The ocular microbiome and microbiota and their effects on ocular surface pathophysiology and disorders.

Hydrophobic acrylic intraocular lens (IOL) is the most popular material in cataract surgery. Posterior capsule opacification (PCO) is a long-term complication of cataract surgery. It can impair vision and adversely affect the prognosis of IOL delamination. The objective of this study was to perform a systematic review and meta-analysis to provide an updated evaluation of long-term complications and visual function after implantation with hydrophobic acrylic and silicone intraocular lenses. PubMed, Embase, and Cochrane Library were searched from January 2000 until March 2021. Randomized controlled trials (RCTs) and retrospective studies were finally included. The main outcomes were PCO value and neodymium-doped yttrium aluminum garnet (Nd : YAG) capsulotomy rate. Subgroup analysis was performed to compare hydrophobic acrylic and silicone IOLs during the follow-up period. Sensitivity analysis was also performed. The meta-analysis included a total of 17 studies. When the follow-up period was considered, the results of the analysis revealed higher PCO value (Group 3: standardized mean difference (SMD), −0.59; 95% confidence interval (CI), −0.90 to −0.28) and Nd : YAG capsulotomy rate (Group 3: risk ratio (RR), 0.60; 95% CI, 0.40–0.89) for hydrophobic acrylic IOLs than silicone IOLs during a long-term (≥6 years) follow-up. In conclusion, both the PCO value and the Nd : YAG capsulotomy rates were higher in hydrophobic acrylic IOLs group than the silicone IOLs group at long-term use (more than 6 years) after implantation.

https://downloads.hindawi.com/journals/joph/2022/3570399.pdf

Posterior Capsule Opacification after Cataract Surgery via Implantation with Hydrophobic Acrylic Lens Compared with Silicone Intraocular Lens: A Systematic Review and Meta-Analysis

Purple urine bag syndrome (PUBS) is a rare condition characterized by purple discoloration of urine and urine bags. Although it is benign, it represents an alarming symptom to the patients and their relatives because of purple discoloration. We have physically characterized urine and urine bags belonging to a patient suffering from PUBS using an approach that combines Raman spectroscopy (RS) and scanning electron microscopy (SEM) coupled with energy dispersive X-ray (EDX). Five “blue” discolored bags and one sterile urine bag, representing the control, were cut into 1 cm2 square samples and analyzed by using RS and SEM + EDX technique. RS enabled us to identify the presence of indigo, a metabolite of tryptophan, while SEM analysis showed the biofilm deposit, probably due to the presence of microorganisms, and the EDX measurements exhibited the elemental composition of the bags. In particular, urine bags before and after the presence of PUBS urine showed an increase of ~32% of Cl, ~33% of O, ~667% of Ca, ~65% of Al and Mg, while C decreased by about 41%. Our results, to be taken as a proof-of-principle study, are promising for the aim to characterizing the urine bags in a flexible, inexpensive, and comprehensive manner.

/pdf/use-of-raman-spectroscopy-scanning-electron-microscopy-and-1y91hhag.pdf

Use of Raman Spectroscopy, Scanning Electron Microscopy and Energy Dispersive X-ray Spectroscopy in a Multi-Technique Approach for Physical Characterization of Purple Urine Bag Syndrome

This is an investigator-initiated study supported by an unrestricted research grant from Medicontur AVI. David P Pinero was supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramon y Cajal (RYC-2016-20471).

/pdf/long-term-clinically-significant-posterior-capsular-2zobconxoo.pdf

Long-Term Clinically Significant Posterior Capsular Opacification Development Pattern in Eyes Implanted with an Aspheric Monofocal Intraocular Lens with a Square Optic Edge.

Cataract surgery is widespread. The surgical procedure is associated with damage to the epithelial barrier and interruption of the corneal innervation. In addition, pathological events sustain signs and symptoms that may persist for a long time. Recently, a fixed combination of alpha-glycerylphosphorylcholine and D-Panthenol (Oftassiale) has been available as eye drops. The present study investigated the effects of an Oftassiale therapy in 20 patients undergoing cataract surgery. A comparison group included 20 patients treated with topical hyaluronic acid. Standard prophylactic and anti-inflammatory treatment was prescribed to all patients. Clinical signs and symptoms were assessed over time. In vivo confocal microscopy (IVCM) was performed accordingly. Oftassiale treatment significantly reduced clinical features and improved IVCM outcomes. In addition, therapy was well-tolerated, and no clinically significant adverse events occurred. In conclusion, this study confirmed that IVCM helps assess the tunnel after cataract surgery due to its ability to provide microscopic details in vivo. Topical therapy with alpha-glycerylphosphorylcholine and D-Panthenol eye drops promoted and stabilized the reepithelialization process. This fixed combination also accelerated and modulated the repair of the corneal innervation. Moreover, this treatment was well-tolerated and safe.

