Fatal outcome of severe fever with thrombocytopenia syndrome (SFTS) and severe and critical COVID-19 is associated with the hyperproduction of IL-10 and IL-6 and the low production of TGF-ß.

Severe fever with thrombocytopenia syndrome virus (SFTSV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause the hyperproduction of inflammatory cytokines, which have pathological effects in patient including severe or fatal cytokine storms. To characterize the effect of SFTSV and SARS-CoV-2 infection on the production of cytokines in severe fever with thrombocytopenia syndrome (SFTS) and COVID-19 patients, we performed an analysis of cytokines in SFTS and COVID-19 patients and also investigated the role of interleukin-10 (IL-10) in vitro studies: lipopolysaccharide-induced THP-1-derived macrophages, SFTSV infection of THP-1 cells, and SARS-CoV-2 infection of THP-1 cells. In this study, we found that levels of both IL-10 and IL-6 were significantly elevated, the level of transforming growth factor-ß (TGF-ß) was significantly decreased and IL-10 was elevated earlier than IL-6 in severe and critical COVID-19 and fatal SFTS patients, and inhibition of IL-10 signaling decreased the production of IL-6 and elevated that of TGF-ß. Therefore, the hyperproduction of IL-10 and IL-6 and the low production of TGF-ß have been linked to cytokine storm-induced mortality in fatal SFTS and severe and critically ill COVID-19 patients and that IL-10 can play an important role in the host immune response to severe and critical SARS-CoV-2 and fatal SFTSV infection.

Coinfection of Severe Fever With Thrombocytopenia Syndrome Virus and Coxiella burnetii in Developmental Stage of Hard Ticks in Subtropical Region of Korea.

BACKGROUND: Severe fever with thrombocytopenia syndrome virus (SFTSV) is transmitted through tick bites. Ticks are potential vectors for the bacterium Coxiella burnetii that causes Query fever. Here, we analyzed SFTSV and C. burnetii co-infection rates in ticks in rural areas of Jeju Island, South Korea. METHODS: Free ticks were collected from the natural environment of the island between 2016 and 2019, and SFTSV RNA was extracted. Additionally, ribosomal RNA gene sequencing was used to identify Coxiella species. RESULTS: Haemaphysalis longicornis was the most common tick species followed by H. flava. Tick number gradually increased from April, peaked in August, and was lowest in March. Of all the collected ticks, 82.6% (2,851/3,458) were nymphs, 17.9% (639/3,458) adults, and 0.1% (4/3,458) larvae. SFTSV-infected ticks comprised 12.6% of all ticks; their numbers were the lowest in November-December, increased from January, and were mostly identified in the adult stage during June-August. C. burnetii infections were detected in 4.4% of the SFTSV-infected H. longicornis ticks. C. burnetii co-infection was mainly observed in the nymph stage of H. longicornis, with the highest infection rate in January, followed by December and November. CONCLUSION: Our findings suggest that Jeju Island has a high SFTSV and potential C. burnetii infection in ticks. This study provides important insights regarding SFTS and Q fever risk to humans in South Korea.

Eyelid squinting improves near vision in against-the-rule and distance vision in with-the-rule astigmatism in pseudophakic eyes: an eye model experimental study.

BACKGROUND: To elucidate whether eyelid squinting improves near and distance vision in against-the-rule (ATR) and with-the-rule (WTR) simple myopic astigmatism in pseudophakic eyes. METHODS: A refraction-model eye was mounted on a wavefront analyzer. The eyelid fissure was simulated using a slit placed horizontally in front of the model eye. Four different refractive statuses [- 1.50 diopters (D) and - 3.00 D of both WTR and ATR simple myopic astigmatism] were set using cylindrical lenses. For each refractive status (emmetropia, - 1.50 D WTR, - 1.50 D ATR, - 3.00 D WTR, and - 3.00 D ATR astigmatism), wavefront aberrations were measured, both with and without the slit, 40 times each. RESULTS: The 2 mm horizontal slit caused a hyperopic focus shift (+ 6.69 µm) in - 1.50 D WTR astigmatism, whereas, in - 1.50 D ATR astigmatism, it caused a myopic focus shift (- 2.01 µm). The astigmatism was decreased in the ATR astigmatism groups and increased in the emmetropia and WTR astigmatism groups, respectively. Total aberrations were decreased in the emmetropia and WTR astigmatism groups and increased in the ATR astigmatism groups. When the reference plane was set to the near plane, total aberrations were decreased in the ATR astigmatism groups. CONCLUSION: As the horizontal slit was placed in front of the model eye, the focus moves nearer in ATR astigmatism and farther in WTR astigmatism. These effects of eyelid cause improvement of near vision of pseudophakic eyes with ATR astigmatism.

