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ABSTRACT Purpose: In this prospective study, we compared ocular clinical variables in patients with acne vulgaris with those of healthy controls. These variables included tear film break-up time, meibomian gland dropout rate, and anterior chamber parameters. Methods: Our sample comprised 73 eyes from 73 patients with acne vulgaris and 67 eyes from 67 healthy controls. All participants underwent a non-invasive first tear film break-up time test and the average tear film break-up time was evaluated. Meibography was used to identify any meibomian gland dropout. The parameters of the cornea and anterior chamber were measured using Scheimpflug topography imaging. Finally, the ocular surface disease index questionnaire was administered to score each participant on their subjective experience of ocular complaints. Results: The noninvasive first tear film break-up time values of the acne vulgaris Group and the control Group were 4.7 ± 2.8 and 6.4 ± 3.5 sec, respectively. There was a significant difference between the groups (p=0.016). The number of eyes with tear break-up at any time during the measurement period was also significantly higher in the acne Group (p=0.018). In the acne vulgaris Group, the mean meibomian gland dropout rates were 33.21 ± 15.5% in the upper lids and 45.4 ± 14.5% in the lower lids. In the control group, these rates were 15.7 ± 6.9% and 21 ± 9.7% respectively. Dropout was significantly higher in the acne group for both the upper and lower lids (p=0.000). Conclusion: We found impaired tear stability in patients with acne vulgaris and a high rate of meibomian gland dropout. These glands play a key role in tear stability and their dropout is likely to result in evaporative dry eye. Measurement of the variables in this study allows objective diagnosis of this condition using a non-invasive, dye-free methodology, with minimum contact.
RESUMO Objetivo: Neste estudo prospectivo, pacientes com acne vulgaris e indivíduos saudáveis do grupo controle foram comparados em relação ao tempo de ruptura do filme lacrimal, taxa de abandono de glândulas meibomianas e parâmetros da câmara anterior, usando o tempo de ruptura do filme lacrimal topográfico não invasivo, meibografia não invasiva e fotografia de Scheimpflug, respectivamente. Métodos: Setenta e três olhos de 73 pacientes com acne vulgaris e 67 olhos de 67 indivíduos saudáveis foram incluídos. Todos os participantes submetidos ao primeiro tempo de ruptura do filme lacrimal não-invasivo e ao tempo médio de ruptura do filme lacrimal não-invasivo foram avaliados pelo uso do tempo de ruptura do filme lacrimal; perda de glândulas meibomianas foram avaliadas por meibografia; os parâmetros da córnea e da câmara anterior foram medidos por fotografia de Scheimpflug; e, finalmente, as queixas oculares subjetivas foram pontuadas com o uso do questionário do Indice de doenças de superfície ocular. Resultados: Os valores do tempo de ruptura do primeiro filme lacrimal não-invasivo do Grupo com acne vulgaris e do Grupo controle foram 4,7 ± 2,8 e 6,4 ± 3,5 segundos, respectivamente, refererindo-se a uma diferença significativa entre os valores dos grupos (p=0,016). Qualitativamente, o número de olhos com ruptura lacrimal a qualquer momento durante o período de medição foi significativamente maior no grupo de pacientes. (p=0,018). No Grupo com acne vulgaris, a perda de glândulas meibomianas nas pálpebras superiores foi de 33,21 ± 15,5% e nas pálpebras inferiores foi de 45,4 ± 14,5%; por outro lado, no Grupo controle foi de 15,7 ± 6,9% e 21 ± 9,7% respectivamente; ambos os casos referem-se a uma diferença significativa entre os grupos (p=0,000). Conclusão: Encontramos estabilidade comprometida do filme lacrimal em pacientes com acne vulgaris. No entanto, o comprometimento foi de grau muito menor, em comparação com a taxa de perda das glândulas meibomianas que desempenham um papel fundamental na estabilidade do filme lacrimal. Esta condição pode ser documentada de forma objetiva - uma metodologia parcialmente sem contato, totalmente não-invasiva e livre de corantes.
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Resumen Las investigaciones en torno a una ruptura de pareja plantean medir las estrategias y conductas que las personas llevan a cabo para terminar sus relaciones románticas. Se propone entender la separación de pareja a partir del Modelo de Inversión de Rusbult (1979). Resulta relevante probar el modelo incluyendo elementos psicométricos que permitan comprender su validez al evaluar las conductas de separación. De esta forma el propósito de este estudio fue someter a prueba, un análisis exploratorio y confirmatorio de una escala que mida las conductas que las personas realizan para terminar su relación de pareja. Para ello se creó una escala de Conductas ante la separación de pareja a partir de un estudio exploratorio. La escala en su versión inicial contó con 50 reactivos en escala tipo Likert, aplicados en línea a 230 adultos de la Ciudad de México y Área Metropolitana. Al inicio del Análisis Factorial Exploratorio se obtuvo una escala final de 18 reactivos distribuidos en 4 factores (alejamiento, confrontación, depresión por separación e infidelidad) que explican el 68,47% de la varianza explicada con una confiabilidad de α = .871. Esta estructura fue corroborada por un Análisis Factorial Confirmatorio. Se encuentra una escala robusta y confiable, y se concluye que las conductas de separación evaluadas a partir del alejamiento con la expareja, que puede ser por medio de la comunicación o de ejercer conductas que transgreden como una infidelidad, afectan principalmente el estado emocional de las personas que lo viven.
