Efficacy of recombinant human epidermal growth factor plus sodium hyaluronate eye drops in diabetic dry eye post-cataract surgery

BACKGROUND Dry eye syndrome(DES)after diabetic cataract surgery can seriously affect the patient’s quality of life.Therefore,effective alleviation of symptoms in patients with this disease has important clinical significance.AIM To explore the clinical effect of recombinant human epidermal growth factor(rhEGF)plus sodium hyaluronate(SH)eye drops on DES after cataract surgery in patients with diabetes.METHODS We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital,Affiliated Hospital of Nankai University between April 2021 and April 2023.They were classified into an observation group(42 cases,rhEGF+SH eye drops)and a control group(40 cases,SH eye drops alone),depending on the different treatment schemes.The therapeutic efficacy,dry eye symptom score,tear film breakup time(TFBUT),basic tear secretion score[assessed using Schirmer I test(SIt)],corneal fluorescein staining(FL)score,tear inflammatory markers,adverse reactions during treat-ment,and treatment satisfaction were compared between the two groups.RESULTS Therapeutic efficacy was higher in the observation group compared with the control group.Both groups showed improved TFBUT and dry eye,as well as improved SIt and FL scores after treatment,with a more pronounced improvement in the observation group.Although no marked differences in adverse reactions were observed between the two groups,treatment satisfaction was higher in the observation group.CONCLUSION rhEGF+SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy,fewer adverse reactions,and high safety levels.Thus,this treatment should be promoted in clinical practice.

Prevalence and Factors Associated with Dry Eyes Syndrome in Glaucomatous Patients on Anti-Glaucoma Eye Drops Followed up at the Garoua Regional Hospital-Northern Cameroon

Background: Dry eye and glaucoma are two common pathologies in the elderly, and are very often associated. This association suggests a link between them and between their treatments. Our purpose for this study is to determine the prevalence of dry eye in our glaucoma patients treated with eye drops and deduce the factors associated with it. Patients and Methods: We conducted a cross-sectional, analytical study from October 2022 to September 2023 in the ophthalmology department of Garoua Regional Hospital in glaucoma patients aged over 15 years able to answer the Ocular Surface Disease Index (OSDI) questionnaires and treated with antiglaucoma eye drops for more than 3 months. These patients underwent a complete ophthalmological examination and a tear film break-up time test. Results: A total of 73 patients (146 eyes) were examined. The average age of the patients was 47.2 ± 16.5 years, with a male predominance of 54.8%. The prevalence of dry eye syndrome in our patients according to the OSDI score was 56.2% (95% CI) (44.8;67.6). The prevalence of dry eye syndrome on clinical examination of the BUT in the right eye was 83.7% (95% CI) (75.1;92.1) and 79.4% (70.2;88.7) in the left eye. The duration of antiglaucoma treatment was the factor associated with dry eye syndrome (p < 0.05) in glaucoma patients in our setting. Conclusion: Dry Eye Syndrome is common in glaucoma patients on drops in our setting. Treatment duration of more than 1 year seems to be associated with dry eyes.

Clinical Observation of Recombinant Bovine Basic Fibroblast Growth Factor Eye Gel Combined with Tobramycin Dexamethasone Eye Drops in the Treatment of Dry Eye Syndrome in Patients after Cataract Surgery

Objective:To evaluate the therapeutic effect of recombinant bovine basic fibroblast growth factor(rbFGF)eye gel combined with tobramycin-dexamethasone(TOB-Dex)eye drops on dry eye syndrome(DES)after cataract surgery.Methods:86 patients with DES after cataract surgery,admitted from November 2021 to November 2023,were randomly divided into groups.The observation group included 43 patients treated with rbFGF eye gel combined with TOB-Dex eye drops.The reference group included 43 patients treated with TOB-Dex eye drops alone.Multiple indicators,including total effective rate and clinical symptom scores,were compared between the two groups.Results:The total effective rate in the observation group was higher than in the reference group(P<0.05).Before treatment,there were no differences in clinical symptom scores,serum factors,or disease severity scores between the two groups(P>0.05).Three weeks after treatment,the observation group had lower clinical symptom scores,serum factors,and disease severity scores compared to the reference group(P<0.05).The adverse reaction rate in the observation group was lower than in the reference group(P<0.05).Conclusion:rbFGF eye gel combined with TOB-Dex eye drops can improve the clinical efficacy for patients with DES after cataract surgery,alleviate disease symptoms,reduce inflammatory responses,and have fewer adverse reactions.

