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At least 109 records · Page 6Linked to original sources

PubMed2006

The impact of the onset time of atopic keratoconjunctivitis on the tear function and ocular surface findings.

PURPOSE: To investigate the tear and ocular surface findings between controls, children, and adults with atopic keratoconjunctivitis (AKC). DESIGN: Prospective comparative study. METHODS: Twenty eyes of 10 childhood-onset, 10 eyes of five adult-onset, AKC adult patients, and 12 eyes of six children with infantile-onset AKC, 14 eyes of seven normal adults and seven normal children were recruited. Corneal aesthesiometry, Schirmer test, tear film break-up time (BUT), vital staining, and conjunctival impression cytology were performed. RESULTS: The Schirmer and Rose Bengal scores in childhood-onset adult AKC patients were considerably worse than adult-onset adult AKC patients, pediatric subjects, and the controls (P < .05). The same significant relation was observed in impression cytology parameters. CONCLUSIONS: Ocular surface disease in childhood-onset adult AKC patients was characterized by greater ocular surface epithelial damage. Prolonged inflammation may be important in the evolution and progression of ocular surface disease in patients with longstanding active AKC.

Adult↗

PubMed2006

Corneal epitheliotrophic capacity of three different blood-derived preparations.

PURPOSE: Serum eye drops have been successfully used in the treatment of severe ocular surface disorders. Fresh frozen plasma (FFP) and platelet concentrates have not yet been tested for use as eye drops, although they are easily available as quality-controlled products from blood banks and are routinely used for transfusion. To test whether FFP or platelet-derived growth factor solutions could be used for ocular surface diseases, we compared the epitheliotrophic capacity of platelet releasate and FFP with that of serum in cell culture models. METHODS: The concentrations of EGF, TGF-beta1, PDGF-AB, fibronectin, vitamin A and vitamin E in serum, FFP, and platelet releasate were evaluated with ELISA and HPLC. Corneal epithelial cells were incubated with the various preparations and cell proliferation, migration, and differentiation were evaluated by means of a luminescence-based adenosine triphosphate (ATP) assay, a colony dispersion assay, and scanning electron microscopy. RESULTS: Growth factor concentrations were significantly higher in platelet releasate than in serum and were lowest in FFP. Fibronectin and vitamins were found in higher concentrations in serum than in FFP and were lowest in platelet releasate. Cell proliferation was best supported by platelet releasate followed by serum and FFP; however, cell migration and differentiation were better supported by serum than by platelet releasate and FFP. The reduced nutrient capacity of FFP was in part found to be due to an antiproliferative effect of citrate used as an anticoagulant in the production process. CONCLUSIONS: Platelet releasate but not FFP may offer additional potential for the treatment of severe ocular surface disease. Platelet releasate may be suitable as a novel treatment option for ocular surface disease with a superior effect on cell growth.

Animals↗

PubMed2006

Ocular effects of cosmetic products and procedures.

Cosmetic products and procedures can produce adverse effects on the ocular surface, ranging from mild discomfort to vision-threatening conditions. Complications of skin and eye products can be related to allergy or toxicity, often attributable to perfumes. Complications of blepharoplasty may be associated with overcorrection, scarring, or uneven contour of the lid margins, conditions that can cause significant ocular surface disease until they are corrected. Ocular surface effects of botulinum toxin injection include dry eye syndromes and also epiphora. More serious complications occur (rarely) and are dose- and location-related. Adverse effects of micropigmentation procedures involve pathological processes or, simply, poor cosmetic results. In certain youth cultures, special-effect contact lenses and even decorative conjunctival implants have gained popularity, presenting a wide variety of dangers, often attributable to poor education about care and hygiene.

Cosmetic Techniques↗

PubMed2004

The precorneal tear film in horses: its importance and disorders.

The precorneal tear film (PTF) is of critical importance in the physiologic and pathologic findings of the cornea. Clinicians should recall that quantitative and qualitative disorders of the PTF can be a cause of corneal diseases as well as a clinical sign of ocular surface diseases. It is also important to consider that some systemic and topical treatments may affect the PTF volume and composition. Not all interactions are known at this time. There is a continued need for basic research into PTF components in healthy and diseased equine eyes, because much remains unknown. Until additional basic information about the biochemical composition and pH of the PTF as well as the interactions between equine corneal pathogens and specific PTF deficits becomes available, it will not be possible to define the cause and effect relations precisely between the various ocular surface diseases and deficiencies,excesses, and imbalances of PTF components. It is quite possible that a number of equine corneal diseases may be manifestations of qualitative PTF disorders.

