摘要:

Purpose.This study characterized ocular symptoms typical of dry eye in an unselected optometric clinical population in the United States and Canada.Methods.Self-administered dry eye questionnaires, one for non–contact lens wearers (dry eye questionnaire) and one for contact lens wearers (contact lens dry eye questionnaire), were completed at six clinical sites in North America. Both questionnaires included categoric scales to measure the prevalence, frequency, diurnal severity, and intrusiveness of nine ocular surface symptoms. The questionnaires also asked how much these ocular symptoms affected daily activities and contained questions about computer use, medications, and allergies. The examining doctors, who were masked to questionnaire responses, recorded a nondirected dry eye diagnosis for each patient, based on their own diagnostic criteria.Results.The dry eye questionnaires were completed by 1,054 patients. The most common ocular symptom was discomfort, with 64% of non–contact lens wearers and 79% of contact lens wearers reporting the symptom at least infrequently. There was a diurnal increase in the intensity of many symptoms, with symptoms such as discomfort, dryness, and visual changes reported to be more intense in the evening. The 22% percent of non–contact lens wearers and 15% of contact lens wearers diagnosed with dry eye (most in the mild to moderate categories) reported symptoms at a greater frequency than those not diagnosed with dry eye.Conclusions.Our results show that symptoms of ocular irritation and visual disturbances were relatively common in this unselected clinical population. The intensity of many ocular symptoms increased late in the day, which suggested that environmental factors played a role in the etiology of the symptoms.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To present our experience with the use of preserved human amniotic membrane on patients with epiphora caused by conjunctivochalasis.Methods.Twelve patients, seven women and five men, ages ranging from 56 to 72 years (mean, 61 years) were referred to our Cornea Service with chronic epiphora. In all patients, no punctal ectropion was present, the lacrimal pathway was patent, and the dye disappearance test was abnormal. All patients had already undergone various therapies including multiple irrigations of the lacrimal system, antibiotic drops, steroid drops, and artificial tear drops. In all patients, conjunctivochalasis, which was not previously diagnosed, was evident on slit-lamp examination. After surgical removal of the excess conjunctiva, preserved human amniotic membrane was placed over and sutured with 10-0 nylon continuous suture to the free conjunctival edges. During the postoperative period, artificial tear drops and steroid/antibiotic drops were applied.Results.Improvement of the epiphora was evident from the first postoperative day. After removal of the suture 10 to 15 days (mean, 12 days) after surgery, no patient complained of epiphora. The dye disappearance test was normal. During the follow-up period, which ranged from 6 to 11 months (mean, 8 months), no patient complained of epiphora and no conjunctivochalasis was detected in the area in which human amniotic membrane was transplanted.Conclusion.In our experience, transplantation of preserved human amniotic membrane greatly improved symptoms of epiphora caused by conjunctivochalasis. Continued education of the general ophthalmologists concerning this condition is required.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.Exposure toAcanthamoebaspecies appears to be ubiquitous, as 50% to 100% of healthy human subjects display anti-Acanthamoebaantibodies. However, the presence of specific anti-Acanthamoebaantibodies in the serum and tears of patients has not been investigated. The prevalence of serum immunoglobulin G (IgG) and tear IgA against three species ofAcanthamoebawas assessed in healthy subjects and patients withAcanthamoebakeratitis.Methods.The level of specific serum IgG and tear IgA againstA. castellanii,A. astronyxis, andA. culbertsoniin the sera of 23 patients and 25 healthy subjects was tested by enzyme-linked immunosorbent assays. Total serum IgM, IgG, and IgA concentrations were measured by nephelometry.Acanthamoebakeratitis was diagnosed clinically and confirmed by in vivo confocal microscopy. In some patients, corneal biopsies were also performed and trophozoites were cultured on lawns ofEscherichia colion non-nutrient agar.Results.All healthy subjects and patients withAcanthamoebakeratitis had detectable serum IgG antibodies against allAcanthamoebaantigens. However, patients withAcanthamoebakeratitis had significantly higher anti-AcanthamoebaIgG antibody titers than healthy subjects. In contrast,Acanthamoeba-specific tear IgA was significantly lower in patients withAcanthamoebakeratitis in comparison with healthy subjects. Total serum immunoglobulins did not differ significantly between healthy subjects and patients withAcanthamoebakeratitis.Conclusions.The results suggest that a low level of anti-AcanthamoebaIgA antibody in the tears appears to be associated withAcanthamoebakeratitis.