摘要:

PurposeTo compare the effects of levobunolol hydrochloride and timolol maleate on tear volume, precorneal tear film stability, and corneal epithelial barrier function in normal human eyes.Subjects and MethodsThe study population consisted of 14 healthy volunteers. To obtain pretreatment baseline values, we determined the radius of the tear meniscus (RTM) by meniscometry; the noninvasive breakup time (NIBUT) of the precorneal tear film with a tear specular microscope; and corneal fluorescein uptake with a fluorophotometer. Levobunolol hydrochloride (0.5%) or timolol maleate solution (0.5%) was instilled twice daily for 4 weeks into 1 eye; the contralateral eye was treated with the other topical drug twice daily for the same period. At the end of the study period, the same tests were performed, and the pre- and posttreatment results were compared.ResultsTimolol solution did, and levobunolol did not, significantly reduce NIBUT from the baseline values. RTM was significantly decreased by treatment with either timolol or levobunolol solution. Corneal fluorescein uptake was not significantly changed, although it was higher after treatment with both topical drugs.ConclusionsFour-week treatment with timolol solution resulted in significant instability of the precorneal tear film. Both timolol and levobunolol solution significantly decreased tear volume on the ocular surface. These results indicate that levobunolol solution applied twice daily has equal effects on the tear volume and corneal epithelial barrier function as does timolol solution applied twice daily and that it affects precorneal tear film stability less than timolol solution.

ISSN:0277-3740    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Background and ObjectiveTo compare astigmatism after suture removal in a retrospective sequential series of patients who had penetrating keratoplasty with either a double running suture technique or an adjustable single running suture technique. During the first year postkeratoplasty, when sutures were in place, the latter technique had produced less astigmatism.Materials and MethodsKeratometry and keratometric astigmatism were measured before and after suture removal. We compared these variables in 30 grafts with the double running suture technique to the same variables in 24 grafts with the single running suture technique.ResultsThe final portion of the double running suture was removed 408 ± 177 (mean ± SD) days after keratoplasty, whereas the single running suture was removed 611 ± 224 days after keratoplasty (P< 0.001). After suture removal, there was no difference between the double running and single running groups in either mean keratometry [46.5 ± 1.8 diopters (D) versus 45.6 ± 2.0 D,P= 0.09, minimum detectable difference (MDD) = 1.5D] or mean astigmatism (4.6 ± 2.7 D versus 5.2 ± 3.2D,P= 0.72, MDD=2.3).ConclusionIn this consecutive series of corneal transplants performed by one surgeon, the results suggest no difference in astigmatism between the two suturing techniques after all sutures have been removed.

ISSN:0277-3740    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PurposeTo evaluate the effect of covering the sclera with conjunctiva during surgical treatment of pterygium on the rate of postoperative complications, cosmetic outcome, and risk of recurrence.MethodsA comparative, prospective clinical design was used. The study population consisted of 371 consecutive patients with unilateral primary advanced pterygium. All underwent bare sclera technique for pterygium excision. At completion of surgery, topical mitomycin C 0.02% was applied for 5 minutes. In the first 189 patients (group A), the conjunctiva was sutured to the sclera 2 mm from the limbus. The next 146 patients (group B), the conjunctiva was sutured at the limbus, covering the whole scleral postexcision defect. In the last 36 patients (group C), the conjunctiva remained unsutured to the sclera. The patients were followed for complications, cosmetic outcome, and recurrence for 26 months.ResultsAfter 26 months, 12 patients in group A (6.35%), 10 in group B (6.85%), and 9 in group C (25%) had recurrent pterygium. There were no cases of acute drug toxicity or scleral melting. Treatable delen were noted in 2 patients in group A (1.05%), 2 (1.36%) in group B, and 9 (25%) in group C. The cosmetic appearance was much better in group A than in groups B and C.ConclusionsLeaving the whole sclera uncovered in pterygium surgery places patients at high risk of complications and recurrence. There is no difference in complications and recurrence between covering the whole sclera with conjunctiva and leaving 2 mm bare, although the latter yields a more esthetic outcome.

ISSN:0277-3740    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PurposeTo evaluate the safety and efficacy of Focus®Night & Day™ extended-wear contact lenses when used for therapeutic purposes.MethodsFifty eyes of 50 consecutive patients presenting at the Ankara University Medical Center, Cornea and Contact Lens Service, and requiring bandage contact lens use for ocular surface disorders, were enrolled. All patients were fitted with Focus®Night & Day™ contact lenses and were followed in regard to patient satisfaction, contact lens fit and performance, and success of treatment.ResultsTwenty-four patients (48%) were male, and 26 (52%) were female. Average age at the time of presentation was 46.9 ± 21.6 years (range 1.5 to 88 years). Therapeutic contact lens indications included Fuchs' dystrophy (2 eyes), toxic epitheliopathy (1 eye), filamentous keratopathy (2 eyes), corneal perforation (2 eyes), corneal stromal melting (2 eyes), recurrent corneal erosion (4 eyes), chemical or traumatic epithelial defect (3 eyes), epithelial irregularity (1 eye), persistent epithelial defect (4 eyes), lamellar laceration (5 eyes), graft insufficiency (2 eyes), pseudophakic bullous keratopathy (7 eyes), aphakic bullous keratopathy (4 eyes), disciform keratitis (1 eye), postkeratectomy (4 eyes), and post–amniotic membrane transplantation or post–limbal autograft transplantation (6 eyes). Mean duration of continuous contact lens wear was 2.4 ± 3.0 months (range 3 days to 12 months). At the end of the follow-up period, the mean change in visual acuity was a gain of 1.8 ± 2.8 logMAR units (0–9 Snellen lines). No sight-threatening complications related to contact lens wear were encountered. A culture-negative sterile corneal infiltrate developed in one patient and was treated with cessation of lens wear and subsequent topical antibiotic and steroids.ConclusionFocus®Night & Day™ contact lenses are safe and effective when used for therapeutic purposes. Infrequent replacement of these lenses seems to be especially advantageous in patients for whom frequent lens insertion and removal may be associated with epithelial trauma, pain, and a potential increase in infection risk. Infrequent replacement of these lenses also decreased the office time and the cost of treatment without an increase in hypoxia-related complications.

