Corneal sensitivity,ocular surface health and tear film stability after punctal plug therapy of aqueous deficient dry eye

AIM： To evaluate the effect of punctal occlusion using thermosensitive（smart plug） versus silicone plug for management of aqueous deficient dry eye on cornea sensitivity, ocular surface health and tear film stability.METHODS： A comparative prospective interventiona case study included 45 patients with bilateral severe form of aqueous deficient dry eye. In each patient, the smar plug was inserted in the lower punctum of the right eye which was considered as study group 1 and silicone plug was inserted in the lower punctum of the left eye o the same patient which was considered as study group2. All patients were subjected to careful history taking and questionnaire for subjective assessment of severity of symptoms. Corneal sensitivity, corneal fluorescein rose bengal staining, Schirmer＇s I test, tear film break up time and conjunctival impression cytology were performed pre and 1, 3 and 6mo post plug insertion.RESULTS： A statistically significant improvement in subjective and objective manifestations occurred following treatment with both types of plugs（P 〈0.01）The thermosensitive plug caused significant overal improvement, decrease in frequency of application o tear substitutes and improvement of conjunctiva impression cytology parameters in the inserted side（P 〈0.01）. Canaliculitis was reported in two eyes（4.4% following punctal occlusion using thermosensitive plug（study group 1）. Spontaneous plug loss occurred in 21eyes（46.6%） in the silicone plug group（study group 2）.CONCLUSION： Improvement of subjective and objective manifestations of aqueous deficient dry eye occurs following punctal plug occlusion. Thermosensitive plug has good patient＇s compliance with fewer complications and lower rates of loss compared to the silicone plug.

Corneal injury and its protection using hydro-gel patch during general anesthesia

AIM: To evaluate corneal injury during general anesthesia and analyze the protective effect of medical hydro-gel eye patch in clinics.METHODS:Seventy-sixpatientswith152 eyesundergoing general anesthesia were included. None had positive corneal fluorescein staining before surgery. Both eyes of each patient were analyzed, with one randomly allocated to receive medical hydro-gel eye patch, and the other to receive common adhesive tape as a control. Corneal injuries were evaluated by scoring fluorescein staining under a hand-held slit lamp immediately after surgery in postanesthesia care unit and 24 h thereafter. Patients’ discomforts were also evaluated.RESULTS: Twelve eyes(15.8%) in the hydro-gel patch group and 30 eyes(39.5%) in the adhesive tape group showed corneal injury immediately after surgery. The eyes protected with hydro-gel patch showed statistically less corneal fluorescein staining than the control group.Four eyes in hydro-gel patch group and 6 eyes in adhesive tape group suffered discomfort immediately after surgery without intergroup difference and all discomforts disappeared after 24h(P =0.257). No side effect was observed in hydro-gel patch group, while 5eyes had brow avulsion and 2 got skin itching in adhesive tape group.CONCLUSION: Corneal injury complication was morefrequent than we thought following general anesthesia.The medical hydro-gel eye patch can protect the occurrence of corneal injury following general anesthesia.

Effect of taurine on GFAP and TauT expressions in rat retinal Müller cells in high glucose culture

Objective： To detect the expression of glial fibrillary acid protein （GFAP） and taurine transporter （TauT） in the retinal Müller cells in high glucose culture with taurine and to explore the influence of glucose on the taurine transporting, and the possible protective effects of taurine on MUller cells in early diabetic retinopathy. Methods： The Müller cells from the rat retina were cultured in high glucose, and GFAP and Taut expressions were detected in the cells treated with different doses of taurine by immuocytochemical fluorescein staining and Western blotting. Results： High glucose enhanced the expression of GFAP and decreased the expression of TauT in Müller cells. Taurine decreased the up-regulation of GFAP in the cells which was induced by high glucose; 0. 1-10 mmol/L taurine increased the expression of TauT in Müller cells. Conclusion： Taurine can inhibit the changes in Müller cell resulted from high glucose.

Prevalence of Dry Eye and Its Association with Various Risk Factors in Rural Setup of Western Uttar Pradesh in a Tertiary Care Hospital

Purpose: To study the prevalence of dry eye in a hospital based population of rural setup and to evaluate its association with various risk factors. Material and Methods: In this cross sectional study, patients above 20 years of age were screened randomly for dry eye. An 8 points questionnaires, slit lamp examination of meibomian glands, tear film breakup time, fluorescein staining of cornea, schirmer test were used to diagnose dry eye. The diagnosis was made when three of the five parameters were positive. The role of various occupations as well as role of different exposure factors like sunlight, excessive wind, smoking, drugs, and air pollution as dry eye risk factors was accessed. Result: Out of 445, 45.39% patients had dry eye. Dry eye prevalence was higher in those above 70 years of age (74%). It was higher in male population (51.82%) compare to female population (37.37%), nearly equal in rural (46.04%) and urban population (44.31%) and highest among factory workers (90%). Correlation of dry eye with drugs (P = 0.0002), sunlight/high temperature (P = 0.0003) and smoking (P = 0.03) were significant. Conclusion: This is a hospital based study which provides prevalence of dry eye in rural region of western Uttar Pradesh. It is more common in old age male population and significantly higher in factory workers. Out of different modifiable risk factors most important are drugs, sunlight/high temperature and smoking.