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Aim: To evaluate the clinical impact, aqueous tear parameters, and meibomian gland morphology in patients with primary meibomianitis before, during, and 3 months after a course of oral minocycline. Methods: 16 patients were prospectively enrolled, 11 male and five female (mean age 69 years old). Each patient received routine clinical evaluations before, after 3 months therapy, and at 6 month study follow up visit. The clinical appearance, tear volume, flow and turnover, evaporation, Schirmer I test, meibomian gland dropout, lissamine green staining, and bacteriology wer evaluated. Results: Improvement was observed in clinical signs of meibomianitis at the second and third visits. Microbial culture findings improved. Decreased aqueous tear volume and flow, and increased evaporation rate range at 35–45% relative humidity (RH) (p<0.05) were also detected. Other related tear parameters did not change. Meibomian gland dropout showed no improvement. Conclusions: 3 months of oral minocycline resulted in clinical improvements in all meibomianitis signs that persisted for at least 3 months after discontinuation despite decreased aqueous tear volume and flow with increased evaporation (35–45% RH). However, there was improvement in the turbidity of secretions. Short term minocycline therapy probably has efficacy in the management of meibomianitis that extends beyond eradication of bacteria.

Aims:To compare clinical outcomes of patients bilaterally implanted with SN60D3 intraocular lenses (IOLs) with outcomes of bilateral monofocal controls, and to determine the validity of implanting an apodised diffractive lens in a healthy patient population.Methods:Six unmasked US investigators prospectively enrolled 72 patients aged ⩽70 years with bilateral cataracts in otherwise healthy eyes. Patients underwent routine cataract extraction via phacoemulsification with SN60D3 implantation. Visual outcomes were assessed 1 week, 1 month and 6 months postoperatively. Patients completed two subjective surveys. As controls, 51 patients who were 6 months postoperative to bilateral implantation of AcrySof monofocal IOLs also were assessed.Results:Corrected and uncorrected distance visual acuity was similar across groups. For uncorrected near and intermediate visual acuity, statistically significant differences were found favouring the SN60D3 group (p<0.0001). Contrast sensitivity was significantly better in monofocal patients at 6 cpd and 18 cpd under various lighting conditions. The Functional Evaluation and the Questionnaire demonstrated that SN60D3 patients achieved significantly higher levels of functional vision and spectacle freedom (p<0.0001).Conclusion:Despite mildly decreased contrast sensitivity when compared with a monofocal IOL, the SN60D3 provided high patient satisfaction, excellent functional vision, and high rates of spectacle freedom.

We examined and treated six patients with acanthamoeba keratitis associated with contact lens wear from 1981 to 1988. Five patients were treated with topical neomycin-polymyxin B-gramicidin (Neosporin) and propamidine isethionate (Brolene) drops. The patients were followed up for an average of 32 months (range 16-75 months). Two patients underwent penetrating keratoplasty at 22 and 26 months after the onset of symptoms and have maintained clear grafts with no evidence of recurrence. In four patients corneal infiltrates cleared on topical medication. All six patients have 6/6 best corrected vision. Early diagnosis and medical treatment alone can result in resolution of corneal infiltrates due to acanthamoebae. With this initial therapy we have had no treatment failures.

One hundred and fifteen patients with chronic blepharitis were compared with 47 normal controls. Six clinically distinct groups of blepharitis were observed: staphylococcal; seborrhoeic, alone, with associated staphylococcal superinfection, meibomian seborrhoea, or secondary inflammation of the meibomian glands; and meibomian keratoconjunctivitis (MKC). Staphylococcus aureus was isolated in appreciable frequency from the staphylococcal and the mixed staphylococcal/seborrhoeic groups in contrast to the normal and non-staphylococcal groups. Coagulase-negative Staphylococcus spp., Propionibacterium acnes, and cornyneform bacteria were the most commonly isolated bacteria from the lid for all groups. Cultures of material expressed from the meibomian glands yielded similar organisms but in reduced frequency. Testing of antibiotic susceptibility revealed Staph aureus to be usually sensitive to most commonly used ophthalmic antimicrobials except sulphonamides.

