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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To evaluate the effect of the topical instillation of hyaluronic acid eye drops with different viscosity on soft contact lens wettability and comfort. Methods: A randomized and participant-masked study was performed, involving 20 participants (25.462.6 years). One eye wore hydrogel (ocufilcon D) contact lenses, and another eye wore silicone-hydrogel (somofilcon A) contact lenses. The in vivo wettability tear film surface quality (TFSQ) index and comfort were measured before and after the instillation of different eye drops: saline solution (control) and 0.1%, 0.2%, and 0.3% hyaluronic acid. Results: Compared with saline solution, the instillation of 0.1%, 0.2%, and 0.3% hyaluronic acid improved the in vivo wettability of the hydrogel contact lenses by decreasing their TFSQ mean for 5, 10, and 30 min, respectively (P,0.05). During silicone-hydrogel contact lens wear, the hyaluronic acid did not affect wettability because there were no changes in TFSQ mean (P$0.05), but the 0.3% hyaluronic acid produced a decrease in comfort for the first 3 min (P,0.05). Conclusions: The instillation of hyaluronic acid eye drops increased the in vivo wettability of the hydrogel contact lens, and the duration of this effect was directly related to its concentration and viscosity.

(1) Background: Artemia salina is a brine shrimp containing high concentrations of dinucleotides, molecules with properties for dry eye treatment. For this reason, the purpose of the study was to evaluate the effect of the artificial tears based on an extract of Artemia salina in a rabbit dry eye model. (2) Methods: A prospective and randomized study was carried out. Twenty rabbits were divided into 4 groups (n = 5, each group): healthy rabbits, dry eye rabbits, dry eye rabbits treated with hypromellose (HPMC), and dry eye rabbits treated with Artemia salina. Dry eye was induced by the topical instillation of 0.2% benzalkonium chloride. The measurements were performed before and after the treatment for 5 consecutive days. (3) Results: The topical instillation of artificial tears containing Artemia salina showed beneficial effects on tear secretion, tear break-up time, corneal staining, the density of Goblet cells, heigh of mucin cloud secreted by these cells, and mRNA levels of IL-1β and MMP9 in conjunctival cells. Compared with the HPMC, there was a statistically significant improvement (p < 0.05) with the Artemia salina in all the variables under study, except for the conjunctival hyperemia, density of Goblet cells, and mRNA levels of IL-6. (4) Conclusions: The potential of artificial tears based on Artemia salina as a secretagogue agent for dry eye treatment was confirmed, opening the door for future clinical trials and studies to extrapolate the findings for dry eye patients.

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