Animals↗

PubMed2001

Phacoemulsification in patients after allogeneic bone marrow transplantation.

OBJECTIVE: To study the outcomes of phacoemulsification in allogeneic bone marrow transplant (allo-BMT) recipients. DESIGN: Retrospective, noncomparative, interventional case series. METHODS: Retrospective study of 34 eyes of 19 consecutive patients who had visually significant cataracts after allo-BMT and subsequently underwent phacoemulsification. MAIN OUTCOME MEASURES: Best-corrected vision at the last follow-up visit and development of postoperative complications. RESULTS: Surgery was done at a mean interval of 37 months after BMT, and the mean postoperative follow-up was 13 months. Twenty-one eyes (62%) had subnormal Schirmer I scores as a result of graft-versus-host disease (GVHD) involving the lacrimal gland. Of these, 71% (15 eyes) additionally had significant ocular surface epitheliopathy because of conjunctival GVHD. Frequent lubrication (95%), punctal occlusion (76%), topical steroids (33%), and other topical immunosuppressive therapies (14%) were used to manage GVHD-induced ocular surface disease before cataract surgery. Twelve patients (63%) also received systemic steroids and immunosuppressives. Patients proceeded to surgery only after their ocular surface disease was well controlled. Early postoperative complications included intraocular pressure elevation (three eyes), worsening of dry eye syndrome (two eyes), and corneal thinning (one eye). Posterior capsular opacification (PCO) requiring laser capsulotomy occurred in 44% of eyes. In eyes with preoperative conjunctival GVHD, 47% had recurrence with cessation of immunosuppressive therapy after surgery. Visual acuity at last follow-up visit was 20/30 or better in 33 (97%) eyes. CONCLUSIONS: Phacoemulsification is an effective procedure in restoring vision in patients who have cataracts develop after BMT. However, coexisting ocular disease must be recognized and aggressively treated both before and after surgery to ensure good visual outcomes.

Adult↗

PubMed1999

Management of coincident corneal disease and cataract.

The status of the cornea is crucial to a good outcome with cataract extraction. Preexisting corneal disease must be managed appropriately to get the high-quality results that we have come to expect with cataract surgery. It is now more common to perform cataract surgery on patients with previous corneal refractive surgery, and in these patients intraocular-lens power calculation is more challenging. Complications following cataract surgery and intraocular-lens implantation that involve the cornea are uncommon because of advances in surgical techniques. Corneal complications can include mechanical or toxic injury of the endothelium, stripped Descemet's membrane, epithelial toxicity and disruption, infectious keratitis, and epithelial ingrowth. Endothelial-cell survival after cataract extraction and lens implantation is still the major concern. Healing of the cornea following clear corneal incisions has become more important, as this technique is more frequently used. Patients with ocular surface disease still require extra lubrication and management of blepharitis to prevent epithelial toxicity at the time of surgery as well as postoperatively. Clear corneal cataract extraction and lens implantation causes minimal disruption of the conjunctiva, allowing cataract surgery to be performed in patients with severe ocular surface disease such as ocular cicatricial pemphigoid. Overall, modern-day cataract extraction is very safe for the cornea.

Cataract↗

PubMed1998

Management of coincidental corneal disease and cataract.

The status of the cornea is crucial to a good outcome with cataract extraction. Preexisting corneal disease must be managed appropriately to get the high quality results that we have come to expect with modern day cataract surgery. It is now more common to perform cataract surgery on patients who have had previous corneal refractive surgery, and in these patients intraocular lens power calculation is more challenging. Complications following cataract surgery and lens implantation that involve the cornea are uncommon because of advances in surgical techniques. Corneal complications can include mechanical or toxic injury of the endothelium, stripped Descemet's membrane, epithelial toxicity and disruption, infectious keratitis, or epithelial ingrowth. Endothelial cell survival after cataract extraction and lens implantation is still the major concern. Healing of the cornea following clear corneal incisions has become more important, as this technique is used more frequently. There are several recent studies looking at the results of clear corneal incisions performed for cataract surgery. Patients with ocular surface disease still require extra lubrication and management of blepharitis to prevent epithelial toxicity at the time of surgery as well as postoperatively. Clear corneal cataract extraction and lens implantation cause minimal disruption of the conjunctiva, allowing cataract surgery to be performed in patients with severe ocular surface disease such as ocular cicatricial pemphigoid. Overall, modern day cataract extraction is very safe for the cornea.

