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AIM: To investigate the preoperative ocular symptoms and the characteristics of asymptomatic ocular surface abnormalities in hospitalized patients with primary pterygium.METHODS: Cross-sectional study. Hospitalized patients diagnosed with primary pterygium and scheduled to receive pterygium excision surgery at the Xiamen Eye Center of Xiamen University from August 2022 to October 2022 were enrolled. Ocular surface disease index questionnaire(OSDI), six examinations including non-invasive tear film break-up time, Schirmer I test, tear meniscus height, lid margin abnormality, meibomian gland dropout and tear film lipid layer thickness, and anterior segment optical coherence tomography(AS-OCT)were performed and statistically analyzed.RESULTS: A total of 178 cases(178 eyes), with a mean age of 54.39±10.75 years old, were recruited, including 75 males(42.1%)and 103 females(57.9%). The average values of ocular surface parameters in these patients included OSDI: 11.47±9.69, tear film break-up time: 7.10±3.86 s; tear meniscus height: 0.16±0.07 mm, Schirmer I test values: 14.39±7.29 mm/5 min, and pterygium thickness: 504.74±175.87 μm. Totally 161 eyes(90.4%)presented with abnormal lid margin, 44 eyes(24.7%)presented with meibomian gland dropout score ≥4, 52 eyes(29.2%)presented with low lipid layer thickness. In the 6 objective examinations, abnormalities in at least 4 of these tests were found in 85.4% of eyes. Pterygium morphology was classified into four grades: 10 eyes(5.6%)of grade Ⅰ, 93 eyes(52.2%)of grade Ⅱ, 60 eyes(33.7%)of grade Ⅲ, and 15 eyes(8.4%)of grade Ⅳ. In patients with a higher grade of pterygium, the tear film break-up time was lower, and the proportion of abnormal lid margin was also significantly higher(P<0.05). The patients were further divided into two subgroups, including 121 eyes(68.0%)with normal OSDI <13 in the normal group and 57 eyes(32.0%)with OSDI ≥13 in the abnormal group. No significant difference was found in the proportion of meibomian gland dysfunction between the two groups of patients(71.9% vs. 71.9%, P=0.872). In addition, there were differences in the number of abnormal objective examinations(4.11±0.85 vs. 4.91±0.99, P<0.001).CONCLUSIONS: Asymptomatic ocular surface abnormalities were present preoperatively in patients hospitalized for primary pterygium. A comparable high incidence of structural or functional meibomian gland dysfunction existed in pterygium patients with or without apparent ocular discomfort. More attention should be paid to the ocular surface abnormalities in those asymptomatic patients before primary pterygium surgery.
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Purpose: The main objective of this study is to explore the efficacy of olopatadine 0.1% treatment in the resolution of symptoms of vernal keratoconjunctivitis (VKC) among the Indian population. Methods: This single?center, prospective cohort study involved 234 patients with VKC. Patients were treated with olopatadine 0.1%, twice daily for a period of 12 weeks and then followed up in 1st week, 4th week, 3rd month, and 6th month. The extent of relief in the symptoms of VKC was measured using total ocular symptom score (TOSS) and ocular surface disease index (OSDI). Results: In the present study, the dropout rate was 5.6%. Total of 136 males and 85 females with a mean age of 37.68 ± 11.35 years completed the study. TOSS score reduced from 58.85 to 5.06 and the OSDI score reduced from 75.41 to 11.2 with statistical significance (P < 0.01) from 1st week to 6th week after olopatadine 0.1% treatment. The data showed relief in subjective symptoms of itching, tearing, and redness, and relief in discomfort in functions related to ocular grittiness, visuals like reading, and environmental like tolerability in dry conditions. Further, olopatadine 0.1% was effective in both males and females, and patients across ages 18–70 years. Conclusion: Based on TOSS and OSDI scores, the findings of this study validate safety and tolerability as revealed by low adverse effects and moderate efficacy of olopatadine 0.1% in reducing VKC symptoms in a broader age group (18–70 years) of both genders.