The effects of proinflammatory cytokines on the apoptosis of corneal endothelial cells following argon laser iridotomy.

The aim of this study was to evaluate the relationship between the expression of proinflammatory cytokines and the apoptosis of corneal endothelial cells after argon laser iridotomy (ALI). ALI was performed on each quadrant of the iris in the right eye of mice (ALI1 group). Left eyes were used as control group. The levels of interleukin (IL)-1ß, tumor necrosis factor (TNF)-α, transforming growth factor (TGF)-ß, and interferon (IFN)-γ in mice eyes were measured, and TUNEL staining was performed 12 h after ALI. Mice in the ALI-Dexa group were pretreated daily with an intraperitoneal injection of dexamethasone for 4 days before undergoing ALI and compared with mice without dexamethasone pretreatment (ALI2 group). Twelve corneas from six rabbits were incubated ex vivo with (n = 6) or without (n = 6) IL-1ß. TUNEL staining was performed 24 h after ex vivo incubation. In the mice experiment, the levels of IL-1ß, TNF-α, TGF-ß, and IFN-γ were increased in the ALI1 group compared to the control group. Although many TUNEL-positive cells were observed in the ALI1 group, those were not detected in the control group. Dexamethasone pretreatment inhibited the increase in the levels of all four proinflammatory cytokines and reduced TUNEL-positive cells. In the rabbit experiment, TUNEL-positive cells were increased in the incubated corneas with IL-1ß compared to those without IL-1ß. Expression of proinflammatory cytokines following ALI seems to play a role in the apoptosis of corneal endothelial cells after ALI. Dexamethasone pretreatment inhibited increases in proinflammatory cytokines and reduced the apoptosis of corneal endothelial cells.

The effect of posterior corneal flat meridian and astigmatism amount on the total corneal astigmatism estimated from anterior corneal measurements.

BACKGROUND: To evaluate the effects of posterior corneal astigmatism and the absolute flat meridian difference between anterior and posterior corneal surfaces (AMDAnt-Post) on the estimation of total corneal astigmatism using anterior corneal measurements (simulated keratometry [K]). METHODS: Ninety-nine eyes of 99 healthy participants were enrolled. Anterior, posterior, and total mean corneal power, cylinder power, flat meridian, and vector components J0, and J45 measured by a dual Scheimpflug camera were analyzed. The correlation between the posterior corneal cylinder power, AMDAnt-Post, and the difference in the cylinder power between simulated K and total cornea (cylinder power differenceSimK-Tot) were evaluated. RESULTS: The cylinder power differenceSimK-Tot was positively correlated with the posterior corneal cylinder power (rho = 0.704 and P < 0.001) and negatively correlated with AMDAnt-Post (rho = -0.717 and P < 0.001). In the multivariate linear regression analysis, anterior corneal J0 was strongly associated with the posterior corneal cylinder power and the AMDAnt-Post. When corneal J0 had a positive value, the cylinder power of simulated K tended to be larger than the total corneal cylinder power. In comparison, the opposite trend was presented in eyes with negative anterior corneal J0. When anterior corneal J0 was larger than 1.0 or smaller than -0.9, the errors from estimating the total corneal cylinder power using anterior corneal measurements tended to be larger than 0.25 D. CONCLUSION: Posterior corneal astigmatism should be considered for more accurate corneal astigmatism predictions, especially in eyes with anterior corneal astigmatism greater than 2.0 D of with-the-rule astigmatism or greater than 1.8 D of against-the-rule astigmatism.

