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At least 19 recordsLinked to original sources
PubMed2005

An open-label evaluation of HP-Guar gellable lubricant eye drops for the improvement of dry eye signs and symptoms in a moderate dry eye adult population.

OBJECTIVE: Evaluate the efficacy of a polymer hydroxypropyl guar (HP-Guar) gellable lubricant eye drop (Systane* Lubricant Eye Drops) in reducing dry eye signs and symptoms among dry eye patients who exhibited at least moderate signs and symptoms. METHODS: 168 patients with moderate dry eye signs and symptoms were enrolled at 29 sites in this open label study. The mean age of patients was 62 years with a minimum age of 28 years and a maximum of 90 years. One hundred and forty-seven patients completed the study, 111 female and 35 male, excluding 1 subject (gender not captured). In order to be included in the study, subjects were required to have a total corneal staining score > or = 4 (NEI grid) in at least one eye, with a grade > or = 2 in at least one zone of the same eye. Patients also had to indicate that their eyes 'felt dry enough to want to use eye drops' at least 'some of the time' on a standardized frequency scale. Eligible patients were dispensed a run-in drop (Opti-Free Express Rewetting Drops*) to use QID for 7 days, and then examined. Patients continuing to meet the inclusion criteria were dispensed the test drops (HP-Guar gellable lubricant eye drops) to use QID, and re-examined on Day 28. At each visit, corneal and conjunctival staining were measured, and six ocular discomfort symptoms were rated on a standardized 0-4 severity scale. At Days 0 and 28, patients subjectively rated product acceptability using a Likert scale. RESULTS: No significant changes in corneal or conjunctival staining were observed with the use of the run-in drop. After 28 days of test drop use, there was a statistically significant reduction in corneal staining (p < 0.0001). Ninety-four percent of patients improved from baseline, with mean reduction in total corneal staining of 4.1 units (0-15 total scale) (62%). Conjunctival staining also improved significantly (p < 0.0001) with a mean total reduction of 3.1 (59%). Patients experienced statistically significant symptomatic relief from day 0 to day 28 for all six ocular discomfort severity questions (p < 0.0001). CONCLUSION: Lubricating drops effectively relieved signs and symptoms associated with moderate dry eye, with measurable improvements evident in both objective staining and subjective questionnaire measures after 28 days in this study population.

Adult↗
PubMedDate not supplied

The effect of lubricant eye drops on ocular wavefront aberrations.

PURPOSE: To study the effect of lubricant eye drop instillation on ocular wavefront aberrations. METHODS: The wavefront aberrations of the entire optical path of 30 eyes of 15 patients before and following instillation of lubricant eye drops (Bion Tears; Alcon Laboratories Inc, Ft Worth, Tex) were obtained over a 6-mm pupil using a Hartmann-Shack wavefront sensor (WaveScan; VISX Inc, Santa Clara, Calif). Additional computation of root-mean-square (RMS) errors of higher order aberrations from third to sixth order were done using Zernike Tool Software (VISX Inc). Main outcome measures include the mean changes of total higher order aberrations RMS, higher order aberrations, and point spread function (PSF) of the higher order aberrations. RESULTS: The mean changes of total higher order aberrations following instillation of lubricant eye drops on the right eyes were -0.07 microm (95% confidence interval [CI], -0.11 to -0.03) and -0.03 microm on the left eyes (95% CI, -0.07 to 0.01). Significant mean changes were noted for coma and trefoil aberrations with a magnitude of -0.08 microm (95% CI, -0.12 to -0.03) and -0.09 (95% CI, -0.13 to -0.05), respectively, as well as a mean change of the PSF of the higher order aberrations (-0.05 diopters, 95% CI, -0.08 to -0.02) on the right eyes. Although no significant changes in these parameters were demonstrated on the left eyes, a similar trend of changes was observed. CONCLUSIONS: Ocular wavefront aberrations may change following eye drop instillation as measured objectively by the WaveScan system. This effect should be taken into consideration in the assessment of patients for wavefront-guided laser vision correction procedures.

Adult↗
PubMed2004

Clinical evaluation of an HP-guar gellable lubricant eye drop for the relief of dryness of the eye.

