AIM:To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens(IOL)during a 12-month follow-up.METHODS:Prospective comparative study including75 eyes of 38 patients(44-70y)u...AIM:To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens(IOL)during a 12-month follow-up.METHODS:Prospective comparative study including75 eyes of 38 patients(44-70y)undergoing uneventful cataract surgery.Each patient was randomly assigned to one type of IOL,bifocal(35 eyes)or trifocal(40 eyes).Visual,refractive,and contrast sensitivity changes were evaluated in a 12-month follow-up.The binocular defocus curve was also measured at 12mo postoperatively.RESULTS:No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities(P≥0.276).Postoperative corrected near visual acuity(33 cm)was significantly better in the trifocal group during all follow-up(P≤0.004)as well as 6-month uncorrected near(P=0.008)and distancecorrected near visual acuities(P=0.016)(33/40 cm).Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group(P〈0.001),which was consistent with differences among groups in binocular defocus curve.Differences among groups in contrast sensitivity were minimal,being only significant at 6 months for some low to medium spatial frequencies(P≤0.006).CONCLUSION:Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up,with a clear benefit of the trifocal IOL for the intermediate vision.展开更多
AIM:To evaluate and compare the efficacy of the astigmatic correction achieved with laser in situ keratomileusis(LASIK)in eyes with myopic astigmatism using wavefront-guided(WFG)and wavefront-optimized(WFO)ablation pr...AIM:To evaluate and compare the efficacy of the astigmatic correction achieved with laser in situ keratomileusis(LASIK)in eyes with myopic astigmatism using wavefront-guided(WFG)and wavefront-optimized(WFO)ablation profiles.METHODS:Prospective study included 221 eyes undergoing LASIK:99 and 122 eyes with low and moderate myopic astigmatism(low and moderate myopia groups).Two subgroups were differentiated in each group according to the ablation profile:WFG subgroup,109 eyes(45/64,low/moderate myopia groups)treated using the Advanced Custom Vue platform(Abbott Medical Optics Inc.),and WFO subgroup,112 eyes(54/58,low/moderate myopia groups)treated using the EX-500 platform(Alcon).Clinical outcomes were evaluated during a 6-month follow-up,including a vector analysis of astigmatic changes.RESULTS:Significantly better postoperative uncorrected visual acuity and efficacy index was found in the WFG subgroups of each group(P≤0.041).Postoperative spherical equivalent and cylinder were significantly higher in WFO subgroups(P≤0.003).In moderate myopia group,a higher percentage of eyes with a postoperative cylinder≤0.25 D was found in the WFG subgroup(90.6%vs 65.5%,P=0.002).In low and moderate myopia groups,the difference vector was significantly higher in the WFO subgroup compared to WFG(P〈0.001).In moderate myopia group,the magnitude(P=0.008)and angle of error(P〈0.001)were also significantly higher in the WFO subgroup.Significantlyless induction of high order aberrations were found with WFG treatments in both low and moderate myopia groups(P≤0.006).CONCLUSION:A more efficacious correction of myopic astigmatism providing a better visual outcome is achieved with WFG LASIK compared to WFO LASIK.展开更多
Strabismic amblyopia is characterized by a distorted spatial perception.In this condition,the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as cro...Strabismic amblyopia is characterized by a distorted spatial perception.In this condition,the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as crowding,deficits in the accommodative response,contrast sensitivity,and ocular motility abilities.The inhibition of the binocular function of the brain by the misaligned amblyopic eye induces a binocular imbalance leading to interocular suppression and the reduction or lack of stereoacuity.Passive treatments such as occlusion,optical and/or pharmacological penalization,and Bangerter foils has been demonstrated to be potentially useful treatments for strabismic amblyopia.Recent researches have proved new pharmacological options to improve and maintain visual acuity af ter occlusion treatment in strabismic amblyopia.Likewise,the active vision therapy,in the last years,is becoming a very relevant therapeutic option in combination with passive treatments,especially during and after monocular therapy,in the attempt of recovering the imbalanced binocular vision.展开更多