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Purpose: Aim of this study was to compare the efficacy of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) eye drops in treating mild to moderate dry eye disease in terms of relief of symptoms, mean change in tear film breakup time, Schirmer’s test, and impression cytology of conjunctiva from baseline. Methods: An observational study was carried out during a 2?year period in our tertiary referral hospital. The study consisted of 60 patients randomly allotted to two groups to receive SH and CMC eye drops for an 8?week period. Ocular surface disease index, tear film breakup time, and Schirmer’s test were performed at baseline visit and 4 and 8 weeks of treatment, and impression cytology of conjunctiva was performed at baseline and 8 weeks. Results: Significant improvement in patient symptoms, tear film breakup time, and Schirmer’s test from baseline was seen in both SH and CMC groups at 8 weeks posttreatment, whereas impression cytology of conjunctiva in both groups did not show significant improvement at 8 weeks of treatment. Data analysis using unpaired t?test showed comparable results. Conclusion: Both CMC and SH demonstrated equal efficacy in treating mild to moderate dry eye disease.
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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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Background: In the recent times, use of smart phone and multimedia devices is extensive. With prolonged use of smart phones, multimedia devices and social media ophthalmic and psychiatric complications are rising in young population. Aim and Objectives: The aim of the study was to find out prevalence of smartphone addiction and dry eye disease and association between smartphone addiction and dry eye disease in medical students. Material and Methods: This study was conducted in M.P. Shah Government Medical College and included 201 medical students. This was analytical survey-based study. Data collection was done through Google form and the survey included demographic questions, pre-structured smartphone addiction scale-short version, and ocular surface disease index questionnaire. Results: The prevalence of dry eye disease in medical students was 52.73% and the prevalence of smartphone addiction was 20%. In our study, dry eye disease was present in 45% of subjects with smartphone addiction. Conclusion: The prolonged usage of smartphone leads to increased screen exposure time which may be causative factor for ophthalmic problems and dry eye disease. More awareness in adolescent and young population about potential hazards of prolonged screen exposure and smartphone is necessary nowadays.
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@#film quality and the quantity of secretion. This low quality of tear secretion can lead to the rapid breakup of tears. In recent times, particularly since the COVID-19 pandemic, the prevalence of dry eye has increased. Relevant studies found that the prevalence of dry eye is higher in females than males. This research work is based only on symptoms of dry eye disease in Malaysia to determine its prevalence among students at the UCSI University KL campus because of the increase in reported cases of dry eyes especially post Movement Control Order (MCO). Methods: A total of 199 students, ranging in age 17 to 30, were included in this research. This is a cross-sectional study that was conducted on participants who fulfilled the inclusion criteria. Demographic questionnaires and Ocular Surface Disease Index (OSDI) results were collected. Results: On the UCSI KL Campus, students who suffer from dry eye are 82% of the population. The Pearson Chi-Square test showed a significant difference between gender and dry eye, X2 (1, N= 199) = 8.64, p < 0.0033. Female students are more likely to develop dry eye than male students. Conclusion: The prevalence of dry eyes among UCSI students is high. This could be attributable to prolonged or improper mask-wearing. It is suggested that researchers and health policymakers should take heed to these emerging risk factors related to wearing of mask.
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AIM: To investigate the clinical features of dry eye in patients with type 2 diabetes mellitus complicated with peripheral neuropathy.METHOD: Prospective cohort study. A total of 192 patients with type 2 diabetes were enrolled in the Department of Endocrinology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from July 2021 to March 2022. The right eyes of all patients were selected as the observation eye, among which 122 patients were diagnosed with diabetic peripheral neuropathy(DPN)and 70 patients were diagnosed with non-diabetic peripheral neuropathy(NDPN). The score of ocular surface disease index(OSDI), tear meniscus height, tear meniscus width, corneal epithelial thickness, corneal endothelial cell density, tear secretion test(Schirmer Ⅰ test, SⅠt), corneal sensitivity, meibomian gland function status score, tear film breakup time(BUT), corneal fluorescein sodium staining score and Toronto clinical scoring system(TCSS)score were compared between two groups. The correlation between OSDI score and TCSS score in type 2 diabetes patients was analyzed as well.RESULTS: The morbidity of dry eye in the DPN group(55 eyes, 45.1%)was significantly higher than that of NDPN group(20 eyes, 28.6%; χ2=5.094, P=0.024), BUT and corneal sensitivity score of DPN were lower than NDPN group(P<0.001), meanwhile, corneal staining score and meibomian gland function score were higher than NDPN group(P<0.001). OSDI scores of all subjects were negatively correlated with TCSS scores(rs=-0.233, P=0.002), and OSDI scores of DPN group were negatively correlated with TCSS scores(rs=-0.511, P<0.001), but there was no significant correlation between the two scores of NDPN patients(rs=0.007, P=0.957).CONCLUSIONS: DPN patients are more likely to develop dry eye than NDPN patients. OSDI score is not an accurate evaluation index for type 2 diabetes patients, especially for DPN patients.
