Eye & Contact Lens-Science and Clinical Practice最新文献

Abstract: This case series reports two cases of scleral lens (SL)-associated suture erosion of polytetrafluoroethylene CV-8 (Gore-Tex, Newark, DE) in scleral-sutured CZ70BD (Alcon, Fort Worth, TX) posterior chamber intraocular lens (SS-PCIOL). Suture erosion after SS-PCIOL has been reported in two of the patients who were fitted with SL for visual acuity improvement. Erosion was corrected in both cases with suture repositioning and corneal patch graft, with one patient requiring the exchange of the intraocular lens. The other patient was able to transition to an SL of a different size parameter. Scleral lens fitting should consider the position of haptic placement in relation to the suture site and be monitored for suture erosion postoperatively. A scleral flap or corneal tissue patch graft may be needed for patients who have scleral thinning from prior surgery.

Objectives: This study aimed to compare temporal changes in tear meniscus height (TMH) and noninvasive tear film break-up time after the instillation of four dry eye treatments: artificial tears (AT), 3% diquafosol sodium long-acting (DQL), 3% diquafosol sodium (DQS), and rebamipide (RB).

Methods: Sixty healthy eyes were randomly divided into four treatment groups. The TMH and noninvasive tear film break-up time were measured using a noninvasive tear film analysis device at baseline and 1, 5, 15, 30, 60, 120, and 180 min after instillation.

Results: TMH and noninvasive tear film break-up time did not show significant differences among the groups. In the AT and RB groups, TMH increased significantly 1 min after instillation compared with baseline. In the DQS group, TMH remained elevated for up to 60 min, whereas the DQL group showed a more prolonged increase, lasting up to 120 min. For the noninvasive tear film break-up time, significant prolongation was observed only at 5 and 15 min after instillation in the DQL group.

Conclusions: Topical instillation of 3% diquafosol ophthalmic solution effectively increased tear volume on the ocular surface, with the long-acting DQL formulation demonstrating a more sustained effect in healthy eyes.

Purpose: This study compared the myopia control effects of corneal high-order aberrations (CHOA) from two orthokeratology (OK) lenses based on their relative corneal refractive power shifts.

Methods: In this prospective cohort study, 101 school children with low to moderate myopia were divided into three groups: group A (N=35) used 3-curve design lenses, group B (N=31) used 4-curve design lenses, and group C (N=35) wore regular spectacles. Cycloplegic refraction, visual acuity, and axial length (AL) were measured at baseline and after one year. Keratometry and CHOA were assessed before and after 3 months of lens wear. Relative corneal refractive power shifts and summed corneal power change (SCPC) were calculated. One-way ANOVA and planned comparison analyzed group differences.

Results: Group B showed significantly slower AL elongation than group A ( P =0.017) after OK treatment. Group B's SCPC was significantly higher than group A's ( P ≤0.005). Group B had a significant increase in horizontal coma ( P =0.004). Increased SCPC led to more coma aberration with four-curve lens wear ( P <0.01).

Conclusions: The four-curve lens design was more effective in slowing AL elongation for OK treatment. It also caused significantly higher horizontal coma aberration than the three-curve design.

Objectives: This study aimed to quantify the differences in the anterior and posterior segment parameters between both eyes of individuals with nonamblyopic myopic anisometropia of ≥2 diopters (D).

Methods: This study enrolled 141 adults (mean age: 24.3±6.0 years; 48.3% men) with myopic anisometropia (binocular refractive difference of ≥2.0 D in spherical power). Bilateral measurements included refractive error (spherical equivalent, SE), mean keratometry, intraocular pressure, axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), peripapillary retinal nerve fiber layer (RNFL) thickness, optic nerve head (ONH) parameters, and macular thickness in Early Treatment Diabetic Retinopathy Study (ETDRS)-defined regions. Linear associations between variables and interocular differences in ocular parameters were statistically evaluated.

Results: The right eyes of the 68 men and 73 women enrolled in this study had significantly high myopia ( P <0.05). The mean interocular difference in the SE was 2.72±0.93 D. The AL, ACD, and ACV were significantly greater for the more myopic eyes than for the contralateral eyes (all P <0.05). The CCT, ETDRS thickness, and ONH parameters (excluding average RNFL thickness) were lower for the more myopic eyes than for the contralateral eyes (all P <0.05). The superior quadrant RNFL thickness decreased with age ( P <0.05). The refractive difference was significantly correlated with interocular differences in AL (r=0.735, P <0.001).

Conclusions: Interocular differences in anterior chamber parameters, macular thickness, and ONH structures were identified in adult patients with nonamblyopic myopic anisometropia. The more myopic eyes had thinner CCT, greater corneal curvatures, and specific ONH and macular layer alterations.

