bluuebunny/crossref_metadata_2025 huggingface dataset:
FYCO1 mutation hotspot in congenital cataract
Authors: ABOUZEID H , HELMY G , EL SADA M , SHERIF M , YACOUB M , BOISSET G , FAVEZ T , SCHORDERET D
Published: August 2012

Purpose To report on the molecular origin of congenital cataract in an Egyptian family.

Methods We performed a genome‐wide SNPs array analysis in a consanguineous family of Egyptian origin with two affected and one unaffected children with congenital cataract. Systemic and ophthalmic examinations were performed.

Results The two affected patients, a 3 month old boy and a 7 year old girl with cataract and nystagmus were studied. Lensectomy was performed on both patients with IOL implantation in the older patient. A homozygous region of 12Mb on chromosome 3 was identified. This region contained the previously reported FYCO1 gene. Molecular analysis revealed a homozygous c.2206C>T mutation (p.Gln736X) in the affected patients. SNP analysis around the gene indicated that the mutation arose on a different genetic background than that reported by Chen et al. (AJHG 2011).

Conclusion Mutations in FYCO1 are also present in the Egyptian population. We have shown that it developed de novo in this family thus indicating that this nucleotide is a hotspot for mutation and does not represent a founder effect.
Sunflower cataract in Wilson’s disease : transmission electron microscopic study
Authors: LEE DW , CHOI CY , BAE JH
Published: August 2012

Purpose To report ultramicrostructures of anterior capsule of sunflower cataract by the transmission electron microscopic study (TEM)

Methods A 37‐year‐old male with liver cirrhosis was referred to department of ophthalmology due to visual disturbance. She has bilateral sunflower cataract & Kayer‐Fleischer ring. Her right eye underwent phacoemulsification with a CCC and intraocular lens implantation. 1. Anterior capsule preparation for transmission electron microscopic examination(TEM) 2. Cross section image by energy filtered TEM 3. Elemental analysis : High‐angle annular dark‐field(HAADF) scanning TEM (STEM) with energy‐dispersive x‐ray analysis (EDAX)

Results TEM shows the multiple heterogeneous dense deposits in the anterior lens capsule. HAADF‐STEM shows bright particle deposits. EDAX shows high emission peaks for copper.

Conclusion This is first report of TEM study for anterior capsule of sunflower cataract. We found the multiple heterogeneous dense deposits in the anterior lens capsule. And we confirmed that copper was a component of these particles using EDAX.
Safer posterior capsule polishing using the silicone sleeve from I/A cannula
Authors: GIRAUD JM , FENOLLAND J , EL CHEHAB H , FRANCOZ M , SENDON D , MESSAOUDI R , DOT C , MAY F , RENARD JP
Published: August 2012

Purpose Removing last particles of nuclear cortex from central posterior capsule is sometimes difficult. Diamond blasted cannulas or silicone tipped needles are provided as extra material. We describe a new costless technique for capsular polish using the silicone sleeve of the Irrigation/Aspiration (I/A) cannula. It is also possible to do safer polish‐aspiration of cortical masses.

Methods We used Bausch & Lomb* single use I/A cannula 85910ST with metallic tip recovered by a silicone sleeve. After standard I/A procedure, we push a little the sleeve ahead from the rigid plastic part of I/A cannula, just to put the sleeve a little ahead the metal cannula and recovering it. Then, we can scrap posterior capsule safely, by direct contact of the end of the silicone sleeve, with irrigation and none or small aspiration. For some adhesives greater parts of cortex, we place a lateral hole of the silicone sleeve just in front of aspiration hole in the metallic cannula. Then we can smoothly and safely scrap the capsula adhesive cortex and just after, when a part of cortex is free, aspire it with strong vacuum.

Results We use this method for years with different types of phacoemulsification devices. It gives a very clean scraping of posterior caspsule with great safety. As far as we can know, we never find a description of similar technique in any publication.

Conclusion This new use of silicon sleeve is very effective and free of additional costs. Compared to specific capsule polisher cannulas, this technique offers possibility to scrap capsule and do I/A in the same time. Compared to classic polishing with metallic extremity of I/A cannula, It seems more safe to do it with a soft, non traumatic silicone sleeve.
Bilateral phacoemulsification in the day: a wise decision?
Authors: RAMIRO P , CABEZON L , MINGUEZ E , CRISTOBAL JA , PADGETT E , JIMENEZ B , ASCASO J , PINILLA I
Published: August 2012

Purpose Bilateral cataract surgery is not part of the regular practice of all centers.It´s indicated only for those cases in which the patient's general condition is very poor

Methods We conducted a retrospective study of 106 patients in which visual acuity was assessed before and after surgery, complications, pre, intra and postoperative, the reason for simultaneous intervention, as well as the rate of total bilateral phacoemulsification interventions between 2007‐2011

Results The best corrected visual acuity was 0.4 preoperatively half while mean postoperative visual acuity was 0.8. The rate of simultaneous bilateral phacoemulsification in that period was 0.83%.

Conclusion Our results show that simultaneous bilateral surgery is a safe and economical way to quickly rehabilitate certain patients with bilateral cataract.
Clinical outcomes following cataract surgery in patients over 90 years old
Authors: MICHALSKA‐MALECKA K , SLOWINSKA‐LOZYNSKA L , GOSCINIEWICZ P
Published: August 2012

Purpose The aim of our study was retrospectively evaluate the effect and safety of cataract surgery and intraocular lens implantation (IOL) for patients aged 90 years or older.