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.We evaluated ocular penetration and drug levels in tears after topical ofloxacin instillation in rabbit eyes with amniotic membrane transplantation (AMT).Methods.Forty-eight New Zealand White rabbits were used. In the first set of experiments, 24 rabbits (24 eyes) were divided into four groups according to the epithelial removal or AMT. Topical ofloxacin was instilled four times every 15 minutes. One hour after the last eyedrop, the concentration of ofloxacin in the amniotic membrane, cornea, and aqueous humor was evaluated. In the second set of experiments, 24 rabbits were divided into six groups according to AMT (transplantation of lyophilized or fresh amniotic membrane) or duration of application. Ofloxacin ointment or two drops of ofloxacin were applied to the right eye, and then tear samples were collected after 0.5, 1, 2, 4, and 6 hours for the analysis of ofloxacin concentration.Results.Mean ofloxacin concentrations in the cornea and aqueous humor were statistically higher in deepithelialized cornea regardless of AMT (p< 0.05). The mean tear levels of ofloxacin in the AMT groups were statistically higher than those in non-AMT groups (p< 0.05). There was no statistical significance in the tear level of ofloxacin between lyophilized amniotic membrane groups and fresh amniotic membrane groups nor between 1-hour amniotic membrane–attached groups and 6-hour amniotic membrane–attached groups.Conclusion.Amniotic membrane transplantation seems to interfere with the ocular penetration of topical ofloxacin in normal rabbit corneas but enhances ofloxacin penetration in corneas with epithelial defects. The ofloxacin level in tears was higher in eyes with AMT up to 1 hour after topical ofloxacin use. Therefore, it seems that amniotic membrane has some potential to act as an effective drug delivery system.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To compare the adherence ofAcanthamoebatrophozoites and cysts to two types of unworn conventional and disposable contact lenses included in groups 1 and 4 of the Food and Drug Administration and to assess the adherence to the center and edge of the lenses.Methods.We used 10 conventional and 10 disposable contact lenses belonging to groups 1 and 4 of the Food and Drug Administration. Each lens was divided into four segments. A human corneal isolate ofAcanthamoebasuspended in saline (1× 105 amoebae/mL) was used. Lens segments were exposed toAcanthamoebacysts and trophozoites for 2 hours. After removal, the count was made with an optical microscope at 100× magnification. Three fields at the center and three fields at the edge were read on each segment.Results.Acanthamoebaadhered to both types of contact lenses, with a proportion of trophozoites to cysts between 6:4 and 7:3. There was a significantly higher adherence to disposable (8.14 ± 3.57 organisms/mm2) than to conventional (4.94 ± 2.33 organisms/mm2) (p< 0.0001) contact lenses. We also found that the greatest adherence was to the edge of the conventional (12.05 ± 4.03 organisms/mm2) and disposable (26.10 ± 7.84 organisms/mm2) (p< 0.0001) contact lenses.Conclusions.This study shows thatAcanthamoebahas varying adherence affinity for different new hydrogel contact lenses. The affinity for disposable lenses (etafilcon A) is significantly higher than that for conventional lenses (polymacon). This adherence is greater for ionic material and high water content. The use of low water content, nonionic contact lenses may reduce the adherence ofAcanthamoeba. Finally, the edge may play an important role as anAcanthamoebavector.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.The aim of the current study was to define the efficacy of saxitoxin as a corneal anesthetic in rabbits after mechanical corneal abrasion and photorefractive keratectomy (PRK).Methods.Twelve Dutch belted rabbits were given a single 1.2-&mgr;g dose of saxitoxin or vehicle after mechanical abrasion of the cornea. Corneal sensation was evaluated hourly for 6 hours. A second group of 12 Dutch belted rabbits was given a 1.2-&mgr;g dose of saxitoxin or vehicle every 5 hours for 30 hours after PRK. Corneal sensation was evaluated after 5, 10, 15, 20, 25, and 30 hours. Pachometry was performed before PRK and again after the epithelial defects had healed. The rate of epithelial defect closure was assessed by measuring the epithelial defect size 25, 42, 65, 88, and 113 hours after PRK.Results.A dose of 1.2 &mgr;g of saxitoxin given every 5 hours produced continuous corneal anesthesia after PRK. There was no difference in the rate of wound healing between eyes treated with saxitoxin and vehicle. There was no difference in the degree of wound healing, as measured by pachometry, between eyes treated with saxitoxin and vehicle. There were no apparent ocular or systemic toxic effects from saxitoxin administration.Conclusion.At a dose of 1.2 &mgr;g, saxitoxin is a safe, effective, long-acting corneal anesthetic in rabbits after PRK.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.Pseudomonas aeruginosaPAO1 deficient in LasA protease was reported to be ocularly avirulent. However, the avirulence of this mutant could not attributed to the loss of LasA protease. The purpose of this study was to define the mechanism for such a mutant's inability to cause corneal disease.Methods.A LasA protease–deficient mutant ofP. aeruginosaPAO1 was constructed by allelic exchange. Virulence of this mutant in mouse and rabbit models of keratitis was assessed by scoring for ocular disease and quantitating viable bacteria from infected corneas. Adherence to scarified mouse corneal tissue was determined with an organ culture assay.Results.In the mouse eye, the LasA protease–deficient mutant was not virulent, despite being as adherent as its parent strain. Virulence of the mutant was also significantly reduced in the rabbit eye. Complementation withlasA did not restore virulence in either model of infection. Neither the mutant nor the mutant complemented withlasA grew well in ocular tissue. An analysis of the mutant showed that it was auxotrophic for leucine.Conclusion.These data show that the mutant's avirulence in the eye is caused by poor growth in the ocular environment and not the loss of a functionallasA gene.