Effects of endogenous dopamine induced by low concentration atropine eye drops on choroidal neovascularization in high myopia mice

AIM:To evaluate effects of endogenous dopamine induced by low concentration atropine eye drops on choroidal neovascularization(CNV)in high myopia mice.METHODS:The C57BL/6J mice were deprived of the right eye for 4wk,and the high myopia was diagnosed by optometry,the diopter was less than-6.00 D,and CNV was induced by 532 nm laser.The changes of dopamine D1 receptor(DRD1),dopamine D2 receptor(DRD2),and vascular endothelial growth factor A(VEGFA)were detected by Western blot technology at 0.5,1,2h,and 7d after 0.01%,0.05%,and 0.1%atropine eye drops,respectively,the area of CNV was measured.RESULTS:Significant increases were observed on the expression of DRD2 in mouse high myopia model at 0.5,1,2h,7d with 0.05%and 0.1%atropine eye drops(P<0.05).Significant decreases were observed on the expression of DRD1 and VEGFA in mouse high myopia model at 0.5,1,2h,7d with 0.05%and 0.1%atropine eye drops(P<0.05).The area of CNV induced by laser in the drug-treated group was significantly smaller than that in the control group,and the higher the concentration,the more significant the inhibitory effect(P<0.05).CONCLUSION:The 0.01%,0.05%,0.1%atropine eye drops can decrease the level of VEGFA and inhibit high myopia CNV indirectly by up-regulating the level of DRD2 and down-regulating the level of DRD1,and the effect of 0.05%and 0.1%atropine eye drops is more significant.

Randomized controlled trial on the efficacy and safety of autologous serum eye drops in dry eye syndrome

BACKGROUND Autologous serum eye drops(ASEDs),a novel treatment derived from blood serum,have emerged as a groundbreaking solution for managing dry eye syndrome(DES).These drops have shown significant promise in relieving the distressing symptoms of DES.This study aimed to evaluate the safety and effectiveness of ASEDs compared to traditional treatments,which often prove inadequate or result in unwanted side effects,particularly in individuals with moderate-to-severe DES.AIM To evaluate whether ASEDs are safer and more effective than conventional artificial tears in the treatment of moderate-to-severe DES.METHODS This multi-centered randomized controlled trial included 240 patients with moderate-to-severe DES from three ophthalmology clinics in China.They were randomly assigned to receive either ASEDs or artificial tears for 12 wk.The primary outcome was the change in the ocular surface disease index(OSDI)score,with secondary outcomes including tear break-up time(TBUT),Schirmer I test,corneal fluorescein staining(CFS),and conjunctival impression cytology(CIC).Statistics analysis was performed using an analysis of covariance with adjustments made for baseline values.RESULTS Our findings revealed that both ASEDs and artificial tears significantly improved the OSDI score,TBUT,Schirmer I test,CFS,and CIC from baseline to week 12.The ASEDs group showed significantly greater improvement in all these measures than the artificial tears group(all P values<0.05).The average difference in the OSDI score between the two cohorts was-10.3(95%confidence interval:-13.6 to-7.0),indicating a substantial improvement in the ASEDs group.The occurrence of adverse events was comparable between cohorts,with no reports of severe adverse events.CONCLUSION ASEDs are more effective and safer than artificial tears for mitigating symptoms of moderate-to-severe DES.ASEDs could be an alternative/supplementary therapy for patients with DES less responsive to traditional treatments.

Common eye drops and their implications for p H measurements in the management of chemical eye injuries

Dear Sir,Eye drops(single use)commonly used in clinics do have varying pH values.The use of such drops in the initial management of chemical eye injury may influence the accuracy of pH measurement of the eye,and subsequently influence its management.Chemical eye injury is an ophthalmic emergency,which may be caused by exposure to an acidic(pH【4)or an alkali(pH】10)solution to the eye.Rinsing the eye decreases the concentration of these solutions on ocular surface.The initial management would be copious irrigation with clean or sterile water or Ringer’s solution(pH 7.3-7.4)or its equivalent,of a

Sirolimus eye drops inhibit acute alkali-burn-induced corneal neovascularization by regulating VEGFR2 and caspase-3 expressions