Methods In the study we involved a total of 122 patients (122 eyes) with senile cataract between the ages of 90 and 100 (mean age 91,22±2,28 years and the gender distribution was 79 females and 43 males). 113 of 122 eyes had phacoemulsification (Phaco) and 9 of 122 eyes had extracapsular extraction (ECCE). Postoperative visual acuity and intraocular pressure (IOP) were observed and analysed on the first day, three months, and six months after surgery. In analysed group there were 26 of 122 patients (21,31%) with glaucoma and 54 of 122 patients (44,26%) with degeneration of the central retina.

Results The best uncorrected preoperative visual acuity was ≤ 0,1 in 94 of 122 eyes (77,05%), between 0,2‐0,4 in 24 of 122 eyes (19,67%) and between 0,5‐0,7 in 4 of 122 eyes (3,28%). Visual acuity improved in 102 of 122 eyes (84%) and remained the same in 20 of 122 eyes (16,39%). In our investigations we have also found statistically significant implications of cataract surgery on decreasing IOP (intraocular pressure) in the studied group of patients suffering from glaucoma, which were not found in patients without glaucoma. The most important cause of visual impairment after cataract surgery was AMD in the studied group. The central degeneration of retina was found in 54 of 122 patients (44,26%).

Conclusion We concluded that advanced age isn’t a contraindication for cataract removal and we have found that cataract surgery with IOL implantation is an effective procedure in aged patients.
Characteristics of the corneal endothelium and pseudoexfoliation syndrome in patients with senile cataract
Authors: KOVALIUNAS E , STECH S , JURKUTE N , CIMBALAS A , ASOKLIS R
Published: August 2012

Purpose To describe the characteristics of the corneal endothelium in patients with and without pseudoexfoliation syndrome (PEX) over 60 years of age with senile cataract.

Methods A prospective age‐matched controlled clinical study was performed on 53 patients (male = 15, female = 38) (53 eyes) with senile cataract from the period January 2012 – May 2012. Endothelial cell density (ECD), mean coefficient of variation in cell size (CV) and mean cell hexagonality were measured using automated specular microscopy. Patients were divided into two groups. 28 patients with PEX (mean age 77.1 years [range 61 ‐ 87] and control group – 25 patients without clinical signs of PEX (mean age 76.8 years [range 62 ‐ 86]. SPSS 21 statistical package was used for statistical analysis.

Results In the group of patients with PEX ECD was 2228.57 cells/mm2 [range 1443 – 2757] (± 290.01), hexagonal cells – 62.18 % [range 47‐75] (± 7.08 %), CV ‐ 31,04 [range 22‐47] ± 5,24. In the control group ECD was 2500.96 cells/mm2 [range 2012 – 3243] (± 351.77), hexagonal cells – 59.64 % [range 45‐70] (± 5.92 %), CV ‐ 31,92 [range 25‐39] ± 4,26. The mean difference between two groups with and without PEX for ECD was found to be significant (2228,57 vs 2500,96 cells/mm2, p = 0.003). There was no statistically significant difference between these two groups comparing hexagonality (62,18% vs 59,64%, p = 0,166) and CV (31,04 vs 31,92, p = 0,507).

Conclusion The endothelial cell density is significantly lower in patients with pseudoexfoliation syndrome. PEX had no impact to hexagonality and coefficient of variation in cell size.
Intraocular scattering, a useful tool for the indication of capsulotomy?
Authors: CRUZ N , CASAS P , CRISTOBAL JA , DEL BUEY MA , ASCASO F , PEIRO C , MINGUEZ E
Published: August 2012

Purpose To evaluate the correlation between the subjective visual parameters and the objective optical quality parameters, before and after the laser YAG‐Neodymium treatment in patients with posterior capsular opacification (PCO).

Methods Prospective study in 30 eyes (30 patients) referred to our service for capsulotomy, without remarkable ocular story except a non complicated phacoemulsification with intraocular implant. We quantify visual acuity (VA), contrast sensitivity (CS) and objective parameters of vision quality measured with a double pass system (Optical Quality Analysis System,

Results 78.5 ± 5.4 years was the average age of our patients, the 65.4% were women. Visual acuity values, intraocular scattering index (OSI) and Strehl ratio before the treatment were respectively: 0.4 ± 0.2; 5.84 ± 3.43; 8.89 ± 7.32; 0.06 ± 0.04. We found a moderate, inverse and statistically significant correlation between OSI values and VA before the treatment: ‐0.564 (p value= 0.003). And also a strong and inverse correlation between OSI values and CS values at 1.5, 3, 6 y 12 cycles per degree (cpd): ‐0.665 (p value < 0.001); ‐0.733 (p value < 0.001); ‐0.725 (p value < 0.001) y ‐0.785 (p value < 0.001) respectively. After capsulotomy, all the parameters, subjective and objective, improved significantly, except the CS at 18 cpd. However, we did not find any significant correlation between OSI and the subjective parameters after treatment.

Conclusion Tthe determination of OSI values is a useful tool to establish the indication of treatment in patients with suspicion of clinical PCO. Once eliminated the main limiting factor of visual quality, PCO, the absence of correlation indicates the influence of other limiting factors in visual quality.
Visual acuity and contrast sensitivity function between spheric and aspheric intraocular lenses implanted in the same patient. A pilot study
Authors: PERIS‐MARTINEZ C , DíEZ‐AJENJO, MA , GARCíA‐DOMENE MC , MENEZO JL
Published: August 2012

Purpose To analyze differences in best corrected visual acuity (BCVA) and contrast sensitivity function (CSF) between spheric (sIOL) and aspheric (aIOL) intraocular lenses with the same subjective patient criteria