PURPOSE: To evaluate the efficacy of a new lubricant eye drop containing polyethylene glycol 400 and propylene glycol demulcents with hydroxypropyl-guar as a gelling agent (Test Product) to a system with carboxymethylcellulose (Control Product) for reducing dry eye signs and symptoms. METHODS: Eighty-seven dry eye volunteers were enrolled at seven sites for this six-week, concurrently controlled, double-masked clinical study. RESULTS: The Test Product significantly reduced conjunctival staining (p = 0.025) and temporal corneal staining (p = 0.024) compared to the Control. The Test Product also significantly reduced symptoms of dryness in the morning and evening, compared to the Control (p = 0.015 and p = 0.023, respectively). Subjects in the Test treatment group reported lower frequencies of foreign body sensation and felt their eyes were "refreshed longer" compared to those in the Control group (p = 0.033 and p = 0.037, respectively). CONCLUSIONS: The Test Product was more effective at reducing both the signs and symptoms of dry eye compared to the carboxymethylcellulose containing Control.

Carboxymethylcellulose Sodium↗
PubMed2004

Rejuvenation of visual functions in older adult drivers and drivers with cataract during a short-term administration of N-acetylcarnosine lubricant eye drops.

The purpose of this study was to examine using the original halometer glare test of the type of visual impairment mediated by the increased glare sensitivity (halos) and associated with poorer visual function in both the better and worse eyes of older adult drivers and older drivers with cataract. The clinically validated (by Innovative Vision Products Inc.) formula of 1% N-acetylcarnosine (NAC) lubricant eye drops were applied topically to the eyes of older drivers to reduce glare disability and improve distance acuities for driving. This was a randomized, double-blind, placebo-controlled study. The examined subjects consisted of 65 older adults with cataract in one or both eyes, and 72 adult drivers who did not have cataract in either eye. In the control group, comparison with baseline values showed some variability of data in gradual worsening of glare sensitivity at red and green targets and minimal VA changes over 4 months. In the NAC-treated group, 4-month follow-up generally showed an improvement in VA and a significant improvement in glare sensitivity at red and green targets was documented in worse and better eyes using a critical cut point halometer score for driving. The NAC-treated eyes had statistically significant difference in VA, glare sensitivity compared with the control group ( p < 0.001) at 4-month timepoint of treatment, as supported by the overall t-test results of the ratio of the follow-up data to the baseline values. Tolerability of NAC eyedrops was good in almost all patients, with no reports of ocular or systemic adverse effects. It would be advisable for traffic safety if a Halometer glare sensitivity test was implemented for vehicles and/or was regularly added to the requirements for a driver's licence. The results of this study provide a substantial basis for further evaluation of NAC in the treatment and prevention of vision impairment in the older population of drivers for legal driving. The developed ophthalmic drug NAC formula showed potential for the non-surgical treatment of age-related cataracts.

Aged↗
PubMed2005

Analysis of lipid peroxidation and electron microscopic survey of maturation stages during human cataractogenesis: pharmacokinetic assay of Can-C N-acetylcarnosine prodrug lubricant eye drops for cataract prevention.