Background:To investigate the effect of sirolimus(SRL)eye drops on acute alkali-burn-induced corneal neovascularization(CNV)and explore its possible mechanism.Methods:A total of 57 male Sprague-Dawley rats weighing 160-180 g were randomly divided into four groups including a normal control group(NC group,n=12),an untreated alkali-burned model control group(MC group,n=15),a blank eye drop treatment group(BT group,n=15),and an SRL eye drop treatment group(ST group,n=15).Corneal inflammation and CNV were observed and scored under a slit-lamp microscope 3,7,and 14 days after alkali exposure.Three rats were randomly sacrificed in each group before modeling and 3,7,14 days after modeling,and the corneas of right eyes were harvested for Western blotting to compare the expression levels of VEGFR2 and caspase-3.Results:Corneal inflammation scoring showed that the corneal edema and conjunctival congestion were severe in the MC,BT,and ST groups 1 day after alkali exposure but were alleviated at day 3.The corneal transparency was significantly higher in the ST group than in the MC and BT groups at days 7(F=9.77,P<0.05)and 14(F=5.81,P<0.05).At day 1,the corneal limbal vascular network was markedly filled.SNV was obvious at days 3,7,and 14.The new blood vessels were shorter and sparser in the ST group than in the MC and BT groups,and the CNV scores showed significant differences among these groups(day 3:F=8.60,P<0.05;day 7:F=11.40,P<0.05;and day 14:F=41.59,P<0.01).Western blotting showed that the expressions of VEGFR2 and caspase-3 were low before modeling and showed no significant difference among the different groups(F=0.52,P>0.05;F=0.98,P>0.05).The corneal expression of VEGFR2 became significantly higher in the MC and BT groups than in the ST group 3,7,and 14 days after alkali exposure,and there were significant differences in relative gray-scale values among these groups(day 3:F=32.16,P<0.01;day 7:F=85.96,P<0.01;day 14:F=57.68,P<0.01).The increase in the corneal expression of caspase-3 was significantly larger in the ST group than in the MC and BT groups at days 3,7,and 14,and there were significant differences in relative gray-scale values among groups(day 3:F=32.16,P<0.01;day 7:F=53.02,P<0.01;day 14:F=38.67,P<0.01).Conclusions:SRL eye drops can alleviate acute alkali-burn-induced corneal inflammation and inhibit alkali-burn-induced CNV in rat models.It can reduce VEGFR2 expression and increase caspase-3 expression in the corneal tissue,which may contribute to the inhibition of alkali-burn-induced CNV.

Technical Evaluation of Eye Drops Instillation： A Systematic Review

Objective： Assess the profile of eye drops in patients with eye diseases. Methods： Studies available in the scientific literature were identified without any time limits using the databases Embase-Medline, Scielo, Scopus and Web of Knowledge. The selected studies were compared with the following inclusion criteria： （i） if the study evaluated the eye drop instillation, （ii） if the study involved participation of patients with eye diseases. Results： Twelve studies met the inclusion criteria. Of them, 83.33% evaluated the technique of eye drop instillation in patients with glaucoma, 8.33% in patients with eye diseases and 8.33% in patients with cataract after undergoing surgery to correct. 41.66% of studies have chosen to record a video of patients to analyze the technique of instilling eye drops and 41.66% did not describe the/esearch location. Regarding the type of study, 75% had the design as prospective cross-sectional, 8.33% prospective open label study, 8.33% intervention study and 8.33% study called masked trial. Although studies evaluate the technique of eye drop instillation, only 8.33% describe in the article the reference in the literature used to evaluate patients. 50% of articles acknowledged some sort of bias or limitation. Conclusion： The limitations inherent in these types of studies should guide future research.

Effect of 0.01%atropine eyedrops on intraocular pressure in schoolchildren:a randomized clinical trial

