester disease. AJR Am J Roentgenol. 2019;213:1-8. 3. Tan ACS, Yzer S, Atebara N, et al. Three cases of Erdheim-Chester disease with intraocular manifestations: imaging and histopathology findings of a rare entity. Am J Ophthalmol. 2017;176:141-147. 4. Pichi F. Choroidal mass as the first presentation of Erdheim-Chester disease. Am J Ophthalmol Case Rep. 2019;16:100539. 5. Abdellatief A, Mason CM, Ytterberg SR, Boorjian SA, Salomao DR, Pulido J. Choroidal involvement in Erdheim-Chester disease. Ophthalmic Surg Lasers Imaging Retina. 2015;46:674-676.
1. Diamond EL, Dagna L, Hyman DM等。埃尔德海姆-切斯特病诊断和临床管理的共识指南。血。2014;124:483 - 492。2. 王峰，曹旭，牛宁，等。中国厄德海姆-切斯特病患者的多系统影像学表现。刘建军，刘建军，刘建军，等。石油物探。2019;21(3):1-8。3.Tan ACS, Yzer S, Atebara N，等。3例伴有眼内表现的Erdheim-Chester病:罕见的影像学和组织病理学表现。中华眼科杂志，2017;17(6):391 - 391。4. 脉络膜肿块是Erdheim-Chester病的第一个表现。中华眼科杂志，2019;16(1):100 - 100。5. Abdellatief A, Mason CM, Ytterberg SR, Boorjian SA, Salomao DR, Pulido J. Erdheim-Chester病的脉管炎。眼科外科激光成像视网膜。2015;46:674-676。
{"title":"Delayed necrobiotic granulomatous reaction following removal of eyelid platinum chain","authors":"T. Ryan, V. Juniat, C. James, D. Selva","doi":"10.1111/ceo.13682","DOIUrl":"https://doi.org/10.1111/ceo.13682","url":null,"abstract":"1. Diamond EL, Dagna L, Hyman DM, et al. Consensus guidelines for the diagnosis and clinical management of Erdheim-Chester disease. Blood. 2014;124:483-492. 2. Wang F, Cao X, Niu N, et al. Multisystemic imaging findings in Chinese patients with Erdheim-Chester disease. AJR Am J Roentgenol. 2019;213:1-8. 3. Tan ACS, Yzer S, Atebara N, et al. Three cases of Erdheim-Chester disease with intraocular manifestations: imaging and histopathology findings of a rare entity. Am J Ophthalmol. 2017;176:141-147. 4. Pichi F. Choroidal mass as the first presentation of Erdheim-Chester disease. Am J Ophthalmol Case Rep. 2019;16:100539. 5. Abdellatief A, Mason CM, Ytterberg SR, Boorjian SA, Salomao DR, Pulido J. Choroidal involvement in Erdheim-Chester disease. Ophthalmic Surg Lasers Imaging Retina. 2015;46:674-676.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87406337","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}
M. Ziaei, Hans R Vellara, A. Gokul, Noor Q Ali, C. McGhee, Dipika V. Patel
Keratoplasty is a surgical procedure to create a more regular optical surface following biomechanical weakening of the cornea in keratoconus. The ideal keratoplasty procedure should also restore corneal biomechanics to that of the healthy cornea.
{"title":"Comparison of corneal biomechanical properties following penetrating keratoplasty and deep anterior lamellar keratoplasty for keratoconus","authors":"M. Ziaei, Hans R Vellara, A. Gokul, Noor Q Ali, C. McGhee, Dipika V. Patel","doi":"10.1111/ceo.13677","DOIUrl":"https://doi.org/10.1111/ceo.13677","url":null,"abstract":"Keratoplasty is a surgical procedure to create a more regular optical surface following biomechanical weakening of the cornea in keratoconus. The ideal keratoplasty procedure should also restore corneal biomechanics to that of the healthy cornea.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"198 1","pages":"174 - 182"},"PeriodicalIF":0.0,"publicationDate":"2019-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76035153","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}
Noha Ali, Danuta M. Sampson, A. A. Yong, Rumaanah Jeewa, Saumya Rajgopal, Deepaysh D C S Dutt, Mohamed Sharaf, Shehata Mohamed, M. Menghini, A. Hansen, F. Chen
All automated image quality indicators for en face optical coherence tomography angiography (OCTA) images require gold standard validation for determining optimum thresholds.