AIM: To evaluate the interchangeability of keratometric and asphericity measurements provided by three measurement systems based on different optical principles.METHODS: A total of 40 eyes of 40 patients with a mean a...AIM: To evaluate the interchangeability of keratometric and asphericity measurements provided by three measurement systems based on different optical principles.METHODS: A total of 40 eyes of 40 patients with a mean age of 34.1 y were included. In all cases, a corneal curvature analysis was performed with IOL-Master(IOLM), iDesign 2(ID2), and Sirius systems(SIR). Differences between instruments for flattest(K1) and steepest(K2) keratometric readings, as well as for magnitude and axis of corneal astigmatism were analyzed. Likewise, differences in asphericity(Q) between SIR and ID2 were also evaluated. RESULTS: Mean differences between devices for K1 were 0.20±0.21(P<0.001),-0.12±0.36(P=0.046) and-0.32±0.36 D(P<0.001) for the comparisons IOLM-SIR, IOLM-ID2 and SIR-ID2, respectively. The ranges of agreement for these comparisons between instruments were 0.41, 0.70, and 0.70 D. For K2, mean differences were 0.31±0.33(P<0.001),-0.08±0.43(P=0.265) and-0.39±0.38 D(P<0.001), with ranges of agreement of 0.65, 0.84, and 0.74 D. Concerning magnitude of astigmatism, ranges of agreement were in the limit of clinical relevance(0.49 D, P=0.011; 0.55 D, P=0.386; 0.43 D, P=0.05). In contrast, ranges of agreement were clinically relevant for astigmatic axis(26.68o, 33.83o and 18.37o, P≥0.121) and for Q between SIR and ID2(0.16, P<0.001). CONCLUSION: The keratometric corneal power, astigmatic axis and asphericity measurements provideby the three systems evaluated cannot be considered as interchangeable, whereas measurements of corneal astigmatism obtained with SIR and ID2 can be considered as interchangeable for clinical purposes.展开更多
【正】INTRODUCTION Anterior ciliary arteries provide 70%of the vascular supply of the anterior segment.A significant interruption of the vascular flow of these arteries increases the risk for anterior ischemia.Althoug...【正】INTRODUCTION Anterior ciliary arteries provide 70%of the vascular supply of the anterior segment.A significant interruption of the vascular flow of these arteries increases the risk for anterior ischemia.Although the frequency of this special condition is low after strabismus surgery(1:13 000)[1],its effects may involve substantial visual problems[2].We report the successful outcome of a new surgical approach for strabismus management in a case of high risk for anterior ischemia.Specifically,we show the correction of the horizontal ocular deviation by means of an adjustable muscle展开更多
Our purpose is to report alterations in contrast sensitivity function(CSF)and in the magno,parvo and koniocellular visual pathways by means of a multichannel perimeter in case of an essential tremor(ET).A complete eva...Our purpose is to report alterations in contrast sensitivity function(CSF)and in the magno,parvo and koniocellular visual pathways by means of a multichannel perimeter in case of an essential tremor(ET).A complete evaluation of the visual function was performed in a 69-year old patient,including the analysis of the chromatic discrimination by the Fansworth–Munsell 100 hue test,the measurement of the CSF by the CSV-1000E test,and the detection of potential alteration patterns in the magno,parvo and koniocellular visual pathways by means of a multichannel perimeter.Visual acuity and intraocular pressure(IOP)were within the ranges of normality in both eyes.No abnormalities were detected in the fundoscopic examination and in the optical coherence tomography(OCT)exam.The results of the color vision examination were also within the ranges of normality.A signi¯cant decrease in the achromatic CSFs for right eye(RE)and left eye(LE)was detected for all spatial frequencies.The statistical global values provided by the multichannel perimeter confirms that there were significant absolute sensitivity losses compared to the normal pattern in RE.In the LE,only a statistically significant decrease in sensitivity was detected for the blue-yellow(BY)channel.The pattern standard deviation(PSD)values obtained in our patient indicated that there were significant localized losses compared to the normality pattern in the achromatic channel of the RE and in the red-green(RG)channel of the LE.Some color vision alterations may be present in ET that cannot be detected with conventional color vision tests,such as the FM 100 Hue.展开更多