·AIM:To assess the effect of 0.01%atropine eye drops on intraocular pressure(IOP)in myopic children.·METHODS:A placebo-controlled,double-masked,randomized study.Totally 220 children aged 6 to 12 y with myopia ranging from-1.00 to-6.00 D in both eyes were enrolled.Children were randomized in a 1:1 ratio to either 0.01%atropine eye drops or a placebo group using generated random numbers.All participants underwent the examination of IOP and cycloplegic refraction at baseline,6 and 12 mo.The change of IOP and the proportion of subjects with increased IOP in atropine and placebo groups were compared.·RESULTS:Of 220 children,117 were boys(53.2%).A total of 159(72.3%)participants completed the follow-up at the 1-year study.At baseline,the mean IOP was 15.74 mm Hg(95%CI,15.13 to 16.34 mm Hg)for the 0.01%atropine group and 15.59 mm Hg(95%CI,15.00 to 16.19 mm Hg)for placebo group(mean difference,0.14 mm Hg;P=0.743)after adjusting for central corneal thickness at baseline.At one year follow-up,the mean change of IOP was 0.16 mm Hg(95%CI,-0.43 to 0.76 mm Hg)for the 0.01%atropine group and-0.11 mm Hg(95%CI,-0.71 to 0.50 mm Hg)for placebo group(mean difference,0.27 mm Hg;P=0.525)after adjusting for central corneal thickness.The 51.4%of children have increased IOP in the 0.01%atropine group,compared with 45.9%in the placebo group(P=0.511).·CONCLUSION:The 0.01%atropine eye drops do not significantly affect the risk of elevated IOP.It is relatively safer to use in the studies that try to minimize myopia progression.However,a further long-duration study is required to be validated.

Effect of mistletoe combined with carboxymethyl cellulose on dry eye in postmenopausal women

AIM： To investigate the protective effect of mistletoe combined with carboxymethyl cellulose eye drops on dry eye in postmenopausal women.METHODS： Sixty postmenopause female patients diagnosed of dry eye were assigned randomly to mistletoe combined with carboxymethyl cellulose eye drops treatment group（n=30） and control group treated with normal saline eye drops（n=30）. The subjective symptoms of ocular surface, Ocular Surface Disease Index（OSDI）, tear film function tests, tear protein and corneal morphology by confocal scanning microscopy were analyzed before treatment and at 1, 2, 4 and 8 wk after treatment respectively. To ensure the safety of the trial, all patients were examined with systolic pressure, diastolic pressure, glutamic-pyruvic transaminase, glutamic oxaloacetic transaminase, urine creatinine, and blood urea nitrogen at 8 wk after treatment.RESULTS： There were no obvious differences between two groups before the treatment（P〉0.05）. In two months after the treatment, the symptoms of ocular surface, OSDI, tear protein, and tear film function were only slightly changed in normal saline eye drops group. However, all indices were improved after the treatment of mistletoe combined with carboxymethyl cellulose eye drops group（P〈0.05）. In addition, the average amount of corneal epithelium basal cells and inflammatory cells of mistletoe treated group were 3174±379 and 38±25 cells/mm2, significantly decreased as compared to the control group with 4309±612 and 158± 61 cells/mm2, respectively. In the control group, althoughnerves still maintained straight under corneal epithelium, the number of nerves were significantly decreased, as compared with normal female. In the mistletoe treated group, the number of nerves was only slightly reduced, compared with normal female.CONCLUSION： Mistletoe combined with carboxymethyl cellulose eye drops can alleviate the symptoms and signs of dry eye symptoms.

Effect of Cyclosporin a Eye Drop on Keratoconjunctivitis Sicca and Its Mechanism

In this study, the effect of cyclosporin A （CsA） eye drop on keratoconjunctivitis Sicca （KCS） and its mechanism were studied. The KCS models were established by injecting Pertussis vaccine, complete freund＇s adjuvant （CFA） and antigen of conjunctiva from isotype mice. Then the KCS models were treated with cyclosporin A eye drop. Changes in breaking-up time （BUT）, lacrimal secretion in 30 min and diversion in 24 h were measured. The percentage of beaker cells, the lymphocytic infiltration in conjunctiva were observed. The expression levels of Aquaporin-3 （AQP3） in conjunctiva epithelial cells, beaker cells and accessory lacrimal gland were immunohistochemically detected. The results showed that there were significant differences in BUT, the percentage of beaker cells, lacrimal secretion in 30 min, the lymphocytic infiltration and the expression of AQP3 between the experimental group and an control group. It was concluded.that CsA eye drop exerts marked therapeutic effect on KCS by inhibiting T lymph cells, increasing the goblet cells and AQP3 expression in conjunctiva.