{"title":"Clinical validation of the RTVue optical coherence tomography angiography image quality indicators","authors":"Noha Ali, Danuta M. Sampson, A. A. Yong, Rumaanah Jeewa, Saumya Rajgopal, Deepaysh D C S Dutt, Mohamed Sharaf, Shehata Mohamed, M. Menghini, A. Hansen, F. Chen","doi":"10.1111/ceo.13680","DOIUrl":"https://doi.org/10.1111/ceo.13680","url":null,"abstract":"All automated image quality indicators for en face optical coherence tomography angiography (OCTA) images require gold standard validation for determining optimum thresholds.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"17 1","pages":"192 - 203"},"PeriodicalIF":0.0,"publicationDate":"2019-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84702636","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}
J. Treloggen, Helen McKeon, C. Hodge, C. Petsoglou
Amniotic membrane (AM) has been used across ophthalmology for almost 80 years. AM has been shown to stimulate wound repair while suppressing inflammation, angiogenesis and scarring offering potential opportunities for the successful treatment of an increasing number of ophthalmic indications. Essential for use in ocular surgery, the tissue is non-reactive and largely transparent. Recently, the New South Wales Organ & Tissue Donation Service (NSW OTDS) established an AM retrieval and processing pathway to support local surgical demand. The process of AM retrieval follows standard living donor protocols inclusive of strict exclusion criteria. Following consent, AM is accessed through planned caesarean birth and full-term pregnancy. After procurement, tissue is placed within a sterile medium and kept between 2-8 degrees for transport. At the preparation stage, AM is separated from the chorion, decontaminated and incubated with antibiotic and antimycotic solutions before application to a carrier surface (nitrocellulose paper) which is then cut into standard dimensions (5 × 5 cm, 5 × 10 cm, 10 × 10 cm). AM is then cryopreserved up to a period of 12 months from day of retrieval. Microbiology is performed both as a batch and as individual grafts to exclude organism contamination (prior to bioburden reduction, post-production swab of individual graft and culture of both wash solution and remnant). All donors are followed up after routine new-born checks via a phone interview to exclude post-donation concerns. Beginning in 18 October 2018 separate AM donations have been accessed principally through the Mater Hospital (North Sydney, NSW, Australia). The mean age of mothers was 36.2 ± 4.1 years (range 28 to 40 years). An average of 26.3 tissue sections were processed from primary donor tissue (median 25, range 12 to 38). 16 AM sections of nine patients were found to be positive for microbiology and were either removed from consideration or utilized for research purposes only. Microbiology findings were consistent with the patient-hospital environment and or contamination (S. epidermis, S. cohnii, S. Warneri, Cutibacterium acnes, Paenibacillus urinalis, Paenibacillus sp). Following the introduction of the service, NSW OTDS has received 119 AM tissue requests with the absolute majority for ophthalmic indications (96.6%). Requests have been received and completed from 58 ophthalmic surgeons across all states and territories except Northern Territory suggesting a basic national demand for AM. Fifty-nine percent of recipients were male with a mean age of 64.0 ± 17.3 years (range 6 to 93) corresponding with population findings from the existing ophthalmic literature. Seven patients required multiple tissue applications for surface reconstruction or tectonic repair (neoplasia, corneal ulcer at risk of perforation, infectious scleritis and alkali burn). Tissue requests largely reflect the potential benefits of AM transplantation which include faster wound healing,
{"title":"Ophthalmic use of amniotic membrane tissue in Australia: Introduction and initial use of a service","authors":"J. Treloggen, Helen McKeon, C. Hodge, C. Petsoglou","doi":"10.1111/ceo.13678","DOIUrl":"https://doi.org/10.1111/ceo.13678","url":null,"abstract":"Amniotic membrane (AM) has been used across ophthalmology for almost 80 years. AM has been shown to stimulate wound repair while suppressing inflammation, angiogenesis and scarring offering potential opportunities for the successful treatment of an increasing number of ophthalmic indications. Essential for use in ocular surgery, the tissue is non-reactive and largely transparent. Recently, the New South Wales Organ & Tissue Donation Service (NSW OTDS) established an AM retrieval and processing pathway to support local surgical demand. The process of AM retrieval follows standard living donor protocols inclusive of strict exclusion criteria. Following consent, AM is accessed through planned caesarean birth and full-term pregnancy. After procurement, tissue is placed within a sterile medium and kept between 2-8 degrees for transport. At the preparation stage, AM is separated from the chorion, decontaminated and incubated with antibiotic and antimycotic solutions before application to a