Case Commentary: When Voldemort Meets Sauron: Treatment Considerations for Emerging Dual-Carbapenemase-Producing Extensively Drug-Resistant Pseudomonas aeruginosa.

Infections caused by extensively drug-resistant Pseudomonas aeruginosa are difficult to treat due to limited effective treatment options. In this issue, a patient with a corneal infection caused by a Verona integron-encoded metallo-ß-lactamase (VIM)- and Guiana extended-spectrum ß-lactamase (GES)-coproducing P. aeruginosa strain associated with the recent artificial tears-related outbreak in the United States is described. This resistance genotype/phenotype further compromises therapeutic options, and this report provides insights into diagnostic and treatment approaches for clinicians dealing with infections due to this highly resistant P. aeruginosa.

Effects of electroacupuncture on dry eye: A pilot randomized controlled trial.

PURPOSE: The purpose of the study was to assess the efficacy of electroacupuncture on dry eye (DE). METHODS: Eighty-four DE patients were randomly assigned to receive electroacupuncture (EAG) three times a week or 0.1% sodium hyaluronate artificial tears (ATG) four times per day for 4 weeks. The primary outcomes were non-invasive tear film breakup time (NIBUT) and tear meniscus height (TMH). The secondary outcomes included the ocular surface disease index (OSDI), Schirmer I test (SIT), corneal sodium fluorescein staining (CFS) score, corneal topography descriptors surface asymmetry index (SAI) and surface regularity index (SRI), corneal sensitivity, 36-item Short-form Health Survey (SF-36) score and Hospital Anxiety and Depression Scale (HADS) score. All outcomes were assessed at Week 0 (baseline), Week 4 (after-treatment) and Week 8 (follow-up). RESULTS: Between-group comparisons showed significant differences in the changes in NIBUT (Week 4, p = 0.003; Week 8, p = 0.008), TMH (Week 4, p = 0.014; Week 8, p = 0.009), OSDI (Week 4, p = 0.029; Week 8, p = 0.022), CFS score (Week 8, p = 0.036) and SF-36 role-physical score (Week 4, p = 0.010), favouring EAG. Mean changes in SIT, SAI, SRI, corneal sensitivity and HADS scores were statistically equal between the two groups (all p > 0.05). Treatment with electroacupuncture was well-tolerated and showed minimal adverse events. CONCLUSIONS: Compared with artificial tears, electroacupuncture shows superior efficacy in improving tear film stability and symptoms of DE.

Effectiveness of acupuncture at acupoint BL1 (Jingming) in comparison with artificial tears for moderate to severe dry eye disease: a randomized controlled trial.

BACKGROUND: The global incidence of dry eye disease (DED) is very high. DED seriously affects the quality of life of patients; however, the current curative effect of medicine for moderate to severe DED is poor. This randomized clinical trial was planned to investigate the effect of acupuncture compared with artificial tears (AT) on moderate to severe DED. METHODS: A randomized clinical trial was performed at 2 hospitals in China. 120 DED patients were randomly equally divided into an acupuncture and an artificial tear group. Either acupuncture or artificial tears was performed for an 8-week period, and a 24-week follow-up was performed. The primary outcome measure was the Schirmer-I test (SIT) change from baseline. The secondary outcome measures included the numerical rating scale (NRS) change from baseline for improvement in ocular symptoms, the ocular surface disease index (OSDI), the tear-film break-up time (TBUT), corneal fluorescein staining (CFS), and acupuncture acceptability. Adverse events also were monitored and documented. RESULTS: For the primary outcome, the mean changes from baseline in the SIT values were significantly different between the acupuncture (5.75 [2.53-9.75]) and AT (0.52 [- 1.18-2.46]) groups at week 8 with a between difference of 5.23 (P < 0.05). Between-group differences of 8.49 in OSDI score change from baseline differed significantly at week 8 (P < 0.05). However, between-group differences of the changes in the average symptom NRS score, TBUT, and CFS did not differ significantly at week 8. Five cases experienced acupuncture-related adverse events. CONCLUSIONS: This randomized clinical trial found that acupuncture at BL1 significantly promoted tear secretion. Acupuncture showed greater benefits than AT for moderate to severe DED. However, the study findings warrant verification. TRIAL REGISTRATION: Registration number: ChiCTR1800015831. Name of trial registry: Efficacy and safety of acupuncture in the treatment of moderate to severe dry eye disease: a randomized controlled trial. Registered on 23 April 2018 ( https://clinicaltrials.gov/ ).

