Economic, clinical and social impact of simple limbal epithelial transplantation for limbal stem cell deficiency.

Aims: To report the global uptake of simple limbal epithelial transplantation (SLET) and compare the economic, clinical and social outcomes of SLET with those of cultured limbal epithelial transplantation (CLET).

Methods: A comprehensive literature review and an online survey of eye surgeons were conducted to understand the efficacy and current uptake of SLET surgery. A de novo economic model was developed to estimate the cost savings with SLET compared with CLET.

Ocular microbiota and lens contamination following Mel4 peptide-coated antimicrobial contact lens (MACL) extended wear.

Purpose: The purpose of this study was to investigate the effect of Mel4 antimicrobial peptide-coated contact lenses (MACL) on the microbiota of the conjunctiva and lenses during three months of extended wear.

Methods: One hundred and seventy-six participants were recruited into a randomised, contralateral, double masked, biweekly extended wear MACL and uncoated control lens trial. At the one month and 3-month visit, the conjunctival microbiota was sampled using sterile cotton swabs and contact lenses were collected aseptically.

Long term observation of ocular surface alkali burn in rabbit models: Quantitative analysis of corneal haze, vascularity and self-recovery.

Limbal Stem Cell Deficiency (LSCD), caused due to corneal injury, primarily by chemical/alkali burns, leads to compromised vision. Recently, several animal models of corneal alkali burn injury have become available. The majority of the studies with these animal models start interventions soon after the injury.

Tear secretion from the lacrimal gland: variations in normal versus dry eyes.

Purpose: To investigate the secretory status of the main lacrimal gland in healthy and dry eye disease (DED) via fluorescein-assisted direct assessment of tear secretion from the palpebral lobes.

Methods: Included were 25 healthy subjects (50 lobes) and 75 subjects with DED (cicatrising conjunctivitis (CC, n=27), evaporative dry eyes (EDE, n=25) and Sjogren's syndrome (SS, n=23)). Analysed parameters included number and location of ductular openings, tear flow rate per gland and per ductule, and the time lag for the initiation of secretion.

Seropositivity of blood samples of 31,355 cornea donors from a tertiary care network of eye banks.

Purpose: To evaluate the seropositivity of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis from blood samples of cornea donors and assess correlation between seropositivity for HIV and syphilis.

Methods: Retrospective analysis of blood samples of 31,355 cornea donors for HIV, HBV, HCV, and syphilis was performed. Postmortem blood samples were analyzed by a rapid screening test for anti-HIV envelope antibodies against HIV 1 and 2, HBV surface antigen, antibody to HCV and anti-cardiolipin antibodies for syphilis by rapid plasma reagin test.

Genetic Markers for Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis in the Asian Indian Population: Implications on Prevention.

This review attempts to collate all the studies performed in India or comprising a population originating from India and to find out if there is an association between the HLA (human leucocyte antigen) type of individual and development of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) subsequent to medication use. The authors performed a PubMed search of all articles published in English from 2009 to 2019 for articles that studied HLA type in patients who developed SJS/TEN after intake of a specific drug in the Asian Indian population or in individuals of Asian Indian origin. The selection criteria were satisfied by a total of 11 studies that reported HLA associations with specific drugs, which induced SJS/TEN, mainly anti-epileptic drugs, and cold medicine/non-steroidal anti-inflammatory drugs.

An Evidence-Based Strategic Approach to Prevention and Treatment of Dry Eye Disease, a Modern Global Epidemic.

Dry eye disease (DED) is an emerging health concern causing significant visual, psychological, social, and economic impact globally. In contrast to visual rehabilitation undertaken at late stages of DED, measures instituted to prevent its onset, establishment, or progression can alter its natural course and effectively bring down the associated morbidity. This review attempts to present the available literature on preventive strategies of DED at one place, including strategies for risk assessment and mitigation, targeting a wide range of population.

Allograft rejection after living-related simple limbal epithelial transplantation.