Abstract Research on a couple's breakup aims to measure the strategies and behaviors that people carry out to end their romantic relationships. We propose to understand couple separation based on Rusbult's Reversal Model (1979). It is revealing to test the model including psychometric elements that allow us to understand its validity. Thus, the purpose of this study was to test an exploratory and confirmatory analysis of a scale that measures the behaviors that people perform to end their relationship. The initial version of the scale had 50 items on a Likert scale, applied online to 230 adults in Mexico City and Metropolitan Area. At the beginning of the exploratory factor analysis, a final scale of 18 items distributed in 4 factors (distancing, confrontation, depression due to separation and infidelity) was obtained, explaining 68.47% of the variance explained with a reliability of α = .871. This structure was corroborated by a Confirmatory Factor Analysis. A robust and reliable scale is found, and it is concluded that the separation behaviors evaluated from the distance with the ex-partner, which can be through communication or exercising behaviors that transgress such as infidelity, mainly affect the emotional state of the people who live it.
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Purpose: This present prospective, cross-sectional study aims to comprehensively evaluate the ocular surface in asymptomatic patients with diffuse blebs after trabeculectomy versus chronic anti?glaucoma medication use and compare it with the age?matched normal population. Methods: Objective clinical evaluation was done by tear film break?up time (TBUT) and Schirmer’s test (ST) in the three groups– trabeculectomy >6 months with a diffuse bleb (Wurzburg bleb classification score ?10), chronic anti?glaucoma medication (AGM >6 months) group, and normal population. In all groups, tear film osmolarity was checked with the TearLab® device (TearLab Corp., CA, USA), and subjective evaluation was performed by administering Ocular Surface Disease Index (OSDI) questionnaire. Patients already on chronic lubricants or any other drug for the treatment of dry eyes (viz. steroids, cyclosporin) or having symptoms suggestive of an abnormal ocular surface, who had undergone refractive or intraocular surgery, and contact lens users were excluded. Results: In total, 104 subjects/eyes were recruited over 6 weeks. Thirty?six eyes recruited in the trab group were compared with 33 eyes studied in the AGM group, and both these groups were compared to 35 normal eyes. When compared to normals, TBUT and ST were significantly lower (P = 0.003 and 0.014) and osmolarity and OSDI were statistically significantly higher (P = 0.007 and 0.003) in the AGM group, whereas only TBUT was statistically significantly different (P = 0.009) when the trab group was compared to normals. Also, when the trab group was compared to the AGM group, ST was found to be higher (P = 0.003) and osmolarity was lower (P = 0.034). Conclusion: To conclude, ocular surface is affected even in asymptomatic patients on AGM but near normalcy is possible following trabeculectomy when blebs are diffuse.
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Purpose: Dry eye disease (DED) is because of a decrease in the tear film’s volume or a change in the composition of tears. Evaporative dry eye is the most common type, which is due to meibomian gland dysfunction (MGD). In this study, the morphology of meibomian glands was evaluated in all kinds of dry eyes to look for any loss of meibomian glands, assess the function of remaining glands, and investigate the relationship between anatomy, function, and severity of DED. Methods: A total of 300 patients were included in the study, with 150 eyes in the study group and 150 in the control group. Meibomian gland morphology was assessed by examining the tarsal plate after everting the eyelids. Tear film function was evaluated using tear film break?up time (TBUT) and Schirmer’s test (SCH I and II). Meibomian gland morphology was examined with a slit?lamp under magnification, a transilluminator using a small light emitting diode (LED) bulb, and non?contact meibography using an auto refracto?keratometer (ARK). Results: Females had a higher prevalence of dry eyes in our study. In all, 103 eyes (68.6%) in the study group had evaporative dry eye, making it the most prevalent type. Among the 150 controls, 104 controls with 69.3% had no dry eye symptoms, and in those with symptoms, the evaporative type was the most common, with a 28% prevalence. Conclusion: TBUT should be performed in all patients with detectable MG abnormality. Meibography has high specificity and sensitivity to diagnose MGD and in turn dry eyes and should be considered a routine screening modality.
