Specialized pro-resolving mediators (SPMs), including Maresins (MaR)-1 and 2, contribute to tear film homeostasis and resolve conjunctival inflammation. We investigated MaR2′s signaling pathways in goblet cells (GC) from rat conjunctiva. Agonist-induced [Ca²⁺]_i and high-molecular weight glycoconjugate secretion were measured. MaR2 increased [Ca²⁺]_i and stimulated secretion. MaR2 and MaR1 stimulate conjunctival goblet cell function, especially secretion, by activating different but overlapping GPCR and signaling pathways, and furthermore counter-regulate histamine stimulated increase in [Ca²⁺]_i. Thus, MaR2 and MaR1 play a role in maintaining the ocular surface and tear film homeostasis in health and disease. As MaR2 and MaR1 modulate conjunctival goblet cell function, they each may have potential as novel, but differing, options for the treatment of ocular surface inflammatory diseases including allergic conjunctivitis and dry eye disease. We conclude that in conjunctival GC MaR2 and MaR1, both increase the [Ca²⁺]_i and stimulate secretion to maintain homeostasis by using one set of different, but overlapping, signaling pathways to increase [Ca²⁺]_i and another set to stimulate secretion. MaR2 also resolves ocular allergy.

Purpose: To investigate corneal sublayer alterations during the postoperative period after small-incision lenticule extraction (SMILE). Setting: Synslaser clinic, Oslo, Norway. Study design: Retrospective. Methods: Patients who underwent SMILE for treating myopia were included. The thicknesses of the corneal epithelium, cap, stromal part of the cap (Stroma_Cap), residual stromal bed (Stroma_Res), and total stroma (Stroma_Tot) were measured using spectral-domain optical coherence tomography at 1 day, 1 week, 1 month, 3 months, and 6 months postoperatively. Postoperative changes in the corneal sublayer thicknesses were analyzed and correlated with changes in spherical equivalence and anterior and posterior keratometry (K). Results: The study was based on analyses of the right eyes of 51 patients. From 1 day to 6 months postoperatively, the corneal epithelium, cap, Stroma_Cap, Stroma_Res, and Stroma_Tot thicknesses increased from 54.4 ± 4.0 µm to 57.3 ± 5.2 µm; 137.1 ± 5.5 µm to 140.3 ± 5.1 µm; 82.7 ± 5.9 µm to 82.8 ± 6.3 µm; 375.0 ± 40.8 µm to 381.4 ± 30.6 µm; and 457.6 ± 41.1 µm to 462.1 ± 36.7 µm, respectively. Between 1 month and 6 months postoperatively, the increase in anterior K correlated significantly with the thickening of the cap (r = 0.37, P = .03) and the stromal component of the cap (r = 0.36, P = .04) within the central cornea. Conclusions: The post-SMILE remodeling behavior between the anterior (Stroma_Cap) and posterior (Stroma_Res) stroma were dissimilar. There was a significant correlation between changes in anterior K and the central cap and the stromal component of the cap. This might be because of biomechanical changes, tissue remodeling, and wound healing or a combination of some or all of the aforementioned processes.

Background: Intravitreal injection (IVI) therapy is the most frequently performed intraocular procedure worldwide, with topical povidone-iodine (PVP-I) as the standard pre-injection antiseptic. However, PVP-I has been shown to exert cytotoxic effects on the ocular surface. The purpose of this study was to evaluate the impact of two years of serial anti-vascular endothelial growth factor (VEGF) IVI on ocular surface parameters. Methods: Patients with neovascular age-related macular degeneration (nAMD) receiving unilateral intravitreal anti-VEGF injections were examined at two time points, separated by a two-year interval. An aseptic protocol with PVP-I was applied prior to each injection. Tear meniscus height (TMH), bulbar redness (BR), and meibomian gland (MG) loss were assessed using the Oculus Keratograph 5M, with the fellow eye serving as control. For statistical analysis, the related-samples Wilcoxon signed-rank test was applied to non-normally distributed data, and the paired-sample Student’s t-test to normally distributed data. Results: Sixty patients (mean age, 78.6 ± 8.5 years; range, 55-96) were included. Between examinations, patients received a mean of 15.5 ± 6.5 IVI (range, 5-30). A significant increase in mean BR was observed in untreated fellow eyes compared with baseline measurements (1.68 ± 0.47 vs. 1.41 ± 0.46; p < 0.001). At follow-up, BR was significantly higher in fellow eyes than in treated eyes ( p < 0.001), and this difference had increased over the study period. Median TMH increased significantly in untreated eyes (0.42 mm [IQR, 0.28–0.57] vs. 0.31 mm [IQR, 0.23–0.47]; p = 0.003), whereas the increase in treated eyes was not significant ( p = 0.74). At follow-up, mean TMH did not differ significantly between treated and fellow eyes ( p = 0.15). Both treated and untreated eyes showed significant MG loss after two years of serial IVI; however, no significant differences in mean MG loss were detected between eyes in either the upper or lower eyelid at follow-up. Conclusions: Eyes receiving repeated intravitreal anti-VEGF injections with preoperative PVP-I antisepsis were significantly less hyperemic than fellow untreated eyes, and this difference increased over two years of continued treatment. Potential mechanisms include a beneficial alteration of the ocular surface microbiome by PVP-I or an antiangiogenic effect of anti-VEGF therapy. Clinical Trial Registration: https://clinicaltrials.gov/study/NCT04458012 , identifier NCT04458012.