Morphological and biophysical techniques described in this study have shown that membrane derangement occurs in human cataractous lenses. The data suggest that these disruptions were globules, vacuoles, multilamellar membranes and clusters of highly undulating membranes. Deleterious structural damage of the lens fibre cell plasma membranes serve as the primary light-scattering centres that cause the observed lens opacity. Nuclear cataract, a major cause of loss of lens transparency in the aging human, has been thought to be associated with oxidative damage, particularly at the site of the nuclear plasma membrane. Phospholipid molecules modified by oxygen accumulate in the lipid bilayer, change its geometry and impair lipid-lipid and protein-lipid interactions in lenticular fibre membranes. Lipid peroxidation (LPO) is a causative and pathogenic factor in cataract. Increased concentrations of primary molecular LPO products (diene conjugates, lipid hydroperoxides, oxy-derivatives of phospholipid fatty acids) and end-fluorescent LPO products have been detected in the lipid moieties of aqueous humour samples and human lenses obtained from patients with senile and complicated cataracts as compared with normal donors. In the present study, a rapid and simple high-performance liquid chromatographic (HPLC) assay for determination of imidazole-containing dipeptides in the aqueous humour of the eye was developed. The method was applied to determine the pharmacokinetic parameters and the time-course of N-acetylcarnosine and L-carnosine-related product in the eye, following a single dosage of topical ocular administration of peptide. Utilising data from pharmacokinetic studies and the specific purity of the N-acetylcarnosine (NAC) ingredient as a source of the pharmacological principle L-carnosine, we have created an ophthalmic time-release prodrug form including the US FDA-approved carboxymethylcellulose lubricant and other essential ingredients (Can-C, private label Nu-Eyes). This formulation increases the intraocular absorption of L-carnosine in the aqueous humour and optimises its specific antioxidant activity in vivo while reducing the toxic effects of lipid peroxides on the crystalline lens. L-carnosine that enters the aqueous humour can accumulate in the lens tissue for a reasonable period of time. The presence of L-carnosine in transparent crystalline lenses during normal aging was detected and its concentration in this case was about 25 microM. At different stages of cataract development, the level of L-carnosine drastically decreased, reaching about 5 microM in ripe human cataracts. However, administration of pure L-carnosine (1% solution) to the rabbit eye (instillation or subconjunctival injection) does not lead to accumulation of this natural compound in the aqueous humour at the time level over 30 minutes at a concentration exceeding that in placebo-treated matched eyes, and its effective concentration is exhausted more rapidly. Use of NAC prodrug eye drops optimises the clinical effects of L-carnosine in the treatment of ophthalmic disorders (such as prevention and reversal of cataracts in human and animal [canine] eyes). The data provided predict a clinical effect with NAC ophthalmic prodrug, and show that the magnitude and duration of this effect are directly related to the bioavailability of L-carnosine released from NAC in the aqueous humour of the anterior eye segment. The ophthalmic NAC drug shows promise in the treatment of a range of ophthalmic disorders that have a component of oxidative stress in their pathogenesis (including cataract, glaucoma, dry eye, vitreous floaters, inflammatory disorders, and corneal, retinal and systemic diseases [such as diabetes mellitus and its ophthalmic complications]). There is a need for further and better collaboration between Innovative Vision Products' cataract control and ophthalmic services, improved education of people affected by cataract, a commitment that N-acetylcarnosine eye drops will be the preferred treatment before orthodox cataract surgery is attempted, and consideration of outcomes and a possible role of the NAC drug cataract treatment as source of referral for orthodox surgical, ophthalmic and optometric services.

Adolescent↗
PubMed2005

The effect of two novel lubricant eye drops on tear film lipid layer thickness in subjects with dry eye symptoms.

PURPOSE: Because the lipid layer of the tear film is recognized as a critical component in dry eye disease, this study was designed to determine if a single eye drop of either Soothe or Systane produces a significant increase in lipid layer thickness (LLT) for subjects reporting symptoms indicative of dry eyes. METHODS: A double-blind, internally paired study was performed. A custom-built lipid layer interferometer, enabling characterization of lipid layer interference patterns, was used to quantify baseline LLT (OU) of eligible subjects. Inclusion criteria included: 1) presence of dry eye symptoms and 2) baseline LLT < or =75 nm. Subjects (n = 40) received a single eye drop of Soothe in one eye and a single eye drop of Systane in the contralateral eye. After the instillation of each test drop, LLT was reanalyzed for all subjects. RESULTS: The mean +/- standard error baseline LLT pre-eye drop instillation was 60.0 +/- 1.8 nm for eyes treated with Soothe and 61.5 +/- 1.8 nm for eyes treated with Systane. These means were not significantly different (p > 0.5). The mean LLT for eyes treated with Soothe increased to 124.4 +/- 4.9 nm (p < 0.0001). The mean LLT for eyes treated with Systane increased to 71.3 +/- 2.6 nm (p < 0.0001). The LLT increase from Soothe was significantly greater than that from Systane (p < 0.0001). CONCLUSIONS: In subjects with symptoms indicative of dry eye states and LLT < or =75 nm, one eye drop of Soothe more than doubled LLT, a 107% mean increase, whereas Systane increased LLT by 16%.

