Purpose.This study aims to explore the safety and efficacy of a novel treatment-intense pulsed light (IPL) in MGD eyes.Methods.This study is a prospective and open label study. Forty eyes of 40 MGD patients were recruited in the study and received 4 consecutive IPL treatments on day 1, day 15, day 45, and day 75. Ten ocular surface symptoms were evaluated with a subjective face score at every visit. Best spectacle corrected visual acuity, intraocular pressure (IOP), conjunctival injection, upper and lower tear meniscus height (TMH), tear break-up time (TBUT), corneal staining, lid margin and meibomian gland assessments, and meibography were also recorded at every visit, as well as the adverse effects on the eye and ocular surface.Results.Significant improvements were observed in single and total ocular surface symptom scores, TBUT, and conjunctival injection at all the visits after the initial IPL treatment (P<0.05). Compared to baseline, the signs of eyelid margin, meibomian gland secretion quality, and expressibility were significantly improved at every visit after treatments. There was no regional and systemic threat observed in any patient.Conclusion.Intense pulsed light (IPL) therapy is a safe and efficient treatment in relieving symptoms and signs of MGD eyes.

Purpose . The purpose is to compare the outcomes of implantation of trifocal intraocular lenses (TIOLs) and extended depth of focus (EDOF) intraocular lenses (IOLs). Methods . A comprehensive search of PubMed, Cochrane Library, EMBASE, and ClinicalTrial.gov was conducted in March 2020 to identify relevant studies. A meta‐analysis of the results was performed. Patients implanted with EDOF IOLs or TIOLs in previous studies were included. The primary outcomes of the study were uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), and defocus curve. Results . TIOLs and EDOF IOLs provided comparable binocular UDVA (MD = ‐0.01, 95% CI: ‐0.04, 0.03, logMAR). However, EDOF IOLs provided better UIVA (MD: ‐0.08, 95% CI: ‐0.14, ‐0.01, logMAR) and worse UNVA (MD: 0.10, 95% CI: 0.06, 0.14, logMAR) than TIOLs. Fewer patients achieved spectacle independence after implantation of EDOF IOLs (RR: 0.74, 95% CI: 0.63, 0.87) than after implantation of TIOLs, especially for near vision (RR = 0.82, 95% CI: 0.68, 0.99). There was no statistically significant difference in contrast sensitivity (CS) under photopic or mesopic conditions with both IOLs. Patient satisfaction after implantation of both IOLs was high. Conclusion . EDOF IOLs and TIOLs provide comparable distance vision. However, EDOF IOLs provide better intermediate vision and worse near vision than TIOLs. The advantages of EDOF IOLs over TIOLs in terms of CS, aberrations, and visual disturbance are not significant. Patients are satisfied with both types of IOLs.

Purpose. To analyze the correlations between the ocular surface signs and symptoms in patients with dry eye.Methods.In this observational study, 176 dry eye patients, including 60 males and 116 females, were enrolled and their dry eye symptoms and ocular signs were observed. Partial correlation analysis was conducted between OSDI score and each ocular surface sign, and the correlations were further discussed in different age groups. Then multiple linear regression analysis was used to further explore the influence of these signs on OSDI score.Results. Our correlation analyses showed that rounding of lid margins, notching of lid margins, vascularity of lid margins, hyperkeratinization, plugging of orifices, main duct dropout, and conjunctival congestion all had a positive correlation with OSDI score, while main duct number (central 1 cm) and BUT had a negative one. Further analysis suggested that these correlations varied in different age groups. Multiple linear regression analysis indicated that main duct number (central 1 cm), rounding of lid margins, and hyperkeratinization significantly affected OSDI score.Conclusions. Close attention should be paid to the morphology and structure of the eyelid margin and the function of meibomian gland in the diagnosis, treatment, and follow-up of dry eye diseases.

