Topical Quercetin and Resveratrol Protect the Ocular Surface in Experimental Dry Eye Disease.

Purpose: To determine the anti-inflammatory effect of quercetin (QCT), resveratrol (RES), and their combination in a dry eye disease (DED) model. Methods: 0.01% QCT, 0.1% RES, 0.01% QCT + 0.1% RES (QCT + RES) or vehicle were topically applied in a desiccating stress (DS) mice model. CD4+ T cells isolated from DS-exposed mice were transferred to athymic recipient mice. Corneal fluorescein staining, tear production, and tear cytokine levels were evaluated in DS-exposed mice, and conjunctival CD4+ T cell infiltration was evaluated in recipient mice. Results: QCT (p < 0.001) and QCT + RES (p < 0.05) reduced corneal staining in DS-exposed mice. IL-1α tear concentration was reduced by QCT, RES, and QCT + RES (p < 0.05, 0.01 and 0.01, respectively) compared to DS + vehicle mice. CD4+ T cells increased in recipients of DS-exposed mice (p < 0.05) and were lower in recipients of QCT- and RES-treated mice (p < 0.05). Conclusion: The anti-inflammatory effect of QCT, RES, and QCT + RES on DED-experimental model suggests that their topical application could be used for DED treatment.

A comparative study of the visual outcomes between a new trifocal and an extended depth of focus intraocular lens.

PURPOSE: To evaluate and compare the visual outcomes and ocular optical performance of the PanOptix trifocal intraocular lens (IOL) and Symfony extended range of vision IOL. METHODS: Sixty-eight eyes of 34 patients were divided into 2 groups: 20 patients with the PanOptix IOL and 14 patients with the Symfony IOL. Binocular uncorrected distance visual acuity, best-corrected distance visual acuity (BCDVA), distance-corrected intermediate visual acuity (DCIVA) at 80 and 60 cm, and distance-corrected near visual acuity (DCNVA) at 40 cm were evaluated. Additionally, preferred reading distance with best-corrected distance and visual acuity at that distance, binocular defocus curves, mesopic and photopic contrast sensitivity, photic phenomena, and monocular total higher order aberrations (HOAs) were also measured. RESULTS: The visual outcomes for PanOptix and Symfony IOL groups, respectively, were as follows: BCDVA: -0.03 ± 0.03 and -0.02 ± 0.03 logMAR; DCIVA at 80 cm: 0.06 ± 0.06 and 0.06 ± 0.04 logMAR; DCIVA at 60 cm: 0.06 ± 0.10 and 0.05 ± 0.04 logMAR; DCNVA: 0.04 ± 0.06 and 0.20 ± 0.07 logMAR (p<0.001). Similar preferred reading distances were found for both groups (37.0 ± 4.6 and 38.9 ± 5.7 cm, respectively). The visual acuities at those distances were 0.09 ± 0.08 and 0.19 ± 0.08 logMAR (p<0.001), respectively. The defocus curves showed significantly better outcomes for the PanOptix IOL from -2.0 to -4.0 D (p<0.001). No significant differences were found for contrast sensitivity, halometry, or HOAs between the groups. CONCLUSIONS: The PanOptix and Symfony IOLs showed comparable visual performance at distance and intermediate. However, the PanOptix IOL provided better near and preferred reading distance VAs and showed a more continuous range of vision than the Symfony IOL.

Comparison of a new Scheimpflug imaging combined with partial coherence interferometry biometer and a low-coherence reflectometry biometer.

PURPOSE: To evaluate the repeatability of a new biometer using Scheimpflug technology combined with partial coherence interferometry (PCI) (Pentacam AXL) and its agreement with a device based on optical low-coherence reflectometry (OLCR), the Allegro Biograph. SETTING: Oftalvist Centro Integral Ocular Jerez, Jerez de la Frontera, Spain. DESIGN: Evaluation of a diagnostic test. METHODS: The mean keratometry (K), central corneal thickness (CCT), anterior chamber depth (ACD), and axial length (AL) were measured with the 2 devices 3 times by the same examiner in 2 groups (patients with cataract and patients without cataract). The repeatability was determined using the within-subject standard deviation, test-retest repeatability, coefficient of variation, and intraclass correlation coefficient. The correlation was evaluated with the Pearson coefficient and interchangeability with the Bland-Altman plot. RESULTS: Eighty eyes (40 eyes in each group) of 80 patients were analyzed. Significant differences were found between the Scheimpflug-PCI device and the OLCR device for mean K in the normal group (P < .001) and for CCT in the normal group (P < .05) and the cataract group (P < .001). There were no differences between devices in ACD and AL in either group. The repeatability between devices was similar. Although a significant correlation between devices was found for all measurements (all P < .001), wide limits of agreement were found in both groups for all biometric parameters. CONCLUSIONS: The Scheimpflug-PCI and OLCR devices showed excellent intravisit repeatability and high correlation for mean K, CCT, ACD, and AL in healthy and cataractous eyes. No differences were found in AL; however, the 2 devices might not be interchangeable.

