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Query: UMLS:C0022575 (keratoconjunctivitis sicca)
 772 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Solutions of hydroxypropylmethylcellulose (HPMC) and polyvinyl alcohol (PVA) are widely used as artificial tears. However, their usefulness is limited by the short duration of their effect. Dilute sodium hyaluronate (SH) solutions exhibit non-Newtonian rheology with high viscosities at low shear rates, which would be expected to enhance their ocular surface residence time. Using quantitative gamma scintigraphy, estimates of the ocular surface residence times of 0.3% HPMC, 1.4% PVA, and 0.2% SH were made in six patients with keratoconjunctivitis sicca. The sodium hyaluronate solution had a mean half-life on the ocular surface of 321 s, significantly longer than hydroxypropylmethylcellulose (44 s; p = 0.012) and polyvinyl alcohol (39 s; p = 0.013).
Cornea 1992 Jul
PMID:Ocular surface residence times of artificial tear solutions. 142 47

In order to evaluate the therapeutic value of an unpreserved carboxymethylcellulose-based artificial tear in treatment of keratoconjunctivitis sicca (KCS), 56 patients with severe keratoconjunctivitis sicca were enrolled, at a single study center, in a randomized, double-masked, 8-week comparison with a preserved hydroxypropylmethylcellulose (HMC)-based artificial tear. Patients treated with the carboxymethylcellulose (CMC)-based tear showed significant improvement in fluorescein staining, symptoms, and impression cytology grades. Patients treated with HMC-based tears showed minimal improvement in a few variables. Impression cytology specimens were analyzed by a modified technique that maps the distribution of the various grades present on the specimen. With this technique, improvement in the cytology grades was noted in the group of patients using CMC-based tears. The improvement correlated with observed decreases in symptoms of discomfort and with scores for superficial punctate staining. This study supports the observed therapeutic value of unpreserved CMC-based artificial tears and suggests the possible reversal of squamous metaplasia in patients with KCS. Further studies are required to separate the benefit of the CMC formulation from the benefits of preservative elimination.
Cornea 1992 Jul
PMID:Unpreserved carboxymethylcellulose artificial tears evaluated in patients with keratoconjunctivitis sicca. 142 48

Peripheral ulcerative keratopathy and necrotizing scleritis have been reported in rheumatoid arthritis patients after cataract surgery, but the incidence of these complications during the immediate postoperative period is unknown. We retrospectively studied 70 patients with rheumatoid arthritis who underwent a total of 86 cataract extractions between 1973 and 1988. Only 15 of the patients had a preoperative history of keratoconjunctivitis sicca. The best corrected postoperative visual acuity was greater than or equal to 20/30 in 81% of eyes. No episodes of scleritis or peripheral ulcerative keratopathy occurred during the 8-week postoperative period. Three patients (all from the sicca group) developed diffuse superficial punctate keratopathy and/or filamentary keratitis. Results suggest that serious corneal complications after cataract surgery are uncommon in rheumatoid arthritis patients similar to the population found in our study (95% Poisson confidence interval 0-6.6%).
Cornea 1992 Mar
PMID:Corneal complications after cataract surgery in patients with rheumatoid arthritis. 158 18

The diagnosis of Sjogren's syndrome (SJ) as an underlying disease of keratoconjunctivitis sicca is important because of the many ocular and systemic complications. We compared the results of impression cytology of conjunctiva (ICC) and the results of labial salivary gland biopsy (LSB) with impression cytology of buccal mucosa (ICB) in 33 patients with SJ. LSB, ICC, and ICB were considered positive in all patients. Moderate to severe changes were graded in 85% of the biopsy specimens, 94% of the conjunctival specimens, and 76% of the buccal mucosa specimens. The rate of agreement between LSB and ICB was 97%. The use of ICB in the clinical ophthalmological examination may be helpful in patients with consistent history, and clinical and ocular findings, before the biopsy procedure.
Cornea 1991 May
PMID:Sjogren's syndrome: a comparative study of impression cytology of the conjunctiva and buccal mucosa, and salivary gland biopsy. 205 24

Keratoconjunctivitis sicca patients diagnosed on the basis of a history, dry-eye symptoms, and definite clinical signs of keratoconjunctivitis sicca, with the associated symptoms of dry mouth and/or arthritis, had measurements of tear osmolarity, Schirmer tear test without anesthetic, stimulated parotid salivary flow, and serum analysis for the presence of autoantibodies associated with Sjogren's Syndrome. In contrast to previous studies, a lower incidence of SS-A or SS-B (1-3%), ANA (41-47%), DNA (11-16%), and RF (9-12%) serum antibodies was detected. Salivary-stimulated parotid flow was abnormally decreased in 59% of the patients. Sjogren's syndrome, as indicated by the presence of serum antibodies, appears to have a lower incidence in keratoconjunctivitis sicca than considered previously.
Cornea 1991 May
PMID:Sjogren's syndrome and keratoconjunctivitis sicca. 205 25

