Frequently Experienced Problems in the Early Stages after Prescribing Rigid Gas Permeable Contact Lenses

Prescribing rigid gas-permeable (RGP) lenses involves a series of processes that determine the most appropriate final lens through the trial use of test lenses based on the results of slit lamp microscopy, measuring refraction and corneal curvature, and corneal topography. The final prescription is reached by judging the dynamic lens movement, adequacy of the tear layer around the lens, corrected vision, and quality of vision. Various problems are encountered soon after prescribing lenses, including foreign body sensation, tear hypersecretion, decreased visual acuity, blurring, visual acuity change, redness, dryness, sudden pain, lens centering, and lens fallout. Here, we examine these problems and how to solve them.

Local immunosuppression in WZS-pig to rhesus monkey Descemet’s stripping automated endothelial keratoplasty: An innovative method to promote the survival of xeno-grafts

Corneal xenotransplantation is an effective solution for the shortage of human corneas. We investigated the feasibility and efficacy of different postoperative protocols on xeno-Descemet's stripping automated endothelial keratoplasty (DSAEK) grafts. Thirty rhesus monkeys were randomly divided into three groups: control group (C), only Descemet's membrane (DM) stripping; DSAEK 1 (D1) and DSAEK 2 (D2) groups, DM stripping followed by endothelial keratoplasty. Betamethasone 3.5 mg was subconjunctival injected in groups control and D1 postoperatively, while animals in group D2 were treated with topical 0.1% tacrolimus and topical steroids. All groups were evaluated by slit-lamp microscopy, anterior segment OCT and LSCM for at least nine months. A total of 24 monkeys (24 eyes) met the inclusion criteria. Nine months after DSAEK surgery, all xenografts showed good attachment, and most corneas were transparent. Graft rejection occurred in 25% of the cases in group D1 and 28.57% of those in group D2 (P > 0.05). The corneal endothelium density in the DSAEK groups was 2715.83±516.20/mm² (D1) and 2220.00 ± 565.13/mm² (D2) (P > 0.05). Xenogeneic corneal endothelial grafts can survive and function in rhesus monkey eyes for a long time with subconjunctival steroid or topical tacrolimus and steroid treatment.

Factors Associated with Anatomic Failure and Hole Reopening after Macular Hole Surgery

A macular hole (MH), particularly an idiopathic macular hole (IMH), is a common cause of central vision loss. Risk factors for nonidiopathic MH include high myopia, cystoid macular edema, inflammation, and trauma. MH is primarily diagnosed using slit-lamp microscopy and optical coherence tomography (OCT). Half of the patients with stage I MHs are treated conservatively and may show spontaneous resolution. The main treatment methods for MHs currently include vitrectomy and stripping of the internal limiting membrane (ILM). However, in some patients, surgery does not lead to anatomical closure. In this review, we summarize the factors influencing the anatomical closure of MHs and analyze the potential underlying mechanisms.

Effects of chalazion and its treatments on the meibomian glands: a nonrandomized, prospective observation clinical study

Background To observe the effects of chalazion and its treatments on meibomian gland function and morphology in the chalazion area.Methods This nonrandomized, prospective observational clinical study included 58 patients (67 eyelids) who were cured of chalazion, including 23 patients (23 eyelids) treated with a conservative method and 35 patients (44 eyelids) treated with surgery. Infrared meibomian gland photography combined with image analysis by ImageJ software was used to measure the chalazion area proportion. Slit-lamp microscopy was employed to evaluate meibomian gland function, and a confocal microscope was used to observe meibomian gland acinar morphology before treatment and 1 month after complete chalazion resolution.Results At 1 month after chalazion resolution, the original chalazion area showed meibomian gland loss according to infrared meibomian gland photography in both groups. In patients who received conservative treatment, the meibomian gland function parameters before treatment were 0.74±0.75, 0.48±0.67, and 1.22±0.60, respectively. One month after chalazion resolution, the parameters were 0.35±0.49, 0.17±0.49, and 0.91±0.60, respectively; there was significant difference (P<0.05). The proportion of the chalazion area before treatment was 14.90 (11.03, 25.3), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.64 (10.33, 25.77); there was no significant difference (P>0.05). In patients who underwent surgery, the meibomian gland function parameters before surgery were 0.93±0.87, 1.07±0.70, and 1.59±0.76, respectively, and at 1 month after chalazion resolution, they were 0.93±0.82, 0.95±0.75, and 1.52±0.70, respectively; there was no significant difference (P>0.05). The proportion of the chalazion area before surgery was 14.90 (12.04, 21.6), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.84 (11.31, 21.81); there was no significant difference (P>0.05). The acinar structure could not be observed clearly in the meibomian gland loss area in most patients.Conclusions Chalazion causes meibomian gland loss, and the range of meibomian gland loss is not related to the treatment method but to the range of chalazion itself. A hot compress as part of conservative treatment can improve meibomian gland function at the site of chalazion in the short term.

