Evaluation of the role of ProKera in the management of ocular surface and orbital disorders.

Objectives: To report the efficacy and safety profile of sutureless and adhesiveless amniotic membrane device (ProKera, Bio-Tissue, Inc., Miami, FL) in the management of various ocular surface and orbital disorders.

Methods: Twenty eyes of 20 patients underwent placement of 21 ProKera implants between March 2006 and July 2007 at the University of Texas Southwestern Medical Center.

Corneal deturgescence after Descemet stripping automated endothelial keratoplasty evaluated by Visante anterior segment optical coherence tomography.

Purpose: To evaluate postoperative corneal deturgescence after Descemet stripping endothelial keratoplasty (DSAEK) using the Visante anterior segment optical coherence tomography (OCT) system (Carl Zeiss Meditec Inc, Dublin, California, USA).

Design: Retrospective case series.

Methods: We included 21 eyes (9 males and 12 females; mean age +/- standard deviation, 76.

Impact on ocular surface evaporation of an artificial tear solution containing hydroxypropyl guar.

Objective: To determine whether any acute effects on evaporative parameters are produced when using a solution containing Hydroxypropyl (HP) (Systane) versus normal saline solution in the eyes of patients with Keratoconjunctivis Sicca at 30 and 60 minutes postinstillation.

Methods: Randomized double-blinded placebo-control 2-period cross-over clinical trial. Twelve patients with a clinical diagnosis of Keratoconjunctivis Sicca were enrolled in this study.

Bilateral chronic peripheral ulcerative keratitis secondary to cat-scratch disease.

Purpose: To report a case of bilateral chronic peripheral ulcerative keratitis secondary to cat-scratch disease.

Methods: Case report.

Results: A 66-year-old woman was initially diagnosed with Perinaud oculoglandular syndrome in her right eye.

Corneal melting after use of nepafenac in a patient with chronic cystoid macular edema after cataract surgery.

This report describes a patient who developed a corneal melt after the use of nepafenac, a nonsteroidal antiinflammatory drug. An 82-year-old woman with chronic cystoid macular edema after cataract extraction and intraocular lens implantation in the left eye, which was clinically controlled with a topical nonsteroidal antiinflammatory drug, was initially treated with diclofenac sodium 0.1% before being treated with nepafenac 0.

Avellino corneal dystrophy worsening after laser in situ keratomileusis: further clinicopathologic observations and proposed pathogenesis.

Purpose: To study the nature of the deposits in Avellino corneal dystrophy (ACD) worsening after laser in situ keratomileusis (LASIK), and suggest a mechanism for histopathogenesis.

Design: Interventional case report.

Methods: A 28-year-old woman previously diagnosed with bilateral ACD underwent bilateral LASIK.

Liquid chromatography-mass spectrometric analysis of lipids present in human meibomian gland secretions.

The purpose of the study was to qualitatively characterize the major lipid species present in human meibomian gland secretions (MGS) by means of high-performance liquid chromatography with atmospheric pressure ionization mass spectrometric detection of the analytes (NP HPLC-MS). Two different NP HPLC-MS methods have been developed to analyze lipid species that were expected to be present in MGS. The first method was optimized for the analysis of relatively nonpolar lipids [wax esters (WE), di- and triacyl glycerols (DAG and TAG), cholesterol (Chl) and its esters (Chl-E), and ceramides (Cer)], while the second method was designed to separate and detect phospholipids.

Clinical treatment of ocular demodecosis by lid scrub with tea tree oil.

Purpose: To report clinical outcome of treating ocular demodecosis by lid scrub with tea tree oil (TTO).

Methods: Retrospective review of clinical results in 11 patients with ocular Demodex who received weekly lid scrub with 50% TTO combined with daily lid hygiene with tea tree shampoo.

Results: These 11 patients also had meibomian gland dysfunction (n = 7) manifesting abnormal lipid film with slow lipid film spread, intermittent trichiasis (n = 5), and subjective lash loss (n = 4), suggesting damage to the meibomian glands and lash follicles.

How does amniotic membrane work?

Transplantation of amniotic membrane as a temporary or permanent graft promotes epithelial wound healing and exerts potent anti-inflammatory and anti-scarring effects on the ocular surface. These actions depend on the killing of allogeneic amniotic cells and preservation of the cytokine-containing matrix during the preparation of the amniotic membrane. This review describes how these actions inherently operate in utero and how amniotic membrane transplantation aims to recreate such a fetal environment to exert these actions by insulating the surgical site from the host environment.

The heterogeneous murine corneal stromal cell populations in vitro.

Purpose: To demonstrate that the murine corneal stroma is inhabited by heterogeneous cell populations that include cells expressing nestin.

Methods: Collagenase-isolated corneal stroma cells obtained from newborn and adult mice (2nd and 12th postnatal weeks, respectively), were seeded at low (5 cells/mm2), intermediate (50 cells/mm2), and high (500 cells/mm2) densities in DMEM/F12 containing insulin, transferrin, selenium, and 1% nonessential amino acids. Corneal stroma cells cultured at 500 cells/mm2 were treated with 10 ng/mL human recombinant transforming growth factor (TGF)-beta1 for 5 days.

Lipid tear deficiency in persistent dry eye after laser in situ keratomileusis and treatment results of new eye-warming device.

Purpose: To determine whether lipid tear deficiency is a significant pathogenic factor in persistent dry eyes after laser in situ keratomileusis (LASIK).

Setting: Ocular Surface Center, Miami, Florida, USA.