Fungal corneal ulcer after repair of an overhanging filtering bleb:A case report

BACKGROUND Overhanging filtering bleb is a common complication after trabeculectomy and surgical repair is an effective treatment when the patient presents with apparent symptoms.Filtering bleb relevant infection including in the filtering bleb itself and even endophthalmitis in some severe cases has been reported.However,corneal fungal infection after filtering bleb repair is rarely reported.CASE SUMMARY A 57-year-old Chinese man who had sensations of redness and foreign body sensations in the left eye 3 wk after repair of overhanging filtering bleb.3 wk ago,due to sensations of a foreign body in the left eye for 3 years with worsening for 3 mo.The patient was diagnosed as overhanging filtering bleb and underwent a repair of overhanging filtering bleb.Postoperative,the filtering bleb formed well and the intraocular pressure is normal.But the patient gradually develop redness,pain and a grey infiltrate of the cornea in the eye.Finally it developed into fungal corneal ulcer.Through asking the medical history,we found the patient had irregularly self-medicated for years with glucocorticoid eye drops for years to relieve the foreign body sensation in the eye caused by filtering bleb overhanging.Because the glucocorticoid eye drops he used years ago had provide normal sensation to the eye.After 3 mo of anti-fungal treatment,the inflammation was controlled.CONCLUSION In addition to avoiding the development of overhanging filtering bleb after trabeculectomy,the present case report also suggests that clinicians should pay more attention to the patient’s ocular self-medication history.Particularly in patients with a history of glaucoma or eye surgery.Because these patients may be exposed to more types of eye drops than other individuals,they may select the wrong medi-cations for long-term use,based on their previous experience.

Remote-controlled dexamethasone-duration on eye-surface with a micelle-magnetic nanoparticulate co-delivery system for dry eye disease

Dexamethasone(DEX)is used to treat ocular surface diseases.However,regulating DEX duration in tears while preventing its absorption into the anterior chamber is critical for balancing its therapy effects and the side effects.In this study,a novel magnetic nanoparticle(MNP)-micelle(MC)codelivery system(MMDS)was developed.The MC moiety in the MMDS served as the carrier for DEX and the MNP part endowed the MMDS with magnetic-responsive properties.To extend its residency,the MMDS was magnetically attracted by an external magnet after instilling,which acted as a precorneal drug-depot enabling a sustainable release of DEX in tears.With combination of magnet treatment,the topical instillation of MMDS@DEX significantly prolonged the DEX-retention in tears and increased the DEX-concentration in the cornea and conjunctiva,as well as concurrently reduced the DEX-level in the aqueous humor,when compared with the commercial DEX eye drop treatment.The combination of MMDS@DEX and magnet treatment exerted significantly better therapeutic effects against DED with smaller side effects than conventional treatments including DEX suspension,commercial DEX eye drops,as well as the MMDS@DEX treatment alone.The present work provided a new method for the effective delivery of DEX to ocular surface tissues while reducing its side effects,which will be beneficial to the treatments of a wide range of ocular surface diseases.

Topical delivery of nerve growth factor for treatment of ocular and brain disorders

Neurotrophins are a family of proteins that support neuronal proliferation, survival, and differentiation in the central and peripheral nervous systems, and are regulators of neuronal plasticity. Nerve growth factor is one of the best-described neurotrophins and has advanced to clinical trials for treatment of ocular and brain diseases due to its trophic and regenerative properties. Prior trials over the past few decades have produced conflicting results, which have principally been ascribed to adverse effects of systemic nerve growth factor administration, together with poor penetrance of the blood-brain barrier that impairs drug delivery. Contrastingly, recent studies have revealed that topical ocular and intranasal nerve growth factor administration are safe and effective, suggesting that topical nerve growth factor delivery is a potential alternative to both systemic and invasive intracerebral delivery. The therapeutic effects of local nerve growth factor delivery have been extensively investigated for different ophthalmic diseases, including neurotrophic keratitis, glaucoma, retinitis pigmentosa, and dry eye disease. Further, promising pharmacologic effects were reported in an optic glioma model, which indicated that topically administered nerve growth factor diffused far beyond where it was topically applied. These findings support the therapeutic potential of delivering topical nerve growth factor preparations intranasally for acquired and degenerative brain disorders. Preliminary clinical findings in both traumatic and non-traumatic acquired brain injuries are encouraging, especially in pediatric patients, and clinical trials are ongoing. The present review will focus on the therapeutic effects of both ocular and intranasal nerve growth factor delivery for diseases of the brain and eye.

