The Effect of Amniotic Membrane Extracted Eye Drop on Repairing The Corneal Epithelial in Patients after Trans-Epithelial Photorefractive Keratectomy: An Interventional and Historical Study.

OBJECTIVE: Recent studies imply extensive applications for the human amniotic membrane (hAM) and its extract in medicine and ophthalmology. The content of hAM meets many requirements in eye surgeries, such as refractive surgery as the most important and commonly used method for treating the dramatically increasing refractive errors. However, they are associated with complications such as corneal haziness and corneal ulcer. This study was designed to evaluate the impact of amniotic membrane extracted eye drop (AMEED) on Trans-PRK surgery complications. MATERIALS AND METHODS: This randomized controlled trial was performed during two years (July 1, 2019-September 1, 2020). Thirty-two patients (64 eyes), including 17 females and 15 males, aged 20 to 50 years (mean age of 29.59 ± 6.51) with spherical equivalent between -5 to -1.5 underwent Trans Epithelial Photorefractive Keratectomy (Trans-PRK) surgery. One eye was selected per case (case group) and the other eye was considered as control. Randomization was done using the random allocation rule. The case group was treated with AMEED, and the artificial tear drop every 4 hours. The control eyes received artificial tear drops instilled every 4 hours. The evaluation continued for three days after the Trans-PRK surgery. RESULTS: A significant decrease in CED size was found in the AMEED group on the second day after surgery (P=0.046). Also, this group had a substantial reduction in pain, hyperemia, and haziness. CONCLUSION: This study showed that AMEED drop can increase the healing rate of corneal epithelial lesions after Trans- PRK surgery and reduce the early and late complications of Trans-PRK surgery. Researchers and Ophthalmologists should consider AMEED as a selection in patients with persistent corneal epithelial defects and patients who have difficulty in corneal epithelial healing. We understood AMEED has a different effect on the cornea after surgery; therefore, the researcher must know AMEED's exact ingredients and help expand AMEED uses (registration number: TCTR20230306001).

Choroidal thickness changes following cataract surgery in patients with type 2 diabetes mellitus.

PURPOSE: To evaluate the choroidal thickness changes after cataract surgery in type 2 diabetic patients. METHODS: Three groups of patients were enrolled into this prospective study. Group A included diabetic patients without diabetic retinopathy (DR) or with mild non-proliferative diabetic retinopathy (NPDR) who underwent phacoemulsification, Group B included non-diabetic patients with significant cataract who underwent phacoemulsification, and Group C included diabetic patients without DR or with mild NPDR who followed up without surgical procedure. Choroidal thickness in 5 points (subfoveal and 500 µ temporal, nasal, superior and inferior to the fovea) and central macular thickness were measured before surgery using enhanced depth spectral domain optical coherence tomography. Patients were re-evaluated 1 week, 1 month, and 3 months after operation and compared with the baseline values. RESULTS: In total, 63 eyes from 63 patients were enrolled to this study, including 21 eyes in Group A, 22 eyes in Group B, and 20 eyes in Group C. After three months of follow-up of the patients, choroidal thickness in all measured points was decreased significantly, and central macular thickness was increased significantly following cataract surgery in diabetic eyes (Ggroup A); meanwhile, both choroidal thickness and central macular thickness were increased significantly in non-diabetic eyes (Group B). In Group C, choroidal thickness and central macular thickness had no significant changes, after three months. CONCLUSION: Unlike in non-diabetic eyes, choroidal thickness in diabetic patients decreased following cataract surgery.

Comparison among Ocular Response Analyzer, Corvis ST and Goldmann applanation tonometry in healthy children.