Adult↗
PubMed2005

Inverse Bell's phenomenon observed following levator resection for blepharoptosis.

BACKGROUND: Ptosis surgery is one of the more widely performed surgeries in ophthalmology. Preoperative lagophthalmos, Bell's phenomenon, corneal sensation and dry eye are important factors to be assessed in these cases, which influence the functional and cosmetic results. We herein describe the interesting complication of transient inversion of Bell's phenomenon observed following extensive levator resection performed for congenital ptosis. METHODS: Three patients are described who underwent levator resection and showed an inversion of the Bell's phenomenon in the postoperative period, with the eye going down instead of up, during eyelid closure. RESULTS: The Bell's phenomenon reverted to normal in all three cases within 2 weeks and there were no corneal complications. The patients were given frequent lubricating eye drops during this period. CONCLUSIONS: It is important to look for variations in Bell's phenomenon in all cases of congenital ptosis, especially following levator resection. In cases with a poor or ineffective Bell's phenomenon, it is imperative to keep a close watch on the cornea along with copious lubrication during the early postoperative period.

Adolescent↗
PubMed2006

Effect of topical prednisolone and diclofenac on the short-term change in morphology of posterior capsular opacification.

PURPOSE: To observe and document the effect of steroidal and nonsteroidal antiinflammatory treatment on the formation of Elschnig pearls. DESIGN: A prospective, randomized, double blinded, placebo controlled, two-way-cross-over study. METHODS: Thirty-nine eyes of 32 patients with pronounced, regeneratory posterior capsule opacification (PCO) were included. The patients were treated topically with prednisolone and diclofenac (verum) or with lubricating eye drops (placebo) four times daily for one week. After a wash-out period of two weeks the patients received the contrary treatment also four times daily for one week. Digital retroillumination images were taken at day one, three, five, eight, and 15 of each medication period. The changes in the size of 4,675 Elschnig pearls were analyzed. RESULTS: The mean cumulative area of all marked pearls/eye and follow-up was 1.2 mm(2) (range: 0.1 mm(2) to 3.2 mm(2)). The mean pearl size was 12,809 microm(2) (range: 60 microm(2) to 1.08 x 10(6) microm(2)). Between the follow-up examinations, 1,274 pearls disappeared (mean: 33 pearls/eye, range: five to 69 pearls; 27%) and 777 newly formed pearls appeared (mean: 20 pearls/eye, range: three to 53 pearls; 20%). There was no statistically significant difference in pearl size change and in number of disappeared and newly appeared pearls between the verum and the placebo treatments. CONCLUSIONS: Topical prednisolone and diclofenac do not influence the short-term change of Elschnig pearls. Elschnig pearls disappear and appear within days. The degree of progression and regression varies greatly among eyes.

Administration, Topical↗
PubMedDate not supplied

Computer vision syndrome: a review.

As computers become part of our everyday life, more and more people are experiencing a variety of ocular symptoms related to computer use. These include eyestrain, tired eyes, irritation, redness, blurred vision, and double vision, collectively referred to as computer vision syndrome. This article describes both the characteristics and treatment modalities that are available at this time. Computer vision syndrome symptoms may be the cause of ocular (ocular-surface abnormalities or accommodative spasms) and/or extraocular (ergonomic) etiologies. However, the major contributor to computer vision syndrome symptoms by far appears to be dry eye. The visual effects of various display characteristics such as lighting, glare, display quality, refresh rates, and radiation are also discussed. Treatment requires a multidirectional approach combining ocular therapy with adjustment of the workstation. Proper lighting, anti-glare filters, ergonomic positioning of computer monitor and regular work breaks may help improve visual comfort. Lubricating eye drops and special computer glasses help relieve ocular surface-related symptoms. More work needs to be done to specifically define the processes that cause computer vision syndrome and to develop and improve effective treatments that successfully address these causes.