Effects of chalazion and its treatments on the meibomian glands: a nonrandomized, prospective observation clinical study

Background To observe the effects of chalazion and its treatments on meibomian gland function and morphology in the chalazion area. Methods This nonrandomized, prospective observational clinical study included 58 patients (67 eyelids) who were cured of chalazion, including 23 patients (23 eyelids) treated with a conservative method and 35 patients (44 eyelids) treated with surgery. Infrared meibomian gland photography combined with image analysis by ImageJ software was used to measure the chalazion area proportion. Slit-lamp microscopy was employed to evaluate meibomian gland function, and a confocal microscope was used to observe meibomian gland acinar morphology before treatment and 1 month after complete chalazion resolution. Results At 1 month after chalazion resolution, the original chalazion area showed meibomian gland loss according to infrared meibomian gland photography in both groups. In patients who received conservative treatment, the meibomian gland function parameters before treatment were 0.74±0.75, 0.48±0.67, and 1.22±0.60, respectively. One month after chalazion resolution, the parameters were 0.35±0.49, 0.17±0.49, and 0.91±0.60, respectively; there was significant difference (P<0.05). The proportion of the chalazion area before treatment was 14.90 (11.03, 25.3), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.64 (10.33, 25.77); there was no significant difference (P>0.05). In patients who underwent surgery, the meibomian gland function parameters before surgery were 0.93±0.87, 1.07±0.70, and 1.59±0.76, respectively, and at 1 month after chalazion resolution, they were 0.93±0.82, 0.95±0.75, and 1.52±0.70, respectively; there was no significant difference (P>0.05). The proportion of the chalazion area before surgery was 14.90 (12.04, 21.6), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.84 (11.31, 21.81); there was no significant difference (P>0.05). The acinar structure could not be observed clearly in the meibomian gland loss area in most patients. Conclusions Chalazion causes meibomian gland loss, and the range of meibomian gland loss is not related to the treatment method but to the range of chalazion itself. A hot compress as part of conservative treatment can improve meibomian gland function at the site of chalazion in the short term.

Effects of chalazion and its treatments on the meibomian glands: a nonrandomized, prospective observation clinical study

Background: To observe the effects of chalazion and its treatments on meibomian gland function and morphology in the chalazion area. Methods: This nonrandomized, prospective observational clinical study included 58 patients (67 eyelids) who were cured of chalazion, including 23 patients (23 eyelids) treated with a conservative method and 35 patients (44 eyelids) treated with surgery. Infrared meibomian gland photography combined with image analysis by ImageJ software was used to measure the chalazion area proportion. Slit-lamp microscopy was employed to evaluate meibomian gland function, and a confocal microscope was used to observe meibomian gland acinar morphology before treatment and 1 month after complete chalazion resolution. Results: At 1 month after chalazion resolution, the original chalazion area showed meibomian gland loss according to infrared meibomian gland photography in both groups. In patients who received conservative treatment, the meibomian gland function parameters before treatment were 0.74±0.75, 0.48±0.67, and 1.22±0.60, respectively. One month after chalazion resolution, the parameters were 0.35±0.49, 0.17±0.49, and 0.91±0.60, respectively; there was significant difference (P<0.05). The proportion of the chalazion area before treatment was 14.90 (11.03, 25.3), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.64 (10.33, 25.77); there was no significant difference (P>0.05). In patients who underwent surgery, the meibomian gland function parameters before surgery were 0.93±0.87, 1.07±0.70, and 1.59±0.76, respectively, and at 1 month after chalazion resolution, they were 0.93±0.82, 0.95±0.75, and 1.52±0.70, respectively; there was no significant difference (P>0.05). The proportion of the chalazion area before surgery was 14.90 (12.04, 21.6), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.84 (11.31, 21.81); there was no significant difference (P>0.05). The acinar structure could not be observed clearly in the meibomian gland loss area in most patients. Conclusions: Chalazion causes meibomian gland loss, and the range of meibomian gland loss is not related to the treatment method but to the range of chalazion itself. A hot compress as part of conservative treatment can improve meibomian gland function at the site of chalazion in the short term.