Effect of human autologous serum and fetal bovine serum on human corneal epithelial cell viability,migration and proliferation in vitro

AIM： To analyze the concentration-dependent effects of autologous serum （AS） and fetal bovine serum （FBS） on human corneal epithelial cell （HCEC） viability, migration and proliferation. METHODS： AS was prepared from 13 patients with non- healing epithelial defects Dulbecco＇s modified eagle medium/ Ham＇s F12 （DMEM/F12） with 5% FBS, 0.5% dimethyl sulphoxide （DMSO）, 10 ng/mL human epidermal growth factor, 1% insulin-transferrin-selenium, then were incubated in serum media： DMEM/F12 supplemented by 5%, 10%, 15% or 30% AS or FBS. HCEC viability was analyzed using cell proliferation kit XTI＇, migration using a wound healing assay, proliferation by the cell proliferation enzyme-linked immunosorbent assay （ELISA） BrdU kit. Statistical analysis was performed using the generalized linear model, the values at 30% AS or 30% FBS were used as the baselines. RESULTS： HCEC viability was the highest at 30% AS or 15% FBS and the lowest at 10% AS or 30% FBS application. HCEC migration was the quickest through 30% AS or 30% FBS and the slowest through 5% AS or 5% FBS concentrations. Proliferation was the most increased through 15% AS or 5% FBS and the least increased through 30% AS or 30% FBS concentrations. HCEC viability at 10% and 15% AS was significantly worse （P=0.001, P=0.023） compared to baseline and significantly better at 15% FBS （P=0.003） concentrations. HCEC migration was significantly worse （P〈0.007） and HCEC proliferation significantly better （P〈0.001） in all concentration groups compared to baseline. CONCLUSION： For the best viability of HCEC 30% AS or 15% FBS, for HCEC migration 30% AS or 30% FBS, for proliferation 15% AS or 5% FBS should be used. Therefore, we suggest the use of 30% AS in clinical practice.

In situ modifed screen printed and carbon paste ion selective electrodes for potentiometric determination of naphazoline hydrochloride in its formulation

The construction and performance characteristics of new sensitive and selective in situ modified screen printed （ISPE） and carbon paste （ICPE） electrodes for determination of naphazoline hydrochloride （NPZ-HC1） have been developed. The electrodes under investigation show potentiometric response for NPZ-HC1 in the concentration range from 7.0 x 10-7 to 1.0 x 10-2 M at 25 ~C and the electrode response is independent of pH in the range of 3.1-7.9. These sensors have slope values of 59.7＋0.6 and 59.2＋0.2 mV decade-l with detection limit values of 5.6 ~ 10-7 and 5.9 x 10-7 M NPZ- HC1 using ISPE and ICPE, respectively. These electrodes show fast response time of 4-7 s and 5-8 s and exhibits lifetimes of 28 and 30 days for ISPE and ICPE, respectively. Selectivity for NPZ-HC1 with respect to a number of interfering materials was also investigated. It was found that there is no interference from the investigated inorganic cations, anions, sugars and other pharmaceutical excipients. The proposed sensors were applied for the determination of NPZ-HC1 in pharmaceutical formulation using the direct potentiometric method. It showed a mean average recovery of 100.2% and 102.6% for ISPE and ICPE, respectively. The obtained results using the proposed sensors were in good agreement with those obtained using the official method. The proposed sensors show significantly high selectivity, response time, accuracy, precision, limit of detection （LOD）and limit of quantification （LOQ） compared with other proposed methods.

A cross-sectional study on compliance with topical glaucoma medication and its associated socioeconomic burden for a Chinese population

AIM： To estimate the overall drug compliance for local Chinese glaucoma patients on long-term topical treatment.METHODS： This was a retrospective cross-sectional study.Fifty-seven primary glaucoma patients from the subspecialty clinic of a publicly-funded tertiary care hospital in Hong Kong completed a questionnaire on compliance with topical glaucoma medication,attitude towards glaucoma and therapy and vision related quality of life.Noncompliance was defined as reporting missing more than or equal to 10% of the prescribed topical glaucoma medication during the 2wk immediately prior to the consultation.Relationships between noncompliance and demographics,attitude,disease and treatment status was studied.Cost was estimated with quality of life and direct medical cost involved with noncompliance.Multivariable logistic regression on noncompliance was performed on selected factors.RESULTS： Compliance was calculated as 75%（95% CI： 64%-87%） among 57 subjects（mean age 69 y,female 51%）.No statistical significant relationship was established between noncompliance and any single factors or outcomes.Age（P=0.048） and forgetfulness（P=0.064） were found to be marginally significant predictive factors on noncompliance in multivariable logistic regression.Noncompliance might be related（P=0.130） to poorer self-rated vision-associated quality of life.The societal cost of noncompliance was estimated to be over 2510 life-years and US$ 3.7 million territory-wide.CONCLUSION： The compliance of Chinese glaucoma patients in Hong Kong is comparable to other parts in the world,and carries detrimental impacts on individual and societal levels.Age and forgetfulness are two possible independent predictors for noncompliance.