[Acupuncture and moxibustion treatment for dry eye disease: a network Meta-analysis of rando-mized controlled trial].

OBJECTIVE: A network Meta-analysis based on Bayesian theory was used to evaluate efficacy and safety of acupuncture and moxibustion in the treatment of dry eye disease(DED), so as to provide evidence-based research basis for clinical application. METHODS: Randomized controlled trials (RCT) for acupuncture and moxibustion treatment of DED published from the inception of database to November 25, 2020 were searched from PubMed, Embase, Cochrane Library, Web of Science, Sinomed, CNKI, Wanfang and VIP Database. Two reviewers independently screened the literatures, extracted the data. The quality of the included literature was evaluated, and network Meta-analysis was performed by using Stata14.0 and R4.0.3 software. RESULTS: A total of 71 literatures were identified, including 5 536 patients with DED, covering 11 different interventions. Network Meta-analysis showed that acupuncture+traditional Chinese medicine+artificial tears was the best treatment option in terms of the clinical effective rate, breakup time of tear film (BUT), Schirmer I test (SIT) with surface under cumulative ranking area value. Acupuncture+traditional Chinese medicine+artificial tears was better than artificial tears in the clinical effective rate (odds ratio［OR］=12.34, 95% confidence interval［CI］［4.72, 36.89］), BUT(mean differenc［MD］=2.76, 95%CI［0.16, 5.40］), SIT(MD=4.76, 95%CI［1.23, 8.29］). CONCLUSION: Acupuncture and moxibustion in the treatment of DED are generally better than artificial tears, and acupuncture-moxibustion combined with other traditional Chinese medicine therapy has the best effect.

Autologous serum compared to artificial tear drops for dry eye disease. / Suero autólogo comparado con lágrimas artificiales para ojo seco.

INTRODUCTION: Dry eye is one of the most common ocular surface disorders. Although artificial tear drops therapy is the most widely used treatment, it has recently been suggested that autologous serum could be a beneficial alternative treatment for this disorder, but its use is controversial. METHODS: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE/PubMed, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified six systematic reviews, including seven primary studies overall, of which all were randomized trials. We concluded that autologous serum treatment might not lead to adverse effects compared to artificial teardrops, but the certainty of the evidence is low. On the other hand, we are uncertain whether autologous serum therapy improves the quality of life, severity of the pathology, pain or the corneal epitheliopathy grade compared to artificial tear drops as the certainty of the evidence has been assessed as very low.

INTRODUCCIÓN: El ojo seco es una de las patologías oculares más frecuentes. Si bien el tratamiento más utilizado es el uso de lágrimas artificiales, se ha planteado el uso de suero autólogo como una alternativa terapéutica beneficiosa para pacientes con esta condición. Sin embargo, su uso es controvertido. MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE/PubMed, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método Grading of Recommendations Assessment, Development and Evaluation, GRADE. RESULTADOS Y CONCLUSIONES: Identificamos seis revisiones sistemáticas que en conjunto incluyeron siete estudios primarios, de los cuales, todos corresponden a ensayos aleatorizados. Concluimos que el uso de suero autólogo podría no presentar efectos adversos asociados a su uso, pero la certeza de la evidencia es baja. Por otro lado, no es posible establecer con claridad si el uso de suero autólogo tiene un efecto sobre la mejora de la calidad de vida, severidad del ojo seco, dolor o grado de epiteliopatía corneal debido a que la certeza de la evidencia existente ha sido evaluada como muy baja.

A Novel Multi-Ingredient Supplement Reduces Inflammation of the Eye and Improves Production and Quality of Tears in Humans.