AIM:To evaluate the short-term clinical outcomes of Ferrara rings in keratoconus using an optimized nomogram developed after several years of research and retrospective analysis of clinical data.METHODS:This prospecti...AIM:To evaluate the short-term clinical outcomes of Ferrara rings in keratoconus using an optimized nomogram developed after several years of research and retrospective analysis of clinical data.METHODS:This prospective longitudinal non-comparative clinical trial evaluated 88 eyes of 88 patients(age 18-62 y)with keratoconus diagnosis from two Spanish centers.Ferrara ring segment(AJL Ophthalmic)implantation was performed in all cases,using the mechanical procedure in 25 eyes(28.4%)and a femtosecond laser-assisted procedure in 63 eyes(71.6%).The ring segments implanted in each case were selected using a new optimized nomogram that considered variables such as anterior corneal asphericity and astigmatism or the discrepancy among astigmatism and coma orientations.Visual,refractive,corneal topographic,aberrometric,and pachymetric changes after surgery were evaluated during a 3-month follow-up.RESULTS:The implants induced a significant refractive change as well as an improvement in uncorrected(UDVA)and corrected distance visual acuity(CDVA;P<0.001).Postoperative CDVA of 0.10 log MAR or better was achieved in 28.4%and 46.5%of eyes,respectively.Two eyes(2.3%)lost two or more lines of CDVA whereas a total of 53.5%of eyes gained lines of CDVA.A significant central anterior and posterior corneal flattening was induced(P≤0.003),with a significant reduction of anterior(P<0.001)and posterior corneal astigmatisms(P=0.048),and a change in anterior asphericity(P<0.001).Total primary coma(6 mm pupil)change was also statistically significant(preoperative 3.66±3.04μm vs postoperative 2.33±2.26μm,P<0.001).No significant differences were found in the effect of ring segments between cases implanted using the mechanical and femtosecond techniques(P≥0.101).CONCLUSION:The implantation of Ferrara rings based on the nomogram evaluated is safe and effective for promoting a visual rehabilitation in keratoconus,with a relevant control of primary coma aberration.展开更多
Dear Sir,I am Dr. Peter Mojzis from Premium Clinic in Teplice （Czech Republic）. I write to present the results of a comparative study of clinical outcomes obtained with two different types of tinted intraocular lens...Dear Sir,I am Dr. Peter Mojzis from Premium Clinic in Teplice （Czech Republic）. I write to present the results of a comparative study of clinical outcomes obtained with two different types of tinted intraocular lenses （IOLs）, yellow-vs violet-tinted IOLs. IOLs containing a yellow chromophore that filters simultaneously ultra violet （UV） and blue light were developed several years ago in the attempt of avoiding that blue and violet visible light reached the retina in the pseudophakic eye.展开更多
Background:Ocular surface disease in glaucoma patients is a significant ocular co-morbidity that can affect 40%to 59%of these patients worldwide.The current study was aimed at evaluating the potential clinical benefit...Background:Ocular surface disease in glaucoma patients is a significant ocular co-morbidity that can affect 40%to 59%of these patients worldwide.The current study was aimed at evaluating the potential clinical benefit of an intense pulsed light(IPL)-based treatment in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop treatments.To our knowledge,this is the first series analyzing the therapeutic effect of this treatment option in this type of patients.Methods:This non-comparative prospective case series study enrolled a total of 30 glaucoma patients ranging in age from 57 to 94 years old and treated with hypotensive eyedrops for years with dry eye symptomatology.All patients received four sessions of IPL treatment using the Optima IPL system(Lumenis,Yokneam,Israel)adjusted to the official optimized Lumenis setting.Changes in symptomatology,corneal staining,conjunctival hyperemia,non-invasive break-up time(NIBUT),tear osmolarity,tear meniscus height(TMH),meiboscore and meibomian gland expressibility was analyzed after treatment.Results:Statistically significant reductions were observed after IPL treatment in the symptomatology scores measured with different questionnaires[ocular surface disease index(OSDI),standard patient evaluation of eye dryness(SPEED)and symptom assessment questionnaire in dry eye(SANDE)]as well as with the visual analogue scale(P<0.001).Mean change in OSDI was−15.0±11.3.A significant reduction was found after treatment in the corneal staining score(P<0.001).A significant reduction was found in tear film meniscus height(P=0.012),as well as in tear film osmolarity(P=0.001).A significant reduction was also found in meibomian gland expressibility(P=0.003),changing the percentage of grade 3 eyes from 44.4%before IPL to 17.2%after treatment.Conclusions:IPL therapy combined with meibomian gland expression(MGX)seems to be an effective option to improve symptomatology in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop treatments,with an additional improvement in clinical signs,such as tear osmolarity and corneal staining.展开更多