carrier surface (nitrocellulose paper) which is then cut into standard dimensions (5 × 5 cm, 5 × 10 cm, 10 × 10 cm). AM is then cryopreserved up to a period of 12 months from day of retrieval. Microbiology is performed both as a batch and as individual grafts to exclude organism contamination (prior to bioburden reduction, post-production swab of individual graft and culture of both wash solution and remnant). All donors are followed up after routine new-born checks via a phone interview to exclude post-donation concerns. Beginning in 18 October 2018 separate AM donations have been accessed principally through the Mater Hospital (North Sydney, NSW, Australia). The mean age of mothers was 36.2 ± 4.1 years (range 28 to 40 years). An average of 26.3 tissue sections were processed from primary donor tissue (median 25, range 12 to 38). 16 AM sections of nine patients were found to be positive for microbiology and were either removed from consideration or utilized for research purposes only. Microbiology findings were consistent with the patient-hospital environment and or contamination (S. epidermis, S. cohnii, S. Warneri, Cutibacterium acnes, Paenibacillus urinalis, Paenibacillus sp). Following the introduction of the service, NSW OTDS has received 119 AM tissue requests with the absolute majority for ophthalmic indications (96.6%). Requests have been received and completed from 58 ophthalmic surgeons across all states and territories except Northern Territory suggesting a basic national demand for AM. Fifty-nine percent of recipients were male with a mean age of 64.0 ± 17.3 years (range 6 to 93) corresponding with population findings from the existing ophthalmic literature. Seven patients required multiple tissue applications for surface reconstruction or tectonic repair (neoplasia, corneal ulcer at risk of perforation, infectious scleritis and alkali burn). Tissue requests largely reflect the potential benefits of AM transplantation which include faster wound healing, ","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79308337","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}
P. House, A. Abdul Rahman, J. Richards, Blasco D'Souza
Glistenings in intra-ocular lenses have been noted by clinical observation at the slit lamp in over 90% of Alcon Acrysof lenses on follow up 15 to 20 years after insertion in a cohort of 31 cases. A recent audit conducted by RANZCO showed glistenings still occurred in lenses produced after a decade long improvement in manufacturing techniques undertaken by Alcon. A two surgeon clinical audit was conducted to determine the incidence of glistenings in Alcon IOLs of different ages, models and chromophore content. All patients with Alcon IOLs presenting at routine follow up were audited sequentially by surgeon BDS (68 SA60AT lenses) and surgeon PH (all other lenses). Glistenings were graded using the criteria outlined by Werner et al with the addition of a Grade 4 density level for those worse than Grade 3. Implantations occurred between 1998 and 2016. Four IOL models were assessed (17 three-piece MA series, 74 SA60AT, 57 SN60AT, 153 SN60WF—including torics). Among the 284 lenses audited 35% of clear lenses but 66% of yellow lenses showed glistenings. Considering glistenings graded as 2 or greater, which may be more significant clinically, 2% of clear lenses and 35% of yellow lenses were affected (Figure 1). Glistening density was not strongly associated with duration in the Eye (Figure 1). In the subset of chromophore free three-piece lenses (N = 17) with a long mean time in the eye of 17 years, only seven showed grade one glistenings and there were no higher grades. In order to address the question whether differences in glistenings density were IOL model related or chromophore related, a comparison of SA60AT chromophore-free lenses with SN60AT and SN60WF yellow lenses with similar times in situ was undertaken. This analysis was achieved by excluding 79 of the SN60WF lenses with the shortest times in situ. This resulted in three groups of IOLs of similar size and with similar times in situ (Table 1). A pairwise Wilcoxon test showed a statistically significant difference between the IOLs with the chromophore and those without (P < .0001). However, the chromophore lenses SN60AT and SN60WF were not significantly different from each other. This audit suggests lenses containing chromophore were more likely to show glistenings and have higher density of glistenings than chromophore free lenses of the same material. Glistenings did not differ significantly between lens models unless there was a difference in chromophore status. There have been many glistenings related publications over the last 20 years, but our literature search did not find papers with long-term follow up which specifically address the significance of the chromophore. These results suggest that the chromophore is strongly associated with glistening formation. A possible methodologic weakness in this study is that BDS contributed most of the clear lenses (68 of the 74 SA60AT cases) but all other cases came from PH. However, both surgeons had very similar surgical techniques and operated