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.In 1979 Pintucci developed a biointegrable keratoprosthesis with polymethylmethacrylate optical cylinder integrated with a Dacron tissue-colonizable supporting element to avoid the complications caused by the interaction between the haptic element and the eye. The purpose of this article is to compare the colonization of three Dacron fabrics (thicknesses of 0.25 mm, 0.6 mm, and 1.4 mm) in vitro and in vivo to optimize the device performance.Methods.In vitro three different Dacron fabrics were cultured for 3 days with 3.5 × 105human fetal lung fibroblasts and observed with a scanning electron microscope. In vivo three different Dacron fabrics were implanted on the sclera near the superior rectus insertion in the right eye of six albino rabbits and were observed after 4 days with light and scanning electron microscopy.Results.In the in vitro experiments, the cells were preserved and their structure was found to be normal. The 0.25-mm thick fabric was coated only on the surface, and the other fabrics were colonized in three dimensions. In the in vivo experiments, the 0.25-mm thick fabric appeared coated only on its surface. The other fabrics were three-dimensionally colonized and the Dacron filaments appeared embedded in neovascularized connective tissue with minimal foreign body reaction. The 1.4-mm thick colonized fabric showed a substantial loss of pliability.Conclusion.Given that the 0.25-mm thick fabric was coated only by connective tissue, that the 0.6-mm and 1.4-mm thick fabrics were perfectly colonized, and that the 1.4-mm thick fabrics showed a substantial loss of pliability, the 0.6-mm thick fabric haptic part of the Pintucci keratoprosthesis is preferred. For 19 years, the 0.6-mm Dacron fabric Pintucci keratoprosthesis was implanted in 159 eyes with good results, overcoming the apparently inseparable difficulties represented by mechanical anchorage and biointegrability of a keratoprosthesis.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.We aimed to investigate the possible association of proteoglycans with D-periodic collagen fibrils in the human cornea and sclera, using energy-filtering transmission electron microscopy (EF-TEM) and atomic force microscopy (AFM).Methods.Human cornea and sclera were digested with keratanase to eliminate keratan sulfate proteoglycans (KSPGs). For EF-TEM observation, surface proteoglycans were detected by cupromeronic blue (CB) staining. For AFM observation, cornea and sclera were treated with sodium hydroxide before and after keratanase digestion, and the surface topology of collagen fibrils was analyzed.Results.With CB staining, numerous CB-positive short filaments of surface proteoglycans (proteoglycan filaments) were observed in the interfibrillar spaces of cornea and sclera associated with collagen fibrils. AFM imaging showed that the depth and periodicity of D-periodic collagen fibrils in keratanase-treated corneal collagens were deeper and more regular than in untreated ones. Moreover, the depth and periodicity of keratanase-untreated corneal collagens were shallow and irregular in comparison with keratanase-untreated scleral collagens. On the other hand, there was no difference in depth or regularity between keratanase-treated and -untreated scleral collagen fibrils. Using AFM imaging, additional thin grooves sub-bands were detected on the surface of keratanase-treated corneal collagen fibrils. The grooves were not detected in keratanase-untreated collagen fibrils nor in scleral collagen fibrils with or without keratanase digestion. Comparing densitometry waves, the grooves of D-periodic corneal collagen sub-bands corresponded to a and c bands.Conclusion.Using AFM and EF-TEM to study corneal and scleral collagen fibrils and their association with proteoglycans, we conclude that KSPG is found in ample amounts in the human cornea in comparison with sclera. Moreover, we topologically detected KSPG attached to a and c bands of collagen fibrils.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To determine the effect of short-term topical therapy with 1% prednisolone acetate (PA) on normal immune adenoviral clearance in the rabbit ocular model.Methods.Thirty rabbits were topically inoculated in both eyes with adenovirus type 5 (Ad5). On day 1, the rabbits were divided into three topical treatment groups: 1% PA four times daily for 3 days, 1% PA four times daily for 5 days, control (artificial tears) four times daily for 5 days. Eyes were cultured for virus on days 0, 1, 3, 4, 5, 7, 9, 11, and 14.Results.Compared with the control group, treatment with 1% PA for 3 or 5 days significantly increased the total and daily number of Ad5-positive cultures from days 7 to 14, prolonged the duration of Ad5 shedding, and increased the mean combined Ad5 titer from days 1 to 5. In addition, treatment with 1% PA for 5 days increased the mean combined Ad5 titer from days 7 to 14.Conclusion.Treatment of an ocular adenoviral infection with 1% PA for as little as four times daily for 3 days significantly enhanced adenoviral replication compared with the control group. Short-term corticosteroid treatment of acute adenoviral ocular infections with 1% PA should be used judiciously.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID