Topical Cyclosporine (0.05%) for Management of Dry Eyes in Patients Undergoing Cataract Surgery-A Comparative Study

Purpose: To assess the efficacy of topical cyclosporine 0.05% in the management of cataract surgery induced dry eye. Methods: This prospective, comparative, randomized, interventional study included 67 patients undergoing cataract surgery. The patients were randomized into three categories Group A: patients on topical lubricants and cyclosporine 0.05%, Group B: patients on topical lubricants only and Group C: patients not on any dry eye medication. Patients were given the respective treatment 2 weeks prior and 3 months after cataract surgery, along with an identical perioperative regimen of topical steroids, antibiotics and NSAIDs. Dry eye evaluation done 2 weeks pre-op, 1 week post-op and 3 months post-op consisted of a subjective questionnaire, tear osmolarity, Tear Break Up Time (TBUT) and Schirmer’s 1 without and with anaesthesia. Results: Pre-operatively, all the 3 groups were matched in terms of mean age, tear osmolarity, TBUT and Schirmer’s 1 without and with anaesthesia scores. At 3 months, patients treated with both topical lubricants and cyclosporine (0.05%)(Group A) showed improvement subjective questionnaire, tear osmolarity, TBUT and Schirmer’s 1 tests. Patients treated with lubricants only (Group B) showed a significant worsening in TBUT and tear osmolarity at 1 week, however, the values returned to baseline at 3 months.The control group (Group C) had the worst TBUT scores at the end of 3 months and showed the persistence of raised tear osmolarity, suggestive of a prolonged ocular inflammation resulting in patient dissatisfaction. Conclusion: Topical cyclosporine (0.05%) may be a useful adjuvant to prevent and treat cataract surgery associated with dry eye symptoms, especially in patients with pre-existing dry eye disease.

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A study to assess the efficacy of topical cyclosporine A 0.05% in the management of dry eye with meibomiam gland dysfunction

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.18231/j.ijceo.2021.134 ◽

2022 ◽

Vol 7 (4) ◽

pp. 667-671

Author(s):

Prajwalli Reddy ◽

Wajeeha Umam

Keyword(s):

Dry Eye ◽

Cyclosporine A ◽

Ocular Surface ◽

Tear Film ◽

Meibomian Gland ◽

Meibomian Gland Dysfunction ◽

Control Group ◽

Dry Eyes ◽

Group A ◽

Group B

: Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Meibomian Gland Dysfunction (MGD) is an abnormality of the meibomian gland that blocks the secretion of lipids. Without sufficient lipid production, tears evaporate quickly causing Dry Eye.MGD is associated with multiple pathological mechanisms including inflammation, microbial factors and lipid deficiencies. Topical Cyclosporine A (CsA) 0.05% is a calcineurin inhibitor that reduces inflammation by specifically inhibiting T‑cell activity, which reduces ocular surface inflammation and improves tear film dynamics. This was a prospective observational study done on 100 patients at the Department of Ophthalmology Basaveshwar teaching and general hospital, on patients of dry eyes due to meibomian gland dysfunction. Patients who were diagnosed with dry eyes due to meibomian gland dysfunction were invited to take part in the study. Patients were divided randomly into two groups of 50 patients each. This study, was explained in detail to them. An informed consent was obtained. Patients fulfilling the inclusion criteria were listed.All OSDI scores (symptom intensity, frequency and aggravation) revealed decreasing patterns throughout the observation period in both the groups. In single analysis, the cyclosporine A 0.05% group showed a significant improvement for each score at 3 months (p < 0.01, p = 0.01, p = 0.02, respectively). The mean TBUT after treatment in the group A (cyclosporine A group) increased to 12.36± 3.58(p<0.001) seconds, and in the group B (Control group) the TBUT score increased to 11.01±3.06 seconds. After 3 Months, there was statistically significant improvement in the mean Schirmer’s scores in both the treatment groups, however improvement was significantly greater in Cyclosporine A group. Prior to the treatment in group A (Cyclosporine A) mean Lissamine staining score was 2.73±0.15 and post treatment it reduced to 1.32±0.15 which was statistically significant (P<0.001). In group B (Control group) score before treatment was 2.46±0.15 and after treatment it reduced to 2.39±0.27 (p=0.11), not much difference was seen. : Findings from our study showed that there were significant improvements in the dry eye conditions due to defect in meibomian gland by treatment of topical Cyclosporine A 0.05% and sodium hyaluronate 0.1%.