ISSN:0277-3740    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PurposeTo evaluate the use of a human fibrin tissue adhesive in the adherence of corneal lamellar flaps in rabbit eyes.MethodsCorneal flaps were made using a microkeratome in both eyes of six New Zealand white rabbits. In the right eyes, the flaps were glued with fibrin tissue adhesive; in the left eyes, flaps were allowed to heal without adhesive (controls). All eyes were treated with antibiotics and steroids once daily for 10 days. Slit-lamp biomicroscopy was performed 1 and 10 days after surgery. The rabbits with surviving flaps were euthanized and the corneas obtained for histopathologic examination 10 days after surgery.ResultsSlit-lamp examinations showed no interface deposits and no other signs of corneal toxicity. Histologically, a few inflammatory cells were seen in both the experimental and control eyes, and microscopic gapping and tissue debris were observed in three of the six control eyes.ConclusionsHuman fibrin tissue glue was well tolerated in these eyes, with no or minimal corneal toxicity. Further studies are needed to determine the tensile strength of the adhesive bond in the cornea.

ISSN:0277-3740    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PurposeThe structure of mucin balls collected from silicone hydrogel contact lens wearers was examined to determine their nature.MethodsTears containing mucin balls were collected using a capillary tube. These were processed for light microscopic histochemistry, scanning electron microscopy, and electron microscopic elemental analysis. Mucin balls were also observed in vivo using confocal microscopy.ResultsHistology showed that the mucin balls were PAS positive, indicating that glycoproteins form a major component. Lipids and bacteria were not detected. Scanning electron microscopy did not show the surface to be smooth but revealed a variation in density across the surface. Elemental analysis was inconclusive.ConclusionsMucin balls are likely to be made from collapsed mucin and are unlikely to have been formed as a result of pearling around a silicon, lipid, or bacterial kernel.

ISSN:0277-3740    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PurposeTo discover if initial culturing conditions (plate temperature and time delay to incubation) adversely influence the recovery of organisms associated with bacterial keratitis.MethodsThe rate of temperature equilibration of culture plates taken from a refrigerator and placed in an incubator and left on the desk was evaluated with a digital thermometer. A standard inoculum for each of five organisms (S. aureus,S. pneumoniae,P. aeruginosa,E. aerogenes,K. oxytoca) isolated from human bacterial keratitis was spread evenly on blood agar plates at refrigerator (Tcold; 4°C), room (Troom; 24°C), and incubator (Twarm; 37°C) temperatures. The plates were then kept at room temperature for 0, 1, 3, 5, and 8 hours before overnight incubation at 37°C (S. pneumoniaeunder microaerophilic conditions), and the number of colony-forming units was counted.ResultsCold plates took at least 15 minutes in an incubator to attain room temperature, and up to an hour when left on the desk. Increased organism recovery was found comparing both Twarmand Troomplates (6.2 to 24.8% and 7.0 to 14.7%, respectively,P< 0.001) to Tcoldplates for all organisms exceptS. pneumoniae(P= 0.057). Comparing Twarmplates to Troomplates demonstrated an increased recovery (P< 0.001) forS. aureus.Delayed incubation resulted in decreased recovery forS. pneumoniae(P< 0.001).ConclusionsCulture plates should preferably be warmed at least to room temperature before inoculation, as well as promptly incubated to increase bacterial recovery from cases of septic keratitis.

ISSN:0277-3740    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PurposeTo report the appearance of an unusual vortex pattern of corneal deposits in two patients with the R555W mutation in the transforming growth factor &bgr;–induced gene (TGFB1) associated with granular corneal dystrophy.MethodsDNA from affected patients and unaffected relatives was isolated from buccal swabs, andTGFB1mutation screening was performed.ResultsThe proband and an affected daughter demonstrated rays of deposits emanating from a point in the inferior cornea of each eye in a “sea fan” or vortex pattern. Screening all 17 exons ofTGFB1in the proband identified a single missense mutation (C1710T) in exon 12, consistent with the diagnosis of granular corneal dystrophy. The identical mutation was identified in the affected daughter.ConclusionsIn spite of the strict phenotype–genotype correlation reported for theTGFB1-associated corneal dystrophies, atypical clinical findings may be produced by previously identified, conserved mutations.

ISSN:0277-3740    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

PurposeTo describe treatment of a child with recalcitrant ligneous conjunctivitis secondary to a systemic plasminogen deficiency.DesignInterventional case report.MethodsA seven-year-old boy developed severe unilateral membranous conjunctivitis recalcitrant to surgical debridement and treatment with topical prednisone, topical cyclosporine, and oral prednisone. Systemic evaluation revealed a severe plasminogen deficiency.ResultsTreatment with surgical debridement and topical plasmin was ineffective and resulted in prompt recurrence of dense conjunctival membranes. Treatment with topical plasminogen resulted in dramatic improvement and complete resolution of the membranes.ConclusionsLigneous conjunctivitis is secondary to a systemic plasminogen deficiency. Treatment with topical plasminogen resulted in prompt resolution of the membranes. Treatment with topical plasmin was ineffective.

ISSN:0277-3740    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-3740    

出版商:OVID    

年代:2003

数据来源: OVID