文摘AIM:To evaluate and compare the clinical outcomes with a diffractive bifocal and trifocal intraocular lens(IOL)during a 12-month follow-up.METHODS:Prospective comparative study including75 eyes of 38 patients(44-70y)undergoing uneventful cataract surgery.Each patient was randomly assigned to one type of IOL,bifocal(35 eyes)or trifocal(40 eyes).Visual,refractive,and contrast sensitivity changes were evaluated in a 12-month follow-up.The binocular defocus curve was also measured at 12mo postoperatively.RESULTS:No statistically significant differences between groups were found in postoperative uncorrected and corrected distance visual acuities(P≥0.276).Postoperative corrected near visual acuity(33 cm)was significantly better in the trifocal group during all follow-up(P≤0.004)as well as 6-month uncorrected near(P=0.008)and distancecorrected near visual acuities(P=0.016)(33/40 cm).Significantly better uncorrected intermediate and distance corrected-intermediate visual acuity were found during all follow-up in the trifocal group(P〈0.001),which was consistent with differences among groups in binocular defocus curve.Differences among groups in contrast sensitivity were minimal,being only significant at 6 months for some low to medium spatial frequencies(P≤0.006).CONCLUSION:Bifocal and trifocal diffractive IOLs are able to provide an effective visual restoration which is maintained during a 12-month follow-up,with a clear benefit of the trifocal IOL for the intermediate vision.
基金Partially supported by a grant from Abbott Medical Optics
文摘AIM:To evaluate and compare the efficacy of the astigmatic correction achieved with laser in situ keratomileusis(LASIK)in eyes with myopic astigmatism using wavefront-guided(WFG)and wavefront-optimized(WFO)ablation profiles.METHODS:Prospective study included 221 eyes undergoing LASIK:99 and 122 eyes with low and moderate myopic astigmatism(low and moderate myopia groups).Two subgroups were differentiated in each group according to the ablation profile:WFG subgroup,109 eyes(45/64,low/moderate myopia groups)treated using the Advanced Custom Vue platform(Abbott Medical Optics Inc.),and WFO subgroup,112 eyes(54/58,low/moderate myopia groups)treated using the EX-500 platform(Alcon).Clinical outcomes were evaluated during a 6-month follow-up,including a vector analysis of astigmatic changes.RESULTS:Significantly better postoperative uncorrected visual acuity and efficacy index was found in the WFG subgroups of each group(P≤0.041).Postoperative spherical equivalent and cylinder were significantly higher in WFO subgroups(P≤0.003).In moderate myopia group,a higher percentage of eyes with a postoperative cylinder≤0.25 D was found in the WFG subgroup(90.6%vs 65.5%,P=0.002).In low and moderate myopia groups,the difference vector was significantly higher in the WFO subgroup compared to WFG(P〈0.001).In moderate myopia group,the magnitude(P=0.008)and angle of error(P〈0.001)were also significantly higher in the WFO subgroup.Significantlyless induction of high order aberrations were found with WFG treatments in both low and moderate myopia groups(P≤0.006).CONCLUSION:A more efficacious correction of myopic astigmatism providing a better visual outcome is achieved with WFG LASIK compared to WFO LASIK.
基金Supported by the Ministry of Economy,Industry and Competitiveness of Spain within the program Ramón y Cajal(RYC-2016-20471)。
文摘Strabismic amblyopia is characterized by a distorted spatial perception.In this condition,the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as crowding,deficits in the accommodative response,contrast sensitivity,and ocular motility abilities.The inhibition of the binocular function of the brain by the misaligned amblyopic eye induces a binocular imbalance leading to interocular suppression and the reduction or lack of stereoacuity.Passive treatments such as occlusion,optical and/or pharmacological penalization,and Bangerter foils has been demonstrated to be potentially useful treatments for strabismic amblyopia.Recent researches have proved new pharmacological options to improve and maintain visual acuity af ter occlusion treatment in strabismic amblyopia.Likewise,the active vision therapy,in the last years,is becoming a very relevant therapeutic option in combination with passive treatments,especially during and after monocular therapy,in the attempt of recovering the imbalanced binocular vision.