INTRODUCTION: Dry eye is a multifactorial condition of the eye caused by insufficient tear production and imbalance in tear composition leading to faster evaporation of tear fluid. It is also associated with inflammation that often leads to ocular surface damage. Symptoms of dry eyes include itchiness, soreness, red eyes, a burning sensation, eye fatigue and blurred vision. The objective of this study was to evaluate the efficacy and safety of our multi-ingredient supplement in subjects with dry eye syndrome (DES). METHODS: We recruited 60 subjects with mild to moderate DES who were randomized in a 1:1 ratio in a single-center study to receive LCD (lutein 20 mg, zeaxanthin 4 mg, curcumin 200 mg curcuminoids, vitamin D3 600 IU) or placebo (soybean oil) capsules for 8 weeks. The primary outcomes evaluated were changes in tear volume by Schirmer's test and ocular symptoms by the Ocular Surface Disease Index (OSDI); secondary outcomes included evaluation of changes in Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, tear film break-up time (TBUT), corneal and conjunctival staining, tear osmolarity, matrix metalloproteinase-9 (MMP-9), artificial tear use and safety assessments. The outcomes were compared between the LCD and placebo groups at baseline and day 56 of supplementation. RESULTS: Fifty-nine subjects, 30 from LCD and 29 from placebo group, completed the study. The LCD group showed significant improvements (P < 0.0001) for Schirmer's test, OSDI, TBUT, SPEED, ocular staining scores, tear osmolarity (P = 0.0005), MMP-9 (P = 0.0017) and reduced artificial tear use (P = 0.0004) and its frequency of use (P < 0.0001) in subjects compared to placebo from baseline to day 56. No safety issues were observed in the study. CONCLUSION: The LCD supplement showed significant improvements in the production, stability and quality of tears by reducing ocular surface damage and tear inflammation and can be used as an adjuvant to artificial tears in subjects with DES. TRIAL REGISTRATION: Clinical Trials Registry of India (http://ctri.nic.in/) identifier: CTRI/2021/01/030493.

Metabolomics analysis revealed acupuncture treatment target the upstream for dry eye disease / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To find out the pathogenesis of dry eye disease(DED)and the possible mechanisms of available effective treatments.<p>METHOD:Here we employed a non-targeted technology, ultra-high performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry(UHPLC-Q-TOF-MS), to investigate metabolic characterizations for tear samples from 18 patients with DED upon drug or acupuncture treatment. <p>RESULTS:A total of 190 named metabolites were identified, which presented so far the broadest tear metabolome. Further analysis indicated a significantly distinct metabolomics profile among all patients, but very subtle metabolic differences upon drug or acupuncture treatment. On one hand, only six significantly changed metabolites were determined after drug treatment, five of which including inosine, monopalmitin, urate, propionylcarnitine, and nicotinamide were all increased and involved in inflammatory responses. On the other hand, merely four metabolites including alanine, serine, and homoserine were found to be significantly different. Further pathway analysis of those six and four significantly changed metabolites revealed that only one pathway, aminoacyl-tRNA biosynthesis was significantly influenced in acupuncture-treated patients, which were highly associated with the cause of the disease. The results here indicated acupuncture treatment may address the cause rather than the symptoms for dry eye disease, displaying partially better compared with drug treatment.<p>CONCLUSION: Collectively, this work extended our understanding on the key regulatory elements or pathways involved in the potential mechanisms of available effective treatments, and would be useful for providing novel potential targets and therapeutic strategies for DED.

Effects of Aqueous-Supplementing Artificial Tears in Wearers of Biweekly Replacement Contact Lenses vs Wearers of Daily Disposable Contact Lenses.