A 23-year-old man presented with congestion, peripheral corneal vascularization, an elevated ridge-like epithelial line and cellular infiltration around limbal transplants, 15 months after undergoing living-related simple limbal epithelial transplantation (SLET) for total limbal stem cell deficiency. A diagnosis of acute allograft rejection was made and he was treated with intravenous methylprednisolone, topical and oral prednisolone as well as systemic cyclosporine and azathioprine, leading to reversal of the signs. Similar findings were noted during a later rejection episode.

Quantitative corneal neural imaging using confocal microscopy in cases of congenital corneal anesthesia: A prospective analysis and clinical correlation.

Purpose: Congenital corneal anesthesia (CCA) is a rare clinical entity that poses a diagnostic dilemma, particularly in the pediatric age group with very little literature on this. Accurate initial diagnosis, evaluation, early identification of risk factors, aggressive systemic workup, and appropriate therapy are paramount to prevent visual loss due to long-term complications of corneal anesthesia. The purpose of the study was to estimate and compare the corneal neural architecture using real time, in vivo confocal microscopy (IVCM) in patients with CCA as against a control population.

Congenital central corneal dermoid: A rare entity.

Background: To understand the pathogenesis of a central corneal dermoid (CD) in a 12-day-old child, a comparison of CD specimen was done with limbal dermoid (LD) and cadaveric corneal (CC) specimens by immuno-histochemical staining.

Methods: The child underwent penetrating keratoplasty for visual rehabilitation. The corneal tissue was sent for histo-pathological and immunochemistry evaluation.

Ocular Involvement in Sjögren Syndrome: Risk Factors for Severe Visual Impairment and Vision-Threatening Corneal Complications.

Purpose: To assess the risk factors for severe visual impairment (SVI) and corneal complications in primary and secondary Sjögren syndrome (SS).

Design: Retrospective case series.

Methods: Ocular data of all consecutive SS patients presenting to an eye-care network and receiving a diagnosis according to 2012 American College of Rheumatology criteria over the past 8 years were reviewed.

Serial anterior segment optical coherence tomography post autologous simple limbal epithelial transplantation.

A 24-year-old young man presented to us with total limbal stem cell deficiency (LSCD) in the right eye 1 year post ocular chemical burn. The patient subsequently underwent limbal biopsy in the healthy contralateral eye and autologous simple limbal epithelial transplantation in the right eye. The patient was followed up with sequential imaging of the cornea with high-resolution anterior segment optical coherence tomography (HR-ASOCT) for 3 years.

Simultaneous surgical management of unilateral limbal stem cell deficiency and symblepharon post chemical burn.

A 6-year-old female child presented with severe acute ocular chemical burn in the right eye 2 days after injury with cement. She underwent removal of all foreign bodies from the ocular surface and amniotic membrane transplantation. Three months later, she developed unilateral total limbal stem cell deficiency (LSCD) with symblepharon in two quadrants.

Ocular Features in a Large Cohort of Indians With Xeroderma Pigmentosum.

Purpose: Xeroderma pigmentosum (XP) is an extreme hypersensitivity to sunlight causing skin freckling and pigmentary changes because of defective DNA repair mechanisms. The purpose of this article is to evaluate the spectrum of ocular and systemic features in XP at a tertiary eye care center in India over 32 years.

Methods: Data from 418 eyes of 209 patients diagnosed with XP from 1987 to 2018 were reviewed retrospectively for demographics, complaints, ocular features, systemic associations, and their management.

Visual outcomes of sterile corneal infiltrates after photorefractive keratectomy.

Purpose: Sterile infiltrates following laser refractive surgery is an uncommon complication. This study was undertaken to analyze the visual outcomes of sterile infiltrates following photorefractive keratectomy (PRK).

Methods: This retrospective study included 14 eyes that developed sterile infiltrates following PRK out of a total of 6280 eyes that underwent PRK between 2014 and 2017.

Epidemic keratoconjunctivitis in India: electronic medical records-driven big data analytics report IV.

Aims: To describe the clinical profile of epidemic keratoconjunctivitis (EKC) in patients presenting to a multitier ophthalmology hospital network in India.

Methods: This retrospective hospital-based study included 2 408 819 patients presenting between August 2010 and February 2020. Patients with a clinical diagnosis of EKC in at least one eye with a recent onset (≤1 week) were included as cases.