Comparison of visual outcomes after bilateral implantation of extended range of vision and trifocal intraocular lenses.

PURPOSE: To compare visual outcomes after cataract surgery with bilateral implantation of 2 intraocular lenses (IOLs): extended range of vision and trifocal. METHODS: Each group of this prospective study comprised 40 eyes (20 patients). Phacoemulsification followed by bilateral implantation of a FineVision IOL (group 1) or a Symfony IOL (group 2) was performed. The following outcomes were assessed up to 1 year postoperatively: binocular uncorrected distance visual acuity (UDVA), binocular uncorrected intermediate visual acuity (UIVA) at 60 cm, binocular uncorrected near visual acuity (UNVA) at 40 cm, spherical equivalent (SE) refraction, defocus curves, mesopic and photopic contrast sensitivity, halometry, posterior capsule opacification (PCO), and responses to a patient questionnaire. RESULTS: The mean binocular values in group 1 and group 2, respectively, were SE -0.15 ± 0.25 D and -0.19 ± 0.18 D; UDVA 0.01 ± 0.03 logMAR and 0.01 ± 0.02 logMAR; UIVA 0.11 ± 0.08 logMAR and 0.09 ± 0.08 logMAR; UNVA 0.06 ± 0.07 logMAR and 0.17 ± 0.06 logMAR. Difference in UNVA between IOLs (p<0.05) was statistically significant. There were no significant differences in contrast sensitivity, halometry, or PCO between groups. Defocus curves were similar between groups from 0 D to -2 D, but showed significant differences from -2.50 D to -4.00 D (p<0.05). CONCLUSIONS: Both IOLs provided excellent distance and intermediate visual outcomes. The FineVision IOL showed better near visual acuity. Predictability of the refractive results and optical performance were excellent; all patients achieved spectacle independence. The 2 IOLs gave similar and good contrast sensitivity in photopic and mesopic conditions and low perception of halos by patients.

Effect of the osmolarity change in multipurpose solutions induced by an improper contact lens case cleaning procedure.

PURPOSE: To determine whether variations in multipurpose disinfecting solution (MPDS) storage osmolarity from inappropriate contact lens (CL) case cleaning affect ocular surface integrity and wearer comfort. METHODS: There were twenty contact lens cases (study CLCs) in the study group. Ten were filled with ReNu Multiplus(®) and 10 with SoloCare Aqua™ (MPDS-1 and -2, respectively) and kept closed for 8h; the cases were then emptied and kept open for air-drying for 16h. This procedure was carried out every day for two months. Storage solution osmolarity was measured on days 0, 15, 30, 45 and 60. Ten subjects were then fitted with both month-old lenses stored in the study CLCs and with new lenses stored in new cases with fresh solution for 24h (control CLCs). Symptoms, tear osmolarity and percentage of subjects whose conjunctival hyperaemia and ocular surface staining scores changed were determined after 1h of wear. RESULTS: Study CLC osmolarity increased in both solutions after two months (p<0.05). For MPDS-1 there were differences in stinging between study CLCs and control CLCs after 10min of CL wear (p=0.04), and in comfort after 10 (p=0.035) and 60min wear (p=0.042). Significant (p<0.05) differences between study CLC and control CLC groups were also found for MPDS-2 in limbal hyperaemia (study: 50% change; control: 0% change) and bulbar and corneal staining (study: 80% change; control: 20% change). CONCLUSION: The stored-MPDS osmolarity increase caused by air-drying the CLCs could affect the ocular surface. This increase might reduce lens wear comfort.

Quercetin and Resveratrol Decrease the Inflammatory and Oxidative Responses in Human Ocular Surface Epithelial Cells.

