For the last 20 years, a great amount of evidence has accumulated through epidemiological studies that most of the dry eye disease encountered in daily life, especially in video display terminal (VDT) workers, involves short tear film breakup time (TFBUT) type dry eye, a category characterized by severe symptoms but minimal clinical signs other than short TFBUT. An unstable tear film also affects the visual function, possibly due to the increase of higher order aberrations. Based on the change in the understanding of the types, symptoms, and signs of dry eye disease, the Asia Dry Eye Society agreed to the following definition of dry eye: "Dry eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage." The definition stresses instability of the tear film as well as the importance of visual impairment, highlighting an essential role for TFBUT assessment. This paper discusses the concept of Tear Film Oriented Therapy (TFOT), which evolved from the definition of dry eye, emphasizing the importance of a stable tear film.

The study results suggest that IPL can significantly reduce inflammatory markers in tears of patients suffering with DED owing to MGD after IPL treatment. These findings indicate that IL-17A and IL-6 play roles in the pathogenesis of DED owing to MGD, and the reduction of the inflammatory factors is consistent with the improvement of partial clinical symptoms and signs.

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IPL combined with MGX safely and effectively treated MGD.

Meibomian gland dysfunction (MGD) is one of the most common diseases observed in clinics; it influences a great number of people, and is the leading cause of evaporative dry eye. Given the increased recognition of the importance of MGD, a great amount of attention has been paid to therapies targeting this condition. The traditional treatments of MGD consist of warm compresses and lid hygiene for removing an obstructed meibum, as well as antibiotics and anti-inflammatory agents to improve the quality of the meibum. However, each of these treatments has a different shortcoming and the treatment of MGD remains challenging. Despite the numerous possible treatment options for MGD, it is still difficult to obtain complete relief of signs and symptoms. This review focuses on current emerging treatment options for MGD including intraductal meibomian gland probing, emulsion eye drops containing lipids, the LipiFlow® thermal pulsation system, N-acetyl-cysteine, azithromycin, oral supplementation with omega-3 essential fatty acids, and cyclosporine A.

Using low-pressure chemical vapor deposition of silicon dioxide, we have reduced the size of 56-nm features in a silicon nitride membrane, called a stencil, down to 36 nm. Sub-50-nm uniformly sized nanoparticles are fabricated by electron-beam deposition of Pt through the stencil mask. A self-assembled monolayer (SAM) of tridecafluoro-1,1,2,2-tetrahydrooctyl-1-trichlorosilane was used to reduce Pt clogging of the nanosize holes during deposition as well as to protect the stencil during the postdeposition Pt removal. X-ray photoelectron spectroscopy shows that the SAM protects the stencil efficiently during this postdeposition removal of Pt.

Electron beam lithography (EBL), size reduction lithography (SRL), and nanoimprint lithography (NIL) have been utilized to produce platinum nanoparticles and nanowires in the 20-60-nm size range on oxide films (SiO 2 and Al 2 O 3 ) deposited onto silicon wafers. A combination of characterization techniques (SEM, AFM, XPS, AES) has been used to determine size, spatial arrangement and cleanliness of these fabricated catalysts. Ethylene hydrogenation reaction studies have been carried out over these fabricated catalysts and have revealed major differences in turnover rates and activation energies of the different nanostructures when clean and when poisoned with carbon monoxide. The oxide-metal interfaces are implicated as important reaction sites that remain active when the metal sites are poisoned by adsorbed carbon monoxide.

Objectives: To compare the efficacy of intense pulsed light (IPL) combined with Meibomian gland expression (MGX), and instant warm compresses combined with MGX, for treatment of dry eye disease (DED) due to meibomian gland dysfunction (MGD). Methods: In a prospective, multicenter, interventional study, 120 subjects with DED due to MGD were randomized 1:1 to an IPL arm or a control arm. Each subject was treated 3 times at 3-week intervals. The primary outcome measure was the tear break up time (TBUT). Tear break up time and a few additional outcome measures were evaluated at the baseline and at 3 weeks after the last treatment. Results: All outcome measures improved in both arms, but in general, the improvement was significantly larger in the IPL arm. Tear break up time increased by 2.3±1.9 and 0.5±1.4 sec, in the IPL and control arms respectively ( P <0.001). SPEED was reduced by 38% and 22% in the IPL and control arms, respectively ( P <0.01). Meibomian Gland Yielding Secretion Score was improved by 197% in the IPL arm and 96% in the control arm. Corneal fluorescein staining also decreased by 51% and 24% in the IPL and control arms respectively, but the differences between the two arms were not statistically significant ( P =0.61). A composite score of lid margin abnormalities improved in both arms, but more in the IPL arm ( P <0.05). Conclusions: Intense pulsed light combined with MGX therapy was significantly more effective than instant warm compresses followed with MGX. This suggests that the IPL component has a genuine contribution to the improvement of signs and symptoms of DED.