Use of corneal power-specific constants to improve the accuracy of the SRK/T formula.

PURPOSE: To evaluate the effect of average corneal power (K) and axial length (AL) in a data-adjusted A-constant for improving the refractive outcome in the Sanders-Retzlaff-Kraff (SRK)/T formula. DESIGN: Retrospective, consecutive, case series. PARTICIPANTS: A total of 637 patients (637 eyes) who underwent uncomplicated phacoemulsification with implantation of the Acrysof IQ (IQ; Alcon, Fort Worth, TX; 314 eyes) or Akreos AO (AO; Bausch & Lomb, Rochester, NY; 323 eyes) intraocular lens (IOL) by a single surgeon. METHODS: The correlation among the K, AL, and predicted refractive error in the SRK/T formula was analyzed. Patients were divided into 2 subgroups, the first to calculate the different data-adjusted A-constants based on the K and the second to compare the median absolute error (MedAE) based on different A-constants with the traditional A-constant in the SRK/T formula. MAIN OUTCOME MEASURES: The data-adjusted A-constant and the MedAE (diopters [D]). RESULTS: The data-adjusted A-constant showed a decreasing trend as K increased. The data-adjusted A-constant was 119.04 in the IQ group and 118.27 in the AO group. The calculated A-constant was 119.33 in the IQ group and 118.57 in the AO group when the cornea was flatter than 43.0 D and 43.2 D, respectively. The A-constant was 118.71 in the IQ group and 117.96 in the AO group when the cornea was steeper than or equal to 44.7 D and 45.0 D, respectively. The MedAE decreased from 0.29 D to 0.23 D in the IQ group (P = 0.001) and from 0.44 D to 0.38 D in the AO group (P < 0.001) when different A-constants were used. The MedAE further decreased from 0.36 D to 0.24 D in the IQ group (P = 0.005) and from 0.58 D to 0.37 D in the AO group (P < 0.001) when subjects with K 1.00 D or more above or 1.00 D below the most accurate K in each group were compared. CONCLUSIONS: For a steep cornea, the calculated A-constant was smaller than that of the entire K, but for a flat cornea, a larger A-constant was calculated. Using different A-constants based on the K improved the refraction outcomes relying on the SRK/T formula.

Inactivation of foodborne pathogens in ground pork tenderloin using 915 MHz microwave heating depending on power level.

The main purpose of this research was to investigate the effect of power level of 915 MHz microwave heating on the inactivation of foodborne pathogens in ground pork and its bactericidal mechanism. It was demonstrated that the heating rate was proportional to the power level. For instance, the heating rates observed at microwave heating powers of 2, 3, 4, and 5 kW were 1.70, 2.77, 3.35, and 4.03℃/s, respectively. The bactericidal effect of microwave heating also significantly (P < 0.05) increased with increasing power level. In particular, when ground pork was subjected to microwave heating at 5 kW, the reduction level of pathogens was>2 log units higher than at 2 kW. To determine the bactericidal mechanism of microwave heating depending on power level, changes in transmembrane potential and DNA damage were determined using fluorescence. The extent of depolarization in membrane potential of pathogens significantly (P < 0.05) increased as power level increased. There was no significant difference in degree of DNA damage at different power levels. However, the percentage of DNA damage was>86% at all power levels. The transmembrane potential assay indicates that the bacteria exhibited dramatic pore formation on the membrane at 5 kW. Through transmission electron microscopy, the electroporation effect was enhanced as power level increased. Moreover, the quality of ground pork subjected to microwave heating at 2-5 kW was determined by measuring the moisture content, cooking loss, and texture profile.

Serological Evidence of Severe Fever with Thrombocytopenia Syndrome Virus and IgM Positivity Were Identified in Healthy Residents in Vietnam.