Methods We evaluated 10 patients with bilateral cataract that were implanted in one eye a sn60wf aIOL, and a sn60at sIOL (Alcon, USA) in the other eye. Patients were evaluated at 3 months after surgery. We measured BCVA with an EDTRS chart, CSF with a CSV‐1000 test and pupil diameter in photopic/mesopic conditions

Results We compared the differences of BCVA and photopic CSF between both eyes from the same patient, in order to ensure the same subjective response in both lenses. We used for the analysis a Mann‐Whitney test with paired samples. Mean IOL power of sIOL was 23.1+3D and for aIOL was 22.9+3D,without differences (p=0.4).Mean pupil diameter was 3.1+0.6mm in photopic and 4.0+0.7mm in mesopic conditions. BCVA in sIOL was 0.02+0.03 logMAR units, and 0.01+0.02 logMAR for aIOL, without differences (p=0.13). The sIOL CSF was better than the aIOL, but we didn’t found significant differences at any spatial frequency (p=0.61 for 3cpd, p=0.65 for 6cpd, p=0.27 for 12cpd and p=0.82 for 18cpd).

Conclusion VA and CSF are subjective measures to assess visual quality, because depending on the patient’s subjective criteria, the responses of 2 subjects with similar optical quality may differ. We eliminate this drawback when the patient is implanted with both lenses.When we used VA and CSF to evaluate visual quality of patients,we didn’t found a great improvement of aIOL. According literature, differences are significant at 6mm pupil diameter.
Intraocular lens power adjustment calculator after myopic LASIK/PRK
Authors: DIAZ ALEMAN VT , PAZOS M , LOPEZ MJ
Published: August 2012

Purpose To develop a nomogram application for allowing simple and efficient intraocular (IOL) power calculations at the time of cataract surgery in postmyopic LASIK and PRK eyes. Keratorefractive surgery has become the most extended technique for correcting preexisting refraction defects in the last 10 years. It is anticipated that the incidence of cataract in these patients will increase over time. Technically, cataract surgery in patients with prior refractive corneal surgery has shown to be as successful as in virgin eyes. However, difficulties have been found in applying the standard methods for determining the power of the IOL in eyes that have had refractive corneal surgery. Therefore, we propose a computerized‐nomogram calculator to facilitate IOL power prediction using pre‐operative data if available or only postsurgical biometric measurements.

Methods After literature review, the 6 most accurate IOL power calculation formulae for myopic LASIK/PRK patients were selected: Double‐K (SRKT), Feiz‐Mannis, Latkany Flat‐K, Modified Masket, Haigis‐L formulate and Shammas. DrPhyton 3.11.3 in Linux Fedora 14 environment was used as programming language for developing an informatics application nomogram.

Results Our application provides an intuitive and straightforward computer program to achieve a simple solution for a difficult problem.

Conclusion A computerized IOL calculator is an efficient way to facilitate the selection of IOL power in patients that have had prior refractive surgery.
Unusual phenotype in a family with the R124C mutation in the TGFBI gene
Authors: UDZIELA M , OLDAK M , FEDEROWICZ A , PLOSKI RAFAL , SZAFLIK JP , SZAFLIK J
Published: August 2012

Purpose To report on a Polish family with unusual corneal changes associated with the arginine‐124

Methods We report on a 2‐generation Polish family in which corneal phenotype was assessed by slit lamp and confocal microscopy in vivo. Genomic DNA was obtained from blood samples and all exons known to contain mutation hot spots within the TGFBI gene, were PCR amplified and sequenced on both strand

Results Affected family members complained of ocular discomfort, pain and visual impairment. The symptoms in the proband began in the third decade of life, while in the daughter in the second decade and have progressed slowly. Ophthalmologic examination revealed the presence of linear and branching structures within the anterior stroma, typically observed in lattice corneal dystrophy. Interestingly, these changes were accompanied by the presence of highly reflective deposits characteristic for granular corneal dystrophy. Genetic testing identified a heterozygous missense (CGC to TGC) mutation, which changed arginine in codon 124 to cysteine in the TGFBI gene in both affected family members

Conclusion Mutation of arginine 124 to cysteine (R124C) of the TGFBI gene represents one of the most frequent mutations detected in patients with lattice corneal dystrophy. However, to the best of our knowledge, this is the first report on a family carrying the R124C mutation and presenting features of both granular and lattice lesions. The state of compound heterozygosity does not account for the observed mixed phenotype, as no other mutation within the TGFBI gene was found. If corneal buttons are available, histopathological examinations will be carried out to identify the nature of the deposits and better understand the mechanism of the disease
Progression of geographic atrophy and polymorphisms of genes CFH, BF, C3, FHR 1‐3, FRH3 and ARMS2/HTRA in Age‐Related Macular Degeneration
Authors: RECALDE S , FERNANDEZ‐ROBREDO P , CAIRE J , GARCIA‐GARCIA L , MORENO‐ORDUñA M , FERNANDEZ‐GARCIA V , GARCIA‐LAYANA A , SPANISH MULTICENTER GROUP ON AMD S
Published: August 2012

Purpose To determine if genotype is associated with rate of growth of geographic atrophy (GA) in eyes with age‐related macular degeneration (AMD). We assessed the relationship of GA progression, with previously identified genetic variants associated with AMD.

Methods A prospective analysis of participants in a controlled clinical trial from 9 Spanish Hospitals. Fundus autofluorescence photographs were taken at 0, 12 and 24 months from 214 eyes of 107 patients with GA form and evaluated depending on changes in cumulative area of GA. DNA samples were collected to analyse polymorphisms (SNP) of genes CFH, BF, C3, FHR 1‐3, FRH3 and ARMS2/HTRA. Simultaneous detection of SNPs was based on Multiplex PCR technology and minisequencing.

