The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by ...The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by trauma,delayed presentation,and corneal perforation—PK restores globe integrity and provides limited visual recovery.However,its application is constrained by graft-related complications and donor shortages,particularly in low-resource settings.These limitations highlight the need for earlier,globe-sparing strategies to prevent progression and reduce surgical demand.Photoactivated chromophore for infectious keratitis-corneal collagen cross-linking(PACK-CXL)has emerged as a promising adjunct or alternative.With both antimicrobial and tissue-stabilizing effects,PACK-CXL may control infection and preserve corneal structure in earlier stages.A layered treatment framework that incorporates PACK-CXL as an initial intervention and reserves PK for refractory cases may help improve clinical outcomes.Further studies are needed to define their best use in practice.展开更多
AIM:To compare the tear film quantity and stability parameters in keratoconus(KCN)and normal eyes using test breakup time(TBUT),noninvasive TBUT(NITBUT),and Schirmer test.METHODS:All participants(n=166),including pati...AIM:To compare the tear film quantity and stability parameters in keratoconus(KCN)and normal eyes using test breakup time(TBUT),noninvasive TBUT(NITBUT),and Schirmer test.METHODS:All participants(n=166),including patients with KCN and age-matched healthy individuals with normal corneas,were recruited from those referred to Farabi Eye Hospital,Iran,in 2023.To better account for genetic and environmental factors,the control group comprised healthy individuals who were relatives of KCN patients and had normal corneal topography.Tear quantity parameters were evaluated in the following order:NITBUT,TBUT,and Schirmer tests.RESULTS:The mean age of cases in KCN(61.7%males)and normal(63.5%males)participants was 27.54±5.44y(range 19 to 38)and 27.52±5.63y(range 20 to 38),respectively(P=0.976).NIBUT,TBUT,and Schirmer’s tests were significantly lower in KCN group compared to normal controls(all P<0.001).The mean difference for NIBUT was-7.81s(P<0.001),and for TBUT was-7.61s(P<0.001).Schirmer test values were also significantly lower in the KCN group,with a mean difference of-5.61 mm compared to normal people(P<0.001).CONCLUSION:Our findings demonstrate significant tear film impairment in KCN.The reductions in NIBUT,TBUT and Schirmer scores highlight an underlying tear film dysfunction in KCN that extends beyond the morphological changes of the cornea.展开更多
文摘The retrospective study by Edwar et al reinforces the role of therapeutic penetrating keratoplasty(PK)as a vital intervention in severe,treatment-resistant infectious keratitis.In advanced cases—often complicated by trauma,delayed presentation,and corneal perforation—PK restores globe integrity and provides limited visual recovery.However,its application is constrained by graft-related complications and donor shortages,particularly in low-resource settings.These limitations highlight the need for earlier,globe-sparing strategies to prevent progression and reduce surgical demand.Photoactivated chromophore for infectious keratitis-corneal collagen cross-linking(PACK-CXL)has emerged as a promising adjunct or alternative.With both antimicrobial and tissue-stabilizing effects,PACK-CXL may control infection and preserve corneal structure in earlier stages.A layered treatment framework that incorporates PACK-CXL as an initial intervention and reserves PK for refractory cases may help improve clinical outcomes.Further studies are needed to define their best use in practice.
文摘AIM:To compare the tear film quantity and stability parameters in keratoconus(KCN)and normal eyes using test breakup time(TBUT),noninvasive TBUT(NITBUT),and Schirmer test.METHODS:All participants(n=166),including patients with KCN and age-matched healthy individuals with normal corneas,were recruited from those referred to Farabi Eye Hospital,Iran,in 2023.To better account for genetic and environmental factors,the control group comprised healthy individuals who were relatives of KCN patients and had normal corneal topography.Tear quantity parameters were evaluated in the following order:NITBUT,TBUT,and Schirmer tests.RESULTS:The mean age of cases in KCN(61.7%males)and normal(63.5%males)participants was 27.54±5.44y(range 19 to 38)and 27.52±5.63y(range 20 to 38),respectively(P=0.976).NIBUT,TBUT,and Schirmer’s tests were significantly lower in KCN group compared to normal controls(all P<0.001).The mean difference for NIBUT was-7.81s(P<0.001),and for TBUT was-7.61s(P<0.001).Schirmer test values were also significantly lower in the KCN group,with a mean difference of-5.61 mm compared to normal people(P<0.001).CONCLUSION:Our findings demonstrate significant tear film impairment in KCN.The reductions in NIBUT,TBUT and Schirmer scores highlight an underlying tear film dysfunction in KCN that extends beyond the morphological changes of the cornea.
