Eyeworld

17 EW NEWS & OPINION August 2018 only after safety is assured," Dr. Reid said. "Probiotic strains don't tend to colonize, so the intent would be to manipulate the function and output of the existing microbiota or the metabolic activity that is causing disease." However, a continued focus on the ocular surface microbiome will enhance understanding of the role of homeostasis microorganisms in ophthalmic disease and may inspire the development of new probiotic- based therapies to prevent and treat ocular disease, noted Lu and Liu in their report. 7 EW References 1. Chisari G, et al. Aging eye microbiota in dry eye syndrome in patients treated with Entero- coccus faecium and Saccharomyces boulardii. Curr Clin Pharmacol. 2017;12:99–105. 2. Watters GA, et al. Ocular surface microbi- ome in meibomian gland dysfunction. Clin Exp Ophthalmol. 2017;45:105–111. 3. Dennis-Wall JC, et al. Probiotics (Lactoba- cillus gasseri KS-13, Bifidobacterium bifidum G9-1, and Bifidobacterium longum MM-2) improve rhinoconjunctivitis-specific quality of life in individuals with seasonal allergies: a double-blind, placebo-controlled, randomized trial. Am J Clin Nutr. 2017;105:758–767. 4. Astafurov K, et al. Oral microbiome link to neurodegeneration in glaucoma. PLoS One. 2014;9:e104416. 5. Lin P. The role of the intestinal microbiome in ocular inflammatory disease. Curr Opin Ophthalmol. 2018;29:261–266. 6. Shin H, et al. Changes in the eye microbiota associated with contact lens wearing. MBio. 2016;7:e00198. 7. Lu LJ, Liu J. Human microbiota and ophthalmic disease. Yale J Biol Med. 2016;89:325–330. Editors' note: The physicians have no financial interests related to their comments. Contact information Park: lisa.park@columbia.edu Reid: gregor@uwo.ca Shah: rupas@revisioneyes.com Wang: drwang@wangvisioninstitute.com presence of Methylobacterium, Lac- tobacillus, Acinetobacter, and other bacteria. Although the results show that contact lens wear alters the mi- crobial structure of the ocular con- junctiva, more research is needed to find out if the microbiome structure provides less protection from infec- tion, the researchers concluded. Bringing it together It is too early to recommend specific treatments with the attempt to change the makeup of the ocular microbiome, said Ming Wang, MD, PhD, Wang Vision 3D Cataract & LASIK Center, Nashville, Tennes- see. "This appears to be because as a field, we still do not understand the significance of the bacteria that reside on the eye and how we can alter this to promote good health," he said. "Unfortunately, research on the ocular microbiota still lags behind other body sites such as the gut, skin, and oral cavity, and large-scale double-blinded studies are ultimate- ly needed to make solid recommen- dations on this subject," said Rupa Shah, MD, ReVision Cataract and Refractive Surgery, Columbus, Ohio. That said, improved eyelid hygiene and cleaning along the eyelids can help to reduce bacterial proliferation in that area, and that could lead to a restoration of normal healthy bacteria on the cornea and conjunctiva, Dr. Wang said. Ophthalmologists can continue to advise patients to avoid extend- ed contact lens wear and maintain good contact lens hygiene, Dr. Shah said. "Furthermore, one should avoid harsh chemicals in the perioc- ular region that could alter our natu- ral microbiome and could contribute to pathologic states," she said. It is too early to say if probiot- ics—either geared toward the eye or taken orally—can improve ocular health, and Dr. Reid was not aware of any research until now that has led to inserting probiotic strains in the eye. "The opportunity to reduce inflammation, improve healing, and potentially deliver treatments for various conditions exists, but it will require low doses to be used, and I N S T R U M E N T S | S I N G L E U S E | D R Y E Y E | B I O L O G I C S Look to Stephens For sterile tissue allografts. Stephens Instruments | 2500 Sandersville Rd | Lexington KY 40511 USA Toll Free ( USA ) 800.354.7848 | info@stephensinst.com | stephensinst.com © 2018 Stephens Instruments. All rights reserved. Distributed exclusively through Stephens Instruments Learn more at halograft.org Stephens Instruments is the exclusive distributor of Halo implant patch grafts. Packaged in our patented easy-peel packaging system for rapid introduction on to the sterile field, halo tissues require no rinsing or reconstitution. Halo sterile tissues are high-quality and backed by the superior service that Stephens is known for. Stephens – more than instruments. SCLERA CORNEA PERICARDIUM

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