Results Our data show that the 27,1% of patient presented a slow, 38,6% moderate and 34,3% a fast growth in the progression of GA. Individual analysis of each SNP showed that the R102G SNP of C3 gene was significantly associated (P<0.05) with a further increase in the rate of progression of the area of atrophy.

Conclusion Our results suggest that the genetic alleles related to the progression of atrophic AMD lesions are different than those to predict establishment of AMD. Supported by Grants FIS PI08/1705, FIS PI11/00898 and RETICS RD 07/0062. Ministerio de Ciencia e Innovación.
Prevalence of visual impairment among the elderly: can it be corrected?
Authors: YEKTA AA , HASHEMI H , KHABAZKHOOB M , SHAFAEE SH , OSTADIMOGHADDAM H , AZIMI A , HERAVIAN J , REZVAN F , YEKTA R
Published: August 2012

Purpose To determine the prevalence of visual impairment,low vision and blindness among the elderly of Sari in north of Iran.

Methods Through cluster random sampling, 60 clusters were selected, out of which 20 people were systematically selected for this study. Participants received eye examinations including vision, actual visual acuity (AVA), optimal visual acuity (OVA) and refraction. Non‐cycloplegic refraction was performed with an auto refractometer and the results were checked with retinoscopy and subjective refraction. Visual impairment , low vision and blind were defined as vision worse than 20/60, 20/60 to 20/400 and worse than 20/400 in the better eye respectively.

Results In this study, 937 people with mean age of 64.7±7.5 years old (from 55 to 87 years) were investigated. The prevalence of visual impairment, blindness, and low vision, based on actual visual acuity (AVA), were 11.0% (9.0‐13.0 CI 95%), 3.7% (2.5‐5.0 CI 95%), and 7.4% (5.7‐9.0 CI 95%), respectively. These findings were 3.7% (2.3‐5.1 CI 95%), 1% (0.2‐1.7 CI95%), and 2.7% (1.5‐3.9 CI 95%), based on OVA respectively. No significant difference was found between genders, but visual impairment was significantly higher in people over 75 years as compared with 55‐59 years old. The most common reasons for visual impairment based on AVA were refractive errors (68.6%) and cataract (16.7%). After correcting refractive errors, the most common causes of visual impairment were cataract (61.3%) and diabetic retinopathy (25.8%).

Conclusion Refractive errors and cataract are the main causes of visual impairment in Iranian elderly. Correcting refractive errors and cataract reduces 85% of visual impairment based on AVA.
Measurement of scleral curvature using anterior segment optical coherence tomography
Authors: CHOI HJ , KANG MH , KIM SH
Published: August 2012

Purpose To work out a way to measuring radius of scleral curvature using anterior segment optical coherence tomography (OCT).

Methods Twenty four volunteers were enrolled. With OCT, horizontal and vertical images centered on the visual axis and four images centered on the upper, lower, nasal, and temporal limbus were obtained. To evaluate tangential radius of curvature, we used each nasal and temporal OCT image and calculated the radius of a circle, which passes by three points of scleral surface at 1, 2 and 3 mm from the limbus. To evaluate axial radius of curvature, central horizontal, nasal and temporal OCT images were composed to a new one and the radius of a circle, the center of which is on the visual axis and passes by the point of scleral surface at 2 mm from the limbus, was calculated. The differences in radius of curvature were analyzed by the student t‐test and correlation between two axial radii of curvature calculated by two different reviewers was measured by Pearson correlation coefficient.

Results The mean axial radius of nasal curvature (13.33 ± 1.12 mm) was significantly longer than that of temporal curvature (12.32 ± 0.77 mm). The mean tangential radius of nasal curvature (15.14 ± 2.63 mm) was also longer than that of temporal curvature (14.18 ± 2.24 mm). The axial radii of nasal (13.33 ± 1.12 mm) and temporal (12.32 ± 0.77 mm) curvature from one reviewer were very close to those (13.01 ± 1.16 mm and 12.33 ± 0.78 mm) from the other reviewer (Pearson correlation coefficients 0.942 and 0.841, p < 0.001 in both).

Conclusion Anterior segment OCT is a useful tool in measuring the radius of scleral curvature. Measurement of axial radius of curvature is more accurate than that of tangential radius of curvature, and has a good reproducibility.
Morphormetric changes of optic nerve in experimentally induced type 2 diabetic rats
Authors: KANG MH , LIM HU
Published: August 2012

Purpose To investigate the morphometric changes of optic nerve and evaluate the effect of restriction of diet in experimentally‐induced type 2 diabetic rats.

Methods Thirty Strague‐Dawley(S.D.) rats were divided into three groups. At 13‐week old age, control group (group A) was performed to just open and close the abdominal cavity and partial pancreatectomy was done in group B and C. Group B(ad libitum) was admitted to intake normal diet and group C(restriction) was restricted to intake from 6 week post‐operation until to be sacrificed at 24‐week old age. We measured the size of optic nerve, axon, the thickness of the myelin sheath, the ratio of axon per myelin, the histologic findings of the optic nerve in electron microscopy.

Results From the 19th week to 24th week‐old‐age mean blood glucose (mg/dl) was 99.9±11.10 in group A, 399.8±108.42 in group B and 197 ±83.48 in group C(p<0.05). Mean axon size (µm2) was 0.699±0.094 in group A, 0.579±0.089 in group B and 0.672±0.023 in group C(p>0.05). The mean ratio of myelin to axon was 1.155 ±0.121 in group A, 1.667±0.075 in group B and 1.070±0.324 in group C(p<0.05). Disappearance of regular axonal shape was found in group B and lamellar separation of myelin sheath was found in group C.