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Role of punctal plugs as a primarily treatment modality in moderate to severe dry eye

International Journal of Clinical Trials ◽

10.18203/2349-3259.ijct20201713 ◽

2020 ◽

Vol 7 (2) ◽

pp. 72

Author(s):

Sonali V. Kumar

Keyword(s):

Dry Eye ◽

Treatment Modality ◽

Primary Treatment ◽

Punctal Plugs ◽

Primary Treatment Modality ◽

Staining Score ◽

Group A ◽

Eye Symptoms ◽

Group B ◽

Dry Eye Symptoms

Background: In dry eye syndrome tear film disrupts which lead to ocular discomfort. Treatment of dry eye is very challenging and time consuming. Multiple treatment options are available for treating dry eye and one of them is punctal plugs. It blocks the drainage of tear by occluding puncta which helps in the preservation of natural tears on the ocular surface and relieve dry eye symptoms. This study was conducted to assess the safety and efficacy of punctal plugs as a primary treatment modality in moderate to severe dry eye.Methods: Fifty patients were included in this study and they were divided into two groups. In group A which included 25 patients punctal plugs were inserted and in group B (25 patients or 50 eyes) artificial tear drop was prescribed. The primary treatment outcome was the improvement in dry eye symptoms and secondary outcome was Schirmer test score, tear break up time and rose bengal staining score.Results: There was drastic improvement in dry eye symptoms in group A (punctal plugs) compared to group B (artificial tear group). Schirmer test score, tear break up and rose bengal staining score also improved in punctal plug group.Conclusions: This study has shown that punctal plug can be used as a primary treatment modality in moderate to severe dry eye as it improves greater symptomatic relief and also improves the condition of damaged ocular surface.

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Cataract Surgery in Exudative Uveitis: Effectiveness of Total Lens Removal, Anterior Vitrectomy, and Scleral Fixation of PC Iols

European Journal of Ophthalmology ◽

10.1177/112067210801800209 ◽

2008 ◽

Vol 18 (2) ◽

pp. 220-225 ◽

Cited By ~ 6

Author(s):

A.G. Secchi

Keyword(s):

Cataract Surgery ◽

Cataract Extraction ◽

Control Group ◽

Extracapsular Cataract Extraction ◽

Total Removal ◽

Scleral Fixation ◽

Anterior Vitrectomy ◽

Frequent Relapses ◽

Group A ◽

Group B

Purpose Cataract surgery in exudative uveitis is often followed by severe complications (pupillary seclusion/occlusion, dense posterior capsule/anterior vitreous opacification, cystoid macular edema following repeat YAG laser procedures) which often drastically limit functional recovery Total removal of cataract, anterior vitrectomy, and scleral fixation of a posterior chamber (PC) intraocular lens (IOL) has been tried as a surgical alternative, searching for lessened postsurgical complications and a better outcome. Methods Group A was a cohort of 12 patients with cataract after exudative (mostly sarcoidosis and Vogt-Koyanagi-Harada) uveitis, subjected to intracapsular cataract extraction, anterior vitrectomy, and scleral fixation of PC IOLs. Group B was the control group, including 12 patients with a similar clinical condition subjected to phacoemulsification or extracapsular cataract extraction plus in-the-bag or in-the-sulcus IOL implantation. Follow-up time for both groups was at least 7 years. Results Postoperative inflammatory signs were substantially less in Group A patients, from 2 days up to >7 years postsurgery Group A patients showed no cells/exudates adhering to the IOL surfaces, no synechiae, minimal (as compared to Group B) vitreous opacifications, and significantly higher visual acuity (p=0.024 at the seventh year control). Group A patients reported less frequent relapses of uveitis postsurgery, but the relevant clinical data did not allow statistical evaluations. Conclusions Total removal of cataract in highly exudative uveitic eyes, plus anterior vitrectomy and scleral fixation of PC IOLs, although technically a more demanding surgical procedure, proved to be safe and more effective than classical procedures.

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Hyaluronic Acid/Trehalose Ophthalmic Solution in Reducing Post-Cataract Surgery Dry Eye Signs and Symptoms: A Prospective, Interventional, Randomized, Open-Label Study

Journal of Clinical Medicine ◽

10.3390/jcm10204699 ◽

2021 ◽

Vol 10 (20) ◽

pp. 4699

Author(s):

Rita Mencucci ◽

Eleonora Favuzza ◽

Giulia Decandia ◽

Michela Cennamo ◽

Fabrizio Giansanti

Keyword(s):