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AIM:To observe the clinical effect of different concentration of fluorometholone eye drops on severe mixed vernal keratoconjunctivitis in children.METHODS: A total of 50 cases(100 eyes)of children with severe mixed vernal keratoconjunctivitis treated in the outpatient department of our hospital from March to September, 2022 were selected and randomly divided into two groups. Group A consisted of 25 cases(50 eyes)who were treated with 0.1% fluorometholone eye drops combined with 0.05% cyclosporine eye drops(Ⅱ), while 25 patients(50 eyes)in group B were treated with 0.02% fluorometholone eye drops combined with 0.05% cyclosporine eye drops(Ⅱ). After 1mo of treatment, SPEED questionnaire score, corneal fluorescein staining(FL)score, tear break-up time(TBUT), Schirmer I test(SⅠt), R-scan, non-invasive tear meniscus height(NIKTMH), corneal optical density and other ocular parameters of the two groups were observed, and the occurrence of adverse reactions were recorded.RESULTS: After 1mo of treatment, there were significant differences in SPEED score, FL score and R-scan results between the two groups(all P<0.05), and no differences in TBUT, SⅠt and NIKTMH results(all P>0.05). However, there were statistical significance in corneal optical density in different corneal depth and diameter ranges(all P<0.05). After 1mo of treatment, there was no significant difference in intraocular pressure between the two groups(16.21±2.90mmHg vs. 16.05±2.75mmHg, P>0.05), and no obvious adverse reactions occurred during treatment.CONCLUSION: The 0.1% fluorometholone eye drops can effectively treat severe mixed vernal keratoconjunctivitis in children, and its effect is better than 0.02% fluorometholone eye drops.
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AIM: To investigate the efficacy of optimal pulse technology(OPT)in the treatment of demodex blepharitis and its influence on ocular surface function.METHODS: A retrospective study was conducted from February 2018 to October 2020. A total of 127 patients(254 eyes)with demodex blepharitis were assigned to the observation group and the control group according to the treatment method. The control group(63 patients, 126 eyes)were given conventional hot compress, eye cleansing and drug therapy. On this basis, the observation group(64 patients, 128 eyes)was treated with OPT. Both groups were given 6wk of continuous treatment. Demodex count, Marx's line scores, meibum character scores, ocular surface disease index(OSDI)scores, non-invasive tear break-up time(NIBUT), non-invasive tear meniscus height(NITMH)and lipid layer thickness(LLT)were compared between the two groups, and safety was evaluated.RESULTS: After 6wk of treatment, demodex count, Marx's line scores, meibum character scores and OSDI scores of the two groups decreased. NIBUT, NITMH and LLT increased. Meanwhile, demodex count, Marx's line scores, meibum character scores and OSDI scores of the observation group were significantly lower than those in the control group. NIBUT, NITMH and LLT were longer/larger than those in the control group(P<0.001). No obvious abnormality of intraocular pressure or conjunctival/corneal injury was observed in either group.CONCLUSION:OPT is effective and safe in the treatment of demodex blepharitis.
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AIM: To investigate the postoperative ocular surface changes in acute attack eye and contralateral eye with primary angle-closure glaucoma(PACG)and cataract.METHODS: A total of 40 patients with monocular acute PACG combined with cataract who admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2021 to January 2022 were selected. Trabeculectomy combined with phacoemulsification and intraocular lens implantation was carried out in the acute attack eyes, and phacoemulsification and intraocular lens implantation were carried out in the contralateral eyes. The ocular surface disease index(OSDI)questionnaire, noninvasive first tear film break-up time(NifBUT), noninvasive average tear film break-up time(NiaBUT)and tear meniscus height(TMH)were assessed preoperatively and 1, 3 and 6mo postoperatively.RESULTS: The OSDI scores of the included patients at 1 and 3mo postoperatively(14.72±3.07, 11.39±2.24)were significantly higher than those preoperatively(9.68±1.98; all P<0.0083), and there was no significant difference between 6mo postoperatively(10.18±1.84)and preoperatively. NifBUT of the acute attack eyes at 1 and 3mo postoperatively was significantly lower than that preoperatively, and NiaBUT of the acute attack eyes at 1, 3 and 6mo postoperatively was significantly lower than that preoperatively(all P<0.0083). The NifBUT and NiaBUT of the contralateral eyes at 1mo postoperatively were significantly lower than those preoperatively(all P<0.0083), and there was no significant difference between 3 and 6mo postoperatively and preoperatively. There was no significant difference in TMH of the attack eyes and the contralateral eyes postoperatively and preoperatively(P>0.05).CONCLUSION: The stability of tear film after surgery of PACG and cataract is decreased. The acute attack eye needs 6mo or even longer to recover, while the contralateral eye needs roughly 3mo.