基金supported by the Ministry of Economy,Industry and Competitiveness of Spain within the program Ramón y Cajal,RYC-2016-20471Additionally he received an unrestricted grant from Johnson and Johnson Vision for the performance of this research
文摘AIM: To evaluate the interchangeability of keratometric and asphericity measurements provided by three measurement systems based on different optical principles.METHODS: A total of 40 eyes of 40 patients with a mean age of 34.1 y were included. In all cases, a corneal curvature analysis was performed with IOL-Master(IOLM), iDesign 2(ID2), and Sirius systems(SIR). Differences between instruments for flattest(K1) and steepest(K2) keratometric readings, as well as for magnitude and axis of corneal astigmatism were analyzed. Likewise, differences in asphericity(Q) between SIR and ID2 were also evaluated. RESULTS: Mean differences between devices for K1 were 0.20±0.21(P<0.001),-0.12±0.36(P=0.046) and-0.32±0.36 D(P<0.001) for the comparisons IOLM-SIR, IOLM-ID2 and SIR-ID2, respectively. The ranges of agreement for these comparisons between instruments were 0.41, 0.70, and 0.70 D. For K2, mean differences were 0.31±0.33(P<0.001),-0.08±0.43(P=0.265) and-0.39±0.38 D(P<0.001), with ranges of agreement of 0.65, 0.84, and 0.74 D. Concerning magnitude of astigmatism, ranges of agreement were in the limit of clinical relevance(0.49 D, P=0.011; 0.55 D, P=0.386; 0.43 D, P=0.05). In contrast, ranges of agreement were clinically relevant for astigmatic axis(26.68o, 33.83o and 18.37o, P≥0.121) and for Q between SIR and ID2(0.16, P<0.001). CONCLUSION: The keratometric corneal power, astigmatic axis and asphericity measurements provideby the three systems evaluated cannot be considered as interchangeable, whereas measurements of corneal astigmatism obtained with SIR and ID2 can be considered as interchangeable for clinical purposes.
文摘【正】INTRODUCTION Anterior ciliary arteries provide 70%of the vascular supply of the anterior segment.A significant interruption of the vascular flow of these arteries increases the risk for anterior ischemia.Although the frequency of this special condition is low after strabismus surgery(1:13 000)[1],its effects may involve substantial visual problems[2].We report the successful outcome of a new surgical approach for strabismus management in a case of high risk for anterior ischemia.Specifically,we show the correction of the horizontal ocular deviation by means of an adjustable muscle
文摘Our purpose is to report alterations in contrast sensitivity function(CSF)and in the magno,parvo and koniocellular visual pathways by means of a multichannel perimeter in case of an essential tremor(ET).A complete evaluation of the visual function was performed in a 69-year old patient,including the analysis of the chromatic discrimination by the Fansworth–Munsell 100 hue test,the measurement of the CSF by the CSV-1000E test,and the detection of potential alteration patterns in the magno,parvo and koniocellular visual pathways by means of a multichannel perimeter.Visual acuity and intraocular pressure(IOP)were within the ranges of normality in both eyes.No abnormalities were detected in the fundoscopic examination and in the optical coherence tomography(OCT)exam.The results of the color vision examination were also within the ranges of normality.A signi¯cant decrease in the achromatic CSFs for right eye(RE)and left eye(LE)was detected for all spatial frequencies.The statistical global values provided by the multichannel perimeter confirms that there were significant absolute sensitivity losses compared to the normal pattern in RE.In the LE,only a statistically significant decrease in sensitivity was detected for the blue-yellow(BY)channel.The pattern standard deviation(PSD)values obtained in our patient indicated that there were significant localized losses compared to the normality pattern in the achromatic channel of the RE and in the red-green(RG)channel of the LE.Some color vision alterations may be present in ET that cannot be detected with conventional color vision tests,such as the FM 100 Hue.