Hyaluronic Acid ◽

Cataract Surgery ◽

Dry Eye ◽

Ophthalmic Solution ◽

Signs And Symptoms ◽

Ocular Surface Disease Index ◽

Open Label ◽

Open Label Study ◽

Group A ◽

Group B

The purpose of this prospective study was to evaluate the efficacy of the perioperative use of a hyaluronic acid (HA) and trehalose ophthalmic solution (Thealoz® Duo) in reducing post-cataract surgery dry eye signs and symptoms in patients with mild/moderate dry eye disease (DED). One hundred and twenty patients, scheduled for unilateral cataract surgery, were randomized into three groups: (1) group A: HA/trehalose three times/day in the preoperative week and for 5 postoperative weeks; (2) group B: HA/trehalose for only 5 postoperative weeks; (3) group C: no artificial tears. In groups A and B, OSDI (Ocular Surface Disease Index) questionnaire scores were significantly lower than group C at all the postoperative visits; in group A they were significantly lower than group B on the day of surgery, with similar results in the first and fifth weeks after surgery. In groups A and B, break-up time (BUT) was significantly higher than group C during the postoperative period (p ≤ 0.001). In comparison to the preoperative values, BUT in group A remained stable 7 days after surgery; however, in groups B and C, it significantly decreased. In conclusion, the HA/trehalose ophthalmic solution effectively reduced post-cataract surgery DED signs and symptoms in patients with mild/moderate DED, particularly if also administered in the preoperative period.

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Comparative Evaluation of Tear Film Parameters Following Cataract Surgery in Diabetic Patients.

10.37191/mapsci-joo-2-012 ◽

2021 ◽

Author(s):

Sagarika Dash

Keyword(s):

Cataract Surgery ◽

Outcome Measures ◽

Dry Eye ◽

Tear Film ◽

Diabetic Patients ◽

Small Incision Cataract Surgery ◽

Fluorescein Staining ◽

Small Incision ◽

Group A ◽

Group B

Purpose: To compare the propensity of manual small incision and phacoemulsification cataract surgery in causing tear film dysfunction and dry eye syndrome in diabetic patients. Methods: Diabetic patients in group A underwent manual small Incision Cataract surgery whereas in group B underwent phacoemulsification with similar post-operative regimes. The primary outcome measures were the Ocular Surface Disease Index (OSDI), a Subjective questionnaire. The secondary outcome measures were the Subjective Dry Eye (DE) questionnaire, Corneal Fluorescein staining, Tear meniscus height, Schirmer’s II test, and Tear film break-up time. All parameters were measured pre and then postoperatively. Result: 126 patients were divided into group A (undergoing small incision cataract surgery) and group B (undergoing phacoemulsification). The OSDI and subjective DE scores continued to be worse for Group A until the first month after which they became similar to group B with no statistically significant difference (p-value of 0.726 and 0.347 respectively). The OSDI and subjective DES at 3 months were better in both groups as compared to baseline (p <0.0001). The objective tear film parameters (Schirmer’s, TBUT, TMH, and fluorescein staining scores) showed statistically significant changes from the baseline in both groups but the scores remained in the normal range clinically. Schirmer’s test scores were different between the two groups at three months (p=0.007) in SICS group being higher. Conclusion: Manual Small Incision Cataract Surgery (SICS) causes subjective dry eye symptoms more than phacoemulsification until 1 month of surgery in diabetic patients after which the subjective symptoms become similar to phacoemulsification at 3 months.

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Clinical effect of Suvarna Bindu Prashan

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i3.8203 ◽

2017 ◽

Vol 2 (3) ◽

Cited By ~ 1

Author(s):

Patil Aniket ◽

Dindore Pallavi ◽

Arbar Aziz ◽

Kadam Avinash ◽

Saroch Vikas

Keyword(s):

Physical Health ◽

Eating Habits ◽

Control Group ◽

Inform Consent ◽

Significant Difference ◽

Group A ◽

Group B ◽

Immune Booster ◽

Mental And Physical Health ◽

Apparently Healthy

The quest for excellence in mental and physical health is not new. We find various references and formulations in Ayurvedic classics meant for promoting mental and physical health of a child. Suvarna Prashan is one of the formulations explained in age old Ayurvedic classic Kashyap Samhita. This formulation is very widely used now days as a memory and immune booster for children. But there is very little systematic documented study which can be used to evaluate the efficacy of the formulation. Suvarna Bhasma was prepared in Ayurved Rasayani Pharmacy, Pune. Madhu and Ghrita were collected from KLE Ayurveda Pharmacy, Belgaum. Suvarna Bindu Prashan was prepared in KLE Ayurved pharmacy, Belgaum. It contains Suvarna Bhasma, Ghrita and Madhu. Twenty apparently healthy male and female children with age group of three to four years were ready to sign inform consent form were selected into two groups each. Subjects in Group A received Suvarna Bindu Prashan where as Group B (Control group) did not receive any treatment. Both the groups were observed for six months. Children in Suvarna Bindu Prashan group showed significant reduction in the scores of eating habits, behavior, mood, temperament and scores of event of illness. However there was no significant difference in the score of sleeping habit. There was significant increase in IQ percentage.

