Recombinant Human Clusterin Seals Damage to the Ocular Surface Barrier in a Mouse Model of Ophthalmic Preservative-Induced Epitheliopathy.

There is a significant unmet need for therapeutics to treat ocular surface barrier damage, also called epitheliopathy, due to dry eye and related diseases. We recently reported that the natural tear glycoprotein CLU (clusterin), a molecular chaperone and matrix metalloproteinase inhibitor, seals and heals epitheliopathy in mice subjected to desiccating stress in a model of aqueous-deficient/evaporative dry eye. Here we investigated CLU sealing using a second model with features of ophthalmic preservative-induced dry eye.

Changes in Symptoms of Midday Fogging with a Novel Scleral Contact Lens Filling Solution.

Significance: Midday fogging of scleral contact lenses requires frequent lens removal and reapplication for a large portion of lens wearers. Using a lens filling solution that mimics the composition of tears is hypothesized to have an impact on the production of material trapped under a scleral lens.

Purpose: The purposes of this open-label study were to assess the safety of a scleral lens filling solution, which closely approximates the ionic concentration and pH of human tears, and to assess signs and symptoms of midday fogging with this formulation and with subjects' habitual sodium chloride solutions.

Changes in Tear Lipid Layer Thickness and Symptoms Following the Use of Artificial Tears with and Without Omega-3 Fatty Acids: A Randomized, Double-Masked, Crossover Study.

Purpose: To determine if an eye drop containing omega-3 fatty acids (Refresh Optive MEGA-3, Allergan plc, Dublin, Ireland) increases the lipid layer thickness (LLT) of the tear film versus a non-emollient eye drop (Refresh Optive, Allergan plc).

Methods: Patients (≥30 years) with baseline LLT ≤75 nm completed the Current Symptoms Survey (CSS - a visual analog survey of dry eye symptoms), and LLT was measured pre- and post-instillation (15 and 60 mins) of their randomly assigned treatment. After washout, patients were tested with the other treatment.

Dynasore protects the ocular surface against damaging oxidative stress.

Water soluble "vital" dyes are commonly used clinically to evaluate health of the ocular surface; however, staining mechanisms remain poorly understood. Recent evidence suggests that sublethal damage stimulates vital dye uptake by individual living cells. Since cell damage can also stimulate reparative plasma membrane remodeling, we hypothesized that dye uptake occurs via endocytic vesicles.

Clusterin from human clinical tear samples: Positive correlation between tear concentration and Schirmer strip test results.

Purpose: To investigate the relationship between tear concentration of the homeostatic protein clusterin (CLU) and dry eye signs and symptoms, and to characterize tear CLU protein.

Methods: Two independent studies were conducted, one in Tucson (44 subjects), the other in Los Angeles (52 subjects). A cohort study design was employed to enroll patients without regard to dry eye diagnosis.

Eye wash water flow direction study: an evaluation of the effectiveness of eye wash devices with opposite directional water flow.

Introduction: New designs of eye wash stations have been developed in which the direction of water flow from the fountain has been reversed, with two water streams originating nasally in both eyes and flowing toward the temporal side of each eye. No study has been done to determine the ideal direction of water flow coming from the eye wash in relation to the eye.

Materials And Methods: Ophthalmic eye examinations were conducted before and after the use of two eye wash stations with opposite water flow directionality.

Scleral Lenses in the Management of Corneal Irregularity and Ocular Surface Disease.

Purpose: To describe current practice patterns regarding the use of scleral lens therapy in the management of corneal irregularity and ocular surface disease among eye care providers who fit scleral lenses.

Methods: The Scleral Lenses in Current Ophthalmic Practice: an Evaluation (SCOPE) study group conducted an electronic survey of eye care providers from January 15 to March 31, 2015. Respondents ranked management options for corneal irregularity in the order in which they would generally consider their use.

Demographic Characteristics and Prescribing Patterns of Scleral Lens Fitters: The SCOPE Study.

Objectives: This study reports demographic characteristics of scleral lens providers and indications for scleral lens prescription as assessed by a worldwide online survey.

Methods: The Scleral Lenses in Current Ophthalmic Practice: an Evaluation (SCOPE) study group designed the online survey regarding current scleral lens prescription and management practices. The Mayo Clinic Survey Research Center administered the survey, which was open from January 15 to March 31, 2015.

