Unraveling the Role of Accessory Lacrimal Glands

Learn about the big effect these small glands have on dry eye dynamics.

Srinivas S. Kondapalli, MD; Nandini Venkateswaran, MD; and Ada Noh, OD

Cataract and Refractive Surgery Today

The main lacrimal gland, residing in the lacrimal fossa of the frontal bone, is believed to be the primary contributor to the aqueous layer of the tear film. In contemporary eye care, substantial attention is given to the main lacrimal gland and its innervation and mechanisms to increase output of the gland in the context of treating dry eye disease (DED). But, what about the accessory lacrimal glands of Krause and glands of Wolfring? This article examines the function and role of these lesser-known lacrimal glands in maintaining ocular health and how they are affected in DED. KRAUSE AND WOLFRING: THE HIDDEN PLAYERS There are 20 glands of Krause in the superior conjunctival fornix and 10 glands within the inferior fornix. The glands of Krause are located under the eyelid, where the upper and lower conjunctiva meets. The glands of Wolfring are located within the nonmarginal border of both the superior and inferior tarsal plates (Figure 1).

Combining Vitreoretinal Surgery With EDOF IOL Implantation

The lens technology’s potential to reduce patients’ trips to the OR and loss of accommodation.

Peter Stalmans, MD, PhD

Cataract and Refractive Surgery Today

Cataract surgery is often thought of as an age-related procedure. In numerous European countries, however, including Belgium, where I practice, many patients receiving a vitrectomy undergo concurrent cataract surgery if they are older than 50 years of age to minimize the number of surgical procedures they will require and maximize their UCVA. IOL selection in this situation is challenging because these individuals are typically active members of the workforce who require crisp intermediate and near visual acuity. My colleagues and I therefore conducted a study to evaluate patient satisfaction when vitrectomy was combined with the implantation of an extended depth of focus (EDOF) IOL (AT LARA, Carl Zeiss Meditec).1 WHY AN EDOF IOL? Traditional multifocal IOLs are designed to provide better near visual acuity and greater spectacle independence than monofocal IOLs.2 Patients who receive multifocal IOLs, however, are more likely to experience glare, halos,2,3 and reduced contrast sensitivity.3 An EDOF lens was selected for our study because it can provide good intermediate visual acuity with fewer unwanted visual effects.4 Participants with more than mild corneal astigmatism received a toric model. Earlier research demonstrated high patient satisfaction with EDOF lenses.5,6 Our study is the first to gauge patient satisfaction with an EDOF IOL implanted following a vitrectomy. The study also explored whether unilateral or bilateral IOL status had an impact on quality of life. METHODOLOGY Patients who underwent a vitrectomy at the University Hospitals Leuven in Belgium from January 2019 to January 2022 were invited to participate in our study. In addition to patients with vision-threatening conditions such as retinal detachment (RD) and epiretinal membrane, the study enrolled a small number of individuals who elected to undergo a vitrectomy to remove floaters. Among patients with an RD, only those with macula-on detachments at the time of the procedure or those with macula-off detachment of less than 24 hours’ duration were included.

New Retina Radio Journal Club with VBS: Comparison of Antiseptics Use for IVT

Sruthi Arepalli, MD, Vaidehi Dedania, MD, and Rebecca Soares, MD, MPH

Eyetube

How do endophthalmitis rates after intravitreal injection differ after using povidone-iodine compared with chlorhexidine? Moderator Sruthi Arepalli, MD, hears from panelists Vaidehi Dedania, MD, and Rebecca Soares, MD, MPH, about a recent peer-reviewed retrospective cohort study on this topic. After the break, the trio discuss how to manage patients who do not tolerate antiseptics, the benefits of visualizing antiseptics on the conjunctiva, and the specific practice patterns that work best in their clinics.