Refitting contact lens dropouts into a modern daily disposable contact lens

PURPOSE

To determine the number of previous contact lens (CL) wearers who could be comfortably refitted into delefilcon A (DAILIES TOTAL1®) CLs.

METHODS

This was a 6-month, three-visit study that recruited subjects who discontinued CLs within the past 2 years because of discomfort or dryness symptoms. Subjects were required to have Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire scores ≤3 and to be able to wear spherical study CLs. Subjects were asked to complete a ±50 comfort visual analogue scale (VAS) at 1 month and a Likert questionnaire after 1 and 6 months of CL wear to understand the subjects' CL experience.

RESULTS

All 60 subjects who were fitted with the study CLs were still wearing them after 1 month, while one subject had dropped out by 6 months. Subjects had a median (interquartile range) age of 24.0 (7.0) years (71.7% female). They reported a median VAS score of 44.0 (8.0) units at the 1-month visit, with all reporting a comfortable score. At the 1-month/6-month visits, 98.3%/93.2%, 86.5%/78.0% and 93.2%/91.5% of subjects responded that they were very satisfied or satisfied with their vision, their end-of-day CL comfort and overall CL comfort, respectively. The same subjects responded that they were very likely or likely to continue to wear the study CLs at 1 (89.6%) and 6 months (80.7%) and to recommend the study CLs to a friend at 1 (98.3%) and 6 months (93.2%).

CONCLUSIONS

The results suggest that when encountering a CL dropout, a practitioner could educate a patient about trying an alternative CL and consider delefilcon A lenses as an option.

Determining initial ocular comfort differences between 0.7% olopatadine and 0.035% ketotifen fumarate

PURPOSE

To compare the ocular comfort at application of topical, over-the-counter, 0.7% olopatadine and 0.035% ketotifen fumarate anti-allergy eye drops.

METHODS

This study recruited participants who were minimally symptomatic based upon Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire scores (≤3 units) and who had minimal between-eye inter-ocular comfort differences as judged by visual analog scale scores (VAS; ≤7 units). Baseline comfort was evaluated by eye with a VAS. One drop of 0.7% olopatadine or 0.035% ketotifen fumarate was then applied to the right eye with the alternative drop being immediately applied to the left eye. Participants were next evaluated with the same comfort VAS by eye at drop application, and then at 30 s, 1 min, and 2 min post-application. LogMAR visual acuities and bulbar conjunctival redness were evaluated pre- and post-drop application to judge initial changes.

RESULTS

This study enrolled 159 participants who had a mean ± SD age of 26.3 ± 7.7 years, and 78.6% of the participants were female. The VAS found that the 0.7% olopatadine drop was more comfortable than the 0.035% ketotifen fumarate drop at all time-points. There were no between-eye differences in LogMAR visual acuities, yet bulbar redness was significantly less in 0.7% olopatadine treated eyes compared 0.035% ketotifen fumarate treated eyes.

CONCLUSION

This study found that topically applied 0.7% olopatadine drops were initially more comfortable than 0.035% ketotifen fumarate drops.

Quality of Life in Digital Device Users Who are Treated with Systane Hydration PF

PURPOSE

To understand the impact of Systane Hydration PF on dryness symptoms and quality of life in digital device users and to determine if participants prefer either the unit-dose or multi-dose dispensing system of Systane Hydration PF.

MATERIALS AND METHODS

This 2-week, three visit study recruited regular digital device users. Participants were required to score ≤80 on the Impact of Dry Eye on Everyday Life (IDEEL) Quality of Life (QoL) Work domain and between 13 and 32 on the Ocular Surface Disease Index (OSDI) questionnaire. Participants were randomized to either Systane Hydration PF unit-dose or multi-dose for 1 week and switched to the alternative dosing system for the second week. Participations were evaluated by completing the full IDEEL-QoL module and OSDI questionnaire at each visit. Likert surveys were completed to probe dispensing system preferences.

RESULTS

Thirty participants with a mean ± SD age of 28.6 ± 12.0 years (70% female) were recruited. Participants had significant improvements in all three IDEEL-QoL domains as well as in OSDI scores (all p < 0.0001). Participants had similar preferences for the two dispensing systems, though they were more likely to indicate that they thought that the multi-dose bottle was more environmentally friendly than the unit-dose vials.