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Microecological preparation combined with an modified low-carbon diet improves glucolipid metabolism and cardiovascular complication in obese patients

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00697-6 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Jianguo Liu ◽

Liehui Xiao ◽

Hezhongrong Nie ◽

Yong Pan ◽

Yan Liu ◽

...

Keyword(s):

Intestinal Barrier ◽

Intestinal Barrier Function ◽

Control Group ◽

Obese Patients ◽

Carotid Atherosclerotic Plaque ◽

Low Carbon ◽

Balanced Diet ◽

Group A ◽

Group B ◽

Control Group Group

Abstract Objective To investigate the impact of microecological preparation combined with modified low-carbon diet on the glucolipid metabolism and cardiovascular complication in obese patients. Methods From August 2017 to July 2020, 66 obese patients were recruited, and administrated with an modified low-carbon diet with (group A) or without (Group B) microecology preparation and a balanced diet in control group (group C) for 6 months. Meanwhile, 20 volunteers administrated with a balanced diet were recruited as the healthy control group (group D). Results After 6-month intervention, obese subjects in group A and B showed significant improvement of body and liver fat mass, reduction of serum lipid levels, intestinal barrier function markers, insulin resistance index (IRI), high blood pressure (HBP) and carotid intima thickness, as compared with subjects in group C. More importantly, subjects in group A had better improvement of vascular endothelial elasticity and intimal thickness than subjects in group B. However, these intervention had no effect on carotid atherosclerotic plaque. Conclusion Administration of microecological preparation combined with modified low-carbon diet had better improvement of intestinal barrier function, glucose and lipid metabolism, and cardiovascular complications than low-carbon diet in obese patients, but the effect of a simple low-carb diet on carotid atherosclerotic plaque need to be further addressed.

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Effects of different thermal insulation methods on the nasopharyngeal temperature in patients undergoing laparoscopic hysterectomy: a prospective randomized controlled trial

BMC Anesthesiology ◽

10.1186/s12871-021-01324-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Guanyu Yang ◽

Zefei Zhu ◽

Hongyu Zheng ◽

Shifeng He ◽

Wanyue Zhang ◽

...

Keyword(s):

Thermal Insulation ◽

Primary Outcome ◽

Controlled Trial ◽

Laparoscopic Hysterectomy ◽

Control Group ◽

Prospective Randomized Controlled Trial ◽

Warming Blanket ◽

Group A ◽

Insulation Effect ◽

Group B

Abstract Background This study explored the comparison of the thermal insulation effect of incubator to infusion thermometer in laparoscopic hysterectomy. Methods We assigned 75 patients enrolled in the study randomly to three groups: Group A: Used warming blanket; group B: Used warming blanket and infusion thermometer; group C: Used warming blanket and incubator. The nasopharyngeal temperature at different time points during the operation served as the primary outcome. Results The nasopharyngeal temperature of the infusion heating group was significantly higher than that of the incubator group 60 min from the beginning of surgery (T3): 36.10 ± 0.20 vs 35.81 ± 0.20 (P<0.001)90 min from the beginning of surgery (T4): 36.35 ± 0.20 vs 35.85 ± 0.17 (P<0.001). Besides, the nasopharyngeal temperature of the incubator group was significantly higher compared to that of the control group 60 min from the beginning of surgery (T3): 35.81 ± 0.20 vs 35.62 ± 0.18 (P<0.001); 90 min from the beginning of surgery (T4): 35.85 ± 0.17 vs 35.60 ± 0.17 (P<0.001). Regarding the wake-up time, that of the control group was significantly higher compared to the infusion heating group: 24 ± 4 vs 21 ± 4 (P = 0.004) and the incubator group: 24 ± 4 vs 22 ± 4 (P = 0.035). Conclusion Warming blanket (38 °C) combined infusion thermometer (37 °C) provides better perioperative thermal insulation. Hospitals without an infusion thermometer can opt for an incubator as a substitute. Trial registration This trial was registered with ChiCTR2000039162, 20 October 2020.

