Week in review: Restoring sight in keratoconus, no COVID-19–related increase in keratitis, readability of glaucoma patient information

Comprehensive Ophthalmology, Cornea/External Disease, Glaucoma, Uveitis

A weekly roundup of ophthalmic news from around the web.

A pigskin-derived implant may restore sight in patients with keratoconus. A bioengineered porcine construct, double-crosslinked implantable hydrogel has been successfully used to restore eyesight in 19 of 20 patients in Iran and India with advanced keratoconus. At the 2-year postoperative follow-up visit, the best-corrected visual acuity was 20/26 in 8 of 8 Indian patients and 20/58 in 11 of 12 Iranian patients. Fourteen patients were legally blind in the operated eye prior to surgery, and none were legally blind at the final follow-up visit. While randomized controlled studies are needed to reproduce these findings, the authors conclude that “our results provide evidence that intrastromal implantation of a cell-free bioengineered collagen-based material can be a safe and feasible means to reverse the pathologic corneal thinning and deformation in advanced keratoconus.” Nature Biotechnology

COVID-19 infection may not lead to higher microbial keratitis rates. Researchers at the Manchester Royal Eye Hospital compared incidence rates of microbial keratitis during the year following the start of the first UK COVID-19 lockdown in March 2020 and equivalent data from the 2004–2019 “pre-pandemic” period. Of the 312 corneal scrape specimen samples from the lockdown period that were sent for analysis, 29% were positive for keratitis; the equivalent, pre-pandemic scrapes had positive culture rates of 35%. The causative pathogens also did not appear to differ greatly between the pre-pandemic and the lockdown periods. Clinical Ophthalmology

The average patient has difficulty understanding online glaucoma information, according to investigators in the United Kingdom who assessed 111 patient education materials related to open-angle glaucoma for their readability (i.e., written at an 11- to 12-year-old age level). Materials came from online web sources as diverse as clinical health providers, nonclinical health information sites, and charities. The average Flesch Reading Ease Score of these materials was 55.5, putting them in the “fairly difficult to read” category, with 24% written at a college graduate or higher level. Similar findings were seen with other readability tools, such as the Flesch-Kincaid Grade level. Improving patient health literacy, while also simplifying readability of online resources, may improve inequalities in glaucoma treatment. BMJ Open Ophthalmology

Patients with noninfectious uveitis can keep taking adalimumab long term. Adalimumab has been well studied for the treatment of noninfectious uveitis (NIU). This retrospective, real-world cohort study conducted in the Netherlands looked at the long-term effectiveness of the drug and side-effect profile. Three hundred forty-one patients (633 eyes) with NIU were treated with adalimumab for a median duration of 3.3 years. In that time, 298 patients achieved active disease or remission, with 178 patients maintaining inactive disease with continuation of adalimumab. Median time to first relapse was 3.4 years, and 13% of patients reported adverse events leading to treatment discontinuation, most commonly temporary infection. American Journal of Ophthalmology

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