scholarly journals Clinical Features, Risk Factors, and Therapy of Epithelial Keratitis after Cataract Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yani Wang ◽  
Dongfang Li ◽  
Wenjie Su ◽  
Yunhai Dai
Keyword(s):  
Risk Factors ◽  
Cataract Surgery ◽  
Tear Film ◽  
Meibomian Gland ◽  
Diabetic Group ◽  
Amniotic Membrane Transplantation ◽  
Diabetic Patients ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Tear Film Function

Purpose. The study aimed to assess the clinical characteristics, risk factors, and therapy of epithelial keratitis after cataract surgery. Methods. Medical data of 89 consecutive patients who developed epithelial keratitis after cataract surgery, including 37 patients with diabetes mellitus (37 eyes) and 52 patients without diabetes mellitus (52 eyes), were retrospectively reviewed. The clinical characteristics, risk factors, and therapy in those patients were evaluated. Results. The preoperative tear film function determined by the tear breakup time, meibomian gland atrophy score, and low tear meniscus height in diabetic patients was poorer than nondiabetic patients ( P < 0.001 ). Of diabetic patients, 83.78% (31/37) had been diagnosed with meibomian gland dysfunction before cataract surgery and treated with topical nonsteroidal anti-inflammatory drugs after cataract surgery for 44.69 ± 10.51 days, compared to 42.31% (22/52) of nondiabetic patients receiving the topical nonsteroidal anti-inflammatory treatment for 33.35 ± 5.16 days (both P < 0.001 ). Epithelial lesions progressed within three to four days following cataract surgery in 59.46% (22/37) of diabetic patients, versus 30.77% (16/52) of the nondiabetic patients ( P = 0.025 ). Patients with combined meibomian gland dysfunction and epithelial defects accounted for 48.65% (18/37) in the diabetic group and 25.00% (13/52) in the nondiabetic group ( P < 0.001 ). In vivo confocal microscopy showed absence of subbasal never fibers in eyes with epithelial defects, and central corneal sensation was also significantly depressed in those eyes, but there was no significant difference between the two groups ( P = 0.227 ). Corneal ulceration and herpes simplex keratitis were found in 2.70% (1/37) and 5.41% (2/37) of diabetic patients, respectively. Amniotic membrane transplantation was required in 32.43% (12/37) of patients in the diabetic group, and the proportion was higher than 1.92% (1/52) in the nondiabetic group ( P < 0.001 ). Average healing time of the corneal epithelium in the diabetic group was 40.62 ± 20.0 days, much longer than 21.74 ± 6.94 days in the nondiabetic group ( P = 0.002 ). Conclusion. Epithelial keratitis after cataract surgery in diabetic patients has the characteristics of rapid development, severe epithelial damage, and slow repair of the corneal epithelium. Amniotic membrane transplantation is a good choice for persistent epithelial defects associated with such epithelial keratitis. Attention should be paid to the tear film function and use of topical nonsteroidal anti-inflammatory drugs in patients undergoing cataract surgery.

scholarly journals Meibomian Gland Dysfunction in Type 2 Diabetic Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Xiaolei Lin ◽  
Binbin Xu ◽  
Yuxi Zheng ◽  
Terry G. Coursey ◽  
Yinying Zhao ◽  
...  
Keyword(s):  
Tear Film ◽  
Meibomian Gland ◽  
Diabetic Group ◽  
Meibomian Gland Dysfunction ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Breakup Time ◽  
Type 2 Diabetic ◽  
Tear Film Function

Purpose. To investigate meibomian gland and tear film function in patients with type 2 diabetes.Methods. This prospective study compared changes in meibomian gland and tear film function in type 2 diabetic patients with nondiabetic patients. Meibomian gland function was evaluated by measuring lipid layer thickness (LLT), grading of meibomian gland loss, lid margin abnormalities, and expression of meibum. Tear film function was assessed by measuring tear breakup time (TBUT), the Schirmer I test, noninvasive breakup time (NIBUT), tear meniscus height (TMH), and corneal fluorescein staining.Results. Meibography scores were significantly higher in the diabetic group compared with the nondiabetic group (p=0.004). The number of expressible glands was significantly lower in the diabetic group in temporal, central, and nasal third of the lower eyelid (nasal:p=0.002; central:p=0.040; and temporal:p=0.039). The lid margin abnormality score was significantly higher in the diabetic group than in the nondiabetic group (p=0.04). There was no statistically significant difference in the tear film function parameters between the two groups.Conclusions. Meibomian gland dysfunction (MGD) in type 2 diabetic patients is more severe compared with nondiabetic patients. Overall, most of the diabetic patients manifest as having asymptomatic MGD.

Hoornvliesbeschadiging na cataractchirurgie: belang van het droge-ogensyndroom en topische NSAID’s en oppuntstelling van de behandeling

2021 ◽  
Author(s):  
A. POTVIN ◽  
D. ROELS
Keyword(s):  
Risk Factors ◽  
Cataract Surgery ◽  
Dry Eye ◽  
Ocular Surface ◽  
Dry Eye Disease ◽  
Autologous Serum ◽  
Eye Disease ◽  
Amniotic Membrane Transplantation ◽  
Topical Medication ◽  
Anti Inflammatory