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AIM: To evaluate the applicability of Chinese dry eye questionnaire in college students using the ocular surface disease index(OSDI)questionnaire as a reference.METHODS: Cross-sectional study. A total of 711 college students from Nanyang Medical College were enrolled in the study and assessed for dry eye condition using OSDI questionnaire and Chinese dry eye questionnaire. The response rate of each question in the two questionnaires was counted. Cronbach α was calculated to evaluate the internal consistency of both questionnaires. Correlation between the total scores of the two questionnaires was analyzed to evaluate the criterion validity. Based on OSDI scores, the discriminant validity of Chinese dry eye questionnaire was evaluated; receiver operating characteristic(ROC)curves was plotted for Chinese dry eye questionnaire scores, area under the ROC curve(AUC)was calculated, and diagnostic thresholds and corresponding sensitivity and specificity were also analyzed.RESULT: The response rates of the 12 questions on the OSDI questionnaire were 33.2%-100.0%, while it was 100.0% for each question on the Chinese dry eye questionnaire. The Cronbach α values of OSDI questionnaire and Chinese dry eye questionnaire were 0.905 and 0.789, respectively. The Chinese dry eye questionnaire score was positively correlated with the OSDI score(rs=0.712, P<0.001). According to OSDI questionnaire scores, dry eye severity was divided into normal group, mild dry eye group, moderate dry eye group and severe dry eye group. The scores of Chinese dry eye questionnaire in these groups were 4.00(2.00, 6.00), 9.00(7.00, 11.00), 12.00(9.00, 14.00)and 16.00(13.50, 22.00), respectively, which increased with the severity of dry eye, and the overall difference was statistically significant(P<0.001), as well as pairwise comparison between groups(P<0.05). The AUCs of Chinese dry eye questionnaire in distinguishing normal population from dry eye population, mild dry eye from moderate dry eye, moderate dry eye from severe dry eye were 0.862, 0.661 and 0.769, respectively, and the diagnostic thresholds were 6.5, 11.5 and 14.5, respectively.CONCLUSION:Chinese dry eye questionnaire has an equivalent reliability, validity, discriminant ability and better response rate for dry eye screening and epidemiological survey among college students in China compared with OSDI questionnaire.
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Purpose: To evaluate the correlation of Meiboscale with symptom score (Ocular Surface Disease Index [OSDI]) and meibomian gland dysfunction (MGD) sign score. Methods: We performed a cross?sectional hospital?based study of 53 patients of primary MGD who filled the OSDI questionnaire form and underwent complete ocular examination. The MGD sign score was calculated in both eyes using the sum of six grading systems proposed by Arita et al. in 2016. The participants underwent imaging of the upper and lower eyelids of both eyes (212 eyelids) by specular microscope. The area of meibomian gland loss (MGL) was visually assessed and scored using the Meiboscale photographic card. Correlation between these three values – OSDI score, sign score, and MGL score based on Meiboscale ? was calculated using Spearman’s correlation analysis and Jonckheere– Terpstra (J–T) test. Correlation coefficient rs > 0.5 was considered clinically significant. Results: Associations between MGL score and OSDI score, as well as between OSDI and sign score were statistically significant, but not clinically significant (rs = 0.3684, P < 0.001 and rs = 0.41179, P < 0.001, respectively). The association between MGL score and MGD sign score was statistically as well as clinically significant (rs = 0.8392, P < 0.001). J–T test revealed large effect size (P < 0.001, r?effect = 0.93). Conclusion: The Meiboscale card had not been tested for utility in the Indian outpatient setting yet. Meiboscale can be used for reliable assessment and grading of MGD, and has clinical utility similar to the sum of six MGD sign scores. Additionally, assessment of symptoms using OSDI or a similar questionnaire is also recommended.
