The VA decrease during the scleral lens wearing, filled with preserved saline solution, was due to the increasing post-lens tear layer turbidity.
Purpose: To evaluate changes in tear meniscus dynamics using optical coherence tomography (OCT) after the instillation of different concentrations of sodium hyaluronate (SH) ophthalmic solutions. Methods: An experimental, double-masked, randomized study was performed. Twenty-three healthy subjects (16 women and seven men; mean age 23.57 AE 2.56 years) participated in this study. About 35 ll of 0.1%, 0.2%, 0.3% SH ophthalmic solutions and saline solution was instilled in a randomly assigned eye. Tear meniscus measurements (height, depth and turbidity) were taken with OCT at 30 seconds and 1, 3, 5, 10 and 20 min after instillation. Subsequently, the Schirmer test and tear break-up time (TBUT) were evaluated. Results: Tear meniscus depth and tear meniscus height showed a significant increase with all solutions compared to basal values: up to 3 min for 0.1% SH, up to 5 min for 0.2% and up to 10 min for 0.3% SH ophthalmic solution. Tear meniscus turbidity was also increased at 30 seconds for 0.1%, 0.2% and 0.3% SH artificial tears (p < 0.05). This increase remained significant for up to 1 min for 0.2% and 0.3% SH solutions (p < 0.05). After 5 min of saline and 0.1% SH instillation, the turbidity was lower than basal values (p < 0.05). There was a significant increase in the TBUT for all solutions after instillation (p < 0.05). No differences between the Schirmer pre-and postinstillation were found (p > 0.05). Finally, the comfort was significantly improved for all ophthalmic solutions (p < 0.05). Conclusion: Sodium hyaluronate (SH) ophthalmic solutions increase residence time in healthy subjects and are positively correlated with its concentration and therefore the viscosity.
Purpose: To evaluate the effect of a new nutritional supplement based on melatonin on the intraocular pressure (IOP) in normotensive subjects. Patients and Methods: A short-term and prospective study was designed. Sixty-seven normotensive subjects were recruited. Patients were divided in two groups. The daily group (DG) (n=18) were instructed to take the supplement from 22.00 to 23.00 (before sleeping) during 3 consecutive days. IOP was measured from 10.00 to 11.00 am the day before treatment and during the 3 days of experiment. The acute group (AG) (n=49) was instructed to take the supplement after the second measure (11.00) of the second day. IOP was measured 1 hour and just before the intake of the supplement and one and two hours after. All measures in this group were taken one day before without any supplement (control) and the day of experiment. Results: The DG group showed a significant decreasing in IOP after supplement intake in all days of experiment, from 14.9±3.4 mmHg to 13.8±2.9 mmHg after 3 days of experiment (p value<0.001). For AG, IOP did not change during the control day, however, a reduction of 1 mmHg was found two and three hours after supplement intake, from 15.7±2.5 mmHg to 14.7±2.5 mmHg and 15.1±2.7 mmHg, respectively, being statistically significant (p value<0.001). Conclusion: The supplement based on melatonin was able to reduce the IOP in normotensives subjects after 2 hours of intake. Moreover, the daily intake showed a reduction of IOP during the three days of experiment. Response to Reviewers: Reviewer #1: The work is an interesting one, which offers another target for the treatment of ocular hypertension and glaucoma, but the methodology is quite worrisome.
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