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AIM: To explore the difference of tear film stability among different lipid layer thickness.METHOD: A total of 194 dry eye patients(384 eyes)admitted to our hospital from June 2020 to December 2021 were enrolled in this study. The tear meniscus height, the first tear film break-up time and lipid layer thickness were measured by corneal topographer. The tear meniscus height and the first tear film break-up time among different lipid layer thickness were compared and the correlation between them was analyzed.RESULTS: The included patients(384 eyes)were divided into lipid rich group(49 eyes), lipid balance group(27 eyes), slight lipid deficiency group(266 eyes)and significant lipid deficiency group(42 eyes)according to the lipid layer thickness. The differences of the tear meniscus height were statistically different(P=0.022), while the differences of the first tear film break-up time were not statistically different(P=0.322). The lipid layer thickness was positively correlated with tear meniscus height(rs=0.143, P=0.006). There was no correlation between lipid layer thickness and the first tear film break-up time(rs=-0.090, P=0.083), nor was there correlation between tear meniscus height and the first tear film break-up time(rs=0.038, P=0.460).CONCLUSION: There was no significant difference in tear film stability in dry eye patients with different lipid layer thickness.
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Aims: In this study, we aimed to investigate the intercorrelations between tear film break up time, measured non-invasively using non-invasive keratographic break-up time (NIKBUT), higher order aberrations (HOA) and quality of vision (QoV) in pseudophakic patients.Study Design: Cross-sectional.Methods: Thirty-five pseudophakic aged patients aged 50 years or older, and 35 control phakic patients aged 17 to 23 years with corrected visual acuity of 20/20 were included in this study. All subjects underwent similar examination including QoV questionnaire, aberrometry to measure HOA, and NIKBUT. HOA was measured with the OPD-Scan/ ARK 10000 corneal analyzer (Nidek CO. Ltd), expressed as Root Mean Square (RMS) HOA and NIKBUT was assessed using non-invasive TF-Scan module Keratograph 5M (K5M), equipped with modified tear film scanning function (Oculus, Wetzlar, Germany). Statistical analysis was performed to find the correlation between NIKBUT, HOA and QoV.Results: Patients in the pseudophakic group were significantly older (median age 66 vs. 20 years; P<0.01), had shorter NIKBUT (10.5 vs. 17.2; P<0.01), lower QoV score (1.63 vs. 0.68; P=0.04), and higher RMS HOA (0.5 vs. 0.26; P<0.01) compared to control group. NIKBUT was inversely correlated with RMS HOA (r = -0.19; p = 0.03) and RMS HOA was significantly correlated with QoV, even after adjustment for age and gender (r = -0.21; P0.04). NIKBUT <9.93s was correlated with lower QoV. The area under the curve was 0.81 (95% CI = 0.67 � 0.95, p = 0.012), and had 100% sensitivity and 61% specificity.Conclusion: Shorter NIKBUT was correlated with greater HOA and greater HOA was correlated with lower QoV. NIKBUT value of shorter than 9.93s could potentially predict pseudophakic patients who will likely experience visual symptoms leading to decreased QoV; thus, the use of artificial tears might be beneficial.
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@#AIM: To analyze the effectiveness and safety of different concentrations of tea tree essential oil in the treatment of Demodex blepharitis. <p>METHODS: The clinical data of 120 patients(240 eyes)with blepharitis caused by Demodex infection in our hospital from June 2017 to June 2019 were retrospectively analyzed. According to the use of tea tree essential oil concentrations of 10%, 15%, 20% and 25%, patients were divided into 4 groups(group A, group B, group C, group D), each group with 30 people. All patients were given meibomian gland massage, eyelid margin cleaning, and then scrubbed with different concentrations of tea tree oil to clean the eyelid margin. The number of demodex mites, clinical symptom score, clinical sign score, tear film break-up time(BUT), corneal fluorescein staining(FL)and SchirmerⅠtest(SⅠt)were compared before and 2, 4wk after treatment.<p>RESULTS: The number of Demodex mites, clinical symptom score, clinical sign score, BUT, FL and SⅠt were not statistically significant in the four groups before treatment(<i>P</i>>0.05). After treatment, the number of Dmodex mites, clinical symptom score, and clinical sign score in each group were lower than those before treatment, and the number of Demodex mites, clinical symptom score, and clinical sign score after 4wk of treatment in each group were lower than those after 2wk of treatment(all <i>P</i><0.008). After 2 and 4wk of treatment, the number, clinical symptom score and clinical signs score of Demodex mites in group A were the highest, while those in group D were the lowest(all <i>P</i><0.008). After treatment, the BUT of each group was higher than before treatment, and reached the peak in the 4wk. After 2 and 4wk of treatment, BUT among groups was highest in group D and lowest in group A(all <i>P</i><0.008). After treatment, FL and S I t of each group were lower than before treatment, and reached the lowest value in the 4wk. After 2 and 4wk of treatment, FL among the groups was the lowest in group D and the highest in group A(all <i>P</i><0.008). <p>CONCLUSION: Compared with 10% tea tree essential oil, 15% tea tree essential oil can effectively repel mites, relieve clinical symptoms and eye signs in patients with Demodex blepharitis, and is safer than 20% and 25% tea tree essential oils. As the preferred concentration of tea tree essential oil against Demodex blepharitis.
