Risk for microbial keratitis: Comparative metaanalysis of contact lens wearers and post-laser in situ keratomileusis patients.

PURPOSE: To compare the risk for microbial keratitis in contact lens wearers stratified by wear schedule with the risk after laser in situ keratomileusis (LASIK). SETTING: Hamilton Eye Institute and Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, USA. DESIGN: Comparative metaanalysis and literature review. METHODS: An extensive literature search was performed in the PubMed database between December 2014 and July 2015. This was followed by a metaanalysis using a mixed-effects modeling approach. RESULTS: After 1 year of daily soft contact lens wear, there were fewer microbial keratitis cases than after LASIK, or approximately 2 cases fewer cases per 10 000 (P = .0609). If LASIK were assumed to have essentially a 1-time risk for microbial keratitis, 5 years of extrapolation would yield 11 more cases per 10 000 with daily soft contact lens wear than with LASIK, or approximately 3 times as many cases (P < .0001). The extended use of soft contact lenses led to 12 more cases at 1 year than LASIK, or approximately 3 times as many cases (P < .0001), and 81 more cases at 5 years (P < .0001). When incorporating an estimated 10% retreatment rate for LASIK, these results changed very little. CONCLUSIONS: Microbial keratitis is a relatively rare complication associated with contact lens use and LASIK postoperatively. The risk for microbial keratitis was similar between patients using contact lenses for 1 year compared with LASIK. Over time, the risk for microbial keratitis was higher for contact lens use than for LASIK, specifically with extended-wear lenses.

Low Recurrence Rate of Pterygium After Excision With Conjunctival Limbal Autograft: A Retrospective Study With Long-Term Follow-Up.

PURPOSE: Pterygium excision with conjunctival limbal autograft (CLAG) has been used successfully for prevention of pterygium recurrence. However, long-term follow-up data in the literature are lacking regarding CLAG. METHODS: Retrospective chart review and standard statistical analysis were performed. The records of 289 patients who underwent 323 pterygium excision procedures with CLAG, performed by a single surgeon using the same technique between August 1989 and July 2013, were reviewed. Procedures with at least 4 months of follow-up were included in the final analysis. RESULTS: A total of 234 procedures met the inclusion criteria. After a median follow-up of 25.5 months, there were 5 recurrences (2.14%) after pterygium excision with CLAG. Recurrences were observed in 4 of 58 (6.9%) cases with recurrent pterygium and 1 of 178 (0.57%) with primary pterygium. CONCLUSIONS: This study highlights the safety and efficacy of CLAG in preventing the recurrence of primary and recurrent pterygium.

Development of a Novel Anti-HIF-1α Screening System Coupled with Biochemical and Biological Validation for Rapidly Selecting Potent Anti-Cancer Compounds.

Breast cancer (BCa) is the most diagnosed cancer and the second leading cause of cancer death in the American women. Adaptation to the hypoxic environment seen in solid tumors is critical for tumor cell survival and growth. The activation of hypoxia inducible factor-1 alpha (HIF-1α), an important master transcriptional factor that is induced and stabilized by intratumoral hypoxia, stimulates a group of HIF-1α-regulated genes including vascular endothelial growth factor (VEGF), leading tumor cells towards malignant progression. Therefore, a promising therapeutic approach to cancer treatment is to target HIF-1α. The goal of this project was to develop and validate a screening system coupled with secondary screen/validation process that has the capability to screen large numbers of potential anti-cancer small-molecule compounds based on their anti-HIF-1α activities. Breast cancer MDA-231 cells were used as the model to select potent anti-HIF-1α compounds by their abilities to inhibit transactivation of a VEGF promoter fused to a luciferase reporter gene under hypoxia. Positive compounds were then validated by a series of assays that confirm compounds' anti-HIF-1α activities including measurement of HIF-1α downstream VEGF gene expression and angiogenic ability of BCa cells. Results of our pilot screening demonstrate that this prototype screening coupled with validation system can effectively select highly potent anti-HIF-1α agents from the compound library, suggesting that this prototype screen system has the potential to be developed into a high-throughput screen (HTS) coupled with automated validation process for the screening and identification of novel and effective anti-cancer drugs based on anti-HIF-1α mechanism.

Bilateral microkeratome-assisted anterior lamellar contralateral corneal autograft: a case report.

PURPOSE: To present a case in which bilateral microkeratome-assisted contralateral anterior lamellar corneal autografting was used in the treatment of a patient with a stromal scar in one eye and dense amblyopia in the fellow eye. METHODS: Case report based on chart review. RESULTS: Anterior lamellar flaps were created in both eyes with a microkeratome. Six weeks later, central trephination through both flaps was performed, and the resulting corneal discs were switched. Visual acuity improved to 20/30 in the nonamblyopic eye 1 year after the surgery. CONCLUSIONS: Microkeratome-assisted contralateral lamellar autokeratoplasty can be useful in the treatment of an anterior stromal scar when the fellow eye has a clear cornea and poor vision limited by untreatable noncorneal pathology.