Severe fever with thrombocytopenia syndrome (SFTS), an emerging tick-borne viral disease, is prevalent in East Asia and has also been reported in Southeast Asia since 2019. SFTS patients in Vietnam were first reported in 2019. However, the seroprevalence of severe fever with thrombocytopenia syndrome virus (SFTSV) in Vietnam has not been reported. To investigate the seroprevalence of SFTSV in Vietnam, we collected serum samples from 714 healthy residents in Thua Thien Hue and Quang Nam Province, Vietnam, and the seroprevalence of SFTSV was assessed using immunofluorescence antibody assay (IFA), Enzyme-Linked Immunosorbent Assays (ELISAs) and the 50% focus reduction neutralization test (FRNT50) assay. The seroprevalence of anti-SFTSV IgM or IgG was observed to be 3.64% (26/714), high IgM positivity was >80 (0.28%, 2/714) and the titer of neutralizing antibodies against SFTSV ranged from 15.5 to 55.9. In Pakistan, SFTSV infection confirmed using a microneutralization test (MNT) assay (prevalence is 2.5%) and ELISAs showed a high seroprevalence (46.7%) of SFTSV. Hence, the seroprevalence rate in Vietnam is similar to that in Pakistan and the number of SFTS patients could increase in Vietnam.

New axis-marking method for a toric intraocular lens: mapping method.

PURPOSE: A new axis-marking method, the mapping method, for toric intraocular lens (IOL) implantation is described, and its accuracy is compared with that of conventional methods. METHODS: For toric IOL implantation, the steepest corneal axis was determined by IOLMaster optical biometer measurement (Carl Zeiss Meditec). Three marking methods for accurate alignment of the IOL astigmatism axis to the steepest corneal axis were evaluated and compared. For method 1, the patient was seated at the surgical table and instructed to gaze at a distant target. Using a toric reference marker, the corneal limbus was marked at the 3-, 6-, and 9-o'clock positions. The goal axis was also marked using a toric axis marker. Method 2 used a horizontal slit beam for reference marking points at 3 and 9 o'clock. Method 3 was the new mapping method, in which an anterior segment photograph was used to identify several reference vessel points and axis marking points and to calculate actual lengths from the reference vessel points to the axis marking points. During surgery, the axis marking points were marked on the limbus of the eye using calipers. The accuracy of the three axis-marking methods was evaluated using anterior segment photographs. RESULTS: With method 1, the average axis-marking error was 3.69±1.49°. With method 2, the average axis-marking error was 3.14±1.64°. With method 3, the new mapping method, the average axis-marking error was 2.29±1.06°. The new mapping method was more accurate than methods 1 and 2 (P<.01 and P=.016, respectively, paired t test). Axis-marking errors of the two conventional methods were not significantly different (P=.061). CONCLUSIONS: The new axis-marking method, which uses distinct conjunctival vessels as a reference point, showed less axis-marking error compared to the conventional methods examined in this study.

Anterior stromal puncture for treatment of contact lens-intolerant keratoconus patients.

PURPOSE: To report the results and effectiveness of anterior stromal puncture for contact lens-intolerant keratoconus patients with subepithelial fibrotic nodules. METHODS: Nine eyes of nine keratoconus patients who were rigid gas-permeable contact lenses (RGP)-intolerant due to subepithelial nodular scars were included in this study. The nine patients were enrolled in the study between March 2008 and December 2008. After confirming nodular elevation from slit-lamp biomicroscopy, the area where the epithelium of nodular scars had sloughed was punctured by anterior stromal puncture using a 26-gauge needle attached to a 1-ml syringe under slit-lamp biomicroscopy. The RGPs of all patients were refitted around 4 weeks after the puncture. RESULTS: Five of the nine patients were male, and the average patient age was 29.6 years (SD ± 5.22 years). Mean follow-up time was 13.7 months (SD ± 4.8 months), and the epithelial defect healed in 1.4 days on average. After the puncture, four of nine patients presented with a recurrent erosion of the nodule during follow-up and needed a second puncture. All the patients showed good contact lens tolerance and satisfactory contact lens fit. No complications such as corneal perforation or keratitis developed. CONCLUSIONS: Anterior stromal puncture using a 26-gauge needle can be a successful and effective method to induce corneal epithelium and Bowman's layer reattachment. It can be used as an outpatient procedure to improve RGP tolerance in patients with keratoconus with elevated subepithelial nodules.