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AIM: To investigate the image features of dynamic changes of tear film break-up after corneal fluorescein staining(FL)combined with tear film lipid layer(TFLL)dynamic changes in patients with dry eye and its value of diagnosis in dry eye. METHODS: A prospective study. A total of 66 patients(132 eyes)with dry eye admitted to our hospital during September 2019 to December 2020 were divided area break-up group(17 cases, 28 eyes), circle break-up group(20 cases, 27 eyes), line break-up group(25 cases, 28 eyes), spot break-up group(21 cases, 24 eyes)and random break-up group(20 cases, 25 eyes)according to the different fluorescein tear film break-up patterns(BUPs). The image features of tear film break-up dynamic changes and the image features of TFLL dynamic changes were compared in each group, and the differences in the first non-invasive tear film break-up time(NIBUTf), average non-invasive tear film break-up time(NIBUTav), tear meniscus height(TMH)and fluorescein staining scores were compare,RESULTS:A statistically significant differences were observed in NIBUTf among the groups of patients(P<0.001). Except that there was no difference between spot break-up group and random break-up group(7.56±1.54s vs 8.02±1.86s, P=0.881), other groups had significant differences in pairwise comparisons(P<0.05). There were statistically differences among the groups for NIBUTav(P<0.001). Except that there was no difference between spot break-up group and random break-up group(9.54±2.12s vs 9.73±1.94s, P=0.997), other groups had significant differences in pairwise comparisons(P<0.05). There was statistically difference among the groups for TMH(P<0.001). Except that there was no difference between circle break-up group and line break-up group(0.16±0.03mm vs 0.17±0.03mm, P=0.986), there was no difference between spot break-up group and random break-up group(0.22±0.03mm vs 0.21±0.05mm, P=0.993), other groups had significant differences in pairwise comparisons(P<0.05). There were statistically significant differences among the groups for FL scores and TFLL grading(P<0.001).CONCLUSION:It is shown that different fluorescein BUPs intuitively reflects the tear film structure of the pathological changes according to evaluation and analysis of images feature of dynamic changes of FL tear film and TFLL combined with the results of static examination of tear film. It is helpful for clinicians to identify subtypes of dry eye, which has potential clinical value for the diagnosis and classification of dry eye.
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OBJECTIVE@#To compare the curative effect of Tiaoshen acupuncture combined with artificial tears and artificial tears alone for dry eye syndrome with yin deficiency of liver and kidney.@*METHODS@#A total of 70 patients of dry eye syndrome with yin deficiency of liver and kidney were randomized into an acupuncture combined with medication group (35 cases, 2 cases dropped off) and a medication group (35 cases, 3 cases dropped off). In the medication group, 0.1% sodium hyaluronate eye drop was applied, 3 times a day, 1 drop each time. On the basis of the treatment as the medication group, Tiaoshen acupuncture was applied at Shenting (GV 24), Shenmen (HT 7), Benshen (GB 13), Taixi (KI 3), Taichong (LR 3), Guangming (GB 37), Fengchi (GB 20), Tongziliao (GB 1), Yuyao (EX-HN 4) in the acupuncture combined with medication group, Tongziliao (GB 1) and Yuyao (EX-HN 4) were connect with electroacupuncture, the needles were retained for 30 min, once a day, 6 times a week. Both groups were treated for 2 weeks. Before and after treatment, the clinical symptom score, SchirmerⅠtest (SⅠT), break-up time (BUT), corneal fluorescein staining (FL) score and Hamilton anxiety scale (HAMA) score were observed in the two groups, and the clinical efficacy was compared in the two groups.@*RESULTS@#Compared before treatment, the clinical symptom scores, corneal FL and HAMA scores were decreased (P<0.05), the levels of SⅠT and BUT were increased after treatment in the two groups (P<0.05). After the treatment, the clinical symptom score, FL and HAMA scores in the acupuncture combined with medication group were lower than the medication group (P<0.05), the levels of SⅠT and BUT in the acupuncture combined with medication group were higher than the medication group (P<0.05). The total effective rate in the acupuncture combined with medication group was 90.9% (30/33), which was higher than 71.9% (23/32) in the medication group (P<0.05).@*CONCLUSION@#Tiaoshen acupuncture combined with artificial tears could promote the secretion of tears for patients of dry eye syndrome with yin deficiency of liver and kidney, repair corneal defect and prolong tear film break-up time, and alleviate anxiety state, its curative effect is better than simple artificial tears.