The chemotactic potential of antigens of Acanthamoeba castellanii for macrophages and the ability of naive and immune rat peritoneal macrophages to kill A. castellanii in vitro were assessed. The amoebolytic capacity of immune rat serum and complement was also examined. No parasite was killed in the presence of heat-inactivated naive rat serum. Low numbers of parasites were lysed in the presence of heat-inactivated immune rat serum, whereas significantly greater numbers of parasites were lysed in the presence of nonheat inactivated naive and immune rat serum. Macrophages from naive rats were capable of lysing some parasites. However, the amoebolytic capability of these cells was significantly increased in the presence of serum from immune rats. Regardless of the source of serum used, macrophages from immune rats demonstrated about twice the amoebolytic proficiency of cells from naive rats. Macrophages from naive rats showed their highest capacity for lysing amoebae when incubated in the presence of gamma interferon and immune rat serum. The greatest overall proficiency in lysing parasites was displayed by cells from immune rats incubated with A. castellanii in the presence of gamma interferon and nonheat-inactivated serum from immune rats. The results indicate that low numbers of parasites lyse in the presence of anti-A castellanii antibody alone; that the parasite activates the alternate complement pathway, which results in complement-mediated lysis of significant numbers of A. castellanii; that a substantial component of the ability of both naive and immune macrophages to lyse the parasite is anti-A. castellanii antibody dependent; and, that gamma interferon dramatically activates macrophages from both immune and naive rats in terms of their ability to lyse the parasite. The chemotactic response of macrophages from naive and immune rats to zymosan-activated rat serum (ZAS), medium alone, or A. castellanii antigen was examined. In terms of their response to ZAS, cells from immune rats showed a greater chemotactic response than did cells from naive rats. The chemotactic response of these 2 groups of cells was similar to medium alone and to parasite antigen. Parasite antigen did not alter the chemotactic response of naive rat cells to ZAS. These results suggest that macrophages from both naive and immune rats are attracted to the antigen of the parasite.

Purpose: To evaluate the objective and subjective visual outcomes and refractive results of wavefront-guided LASIK with LADAR CustomCornea and VISX CustomVue. Methods: This prospective randomized single-institution multisurgeon study comprised 100 eyes of 58 patients (50 eyes on each laser platform). Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and manifest refraction were measured postoperatively at 1 day, 1 week, 1 month, and 3 months. Contrast sensitivity, higher order aberrations measurement, and a subjective vision questionnaire were performed preoperatively and at 3 months. Results: Preoperatively, the CustomCornea group had a mean manifest sphere of −3.58±1.61 diopters (D) (range: −0.50 to −7.25 D), cylinder of +0.64±0.45 D (range: 0 to +1.75 D), and manifest refractive spherical equivalent (MRSE) of −3.26±1.56 D. The Custom-Vue group had a manifest sphere of −4.00±1.69 D (range: −1.50 to −7.50 D), cylinder of +0.60±0.52 D (range: 0 to +2.00 D), and MRSE of −3.70±1.64 D. At 3 months, 94% of CustomCornea eyes and 84% of CustomVue eyes had UCVA ⩾20/20 (P=.20). Twenty-four percent of CustomVue eyes and 22% of Custom-Cornea eyes gained 1 line of BSCVA. In both groups, 96% of eyes were within 0.50 D of emmetropia. Mean CustomCornea glare contrast sensitivity improved (P=.04) whereas more eyes improved than worsened in both groups. Spherical aberration and total higher order aberrations increased, and trefoil decreased in both groups. A decrease in coma was noted in 70% of CustomCornea eyes. Conclusions: Wavefront-guided LASIK with both platforms is safe, effective, and delivers excellent visual results. CustomCornea improves contrast sensitivity under glare conditions. [J Refract Surg. 2007;23:26–38.]