AIM: To explore the relationship between different parameters of Ocular Response Analyzer (ORA) and Corvis ST (CST) in a sample of healthy Iranian school-aged children and the relationship between parameters of these 2 instruments against intraocular pressure (IOP), measured by the Goldmann applanation tonometer (GAT-IOP), age and gender, and find possible correlation between ORA and CST with GAT. METHODS: This cross-sectional study included 90 healthy children. A general interview and complete eye examination were performed. Following successful GAT-IOP measurement, ORA and CST were conducted. The CST parameters were A 1/2 length (A1L, A2L), A 1/2 velocity (A1V, A2V), highest concavity deformation amplitude (HCDA), radius of curvature (RoC), peak distance (PD), central corneal thickness (CCT) and IOP. The ORA parameters were corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated IOP (IOP-G) and corneal compensated IOP (IOP-CC). Extracted data was analyzed using the Statistical Package for Social Science software. RESULTS: Totally 39 males with age of 9.08±1.60 (6-12)y and 51 females with age of 8.96±1.55 (6-13)y were included. Many CST parameters were significantly correlated with CH, CRF, IOP-G and IOP-CC. Some CST parameters had a significant correlation with GAT-IOP, including IOP-CST in both eyes and HCDA, A2L, PD, and RoC in the left eye, but none with age, except A2L in the right eye. The CRF measurement showed a significant correlation with GAT-IOP in both eyes and CH in the right eye, yet, none with age. Among all CST and ORA parameters, CCT-CST in both eyes and A1L in right eye had a significant correlation with gender, although this was a negligible negative correlation. Comparison of mean IOP values by different devices showed a significantly highest IOP overestimation by CST and lowest by IOP-CC compared with GAT. Also, IOP-G versus IOP-CST significantly had the lowest IOP overestimation among others. Overall, either low positive correlation or negligible correlation was found between IOP measurements by 3 instruments. CONCLUSION: The study finds the highest IOP overestimation by CST and lowest by IOP-CC compared with GAT. Overall, either low positive correlation or negligible correlation is found between IOP measurements by the 3 instruments.

Quantity and Quality of Vision Using Tinted Filters in Patients with Low Vision Due to Diabetic Retinopathy.

PURPOSE: To investigate the effect of tinted filters on visual acuity (VA), contrast sensitivity and patient satisfaction in diabetic retinopathy associated with low vision. METHODS: In a prospective study, 51 patients with diabetic retinopathy and low vision were assessed. We chose a simple random sampling method and used the patient's files for data collection. LogMAR notations were applied for assessing VA and a contrast sensitivity chart (CSV-1000) was employed for measuring contrast sensitivity. First, measurements were performed without tinted filters and then using them. Appropriate lenses were given to the patients for 2 days, and they were questioned about their satisfaction using them in different places. RESULTS: A total of 20 male and 31 female patients with mean age of 57.3 years participated in the study. With a 527 ± 10 nm filter, mean VA improved significantly (P ≤ 0.05). Using the 527 ± 10 nm and 511 ± 10 nm filters, mean contrast sensitivity was improved significantly at 3 and 6 cycles/degree frequencies (P < 0.05). The effect of other filters on VA and contrast sensitivity was not significant. Patient satisfaction rate was generally high. CONCLUSION: Tinted filters are able to rehabilitate low-vision patients due to diabetic retinopathy. The 527 ± 10 and 511 ± 10 nm wavelength filters improved contrast sensitivity and the 527 ± 10 nm filter improved VA to some extent. Further investigations are recommended to assess the effect of these filters in patients with other causes of low-vision.

Topical cyclosporine a for mustard gas induced ocular surface disorders.

PURPOSE: To evaluate the effectiveness of topical cyclosporine A 0.05% for treatment of mustard gas-induced ocular surface disorders with special attention to conjunctival goblet cell density in patients with severe dry eye. METHODS: This prospective clinical study included 20 eyes of 20 patients previously exposed to mustard gas with dry eye syndrome unresponsive to artificial tears. Before and after treatment with topical cyclosporine A 0.05% twice daily for 3 months, subjects were evaluated for improvement in symptoms using the ocular surface disease index (OSDI) and signs by tear breakup time (TBUT), Schirmer test and measurement of superior bulbar conjunctival goblet cell density. Limbal stem cell deficiency (LSCD) and the degree of corneal squamous cell metaplasia were also assessed before and after treatment. RESULTS: Before treatment, mean OSDI score, Schirmer test I value and mean TBUT were 42.8 ± 6.1, 4.2 ± 1.2 mm and 2.5 ± 1.3 s, respectively. After 3 months of treatment with topical cyclosporine A, these scores reached 36.4 ± 5.2, 5.8 ± 1.6 mm and 4.9 ± 2.1 s, respectively showing a statistically significant improvement (P < 0.001) in all parameters. Mean goblet cell density was 23.3 ± 17.1/high power field (hpf) at baseline which was significantly increased to 47.7 ± 16.1/hpf at the end of the study (P < 0.001). There was no improvement, however, in corneal conjunctivalization, LSCD and the degree of corneal squamous cell metaplasia based on impression cytology reports (P > 0.05). CONCLUSION: Treatment with topical cyclosporine A 0.05% in patients with severe dry eye due to mustard gas injury increases goblet cell density in the bulbar conjunctiva and improves symptoms of the disease.