PURPOSE: To compare the effects of artificial tears (ATs) in wearers of biweekly replacement silicone hydrogel contact lenses (BW-Ws) and wearers of daily disposable contact lenses (DD-Ws) of the same material. MATERIALS AND METHODS: The aqueous-supplementing ATs, OPTOyalA and OPTOidro, were assigned to be used for 2 weeks to healthy and young subjects: 1) 20 (8 and 12, respectively) BW-Ws wearing silicone hydrogel somofilcon A CLs (Clariti Elite), 2) 18 (9 and 9, respectively) DD-Ws wearing silicone hydrogel somofilcon A CLs (Clarity 1 Day), and 3) a control group of 33 (16 and 17, respectively) N-Ws. Ocular symptoms and comfort, tear volume and stability, and ocular surface condition were assessed by Ocular Surface Disease Index (OSDI), 5-Item Dry Eye Questionnaire (DEQ5), tear meniscus height (TMH), non-invasive tear break-up time (NIBUT), and evaluation of ocular redness (OR). The assessment was performed before and after 15 days of use of the ATs in the 3 groups (BW-Ws, DD-Ws, and N-Ws). RESULTS: No clear significant difference was noted in symptoms and signs between OPTOyalA and OPTOidro irrespectively of the group of people studied. ATs use for 15 days produced a significant improvement in DEQ5 and OR in DD-Ws (Δ=-34%, p=0.006; Δ=-23%, p<0.001) and in N-Ws (Δ=-21%, p=0.001; Δ=-10%, p=0.006) but not in BW-Ws (Δ=-5%, p=0.072; Δ=-2%, p=0.257). No significant change was noted for TMH. CONCLUSION: In young and healthy subjects, the aqueous-supplementing effect of the ATs under consideration is more a rinsing and tear replacem ent effect than an increase in tear volume, and it produces an improvement of the eye redness and ocular symptoms. Contact lens wear influenced the effectiveness of ATs in a way which is correlated with the CL replacement schedule.

An artificial tear containing flaxseed oil for treating dry eye disease: A randomized controlled trial.

PURPOSE: To evaluate the efficacy and safety of a nano-emulsion artificial tear (OM3) containing carboxymethylcellulose (CMC) and glycerin, flaxseed oil and castor oil, and three osmoprotectants (levocarnitine, erythritol, and trehalose) compared with an artificial tear (Refresh Optive Advanced [ROA]) containing the same ingredients with the exception of trehalose and flaxseed oil. METHODS: In this multicenter, double-masked, randomized, two-arm, parallel-group, 6-visit study (screening, baseline, and days 7, 30, 60, and 90), subjects with dry eye disease underwent an open-label, 7-day run-in with CMC 0.5% (Refresh Plus), before 1:1 randomization to OM3 or ROA for 90 days (both instilled ≥2 daily). Ocular Surface Disease Index (OSDI; primary endpoint change from baseline at day 90), tear film breakup time (TBUT), and ocular staining (combined/corneal/conjunctival) were assessed; change from baseline in these parameters was calculated at each timepoint. Treatment-related adverse events (AEs) were assessed at each visit. RESULTS: Overall, 242 subjects were randomized (OM3, n = 120; ROA, n = 122). At day 90, significant improvements in OSDI, ocular staining and TBUT were evident in both treatment groups. Significant (P < 0.05) between-group differences in favor of OM3 were observed for combined ocular staining (all timepoints), corneal staining (day 90), and conjunctival staining (day 30). Treatment-related AEs were higher in the ROA (9.8%) versus OM3 (6.7%) group; blurred vision was among the most commonly reported AE (OM3 0% vs ROA 4.1%). CONCLUSION: These findings support the application of OM3, a novel preservative-free, nano-emulsion tear formulation with trehalose and flaxseed oil, for the treatment of dry eye disease.

[Clinical observation of dry eye syndrome treated with acupuncture].

