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The British Journal of Ophthalmology Dec 2023To evaluate changes in the ocular surface and tear film with age and mutational status in congenital aniridia.
AIM
To evaluate changes in the ocular surface and tear film with age and mutational status in congenital aniridia.
METHODS
45 participants with congenital aniridia (89 eyes) in a prospective, cross-sectional study. Whole-exome sequencing identified the causative mutation. Examinations included slit-lamp biomicroscopy, in vivo confocal microscopy, Ocular Surface Disease Index (OSDI) score, blink rate, Schirmer I test, Oxford Staining Score (OSS), tear film break-up time (TFBUT) and Ocular Protection Index (OPI).
RESULTS
There were age-dependent increases in OSDI (β=0.34, 95% CI 0.03 to 0.66; p=0.030), blink rate (β=0.18, 95% CI 0.08 to 0.27; p<0.001) and OSS (β=0.05, 95% CI 0.03 to 0.07; p<0.001) and age-dependent reductions in tear production (β=-0.23, 95% CI -0.43 to 0.02; p=0.029) and TFBUT (β=-0.10, 95% CI -0.17 to -0.04; p<0.001). Perturbed OSDI, OSS, blink rate, tear production and TFBUT were noted after the age of ten and OSDI, OSS, blink rate and TFBUT correlated with deficient corneal nerves and limbal stem cell function. OSDI, blink rate, Schirmer, OSS, TFBUT and OPI were not associated with type of mutation, but OSDI, OSS and blink rate associated with grade of aniridia-associated keratopathy.
CONCLUSIONS
Ocular surface damage and dry eye signs appear in congenital aniridia regardless of mutation, appearing after 10 years of age and progressing thereafter. An early treatment window may exist for therapies to protect the ocular surface homoeostasis and limbal function, to possibly delay keratopathy development and progression.
Topics: Humans; Cross-Sectional Studies; Prospective Studies; Cornea; Tears; Dry Eye Syndromes; Corneal Diseases; Aniridia
PubMed: 36517210
DOI: 10.1136/bjo-2021-320774 -
Arquivos Brasileiros de Oftalmologia 2023A 38-year-old patient who developed aphakia and aniridia secondary to trauma suffered from vision loss. To improve her vision, an iris-intraocular lens complex (Reper®)...
A 38-year-old patient who developed aphakia and aniridia secondary to trauma suffered from vision loss. To improve her vision, an iris-intraocular lens complex (Reper®) was fixed to the sclera with Canabrava's double-flanged technique. There was a satisfactory increase in the patient's visual acuity and no complications were observed during the 6-months follow-up. Canabrava technique simplifies and improves the fixation of the iris-intraocular lens complex to the sclera. It is a safe option that does not require scleral flaps or knots.
Topics: Humans; Female; Adult; Lens Implantation, Intraocular; Sclera; Suture Techniques; Lenses, Intraocular; Iris; Retrospective Studies
PubMed: 35544930
DOI: 10.5935/0004-2749.20230060