Cataract↗

PubMed2003

Ex vivo expansion of corneal limbal epithelial/stem cells for corneal surface reconstruction.

PURPOSE: The management of severe ocular surface disease due to limbal stem cell deficiency has changed dramatically. The concept of limbal stem cells, as the source of corneal epithelium revolutionised the therapeutic approach of ocular surface reconstruction. Deficiency of limbal stem cells results in blinding ocular surface diseases. Grafting viable limbal tissue, from either fellow healthy eye or a donor eye, with the resident stem cell population may replenish limbal stem cells and can restore the corneal surface to normality. Transplanting the limbal tissue can be achieved through a variety of procedures that include cadaveric keratolimbal allograft (KLAL), live or living related conjunctival limbal allograft (Ir-CLAL) and limbal autograft. Advances in tissue engineering techniques have offered a viable alternative to overcome the limitation of limbal tissue available for transplantation. Epithelial stem cells harvested from a small limbal biopsy can be expanded in vitro on a suitable carrier and then transplanted to the diseased cornea to successfully restore the corneal surface. This article is a chronological review of the important steps that brought ex vivo expanded stem cell transplantation in ocular, particularly corneal surface reconstruction. METHODS: The MEDLINE data base was searched for the years 1966-2002, using key words cornea, cell culture, ex-vivo expansion, limbus, stem cell, ocular surface and transplantation. Several articles that were not found by MEDLINE search were taken from references from other articles. Inclusion or exclusion of article was based on the relevance to the subject. CONCLUSIONS: Corneal epithelial reconstruction with ex vivo expanded limbal cells is a potential tool in ocular surface reconstruction, although the technique is currently investigational. Strategies to achieve conjunctival epithelial restoration and tear film replenishment will allow ophthalmic surgeons to truly reconstruct the ocular surface.

Amnion↗

PubMed2005

Microkeratome-assisted phacoemulsification.

This study reports a technique in which phacoemulsification and intraocular lens (IOL) insertion are performed in conjunction with a microkeratome flap in a patient with ocular surface disease. Microkeratome-assisted phacoemulsification was performed in a 72-year-old woman with a history of trachoma during childhood. A 130 microm corneal flap was made using a microkeratome prior to phacoemulsification and IOL insertion. Lifting the flap during surgery allowed a clear view of the anterior chamber through the smooth lamellar interface created by the microkeratome blade. The flap was washed and repositioned without sutures at the end of surgery. There were no complications associated with the microkeratome flap following surgery. Visual acuity improved from hand motion to 20/200. Microkeratome-assisted phacoemulsification is a safe technique for cataract patients with diseases of the ocular surface.

Aged↗

PubMed2000

Low molecular weight analysis of tears using matrix assisted laser desorption ionization-time of flight mass spectrometry.

Many low molecular weight substances in human tears, including protein and lipid species, have yet to be characterized. Some of these uncharacterized substances may well be important in the pathogenesis of ocular surface disease or in ocular discomfort. The aim of this study was to build a biochemical profile of low molecular weight species in tears, and to determine its repeatability. A total of 80 tear samples were collected from 11 subjects. Tear samples were dialysed to remove salts, added to a matrix of alpha-cyano-4-hydroxycinnamic acid, and analysed using matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry. Species were separated based on their mass to charge ratio (m:z). The repeatability of the appearance of the different species was analysed using logistic regression and diurnal and day-to-day repeatability were ascertained. Peptides were identified in the range of 848 3897 Da. Of these, 39 peptides were found to be present in more than 10/80 samples. There was no diurnal variation in the peptides. All species were found to occur repeatably, with the exception of peptide 1653 Da.This study has demonstrated that the majority of low molecular weight species in tears are repeatably present and do not exhibit diurnal variation. Further study aims to characterize these species and to identify changes in tear profiles between subject groups.