ABSTRACTPURPOSE: To evaluate and compare the visual and clinical outcomes of wavefront-guided laser in situ keratomileusis (LASIK) with the Alcon CustomCornea (Alcon Laboratories Inc, Fort Worth, Tex) and VISX CustomVue (VISX, Santa Clara, Calif) systems.METHODS: Ninety-three eyes of 56 patients (50 and 43 consecutive eyes on CustomCornea and CustomVue, respectively) were enrolled in a prospective multisurgeon clinical outcome study. Uncorrected visual acuity (UCVA), best spectaclecorrected visual acuity (BSCVA), and manifest refraction were measured at 1 day, 1 week, 1 month, and 3 months postoperatively. Early treatment diabetic retinopathy study (ETDRS) visual acuity and contrast sensitivity were measured at 1 month and 3 months, and wavefront mapping at 3 months.RESULTS: Preoperatively, the CustomCornea group had a mean sphere of -3.90 ? 1.62 diopters (D) (range -0.50 to -7.25 D), mean cylinder of +0.62 ? 0.39 D (range 0 to +1.50 D), and mean manifest spherical equivalent refraction of -3.59 ? 1.54 D. The CustomVue group had a sphere of -3.87 ? 1.45 D (range -1.75 to -6.75 D), cylinder of +0.49 ? 0.36 D (range 0 to +1.50 D), and manifest spherical equivalent refraction of -3.62 ? 1.46 D. At 3 months, 98% of the CustomCornea group and 95% of the CustomVue group were within ?0.50 D. Ninety -nine percent of eyes did not change >0.50 D (manifest spherical equivalent refraction) between 1 month and 3 months. CustomCornea eyes improved on contrast sensitivity testing and had a better profile than CustomVue for 20/15 Snellen and 20/12.5 ETDRS acuity. Both laser groups had a decrease in higher order aberrations with statistical significance for coma and spherical aberration in the CustomCornea group.CONCLUSION: Wavefront-guided LASIK with both systems is safe and effective. [J Refract Surg 2004;20:S636-S643]

This study examined the captive western lowland gorilla (Gorilla gorilla gorilla) eye as compared and contrasted with the human eye. Bilateral ophthalmic examinations of western lowland gorillas (n = 5) while under general anesthesia were performed opportunistically, including slit-lamp biomicroscopy, dilated fundus examination, cycloplegic retinoscopy, Schiotz tonometry, corneal diameter and thickness measurements, A-scan and B-scan ultrasonography, keratometry, and cultures of the eyelid margins and bulbar conjunctiva. Mean spherical equivalent refractive error by cycloplegic retinoscopy was +1.20 plus or minus 0.59 diopters. Mean intraocular pressure by Schiotz tonometry was 12.0 plus or minus 4.3 mm Hg. Mean optic nerve head cup to disc ratio was 0.42 plus or minus 0.11. Mean horizontal corneal diameter was 13.4 plus or minus 0.8 mm, and mean vertical cornea diameter was 12.7 plus or minus 0.8 mm. Mean central corneal thickness by ultrasound pachymetry was 489 plus or minus 52 mu m. Mean axial length of the eye by A-scan was 22.75 plus or minus 0.71 mm. Mean lens thickness by A-scan was 4.23 plus or minus 0.34 mm. Mean anterior chamber depth by A-scan was 4.00 plus or minus 0.26 mm. Mean keratometry reading was 44.38 plus or minus 1.64 diopters. Eyelid margin and bulbar conjunctival cultures isolated Candida sp. (n = 5), Staphylococcus aureus (n = 4), Staphylococcus epidermidis (n = 3), Staphylococcus saccharolyticus (n = 3), and Micrococcus sp. (n = 3). This study suggests important similarities between western lowland gorilla and human eyes. These similarities may allow diagnostics, techniques, and equipment for human eye surgery, such as those used for cataract extraction and intraocular lens implantation, to be successfully utilized for gorillas.