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@#AIM: To study the clinical changes related to dry eye and evaluate the severity of ocular surface diseases in patients with posterior chamber intraocular lens(ICL)implantation. <p>METHODS: Prospective study. Totally 50 eyes of 50 cases with myopia who were underwent ICL surgery from September 2019 to October 2019. Ocular surface disease index questionnaire(OSDI), fluoresceine staining of cornea tear break up time(TBUT), Schirmer Ⅰ test(SⅠt), and tear meniscus were measured before and 1wk, 1 and 3mo after surgery.<p>RESULTS: The scores of OSDI questionnaire and corneal staining were significantly increased at 1wk and 1mo after operation(<i>P</i><0.05). There was a difference between 3mo and 1wk pastoperatve(χ<sup>2</sup>=5.267,<i>P</i>=0.022), and recovered to the preoperative level at about 3mo. Corneal staining scores were significantly positively correlated with OSDI questionnaire scores at all time points(<i>r<sub>s</sub></i>>0, <i>P</i><0.05). TBUT decreased significantly at 1wk and 1mo after operation(<i>P</i><0.05), and returned to the preoperative level 3mo after operation. There was no significant difference in the basal tear volume(SⅠt)and the height of lacrimal river in the middle of lower eyelid between before and after operation(<i>P</i>>0.05). <p>CONCLUSION: The stability of tear film on the ocular surface will be affected by ICL implantation in the early postoperative period, and the patients will have different degrees of dry eye related symptoms. OSDI questionnaire score can be used to evaluate their subjective discomfort symptoms. However, at 3mo after operation, the stability of tear film on the surface of eyes recovered to the preoperative level. The higher the positive score of corneal staining was, the more obvious the subjective discomfort was.
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@#AIM:To analyze the effects of corneal surface morphology and tear-film with different incisions guided by corneal topography after phacoemulsification.<p>METHODS: Retrospective study. Totally 56 patients(60 eyes)were selected and divided into clear corneal incision group and angle scleral margin incision group who were treated by phacoemulsification in our hospital from June 2019 to December 2020. Best corrected visual acuity(BCVA), ocular surface disease index(OSDI)questionnaire, tear film break-up time(TBUT), corneal surface regularity index(SRI), corneal surface asymmetry index(SAI)and corneal surface astigmatism(CYL)were measured preoperatively and postoperatively, the results were statistically analyzed.<p>RESULTS: BCVA in both groups increased after operation(<i>P</i><0.01). The OSDI score of the two groups increased significantly after surgery(<i>P</i><0.01). TBUT was shortened to varying degrees after surgery(<i>P</i><0.05). SAI and SRI increased to varying degrees in both groups after surgery, and SAI value of angle scleral margin incision group in 1wk and 1mo postoperatively was significantly lower than that in clear corneal incision group(<i>P</i><0.05). The corneal astigmatism at 1wk postoperatively was significant increased in both groups(<i>P</i><0.05). The astigmatism increase of clear corneal incision group at 3mo postoperatively was still higher than that before surgery.<p>CONCLUSION: Angle scleral margin incision has less effect on stability of tear film and corneal surface morphology, which is reliable on phacoemulsification.
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@#AIM: To evaluate the clinical significance of outer zona pellucid in tear ferning image in dry eye patients and explore a new method for evaluation tear lipid layer. <p>METHODS:Forty-seven patients were randomly selected from the outpatient department of ophthalmology, He Eye hospital, Shenyang from May 2018 to July 2019. The right eye was selected as the study object. All patients were investigated by the ocular surface disease index(OSDI)questionnaire and performed lipid layer classification by DR-1 tear interferometry, NIBUT and tear meniscus height examination by OCULUS Keratograph. Then tears were collected and tear ferning tests was performed. The whole tear crystallization images were observed and photographed by microscopy, then measured by Digimizer software and the area ratios of outer transparent belt were calculated. Pearson correlation analysis were performed between area ratios of outer transparent belt and OSDI scores, lipid layer levels, tear meniscus height values, NIBUT values. <p>RESULTS: The area ratios of outer transparent belt were negatively correlated with OSDI scores(<i>r</i>=-0.764, <i>P</i><0.05), negatively correlated with lipid layer levels(<i>r</i>=-0.838, <i>P</i><0.05), positively correlated with NIBUT values(<i>r</i>=0.575, <i>P</i><0.05)and the correlation between tear meniscus height values was not significantly(<i>r</i>=-0.237, <i>P</i>=0.112). <p>CONCLUSION: The outer transparent belt in tear crystallization image can be used to evaluate the lipid layer of tear film; the larger area ratios of outer transparent belt, the thicker the lipid layer. This method has the advantages of quantified results, good repeatability, low requirement on equipment, and is worth popularizing.