Effects of chalazion and its treatments on the meibomian glands: a nonrandomized, prospective observation clinical study

Background To observe the effects of chalazion and its treatments on meibomian gland function and morphology in the chalazion area. Methods This nonrandomized, prospective observational clinical study included 58 patients (67 eyelids) who were cured of chalazion, including 23 patients (23 eyelids) treated with a conservative method and 35 patients (44 eyelids) treated with surgery. Infrared meibomian gland photography combined with image analysis by ImageJ software was used to measure the chalazion area proportion. Slit-lamp microscopy was employed to evaluate meibomian gland function, and a confocal microscope was used to observe meibomian gland acinar morphology before treatment and 1 month after complete chalazion resolution. Results At 1 month after chalazion resolution, the original chalazion area showed meibomian gland loss according to infrared meibomian gland photography in both groups. In patients who received conservative treatment, the meibomian gland function parameters before treatment were 0.74±0.75, 0.48±0.67, and 1.22±0.60, respectively. One month after chalazion resolution, the parameters were 0.35±0.49, 0.17±0.49, and 0.91±0.60, respectively; there was significant difference (P<0.05). The proportion of the chalazion area before treatment was 14.90 (11.03, 25.3), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.64 (10.33, 25.77); there was no significant difference (P>0.05). In patients who underwent surgery, the meibomian gland function parameters before surgery were 0.93±0.87, 1.07±0.70, and 1.59±0.76, respectively, and at 1 month after chalazion resolution, they were 0.93±0.82, 0.95±0.75, and 1.52±0.70, respectively; there was no significant difference (P>0.05). The proportion of the chalazion area before surgery was 14.90 (12.04, 21.6), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.84 (11.31, 21.81); there was no significant difference (P>0.05). The acinar structure could not be observed clearly in the meibomian gland loss area in most patients. Conclusions Chalazion causes meibomian gland loss, and the range of meibomian gland loss is not related to the treatment method but to the range of chalazion itself. A hot compress as part of conservative treatment can improve meibomian gland function at the site of chalazion in the short term.

Delayed-Onset Interface Fluid Syndrome After LASIK Following Phacotrabeculectomy

Background Interface fluid syndrome (IFS) is an unusual complication after laser-assisted in-situ keratomileusis (LASIK). We report the first case of IFS after uncomplicated phacotrabeculectomy in a patient who had undergone LASIK 10 years previously. This case emphasizes the importance of intraocular pressure (IOP) interpretation in eyes that have undergone LASIK. Case presentation A 30-year-old woman with a history of LASIK surgery presented to glaucoma clinic due to uncontrolled IOP despite of maximally tolerable medical treatment. After receiving phacotrabeculectomy, IOP decreased to 3mmHg on the first postoperative day, but again increased up to 21mmHg and a diffuse corneal edema with cloudy flap interface was demonstrated by slit-lamp microscopy. Corneal edema was sustained even after the IOP was lowered to 14 mmHg. Spectral-domain optical coherence tomography scanning of the cornea revealed a diffuse, thin fluid pocket in the corneal interface. After laser lysis of the scleral flap sutures, IOP was further decreased to 9mmHg and interface fluid was resolved. Conclusion IFS should be considered as a possible cause of postoperative corneal edema despite of low IOP in the eyes that underwent LASIK surgery. Additional IOP lowering may be helpful for resolving the corneal edema.

Delayed-Onset Interface Fluid Syndrome After LASIK Following Phacotrabeculectomy

Background Interface fluid syndrome (IFS) is an unusual complication after laser-assisted in-situ keratomileusis (LASIK). We report the first case of IFS after uncomplicated phacotrabeculectomy in a patient who had undergone LASIK 10 years previously. This case emphasizes the importance of intraocular pressure (IOP) interpretation in eyes that have undergone LASIK. Case presentation A 30-year-old woman with a history of LASIK surgery presented to glaucoma clinic due to uncontrolled IOP despite of maximally tolerable medical treatment. After receiving phacotrabeculectomy, IOP decreased to 3mmHg on the first postoperative day, but again increased up to 21mmHg and a diffuse corneal edema with cloudy flap interface was demonstrated by slit-lamp microscopy. Corneal edema was sustained even after the IOP was lowered to 14 mmHg. Spectral-domain optical coherence tomography scanning of the cornea revealed a diffuse, thin fluid pocket in the corneal interface. After laser lysis of the scleral flap sutures, IOP was further decreased to 9mmHg and interface fluid was resolved. Conclusion IFS should be considered as a possible cause of postoperative corneal edema despite of low IOP in the eyes that underwent LASIK surgery. Additional IOP lowering may be helpful for resolving the corneal edema.