Design of a Novel Theranostic Nanomedicine (III): Synthesis and Physicochemical Properties of Tumor-Targeting Cisplatin Conjugated to a Hydrophilic Polyphosphazene.

PURPOSE: A new theranostic nanomedicine involving anticancer-active cisplatin moiety was designed to study its tumor-targeting properties as well as its drug efficacy and toxicity. METHODS: A cisplatin carrier polymer was prepared by grafting equimolar polyethylene glycol of a molecular weight of 550 (PEG550) and aminoethanol to the poly(dichlorophosphazene) backbone. Cisplatin was conjugated to the carrier polymer using cis-aconitic acid as a linker. RESULTS: The cisplatin-loaded polyphosphazene, named "Polycisplatin" was found to be amphiphilic in aqueous solution and self-assembled into nanoparticles with an average particle size of 18.6 nm in diameter. The time-dependent organ distribution study of Cy5.5-labeled Polycisplatin in the A549-tumor-bearing mice exhibited a high tumor selectivity of Polycisplatin by EPR effect despite the relatively small particle size. In order to compare the in vivo efficacy of Polycisplatin and cisplatin, their xenograft trials were performed using nude mice against the human gastric cell line MKN-28. Polycisplatin exhibited slightly less tumor suppression effect compared with cisplatin at the same dose of 1.95 mg Pt/kg, which is the maximum tolerate dose of cisplatin, but at the higher double dose of 3.9 mg Pt/kg, Polycisplatin exhibited a little better efficacy than cisplatin. Furthermore, mice treated with cisplatin at the dose of 1.95 mg Pt/kg exhibited severe body weight decrease by about 25%, while mice treated with Polycisplatin did not show serious body weight decrease even at its double dose of 3.9 mg Pt/kg. Furthermore, kidney indicators including kidney index, BUN, and creatinine values measured displayed that Polycisplatin is much less nephrotoxic than cisplatin. CONCLUSION: Nanoparticular Polycisplatin was successfully prepared by conjugating cisplatin to a hydrophilic polyphosphazene carrier polymer using the acid-cleavable cis-aconitic acid. Polycisplatin nanoparticles exhibit excellent tumor-targeting properties by EPR effect. The xenograft trials exhibited excellent antitumor efficacy and reduced systemic toxicity of Polycisplatin.

Endothelin-1 Augments Therapeutic Potency of Human Mesenchymal Stem Cells via CDH2 and VEGF Signaling.

In our previous study, we identified differences in the levels of CDH2 and vascular endothelial growth factor (VEGF) between effective and ineffective clones of human umbilical cord blood (hUCB) mesenchymal stem cells (MSCs), with regard to the infarcted rat myocardium. In this study, we compared gene expression profiles between the effective and ineffective clones and identified that endothelin-1 (EDN1) is enriched in the effective clone. In the mechanistic analyses, EDN1 significantly increased expression of CDH2 and VEGF through endothelin receptor A (EDNRA), which was prevented by EDNRA blocker, BQ123. To decipher how EDN1 induced gene expression of CDH2, we performed a promoter activity assay and identified GATA2 and MZF1 as inducers of CDH2. EDN1 significantly enhanced the promoter activity of the CDH2 gene, which was obliterated by the deletion or point mutation at GATA2 or MZF1 binding sequence. Next, therapeutic efficacy of EDN1-priming of hUCB-MSCs was tested in a rat myocardial infarction (MI) model. EDN1-primed MSCs were superior to naive MSCs at 8 weeks after MI in improving myocardial contractility (p < 0.05), reducing fibrosis area (p < 0.05), increasing engraftment efficiency (p < 0.05), and improving capillary density (p < 0.05). In conclusion, EDN1 induces CDH2 and VEGF expression in hUCB-MSCs, leading to the improved therapeutic efficacy in rat MI, suggesting that EDN1 is a potential priming agent for MSCs in regenerative medicine.