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Background: Dry eye is recognized as a growing public health problem and one of the most frequent reasons for visiting an ophthalmologist in middle and old age people. Objectives: To the best of our knowledge, very less study has been undertaken in central India on dry eye. The present study was designed to study clinical profile and to evaluate the true prevalence and risk factors of dry eye in central India. Materials and Methods: A total of 1562 participants aged 30 years or more visiting ophthalmology department in a tertiary care rural hospital enrolled in a study. Study duration was 18 months. The study design was a prospective, cross-sectional, and observational study. An ocular surface disease index (OSDI) questionnaire was administered to all participants and individuals with OSDI score greater than 12 were further evaluated with dry eye tests in sequence of tear break-up time, lissamine green staining, Schirmer-1 test, and slit-lamp examination for meibomian gland dysfunction. The participants with OSDI Score ≥13 were diagnosed to be having dry eye. The data were compiled and subjected to statistical analysis using SPSS v.17.0 software (SPSS Inc., Chicago, Illinois, USA). P < 0.05 was considered to be statistically significant. Results: Prevalence of dry eye in our study was 24.7%. Prevalence of lipid layer, aqueous layer, and mucin layer deficiency dry eye was 13.8%, 5.2%, and 7.8%, respectively. Increasing age, illiteracy, and menopause were the significant risk factors and female sex, urban habitat, and laborer and factory worker were insignificant risk factors for dry eye. Conclusion: Prevalence of dry eye in our study is higher than reported in literature in central India. Lipid anomaly dry eye was the most prevalent, followed by mucin layer deficiency and lastly aqueous tear deficiency.
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Background: The study aims to investigate the prevalence of dry eye in college students in the Uparwara community.Methods: This pilot study was conducted tenure to declaration of Helsinki rules with n=240 (males 200 and females 40) with in the age group of 18-25 years, OSDI questionnaire was used to assess the prevalence among the college students of Uparwara community at Raipur.Results: Data from 240 subjects were analyzed with a mean age group of 19.41±0.70 mean±SD. This OSDI questionnaire study with subscales for dry eye symptoms were measured in both the genders males 213 (89%), females 27 (11%). The percentage distributions among the subjects showed that 116 (48.3%) participants reported dry eye symptoms and 124 (51.6%) was normal.Conclusions: This study emphasized on the prolonged usage of VDT and electronic devices i.e., >4 hours as a compliance factor for dry eye, our data suggest that VDT usage less than 4 hours also can be a risk factor for dry eye since all our 116 participants with dry eye symptoms are VDT users and interestingly 78% (90) of them are <4 hours VDT users but still have dry eye symptoms.
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Introduction: Dry eye disease (DED), as defined by thedry eye work shop (DEWS II) guidelines, is a multifactorialdisease with various etiologies ranging from instability andhyperosmolarity of the tear film, inflammation and damageof the ocular surface and neurosensory abnormalities. Studywas done with the purpose to report the prevalence of dry eyedisease (DED) in western India.Material and Methods: This was a cross sectional studyconducted from April 2018 to March 2019. Patients fromoutpatient department > 18 years of age were selected basedon systematic random sampling. The ocular surface diseaseindex (OSDI) questionnaire was explained to the patientsand asked to fill-up and the total OSDI score was calculated.Based on the OSDI scoring, DED prevalence was calculated.Demographic details of the patients were noted and comparedbetween all patients and those with DED.Results: Of the 578 patients included in the study, 198patients (34.26%) had DED. Of those, 95 (47.98%) patientshad mild DED, 63 (31.82%) had moderate DED and 40(20.20%) had severe DED. The mean age of patients withDED was 50.63±18.69 years. Females (54.04%) were morecommonly affected compared to males (45.96%). There wassignificant difference in mean age among the total patientsand DED patients (P= 0.03). The gender ratio was notsignificantly different among total patients and DED patients(P=0.17).Conclusion: The hospital-based prevalence of DED inwestern India is 34.26%. The disease is more common inelderly females.