(1) Background: Dry eye is a multifactorial disease of the ocular surface, the incidence of which has been increasing sharply. The pathogenesis of dry eye, especially in terms of the bacterial flora, has drawn great attention. Additionally, the potential treatment methods need to be explored. (2) Methods: We reviewed more than 100 studies and summarized them briefly in a review. (3) Results: We summarized the bacterial communities found on the ocular surface in the general population and patients with dry eye and found a relationship between dry eye and antibiotic therapy. We identified the possible mechanisms of bacteria in the development of dry eye by discussing factors such as the destruction of the antibacterial barrier, infectious diseases, microbiome homeostasis, inflammatory factors on the ocular surface and vitamin deficiency. (4) Conclusion: We systematically reviewed the recent studies to summarize the bacterial differences between patients with dry eye and the general population and brought up several possible mechanisms and possible treatment targets.

PURPOSE: To compare postoperative corneal sub-basal nerve density and number between small incision lenticule extraction (SMILE) and femtosecond laser–assisted in situ keratomileusis (FS-LASIK). METHODS: A search was made in PubMed, EMBASE, and the Cochrane library for prospective comparative studies. The analysis was divided into two parts: network meta-analysis and traditional meta-analysis of the studies directly comparing two surgical groups. Stata 16 (Stata Corporation) and Rev-Man 5.4 (Cochrane) software were used to analyze the data. RESULTS: Twelve studies (n = 775) were included. In the network meta-analysis, the SMILE group showed a significant increase compared with the FS-LASIK group in corneal nerve density at 1 month postoperatively (mean: 4.23; 95% CI: 0.06 to 8.39, P < .05), and in the number of corneal nerve trunks at 6 months postoperatively (mean: 13.25; 95% CI: 10.20 to 16.30, P < .05). In the traditional meta-analysis, the SMILE group showed significant improvement compared with the FS-LASIK group in corneal nerve density at 1 (weighted mean difference [WMD]: −2.05, 95% CI: −3.11 to −1.00, P < .05) and 3 (WMD: −0.90, 95% CI: −1.30 to −0.50, P < .05) months postoperatively, and in the number of corneal nerve trunks (WMD: −2.52, 95% CI: −4.91 to −0.14, P < .05) and corneal nerve branches (WMD: −2.80, 95% CI: −3.41 to −2.19, P < .05) at 1 month postoperatively. CONCLUSIONS: The corneal nerve injury in the FS-LASIK group was worse than that in the SMILE group. The corneal nerve recovery in the SMILE group was better at 3 months postoperatively. However, there was no significant difference in corneal nerve density and number between the two groups at 6 months postoperatively. [ J Refract Surg . 2022;38(4):277–284.]

Purpose. To assess the effects of oral vitamin B1 and mecobalamin on dry eye disease (DED) and patient satisfaction with treatment. Methods. In this randomized controlled study, DED patients were divided into 4 groups based on treatment: group 1, only artificial tears; group 2, corticosteroid eye drops and artificial tears; group 3, oral vitamin B1, mecobalamin, and artificial tears; and group 4, oral vitamin B1, mecobalamin, corticosteroid eye drops, and artificial tears. DED symptoms, signs, and patient satisfaction with treatment were assessed at baseline and at 1 and 2 months after treatment. Results. In total, 152 eyes from 76 patients (age, 55.25 ± 18.16 years) were included. In group 3, there were significant differences in dryness, foreign body sensation, burning, and tear film breakup time first (TBUTF) between 1 and 2 months after treatment and in satisfaction scores before and after treatment ( ). In group 3, there were also significant differences in dryness, foreign body sensation, photophobia, and TBUTA and between baseline and 2 months after treatment ( ). There was a significant difference in foreign body sensation between 1 and 2 months after treatment in groups 3 and 4 ( ). Furthermore, we also find obvious improvement in corneal nerve fiber density (CNFD) between baseline and 1 and 2 months after treatment in groups 3 and 4 ( ). Conclusions. Oral vitamin B1 and mecobalamin can relieve some dry eye symptoms such as dryness, pain, and photophobia and improve DED signs and patient satisfaction. Thus, vitamin B1 and mecobalamin are potential treatment options for patients with DED.