Asthenopia↗
PubMed2000

Comparison of the clinical efficacy and comfort of olopatadine hydrochloride 0.1% ophthalmic solution and nedocromil sodium 2% ophthalmic solution in the human conjunctival allergen challenge model.

BACKGROUND: Mast cell stabilizers, such as the ocular antiallergic agent nedocromil sodium 2% ophthalmic solution, are not rapid acting and often require a loading period of > or =2 weeks for maximal efficacy. Olopatadine hydrochloride 0.1% ophthalmic solution is a member of a new class of topical antiallergic agents that have combined antihistaminic and mast cell-stabilizing properties. OBJECTIVE: The purpose of this study was to compare the clinical efficacy and comfort of olopatadine with those of nedocromil in the conjunctival allergen challenge model. METHODS: This was a single-center, 3-visit, randomized, double-masked, contralaterally controlled study. Seventy-five subjects with a history of allergic conjunctivitis were screened, and the 52 who responded to conjunctival allergen challenge at visits I and 2 were randomized by eye to receive olopatadine, nedocromil, or placebo (a "natural tears" lubricant eye drop). Because nedocromil may require a 2-week loading period for maximal efficacy, the eyes assigned to that agent received nedocromil for 14 days (between visits 2 and 3), whereas the eyes assigned to olopatadine or placebo received placebo during this period. Throughout the loading phase, subjects instilled 1 drop of the assigned masked medication in each eye twice daily. At the assessment visit (visit 3), subjects received I drop of masked olopatadine, nedocromil, or placebo in each eye and were asked to rate the comfort of each drop on a scale from 0 to 8. Fifteen minutes after instillation of medication, subjects were challenged with the allergen concentration that had elicited a positive conjunctival allergic response at the previous visits. Subjects then scored their itching on a scale from 0 to 4 at 3, 5, and 10 minutes after challenge. Mean itching scores for all eyes were compared by treatment. Paired t tests were performed on the mean itching and ocular comfort scores at each time point. At the end of the study, subjects were asked which treatment they preferred in terms of comfort and efficacy. RESULTS: Forty-nine subjects completed the study. Forty eyes received olopatadine, 36 received nedocromil, and 22 received placebo. Olopatadine was clinically and statistically superior to nedocromil at reducing itching in the conjunctival allergen challenge model (mean unit difference: -1.60 at 3 minutes, -1.68 at 5 minutes, -1.19 at 10 minutes; P < 0.001). One drop of olopatadine was more efficacious than 29 drops of nedocromil. Olopatadine-treated eyes were rated as being significantly more comfortable than nedocromil-treated eyes (0.73 vs 1.55; P = 0.034). Of the 14 subjects treated with olopatadine and nedocromil who stated a preference, 10 (71%) were more satisfied with olopatadine than with nedocromil. CONCLUSION: In the conjunctival allergen challenge model, olopatadine was more efficacious and comfortable than nedocromil in reducing the itching associated with allergic conjunctivitis.

Conjunctivitis, Allergic↗
PubMed2004

Pre-clinical investigation of the efficacy of an artificial tear solution containing hydroxypropyl-guar as a gelling agent.