Scleral Lens Prescription and Management Practices: The SCOPE Study.

Objectives: To assess current scleral lens prescription and management practices by conducting an international online survey of eye care providers.

Methods: The SCOPE (Scleral Lenses in Current Ophthalmic Practice: an Evaluation) study group designed and administered an online survey regarding current scleral lens prescription and management practices. The survey was open from January 15 to March 31, 2015, and generated 723 responses from individuals who had fit at least 5 patients with scleral lenses.

Corneal epithelial bullae after short-term wear of small diameter scleral lenses.

Complications of scleral lens wear are not well documented or understood. While multiple studies focus on oxygen transmission during scleral lens wear and associated corneal swelling, little is known about the effects of varying scleral lens fitting relationships, especially when there is corneal interaction. Scleral lenses, by convention, are designed to completely clear the corneal surface and rest on the conjunctival and scleral tissue.

Tear lipid layer thickness with eye drops in meibomian gland dysfunction.

Purpose: The aim of this study was to evaluate the efficacy of a lipid containing emollient eye drop, Soothe XP, which was reformulated in 2014 with a more stable preservative and buffer system, compared to a control, non-emollient, eye drop (Systane Ultra) in improving lipid layer thickness (LLT) in subjects with dry eye due to meibomian gland dysfunction (MGD).

Patients And Methods: This prospective single-center, open-label, cross-over, examiner masked-study enrolled subjects aged 30-75 years with lipid-deficient dry eye and a clinical diagnosis of MGD as determined by a slit lamp examination, an evaluation of meibomian gland drop out with meibography, and a standard patient evaluation of eye dryness questionnaire of >5. Eligibility was then determined by a LLT of <75 nm at baseline and the inability to increase LLT ≥15 nm with three blinks, as determined by interferometric methods.

Clinical performance of KeraSoft(®) IC in irregular corneas.

Purpose: This study evaluated the clinical performance of KeraSoft(®) IC (KIC) soft contact lenses in subjects with irregular corneas.

Patients And Methods: This was a 12-month, prospective, open-label, observational study, which enrolled 43 subjects who were 18 years of age or older with irregular corneas. Subjects were fit according to the KIC Fitting Manual (kerasoftic.

Planning for life after orthopaedics.

The word retirement is going out of fashion. Many orthopaedic surgeons want to work in some capacity when they stop performing surgery. Making a smooth transition from a busy orthopaedic practice to alternative work demands advanced planning.

A meta-analysis of studies on cosmetically tinted soft contact lenses.

Background: Concerns regarding the safety of cosmetically tinted contact lenses have been reported in the literature. The purpose of this paper is to evaluate the safety of cosmetically tinted contact lenses in a large number of patients across six clinical trials that varied from 1 week to 3 months in duration.

Methods: LENSES TESTED INCLUDED: Naturelle limbal ring daily disposable, Lacelle limbal ring daily disposable, Lacelle colored cosmetic daily disposable, Lacelle limbal ring planned replacement at 2 weeks, and Alamode traditional/annual colored cosmetic lens.

Tear cytokine response to multipurpose solutions for contact lenses.

Purpose: An increased risk of corneal infiltrative events has been noted with the use of certain contact lenses and multipurpose solutions (MPS). This study was designed to evaluate tear cytokine assay as a sensitive, objective, and quantitative measure of the ocular surface response to contact lens/MPS and to consider the assay's clinical relevance in the context of other measures of ocular surface response.

Methods: Two MPS, ReNu® Fresh™ (RNF) and Opti-Free® RepleniSH (OFR), were used with daily wear silicone hydrogel contact lenses in a randomized, prospective crossover study involving 26 subjects.

1. History, evolution, and evolving standards of contact lens care.

Contact lenses and lens care regimens are an important part of eyecare practices and vital to lens-wearing patients. New contact lens materials and cleaning options continue to come to market and affect how patients wear and care for their lenses. In this section we look at how the contact lens and lens solution revolution started, how it has evolved over the last 40 years, and how standards have evolved and impacted these new offerings.

Myopia progression during three years of soft contact lens wear.