ABSTRACTPURPOSE: To evaluate and compare the surgically induced astigmatism in myopic eyes undergoing conventional and wavefront-guided LASIK.METHODS: A retrospective review was performed of the charts of 200 myopic eyes of 121 patients who underwent either custom or conventional treatments via the VISX S4 or LADARVision4000 platforms (50 consecutive eyes in each of the four groups). The primary outcome measure was manifest refraction, which was evaluated preoperatively and at 3 months postoperatively. The magnitude and axis of the unintended surgically induced astigmatism were calculated using vector analysis. The Student t test was used to compare the magnitudes of the surgically induced astigmatism and the absolute angle of error.RESULTS: The mean preoperative manifest cylinder was 0.66?0.38 diopters (D) for conventional VISX S4 and 0.68?0.39 D for VISX CustomVue (P=. 795), and 0.76?0.56 D for LADARVision and 0.61?0.36 D for LADAR CustomCornea (P=. 114). The success index was 0.19?0.41 for VISX S4 and 0.49?0.49 for VISX CustomVue (P= .0013), and 0.25 ?0.47 for LADARVision and 0.20?0.39 for LADAR CustomCornea (P=.5721). The absolute mean angle of error was 4.4?13.9? for VISX S4 versus 14.9?23.9? for VISX CustomVue (P=.0085), and 6.1?12.3? for LADARVision versus 3.9?11.1? for LADAR CustomCornea (P=.3501). Of the VISX CustomVue eyes, 32% had an absolute angle of error >10?, as compared to 10% for both the VISX S4 and LADAR CustomCornea eyes (P=. 013), and 16% for the LADARVision group (P=. 056).CONCLUSIONS: Wavefront-guided ablation is associated with higher surgically induced astigmatism and larger astigmatic axis shift on the VISX platform as compared to the LADAR CustomCornea and the LADAR and VISX conventional platforms. Care should be emphasized mainly during registration/alignment to minimize surgically induced astigmatism in wavefront-guided LASIK. [J Refract Surg. 2005;21:S792-S798.]

This study examined the captive western lowland gorilla (Gorilla gorilla gorilla) eye as compared and contrasted with the human eye. Bilateral ophthalmic examinations of western lowland gorillas (n = 5) while under general anesthesia were performed opportunistically, including slit-lamp biomicroscopy, dilated fundus examination, cycloplegic retinoscopy, Schiotz tonometry, corneal diameter and thickness measurements, A-scan and B-scan ultrasonography, keratometry, and cultures of the eyelid margins and bulbar conjunctiva. Mean spherical equivalent refractive error by cycloplegic retinoscopy was +1.20 ± 0.59 diopters. Mean intraocular pressure by Schiotz tonometry was 12.0 ± 4.3 mm Hg. Mean optic nerve head cup to disc ratio was 0.42 ± 0.11. Mean horizontal corneal diameter was 13.4 ± 0.8 mm, and mean vertical cornea diameter was 12.7 ± 0.8 mm. Mean central corneal thickness by ultrasound pachymetry was 489 ± 52 μm. Mean axial length of the eye by A-scan was 22.75 ± 0.71 mm. Mean lens thickness by A-scan was 4.23 ± 0.34 mm. Mean anterior chamber depth by A-scan was 4.00 ± 0.26 mm. Mean keratometry reading was 44.38 ± 1.64 diopters. Eyelid margin and bulbar conjunctival cultures isolated Candida sp. (n = 5), Staphylococcus aureus (n = 4), Staphylococcus epidermidis (n = 3), Staphylococcus saccharolyticus (n = 3), and Micrococcus sp. (n = 3). This study suggests important similarities between western lowland gorilla and human eyes. These similarities may allow diagnostics, techniques, and equipment for human eye surgery, such as those used for cataract extraction and intraocular lens implantation, to be successfully utilized for gorillas.