OBJECTIVE: To compare the therapeutic effect between acupuncture and hyaluronic acid sodium eye drops for dry eye syndrome. METHODS: A total of 60 patients with dry eye were randomized into an acupuncture group and a western medication group, 30 cases in each one. In the acupuncture group, acupoints around the eyes, abdomen and limbs were selected, such as Jingming (BL 1), Cuanzhu (BL 2), Fengchi (GB 20), Taiyang (EX-HN 5), Guanyuan (CV 4), Qihai (CV 6) and Hegu (LI 4), once 2 days for 1 month, 15 times in total. In the western medication group, hyaluronic acid sodium eye drops was applied, 3 times a day, one drop every time, for 1 month. The tear meniscus height (TMH), tear break-up time (BUT) and conjunctival congestion scores were observed before and after treatment in the two groups, and the clinical effects of the two groups were compared. RESULTS: The total effective rate in the acupuncture group was 68.3% (41/60), which was superior to 30.0% (18/60) in the western medication group (P<0.05). Compared before treatment, the TMH was increased, BUT was prolonged and conjunctival congestion score was reduced after treatment in the acupuncture group (P<0.05, P<0.01). After treatment, the TMH and BUT in the acupuncture group were higher (P<0.05, P<0.01), and the conjunctival congestion score was lower than those in the western medication group (P<0.05). CONCLUSION: The therapeutic effect of acupuncture is superior to hyaluronic acid sodium eye drops. Acupuncture can promote lacrimal gland secretion and increase the tear film stability.

Clinical observation of dry eye syndrome treated with acupuncture / 中国针灸

OBJECTIVE@#To compare the therapeutic effect between acupuncture and hyaluronic acid sodium eye drops for dry eye syndrome.@*METHODS@#A total of 60 patients with dry eye were randomized into an acupuncture group and a western medication group, 30 cases in each one. In the acupuncture group, acupoints around the eyes, abdomen and limbs were selected, such as Jingming (BL 1), Cuanzhu (BL 2), Fengchi (GB 20), Taiyang (EX-HN 5), Guanyuan (CV 4), Qihai (CV 6) and Hegu (LI 4), once 2 days for 1 month, 15 times in total. In the western medication group, hyaluronic acid sodium eye drops was applied, 3 times a day, one drop every time, for 1 month. The tear meniscus height (TMH), tear break-up time (BUT) and conjunctival congestion scores were observed before and after treatment in the two groups, and the clinical effects of the two groups were compared.@*RESULTS@#The total effective rate in the acupuncture group was 68.3% (41/60), which was superior to 30.0% (18/60) in the western medication group (<0.05). Compared before treatment, the TMH was increased, BUT was prolonged and conjunctival congestion score was reduced after treatment in the acupuncture group (<0.05, <0.01). After treatment, the TMH and BUT in the acupuncture group were higher (<0.05, <0.01), and the conjunctival congestion score was lower than those in the western medication group (<0.05).@*CONCLUSION@#The therapeutic effect of acupuncture is superior to hyaluronic acid sodium eye drops. Acupuncture can promote lacrimal gland secretion and increase the tear film stability.

[Effects of subcutaneous embedding of thumb-tack needle on tear film in patients with dry eye].

OBJECTIVE: To observe the effects of subcutaneous embedding of thumb-tack needle combined with mytear and simple mytear on tear film in patients with dry eye. METHODS: Eighty patients of dry eye (160 eyes) were randomly divided into an observation group and a control group, 40 cases in each group. The 0.1% sodium hyaluronate eye drop (alice) was applied in the control group, four times per day for two weeks. On the basis of the control group, the subcutaneous embedding of thumb-tack needle was used at ① Cuanzhu (BL 2), Sizhukong (SJ 23), Sibai (ST 2), ② Yintang (EX-HN 3), Yuyao (EX-HN 4), Taiyang (EX-HN 5). The two groups of acupoints were used alternately. The thumb-tack needle was placed for 2 to 3 days, once a week for two weeks. The subjective symptom score, Schirmer Ⅰ test (SⅠT), tear break-up time (BUT) and corneal fluorescein staining (CFS) were compared before treatment, after treatment and during 2-week follow-up visit in the two groups. The effects of the two groups were compared. RESULTS: Compared before treatment, the subjective symptom score and CFS were reduced but SⅠT and BUT were increased after treatment and during follow-up visit in the two groups (all P<0.05), which in the observation group were superior to those in the control group (all P<0.05). The total effective rate was 90.0% (36/40) in the observation group, which was superior to 85.0% (34/40) in the control group (P<0.05). CONCLUSION: The subcutaneous embedding of thumb-tack needle could increase the amount of SIT, prolong BUT and repair pathological damage of cornea, which could relieve the symptoms of dry eye and improve visual quality.