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Humans , Acupuncture Points , Acupuncture Therapy , Dry Eye Syndromes/therapy , Kidney , Liver , Treatment Outcome , Yin Deficiency/therapyABSTRACT
Objective: To observe the clinical efficacy of combining two needling manipulations, Er Long Xi Zhu (two dragons playing with a pearl) and Guo Yan Re (heat produced to reach the eyes), in treating dry eye syndrome (DES) of lung-yin deficiency pattern. Methods: Fifty-six eligible DES patients of lung-yin deficiency were randomized into an observation group and a control group, with 28 cases in each group. Same acupoints were selected in the two groups: Cuanzhu (BL 2), Sizhukong (TE 23), Taiyang (EX-HN 5) and Fengchi (GB 20) were chosen as the major points and Feishu (BL 13) and Chize (LU 5) as the adjuvant. Er Long Xi Zhu and Guo Yan Re needling manipulations were applied in the observation group while twirling reinforcing manipulation was used in the control group. Treatment was conducted once per day in both groups, for two sets of 15 consecutive days at a 2-day interval. Changes in the symptom score, tear break-up time (BUT) and tear production were observed afterwards, and the clinical efficacy was also compared between the two groups. Results: The total effective rate was 92.8％ in the observation group, higher than 71.4％ in the control group, and the between-group difference was statistically significant (P<0.05). After treatment, the symptom score, tear BUT and tear production showed significant improvements in both groups (all P<0.05); the symptom score, BUT and tear production in the observation group were significantly different from those in the control group (all P<0.05). Conclusion: Given the same acupoint selection, combining Er Long Xi Zhu and Guo Yan Re needling manipulations can produce more significant clinical efficacy than twirling reinforcing manipulation in treating DES of lung-yin deficiency pattern.
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@#AIM:To analyze curative effect of phacoemulsification through clear corneal tunnel incision on cataract and the influences on subjective sylptols of dry eye questionnaire scores(SDES)and break-up time(BUT).<p>METHODS: During the period from June 2015 to January 2019, 117 cataract patients(139 eyes)who underwent cataract surgery in the hospital were divided into group A(<i>n</i>=65, 72 eyes)and group B(<i>n</i>=52, 67 eyes)by random number table method. Groups A and B underwent phacoemulsification through 2.2mm and 3.0mm micro-incision, respectively. The general surgical status, SDES, BUT and curative effect indexes \〖best corrected visual acuity(BCVA), spherical equivalent(SE), endothelial cell density(ECD)\〗 were compared between the two groups.<p>RESULTS: There was no significant difference in ultrasound time, cumulative released energy, operation time or postoperative complications between two groups(<i>P</i>>0.05). After surgery, SDES scores in both groups were significantly increased, BUT was decreased compared with that at 1d before surgery. At 3mo after surgery, SDES and BUT recovered to preoperative levels. At 1d and 1wk after surgery, SDES score in group A was significantly lower than that in group B, while BUT was significantly higher than that in group B(<i>P</i><0.05). After surgery, BCVA LogMAR and ECD in both groups were significantly decreased, while SE and corneal diopter were significantly increased, without significant difference between the two groups(<i>P</i>>0.05). <p>CONCLUSION:The curative effect of phacoemulsification through clear corneal tunnel incision is reliable on cataract. The tear film function is better through 2.2mm micro-incision.
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@#AIM: To compare the non-invasive tear film break-up time(NIBUT), tear break up time(TBUT), basal tear secretion(BTS)and blink rate in four ethnic groups: Malay, Chinese, Indian and Nigerian.<p>METHODS: Totally 120 healthy(61 males and 59 females)subjects(without dry eye symptoms and ocular surface disorder)with the age 20 to 39 years were recruited; 30 were Malays, 30 were Chinese, 31 were Indians and 29 were Nigerians. Based on McMonnies questionnaire and clinical examination, normal subjects were selected. NIBUT, TBUT, BTS were assessed in only one eye(right)of each subject and blink rate was also assessed.<p>RESULTS: There was significant difference in the NIBUT, TBUT, BTS and blink rate among 4 different ethnic groups(<i>P</i>=0.018),(<i>P</i>=0.001),(<i>P</i>=0.011), and(<i>P</i>=0.004)respectively. No statistically significant difference of NIBUT, TBUT, BTS and blink rate was found between the genders among different ethnic groups. Indian had higher median for NIBUT(10±6s), TBUT(7±5s)and BTS(20±20 mm)than others races. Chinese had lower median for NIBUT(7.5±4s)and TBUT(4±2s)while Malay had low BTS(9.5±16 mm)among the groups. There was no significant correlation of blink rate with NIBUT, TBUT and BTS(<i>r</i>= -0.119, <i>P</i>=0.195),(<i>r</i>=-0.086, <i>P</i>=0.352),(<i>r</i>= -0.123, <i>P</i>=0.180)respectively.<p>CONCLUSION: This study showed the variability in tear-film measurements values in four ethnic groups.
