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el based on TR alone. The success of this model shows that peripheral factors including cochlear health and electrode placement may play a predominant role in speech perception with CIs.

A model of speech perception outcomes that incorporates TR, AID, and array design represents an improvement over a model based on TR alone. The success of this model shows that peripheral factors including cochlear health and electrode placement may play a predominant role in speech perception with CIs.

Temporal fine structure information such as low-frequency sounds including the fundamental frequency (F0) is important to separate different talkers in noisy environments. Speech perception in noise is negatively affected by reduced temporal fine structure resolution in cochlear hearing loss. It has been shown that normal-hearing (NH) people as well as cochlear implant patients with preserved acoustic low-frequency hearing benefit from different F0 between concurrent talkers. Though patients with an active middle ear implant (AMEI) report better sound quality compared with hearing aids, they often struggle when listening in noise. The primary objective was to evaluate whether or not patients with a Vibrant Soundbridge AMEI were able to benefit from F0 differences in a concurrent talker situation and if the effect was comparable to NH individuals.

A total of 13 AMEI listeners and 13 NH individuals were included. A modified variant of the Oldenburg sentence test was used to emulate a concurrent talker scena in the AMEIcontra (p = 0.002) and 3.4 dB in the AMEIboth (p = 0.003) condition, compared with 5.0 dB in NH individuals (p < 0.001).

Though AMEI users deal with problems resulting from cochlear damage, hearing amplification with the implant enables a masking release based on F0 differences when F0 between a target and masker sentence was at least 8 semitones. Additional occlusion of the ear canal on the implant side did not affect speech performance. The current results complement the knowledge about the benefit of F0 within the acoustic low-frequency hearing.

Though AMEI users deal with problems resulting from cochlear damage, hearing amplification with the implant enables a masking release based on F0 differences when F0 between a target and masker sentence was at least 8 semitones. Additional occlusion of the ear canal on the implant side did not affect speech performance. The current results complement the knowledge about the benefit of F0 within the acoustic low-frequency hearing.

To compare the survival rate 1 year after Descemet membrane endothelial keratoplasty (DMEK) in pseudophakic eyes versus combined phacoemulsification and DMEK (triple-DMEK).

Retrospective, interventional, consecutive case series. From all DMEKs performed from January 1, 2017, to June 30, 2018, we selected those performed in pseudophakic eyes (pseudophakic DMEK) and those that underwent triple-DMEK. We compared the survival rate 1 year after surgery between both groups and between the Fuchs endothelial dystrophy (FED) cases in both groups, plus the FED cases versus the pseudophakic bullous keratopathy (PBK) cases in the pseudophakic DMEK group. Second, we compared rebubbling rates and the influence of the use of gas or corneal sutures on rebubbling and dislocation rates.

A total of 329 eyes were included (218 eyes pseudophakic DMEK and 111 eyes triple-DMEK). The survival rate at 1 year was 79.8% and 90%, respectively (P = 0.03). When only FED cases were included (133 pseudophakic DMEK and 108 triple-DMEK), no significant difference was found (87.9% vs. 90.7%, P = 0.59). Within the pseudophakic DMEK group, the survival rate was higher in FED cases (87.8%) compared with PBK cases (66.6%) (P = 0.0001). Rebubbling rates were 21.1% (pseudophakic DMEK) and 17.1% (triple-DMEK) (P = 0.39). The use of gas versus air or placing corneal sutures did not seem to influence the rebubbling (P = 0.64 and P = 0.13, respectively) or dislocation rates (P = 0.71 and P = 0.53, respectively).

In the FED cases, performing phacoemulsification before DMEK or doing a combined procedure did not seem to affect the rebubbling or survival rate up to 1 year postoperatively. PBK was associated with a higher failure rate compared with that of FED.

In the FED cases, performing phacoemulsification before DMEK or doing a combined procedure did not seem to affect the rebubbling or survival rate up to 1 year postoperatively. PBK was associated with a higher failure rate compared with that of FED.

To describe cases in which netarsudil ophthalmic solution 0.02% precipitated reversible, reticular cystic epithelial edema.

A retrospective case review at the Brooklyn Veteran’s Association Hospital of patients with corneal stromal edema that were treated with netarsudil and subsequently developed cystic epithelial edema.

Four male patients with a mean age of 72 ± 8.0 years developed a reticular, honeycomb-like pattern of epithelial edema located in the interpalpebral and inferior cornea. In 3 of 4 patients, epithelial edema arose within 1 month compared with 2 months in 1 patient. New epithelial cysts did not correlate with worsening central corneal thickness and best spectacle-corrected visual acuity in every patient, which was likely due to the location of the cysts. Two of 4 patients developed increased central corneal thickness with worsening best spectacle-corrected visual acuity. In comparison, 1 patient had improvement in both parameters, whereas 1 patient had no significant change. In all casesed. Nevertheless, large-scale studies are needed to accurately report on the incidence and clinical significance of this novel finding.

To investigate stamp visibility and endothelial cell loss (ECL) after the application of an orientation mark to Descemet membrane endothelial keratoplasty (DMEK) grafts supported by an air bubble.