Methods: Thirty-four eyes of 17 patients (mean 46.

High prevalence of Demodex in eyelashes with cylindrical dandruff.

Purpose: To determine the prevalence of Demodex in eyelashes with cylindrical dandruff (CD).

Methods: A modified sampling and counting method was applied to 55 clinical cases. Patients were divided in to group A (n = 20) with diffuse CD, group B (n = 12) with sporadic CD, and group C (n = 23) with clean lashes or greasy scales, of which the latter was divided into subgroup C1 (n = 15) without lid hygiene and subgroup C2 (n = 8) using daily lid hygiene for the past year.

Correlation of corneal complications with eyelid cicatricial pathologies in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis syndrome.

Purpose: To look at the correlation between many factors (time of hospitalization, floppy eyelid syndrome, trichiasis, open lacrimal puncta, symblepharon, and aqueous tear deficiency) and corneal complications in Stevens-Johnson syndrome (SJS).

Design: Observational cases series.

Patients: Clinical data were retrospectively reviewed from 38 patients (32.

Intraoperative mitomycin C and amniotic membrane transplantation for fornix reconstruction in severe cicatricial ocular surface diseases.

Purpose: To investigate whether intraoperative application of mitomycin C may enhance the success of amniotic membrane transplantation in symblepharon lysis and fornix reconstruction in severe cicatricial ocular surface diseases.

Design: Noncomparative interventional case series.

Participants: Sixteen patients (8 female, 8 male; 18 eyes) with a mean age of 41+/-23.

Tear film dynamics in floppy eyelid syndrome.

Purpose: Floppy eyelid syndrome (FES) presents nonspecific ocular surface irritation. The hypothesis for the current study was that one contributing factor is the abnormality in tear film dynamics.

Methods: Sixteen patients with FES were consecutively examined.

Detection of corneal epithelial defect through amniotic membrane patch by fluorescein.

Purpose: To demonstrate the usefulness of fluorescein dye to detect a corneal epithelial defect through an amniotic membrane patch in 4 cases.

Patients And Method: Two patients with painful bullous keratopathy, 1 patient with total limbal deficiency, and 1 patient with acute chemical burn underwent surgeries in conjunction with amniotic membrane as patch. Postoperatively, slit-lamp biomicroscopic examination with and without fluorescein staining was performed.

Characterization of corneal pannus removed from patients with total limbal stem cell deficiency.

Purpose: To determine the epithelial lineage of origin in corneal pannus tissue surgically removed from patients with total limbal stem cell (SC) deficiency.

Methods: The lineage of origin of the entire conjunctivalized pannus removed from eight corneas with a diagnosis of total limbal SC deficiency was characterized by anti-keratin (K)-3 and anti-K19 monoclonal antibodies. The protein and mRNA of epithelial outgrowth from segments of five such pannus specimens were analyzed by Western blot and reverse transcription-polymerase chain reaction, respectively.

Sequential changes of lipid tear film after the instillation of a single drop of a new emulsion eye drop in dry eye patients.

Purpose: The lipid tear film stabilizes the tears by lowering the surface tension and preventing aqueous tear evaporation and may be analyzed by kinetic analysis of the tear interference images. This study investigated changes in the lipid film after application of a new emulsion-based eye drop of Refresh Endura (Allergan, Irvine, CA) in normal subjects and patients with dry eyes.

Design: Comparative, nonrandomized interventional study.

A case of conjunctiva-cornea intraepithelial neoplasia successfully treated with topical mitomycin C and interferon alfa-2b in cycles.

Purpose: To report a case of conjunctiva-cornea intraepithelial neoplasia (CCIN) treated with topical mitomycin C (MMC) and interferon alfa-2b in cycles.

Methods: A 52-year-old woman referred for limbal stem cell deficiency and epithelial defect was found instead to have CCIN. The diagnosis was confirmed by impression cytology and treated in cycles with topical 0.

Human keratocytes cultured on amniotic membrane stroma preserve morphology and express keratocan.

Purpose: To develop a new method of expanding human corneal keratocytes in serum while maintaining their characteristic morphology and keratocan expression.

Methods: Human keratocytes were isolated from central corneal buttons by digestion in 1 mg/mL of collagenase A in DMEM and seeded on plastic or the stromal matrix of human amniotic membrane (AM) in DMEM with different concentrations of FBS. On confluence, cells on AM were continuously subcultured for six passages on AM or plastic.

Stromal niche controls the plasticity of limbal and corneal epithelial differentiation in a rabbit model of recombined tissue.

Purpose: The adult rabbit limbal basal epithelium contains corneal epithelial stem cells, which have been characterized by a negative expression of keratin-3 (K3) and a lower expression of connexin 43 (Cx43). This study was conducted to determine whether the limbal stroma dictates the plasticity of limbal and corneal epithelial differentiation.

Methods: Viable epithelial sheets of the central cornea and the pigmented limbus were isolated from Dutch belted rabbits by incubation of 50 mg/mL of dispase II in supplemental hormonal epithelial medium (SHEM) for 18 hours at 4 degrees C.

Novel enzymatic isolation of an entire viable human limbal epithelial sheet.

Objective: To develop a reproducible method of isolating an intact viable human limbal epithelial sheet.

Methods: Human pigmented limbus was incubated at 4 degrees C for 18 hours in supplemental hormonal epithelial medium (SHEM) containing 50 mg/mL dispase II and 100 mM sorbitol. A loose limbal epithelial sheet was separated by a spatula.