PURPOSE: Pre-clinical studies of a new artificial tear product (Systane Lubricating Eye Drops Alcon Laboratories, Inc., Fort Worth, TX) containing the novel gelling agent hydroxypropyl-guar (HP-guar) and two demulcents, polyethylene glycol 400 (PEG) and propylene glycol (PG) were conducted to determine the ability of the product to protect ocular surface epithelial cells from desiccation in vivo and in vitro, and to promote recovery of the damaged corneal epithelial barrier in vivo. Other leading artificial tear products were also evaluated as comparators to determine the relative effectiveness of different polymer systems. METHODS: Damage due to desiccation was assessed by measuring corneal uptake of methylene blue compared to untreated corneas. Corneas of anesthetized rabbits were treated with the new artificial tear product and subjected to desiccation by holding the eyelids open for 2 hours with a speculum. Control eyes were subjected to desiccation without application of a tear formulation. To measure recovery of the corneal epithelium from damage, corneas of anethesthetized rabbits were exposed to 0.01% benzalkonium chloride (BAC) for 5 minutes to increase epithelial permeability. The corneas were exposed to the new artificial tear for 1.5 hours followed by measurement of uptake of 5,6 carboxyfluorescein (CF). In the desiccation and CF uptake experiments, the new tear product was also compared to a tear product formulation without HP-guar and to a commercially available artificial tear containing carboxymethyl cellulose (CMC) and Purite. In a third set of experiments, immortalized human corneal epithelial cells and Chang conjunctival cells in culture were exposed to the PEG/PG/HP-guar tear product, the control formulation without HP-guar, a tear formulation preserved with BAC, or the artificial tear containing CMC/Purite for 15min. The tear formulation was removed and the cells were exposed to desiccating conditions in a laboratory safety hood for 10 or 30min. Cell viability was determined using the MTT assay. RESULTS: The in vivo desiccation model, showed that the new tear product, Systane, offered complete protection of the cornea from desiccation (methylene blue uptake not different than naïve control). Following exposure to 0.01% BAC, the new artificial tear product also provided an environment in which the corneal epithelium recovered completely from damage (CF uptake not different than normal, untreated cornea). This level of protection was not observed when corneas were treated with other formulations. Results from the in vitro desiccation procedure indicated that viability of corneal epithelial and Chang cells treated with the PEG/PG/HP-guar product was significantly greater than viability of cells treated with the tear product without HP-guar or the tear products containing BAC or CMC/Purite. CONCLUSIONS: The tear product containing HP-guar, PEG 400 and propylene glycol satisfies several pre-clinical criteria for an appropriate artificial tear formulation. It gives long-term desiccation protection of the intact cornea and also epithelial cells in culture and has no apparent deleterious affects on cells. It also provides conditions in which a damaged corneal epithelium can recover normal barrier function. The combination of ingredients in the formulation appears to provide an effective mucomimetic artificial tear product. These pre-clinical data suggest that the product will be effective in providing superior relief for the dry eye sufferer.

Animals↗
PubMed1990

Graves' ophthalmopathy--a clinical review.

Graves' ophthalmopathy occurs in 2% to 7% of patients with Graves' disease with the major manifestations being proptosis, ophthalmoplegia, optic neuropathy and/or eyelid retraction. Although autoimmune in nature, the precise pathophysiology is unknown. The course of the ophthalmopathy is not influenced by the mode of treatment of the hyperthyroidism. In addition to restoration of the euthyroid state, the aims of treatment include relief of eye pain, correction of extraocular muscle dysfunction, protection of visual acuity and improvement of appearance. Specific therapy depends on the severity of the ophthalmopathy and varies from lubricating eye drops in mild disease to high-dose steroids and radiotherapy or decompressive surgery in severe cases.

Eye Diseases↗
PubMed2003

[Impression cytology study of dry eyes in patients with congenital aniridia].

PURPOSE: To evaluate the long-term results of ocular surface reconstruction by means of medical treatment, limbal transplantation or amniotic membrane transplantation in patients with congenital aniridia. MATERIAL AND METHODS: Thirty-six eyes from 18 consecutive patients with aniridia were studied by clinical tests (Schirmer test, break-up time and vital rose bengal staining) and impression cytology. Thirteen patients were treated with lubricant drops for ocular dryness. Two eyes from 2 patients also received limbal transplantation, and other 4 eyes underwent amniotic membrane transplantation. RESULTS: Corneal and conjunctival epithelium improved in all patients treated with lubricant drops. Ocular surface epithelium condition was worse in those patients not receiving artificial tears. After 12 months of limbal transplantation, clinical and morphological results showed a significant corneal recovery of at least two grades of squamous metaplasia in comparison with the previous situation. We also carried out amniotic membrane transplantation in patients with aniridia. The improvement was initially observed after 2 months and by the sixth month there was a significant improvement in clinical signs and symptoms, with normal corneal cells next to altered ones. CONCLUSIONS: All the aniridic patients showed dry eye. Treatment with lubricant drops is necessary to decrease the squamous metaplasia process. Limbal transplantation and amniotic membrane implantation are needed for effective corneal surface reconstruction in patients with aniridia, which is followed by a significant improvement of the dry eye.