/pdf/alpha-glycerylphosphorylcholine-and-d-panthenol-eye-drops-in-5o6a1e9p.pdf

Alpha-Glycerylphosphorylcholine and D-Panthenol Eye Drops in Patients Undergoing Cataract Surgery

Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser may cause intraocular lenses (IOLs) damages. Therefore, the effects of Nd:YAG laser on IOLs were evaluated. Twenty-four IOLs (copolymer of 2-hydroxyethylmethacrylate and 2-ethoxyethylmethacrylate) were used. For scanning electron microscope (SEM), twelve IOLs were divided into three groups: Group 1, controls; Group 2, IOLs treated with two laser spots (YC-1800 Nidek Nd:YAG laser set at 1.2 mJ); and Group 3, IOLs treated with six laser spots. All IOLs were critical point dried in CO2 and viewed in a Zeiss EVO LS10 SEM. For Energy Dispersive X-ray spectrometry (EDX), four IOLs of each group were examined with a Jeol JMC-6000 SEM. With SEM, Group 1 IOLs showed well-preserved size, shape and surface. Group 2 IOLs exhibited normal shape and margins, a peripheral furrow with irregular blebs, straight clefts and holes on the wrinkled surface. Group 3 IOLs were swollen and broken into two or three parts. With SEM and EDX, Group 1 and the undamaged surfaces of Groups 2 and 3 showed evident carbon and oxygen peaks, while, in the damaged areas, both atoms were significantly reduced. Nd:YAG laser induced evident changes in IOLs morphology and organic alterations in their chemistry: great care during posterior capsule opacification treatment is required.

PMMA Intraocular Lenses Changes after Treatment with Nd:Yag Laser: A Scanning Electron Microscopy and X-ray Spectrometry Study

Extrusion of the scleral buckle is one of the complications patients may encounter undergoing the surgical treatment for retinal detachment. We present two cases of persistent Pseudomonasaeruginosa-related conjunctivitis which infected the silicone explant after retinal surgery. One of them is a 73-year-old Caucasian female patient with hyperaemia, intense pain and mucopurulent discharge. After the conjunctival swabs detected a P. aeruginosa infection, she started both topical and systemic treatment without any results; for this reason we opted for the buckle removal always under systemic therapy. The second case is an 84-year-old Caucasian female patient with fever, periorbital oedema, chronic ocular pain, hyperaemia and purulent discharge. P. aeruginosa has also been detected in this case. No improvement with topical and systemic treatment, so this convinced us to remove patient9s buckles and to continue systemic therapy. Both cases had the complete resolution after surgery. It is important to quickly recognise exposed scleral buckles because they can be a source of infections and a rare but threatening cause of endophthalmitis.

https://casereports.bmj.com/content/bmjcr/13/1/e232296.full.pdf

Infectious conjunctivitis caused by Pseudomonasaeruginosa in infected and extrused scleral buckles

Background: To study the safety and efficacy provided by a minimal and localized anesthesia in cataract surgery. Methods: Randomized controlled trial. A total of 100 patients undergoing cataract surgery were randomly divided into two groups of 50, which respecitvely received conventional topical anesthesia consisting of preservative-free Oxibuprocaine hydrochloride 0.4% drops or minimal localized anesthesia, administered with a cotton bud soaked in preservative-free Oxibuprocaine hydrochloride 0.4% applied to clear cornea on the access sites for 10 s immediately before surgery. The mean outcome measures were intraoperative pain and the incidence of postoperative ocular discomfort. Results: All patients tolerated well the procedure, giving patin scores between 1–3. Fifteen patients (30%) of group 1 and ten of group 2 (25%) required supplemental anesthesia. No intraoperative complications were recorded. No eyes had epithelial defects at the end of the surgery or at postoperative check-ups. Conclusions: Minimal anesthesia in cataract surgery resulted quick, safe and non-invasive.

Antonio De Maria

Papers

PMMA Intraocular Lenses Changes after Treatment with Nd:Yag Laser: A Scanning Electron Microscopy and X-ray Spectrometry Study

Infectious conjunctivitis caused by Pseudomonasaeruginosa in infected and extrused scleral buckles

Non-Toxic Anesthesia for Cataract Surgery