基金Supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal (RYC-2016-20471)
文摘AIM:To evaluate the short-term clinical outcomes of Ferrara rings in keratoconus using an optimized nomogram developed after several years of research and retrospective analysis of clinical data.METHODS:This prospective longitudinal non-comparative clinical trial evaluated 88 eyes of 88 patients(age 18-62 y)with keratoconus diagnosis from two Spanish centers.Ferrara ring segment(AJL Ophthalmic)implantation was performed in all cases,using the mechanical procedure in 25 eyes(28.4%)and a femtosecond laser-assisted procedure in 63 eyes(71.6%).The ring segments implanted in each case were selected using a new optimized nomogram that considered variables such as anterior corneal asphericity and astigmatism or the discrepancy among astigmatism and coma orientations.Visual,refractive,corneal topographic,aberrometric,and pachymetric changes after surgery were evaluated during a 3-month follow-up.RESULTS:The implants induced a significant refractive change as well as an improvement in uncorrected(UDVA)and corrected distance visual acuity(CDVA;P<0.001).Postoperative CDVA of 0.10 log MAR or better was achieved in 28.4%and 46.5%of eyes,respectively.Two eyes(2.3%)lost two or more lines of CDVA whereas a total of 53.5%of eyes gained lines of CDVA.A significant central anterior and posterior corneal flattening was induced(P≤0.003),with a significant reduction of anterior(P<0.001)and posterior corneal astigmatisms(P=0.048),and a change in anterior asphericity(P<0.001).Total primary coma(6 mm pupil)change was also statistically significant(preoperative 3.66±3.04μm vs postoperative 2.33±2.26μm,P<0.001).No significant differences were found in the effect of ring segments between cases implanted using the mechanical and femtosecond techniques(P≥0.101).CONCLUSION:The implantation of Ferrara rings based on the nomogram evaluated is safe and effective for promoting a visual rehabilitation in keratoconus,with a relevant control of primary coma aberration.
文摘Dear Sir,I am Dr. Peter Mojzis from Premium Clinic in Teplice （Czech Republic）. I write to present the results of a comparative study of clinical outcomes obtained with two different types of tinted intraocular lenses （IOLs）, yellow-vs violet-tinted IOLs. IOLs containing a yellow chromophore that filters simultaneously ultra violet （UV） and blue light were developed several years ago in the attempt of avoiding that blue and violet visible light reached the retina in the pseudophakic eye.
文摘Background:Ocular surface disease in glaucoma patients is a significant ocular co-morbidity that can affect 40%to 59%of these patients worldwide.The current study was aimed at evaluating the potential clinical benefit of an intense pulsed light(IPL)-based treatment in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop treatments.To our knowledge,this is the first series analyzing the therapeutic effect of this treatment option in this type of patients.Methods:This non-comparative prospective case series study enrolled a total of 30 glaucoma patients ranging in age from 57 to 94 years old and treated with hypotensive eyedrops for years with dry eye symptomatology.All patients received four sessions of IPL treatment using the Optima IPL system(Lumenis,Yokneam,Israel)adjusted to the official optimized Lumenis setting.Changes in symptomatology,corneal staining,conjunctival hyperemia,non-invasive break-up time(NIBUT),tear osmolarity,tear meniscus height(TMH),meiboscore and meibomian gland expressibility was analyzed after treatment.Results:Statistically significant reductions were observed after IPL treatment in the symptomatology scores measured with different questionnaires[ocular surface disease index(OSDI),standard patient evaluation of eye dryness(SPEED)and symptom assessment questionnaire in dry eye(SANDE)]as well as with the visual analogue scale(P<0.001).Mean change in OSDI was−15.0±11.3.A significant reduction was found after treatment in the corneal staining score(P<0.001).A significant reduction was found in tear film meniscus height(P=0.012),as well as in tear film osmolarity(P=0.001).A significant reduction was also found in meibomian gland expressibility(P=0.003),changing the percentage of grade 3 eyes from 44.4%before IPL to 17.2%after treatment.Conclusions:IPL therapy combined with meibomian gland expression(MGX)seems to be an effective option to improve symptomatology in glaucomatous patients with ocular surface disease due to prolonged hypotensive eyedrop treatments,with an additional improvement in clinical signs,such as tear osmolarity and corneal staining.
