Search

Background: A higher prevalence of ophthalmological alterations in systemic inflammatory diseases has been demonstrated. Objectives: Our objectives were to determine anterior segment findings and corneal properties in alopecia areata (AA). Methods: This is a case-control study. Severe AA patients (Severity of Alopecia Tool > 50%) and non-AA subjects underwent a general ophthalmological examination, a Pentacam and Corvis scheimpflug technology examination (Oculus Optikgeräte GmbH, Wetzlar, Germany). Visual acuity, refractive error, corneal aesthesiometry, and biomechanical and topographic variables were registered. Results: In total, 25 AA patients (50 eyes; 50.6 ± 8.1 years) and 29 controls (58 eyes; 49.4 ± 8.6 years) were included. AA patients had decreased corneal sensitivity, more corneal staining, and a more advanced cataract (p ≤ 0.004). The anterior topographic flat meridian, mean anterior keratometry, and maximum keratometric point were increased in AA (p ≤ 0.040), while pachymetry values were thinner (p ≤ 0.001). Keratoconus index and Belin/Ambrosio-enhanced ectasia total deviation display were increased (p ≤ 0.007). Two eyes with a topographic diagnosis of keratoconus and four eyes with subclinical keratoconus were detected in AA. Applanation lengths were smaller in AA (p ≤ 0.029). The Corvis Biomechanical Index was increased in AA (p = 0.022). Conclusions: AA patients have reduced corneal sensitivity and increased corneal staining. Topographic and biomechanical parameters are altered, and there could be a higher risk of keratoconus, thus possibly requiring routine ophthalmological examination. [ABSTRACT FROM AUTHOR]

Purpose: To report on the surgical maneuvers recommended for a successful unfolding of very young donors in order to accomplish an uneventful Descemet Membrane Endothelial Keratoplasty (DMEK) surgery. Methods: Five patients (three females and two males, mean age 71.2 ± 6.7 years) with Fuchs endothelial cell dystrophy who underwent DMEK with very young donors (between 20 and 30 years old) were included. The following demographic data were assessed: donor's age, donor's endothelial cell density (ECD), preservation time, recipient's age and sex and unfolding surgical time. Best-corrected visual acuity (BCVA; decimal system), ECD and corneal central thickness (CCT) were assessed preoperatively and at 6-month follow-up. Results: Donors' mean age was 23.6 ± 3.6 years (range 21 to 30) and the mean ECD was 2748.6 ± 162.6 cells/mm2. All of them underwent an uneventful DMEK as a single procedure performed by one experienced surgeon (MAG) with a mean unfolding time of 7.2 ± 4.9 min (range 4 to 15). The essential steps, including patient preparation as well as DMEK graft implantation, orientation, unrolling and centering are detailed. At 6 months, BCVA was 0.6 ± 0.2, ECD was 1945.0 ± 455.5 cells/mm2 and CCT was 497.0 ± 19.7 microns. Conclusions: We hereby present the keys to overcome tightly scrolled grafts of very young donors, which prove perfectly suitable for DMEK surgery. The graft shape tends towards a double-roll and specific maneuvers are strongly recommended. [ABSTRACT FROM AUTHOR]

Dry eye is commonly treated with artificial tears; however, developing artificial tears similar to natural tears is difficult due to the complex nature of tears. We characterized and evaluated a novel artificial tear formulation with components similar to the lipid and aqueous constituents of natural tears. Nano-liposomes, composed in part of phosphatidylcholine, were dispersed in an aqueous solution of bioadhesive sodium hyaluronate. Liposome size, zeta potential, and physicochemical properties of the fresh and stored (4 °C) liposomal formulation were analyzed. In vitro tolerance was tested using human corneal and conjunctival cell lines by exposures of 15 min to 4 h. The tolerance of the liposomal formulation was evaluated in animals (rabbits). The average liposome size was 186.3 ± 7.0 nm, and the zeta potential was negative. The osmolarity of the formulation was 198.6 ± 1.7 mOsm, with a surface tension of 36.5 ± 0.4 mN/m and viscosity of 3.05 ± 0.02 mPa·s. Viability values in the human corneal and conjunctival cell lines were always >80%, even after liposomal formulation storage for 8 weeks. Discomfort and clinical signs after instillation in rabbit eyes were absent. The new formulation, based on phosphatidylcholine-liposomes dispersed in sodium hyaluronate has suitable components and characteristics, including high in vitro cell viability and good in vivo tolerance, to serve as a tear substitute. [ABSTRACT FROM AUTHOR]