Conclusion Experimentally‐induced type 2 diabetic rats showed morphometric changes of optic nerve during early diabetes even if strict control of blood glucose was performed.
Blood‐retinal barrier serum ferritin transport in mouse retina
Authors: MENDES‐JORGE L , RAMOS D , LUPPO M , VALENçA A , CATITA J , DUARTE CM , SIMõES M , CARRAPIçO B , PIRES VMR , NACHER V , NAVARRO M , CARRETERO A , RODRIGUEZ‐BAEZA A , RUBERTE J
Published: August 2012

Purpose The general requirement for iron is due to its involvement in various heme and non‐heme‐containing enzymes, which are ubiquitously involved in metabolic pathways. Iron accumulation is associated with some degenerative diseases, and in the retina with several retinopathies. Iron transport and cell type involved in iron storage mechanisms in the retina are not completely understood.

Methods The iron content was analysed by EDX. Retina ferritin, TIM2 and Scara5 receptors were studied by means of confocal microscopy, rt‐PCR and WB. Horse spleen ferritin (HSF) was intravenously injected in healthy ICR mice and in a murine model of blood‐retinal barrier (BRB) breakdown.

Results EDX detected iron in perivascular cell lysosomes that significatively accumulate iron in comparison with other cellular compartments. In the lower pH of lysosomes iron is released from transferrin and transported to the cytoplasm. However, this mechanism cannot explain the referred iron lysosomal accumulation. Recently, ferritin was proposed as a new iron delivery protein. TIM2 and Scara5 receptors, that bind to H‐ and L‐ferritin, were expressed in mouse retina, suggesting that serum ferritin can be transported across the BRB into the retinal parenchyma. HSF was intravenously injected and, as expected, ferritin crossed the BRB, probably through TIM2 and Scara5 receptor binding, and accumulated in perivascular cells. In the presence of BRB breakdown injected ferritin was also found accumulated in TIM2 and Scara5 positive cells.

Conclusion Serum ferritin uptake could represent a new pathway of iron delivery in the retina and points out perivascular cells as a key element in retinal iron storage.
The effect of infliximab on corneal neovascularization in rabbits
Authors: LEE MA , CHUNG SK
Published: August 2012

Purpose To determine the efficacy of topical application of infliximab (TNF‐α monoclonal antibody) for the treatment of corneal neovascularization in the rabbit model.

Methods With the subject of 12 rabbits (24 eyes), the cornea stroma was sutured to induce corneal neovascularization. 1 week after suture,the corneal neovascularization was confirmed, after which the subjects were divided into 4 groups of 3 rabbits, and the control group was applied sterilized balanced salt solution, and the experiment group was treated with infliximab eye drop of varying concentrations of 1mg/ml, 2mg/ml, 4mg/ml for twice a day for a week. For each group, the area of corneal neovascularization at day 3 and day 7 were measured and analyzed. At day 7, all eyes were extracted to compare the TNF‐α mRNA concentration by reverse transcriptase polymerase chain reaction(RT‐PCR) and the VEGF activity of corneal neovascular tissue was observed by fluorescence immunostain.

Results The area of corneal neovascularization on day 7 was significantly reduced in all three groups treated with 1mg/ml, 2mg/ml, and 4mg/ml compared to the control group (p=0.043, p=0.027, p=0.01). On day 7 of the treatment, TNF‐α mRNA was significantly reduced in all three groups treated with 1mg/ml, 2mg/ml, and 4mg/ml compared to the control group(p=0.038, p=0.031, p=0.022). Also, in the fluorescence immunostain, the reduced expression of VEGF was confirmed in all three groups compared to the control group.

Conclusion The application of Infliximab is expected to effectively inhibit the corneal neovascularization, and further studies for clinical application shall be necessary.
The ocular surface drug correction in patients after LASIK
Authors: SERGEEVA M , KOVALEVSKAYA M , CHERNIKOVA I
Published: August 2012

Purpose Optimization the ocular surface after LASIK

Methods Assessed the ocular surface, tear film and tear production before and after optimization in patients after two‐step LASIK in 4 groups. Group 1 (A) ‐ high myopia and low degree of astigmatism ‐ (43), aged 18 to 35 years, group 2 (B) ‐ medium myopia and low degree of astigmatism – (32), aged 18 to 35 years, group 3 (C) ‐ myopia medium or high and medium degree of astigmatism – (37), older than 35 years, group 4 (D) ‐ hypermetropia medium or high and medium degree of astigmatism ‐ (32), older than 35 years. The criteria for preoperative drug correction of refractive surgery to the stage were the following diagnostic blocks: clinical data in diagnosis of dry eye and corneal status, corneal thickness, the definition of clinical refraction, including patient age, antioxidant and immune activity of tears.

Results The use of moxifloxacin 0.5% and tear lubricants (such as preparation containing hydroxypropylguar and sorbitol or hydroxypropylguar) in groups A and В, and the use of tear lubricants (such as preparation containing hydroxypropylguar and sorbitol or hydroxypropylguar) in groups C and D after LASIK reduces residual astigmatism and the number of complications refractive surgery.