CONCLUSION

Digital device users with dry eye symptoms had meaningful improvements in eye comfort and quality of life scores after being treated with Systane Hydration PF for 2 weeks. Participants did not have a clear dispensing system preference suggesting that the best dispensing system may depend on the patient.

Application of systane complete for the treatment of contact lens discomfort

PURPOSE

To understand the safety of treating contact lens (CL) discomfort with a new artificial tear when it is directly applied to a CL-wearing eye.

METHODS

This was a two-week, two-visit, double-masked study that randomized participants with CL discomfort to use Systane Complete (artificial tear), Sensitive Eyes (rewetting drop), or no treatment. Drops were applied before, twice during, and after CL use each day. Corneal staining served as the primary safety metric. Conjunctival staining, tear break-up time, Schirmer's test, CL comfort (Contact Lens Dry Eye Questionnaire-8 [CLDEQ-8]), and dry eye symptoms (Standardized Patient Evaluation of Eye Dryness [SPEED]) were also evaluated.

RESULTS

This study recruited 73 participants with a mean age of 30.3 ± 11.5 years; 18 % of the participants were male. There were no significant changes in ocular surface signs from baseline or between the artificial tear and rewetting drop groups after two weeks (p ≥ 0.05). Participants in the artificial tear and rewetting drop groups had significant improvements in CLDEQ-8 scores after two weeks of treatment compared with baseline (p < 0.0001), though scores for this test were not significantly different between these groups after two weeks (p = 0.94). CLDEQ-8 scores were significantly better in the artificial tear and rewetting drop groups compared with no treatment after two weeks (p < 0.0001).

CONCLUSIONS

Both drops were found to be safe for use with CLs while also significantly improving ocular symptoms compared to no treatment after two weeks of use.

Gastric involvement with Anisakis sp. larva in a Belgian patient after consumption of cod

A case of acute episode of gastric anisakiasis in a patient, which was acquired through the consumption of infected cod meat and could be successfully resolved by endoscopic extraction, is described and discussed. This is the first report of cod as infection source as well as an authentic case of gastric anisakiasis in Belgium.

Alpha-1-antitrypsin (AAT) and its stimulation in the liver of PiMZ phenotype individuals. A "recruitment-secretory block" ("R-SB") phenomenon

PiMZ individuals in conditions of clinical stimulation show a peculiar immunohistochemical staining pattern for alpha-1-antitrypsin (AAT) in the liver: 1) the positivity involves large zones of parenchyma (up to 100% of hepatocytes); 2) in zone 2 and zone 3 hepatocytes the positivity appears in the form of crescents or rectilinear arrays along the sinusoids. This new pattern is designated type II, in contrast to type I which occurs in periportal hepatocytes in the form of inclusions spread over the whole cytoplasm. This peculiar staining pattern is associated with serum elevation of AAT and is considered to be an expression of liver reactivity. Type II positivity marks the hepatocytes which are newly recruited for the synthesis of AAT; owing to its defective export, the Z AAT is retained within the cell and detectable by immunohistochemistry. Thus this staining pattern is an expression of both recruitment for synthesis and block of secretion ("Recruitment-Secretory Block" "R-SB" phenomenon). In PiMZ individuals, the secretory block affects selectively and exclusively the Z fraction of AAT. At the EM level the vast majority of the retained protein is found in the RER, which represents the major and the earliest site of storage. Viewed in the framework of present knowledge of glycoprotein biosynthesis, the results of this study shed further light on the nature and cellular site of the Z AAT defect.

Alpha-1-antitrypsin phenotypes in malignant lymphoma

The alpha-1-antitrypsin (alpha 1 AT) Pi phenotypes have been determined by isoelectric focusing in a series of 228 patients having a histologically diagnosed malignant lymphoma and in 250 healthy controls. The Pi MZ phenotype occurred in 13 patients with lymphoma (5 . 8%) and in five of 250 healthy individuals (2%). Furthermore, one patient with a Pi SS and three patients with an abnormal unknown phenotype, migrating slower than Z, were found in the lymphoma group. No prevalence for a special lymphoma type was observed among the abnormal Pi phenotype patients. The increased incidence of abnormal Pi phenotypes in malignant lymphoma's support the hypothesis of the possible role of alpha 1 AT in development of immunopathological disorders.