SARS-CoV-2 RNA and antibodies in tear fluid.

BACKGROUND/AIMS: SARS-CoV-2 is highly contagious. More evidence concerning extrapulmonary transmission routes such as the eyes is urgently needed. Although the humoral immune response is important in the viral containment, the local response in tears has not yet been studied. The aim of our study was twofold: to assess the prevalence of both SARS-CoV-2 RNA and antibodies in tear fluid. METHODS: In a first series, nasopharyngeal sampling and tear sampling by Schirmer test strips were performed in 26 acutely ill patients with COVID-19 to assess the presence of SARS-CoV-2 RNA by reverse transcription PCR. In a second series, IgG and IgA responses to SARS-CoV-2 spike protein in serum and tear fluid of convalescent individuals (n=22) were compared with control individuals (n=15) by ELISA. RESULTS: SARS-CoV-2 RNA was detected in tears of 7/26 (26.9%) patients with COVID-19. None of them had ocular symptoms. Convalescent individuals displayed a significant higher ratio of IgG (p<0.0001) and IgA (p=0.0068) in tears compared with control individuals. A sensitivity of 77.3% and specificity of 93.3% was observed for IgG, and 59.1% and 100% for IgA. CONCLUSIONS: Our results demonstrate the presence of SARS-CoV-2 RNA and a local IgG and IgA immune response in tear fluid. These data confirm the possibility of SARS-CoV-2 transmission through tear fluid and the importance of the eye as a first defence against SARS-CoV-2, indicating the potential of tears as a non-invasive surrogate for serum in monitoring the host immune response.

Punctal Ectropion repair using the Raus-Garito clamp.

PURPOSE: To evaluate the results from the correction of ectropion of the punctum lacrimale in lower eyelids with a new surgical clamp. DESIGN: Prospective study. METHODS: Eighty eight eyelids in 55 patients with mild and moderate ectropion were included in the study. An excision of a diamond of tarso-conjunctiva with retractor reattachment and concomitant correction of horizontal lid laxity, if present, was performed. RESULTS: Resolution of tearing was obtained in 77 eyes. In 11 eyes, persistent tearing was reported. CONCLUSION: Conclusion:Conclusion: Repair of early to intermediate ectropion of the lacrimal punctum using the Raus-Garito clamp is associated with a good functional and cosmetic outcome.

Radiofrequency surgery: 3500 years old and still young.

PURPOSE: To review the history of Radiofrequency surgery, delineate the actual situation and describe the applications in eyelid surgery. DESIGN: Review. METHODS: Review of literature, personal communication with several pioneers in the field, and own experience. CONCLUSION: Radiofrequency surgery has evolved from rude burning to a sophisticated surgical technique.