Umbilical cord blood serum therapy for the management of persistent corneal epithelial defects

AIM:Toevaluatetheroleofumbilical cord blood serum(CBS) therapy in cases with persistent corneal epithelial defects(PED).METHODS:Sixteen eyes of 14 patients with PED who were resistant to conventional treatment were treated with 20% umbilical cord serum eye drops. Patients were followed-up weekly until epithelization was complete.The collected data included the grade of corneal lesion(Grade I: epithelial defect +superficial vascularization,Grade II: epithelial defect +stromal edema, Grade III:corneal ulcer +stromal melting), the size of epithelial defect(pretreatment, 7th, 14 thand 21stdays of treatment),and follow-up time was evaluated retrospectively.RESULTS:The mean size of epithelial defect on two perpendicular axes was 5.2×4.6-mm2(range: 2.5-8 mm×2.2-9 mm2). Mean duration of treatment was 8.3 ±5wk.CBS therapy was effective in 12 eyes(75%) and ineffective in 4 eyes(25%). The epithelial defects in 4ineffective eyes were healed with amniotic membrane transplantation and tarsorrhaphy. The rate of complete healing was 12.5% by 7d, 25% by 14 d, and 75% by 21 d.The healing time was prolonged in Grade III eyes in comparison to eyes in Grade I or Grade II.CONCLUSION:The results of the current study indicated the safety effectiveness of CBS drops in the management of PED. The grade of disease seems have a role on the healing time.

Preparation of bromfenac-loaded liposomes modified with chitosan for ophthalmic drug delivery and evaluation of physicochemical properties and drug release profile

The purpose of this study was to design a submicron-sized liposomal non-steroidal antiinflammatory drug(NSAID)preparation that targets the retina via topical instillation of eye drops.Bromfenac(BRF)-loaded liposomes were prepared using the calcium acetate gradient method.Liposome sizes and encapsulation efficiencies were optimized by screening several liposome formulations of lipid,drug concentration,and buffer solution.BRF entrapment efficiency was greater than 90%using this method,and was low using conventional hydration methods.High initial BRF loading using the pH gradient method caused aggregation of liposomes.To circumvent aggregation,the negatively charged lipid dicetylphosphate was incorporated into liposomes,which formed anion layer preventing coalescence.Release of BRF from liposomes was sustained for several hours depending on lipid concentration,inner water phase,initial drug amounts,and surface properties.Surface modification with chitosan(CS),a mucoadhesive cationic polymer,was achieved using electrostatic interactions of negatively charged liposomes.The optimal concentration of CS for evasion of liposome aggregation was 0.15%.

An overview of functional biolubricants

At present,more and more diseases are associated with the lubrication dysfunction,which requires a systematic study of the complex lubrication behavior of tissues and organs in human body.Natural biomacromolecular lubricants are essential for maintaining ultra-low coefficients of friction between sliding biological interfaces.However,when the surface lubrication performance of tissues or organs destroys heavily,it will bring friction/shear damage for sliding contact interfaces.Therefore,the application of exogenous biological lubricating materials to improve the lubrication situation of damaged tissue or organ interfaces has attracted extensive attention of researchers.In this review,based on a simple summary of lubrication mechanism at sliding biological interface,we systematically introduce the research progress of several kinds of representatively biolubrication materials,including eye drops,tissue anti-adhesion agents,joint lubricants,and medical device lubricants.Meanwhile,the lubrication mechanism and individual advantage and shortcoming for each of these synthetic exogenous lubricated materials are clarified.Correspondingly,the important lubrication application functionality of these biolubricant materials in typically medical surgery scenes,such as dry eye syndrome,tissue adhesion,arthritis,and interventional medical devices,is discussed.Finally,we look forward to the future development direction of artificial biolubricant materials.