A randomized,fellow eye,comparison of keratometry,aberrometry,tear film,axial length and the anterior chamber depth after eye rubbing in non-keratoconic eyes

Background:To investigate the effect of eye rubbing on keratometry(K),aberrometry,tear film break-up-time(TFBUT)and anterior chamber depth(ACD).Methods:Volunteers without any corneal pathology or dry eyes were randomised to rubbing in one eye and the fellow-eye was control.Eye rubbing was performed for 2 min.Primary outcomes studied were anterior and posterior K changes.Secondary outcomes were changes in TFBUT,axial length(AL)&ACD,K changes in various zones,asphericity and aberrometry.Pre and post rubbing K,aberrometry,ACD and TFBUT were assessed in a predetermined sequence.The relationship of the above parameters to axial length(AL)was also assessed.Astigmatism was analysed using vector analysis.Results:Pre versus post rubbing,anterior flatter K further flattened(42.51±1.52 D vs.42.36±1.53 D,p=0.003)and the changes to J0 vector in central cornea(−0.16±0.26 D vs.-0.27±0.33 D,p=0.038)suggested change to against-the-rule(ATR)astigmatism.There was significant change in Z^(+2)_(2) polynomial following rubbing.We found a positive correlation between axial length and change in posterior K(r=0.335,p=0.020).The TFBUT reduced following eye rubbing(15.3 s vs.13.9 s,p=0.0001).There was a positive correlation between AL and increase in ACD post rubbing(r=0.300,p=0.038).There was a positive correlation between ACD and change in mean posterior K(r=0.305,p=0.035).Conclusions:In healthy eyes,following eye rubbing,there is a significant change in TFBUT and central anterior K changes towards ATR astigmatism.Longer eyes had more changes in posterior K and ACD.Whereas,eyes with deeper ACD showed more steepness of posterior K.

Medium-term mortality after hip fractures and COVID-19:A prospective multicentre UK study

Purpose:The COVID-19 pandemic has caused 1.4 million deaths globally and is associated with a 3-4 times increase in 30-day mortality after a fragility hip fracture with concurrent COVID-19 infection.Typically,death from COVID-19 infection occurs between 15 and 22 days after the onset of symptoms,but this period can extend up to 8 weeks.This study aimed to assess the impact of concurrent COVID-19 infection on 120-day mortality after a fragility hip fracture.Methods:A multi-centre prospective study across 10 hospitals treating 8%of the annual burden of hip fractures in England between 1st March and 30th April,2020 was performed.Patients whose surgical treatment was payable through the National Health Service Best Practice Tariff mechanism for"fragility hip fractures"were included in the study.Patients'120-day mortality was assessed relative to their perioperative COVID-19 status.Statistical analysis was performed using SPSS version 27.Results:A total of 746 patients were included in this study,of which 87(11.7%)were COVID-19 positive.Mortality rates at 30-and 120-day were significantly higher for COVID-19 positive patients relative to COVID-19 negative patients(p<0.001).However,mortality rates between 31 and 120-day were not significantly different(p=0.107),16.1%and 9.4%respectively for COVID-19 positive and negative patients,odds ratio 1.855(95%CI 0.865-3.978).Conclusion:Hip fracture patients with concurrent COVID-19 infection,provided that they are alive at day-31 after injury,have no significant difference in 120-day mortality.Despite the growing awareness and concern of "long-COVID"and its widespread prevalence,this does not appear to increase mediumterm mortality rates after a hip fracture.