Objectives: This systematic review aims to evaluate loteprednol etabonate's efficacy and safety in reducing post-cataract pain and inflammation.

Methods: A literature search was conducted to identify randomized controlled trials comparing loteprednol etabonate and placebo for post-cataract pain and inflammation. The primary outcome was the proportion of patients with complete resolution of anterior chamber inflammation (ACI) and grade zero pain. The quality of the studies was assessed using the RoB 2 tool, and a meta-analysis was performed using RevMan 5 software.

Results: This systematic review identified eight clinical trials (n=3,332 patients) fulfilling research criteria. Meta-analysis results showed that loteprednol etabonate significantly improved ACI resolution compared with placebo at 8, 15, and 18 days postoperatively (RR=2.25, 2.11, and 2.06, respectively, with a P value <0.00001). Loteprednol etabonate also increased the likelihood of achieving no pain (RR=1.54, 1.66, 1.70, and 1.92, respectively, with a P value <0.00001) and reduced the need for rescue therapy (RR=0.47, P <0.00001) while maintaining no change in IOP after 3, 15, and 18 days.

Conclusion: Loteprednol etabonate demonstrates significant efficacy in alleviating pain and inflammation post-cataract surgery, with notable advantages in safety, including minimal impact on intraocular pressure and reduced adverse events.

Objective: To evaluate refractive and topographic outcomes following photorefractive keratectomy (PRK) with 75% angle kappa (P-Dist) compensation in myopic eyes.

Methods: This retrospective study included 127 right eyes of patients with myopia and/or myopic astigmatism, who underwent wavefront-optimized PRK, incorporating 75% P-Dist compensation. Visual, refractive, topographic, aberrometric, and point-spread function (PSF) measurements were recorded preoperatively and at 1, 3, and 6 months postoperatively.

Results: The mean P-Dist was 232.13±121.78 μm (range: 31.69-769.84 μm). Eyes were grouped by mean P-Dist: group-1 (<232.13 μm, small-angle kappa, n=67) and group-2 (>232.13 μm, large-angle kappa, n=60). Preoperative P-Dist correlated with root-mean-square of higher-order aberrations (RMS-HOAs) (r=0.24, P =0.01) and coma (r=0.381, P <0.001). Group-2 had higher preoperative coma ( P =0.001). At 6 months, the percentage of eyes within ±0.50 diopters (D) spherical equivalent and≤0.50 D astigmatism, visual acuity, asphericity, mean pupil power, HOAs, and PSF were similar between the groups ( P >0.05 for all). No correlation was found between preoperative P-Dist and postoperative HOAs or PSF changes ( P >0.05 for all).

Conclusions: PRK with 75% angle kappa compensation yields comparable refractive and topographical outcomes in myopic eyes with small- and large-angle kappa. In eyes with a significant angle kappa, aligning ablation with P-Dist may not induce additional corneal refractive or topographical changes.

Abstract: This review examines how gaps within the Food and Drug Administration's|Food and Drug Administration (FDA) regulatory oversight, manufacturing standards, and bottle design requirements contributed to over-the-counter (OTC) eye drop contamination and subsequent product recalls. We also discuss recent growth in the number of patients with dry eye diseases and explosion of electronic commerce (e-commerce) retailers that has created new channels for the widespread circulation of unsafe eye drops. Considering the ongoing FDA recalls, we outline actionable strategies for providers and patients and the role that advocacy organizations play in closing the gaps in OTC eye drop safety.

Objectives: This study aimed to estimate direct and indirect economic costs associated with Acanthamoeba keratitis and explore variations in individual and healthcare characteristics.

Methods: Patients treated at Moorfields Eye Hospital, UK, between January 2011 and August 2014 were surveyed. Patients were included if they had a confirmed diagnosis and wore contact lenses. Direct costs included healthcare expenses, whereas indirect costs encompassed lost wages for patients and caregivers. The Mann-Whitney U test and generalized linear models were used to analyze cost data and their associated factors, with P <0.05 being considered statistically significant.

Results: A total of 73 patients were included, with a mean age of 39.3 years (19-81); 40 patients (54.8%) were female, and 41 (56.2%) had good outcomes. Median direct, indirect, and total costs were £2,966.5 (IQR £5,553.2), £1,776.0 (IQR £3,223.3), and £6,678.6 (IQR £17,268.4), respectively. Higher direct costs were independently associated with multiple medical visits ( P <0.001), steroids before antiamoeba therapy ( P =0.042), and keratoplasty ( P <0.001).

Conclusions: The cost of managing Acanthamoeba keratitis is substantial. Future research should focus on optimizing treatment strategies and improving patient outcomes to help alleviate the financial burden on patients and healthcare systems.