Glistening Formation on a Single-Piece Prehydrated Hydrophobic Acrylic Intraocular Lens in a Diabetic Patient.

PURPOSE: To report a case of intraocular lens (IOL) glistening after uneventful cataract surgery and in-the-bag implantation of an enVista MX60 IOL (Bausch & Lomb, Rochester, NY) in a patient with uncontrolled diabetes mellitus. METHODS: Case report. RESULTS: A 76-year-old woman with non-insulin-dependent diabetes mellitus underwent uncomplicated phacoemulsification with in-the-bag implantation of an enVista MX60 IOL. After 6 months, glistening formation within the IOL optic was observed. In the fellow pseudophakic eye, an acrylic hydrophilic Akreos Adapt AO IOL (Bausch & Lomb) was implanted without complications. CONCLUSIONS: IOL glistening can develop with the enVista MX60 IOL, even after uneventful cataract surgeries in certain situations (eg, uncontrolled diabetes mellitus). Increased vascular permeability due to uncontrolled diabetes mellitus might have been responsible for the postoperative IOL glistening formation. [J Refract Surg. 2016;32(10):710-712.].

Effect of effective lens position on cylinder power of toric intraocular lenses.

OBJECTIVE: To evaluate the effects of effective lens position (ELP) on the corneal plane effective cylinder power of toric intraocular lenses (IOLs). DESIGN: Retrospective cross-sectional study. PARTICIPANTS: Ninety-four eyes from 78 patients who underwent uncomplicated phacoemulsification with implantation of an AcrySof toric IOL (1.50- to 3.00-D cylinder). METHODS: The amount of corneal plane effective cylinder power of toric IOLs given by the manufacturer (target-induced astigmatism vector [TIA]) was compared with the postoperatively achieved cylindrical correction (surgically induced astigmatism vector [SIA]). The theoretical corneal plane cylinder power of toric IOLs was calculated according to ELP and corneal power using a refractive vergence formula. RESULTS: The TIA (1.59 ± 0.43 D) was significantly smaller than the SIA (1.78 ± 0.65 D; p < 0.001). The difference between the magnitudes of SIA and TIA demonstrated a significant negative correlation with ELP (r = -0.219 and p = 0.034). The theoretical corneal plane cylinder power of toric IOLs demonstrated a decreasing trend as the ELP and corneal power increased. The range of changes in corneal plane effective cylinder power according to ELP and corneal power was greater in toric IOLs with high toricity. CONCLUSIONS: The cylinder power of AcrySof toric IOLs should be adjusted according to ELP. For eyes with small ELP, the cylinder power should be reduced, and for eyes with large ELP, the cylinder power should be increased. The amount of reducing or increasing cylinder power of toric IOLs should be increased as the toricity increases.

Toric Intraocular Lens Calculations Using Ratio of Anterior to Posterior Corneal Cylinder Power.

PURPOSE: To evaluate the accuracy of toric intraocular lens (IOL) calculation using estimated total corneal astigmatism based on the anterior-to-posterior corneal cylinder power ratio according to the axis orientation of anterior corneal astigmatism. DESIGN: Retrospective cross-sectional study. METHODS: Nine hundred twenty-eight eyes of 928 reference subjects and 20 cataract patients (20 eyes) implanted with a toric IOL were enrolled. Linear regression analysis parameters (ß0 and ß1) of relationship between the simulated keratometry cylinder (CylSimK) and posterior corneal cylinder power of reference subjects were used to calculate the estimated posterior corneal astigmatism (-[ß1 × CylSimK + ß0] @ 90). When regression analysis was not significant, estimated posterior corneal astigmatism was defined as the negative value of the mean posterior corneal cylinder power @ 90. Estimated total corneal astigmatism was defined as the vectorial sum of anterior corneal astigmatism and estimated posterior corneal astigmatism. Residual astigmatism error, predicted using SimK, was compared with that predicted using estimated total corneal astigmatism. RESULTS: Estimated posterior corneal astigmatism was determined to be -(0.15 × CylSimK + 0.22) @ 90 in eyes with with-the-rule astigmatism, -(0.05 × CylSimK + 0.27) @ 90 in oblique astigmatism, and -0.27 @ 90 in against-the-rule astigmatism. The median magnitude of the predicted residual astigmatism error calculated using estimated total corneal astigmatism (0.30 cylinder diopters) was significantly smaller than that calculated with SimK (0.50 cylinder diopters). CONCLUSIONS: Toric IOL calculations using estimated total corneal astigmatism based on the anterior-to-posterior corneal cylinder power ratio provided a more appropriate toric IOL cylinder power than calculations using SimK astigmatism.