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The Bone Buttress Theory: The Effect of the Mechanical Loading of Bone on the Osseointegration of Dental Implants

Biology ◽

10.3390/biology10010012 ◽

2020 ◽

Vol 10 (1) ◽

pp. 12

Author(s):

David Chavarri-Prado ◽

Aritza Brizuela-Velasco ◽

Ángel Álvarez-Arenal ◽

Markel Dieguez-Pereira ◽

Esteban Pérez-Pevida ◽

...

Keyword(s):

Dental Implants ◽

Mechanical Loading ◽

Bone Growth ◽

Bone Matrix ◽

Test Group ◽

Control Group ◽

Group A ◽

Bone To Implant Contact ◽

The Stability ◽

Group B

Objectives: To determine the effect of mechanical loading of bone on the stability and histomorphometric variables of the osseointegration of dental implants using an experimental test in an animal model. Materials and Methods: A total of 4 human implants were placed in both tibiae of 10 New Zealand rabbits (n = 40). A 6-week osseointegration was considered, and the rabbits were randomly assigned to two groups: Group A (Test group) included 5 rabbits that ran on a treadmill for 20 min daily during the osseointegration period; Group B (Controls) included the other 5 that were housed conventionally. The monitored variables were related to the primary and secondary stability of the dental implants (implant stability quotient—ISQ), vertical bone growth, bone to implant contact (BIC), area of regenerated bone and the percentage of immature matrix. Results: The results of the study show a greater vertical bone growth (Group A 1.26 ± 0.48 mm, Group B 0.32 ± 0.47 mm, p < 0.001), higher ISQ values (Group A 11.25 ± 6.10 ISQ, 15.73%; Group B 5.80 ± 5.97 ISQ, 7.99%, p = 0.006) and a higher BIC (Group A 19.37%, Group B 23.60%, p = 0.0058) for implants in the test group, with statistically significant differences. A higher percentage of immature bone matrix was observed for implants in the control group (20.68 ± 9.53) than those in the test group (15.38 ± 8.84) (p = 0.108). A larger area of regenerated bone was also observed for the test implants (Group A 280.50 ± 125.40 mm2, Group B 228.00 ± 141.40 mm2), but it was not statistically significant (p = 0.121). Conclusions: The mechanical loading of bone improves the stability and the histomorphometric variables of the osseointegration of dental implants.

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Glycine and L-Arginine supplementation ameliorates gastro-duodenal toxicity in a rat model of NSAID (Diclofenac)-gastroenteropathy via inhibition of oxidative stress

Journal of Basic and Clinical Physiology and Pharmacology ◽

10.1515/jbcpp-2020-0307 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Akinleye Stephen Akinrinde ◽

Halimot Olawalarami Hameed

Keyword(s):

Oxidative Stress ◽

Total Protein ◽

Therapeutic Index ◽

Control Treatment ◽

Control Group ◽

Protective Effects ◽

Serum Total Protein ◽

Significant Amelioration ◽

Group A ◽

Group B

Abstract Objectives This study examined the possible protective roles of exogenous glycine (Gly) and L-Arginine (l-Arg) against Diclofenac (DIC)-induced gastro-duodenal damage in rats. Methods Rats were divided into Group A (control), Group B (DIC group) and Groups C–F which were pre-treated for five days with Gly1 (250 mg/kg), Gly2 (500 mg/kg), l-Arg1 (200 mg/kg) and l-Arg2 (400 mg/kg), respectively, before co-treatment with DIC for another three days. Hematological, biochemical and histopathological analyses were then carried out. Results DIC produced significant (p<0.05) reduction in PCV (13.82%), Hb (46.58%), RBC (30.53%), serum total protein (32.72%), albumin (28.44%) and globulin (38.01%) along with significant (p<0.05) elevation of serum MPO activity (83.30%), when compared with control. In addition, DIC increased gastric H2O2 and MDA levels by 33.93 and 48.59%, respectively, while the duodenal levels of the same parameters increased by 19.43 and 85.56%, respectively. Moreover, SOD, GPx and GST activities in the DIC group were significantly (p<0.05) reduced in the stomach (21.12, 24.35 and 51.28%, respectively) and duodenum (30.59, 16.35 and 37.90%, respectively), compared to control. Treatment with Gly and l-Arg resulted in significant amelioration of the DIC-induced alterations although l-Arg produced better amelioration of RBC (29.78%), total protein (10.12%), albumin (9.93%) and MPO (65.01%), compared to the DIC group. The protective effects of both amino acids against oxidative stress parameters and histological lesions were largely similar. Conclusions The data from this study suggest that Gly or l-Arg prevented DIC-induced gastro-duodenal toxicity and might, therefore be useful in improving the therapeutic index of DIC.

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