Eighteen DMEK grafts were prepared at an eye bank using a technique where an orientation mark was applied to the stromal surface of a DMEK graft that was supported by a small air bubble placed at the edge of the 2 endothelial surfaces of the graft. Grafts were evaluated at 2 and 5 days for stamp visibility and at 5 days with calcein-AM staining for ECL. Nine grafts underwent cross-country shipping, and the ECL of shipped and nonshipped grafts was compared using unpaired t test.

All 18 DMEK grafts exhibited a single, solid, readily visible orientation mark 2 and 5 days after preparation with a mean ECL of 13.5% ± 4.9%. Shipping conditions had no effect on stain retention or ECL.

The application of an orientation stamp to a DMEK graft over an air bubble in an eye bank setting results in a single, solid orientational benefit of conserving the stromal cap for use in other anterior lamellar procedures, thereby making efficient use of donor tissue.

NOV03 has a unique dual mode of action to address dry eye disease (DED) associated with meibomian gland dysfunction. SEECASE evaluated the efficacy, safety, and tolerability of NOV03 at 2 dosing regimens compared with a saline comparator in patients with DED.

SEECASE was a prospective, multicenter, randomized, double-masked, saline-controlled clinical study. A total of 336 DED patients [tear film breakup time ≤5 seconds, abnormal meibum secretion, total corneal fluorescein staining (tCFS) score of 4 ≤ X ≤ 11 (National Eye Institute scale), Schirmer of ≥5 mm] were randomized in a 2211 manner to NOV03 4 times daily (QID), NOV03 twice daily (BID), saline BID, and saline QID, respectively. The primary efficacy endpoint was tCFS staining at 8 weeks for both regimens. Secondary endpoints included visual analog scales and the Ocular Surface Disease Index questionnaire for symptom assessment.

The study met its primary endpoint, change from baseline of tCFS over control, for both dosing regimens QID and BID (P < 0.001 and P = 0.009, respectively). NOV03 also showed pronounced improvement in various symptoms. For the Eye Dryness Score, changes from baseline were statistically significant compared with those of the control at week 8 [P < 0.001 (QID) and P = 0.002 (BID)]. buy VX-702 Benefits on tCFS and symptoms started at 2 weeks after start of treatment and were maintained over the study duration. The effects were dosing schedule dependent. NOV03 was well tolerated with instillation site reactions below 3% in both treatment regimes.

The SEECASE study demonstrated that NOV03 improves signs and symptoms in patients with highly symptomatic evaporative dry eye disease.

The SEECASE study demonstrated that NOV03 improves signs and symptoms in patients with highly symptomatic evaporative dry eye disease.

To evaluate the efficacy of autologous blood eye drops in patients diagnosed with severe ocular surface disease and dry eye who were unresponsive to conventional therapy and who would otherwise be considered for autologous serum eye drops.

A total of 38 eyes of 19 patients (15 women and 4 men) with ocular surface disease and severe dry eye refractory to conventional treatment were treated with fingerprick autologous blood 4 times daily for 6 months. Follow-up visits occurred at 1-, 3-, and 6-month intervals. At each visit, visual acuity, Oxford Grading Scheme score, tear film break-up time, Schirmer test, and ocular surface disease index were measured.

There was a significant improvement in the ocular surface staining score at all time gates. The mean score at presentation was 2.13, and this improved to 1.50 at 1 month (P < 0.001), 1.29 at 3 months (P < 0.01), and 1.42 at 6 months (P < 0.01). There was an improvement in tear film break-up time from 4.75 seconds at baseline to 6.79 seconds at 3 months (P < 0.01) and 7.0 seconds at 6 months (P < 0.001). An improvement in the Schirmer test was only found at 6 months with an improvement from 3.67 mm to 13.33 mm (P < 0.05). There was no statistical change in visual acuity at any time gate or ocular surface disease index score, although 83% of patients reported an improvement in their symptoms at 6 months. There were no adverse events reported.

Fingerprick autologous blood is an effective, readily accessible, and safe therapy for the treatment of recalcitrant cases of severe ocular surface disease and dry eye unresponsive to conventional therapy.

Fingerprick autologous blood is an effective, readily accessible, and safe therapy for the treatment of recalcitrant cases of severe ocular surface disease and dry eye unresponsive to conventional therapy.

To identify barriers and facilitators to adopting deep anterior lamellar keratoplasty (DALK) for nonendothelial corneal pathology.

An anonymous survey consisting of 22 multiple choice and free text questions was designed to gather information on demographic factors of surgeons and DALK surgical practices. The survey was emailed to members of the kera-net, a global online corneal surgeon/surgery platform.

A total of 100 surgeons completed the survey, most of whom practice in the United States (73%). Most surgeons (89%) reported performing DALK. Surgeons who did not learn DALK during fellowship (34%) tended to be in practice for higher numbers of years (P < 0.001). Surgeons in private practice are more likely to perform DALK versus those in other settings (92.7% vs. 80.8%, P = 0.087). Surgeons performing more corneal surgeries (at least 100 per year) are more likely to perform DALK than those who perform fewer than 100 per year (52% vs. 14%, P = 0.01). Surgeons who perform Descemet membrane endothelial keratoplasty are more likely to perform DALK than those who do not (81.