Comparison of Hoffer Q and Haigis formulae for intraocular lens power calculation according to the anterior chamber depth in short eyes.

PURPOSE: To compare the accuracy of the Hoffer Q and Haigis formulae according to the anterior chamber depth (ACD) in cases of short axial length (AL). DESIGN: Retrospective cross-sectional study. METHODS: A total of 75 eyes from 75 patients with an AL of less than 22.0 mm implanted with an Acrysof IQ intraocular lens (IOL) were enrolled. The median absolute errors (MedAEs) predicted by the Hoffer Q and Haigis formulae were compared. The correlations between ACD and the predicted refractive error calculated using the 2 formulae were analyzed. RESULTS: There were no significant differences in the MedAEs predicted by the Hoffer Q and Haigis formulae (0.40 and 0.40 diopter [D], respectively). The difference between the refractive errors predicted by the Hoffer Q and Haigis formulae increased significantly as the ACD decreased (R(2) = 0.644, P < .001). The MedAE predicted by the Haigis formula (0.40 D) was significantly smaller than that predicted by the Hoffer Q formula (0.66 D) in eyes with an ACD of less than 2.40 mm (P = .027). There were no significant differences found between the MedAEs predicted by the Hoffer Q and Haigis formulae in eyes with an ACD of 2.40 mm or more. CONCLUSIONS: The differences between the predicted refractive errors of the Hoffer Q and Haigis formula increased as ACD decreased in short eyes. Therefore, ACD should be taken into consideration when evaluating the accuracy of the IOL power calculation formulae in short eyes.

Comparison of meibomian gland loss and expressed meibum grade between the upper and lower eyelids in patients with obstructive meibomian gland dysfunction.

PURPOSE: The aim of this study was to compare meibomian gland loss (MGL) and expressed meibum grade between upper and lower eyelids in patients with obstructive meibomian gland dysfunction (MGD) and to evaluate the correlation between these 2 parameters and other clinical measurements. METHODS: Twenty-six eyes of 26 patients with obstructive MGD were enrolled. Upper and lower MGLs were evaluated using noncontact meibography. Expressed meibum quality was assessed in 8 glands of the central third area of the upper and lower eyelids on a scale of 0 to 3 for each gland (total score range, 0-24). Tear film stability was evaluated based on tear break-up time (TBUT), and corneal staining was graded according to the National Eye Institute scale (range, 0-15). RESULTS: The mean MGL in the lower eyelids (24.1% ± 10.8%) was significantly greater than that of the upper eyelids (11.2% ± 5.2%) (P < 0.001). The mean expressed meibum grade in the lower eyelids (16.5 ± 5.1) was also significantly larger than that of the upper eyelids (11.2 ± 5.2) (P < 0.001). MGL was significantly correlated with expressed meibum grade in both eyelids (r = 0.451, P = 0.021 in the upper eyelids; r = 0.626, P = 0.001 in the lower eyelids). The meibum grades of both the upper and lower eyelids were negatively correlated with TBUT and positively correlated with corneal staining score. However, the MGL in both the eyelids was not correlated with TBUT or with corneal staining score. CONCLUSIONS: In patients with obstructive MGD, MGL and meibum grade in the lower eyelids were significantly greater than those of the upper eyelids. Although MGL and meibum quality showed a positive correlation with each other, TBUT and corneal staining score were significantly correlated with only meibum grade, and not with MGL.

A simple method to shorten the unfolding time of prehydrated hydrophobic intraocular lens.