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Background: Ocular surface disease is the most common, underdiagnosed comorbidity of glaucoma. Ocular surface diseaseaffects the quality of life of glaucoma patients apart from causing visual disturbances. Evaluation of ocular surface disease isimportant for complete management of glaucoma.Aims and Objectives: This study aims to evaluate the subjective and objective measures of ocular surface disease in patientswith glaucoma.Materials and Methods: A cross-sectional study was carried out on 108 eyes of 54 glaucoma patients on topical antiglaucomamedications for >6 months at the department of ophthalmology from January 2018 to January 2019. Subjective evaluation withocular surface disease index (OSDI) score and objective evaluation with tear breakup time (TBUT) and Schirmer test werecarried in all patients.Results: The subjective measure with OSDI score >12 was observed in 55.6% of glaucoma patients. The objective measures withTBUT <10 s and Schirmer test <10 mm in 5 min were observed, respectively, in 64.8% and 53.7% of glaucoma patients. Patientson longer duration (>15 months) of topical antiglaucoma medications and patients on multiple topical antiglaucoma drugs had higherOSDI score, lesser TBUT, and lesser Schirmer test values. OSDI score had strong positive correlation with TBUT and Schirmer test.Conclusion: Prompt evaluation of ocular surface disease, use of fixed-drug combinations, use of preservative-free antiglaucomaeye drops, and supplementation with lubricants will improve the compliance of patients and outcome of glaucoma management.
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@#AIM: To study the recovery of cornea sensitivity after small incision lenticule extraction(SMILE)surgery by different incision sites.<p>METHODS: Totally 30 SMILE patients(60 eyes)were selected from 05/12/2016-01/18/2018. The incision in the right eye was designed at 135° while that in the left eye was designed at 90°. Cornea sensitivity were examined and noted by an experienced examiner preoperative, 1d, 7d,1mo and 3mo 3mm from central cornea postoperative at 3, 6, 9,12 o'clock and the central cornea. The eye surface disease index(ocular surface disease index, OSDI)was also noted at the same time.<p>RESULTS: The comparison of corneal sensitivity results from different eyes showed that there was no significant difference on all time points at different position(<i>P</i>>0.05). After further comparison, cornea sensitivity of both eyes was found to be lower on 1d postoperative than that preoperative, 1mo postoperative and 3mo postoperative(<i>P</i><0.05), while restored to the level of preoperative at 1mo and 3mo(<i>P</i>>0.05). The OSDI scores on different time points are 10.739±7.576, 15.003±11.296, 16.357±14.467, 14.020±10.128, 11.968±7.586 respectively. The comparison showed no significant difference(<i>F</i>=1.583, <i>P</i>=0.204).<p>CONCLUSION: There is no significant difference on cornea sensitivity between two eyes after SMILE surgeries. The corneal sensitivity declined at 1d postoperative and the recovery was faster at about 1mo.
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@#AIM: To observe the effect of corneal bandage lens on ocular surface repair after pterygium excision combined with limbal stem cell transplantation.<p>METHODS: Totally 52 patients with unilateral primary pterygium were selected from January 2016 to January 2018 in the ophthalmology department of our hospital. All 26 cases(26 eyes)underwent pterygium excision combined with limbal stem cell transplantation and who were placed with bandage lens as the experimental group, the other 26 cases(26 eyes)without bandage lens placed as the control group. Ocular surface disease index(OSDI)questionnaires, tear break-up time(BUT), and corneal fluorescein staining(CFS)were recorded before operation and after operation.<p>RESULTS: BUT in the experimental group was longer than that in the control group(<i>P</i><0.05), OSDI and CFS scores were lower than those in the control group(<i>P</i><0.05)at 2wk, 1mo after operation. Compared with the preoperative situation, BUT in the two groups was shorter, OSDI and CFS scores were higher(<i>P</i><0.05). At 1mo after operation there were no significant differences in BUT, OSDI and CFS between the experimental group and those before the operation(<i>P</i>>0.05), but in the corresponding period, BUT in the control group was still shorter, OSDI and CFS scores were still higher than those before the operation(<i>P</i><0.05).<p>CONCLUSION: Surgical excision combined with autologous limbal stem cell transplantation and placing corneal bandage lens is a safe method to promote corneal healing, improve tear film stability and reduce postoperative discomfort in pterygium patients in the early stage after surgery, which is conducive to the repair of the ocular surface and has certain clinical application value.