Adult↗

PubMed1996

[Distribution of conjunctival goblet cells and observation of goblet cells after conjunctival autotransplantation in rabbits].

Conjunctival goblet cells are essential for maintaining a normal ocular surface and important for recovering a diseased ocular surface. However, how goblet cells in conjunctival epithelium evolve after transplantation are uncertain. We experimented with albino rabbits to study the distribution of goblet cells in normal conjunctiva. We performed autograftings of conjunctiva which contained many goblet cells on the sclera of albino rabbits, and made histological observations on how goblet cells evolved after transplantation. The results were as follows. 1. Goblet cells in the normal rabbits were most abundant at the lid margin of both upper and lower tarsal conjunctiva. 2. We made autograftings of conjunctiva on the sclera of albino rabbits. The goblet cells on the transplanted conjunction disappeared for a short time on the 3rd day after transplantation. On the 7th day and onwards they reappeared, and by the 14th day a large number of goblet cells were observed. 3. Between the 7th and 14th day after autografting, epithelial differentiation of the grafted conjunctiva occurred.

Animals↗

PubMed1996

Differential diagnosis of dry eye conditions.

The pre-ocular tear film is a complex biochemical structure produced by the lacrimal glands and epithelial cells on the ocular surface. Clinical syndromes of ocular irritation may result from deficiencies in one or more of these layers. At a recent dry eye workshop at the National Eye Institute, dry eye conditions were classified into those with adequate aqueous tear production and those with aqueous tear deficiency. The majority of patients with aqueous adequate dry eye suffer from meibomian gland dysfunction that results in lipid tear deficiency. Aqueous tear deficiency can be subclassified into non-Sjögren's syndrome and Sjögren's syndrome (SS) groups. Patients with non-Sjögren's aqueous tear deficiency have less-severe symptoms and ocular surface disease than those with SS. The etiology of non-Sjögren's aqueous tear deficiency has not been established, but it appears to be multifactorial. In SS, immune-mediated destruction of the lacrimal gland results in severe aqueous tear deficiency. Aqueous tear deficiencies lead to ocular surface disease, termed keratoconjunctivitis sicca (KCS). KCS results from abnormal terminal differentiation of the ocular surface epithelia and is associated with marked reduction in mucin production by these cells. Clinical features helpful in differentiating the various dry eye syndromes are reviewed.

Diagnosis, Differential↗

PubMed1991

New developments in curative and refractive surgery for corneal and conjunctival disorders.

Ocular surface diseases especially after severe lye burns are an unresolved challenge. Autologous nasal mucosa transplantation, keratoepithelioplasty, and polytef alloplastic grafting are current tools in surgical management of the ocular surface diseases. "Merest sclera" surgery is an approach in surgical management of pterygium. Procedures for refractive corneal surgery, such as epikeratoplasty, radial keratotomy, and keratomileusis, are discussed. Anterior stromal puncture technique is a surgical treatment of recurrent corneal erosions. Curative corneal surgeries are keratoplasty alone or as combined procedure. Problems of graft-failure are discussed. The new technique of excimer-laser (193 nm) elliptical keratoplasty is described.

Conjunctival Diseases↗

PubMed1995

Pyogenic granulomas of the cornea.

BACKGROUND: Pyogenic granulomas are vascular inflammatory lesions that represent an aberrant wound healing response. They typically arise from mucous membranes or skin. Pyogenic granulomas primarily involving the cornea have been rarely reported. METHODS: Between January 1983 and July 1994, 14 patients with histologically proven pyogenic granulomas of the cornea were treated. RESULTS: The precipitating event was a persistent epithelial defect in nine patients. Ocular surface disease was present in all patients. Predisposing conditions included indolent corneal ulceration, cry eye syndrome, trachoma, trichiasis, alkali burn, multiple topical drug use, previous orbital irradiation, and ocular cicatricial pemphigoid. CONCLUSIONS: Ophthalmologists should be aware that pyogenic granulomas may involve the cornea and include this entry in the differential diagnosis of tumors involving the limbus or cornea. The typical clinical appearance, rapid growth, minimal staining with rose bengal dye, response to topical steroids, and associated ocular surface disease help to distinguish this lesion from a neoplastic epithelial tumor of the conjunctiva or cornea.