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OBJECTIVE: To observe the effect of acupuncture on expression of transforming growth factor-β1(TGF-β1) in lacrimal gland of rabbits with dry eye, so as to explore its underlying mechanism in improving dry eye. METHODS: Healthy male New Zealand rabbits were randomly assigned to 5 groups (n=6 in each group), namely, blank group, model group, western medicine group, acupuncture group and sham acupuncture group. The dye eye rabbit model was estabilished by subcutaneous injection of Scopolamine Hydrobromide solution for 21 days. After modeling, rabbits in the western medicine group were treated with Flumirone eye drops in their eyes 3 times a day, one drop each time. Rabbits of the acupuncture group reveived electroacupuncture(4 Hz/20 Hz, 1 mA) at "Cuanzhu"(BL2) and "Tongziliao"(GB1) for 15 min, and received acupuncture at "Jingming"(BL1), "Taiyang" (EX-HN5) and "Sizhukong"(TE23) for 15 min, once a day. Rabbits of the sham acupuncture group received blunt acupuncture at the surface of the same acupoints once a day. All the treatments were conducted for 14 days. The changes of tear flow, tear film break-up time (BUT) and lacrimal gland morphology in each group were observed. The expression of TGF-β1 protein and mRNA in lacrimal gland were detected by Western blot and quantitative real-time fluorescence PCR respectively. RESULTS: Following modeling, except for the blank group, the tear flow and BUT in other 4 groups decreased significantly (P<0.01). Compared with their own pretreatment, the tear flow and BUT in western medicine group and acupuncture group increased after the treatment (P<0.05). Compared with the model group, the tear flow and BUT increased in the western medicine group and the acupuncture group(P<0.05). Atrophic lacrimal epithelial cells and the stroma of mucous membrane infiltrated by lymphocytes and plasma cells were found in rabbits of the model group and the sham acupuncture group. By contrast, in the western medicine group and the acupuncture group, the structure of lacrimal epithelial cells was basically normal, and the infiltration of lymphocytes and plasma cells were scattered in the stroma of mucous membrane. In comparison with the blank group, the expression of TGF-β1 protein and mRNA in lacrimal gland were significantly up-regulated in the model and sham acupuncture groups (P<0.01). Compared with the model group, the expression of TGF-β1 protein and mRNA were significantly down-regulated in the western medicine and acupuncture groups (P<0.01, P<0.05). CONCLUSION: Acupuncture intervention can increase tear flow and BUT in rabbits with dry eye, which may be related to the regulation of TGF-β1 expression in lacrimal gland.
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@#AIM: To evaluate ocular surface functions in pregnant women with gestational diabetes mellitus(GDM)using Keratogragh 5M. <p>METHODS: Pregnant women with GDM and normal pregnant women were enrolled. All subjects were asked to answer ocular surface disease index(OSDI)questionnaire survey, and then underwent ophthalmic examination including tear meniscus height(TMH), average noninvasive Keratograph tear film break-up time(NIKBUTav), ocular redness analysis, and meibomial gland analysis.<p>RESULTS: There were no statistically significant differences in OSDI, TMH, NIKBUTav, eye redness analysis and meibomial gland analysis between the GDM group and the normal pregnant group(<i>P</i>>0.05). The OSDI scores were 8.02±4.25 and 7.50±4.28(<i>P</i>=0.557), TMH values were 0.22±0.05 and 0.20±0.04mm(<i>P</i>=0.158), NIKBUTav values were 8.01±2.15s and 8.02±1.53s(<i>P</i>=0.971).<p>CONCLUSION: There was no statistically significant difference between the GDM group and the normal pregnant group in ocular surface indexes. GDM had no negative effects on ocular surface, which may be related to good controlling of the blood glucose.
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@#AIM: To investigate the effect of strabismus surgery on tear film and the incidence of dry eye.<p>METHODS: A total of 66 eyes of 58 patients admitted and underwent surgery in our hospital between September 2018 to September 2019 with concomitant strabismus were enrolled. The patients were divided into two groups based on surgical methods: Group 1 included 25 cases(33 eyes)who underwent a single horizontal rectus cut; Group 2 included 33 cases(33 eyes)who underwent both horizontal rectus cut in. The noninvasive tear film break-up time(NIBUT)was examined with sirius anterior analysis system at the time of 1d preoperatively and 3d, 1wk, 2wk and 3wk after operation. In addition, the tear film break-up time(BUT), Schirmer I test(SⅠt)and corneal fluorescein examination were tested. The patients were diagnosed with dry eye in both groups according to the consensus of clinical experts specialized in the diagnosis and treatment of dry eye. <p>RESULTS: There were no statistically significant differences when compared to SⅠt between the two groups before and after surgery(<i>P</i>>0.05). The BUT of group 1 was higher than group 2 at postoperative 3d, 1wk and 2wk(<i>P</i><0.05), while there was no difference between the two groups at 3wk postoperative(<i>P</i>>0.05); BUT returned to baseline by 2wk after surgery in group 1 and by 3wk after surgery in group 2. There were no differences between the NIBUT measured by sirius anterior segment analysis system and the BUT measured by traditional method before and after operation(<i>P</i>>0.05). The lowest incidence of dry eye was found at postoperative 2wk and 3wk in group 1(24%, 18%). The lowest incidence of dry eye was found at postoperative 3wk in group 2(15%). Besides, the incidence of dry eye in group 2 was higher than that in group 1 at postoperative 2wk(52% <i>vs</i> 24%, <i>P</i><0.05). <p>CONCLUSION: There was no obvious influence on the SⅠt after strabismus surgery; the surgical effect on tear film was mainly reflected in BUT. The fewer muscles operated, the lesser tear film was affected and the tear film was recovered faster. The incidence of dry eye decreased as time went by.