Adolescent↗
PubMed2002

Risk factors for intraoperative epithelial defect in laser in-situ keratomileusis.

PURPOSE: To report intraoperative epithelial defects (IED) in eyes undergoing laser in-situ keratomileusis (LASIK). DESIGN: Consecutive interventional case series. METHODS: Retrospective review of 247 eyes (133 patients) that underwent primary LASIK by a single surgeon at an academic institution using the Hansatome microkeratome. Patient characteristics and variations in preoperative and operative technique were analyzed. The main outcome measure was occurrence of IED (defined as loose epithelium that is > 1 mm or cannot be stably repositioned or absent epithelium). Multivariate logistic regression was performed. RESULTS: Intraoperative epithelial defects occurred in 24 (9.7%) of 247 eyes. Intraoperative epithelial defects significantly increased with older age (odds ratio [OR] 2.39/decade; 95% confidence interval [CI] 1.46-3.92), thicker preoperative corneal thickness (OR 2.30/50 microm; 95% CI 1.24-4.28), and maintenance of suction ring vacuum during the reverse pass of the microkeratome (OR 1.76; 95% CI 1.01-3.06). The preoperative and intraoperative eye-drop regimen (anesthetic, mydriatics, lubricants, and intraoperative tonometry) had a significant effect on IED risk (OR, 0.163 best vs worst regimen; 95% CI, 0.033-0.792). In patients undergoing bilateral LASIK, the incidence of IED is much higher in the second eye if the first eye developed an IED (57% vs 1%). CONCLUSIONS: Modifying the eyedrop regimen was the more effective technical approach to decrease the risk of IED. Age and corneal thickness are valuable patient characteristics for preoperative risk assessment. Intraoperative epithelial defects in the first eye is highly predictive of IED in the second eye of the same patient.

Adult↗
PubMed2002

Low-concentration homogenized castor oil eye drops for noninflamed obstructive meibomian gland dysfunction.

OBJECTIVE: We developed low-concentration homogenized castor oil eye drops for the treatment of patients with noninflamed obstructive meibomian gland dysfunction (MGD), a major cause of lipid-deficiency dry eye, and assessed the safety, stability, and efficacy of the eye drops. DESIGN: Randomized, double-masked, placebo-controlled crossover clinical trial. PARTICIPANTS: Forty eyes of 20 patients with noninflamed MGD. METHODS: After a preliminary study of eye drops containing castor oil, 2% castor oil and 5% polyoxyethylene castor oil (emulsifier) were mixed to formulate homogenized oil eye drops. The patients were assigned randomly to receive oil eye drops or placebo six times daily for 2 periods of 2 weeks each. MAIN OUTCOME MEASURES: At the end of each treatment period, we assessed symptoms, tear interference grade, tear evaporation, fluorescein and rose bengal scores, tear break-up time (BUT), and meibomian gland orifice obstruction. Safety and stability tests were also performed. RESULTS: Symptom scores, tear interference grade, tear evaporation test results, rose bengal scores, tear BUT, and orifice obstruction scores after the oil eye drop period showed significant improvement compared with the results after the placebo period. No complications attributable to the eye drops were observed. The oil eye drops were stable when stored at 4 degrees C. CONCLUSIONS: The results indicate that castor oil eye drops are effective and safe in the treatment of MGD. The possible mechanisms of this treatment are improvement of tear stability as a result of lipid spreading, ease of meibum expression, prevention of tear evaporation, and the lubricating effect of the oil eye drops.

Castor Oil↗
PubMed1991

Congenital ichthyosis in a Libyan child with ophthalmic manifestations.

This report presents a Libyan child with congenital ichthyosis of the recessive lamellar variety complicated by severe ectropion of both upper and lower eyelids. Over a period of 12 months the degree of ectropion diminished and the anterior segments of the eyes were preserved using regular lubricating drops, vitamin A ointment and intermittent topical antibiotic therapy. Despite the pronounced initial upper eyelid ectropion no surgery was required to relieve the ectropion or prevent corneal exposure.

Anti-Bacterial Agents↗