Assessment of tear film parameters post-treatment with commercial eyelid cleaning wipes:a pilot study

AIM:To investigate the short-term effects of commercially available eyelid-cleaning wipes on film parameters.METHODS:This study enrolled 48 healthy participants aged 20-35y(both males and females).Clinical assessment included the Ocular Surface Disease Index(OSDI)questionnaire,non-invasive tear break-up time(NITBUT),tear meniscus height(TMH),and lipid layer pattern(LLP).Based on these initial results,participants were categorized as either non-dry eye or dry eye.Participants in each group were randomly allocated to either Blephaclean■or Systane■treatments.Changes in NITBUT,TMH,and LLP levels before and after lid wipe treatment were assessed.RESULTS:The dry eye group exhibited significantly higher OSDI scores and lower NITBUT and TMH levels than in the non-dry eye group(P<0.001).Following the application of eyelid wipes(Systane■wipes),dry eye subjects experienced a significant improvement in NITBUT levels(P=0.0014)compared to the non-dry eye individuals.Although the remaining participants showed a marginal increase in TMH and NITBUT levels,these changes did not achieve statistical significance(P>0.05).Similarly,the LLP levels were significantly improved with Systane■(P<0.001)post-treatment compared to individuals in the non-dry eye group.However,the dry eye subjects showed higher posttreatment LLP levels than the untreated group(P<0.02).CONCLUSION:The short-term effects of Systane®eyelid wipes on tear film parameters suggest their effectiveness in dry eye disease.Nonetheless,further exploration of their long-term impact is essential to justify their cost effectiveness and efficacy in treating both aqueous deficiency and evaporative dryness.

Lid scrubbing with a gel combining natural extracts for dry eye treatment

AIM:To evaluate the effect of lid scrubbing using a gel combining different natural extracts on ocular signs and symptoms of dry eye patients.METHODS:A retrospective study was performed on 19 dry eye patients(51.1±16.0y).Non-invasive tear break-up time,tear meniscus height,meibomian gland loss,lipid layer thickness,conjunctival redness,corneal staining,ocular surface disease index(OSDI),and ocular pain intensity were measured before(baseline),1wk,and 2mo after lid scrubbing with a gel containing different natural extracts(okra extract,aloe vera leaf juice,hydrolysed soy protein,caffeine,citrus unshiu peel extract,and raspberry seed oil).RESULTS:Compared with the baseline,there was a statistically significant improvement in both first(P=0.048)and average(P=0.026)non-invasive tear break-up time 2mo after treatment,as well as in corneal staining(P=0.043,0.012),OSDI(P<0.001),and ocular pain intensity(P<0.001)after 1wk and 2mo.In addition,there was no correlation between ocular signs and symptoms.CONCLUSION:The lid scrubbing with a gel combining different natural extracts show beneficial effects on tear film stability,corneal damage,and ocular symptoms,which is the reason why this therapeutic procedure is proposed as an alternative for dry eye management.However,it is not possible to attribute this beneficial effect solely to the presence of the natural extracts in the gel,primarily due to the absence of a negative control group.

Rabbit models of dry eye disease: comparative analysis

AIM:To report ocular changes in rabbits after the implementation of three different induction methods to create dry eye(DE)conditions and provides evidence of DErelated disease evolution.METHODS:Experimental methods were divided into 3 models.The first model used involved triple injection of complete Freund’s adjuvant,50µL each,also called the meibomian gland dysfunction(MGD)model.In the second model,DE conditions were created by the resection of nictitating membranes(NM),Harderian glands(HG),and main lacrimal glands(LG),also called the LGR model.The third model involved the topical administration of benzalkonium chloride(BAK)0.1%solution.The Schirmer test,ocular surface staining with fluorescein,and tear breakup time tests were implemented before and after excision.After euthanasia,the ocular tissues were dissected.Cornea,conjunctiva,and meibomian glands were treated with periodic acid–Schiff(PAS)staining and haematoxylin–eosin staining.RESULTS:The MGD model triggered inflammation of meibomian glands.It detected changes in the lipid layer of the tear film.The bilateral resection of NM,HG,and LG reduced the watering layer of the tear film.The topical administration of BAK of 0.1%solution impacted the mucosal layer of the tear film.CONCLUSION:Different changes are observed with different DE syndrome models.The composition of the tear film differ depending on which part of the eye is targeted.More studies need to be done to confirm whether an increased thickness of the cornea has any impact on the DE disease.