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OBJECTIVE@#To observe the clinical effect of needle-knife at cervical spine area as adjunctive therapy on dry eye syndrome.@*METHODS@#A total of 84 patients with dry eye syndrome were randomized into 3 groups, named group A, group B and group C, 28 cases in each one (1 case dropped off in the group A, 2 cases dropped off in both group B and C). In the group A, needle-knife was applied at the margo inferior of external occipital protuberance, the range of 4 cm bilateral to external occipital protuberance, the spinous process of C, the range of 3 cm bilateral to 2 cm above C spinous process, the range of 2 cm bilateral to C, C, C spinous process for once a week; acupuncture was applied at Jingming (BL 1), Cuanzhu (BL 2), Zusanli (ST 36), Sanyinjiao (SP 6), Taixi (KI 3), Yanglao (SI 6), Ganshu (BL 18), Shenshu (BL 23), etc. for once a day, 6 times a week; sodium hyaluronate eye drop was given one drop once, 5-6 times a day. Treatment of acupuncture and sodium hyaluronate eye drop was given in the group B, sodium hyaluronate eye drop was given in the group C, the acupoints selection and the manipulation of acupuncture, the dosage of sodium hyaluronate eye drop were the same as the group A. One week was as one course and 3 courses were required in the 3 groups. SchirmerⅠtest (SⅠT), break-up time (BUT), scores of corneal fluorescein staining (CFS) and eye symptom before and after treatment were observed, the clinical effect was evaluated in the 3 groups.@*RESULTS@#SⅠT was increased, BUT was prolonged, scores of CFS and eye symptom were reduced after treatment in the group A and group B (<0.01); scores of CFS and eye symptom were reduced after treatment in the group C (<0.01). The variations of SⅠT, BUT and the scores of CFS and eye symptom in the group A were greater than those in the group B and the group C (<0.01); the variations of above indexes in the group B were greater than those in the group C (<0.05, <0.01). The total effective rate was 94.4% (51/54) in the group A, which was superior to 78.8% (41/52) in the group B and 48.1% (25/52) in the group C (<0.01), and the total effective rate in the group B was superior to the group C (<0.01).@*CONCLUSION@#Needle-knife at cervical spine area as adjunctive therapy can relieve the clinical symptoms and improve the function of lacrimal gland in patients with dry eye syndrome.
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Humans , Acupuncture Points , Acupuncture Therapy , Combined Modality Therapy , Dry Eye Syndromes , Therapeutics , NeedlesABSTRACT
Background: The aim was to study the demographic profile and analyze risk factor associated with dry eye disease in North West Rajasthan, India.Methods: This was a hospital-based study conducted in Department of Ophthalmology, Sardar Patel Medical College, Bikaner, Rajasthan. Sample size of this study was 100 patients. All participants underwent a general ophthalmic assessment including history of any previous ocular and systemic illness along with ocular examination on slit lamp and specific tests for dry eye (Schirmer's test and Tear film break up time) were performed.Results: Dry eye were seen maximum in age group 46 to 60 years (41%), followed by 61-75 years (23%). Female’s preponderance was seen compared with male. Dry eye patients belong from rural areas were (57%) while remaining (43%) from urban areas and among these highest were farmer/labourers (32%). Several known risk factors were found in this study which include post-menopause. Climatic condition like excessive wind, high temperature and computers users had strong association with dry eye. In Systemic disease rheumatoid arthritis was commonly associated with dry eye were. Smoking contact lens use were also associated with increased risk of developing dry eye.Conclusions: Dry eye disease are more common in older age group patients. Female’s preponderance were found in the study especially postmeopausal women. Dry eye disease are more common in patients belongs to rural areas. Risk factor associated with dry eye were Climatic condition like excessive wind, high temperature and computers users, systemic disease like rheumatoid arthritis Smoking, contact lens users.