Purpose: To analyze the effect of lens material alone on myopia progression in a multi-center non-randomized prospective study of daily wear hydrogel and continuous wear silicone hydrogel contact lenses.

Methods: Refractive error data from completing subjects were collected during a 3-year study of 54 subjects wearing low-Dk/t hydrogel contact lenses for daily wear and 230 wearing silicone hydrogel contact lenses for up to 30 nights continuous wear. Univariate analysis of refractive error changes was first conducted on factors of lens type, age at baseline, and baseline refractive error.

Higher-order aberrations when wearing sphere and toric soft contact lenses.

Purpose: To determine the on-eye effect of spherical and toric contact lens design on higher-order aberrations (HOA).

Methods: Thirty eyes (15 subjects) entered a masked, randomized, cross-over study. Each eye was fitted with the spherical and toric lens of the following brands in random order: Acuvue Advance, Biomedics 55, Frequency 55, and SofLens 66.

Fluorescein pattern interpretation in keratoconus.

Purpose: The purpose of this study is to assess the effect of disease severity on how accurately contact lens fluorescein patterns can be interpreted in keratoconus by clinician assessment.

Methods: Two clinicians evaluated fluorescein patterns on 111 eyes of 60 patients with mild (<45 D, 14 eyes), moderate (45 D to 52 D, 61 eyes,) and severe (>52 D, 36 eyes) keratoconus. The masked clinicians were given six contact lenses in random order, the lens that just cleared the corneal apex (the first definite apical clearance lens), three lenses flatter (in 0.

Visual acuity with spherical and toric soft contact lenses in low- to moderate-astigmatic eyes.

Purpose: To evaluate the visual acuity of myopic, astigmatic eyes, with spherical and toric soft contact lenses.

Methods: A randomized, masked, cross-over study was conducted to compare acuity with soft spherical and toric contact lenses on patients with between -0.75 and -2.

The stability of dryness symptoms after refitting with silicone hydrogel contact lenses over 3 years.

Purpose: To assess the stability of dryness symptoms after refitting patients wearing low-Dk/t hydrogel contact lenses with high-Dk/t silicone hydrogel contact lenses and to determine whether early dryness symptoms were predictive of discontinuation in the 3-year study.

Methods: Two hundred seventy-eight hydrogel lens wearers were refitted with lotrafilcon A silicone hydrogel contact lenses for continuous wear of up to 30 nights. Self-administered questionnaires at baseline, 1 week, and 3 years captured the frequency and intensity of dryness symptoms during the day and at the end of the day.

Inflammatory and mechanical complications associated with 3 years of up to 30 nights of continuous wear of lotrafilcon A silicone hydrogel lenses.

Purpose: To report the ocular complications occurring during a 3-year clinical trial of subjects wearing lotrafilcon A silicone hydrogel lenses for up to 30 nights of continuous wear.

Methods: Nineteen sites enrolled 317 subjects (286 current wearers and 31 new wearers), who were dispensed lotrafilcon A lenses with 3 years of follow-up.

Results: By the 1-month visit, continuous wear of up to 30 nights was recommended for 87% of subjects.

Long-term clinical results: 3 years of up to 30-night continuous wear of lotrafilcon A silicone hydrogel and daily wear of low-Dk/t hydrogel lenses.

Purpose: To summarize results of a 3-year clinical trial assessing subjective and objective experience with lotrafilcon A silicone hydrogel (SH) lenses for up to 30 nights of continuous wear or low-Dk/t daily-wear (LDW) hydrogel lenses.

Methods: Nineteen sites dispensed SH lenses to 317 subjects (286 current wearers and 31 new wearers) and 2-week replacement LDW lenses to 81 new wearers in a 3-year study.

Results: For the SH cohort, limbal redness, conjunctival redness, and corneal neovascularization improved among 23%, 21%, and 13% of eyes, respectively (P<0.

Predictive factors for corneal infiltrates with continuous wear of silicone hydrogel contact lenses.

Objective: To estimate the cumulative probability and risk factors for developing corneal infiltrates after up to 3 years of continuous wear (CW) with lotrafilcon A lenses.

Methods: Patients were fitted with lotrafilcon A lenses and followed up for 3 years. The main outcome variable was the first occurrence of any infiltrative event in either eye.