Adolescent↗

PubMed2002

The role of nitric oxide in ocular surface cells.

The role of nitric oxide (NO) in the ocular surface remains unknown. We investigated the conditions leading to an increase of NO generation in tear and the main sources of NO in ocular surface tissue. We evaluated the dual action (cell survival or cell death) of NO depending on its amount. We measured the concentration of nitrite plus nitrate in the tears of ocular surface diseases and examined the main source of nitric oxide synthase (NOS). When cultured human corneal fibroblast were treated with NO producing donor with or without serum, the viabilities of cells was studied. We found that the main sources of NO in ocular surface tissue were corneal epithelium, fibroblast, endothelium, and inflammatory cells. Three forms of NOS (eNOS, bNOS, and iNOS) were expressed in experimentally induced inflammation. In the fibroblast culture system, the NO donor (SNAP, S-nitroso-N-acetyl-D, L-penicillamine) prevented the death of corneal fibroblast cells caused by serum deprivation in a dose dependent manner up to 500 micrometer SNAP, but a higher dose decreased cell viability. This study suggested that NO might act as a double-edged sword in ocular surface diseases depending on the degree of inflammation related with NO concentration.

Animals↗

PubMed2001

The ocular surface and tear film and their dysfunction in dry eye disease.

The ocular surface, tear film, lacrimal glands, and eyelids act as a functional unit to preserve the quality of the refractive surface of the eye and to resist injury and protect the eye against changing bodily and environmental conditions. Events that disturb the homeostasis of this functional unit can result in a vicious cycle of ocular surface disease. The tear film is the most dynamic structure of the functional unit, and its production and turnover is essential to maintaining the health of the ocular surface. Classically, the tear film is reported to be composed of three layers: the mucin, aqueous, and lipid layers. The boundaries and real thickness of such layers is still under discussion. A dysfunction of any of these layers can result in dry eye disease.

Cornea↗

PubMed2006

Fungal keratitis at the new york eye and ear infirmary.

INTRODUCTION: This study was designed to review the clinical experience at our institution with fungal keratitis during a 16-year period. MATERIALS AND METHODS: A review of the clinical and microbiology records of the New York Eye and Infirmary identified 61cases of fungal keratitis in 57 patients between January 1, 1987 and June 1, 2003. The medical records of all patients were retrospectively reviewed to better delineate patient demographics, risk factors, etiologic organisms, treatment, and outcomes. RESULTS: A total of 5083 positive corneal cultures were recorded'from January 1, 1987 to June 1, 2003. Sixty-one eyes in 57 patients (37 women) were positive for fungus (1.2%). Three'patients had bilateral simultaneous infections. Candida albicans accounted for 29 of 61 cases (48%). Human immunodeficiency virus (HIV) seropositivity (15 eyes), chronic ocular surface disease (14 eyes), and trauma (7 eyes) were the most commonly associated risk factors. CONCLUSIONS: Our experience with fungal keratitis in the northeastern United States appears to be different than those reported from other areas of the United States. Serologic positivity for HIV and chronic ocular surface disease were the most common associated risk factors followed by trauma, herpes simplex keratitis, and contact lens use. Candida species predominated, whereas filamentous fungi were uncommon.

Eye Infections, Fungal↗

PubMed2006

[Congenital aniridia keratopathy treatment].

OBJECTIVE: To attempt to review the aniridia keratopathy pathogenesis and establish a treatment protocol according to the severity of the symptoms. METHODS: Personal experience in aniridic keratopathy management and a bibliography review. RESULTS: The ocular manifestations of this anomaly include defects of the cornea, glaucoma, lens subluxation, cataracts, hypoplasia of the iris, fovea and optic nerve, amblyopia and nystagmus. The keratopathy occurs in a 20% of patients with aniridia. The correct PAX6 expression is necessary for normal corneal development, limbal stem cell activity and correct corneal epithelial cell migration and adhesion. CONCLUSIONS: The management of ocular surface diseases due to limbal stem cell deficiency in aniridia is complex but has changed in recent years, as an understanding of the limbal stem cells and their microenvironment has modified the therapeutic approach. The use of autologous serum eye drops, amniotic membrane transplantation, limbal transplantation or cultivated limbal cell transplantation have all been reported as a treatment for several ocular surface diseases.

Aniridia↗