Dry eye disease and cataract surgery: identification of risk factors for corneal damage and optimisation of treatment Various factors in the perioperative cataract surgery period can synergistically initiate a vicious inflammatory cycle of dry eye disease (DED) and tissue damage, with dire consequences. A careful anamnesis and preoperative assessment of the ocular surface can reveal some of the risk factors and facilitate an appropriate perioperative approach. Attention should be paid to DED and associated conditions, such as Meibomian gland dysfunction, as these conditions are very common. In the postoperative period, it is wise to avoid preserved topical medication, as well as to use topical medication that may be toxic to the ocular surface, such as non-steroidal anti-inflammatory drugs (NSAIDs), with care in specific cases. The treatment of DED and its complications consists primarily of the careful use of lubricating, antibiotic and anti-inflammatory agents. In serious DED cases, autologous serum promotes tissue regeneration by promoting epithelialisation and stromal recovery, and can be a useful adjunct to the first-line treatment. In extreme and rare cases, DED can, in combination with the use of topical NSAIDs and other risk factors, lead to sight-threatening complications, such as corneal melting. A surgical treatment consisting of conjunctival flap transplantation, amniotic membrane transplantation, gluing of the cornea or tectonic keratoplasty may be necessary when perforation is imminent.

scholarly journals Cistoidni makularni edem nakon operacije katarakte

2019 ◽  
Vol 55 (2) ◽  
pp. 152-158
Author(s):  
Maja Merlak ◽  
Tamara Paravić ◽  
Petra Grubešić ◽  
Ivana Valković Antić ◽  
Marijana Bilen Babić ◽  
...  
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Cataract Surgery ◽  
Anterior Segment ◽  
Common Complication ◽  
Research And Practice ◽  
The Core ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Surgically Induced

Pseudophakic cystoid macular edema (PCME) is the most common complication of cataract surgery and is one of the possible causes of low visual acuity after cataract surgery. Various factors are implicated in its development but the core mechanism is likely surgically induced anterior segment inflammation that results in the release of endogenous inflammatory mediators. Anti-inflammatory medicines, including steroid and nonsteroid anti-inflammatory drugs, are postulated as having a role in both the prophylaxis and treatment of PCME. This article presents an updated review on the pathogenesis, risk factors, prophylaxis and treatment in PCME that reflect current research and practice.

Adverse reactions with the use of non-steroidal anti-inflammatory drugs

2020 ◽  
pp. 35-50
Author(s):  
M. L. Maksimov ◽  
N. M. Kiseleva ◽  
D. G. Semenikhin ◽  
B. K. Romanov
Keyword(s):  
Risk Factors ◽  
Adverse Reactions ◽  
Effective Prevention ◽  
Chemical Structures ◽  
Wide Range ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Prevention Method ◽  
Effective Medication ◽  
Upper Gastrointestinal

Non-steroidal anti-inflammatory drugs (NSAIDs) are included in a pharmacological group of drugs with different chemical structures providing anti-inflammatory, analgesic and antipyretic actions, as well as antiplatelet action to a certain degree. Unfortunately, NSAIDs can cause a wide range of adverse reactions (AR) posing a serious risk to the health and life of patients. Therefore, the rational use of NSAIDs should include methods for effective prevention of drug complications. Many NSAIDs have a pronounced therapeutic effect, simultaneously causing many undesirable effects, so the drug shall be chosen considering the development of predicted side effects and modern algorithms. According to clinical recommendations, risk factors and administration of safer NSAIDs shall be considered as the main prevention method. Besides, it is possible to protect the patient from the upper gastrointestinal tract complications using proton pump inhibitors. It should be noted that there are no effective medication methods for kidney and liver protection to reduce the risk of NSAID-associated complications.

scholarly journals Rheumatoid arthritis: influence of inflammation and anti-inflammatory therapy on cardiovascular risk factors

2020 ◽  
pp. 32-44
Author(s):  
D. I. Trukhan ◽  
D. S. Ivanova ◽  
K. D. Belus
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Cardiovascular Risk Factors ◽  
Chronic Inflammation ◽  
Pharmacological Intervention ◽  
Increased Risk ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Rheumatoid arthritis is a frequent and one of the most severe immuno-inflammatory diseases in humans, which determines the great medical and socio-economic importance of this pathology. One of the priority problems of modern cardiac rheumatology is an increased risk of cardiovascular complications in rheumatoid arthritis. In patients with rheumatoid arthritis, traditional cardiovascular risk factors for cardiovascular diseases (metabolic syndrome, obesity, dyslipidemia, arterial hypertension, insulin resistance, diabetes mellitus, smoking and hypodynamia) and a genetic predisposition are expressed. Their specific features also have a certain effect: the “lipid paradox” and the “obesity paradox”. However, chronic inflammation as a key factor in the development of progression of atherosclerosis and endothelial dysfunction plays a leading role in morbidity and mortality from cardiovascular diseases in rheumatoid arthritis. This review discusses the effect of chronic inflammation and its mediators on traditional cardiovascular risk factors and its independent significance in the development of CVD. Drug therapy (non-steroidal anti-inflammatory drugs, glucocorticosteroids, basic anti-inflammatory drugs, genetically engineered biological drugs) of the underlying disease also has a definite effect on cardiovascular risk factors in patients with rheumatoid arthritis. A review of studies on this problem suggests a positive effect of pharmacological intervention in rheumatoid arthritis on cardiovascular risk factors, their reduction to a level comparable to the populations of patients not suffering from rheumatoid arthritis. The interaction of rheumatologists, cardiologists and first-contact doctors (therapist and general practitioner) in studying the mechanisms of the development of atherosclerosis in patients with rheumatoid arthritis will allow in real clinical practice to develop adequate methods for the timely diagnosis and prevention of cardiovascular diseases in patients with rheumatoid arthritis.

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