The Effect of Topical Cyclosporine 0.05% on Tear Osmolarity for Dry Eye Syndrome

PURPOSE: To evaluate the effect of topical cyclosporine 0.05% (Restasis; Allergan, Irving, CA, USA) on tear osmolarity in patients with dry eye disease. METHODS: The present study was a single-center, randomized, prospective, and longitudinal trial. Patients who had been using artificial tears to treat dry eye disease were prescribed cyclosporine 0.05% and evaluated using tear osmolarity, tear break-up time, ocular surface staining score, Schirmer test, and the Ocular Surface Disease Index for symptomatic improvement. Clinical measurements of commonly used objective tests were performed at baseline and after 1, 3, and 6 months. RESULTS: At the end of the study, patients demonstrated statistically significant improvement in tear break-up time (6.26 +/- 1.26 sec at 3 months vs. 4.41 +/- 1.63 sec at baseline, p = 0.022) and OSDI (34.98 +/- 20.19 at 3 months vs. 45.02 +/- 22.38 at baseline, p = 0.032) only at 3 months. Other measures such as Schirmer test, ocular surface grade, and tear osmolarity also showed improvement. However, the differences were not significant. CONCLUSIONS: Over a 6-month period, topical cyclosporine 0.05% showed beneficial effects on symptoms and other commonly used signs of dry eye disease for 3 months; however, the tear osmolarity values were not significantly improved.

Comparison of Clinical Results between Transepithelial Photorefractive Keratectomy and Brush Photorefractive Keratectomy

PURPOSE: To compare the results of transepithelial photorefractive keratectomy (trans PRK) and brush-assisted photorefractive keratectomy (brush PRK) for the treatment of myopia. METHODS: A total of 146 eyes from 78 patients who received brush PRK or trans PRK with the Schwind Amaris laser platform were included in the present study. Uncorrected distance visual acuity (UDVA) and manifest refraction spherical equivalent (MRSE) at postoperative 1 week, 1, 3, 6, and 12 months were compared between the 2 groups as well as epithelial healing time. RESULTS: The mean time to complete epithelial healing was 3.27 +/- 0.75 days in the trans PRK group and 3.67 +/- 0.93 days in the brush PRK group (P < 0.05). At 1 week after surgery, UDVA recovered more rapidly after trans PRK than brush PRK (brush PRK: 0.13 +/- 0.12 log MAR units, trans PRK: 0.09 +/- 0.08 log MAR units, P < 0.05), however, UDVA was not significantly different at 1, 3, 6, and, 12 months postoperatively between the 2 groups. CONCLUSIONS: Re-epithelialization and visual recovery were faster in the trans PRK group while visual outcome and postoperative complications were equivalent to the brush PRK group.

Ocular Perforation and Visual Field Defect Caused by an Acupuncture Needle: a Case Report

PURPOSE: To report a case of globe perforation and linear retinal tear after periocular acupuncture therapy which resulted in persistent temporal field defect with normal retinal function evidenced by multifocal electroretinogram (MERG). CASE SUMMARY: A 42-year-old female presented with decreased visual acuity and pain in her right eye after a periocular acupuncture therapy for blepharospasm. At initial presentation, the best corrected visual acuity (BCVA) was 0.08 in the injured eye and the intraocular pressure was 15 mmHg. Ultrasonography showed minimal vitreous hemorrhage and fundus examination revealed a linear retinal tear in the posterior pole sparing the macula. Consequently, barrier laser photocoagulation was performed around the lesion. The patient suffered from metamorphopsia and persistent decreased visual acuity even after 3 months. On fundus examination, epiretinal membrane with macular pucker was observed on the macula. Spectral domain optical coherence tomography (SD-OCT) revealed retinal nerve fiber layer defect with a full-thickness posterior wall tear. Multifocal electroretinogram showed normal retinal function; however, Humphrey visual field test demonstrated field defect corresponding to the injury. A 25-gauge pars plana vitrectomy was performed with membranectomy and ILM peeling. One month postoperatively, improvement in BCVA and metamorphopsia was achieved; however, the scotomata remained unchanged. CONCLUSIONS: Ocular perforation or retinal tear caused by an acupuncture needle is a rare condition that has not been reported previously in Korea. Furthermore, no case of traumatic visual field defect with preserved retinal function has been reported elsewhere. Hence, the authors present a case of isolated visual field defect without retinal dysfunction following full-thickness retinal tear caused by an acupuncture needle.