{"title":"Long‐term clinical audit of glistenings in Alcon Acrysof intra‐ocular lenses with and without yellow chromophore","authors":"P. House, A. Abdul Rahman, J. Richards, Blasco D'Souza","doi":"10.1111/ceo.13679","DOIUrl":"https://doi.org/10.1111/ceo.13679","url":null,"abstract":"Glistenings in intra-ocular lenses have been noted by clinical observation at the slit lamp in over 90% of Alcon Acrysof lenses on follow up 15 to 20 years after insertion in a cohort of 31 cases. A recent audit conducted by RANZCO showed glistenings still occurred in lenses produced after a decade long improvement in manufacturing techniques undertaken by Alcon. A two surgeon clinical audit was conducted to determine the incidence of glistenings in Alcon IOLs of different ages, models and chromophore content. All patients with Alcon IOLs presenting at routine follow up were audited sequentially by surgeon BDS (68 SA60AT lenses) and surgeon PH (all other lenses). Glistenings were graded using the criteria outlined by Werner et al with the addition of a Grade 4 density level for those worse than Grade 3. Implantations occurred between 1998 and 2016. Four IOL models were assessed (17 three-piece MA series, 74 SA60AT, 57 SN60AT, 153 SN60WF—including torics). Among the 284 lenses audited 35% of clear lenses but 66% of yellow lenses showed glistenings. Considering glistenings graded as 2 or greater, which may be more significant clinically, 2% of clear lenses and 35% of yellow lenses were affected (Figure 1). Glistening density was not strongly associated with duration in the Eye (Figure 1). In the subset of chromophore free three-piece lenses (N = 17) with a long mean time in the eye of 17 years, only seven showed grade one glistenings and there were no higher grades. In order to address the question whether differences in glistenings density were IOL model related or chromophore related, a comparison of SA60AT chromophore-free lenses with SN60AT and SN60WF yellow lenses with similar times in situ was undertaken. This analysis was achieved by excluding 79 of the SN60WF lenses with the shortest times in situ. This resulted in three groups of IOLs of similar size and with similar times in situ (Table 1). A pairwise Wilcoxon test showed a statistically significant difference between the IOLs with the chromophore and those without (P < .0001). However, the chromophore lenses SN60AT and SN60WF were not significantly different from each other. This audit suggests lenses containing chromophore were more likely to show glistenings and have higher density of glistenings than chromophore free lenses of the same material. Glistenings did not differ significantly between lens models unless there was a difference in chromophore status. There have been many glistenings related publications over the last 20 years, but our literature search did not find papers with long-term follow up which specifically address the significance of the chromophore. These results suggest that the chromophore is strongly associated with glistening formation. A possible methodologic weakness in this study is that BDS contributed most of the clear lenses (68 of the 74 SA60AT cases) but all other cases came from PH. However, both surgeons had very similar surgical techniques and operated ","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86169053","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}
Joaquín Fernández, A. Sánchez-García, M. Rodríguez-Vallejo, D. Piñero
Intraocular lens (IOL) opacification is an infrequent complication of cataract surgery. Surface analysis has demonstrated that the opacification of IOLs is related to calcium or phosphate precipitation on or within the lenses, but the associated mechanisms are unknown, and the scientific literature is heterogeneous and limited to case series and retrospective studies. The purpose of this systematic review was to analyse the most frequent conditions associated with opacification of IOLs reported by studies. A search was carried out using the PubMed MEDLINE, Web of Science and Scopus databases. The quality of the studies selected was evaluated using the Pierson tool. The search provided a total of 811 articles, of which 39 were selected following the inclusion and exclusion criteria. The most common opacified lenses were hydrophilic IOLs according to our analysis. The mean time of appearance of lens opacification was 14.93 ± 17.82 months. The most frequent conditions associated with opacification of the IOLs were Descemet Stripping with Automated Endothelial Keratoplasty (DSAEK/DSEK) and diabetes mellitus (DM), followed by pars plana vitrectomy (PPV), blood hypertension (HT), and glaucoma. Concerning the quality analysis, the mean score was 7.00 ± 1.43 (scoring range from 0 to 10), indicating an acceptable quality of the case reports and retrospective studies. In conclusion, DSAEK/DSEK, DM, PPV, glaucoma and hypertension are conditions with potential risk of IOL opacification after cataract surgery, especially when implanting hydrophilic acrylic IOLs.