Conclusion We found the dependence tear lubricants choice for optimizing the ocular surface after LASIK from the indices of corneal status, corneal thickness, the definition of clinical refraction, degree of astigmatism, including patient age, antioxidant and immune activity of tears. Pathogenetically substantiated using of preparations containing hydroxypropylguar and sorbitol or hydroxypropylguar after LASIK reduces the degree of residual aberrations.
The role of compliance in optimizing the ocular surface after two‐step LASIK
Authors: SERGEEVA M , KOVALEVSKAYA M , CHERNIKOVA I
Published: August 2012

Purpose Development and evaluation of optimizing the ocular surface after two‐step LASIK, based on compliance

Methods Assessed the ocular surface, tear film and tear production before and after optimization in patients after two‐step LASIK in 4 groups. Group 1 (A) ‐ high myopia and low degree of astigmatism ‐ (43), aged 18 to 35 years, group 2 (B) ‐ medium myopia and low degree of astigmatism – (32), aged 18 to 35 years, group 3 (C) ‐ myopia medium or high and medium degree of astigmatism – (37), older than 35 years, group 4 (D) ‐ hypermetropia medium or high and medium degree of astigmatism ‐ (32), older than 35 years. The criteria for preoperative drug correction of refractive surgery to the stage were the following diagnostic blocks: clinical data in diagnosis of dry eye and corneal status, corneal thickness, the definition of clinical refraction, including patient age, antioxidant and immune activity of tears, determine of compliance

Results Pathogenetically substantiated the two preparations after two‐step LASIK ‐ moxifloxacin 0.5% and hydroxyproylguar and sorbitol in group A, and moxifloxacin 0.5% and hydroxyproylguar in group B provide medium compliance. Using only hydroxyproylguar and sorbitol in Group C and hydroxyproylguar in Group D demonstrated a high compliance.

Conclusion First pathogenetically substantiated the choice of therapy based сompliance in patients after two‐step LASIK.
Use of lissamine green before conjunctival impression cytology and flow cytometry in patients with sjögren’s syndrome
Authors: TOMLINS PJ , BOWMAN S , BRON A , RAUZ S , CURNOW SJ
Published: August 2012

Purpose Lissamine Green (LG) is a vital dye that stains damaged epithelial cells in ocular surface disease. Conjunctival Impression Cytology (CIC) is used with flow cytometry, to examine surface epithelial cells. We were concerned that, if used prior to CIC, cell uptake of LG might affect the fluorescent signal during flow cytometry. We therefore studied whether the use of LG before CIC, could cause fluorescence interference.

Methods CIC was performed with two autoclaved Supor semicircular filters applied to the lateral bulbar conjunctiva of 6 patients with Sjögren's Syndrome. LG was eluted from a standard strip with a drop of anaesthetic and delivered into the inferior fornix. Two further filters were applied to the medial bulbar conjunctiva. Cells were recovered by agitation for 1 minute, washed, stained and analysed by flow cytometry.

Results When compared with samples taken before LG instillation, cells isolated from all 6 samples taken after LG instillation, and excited at 630nm, showed an increase in fluorescence at 665nm. Some increased fluorescence was also noted at 680nm but was within the limits of spectral compensation. There was no observable effect of LG when cells were excited at 488nm.

Conclusion Cell uptake of LG is detected by flow cytometry, predominantly in the 665nm channel when excited at 630nm. This persists despite cell washing. Whilst this excludes the use of fluorochromes that emit within this spectrum, the use of fluorochromes excited or emitting at other wavelengths, is feasible after LG staining.
Lacrymal secretion in the non‐affected fellow eye of patients with recurrent unilateral herpetic keratitis
Authors: MGARRECH M , ROUSSEAU A , SAUER A , KASWIN G , BARREAU E , BOURCIER T , LABETOULLE M
Published: August 2012

Purpose To assess the potential impact of unilateral recurrent herpetic keratitis on the tear secretion of the fellow eye.

Methods Patients referred for a recurrent herpetic unilateral stromal keratitis and control patients, age‐ and sex‐matched, with no history of corneal disease. .Dry eye conditions where tested in keratitis patients after a minimum quiescent period of three months. Osmolarity (using the TearLab®), tear break‐up‐time (TBUT), tear reflex (Schirmer I test), and central corneal sensitivity (using the Cochet‐Bonnet aesthesiometer) were assessed in the two eyes of patients and controls. Values were compared using non‐parametric tests, and statistical significance was defined as p<0.05 (2‐tailed).

Results Thirty‐five patients (mean age: 52.3 ± 7.3 years) and 35 control subjects (mean age: 52.8 ± 8.5 years) were consecutively included in the study. We found no difference between right and left eyes of control patients. The corneal sensitivity and TBUT was strongly reduced in the affected side (4,85g/mm2 ± 2.0; 4.6sec ± 1.1 respectively) compared to the non‐affected side (0.57 g/mm2 ± 0.13 p=0.001; 7.7sec ± 1.4 p<0,001 respectively). The average tear osmolarity in non‐affected eyes was higher than the average of the highest values observed in control subjects (316.3 versus 303.8 mmol/L, p=0.0001). Similarly, the average BUT in non‐affected eyes of herpetic patients was lower than the average of the lowest values observed in control subjects (7.7 versus 12.2 sec, p=0.0001).

Conclusion This study suggests that unilateral recurrent stromal herpetic keratitis induces dry eye condition in the non‐affected eye.
Observation of dendritic cells in subclinical corneal graft disease using confocal microscopy imaging
Authors: WOJCIK L , WYLEGALA E , SMEDOWSKI A , ORSKI M
Published: August 2012

Purpose The aim of this study was to show the applicability of confocal microscopy for the diagnosis of corneal graft disease in presence of masking corneal changes.

Methods The examined group consisted of 12 patients with suspected corneal graft rejection, in which the local state of the cornea caused difficulties in diagnosis. 7 patients was after DALK procedure, 4 after PK, 1 after DSAEK. Local state of corneal transplant included: edema in secondary glaucoma (3 patients), inflammation with ulceration (3 patients), edema in bullous keratopathy (1 patient), edema in keratouveitis (4 patients), haze after inflammation (1 patient). We performed following procedures: slit lamp examination, scans using a Scheimpflug camera (Pentacam, OCULUS), confocal microscopy in vivo (Rostock Cornea Module, Heidelberg Engineering Retina Tomograph III).