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Objeetive To investigate tear film lipid layer thickness (LLT) and its association with clinical symptom and sign in different types of dry eye patients.Methods A serial case-observational study was carried out.Three hundred and six eyes of 306 dry eye patients were included in Beijing Tongren Hospital from April to August 2016.Ocular surface disease index (OSDI) questionnaire,eyelid slit lamp examination,the measurement of tear film lipid thickness (LLT),tear film break-up time (TBUT),Schirmer Ⅰ test (S Ⅰ t) and the infrared meibomian photography were performed on the patients.The 157 patients with OSDI ＞12 and eyelid score ≥2 served as the MGD group;53 patients with OSDI ＞12 and S Ⅰ t value ＜ 5 mm/5 minutes served as ADDE group;96 patients with OSDI＞12,eyelid score ≥2 and S Ⅰ t value ＜ 5 mm/5 minutes served as MGD/ADDE group.Tear film LLT was detected with LipiView(R) ocular surface interferometer and the association of LLT with clinical characteristics of the patients was analyzed.This study protocol was approved by Ethic Committee of Beijing Tongren Hospital and written informed consent was obtained from each patient prior to any relative medical examination.Results Tear film LLT of the participants was normally distributed with the average was (60.41±18.57)nm.LLT in the MGD group,ADDE group,MGD/ADDE group were (57.04 ± 18.26),(63.52 ± 18.44) and (60.56 ± 18.71) nm,respectively,with a significant difference among the three groups (F =2.347,P =0.035),and the LLT value was significantly lower in the MGD group than that in the ADDE group (t =2.077,P =0.039).The LLT value showed negative correlations with the severity of dry eye symptom,S Ⅰ t and meibomian gland loss rate (r=-0.201,P=0.003;r=-0.146,P=0.005;r=-0.156,P=0.046).OSDI score was significantly correlated with LLT only in the MGD group (r =-0.285,P =0.000).No significant correlation was seen between LLT and S I t in all the groups (all at P＞0.05).In the MGD/ADDE group and MGD group,the correlation between LLT and meibomian gland loss rate was significantly greater than the overall correlation (r=-0.335,-0.248,-0.156).The dry eye symptoms in OSDI questionnaire like foreign body sensation,eye pain,discomfort when watching TV or computer showed significant correlations with LLT (r =-0.243,-0.205,-0.223,-0.258,all at P ＜0.05).Conclusions The tear LLT is appeared to be varied in different types of dry eye.The LLT is thinner in the dry eyes with MGD and thicker in the dry eyes with ADDE.There are association between tear LLT and foreign body sensation,eye pain,discomfort when watching TV or computer.
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PURPOSE: To evaluate the correlation between the ocular surface disease index (OSDI score) and objectively quantifiable parameters in dry eye syndrome patients, and to assess environmental and lifestyle risk factors in severe OSDI patients. METHODS: The present study was retrograde and included 30 patients (30 eyes) diagnosed with dry eye syndrome at Ilsan Paik Hospital for the first time. Shirmer's test, corneal staining, and conjunctiva staining were assessed, and tear break-up time, meibum quality, and OSDI questionnaires were performed. We measured the lipid layer thickness in tear meniscus and counted the amount of partial eyelid blinking using Lipiview®. Moreover, we modified images of the lower lid meibography and calculated the percentage of meibomian glands outside the lower tarsal plate using the ImageJ® software. We analyzed the Pearson's correlation and performed a multiple linear regression analysis between the test values and OSDI. In addition, logistic regression analysis was used to determine the risk factors of the severe OSDI group, such as insomnia, level of computer use, and exposure to fully air-conditioned indoor environments. RESULTS: According to the Pearson's correlation analysis, quality of the meibum showed the highest statistically significant correlation with OSDI, followed by age, conjunctiva staining score, counts of partial blinking, and corneal staining score. The multiple linear regression analysis revealed that quality of the meibum and age were statistically significant factors affecting the OSDI score. Based on the logistic regression analysis, using a computer for more than 4 hours at a time exhibited a 7.43-fold odds ratio for severe OSDI (p-value = 0.029). CONCLUSIONS: Meibomian gland dysfunction and age should be considered to be important factors, especially in treating dry eye syndrome patients who complain severely. Moreover, we should also consider environmental factors such as long-term computer use for the treatment of dry eye syndrome patients with severe symptoms.