PURPOSE: To determine the anti-inflammatory and antioxidant effects of quercetin (QCT) and/or resveratrol (RES) on human conjunctival (IOBA-NHC) and corneal (HCE) epithelial cell lines. METHODS: IOBA-NHC and HCE cells were treated with QCT (0.5-25 µM), RES (0.5-50 µM) and a low-dose mixture of QCT (0.5 µM) and RES (5 µM) (QCT+RES) and stimulated with either TNF-α or ultraviolet (UV)-B radiation. Cytokine production (IL-6, IL-8, IP-10, and VEGF) was analyzed by an immune bead-based array, and intracellular reactive oxygen species (ROS) production was determined by a H2DCF-DA dye assay. RESULTS: Stimulation of IOBA-NHC and HCE cells with TNF-α induced an increase of IL-6, IL-8, and IP-10 secretion in both cell lines. Quercetin and RES decreased IL-6 and IP-10 secretion in a dose-dependent manner in both cell lines. Interleukin-8 secretion was also inhibited in a dose-dependent manner by QCT in HCE, but only at 20 and 25 µM QCT and 50 µM RES in IOBA-NHC and at 50 µM RES in HCE. QCT+RES decreased IL-6 and IL-8 secretion (P < 0.01 and P < 0.05, respectively) in IOBA-NHC cells. Ultraviolet-B induced a significant increase of ROS in both cell lines (P < 0.01 and P < 0.001 for IOBA-NHC and HCE cells, respectively), which was significantly decreased in a dose-dependent manner by QCT and RES in HCE cells. Reactive oxygen species production in IOBA-NHC cells was inhibited (P < 0.05) by 50 µM RES. CONCLUSIONS: Quercetin and RES have anti-inflammatory and antioxidant effects on IOBA-NHC and HCE cells. These in vitro data suggest that both polyphenols may have a therapeutic potential in the treatment of inflammatory ocular surface diseases.

In Vitro Model for Predicting the Protective Effect of Ultraviolet-Blocking Contact Lens in Human Corneal Epithelial Cells.

PURPOSE: To develop an in vitro method to determine the protective effect of UV-blocking contact lenses (CLs) in human corneal epithelial (HCE) cells exposed to UV-B radiation. MATERIALS AND METHODS: SV-40-transformed HCE cells were covered with non-UV-blocking CL, UV-blocking CL or not covered, and exposed to UV-B radiation. As control, HCE cells were covered with both types of CLs or not covered, but not exposed to UV-B radiation. Cell viability at 24, 48 and 72 h, after UV-B exposure and removing CLs, was determined by alamarBlue(®) assay. Percentage of live, dead and apoptotic cells was also assessed by flow cytometry after 24 h of UV-B exposure. Intracellular reactive oxygen species (ROS) production after 1 h of exposure was assessed using the dye H(2)DCF-DA. RESULTS: Cell viability significantly decreased, apoptotic cells and intracellular ROS production significantly increased when UVB-exposed cells were covered with non-UV-blocking CL or not covered compared to non-irradiated cells. When cells were covered with UV-blocking CL, cell viability significantly increased and apoptotic cells and intracellular ROS production did not increase compared to exposed cells. CONCLUSIONS: UV-B radiation induces cell death by apoptosis, increases ROS production and decreases viable cells. UV-blocking CL is able to avoid these effects increasing cell viability and protecting HCE cells from apoptosis and ROS production induced by UV-B radiation. This in vitro model is an alternative to in vivo methods to determine the protective effect of UV-blocking ophthalmic biomaterials because it is a quicker, cheaper and reliable model that avoids the use of animals.

Contact lens case cleaning procedures affect storage solution pH and osmolality.

PURPOSE: To investigate pH and osmolality changes in the solutions stored in contact lens (CL) cases, when different case rinsing and drying methods are used on a daily basis. METHODS: Four multipurpose solutions (Opti-Free Express, Solo-Care Aqua, Re-Nu Multiplus, and Complete) and two hydrogen peroxide systems (AOsept and Oxysept) were studied. Cases were filled with the solutions and kept sealed. After 8 h, the cases underwent different rinsing (rinsing; non-rinsing) and drying (air drying-AD; lint-free tissue drying-LFTD; non-drying-ND) procedures on a daily basis. Five cases of each rinsing/drying combination for each solution were evaluated. The pH and osmolality of the case-contained solution were evaluated on the 1st, 7th, 15th, and then, 30th day. RESULTS: pH and osmolality increased significantly from day 1 to 30, except for Complete in which a significant decrease in pH was found. Rinsing vs. non-rinsing CL cases did not have any influence on the pH or osmolality, except for Oxysept, which showed a significantly higher osmolality value when cases were not rinsed. However, the drying procedure did influence both measurements; pH was significantly higher in the AD compared with the ND group (p < 0.05), and there was a significant difference in osmolality between the three drying conditions (p < 0.05), with the AD group showing the highest values, and the LFTD group showing the lowest. CONCLUSIONS: Osmolality and pH values are time and drying process-dependent in a CL case cleaning schedule. Regarding drying conditions, LFTD causes less increase in osmolality. Future studies should determine whether these changes might affect bacterial growth, lens parameters, or subject comfort during CL wear.