Analysis of SARS-CoV-2 in Corneal Tissue of Deceased Asymptomatic Novel Coronavirus Disease 2019 Donors.

PURPOSE: The aim of this study was to analyze the presence of the SARS-CoV-2 virus in the corneal tissue of asymptomatic deceased novel coronavirus disease 2019 (COVID-19) patients. METHODS: This was a cross-sectional study performed at a tertiary eye hospital. All corneas of the deceased asymptomatic donors who tested positive for SARS-CoV-2 on a nasopharyngeal swab at the time of corneal tissue harvesting were included in the study. Histopathological examination and immunohistochemistry were performed. mRNA in situ hybridization for SARS-CoV-2 was performed in all specimens that showed positive immunostaining. The main outcome measure was the presence of SARS-CoV-2 virus in the corneal tissues. RESULTS: Twenty-two corneal tissues of 11 donors were analyzed. The mean age was 72.2 ± 14.2 years. On histological examination, no signs of inflammation or any other abnormalities were detected in the cornea and adjacent bulbar conjunctiva. Immunohistochemistry revealed faint to moderate cytoplasmic staining in the basal layer of the corneal epithelium in 8 specimens from 5 patients. None of the specimens with positive immunostaining showed the presence of SARS-CoV-2 mRNA. CONCLUSIONS: In line with previous studies , our study also reflects the absence of SARS-CoV-2 viral mRNA in corneal tissues of clinically asymptomatic deceased COVID-19 donors, thereby indicating a probable low risk of transmission of the SARS-CoV-2 virus through the transplantation of corneas from donors who tested positive for, but were asymptomatic for COVID-19. In addition, further studies on the subject should include histopathological examination because of the false positive and negative rates of molecular tests.

Flap amputation for long-standing post-LASIK flap dislocation with epithelial ingrowth.

A man aged 26 years presented with complaints of diminution of vision in his right eye for 1 year following a fist injury. He had a history of laser-assisted in situ keratomileusis in both eyes 5 years earlier. On examination, his uncorrected distance visual acuity (UDVA) in the right eye was 1.0 logMAR. Slit-lamp examination of the right eye revealed a superotemporal dislocation of the flap with coexisting epithelial ingrowth encroaching the pupillary area. Due to the presence of long-standing fixed flap folds, a flap amputation was performed along with removal of the epithelial ingrowth using 0.02% mitomycin C as adjunct. Postoperatively, the UDVA was 0.3 logMAR on day 1, which improved to 0.2 logMAR at 1 week. At 1 year, the UDVA was 0.2 logMAR improving to 0.1 logMAR with refraction, with minimal paracentral corneal haze and no signs of corneal ectasia.

Impact of Taping The Upper Mask Edge On Ocular Surface Stability and Dry Eye Symptoms.

PURPOSE: To evaluate the impact of taping the upper mask edge on ocular surface stability, dry eye symptomology, and tear osmolarity in N95 mask users. DESIGN: Prospective interventional before-and-after study. METHODS: Fifty eyes of 50 health care workers regularly using N95 masks were included. Preintervention, ocular surface parameters, subjective dry eye score, and visual acuity were assessed at the end of an 8-hour shift when the subjects used an N95 face mask without taping the upper edge. Next day, the upper edge of the N95 mask was taped to the nasal bridge in all subjects at the beginning of the 8-hour shift, and postintervention assessment was performed after the shift. The primary outcome measure was change in noninvasive tear break-up time (NIBUT). Secondary outcome measures were change in the symptom score, tear lipid layer thickness (LLT), tear break-up time (TBUT), Schirmer I test, tear meniscus height (TMH), osmolarity, and visual acuity. RESULTS: Mean age of the cohort was 26.7 ± 3.67 years. Post-taping, significantly better ocular surface stability was observed in terms of NIBUT (P < .001), TBUT (P < .001), LLT (P < .001), TMH (P = .01), corneal staining score (P = .001), and tear osmolarity (P = .04). There was no significant change in visual acuity, Schirmer I, and Ocular Surface Disease Index score (P > .05). Symptom improvement was reported by 68% patients (SANDE version 2), which correlated well with change in NIBUT (r = 0.38; P = .005), TMH (r = 0.37; P = .007), LLT (r = 0.35; P = .01), and TBUT (r = 0.28; P = .04). CONCLUSION: Taping of the upper mask edge resulted in significantly better ocular surface stability, which correlated well with decrease in dry eye symptoms.