Effects of subcutaneous embedding of thumb-tack needle on tear film in patients with dry eye / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of subcutaneous embedding of thumb-tack needle combined with mytear and simple mytear on tear film in patients with dry eye.</p><p><b>METHODS</b>Eighty patients of dry eye (160 eyes) were randomly divided into an observation group and a control group, 40 cases in each group. The 0.1% sodium hyaluronate eye drop (alice) was applied in the control group, four times per day for two weeks. On the basis of the control group, the subcutaneous embedding of thumb-tack needle was used at ① Cuanzhu (BL 2), Sizhukong (SJ 23), Sibai (ST 2), ② Yintang (EX-HN 3), Yuyao (EX-HN 4), Taiyang (EX-HN 5). The two groups of acupoints were used alternately. The thumb-tack needle was placed for 2 to 3 days, once a week for two weeks. The subjective symptom score, Schirmer Ⅰ test (SⅠT), tear break-up time (BUT) and corneal fluorescein staining (CFS) were compared before treatment, after treatment and during 2-week follow-up visit in the two groups. The effects of the two groups were compared.</p><p><b>RESULTS</b>Compared before treatment, the subjective symptom score and CFS were reduced but SⅠT and BUT were increased after treatment and during follow-up visit in the two groups (all <0.05), which in the observation group were superior to those in the control group (all <0.05). The total effective rate was 90.0% (36/40) in the observation group, which was superior to 85.0% (34/40) in the control group (<0.05).</p><p><b>CONCLUSION</b>The subcutaneous embedding of thumb-tack needle could increase the amount of SIT, prolong BUT and repair pathological damage of cornea, which could relieve the symptoms of dry eye and improve visual quality.</p>

Fumigation treatment of Four Yellow Qing Ling Water with artificial tears for dry eyes / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To observe the clinical efficacy of fumigation treatment of traditional Chinese medicine(Four Yellow Qing Ling Water) for dry eye, and to provide the reference for clinical treatment of dry eye. · METHODS: Totally 82 patients (164 eyes) were randomly divided into two groups from June 2016 to December 2016 in Ophthalmology Department of our hospital. The patients in control group were given artificial tears;the patients in the observation group were given artificial tears and fumigation treatment of traditional Chinese(Four Yellow Qing Ling Water) once a day. After treatment for 14d, the SchirmerⅠtest (SⅠt), break-up time (BUT), cornea fluorescein staining (FL) and clinical efficacy of two groups were compared. ·RESULTS:The efficiency rate of observation group was significantly better than the control group (87. 8% vs 70.7%,P<0.5). The SⅠt and BUT in the observation group were significantly higher than those in the control group (8.43 ± 2.51mm/5min vs 6.38 ± 2.52mm/5min, P<0.05;8.60±2.47s vs 6.35±2.29s, P<0.05); the FL in the observation group (0.84 ± 0.75 vs 1.26 ± 0.84, P<0.05) significantly lower than those in the control group. ·CONCLUSION: The fumigation treatment of traditional Chinese medicine (Four Yellow Qing Ling Water) combined with artificial tears for dry eyes can improve the clinical symptoms of dry eye syndrome.

Oral supplementation with a nutraceutical formulation containing omega-3 fatty acids, vitamins, minerals, and antioxidants in a large series of patients with dry eye symptoms: results of a prospective study.

PURPOSE: To assess the benefits and tolerability of a dietary supplement based on omega-3 fatty acids to relieve dry eye symptoms. METHODS: A total of 1,419 patients (74.3% women, mean age 58.9 years) with dry eye syndrome using artificial tears participated in a 12-week prospective study. Patients were instructed to take 3 capsules/day of the nutraceutical formulation (Brudysec(®) 1.5 g). Study variables were dry eye symptoms (scratchy and stinging sensation, eye redness, grittiness, painful and tired eyes, grating sensation, and blurry vision), conjunctival hyperemia, tear breakup time (TBUT), Schrimer I test, and Oxford grading scheme. RESULTS: At 12 weeks, each dry eye symptom improved significantly (P<0.001), and the use of artificial tears decreased significantly from 3.77 (standard deviation [SD] =2.08) at baseline to 3.45 (SD =1.72) (P<0.01). In addition, the Schirmer test scores and the TBUT increased significantly, and there was an increase in patients grading 0-I in the Oxford scale and a decrease of those grading IV-V. Significant differences in improvements of dry eye symptoms were also found in compliant versus noncompliant patients as well as in those with moderate/severe versus none/mild conjunctival hyperemia. CONCLUSION: Oral ω-3 fatty acids supplementation was an effective treatment for dry eye symptoms.