We reviewed the records of 56 patients (109 eyes) who satisfied our criteria for keratoconjunctivitis sicca (KCS) to determine factors associated with the development of sterile corneal ulcers. The patient's age, sex, and associated local ocular surface and/or systemic disease were studied. We found a statistically significant association between the development of corneal ulceration and the presence of an underlying condition or disease state, especially chronic rheumatoid arthritis. Patient sex and age were not significantly associated with the development of corneal ulceration. We present three case histories that illustrate the complications that arise in managing KCS plus an associated disease and methods of management.
Cornea 1990 Apr
PMID:Keratoconjunctivitis sicca and corneal ulcers. 232 84

Impression cytology refers to the application of cellulose acetate filter material to the ocular surface to remove the superficial layers of the conjunctival epithelium. Impression cytology has been found to be useful in assessing the ocular surface in various dry eye disorders, such as keratoconjunctivitis sicca (KCS), cicatricial ocular pemphigoid, and vitamin A deficiency. The technique is noninvasive, is easy to perform, causes minimal discomfort to the patient, and can be used to follow changes in the conjunctival ocular surface over time. With this method, the morphology of the conjunctival ocular surface can be studied and the degree of squamous metaplasia assessed. A specific criteria based on the appearance of the epithelial cells and the density of the goblet cells can be used to assign a grade (0-3) to the ocular surface. The grade of the ocular surface is related to the degree of squamous metaplasia and usually parallels the severity of clinical disease. Impression cytology can also be used to differentiate between various dry eye disorders. Disorders that are extrinsic or environmental (such as KCS) often affect the exposed interpalpebral ocular surface before the more protected inferior palpebral ocular surface. Intrinsic surface disorders (such as ocular pemphigoid) affect the palpebral, as well as the bulbar ocular surfaces, early in the disease.
Cornea 1988
PMID:Impression cytology. 328 Feb 39

A review of 100 patients who underwent penetrating keratoplasty revealed 47 who required therapeutic soft contact lenses in the early postoperative period. Twelve corneal ulcer-infiltrates, 11 of which were culture positive, occurred during soft contact lens wear (23% incidence of this complication in contact lens fitted eyes). The most common offending organism was coagulase-negative staphylococcus. The only statistically significant risk factor for infection if a lens was used was the presence of a persistent epithelial defect (p = 0.03). Factors which could not be statistically correlated with corneal ulcer-infiltrate included keratoconjunctivitis sicca, the type of contact lens, the method of donor cornea preservation, lens hygiene, antibiotic and steroid usage, the presence of blepharitis, preoperative bacterial keratitis, and the history of a previously failed penetrating keratoplasty.
Cornea 1984
PMID:Corneal ulcer-infiltrate associated with soft contact lens use following penetrating keratoplasty. 639 34

We compared measurement of lactoferrin concentration by the LactoCard solid phase ELISA assay with the LactoPlate radial immunodiffusion assay in tears of normal patients and those with keratoconjunctivitis sicca. The LactoCard, a new lactoferrin assay, allows rapid determination of tear lactoferrin concentration in 10-15 min, a notable improvement over the 3 days required of the LactoPlate. There was no statistically significant difference between the accuracy of the two assays in normal patients nor in those patients with a diagnosis of keratoconjunctivitis sicca. Both assays showed a significant decrease in tear lactoferrin concentration in patients with severe keratoconjunctivitis sicca when compared to normal patients. The LactoCard is a rapid and reliable means of measuring tear lactoferrin concentration in a clinical setting.
Cornea 1994 Nov
PMID:Rapid assay of lactoferrin in keratoconjunctivitis sicca. 784 9

Dried tears from keratoconjunctivitis sicca eyes fail to exhibit the fern-like crystallization patterns observed with tears from eyes with normal tear function. To test our hypothesis that the extent of ferning depends on the ratio of salts to protein and mucin in the tear sample, dried tears from six normal subjects were subjected to scanning electron microscopy (SEM) and X-ray analyses. X-ray diffraction identified sodium chloride and potassium chloride as the major components of tear fern crystals. X-ray fluorescence detected the elements potassium, chlorine, calcium, and sulfur in the dried tear samples, with sulfur indicating the presence of protein and/or mucin. As well as confirming the presence of cubic fern nuclei, SEM revealed two kinds of material, having crystalline and globular appearances, that are hypothesized to be composed of salts and protein/mucin, respectively. Globular material appeared to block extension of crystal fern arms or to coat crystalline material, but did not crystallize. These findings suggest that tear fern crystals are composed of sodium and potassium chloride, with proteinaceous material controlling crystallization indirectly by coating crystal faces and blocking fern extension. This structural composition is consistent with the hypothesis that the ratio of salt to macromolecular species is an important determinant of tear ferning.
Cornea 1994 Jan
PMID:X-ray and scanning electron microscopic analysis of the structural composition of tear ferns. 813 8


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