Results In a slit lamp examination, uncharacteristic macroscopic changes were described ‐ focal turbidity, endothelial deposits and edema. In an examination with the Scheimpflug camera an increased thickness and haze in the posterior stroma was reported. In order to search for microstructural evidence of rejection underwent corneal confocal microscopy which in 11/12 cases showed infiltration of dendritic cells. These cells were located at well‐defined depth (where the adhesion of the corneal transplant) and was not appearing in other parts of the cornea.

Conclusion In vivo confocal microscopy is a useful method for the detection of corneal transplant disease also in presence of local changes masking rejection symptoms. This examination is characterized by high sensitivity and ranges in this study of about 92%.
Observation of dendritic cells in corneal graft disease in keratoconus patient after deep anterior lamellar keratoplasty using confocal microscopy imaging
Authors: WOJCIK L , WYLEGALA E , SMEDOWSKI A , ORSKI M
Published: August 2012

Purpose The aim of this study was to present the applicability of corneal confocal microscopy for the early identification and monitoring of treatment efficacy in corneal graft disease.

Methods In the 45‐year‐old patient after transplantation because of keratoconus, suspected of graft rejection was performed the following tests: basic slit lamp examination, corneal scans using a Scheimpflug camera (Pentacam, OCULUS) and corneal confocal microscopy in vivo (Rostock Cornea Module Heidelberg Retina Tomograph III Engineering). The study was performed on admission and one week and two weeks after the implementation of local steroids.

Results In a slit lamp examination, uncharacteristic macroscopic changes were described ‐ focal turbidity, endothelial deposits and oedema. In an examination with the Scheimpflug camera, endothelial deposits were seen as highly hiperreflective structures reaching the level of the endothelium to the posterior of the corneal stroma. These symptoms are not also unique to transplant disease. In order to search for microstructural evidence of rejection underwent corneal confocal microscopy in which visualized monomorphic intense infiltration of inflammatory cells and dendritic cells, located primarily in the area near the posterior stroma and Descemet membrane. During the steroidotherapy reduction with number of dendritc cells were observed cell infiltration set up to complete disappearance of their normal structure and appearance of the endothelium.

Conclusion Corneal confocal microscopy is a useful method for early detection and monitoring of disease corneal transplant.
Epidemiology of microbial keratitis: A review of 508 cases
Authors: HOFFART L , DORNADIN A , DRANCOURT M
Published: August 2012

Purpose To describe epidemiological and microbial characteristics of infectious keratitis

Methods The infectious agents of microbial keratitis remains frequently undetermined. We conducted a prospective study to evaluate systematic screening for bacterial, viral, fungal and amoebic pathogens. All patients referred to the participating ophthalmology departments in France from April 2006 to April 2012 had a microbial keratitis that were analyzed by corneal scraping and contact lens and contact lens care testing if patients wore contact lens. The standardized protocol for laboratory investigations included cultures (standard, culture of amoeba and amoeba‐based culture of pathogens), and PCR (16s, 18s, mycobacterium, universal fungal, amoeba, HSV, ZVZ, CMV, mimivirus and sputnik).

Results 508 cases of microbial keratitis were included, the average of age was 49.4 years (SD: 23.2), the sex ratio 1:1. Predisposing risk factors were identified in 71.1% of patients: the most frequent was the contact lens wear in 41.2% cases, then ocular trauma and ocular surface disease (8.2% each), ocular surgery (7.5%) and multifactorial in 6.3 %. Among the 508 included patients, an infection was diagnosed in 185 cases (36.4%): 62% on corneal samples, 28% on contact lens and contact lens care and 10 % on both. On corneal samples, 78.5% were caused by bacteria (Pseudomonas aeruginosa was the most frequent), 3 % by mycobacteria, 10.5% by virus, 6% by fungus and 2% by protozoa.

Conclusion Microbial keratitis was rare without risk factor and contact lens wear appear to be the most important risk factor. Microbiological agents responsible of infectious keratitis remain essentially bacterial.
The contribution of tear osmolarity measurement to ocular surface assessment in soft contact lens wearers
Authors: MUSELIER A , MATHIEU B , BRIGNOLE‐BAUDOUIN F , NIAZI A , BRETILLON L , BRON A , CREUZOT‐GARCHER C
Published: August 2012

Purpose To determine whether tear osmolarity using the TearLabTM Osmolarity System contributes to the assessment of the ocular surface in contact lens (CL) wearers.

Methods Data were collected from 44 CL wearers (28 tolerant and 16 intolerant) and 34 healthy subjects. Every patient underwent a thorough ophthalmic examination and tear osmolarity test, conjunctival impression cytology and meibomian lipid sampling. Symptoms, break‐up time (BUT), tear osmolarity, conjunctival expression of HLA‐DR and meibomian fatty acid composition were evaluated.

Results Tear osmolarity was significantly higher in the controls compared to tolerant and intolerant CL wearers (p=0.0007). Flow cytometry results expressed in antibody‐binding capacity (ABC) units and percentage of positive cells revealed a significant difference between intolerant CL wearers group and control group (p<0.0001). Moreover, impression cytology analysis showed similar values in the tolerant CL wearers and the control group. BUT was significantly shorter in intolerant and tolerant CL wearers subjects than in healthy subjects (p<0.0001), whereas there was no significant difference in meibomian fatty acid composition (p=0.98) between groups.

