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ocular surface evaluation in eyes with chronic glaucoma on long term topical antiglaucoma therapy

International Journal of Ophthalmology(English edition) 2017年第6期10卷 931-938页

作者： Manu Saini Murugesan Vanathi Tanuj Dada Tushar Agarwal Rebika Dhiman Sudarshan Khokhar cornea ＆ ocular surface services Dr R P Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi 110029 India

AIM： To evaluate ocular surface changes and its correlation with the central corneal subbasal nerve fibre layer in chronic glaucoma patients. METHODS： A prospective comparative study of ocular surface evaluation was performed in 50 eyes of 25 patients using two or more antiglaucoma medications for at least 6too and 50 eyes of 25 normal subjects without any ocular problems as controls. The study parameters evaluated included visual acuity, intraocular pressure, ocular surface evaluation parameters [fluorescein break-up time （FTBUT）, Schirmer＇s I test, ocular surface staining scores and ocular surface disease index score （OSDI）], central corneal sensation （Cochet Bonnett aesthesiometer）, central subbasal nerve fiber layer density （SBNFLD） by confocal microscopy. RESULTS： The mean values in the glaucoma cases and control groups respectively were as follows： OSDI score （35.89±16.07/6.02±3.84; P=-0.001）, Schirmer＇s I test score （7.632.64 mm/12.86±1.93 mm; P=-0.001）, FTBUT （9.442.76s/11.8±1.88s; P=0.001）, corneal （5.7±2.33/ 1.1±0.58; P=0.001） and conjunctival staining score （5.061.94/0.84±0.46; P=0.001）, corneal sensitivity （4.68±0.44/5.07±0.37; P=0.076）, mean subbasal nerve fiber number （3.58±0.99/5.40±1.70; P=0.001）, SBNFL length （1101.44±287.56 pm/1963.70±562.56 pro; P=0.001） and density （6883.941798.03 pm/mm/12 273.153516.04 pm/mm2; P=O.O01）. Dry eye severity of level 2 and 3 was seen in 66% of glaucoma group. corneal （/=0.86） and conjunctival staining （R2=0.71） and OSDI score （R=0.67） showed statistically significant negative correlation with central corneal SBNFLD while FTBUT （R==0.84）, corneal sensitivity （/=0.52） showed positive correlation to central corneal SBNFLD in the long term topical antiglaucoma medication group. CONCLUSION： ocular surface changes and antiglaucoma therapy induced dry eye is found to be associated with decreased SBNFLD in eyes on long term topical antiglaucoma medications.

关键词： confocal microscopy glaucoma ocularsurface disease subbasal nerve fiber layer therapy

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Interconnections between diabetic corneal neuropathy and diabetic retinopathy:diagnostic and therapeutic implications

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Neural Regeneration Research 2025年第8期20卷 2169-2180页

作者： Mingyi Yu Faith Teo En Ning Chang Liu Yu-Chi Liu Tissue Engineering and Stem Cell Group Singapore Eye Research InstituteSingapore Yong Loo Lin School of Medicine National University of SingaporeSingapore Department of cornea and External Eye Disease Singapore National Eye CenterSingapore Ophthalmology and Visual Sciences Academic Clinical Program Duke-NUS Medical SchoolSingapore

Diabetic corneal neuropathy and diabetic retinopathy are ocular complications occurring in the context of diabetes *** corneal neuropathy refers to the progressive damage of corneal *** retinopathy has traditionally been considered as damage to the retinal ***,growing evidence suggests that diabetic retinopathy is a complex neurovascular disorder resulting from dysfunction of the neurovascular unit,which includes both the retinal vascular structures and neural *** retinopathy is one of the leading causes of blindness and is frequently screened for as part of diabetic ocular ***,diabetic corneal neuropathy is commonly overlooked and underdiagnosed,leading to severe ocular surface *** studies have found that these two conditions tend to occur together,and they share similarities in their pathogenesis pathways,being triggered by a status of chronic *** review aims to discuss the interconnection between diabetic corneal neuropathy and diabetic retinopathy,whether diabetic corneal neuropathy precedes diabetic retinopathy,as well as the relation between the stage of diabetic retinopathy and the severity of corneal *** also endeavor to explore the relevance of a corneal screening in diabetic eyes and the possibility of using corneal nerve measurements to monitor the progression of diabetic retinopathy.

关键词： cornea corneal nerves diabetes diabetic corneal neuropathy diabetic retinopathy retina

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ocular Graft versus Host Disease: A Review of Clinical Manifestations, Diagnostic Approaches and Treatment

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Open Journal of Ophthalmology 2016年第1期6卷 20-33页

作者： Sridevi Nair Murugesan Vanathi Anita Ganger Radhika Tandon cornea & ocular surface services Dr Rajendra Prasad Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi India

Allogenic haematological stem cell transplantation (allo-SCT) from a human leukocyte antigen (HLA) matched related or unrelated donor is used as a curative therapy for a large number of malignant and non-malignant haematological diseases. The curative effect of allo-SCT is achieved by graft versus leukaemia effect while the downside of the graft versus patient activity is the graft-versus-host-disease (GVHD), a major reason for mortality and morbidity. The search of articles for this review had been accomplished using Ovid, Medline, Embase, Pubmed and was supplemented by retrieving cross references also. Electronic literature search for English language articles with full text access was performed using graft versus host disease, ocular, management, dry eyes as key words. This review has been intended to explicate the classification, pathogenesis, risk factors and management of ocular graft versus host disease.

关键词： Stem Cell Transplantation ocular Graft Host Disease

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The Long-Term Clinical Efficacy of Smart Plug in the Treatment of Aqueous Tear Deficiency Dry Eye: Results of a 5-Year Study

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Open Journal of Ophthalmology 2020年第1期10卷 21-27页

作者： Zhaoxia Kuang Yong Yao Ye Yuan Yueting Ma Guanglin Chen Yingying Su Xingkai Zhang Vishal Jhanji Dennis Lam Department of cornea and ocular surface Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong Shantou China Department of cornea and ocular surface C-MER Shenzhen Dennis Lam Eye Hospital Shenzhen China C-MER Kunming Eye Hospital Kunming China Department of cornea and ocular surface Dongguan Aier Eye Hospital Dongguan China

Background: Dry eye syndrome, which affects 10% to 20% of adults, is a disorder of the tear film and is associated with symptoms of ocular discomfort. Smart Plug is a mechanical treatment in which the tear drainage system is blocked in order to aid in the preservation of natural tears on the ocular surface. Purpose: To evaluate the long-term clinical efficacy of Smart Plug in the treatment of aqueous tear deficiency dry eye. Patients and Methods: Retrospective study. Three hundred and two patients with aqueous tear deficiency dry eye were enrolled and all the patients accepted the punctual plug of Smart plug from Jan. 2011 to Jan. 2016. The clinical symptoms, Schirmer’s I test, Fluorescein staining (FL), tear break up time (TBUT), and complications were observed and analyzed. Results: Three hundred and two patients (604 eyes) were treated with Smart Plug (22 cases accepted upper and lower punctual plug, 280 cases only lower punctual plug). There were 109 males (36.1%) and 193 females (63.9%) with a mean age of 44.54 years old (Range from 25 to 83 years). Ten cases required the upper Smart Plug after lower punctual plug insertion because of no significantly improved symptoms. Smart plug was removed in 3 patients (1%) due to tearing. Six patients had mild postoperative tearing and no special treatment was required. Lacrimal canaliculitis occurred postoperatively in 8 cases (2.6%) (6 lower and 2 upper), and the affected plug was removed and treated with topical antibiotic eye drops. The BUT, SIT and FL scores of all patients were significantly improved from (2.11 ± 1.01, 4.20 ± 1.07, 6.06 ± 1.97) to (4.34 ± 1.22, 9.01 ± 1.56, 2.33 ± 1.28) respectively after at least 36 months of follow-up (All P P Conclusion: During a mean follow-up of 4.3 years, Smart plug is an effective method for the treatment of aqueous tear deficiency dry eye in spite of its postoperative complications such as canaliculitis and tearing.

关键词： Lacrimal Dry Eye Treatment Smart-Plug Punctual Plug

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Patch graft for pterygium surgery:stitch it or stick it?

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Annals of Eye Science 2017年第1期2卷 344-348页

作者： Arun K.Jain Parul Goyal Chintan Malhotra cornea Cataract&Refractive Surgery ServicesAdvanced Eye CentrePost Graduate Institute of Medical Education and ResearchChandigarhIndia

Pterygia are an extremely common ocular condition believed to be occurring due to proliferation and overgrowth of abnormal epithelial and fibrovascular tissue onto the *** are characterized by cellular proliferation,neovascularization and *** for treatment vary from minor cosmetic concerns to significant visual *** options include an array of surgical techniques including simple resection(leaving the sclera bare),or resection followed by covering the sclera with primary conjunctival closure,a conjunctival or conjunctivolimbal autograft(CAG and CLAG respectively)from another site on the bulbar conjunctiva of the same eye,or with human amniotic membrane(HAM).

关键词： graft surgery ocular

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Polymicrobial Keratitis—Importance of Detecting and Treating More Than One Organism

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Open Journal of Ophthalmology 2017年第1期7卷 64-72页

作者： Uma Sridhar Parul Jain Jyoti Batra Neelam Sapra cornea services ICARE Eye Hospital Noida India Sapra Microbiology Centre Gurugram India

corneal ulcers may become non-healing if inappropriately managed. Empirically giving broad spectrum antibiotics or prescription of a “cocktail” of topical antibacterial, antifungal and antiviral medication may only add to drug toxicity and drug resistance. We present a series of four cases of microbial keratitis which are complicated due to presence of more than one causative organism. Microbiological work-up revealed Proteus species and fungal hyphae in smears only in the first case, atypical Mycobacteria and Staphyloccocus species in the second case, Moraxella and Streptococcus viridans in the third case and Aspergillus flavus and Nocardia species in the fourth case. Authors would like to emphasize the need for laboratory support in the treatment of corneal ulcers and importance of proper management of this sight threatening disease.

关键词： Polymicrobial Keratitis Broad Spectrum Antibiotics Microbiological Work-Up

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正常人角膜前后表面地形及全角膜厚度的研究

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中华眼科杂志 2001年第2期37卷 125-128页

作者：刘祖国谢玉环张梅中山医科大学中山眼科中心广州510060 ocular surface Center

目的　了解正常人的角膜前后表面形态及全角膜厚度 ,为诊断异常角膜提供参考依据。方法　应用Orbscan角膜地形图仪对 46例正常人 (4 6只眼 )的角膜进行检测 ,建立其正常参数。结果正常人角膜最薄处为 (0 5 5± 0 33)mm ,平均位于距视... 详细信息

目的　了解正常人的角膜前后表面形态及全角膜厚度 ,为诊断异常角膜提供参考依据。方法　应用Orbscan角膜地形图仪对 46例正常人 (4 6只眼 )的角膜进行检测 ,建立其正常参数。结果正常人角膜最薄处为 (0 5 5± 0 33)mm ,平均位于距视轴 (0 90± 0 5 1)mm处。 32例 (70 % )角膜最薄点位于颞下方 ,11例 (2 4% )位于颞上方 ,2例 (4 % )位于鼻下 ,1例 (2 % )位于鼻上方。角膜厚度以角膜中央最薄 (0 5 6± 0 0 3)mm ,角膜上方最厚 (0 6 4± 0 0 3)mm。模拟角膜屈率 (SimK)为 (4 4 2 4± 1 6 1/43 31± 1 6 6 )D ,散光度为 (0 90± 0 41)D。角膜前表面高度地形图的图形中 ,岛形最多 ,其次为不完全嵴形。角膜后表面高度地形图的图形中 ,岛形最多 ,其次为规则嵴形及不完全嵴形。在前表面角膜屈率地形图的图形中 ,对称蝴蝶结形最多 ,其次为椭圆形及不对称蝴蝶结形。在角膜厚度彩色地形图中 ,椭圆形最多 ,其次为圆形。结论　了解正常人全角膜厚度、角膜高度形态及角膜前表面角膜屈率地形图将为诊断异常角膜提供依据。Orbscan角膜地形图仪是一种测量角膜地形及全角膜厚度的有用工具。

关键词：角膜角膜厚度 Orbscan角膜地球仪角膜手术

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The Role of Ozone Carried by Liposomes in the Therapy of Infectious and Skin-Regenerating ocular surface

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Journal of Biomedical Science and Engineering 2019年第7期12卷 347-353页

作者： Anna Cutarelli Gianpaolo Carlini Federica Sarno Angela Nebbioso Francesca Garofalo Lucia Altucci Federica Corrado Istituto Zooprofilattico Sperimentale del Mezzogiorno di Portici (NA) Naples Italy Pathology Center of the cornea and ocular surface-U.O. of Ophthalmology P.O. San Giovanni Bosco Naples Italy Department of Medicine of Precision University of Studi della Campania Luigi Vanvitelli Naples Italy

Effect of the ozonated oil in liposomes: they act against Staphylococcus aureus and Pseudomonas aeruginosa is among the most frequent eye pathogens and causes acute and chronic infections of the ocular surface. Staphylococcus aureus and Pseudomonas aeruginosa were tested in this study. The bacterial suspension of Staphylococcus aureus was diluted to obtain 150 CFU/ml. The bacterial suspension of Pseudomonas aeruginosa was diluted to obtain 15 CFU/ml. Various volumes of liposome-vehiculated ozonated oil were added (400 μl, 200 μl, 100 μl and 50 μl) to 100 μl of bacterial suspension;both of Staphylococcus aureus and Pseudomonas aeruginosa are incubated at 37?C for 10 minutes. The cytotoxicity of liposome-vehiculated ozonated oil was analysed at the University of Campania “Luigi Vanvitelli”, Department of Precision Medicine. The HaCaT epidermal keratinocyte cell line (ATCC, USA) was grown in Dulbecco’s Modified Eagle Medium (Euroclone) with the addition of 10% foetal bovine serum (FBS) (Euroclone), 2 mM of L-glutamine (Euroclone) and antibiotics (100 U/ml penicillin, 100 g/ml streptomycin) (Euroclone). The microbiological results clearly show the antimicrobial efficacy of liposome-vehiculated ozonated oil against bacterial strains such as Staphylococcus aureus and Pseudomonas aeruginosa. Furthermore, the studies carried out in vitro on the keratinocyte line showed how ozonated oil in liposomes does not evidence any cell toxicity, and that after 3 days of treatment, it promotes cell growth compared to the positive control.

关键词： Ozonated Oil in Liposomes Staphylococcus aureus Pseudomonas aeruginosa Cytotoxicity MTT Assay

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Significant impact of cryopreserved amniotic membrane on acute ocular Stevens-Johnson syndrome and toxic epidermal necrolysis

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Eye Science 2016年第3期31卷 121-123页

作者： Army M.S.Cheng Scheffer C.G.Tseng ocular surface Center MiamiFloridaUSA Florida International University Herbert Wertheim College of MedicineFloridaUSA

The ocular surface is covered by an epithelium encompassing an area including the cornea,the limbus and the conjunctiva bordered by the upper and lower *** healthy state of the ocular surface epithelium depends on a stable and protective preocular tear film when the eye is open.A stable preocular tear film is governed by sound ocular surface defense that involves effective

关键词： cryopreserved amniotic membrane Stevens-Johnson syndrome toxic epidermal necrolysis

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Changes in post-keratoplasty astigmatism after suture removal:refraction vs tomography vs aberrometry

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International Journal of Ophthalmology(English edition) 2021年第11期14卷 1707-1713页

作者： Suraj Kumar Chaurasiya Jagadesh C.Reddy Pravin K.Vaddavalli Christopher J.Rapuano Brien Holden School of Optometry and Vision Sciences L V Prasad Eye Institute(LVPEI)Hyderabad 500034India Cataract and Refractive Surgery services The Cornea InstituteL V Prasad Eye Institute(LVPEI)Hyderabad 500034India Comea Service Wills Eye HospitalPhiladelphiaPennsylvania 19107USA

AIM:To analyse the changes in magnitude and orientation of astigmatism after suture removal(SR)in keratoplasty eyes as measured by refraction,tomography,and ***:Twenty-six eyes of 25 patients after optical keratoplasty requiring SR to reduce the astigmatism during the follow-up period were prospectively *** with poor quality topography scans or if there were no sutures in the steepest semi meridian were *** distance visual acuity(CDVA),manifest refraction,corneal tomography and aberrometr y were per formed on all patients before and after ***:The mean age of the patients was 40.8±14.4 *** keratoplasty was performed in 23 eyes(89%)and deep anterior lamellar keratoplasty was done in 3 eyes(11%).There was a statistically significant reduction in the magnitude of refractive,tomographic and aberrometry astigmatism after SR(Pcorneal tomography compared to refractive astigmatism(Pocular log MAR CDVA improved from 0.57 D to 0.49 D after SR(P=0.002).CONCLUSION:The net reduction in the magnitude of astigmatism after SR is greater in the tomography and aberrometry *** one episode of SR,there is no difference in the aberration profile.

关键词： keratoplasty astigmatism suture removal

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