摘要人工晶状体混浊是白内障手术中一种罕见的并发症。表面分析表明，人工晶状体的混浊与晶状体上或内部的钙或磷酸盐沉淀有关，但相关机制尚不清楚，科学文献也不一致，仅限于病例系列和回顾性研究。本系统综述的目的是分析研究报告的与人工晶状体混浊相关的最常见情况。使用PubMed MEDLINE、Web of Science和Scopus数据库进行搜索。使用Pierson工具评估所选研究的质量。检索共获得811篇文献，其中39篇按照纳入和排除标准入选。根据我们的分析，最常见的混浊晶体是亲水性iol。晶状体混浊出现的平均时间为14.93±17.82个月。与人工晶状体混浊相关的最常见情况是自动内皮角膜移植术(DSAEK/DSEK)和糖尿病(DM)，其次是玻璃体切割(PPV)、高血压(HT)和青光眼。在质量分析方面，平均得分为7.00±1.43分(评分范围从0到10)，表明病例报告和回顾性研究的质量是可以接受的。综上，DSAEK/DSEK、DM、PPV、青光眼和高血压是白内障术后人工晶状体混浊的潜在风险，尤其是在植入亲水丙烯酸人工晶状体时。
{"title":"Systematic review of potential causes of intraocular lens opacification","authors":"Joaquín Fernández, A. Sánchez-García, M. Rodríguez-Vallejo, D. Piñero","doi":"10.1111/ceo.13650","DOIUrl":"https://doi.org/10.1111/ceo.13650","url":null,"abstract":"Intraocular lens (IOL) opacification is an infrequent complication of cataract surgery. Surface analysis has demonstrated that the opacification of IOLs is related to calcium or phosphate precipitation on or within the lenses, but the associated mechanisms are unknown, and the scientific literature is heterogeneous and limited to case series and retrospective studies. The purpose of this systematic review was to analyse the most frequent conditions associated with opacification of IOLs reported by studies. A search was carried out using the PubMed MEDLINE, Web of Science and Scopus databases. The quality of the studies selected was evaluated using the Pierson tool. The search provided a total of 811 articles, of which 39 were selected following the inclusion and exclusion criteria. The most common opacified lenses were hydrophilic IOLs according to our analysis. The mean time of appearance of lens opacification was 14.93 ± 17.82 months. The most frequent conditions associated with opacification of the IOLs were Descemet Stripping with Automated Endothelial Keratoplasty (DSAEK/DSEK) and diabetes mellitus (DM), followed by pars plana vitrectomy (PPV), blood hypertension (HT), and glaucoma. Concerning the quality analysis, the mean score was 7.00 ± 1.43 (scoring range from 0 to 10), indicating an acceptable quality of the case reports and retrospective studies. In conclusion, DSAEK/DSEK, DM, PPV, glaucoma and hypertension are conditions with potential risk of IOL opacification after cataract surgery, especially when implanting hydrophilic acrylic IOLs.","PeriodicalId":15372,"journal":{"name":"Journal of Clinical & Experimental Ophthalmology","volume":"12 1","pages":"89 - 97"},"PeriodicalIF":0.0,"publicationDate":"2019-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81965481","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：