Conclusion CL wear is responsible for ocular surface alterations whose patterns are very similar to those reported in dry eye syndrome. However, the yield of tear osmolarity with TearLabTM in assessing ocular surface disorders in CL wearers deserves further investigation.
Quality of vision in patients with herpetic keratitis
Authors: ROUSSEAU A , KASWIN G , BARREAU E , M'GARRECH M , LABETOULLE M
Published: August 2012

Purpose Patients with history of recurrent herpetic keratitis very often complain about their vision despite normal visual acuity (VA). The purpose of this study was to assess the optical aberrations and the quality of vision of the affected eye in patients with unilateral recurrent herpetic keratitis with preserved VA, and to compare these results with those of the non‐affected eye.

Methods Patients (n=15) with unilateral recurrent herpetic keratitis and an normal VA (Best corrected VA≤0 logMAR) were included in this study. Corneal optical aberrations of both eyes were assessed using dynamic skiascopy with OPD Scan II® (Nidek™). Wavefront analysis was performed during a quiescent period of the herpetic disease. The fellow eye was used as control. A blinded examiner retrospectively analyzed all the datas.

Results The root mean square was significantly increased for high order aberrations (p=0.004) in the affected eye and particularly for trefoil and tetrafoil (p=0.004 and 0.02, respectively). In addition, The modulation transfer function (area under the curve) and the Strehl’s ratio were significantly lower in the affected eyes compared to the non affected eyes (p=0.02 and 0.02).

Conclusion Our data show that herpetic keratitis induces wavefront abnormalities which could explain visual discomfort reported by patients with normal VA. A prospective study including more patients should provide further informations on the rate and the clinical significance of these optical aberrations.
Assessment of the improvement of the quality of vision after Meibopatch© treatment, with OQAS and Hartmann‐Shack aberrometry in patients with meibomian gland dysfunction
Authors: DUPONT L , NOCHEZ Y , PISELLA PJ , COCHENER B , GICQUEL JJ
Published: August 2012

Purpose To assess optical quality before and after treatment with Meibopatch© (eyelid‐warming device) in patient with mild and severe Meibomian gland dysfunction.

Methods The Meibopatch© was applied for 5 minutes twice a day for one month to 20 eyes of 10 patients who exhibited dry‐eye symptoms (OSDI), decreased tear film break‐up time (TFBUT) due to altered meibomian gland secretions. We examined TFBUT, meibomian gland secretions, dry‐eye symptoms, and assessed optical quality with OQAS (MTF and OSI) and Hartmann‐Schack (RMS) aberrometry before, 15 days and 1 month after treatment.

Results We have observed a significant improvement of the BUT, OSDI, Meibomian gland secretion quality, MTF and OSI after treatment.

Conclusion The Meibopatch © eyelids warming device improved dry‐eye symptoms, TFBUT and meibomian gland secretion quality. Our study showed also a significant improvement of both MTF and OSI.
Prospective study of a new matrix therapy agent (RGTA) for the treatment of neurotrophic ulcers
Authors: GUEUDRY J , AIFA A , PORTMANN A , DELCAMPE A , MURAINE M
Published: August 2012

Purpose To evaluate the efficacy of a new matrix therapy agent (RGTA, Cacicol®), an analogue of heparan sulphates, for management of severe neurotrophic keratopathy.

Methods We carried out a prospective, single‐centre, uncontrolled study of 11 eyes in 11 patients, presenting corneal neurotrophic ulcers, despite use of preservative‐free artificial tears for 15 days. Mean age was 58 years. All patients had corneal anaesthesia. RGTA treatment was instilled in the morning,as the fist eyedrop, on alternate days. Main outcome measures were for each patient healing of the corneal surface and best corrected visual acuity during and after treatment.

Results Eight patients displayed complete healing of the ulcer, after a mean period of 8.7 weeks (range; 1 to 22 weeks). Mean ulcer area decreased significantly, from 11.12% to 6.37% (p=0.0479) in the first week, to 1.56% (p=0.0054) at one month. Treatment failure was observed in three cases, requiring amniotic membrane transplantation in two patients and penetrating keratoplasty in one patient. At the end of the study, none of the patients displayed a significant improvement in visual acuity. None of the patients reported pain or discomfort during instillation of RGTA eyedrops.

Conclusion This heparin mimetic, which may stimulate extracellular matrix healing, may be a possible, non‐invasive, alternative therapy in severe neurotrophic keratopathy. However, randomized studies are necessary.
Polymeric membranes for corneal epithelium engineering based on chitosan and structural proteins
Authors: WOWRA B , WYLEGALA E , GROLIK M , DOBROWOLSKI D , SCZUBIALKA K , NOWAKOWSKA M , ORSKI M , SMEDOWSKI A , WOJCIK L
Published: August 2012

Purpose To develop chitosan hydrogel scaffolds for corneal epithelium cultures.

Methods The hydrogel scaffold in the form of a membrane was obtained from chitosan‐natural linear polysaccharide derived from chitin from crustacean shells. It is anti‐bacterial, biocompatible, biologically inert, stable in the natural environment and safe for human. Chitosan films containing keratin and collagen were cross‐linked with genipin, a naturally occurring and nontoxic agent compound found in the gardenia fruit extract. Corneal epithelial cells were seeded on chitosan hydrogel scaffold and were cultivated for 14 days in standard condition using DMEM/F12HAM medium with 3T3 fibroblast co‐culture.

Results Mean number of cell layers was 5,2 (3‐8). Immunostaining for cytokeratin 3 and 12,protein p63, connexin 43 was performed to confirm origin of the epithelium and presence of low differentiated cells.

Conclusion Genipin crosslinked chitosan hydrogel seems to be a promising material for further clinical tests directed towards the development of implantable corneal epithelial cells