Fat management in upper blepharoplasty:Addition or subtraction blepharoplasties,how and when

BACKGROUND As one of the most common aesthetic surgical procedures carried out today,blepharoplasty should be in the repertoire of every plastic surgeon.The term blepharoplasty encompasses a wide range of techniques and options that must be tailored to the specific defect and patient one has to treat.A sound knowledge of the upper and lower eyelids’anatomy is essential for proper surgical execution.Trends have shifted towards more conservative methods(especially of the fat compartment)and sometimes in combination with augmentation techniques,helping to reach a rejuvenated appearance.AIM To present an overview of the surgical techniques considered for upper lid blepharoplasty and fat pad management,in addition to information on how a surgeon may approach the best treatment for his patient based on current publications in literature.METHODS We searched the literature published between 2013,to 2023 using Medline and Reference Citation Analysis.The database was searched using the keywords“upper blepharoplasty”AND“fat”.Papers without full text/abstracts and reviews were excluded.The search strategy followed the PRISMA.The American Society of Plastic Surgeons guidelines for Therapeutic Studies checklist was used to assess all articles.Two authors individually reviewed each article and rated them for importance and relevance to the topic.A consensus was sought and the most relevant studies.RESULTS After the application of the selection criteria used in our review,13 publications were found to address upper lid blepharoplasty specifically.Three of these studies were reviews and three were retrospective studies.Five publications were comparative studies and a further two were clinical trials.CONCLUSION The tendency of modern surgery is to be conservative,by removing adipose tissue only if strictly necessary and restoring the volume of the upper eyelid in a concept of beauty that espouses a"full"sight.There is no gold standard technique to achieve younger and enhanced eyelids.Long-term prospective comparative studies are fundamental in understanding which path is the best to follow.

Modified lower eyelid blepharoplasty improves aesthetic outcomes in patients with hypoplastic malar prominences

Aim: Aging affects the appearance of the eyelids and the surrounding malar region. Blepharoplasty improves the aesthetic appearance of this region, and multiple variants of the procedure have been reported. We here report our technique for modified lower lid blepharoplasty and cheek lift for patients with hypoplastic malar regions, which was introduced after observing prominent lower orbital rims in patients with flat malar prominences after blepharoplasty. Methods: This technique combines standard canthopexy and cheek-lift for rejuvenation of the mid-face with redraping of orbital fat and concurrent sub orbicularis oculi fat pad (SOOF) lift to 'double-breast' the lower orbital margin. Data on 33 patients who had undergone this modified lower lid blepharoplasty was collected retrospectively. Results: Thirty-three patients underwent the modified lower lid blepharoplasty resulting in smooth and youthful appearance of the malar region that was consistent and sustained. No recurrence of V-deformity was observed on a median follow-up of 14 months. twenty-two (66.6%) and 11 (33.3%) patients were pleased and satisfied with postoperative outcomes respectively. Three (9.1%) patients experienced minor postoperative complications and no major complication was observed. Conclusion: The proposed modified lower lid blepharoplasty is a safe and effective alternative to the existing technique with improved aesthetic outcomes and therefore is recommended in patients with flat malar prominences.

不同术式治疗中老年女性上睑区松弛的临床效果

目的探讨中老年女性上睑区松弛的临床分度，以及选择不同的术式治疗效果。方法对2005年1月至2015年9月就诊的133例40岁以上中老年女性美容就医者，根据上睑皮肤软组织松弛程度、眉下垂的情况、眼功能的影响等因素进行分度。分别采取重睑去皮术、眉下切口去皮术、眉上切口提眉术及重睑去皮＋眉上切口提眉术4种术式治疗。结果133例美容就医者中非常满意107例（80．4％），基本满意19例（14．3％），不满意7例（5．3％）。结论了解美容就医者上睑区松弛的特点，根据上睑区松弛的分度设计个性化治疗方案，选择适合的手术方式，是治疗中老年女性上睑区松弛并取得满意效果的关键。

老年性上睑下垂合并上睑松弛的手术治疗

目的探讨老年性上睑下垂合并上睑松弛的手术方法及效果。方法对46例（61眼）老年性上睑下垂并上睑松弛分别行上睑提肌缩短或（上睑提肌腱膜折叠）眼睑皮肤松弛矫正术及眉下垂矫正联合手术。结果术后随访6-18个月，矫正满意者55眼；欠矫4眼；过矫2眼。欠矫者半年后再次行上睑提肌缩短术，效果良好；过矫者，其中1例半年后行上睑提肌延长术，得以矫正，另1例患者不愿意再次手术，术后并发暴露性角膜炎，长期在门诊治疗。随访期间，患者满意率达90．16％。结论联合手术治疗老年性上睑下垂并上睑松弛，可以改善视功能与外观，使老年患者的生活质量明显改善。