Results
OCULAR SURFACE DISEASE, COMPLICATIONS
Among the 80 participants enrolled, 35 participants in the CMC group completed the follow-up period, and 31 participants in the PEG group completed the follow-up period. No intervention-associated complications were observed, and both interventions were well tolerated. Participant characteristics are displayed in the Participant CharacteristicsParticipant characteristics were not significantly different between treatment groups at a 95% confidence threshold using statistical tests indicated (At baseline, the mean (standard deviation [SD]) OSDI scores were 7.69 (9.35) for the CMC group and 5.71 (7.70) for the PEG group. After intervention, the mean (SD) OSDI scores were 4.77 (7.93) for the CMC group and 3.35 (4.56) for the PEG group. This constituted a mean ΔOSDI (SD) of −2.91 (4.43) for the CMC group and −2.35 (5.42) for the PEG group. Both interventions were associated with a significant reduction in OSDI scores by pairwise Wilcoxon signed rank test (Box plots of ocular surface disease index scores. Outliers are shown as circles, and extreme outliers are shown as asterisks. (a) Ocular surface disease index scores are significantly lower after either CMC or PEG interventions. (b) There was no significant difference in reduction of ocular surface disease index scores between groups.Sequencing generated a maximum of 590 ASVs. The total number of reads from all participant samples and controls was 8,894,613 and was reduced to 4,554,231 after filtering and denoising. After contaminant filtering, 490 ASVs remained for analysis and were classified into 12 phyla (Next-Generation Sequencing Results. Taxonomic classification summary for all unfiltered samples at the (a) phylum and (b) class level. Sample letters indicate participant and numbers indicate before or after intervention. Asterisks indicate no classification available at this taxonomic level. (c) Principal coordinate analysis of unweighted UniFrac distances showing negative control samples have a distinct grouping within unfiltered sample microbiomes. (d) Principal coordinate analysis of weighted UniFrac distances showing negative control samples have a distinct grouping within unfiltered sample microbiomes.Box plots of alpha diversity. Alpha diversity measures are displayed for samples collected from both intervention groups at days 1 and 7. Outliers are shown as circles, and extreme outliers are shown as asterisks. (a) Species richness is not significantly different between groups at any time point. (b) Species diversity is not significantly different between groups at any time point.Differences in the microbial community structure were compared using UniFrac. Mann-Whitney repeated-measure comparisons of unweighted UniFrac distances (Beta diversity analysis. (a) Box plot of pairwise unweighted Unifrac distances between day 1 and day 7 time points, showing no significant differences between the two intervention groups. (b) Box plot of pairwise weighted UniFrac distances between day 1 and day 7 time points, showing no significant differences between the two intervention groups. (c) Principal coordinate analysis of unweighted UniFrac distances showing no significant grouping by intervention or time point. (d) Principal coordinate analysis of weighted UniFrac distances showing no significant grouping by intervention or time point. (e) Principal coordinate analysis of unweighted UniFrac distances shows grouping by participant sex. (f) Principal coordinate analysis of weighted UniFrac distances shows no significant grouping by participant sex.Bacterial relative abundance. (a) Bar graph of the top 10 most abundant bacterial genera from all ocular surface microbiome samples, with mean relative abundances listed. (b) LEfSe taxonomic analysis of taxa before and after CMC AT treatment at the genus level. (c) LEfSe taxonomic analysis of species before and after PEG AT treatment at the genus level.