OBJECTIVE: To evaluate the effect of warm ophthalmic viscosurgical devices (OVDs) on the unfolding time of prehydrated hydrophobic acrylic intraocular lenses (IOLs). DESIGN: Experimental study and human trial. PARTICIPANTS: Three foldable hydrophobic acrylic IOLs (enVista MX60, AcrySof SN60AT, and Tecnis 1 ZCB00). METHODS: The unfolding times of 3 kinds of IOLs were measured according to temperature from 26°C to 32°C in a transparent container filled with a mixture of OVDs and balanced salt solution. The unfolding time of each IOL was measured 4 times for each temperature. Unfolding time was defined as the time required for the folded IOL to recover ≥ 90% of its overall optic diameter before folding. In human trials, the unfolding time of the MX60 in a capsular bag filled with 30°C OVDs was compared with that filled with room temperature OVDs for 4 cases in each group. RESULTS: The unfolding time of the MX60 (215 ± 25 seconds) was significantly longer than that of the SN60AT (28 ± 7 seconds) and the ZCB00 (29 ± 7 seconds) at 26°C (p = 0.013). However, there were no differences in the unfolding time of 3 IOLs at 32°C. In human trials, the unfolding time of the MX60 was shorter in a capsular bag filled with 30°C OVDs (32 ± 13 seconds) than if filled with OVDs kept at room temperature (127 ± 27 seconds; p = 0.029). CONCLUSIONS: When fast and complete unfolding characteristics are needed, filling the anterior chamber and capsular bag with OVDs warmed to 30°C before IOL implantation is recommended.

Correlation between quantitative measurements of tear film lipid layer thickness and meibomian gland loss in patients with obstructive meibomian gland dysfunction and normal controls.

PURPOSE: To evaluate the correlation between tear film lipid layer thickness and other objective measurements such as tear film break-up time (TBUT), upper and lower meibomian gland losses, and Schirmer 1 test in patients with obstructive meibomian gland dysfunction (MGD) and normal controls. DESIGN: Cross-sectional study. METHODS: Thirty eyes of 30 patients with obstructive MGD and 25 eyes of 25 normal controls were enrolled. Lipid layer thickness was measured using an interferometer. Tear film stability and tear production were evaluated by TBUT and Schirmer 1 test. Upper and lower meibomian gland losses were evaluated using noncontact meibography. The correlations among variables were evaluated in the obstructive MGD group and the control group. RESULTS: TBUT was significantly shorter in the obstructive MGD group than in the control group (P < .001). Upper and lower meibomian gland losses were higher in the obstructive MGD group than in the control group (P < .001 and P < .001, respectively), and lipid layer thickness was significantly thicker in the control group than in the obstructive MGD group (P = .028). Lipid layer thickness was significantly negatively correlated with upper and lower meibomian gland losses in both groups. CONCLUSIONS: Lipid layer thickness objectively measured with the interferometer was significantly thicker in the control group than in the obstructive MGD group. Lipid layer thickness was negatively correlated with upper and lower meibomian gland losses in the control group as well as in the obstructive MGD group.

Traumatic aniridia through opposite clear corneal incision in a pseudophakic eye.

A 56-year-old man complaining of decreased visual acuity in his left eye visited the emergency room 1 hour after blunt trauma. Slitlamp examination showed no visible iris tissue. The corneal wound at 5 o'clock was sharp, and Seidel was negative. In the right eye, there was a main clear corneal incision (CCI) at 11 o'clock and an opposite CCI (OCCI) to correct corneal astigmatism at 5 o'clock in the left eye. Anterior chamber inflammation and hyphema resolved 4 weeks after the trauma. The intraocular lens and capsular bag were intact, and the corrected distance visual acuity returned to 20/25. To our knowledge, this is the first report of traumatic iris expulsion through a 3.0 mm OCCI. An OCCI may seal better than a main CCI, which is used in cataract surgery, because the OCCI is not used during the cataract procedure. However, surgeons should be aware of the risk for postoperative wound dehiscence associated with the OCCI.