Comparative outcomes of the pathogen in cultured Jones tubes used in lacrimal bypass surgery according to follow up periods

AIM:To evaluate the pathogens in cultured Jones tubes used in lacrimal bypass surgery according to the postoperative periods and to obtain data for the prevention of infection of functional lacrimal stent invention.METHODS:Totally 71 patients(81 eyes)who underwent the removal of Jones tubes were enrolled in study.All the removed Jones tubes were cultured for bacterial and fungal identification and tested for bacterial antibiotic sensitivity.The results were analyzed according to the duration of the inserted Jones tube after lacrimal bypass surgery.RESULTS:Of the 81 eyes,bacteria were isolated from 69 eyes(85.2%)and fungi from 6 eyes(7.4%).Among 69 eyes,40.6% showed Staphylococcus aureus(S.aureus),11.6% were Pseudomonas aeruginosa(P.aeruginosa).Gram-positive bacteria were isolated more than Gramnegative bacteria,but Gram-negative bacteria showed a higher incidence in the Jones tube implanted for over 10y(P=0.035).The antibiotic sensitivity test showed that 46.4% of S.aureus were resistant to oxacillin.In terms of antibiotics commonly used in ocular clinical practice,vancomycin was sensitive to S.aureus and Streptococcus pneumoniae(S.pneumoniae),amikacin responded to P.aeruginosa and Proteus mirabilis(P.mirabilis).Trimethoprim/sulfamethoxazole(TMP/SMX)was all sensitive to S.aureus,S.pneumoniae and P.mirabilis except P.aeruginosa.CONCLUSION:S.aureus is the most commonly found organism in the Jones tube after lacrimal bypass surgery,and 46.4% of them are methicillin-resistant S.aureus(MRSA),sensitive to vancomycin.Especially,P.mirabilis responded with amikacin is dominantly detected in the Jones tubes implanted for more than 10y.

Effects of dietary high dose DHA omega-3 supplement in dry eye with meibomian gland dysfunction

AIM:To evaluate the clinical efficacy of dietary supplement of high dose DHA omega-3 in dry eye with meibomian gland dysfunction(MGD).METHODS:Prospective randomized double-masked,placebo-controlled clinical trial was conducted in mild to moderate dry eye patients with MGD.Patients have no history of taking any dietary omega-3 supplements before 3 mo.Patients were divided into two groups:24 patients in the omega-3 group and 26 patients in the placebo group.The omega-3 group received two capsules of Easyeye Dry?,total containing 600 mg of EPA and 1640 mg of DHA,while the placebo group received two capsules containing 3000 mg of olive oil.All patients take two pills once a day.The examination of MGD scores,tear break-up time(TBUT),corneal staining test(NEI),strip meniscometry(SM tube),and ocular surface disease index(OSDI)scores were performed at baseline,after 4 and 8 wk.RESULTS:A total of 50 patients were included.There were no differences in baseline characteristics between the two groups,such as age,sex,and other ocular examination findings.The TBUT,NEI,and OSDI scores significantly improved after 4 and 8 wk in both groups.While after 8 wk TBUT(6.00±1.62 s vs 5.08±1.28 s,P=0.034)and MGD score(7.2±1.8 vs 8.1±2.6,P=0.033)in the omega-3 group was more significantly improved than that of the placebo group.CONCLUSION:Dry eye with the MGD patient,a high dose of DHA omega-3 dietary supplement can improve TBUT and MGD score after 8 wk,effective in stabilizing the tear film.

Evaluation of the safety of anterior capsule staining with trypan blue under air: a retrospective analysis

AIM: To evaluate the safety of using 0.03% trypan blue under air for anterior capsule staining in cataract surgery.METHODS: The current study involved a retrospective analysis of the medical records of 86 patients with vitreous hemorrhage, who underwent pars plana vitrectomy and cataract surgery.The patients were classified into two groups.The trypan blue group(n=45) comprised patients who underwent anterior capsule staining with 0.03% trypan blue under an air bubble.The control group(n=41) comprised of patients who underwent intracameral illuminator-assisted capsulorhexis.The status of endothelial cell density(ECD) in both the groups was analyzed.RESULTS: The trypan blue group displayed significant decline in ECD at 1 mo(7.91% loss, P<0.001) and 3 mo(9.65% loss, P<0.001) after the surgery, whereas no significant changes were observed in the control group.Moreover, the number of patients who did not display a postoperative decline in ECD was significantly higher in the control group(43.9%;18 patients) than in the trypan blue group(17.1%;7 patients, P=0.004).CONCLUSION: Anterior capsule staining with trypan blue under the air bubble would not be as safe as the intracameral illuminator.The ECD loss might be attributed to the air bubble rather than to the deleterious effects of 0.03% trypan blue.Further studies are required to clarify this.

Clinical efficacy of 0.05%cyclosporine nano-emulsion in the treatment of dry eye syndrome associated with meibomian gland dysfunction

AIM:To evaluate the clinical efficacy of topical 0.05%cyclosporine nano-emulsion in the treatment of dry eye syndrome(DES)with meibomian gland dysfunction(MGD).METHODS:This prospective study included 64 patients with DES and MGD who were randomly assigned to three groups:Group 1(n=24,conventional cyclosporine),Group 2(n=21,nano-emulsion cyclosporine),and Group 3(n=19,control).Lid margin telangiectasia(LMT),meibomian gland secretion(MGS),conjunctival injection(CI),corneal staining(CS),tear break-up time(TBUT),Schirmer test I(STI),Ocular Surface Disease Index(OSDI),and lipid layer thickness(LLT)was evaluated at 4,8,and 12wk of treatment.RESULTS:In Group 3(control),LMT,CS,and CI improved after 8wk,MGS,TBUT after 12wk of treatment.In Group 1(conventional cyclosporine),LMT,MGS,and TBUT improved significantly after 4wk,whereas CS,CI,STI,and LLT improved significantly after 8wk,and OSDI at 12wk.In Group 2(nano-cyclosporine),LMT,MGS,CS,CI,TBUT,and OSDI significantly improved after 4wk,and STI after 8wk.Especially,LLT was significantly higher than other groups after 4wk.CONCLUSION:Cyclosporine and nano-cyclosporine shows significant improvement in DES with MGD than the control group.In contrast,the nano-cyclosporine group shows more statistically improved CI and CS at 4wk,especially LLT at 4,8,and 12wk compared to the conventional cyclosporine group.