Langmuir films study on lipid-containing artificial tears.

Lipid-containing artificial tears are a type of artificial tears that use lipid components in order to restore the lipid layer of the tear film. One of these components is lecithin which can be applied in spray solutions containing lecithin liposomes. In this work the behavior of three of these commercial tears based on lecithin, Innoxa, Opticalm and Optrex, are studied using the Langmuir technique. The obtained isotherms are presented, discussed and compared. This technique seems useful in order to see the film behavior of the lipid components of these tears and determine some important parameters such as fluidity and extension at the air-water interface, and allows us to discern differences between these commercial tears. Innoxa and Optrex tears are more similar to each other than to Opticalm tears. Opticalm presents more fluidity, probably due to the presence of more insaturations in the fatty acid chains of the phospholipids of the lecithin used in fabrication.

Clinical Observation of Traditional Chinese Medicine Combined with Artificial Tears Treating Liver and Kidney Yin Deficiency Type Dry Eyes / 浙江中医药大学学报

Objective]To study traditional Chinese medicine of Yangyin Shengjin and Buyi Ganshen combining artificial tears treating liver and kidney Yin deficiency of patients with dry eyes for clinical effect. [Method] Selection of 62 patients(124 eyes) with liver and kidney Yin deficiency ,who were randomly divided into treatment group and control group. The treatment group given herbs of Yangyin Shengjin and Buyi Ganshen combined with artificial tears,but the control group given only artificial tears, with a course of treatment for 30 days and 3 periods of it. To observe the two groups of changing about the clinical efficacy and Schirmer test ,BUT and FL in pretherapy and post-treatment. [Result] Treatment group total effective rate was 83.87%,control group was 58.06%,the curative effect of treatment group was better than that of control group( P<0.05). Two groups of FL,BUT and STI after treatment compared with before treatment,the differences were statistical y significant(P<0.05 or P<0.01),and the treatment group after treatment BUT and STI changes significantly better than that of control group( P<0.01). [Conclusion] The herbs of Yangyin Shengjin and Buyi Ganshen combined with artificial tears treating patients with dry eyes of liver and kidney Yin deficiency have a good clinical efficacy. It is a way to treat disease from the root.

Rose bengal staining as an assessment of ocular surface damage and recovery in dry eye disease-a review.

PURPOSE: To review the use of ophthalmic rose bengal to assess the ocular surface, especially considering the grading scales used. METHODS: A literature search was undertaken to identify reports where either rose bengal or lissamine green had been used as a 'vital' stain, with a special interest in identifying studies that provided data before and after treatment for dry eye and also considered the mechanism of action of these two chemicals. RESULTS: Between 1985 and 2006, numerous clinical studies used a consistent grading scheme (that attributed to Van Bijsterveld) to assess the outcome of artificial tear treatments on dry eye patients. With such consistency, including the adoption of a treatment period of 1 month, comparisons can be made to indicate the efficacy of rose bengal staining to assess reduction in ocular surface desiccation. However, in the following years, several alternative grading schemes have been used for both rose bengal and lissamine green and assessment periods have been variable so making inter-study comparisons considerably more difficult to undertake. An attribute of rose bengal appears to be its ability to stain the nuclei of cells, but whether this also occurs for lissamine green is unclear. CONCLUSIONS: Ophthalmic rose bengal has been successfully adopted for use to assess the ocular surface over many years as a vital stain. More research is needed to assess whether lissamine green ocular surface staining can simply be substituted for rose bengal in evaluation of dry eye treatments.