The Effect of the Concurrent Therapy of Glucosamine and Aspirin in Uveitis

PURPOSE: To report the anti-inflammatory effect and best-corrected visual acuity (BCVA) response after oral glucosamine (Glucosamine Sulfate 750(R), General Nutrition Companies, Inc.) and aspirin (Aspirin protect(R), Bayer) therapy in patients with uveitis. METHODS: Twenty-seven patients (43 eyes) with uveitis, not easily managed with conventional therapy, were treated with oral glucosamine 750 mg and aspirin 100 mg daily, and underwent BCVA testing and slit-lamp examination of anterior chamber inflammation. Changes in the dose of previously-used oral steroids and immunosuppressants were recorded at baseline, every 2 weeks for the first 2 months, and once every month thereafter. RESULTS: The mean follow-up period was 15.0+/-3.69 weeks and inflammation started to improve within 4.6 weeks. The change in visual acuity was not statistically significant, but grade of inflammation decreased by as much as 1.02+/-1.28, significantly (p<0.01) after treatment. In 12 patients (19 eyes, 44.2%) the dosage of systemic steroids and immunosuppressants could be Reduced. 7 patients (10 eyes, 23.3%) experienced aggravation of uveitis and the dosage of glucosamine and aspirin was increased. CONCLUSIONS: Concurrent oral administration of glucosamine and aspirin could not completely inhibit the recurrence of inflammation nor control it, but consistent use of these drugs may help to reduce inflammation without serious side effects. A longer prospective control study with larger sample size is required to further evaluation of the efficacy of the medication.

Suture Tension Adjustment of Single Running Suture in Penetrating Keratoplasty

We performed suture tension adjustment (STA) in 8 patients who had undergone penetrating keratoplasty with 10-0 nylon running suture closure. 3 to 8 weeks after the surgery, STA was done by loosening the suture tension at the steep meridian and tightening at the flat meridian, guided by automatic keratometery, keratoscopic finding and manifest refraction. Pre-STA astigmatism of 6.27 +/- 1.84 diopter(D) was changed to 1.94 +/- 1.40D immediately after the adjustment. Post-STA astigmatism regressed mostly within two weeks of adjustment, remaining stable thereafter: In one case, suture breakage occurred during adjustment, and resuturing was done using a new 10-0 nylon tied to the broken ends without serious sequela.

Surgical Effect of Type I Nystagmus Blockage Syndrome

Six patients of nystagmus blockage syndrome (type 1) underwent both medial rectus recession and posterior fixation suture. Associated amblyopia wsa treated with occlusion or atropinization before and after surgery. During follow-up period for 12 weeks (4-36 weeks), four patients revealed orthophoria and one was esotropi a less than 5 delta and the other was 4-5 delta exotropia. The tropic status was stable, and in two patients who had manifest latent nystagmus, the amplitude of nystagmus was markedly decreased. Head turn was present in all patients before surgery. After surgery head turn was disappeared in five patients but still remained in one although their tropic status changed to orthophoria and the visual acuities of both eyes were equal.

Surgical Effect of Type I Nystagmus Blockage Syndrome

Six patients of nystagmus blockage syndrome (type 1) underwent both medial rectus recession and posterior fixation suture. Associated amblyopia wsa treated with occlusion or atropinization before and after surgery. During follow-up period for 12 weeks (4-36 weeks), four patients revealed orthophoria and one was esotropi a less than 5 delta and the other was 4-5 delta exotropia. The tropic status was stable, and in two patients who had manifest latent nystagmus, the amplitude of nystagmus was markedly decreased. Head turn was present in all patients before surgery. After surgery head turn was disappeared in five patients but still remained in one although their tropic status changed to orthophoria and the visual acuities of both eyes were equal.

Staining Characteristics of Granular Deposits of Granular Dystrophy in Six Cases

Penetrating keratoplasty was performed in six eyes of granular corneal dystrophy. Vision was improved from worse than 0.05 to better than 0.4. Mean follow-up period is 14 months (12-18 months). Corneal deposits were stained for H and E. Masson trichrome, Wilder's reticulin and Luxol fast blue but not for PAS, Congo red and Oil red a stain. Electron micorscopic examination showed that polymorphic, electron dense rod-shaped bodies were present in the Bowman's layer and between stromal lamellae and in the interceliular space of corneal epithelium. And, for the first time we found a area looked like a transformation from normal stroma to the granular deposit.

The Change of Intraocular Pressure: Retrobulbar vs Peribulbar Anesthesia

In order to compare the influence of retrobulbar and peribulbar anesthesia technique to the change of intraocular pressure(IOP), we measured the IOP sequentially in 40 eyes of 40 patients(retrobulbar group: 20 eyes, peribulbar group: 20 eyes). The intraocular pressure was checked at one hour prior to operation, just after application of Honan apparatus with 30 mmHg for 30 minutes, just after the injcetion of anesthetics with technique retrobulbar and with peribulbar technique, and after digital massage for 5 minutes. Injected volume of anesthetics was 3 ml in retrobulbar technique and 6 ml in peribulbar technique. In retrobular group, the IOP mean was 16.55 mmHg at one hour prior to operation, 10.96 mmHg just after Honan application, 17.36 mmHg just after the injection of anesthetics and 10.38 mmHg after digital massage. In peribulbar group, the IOP mean was 16.97 mmHg at one hour prior to operation, 11.08 mmHg just after Honan application, 18.11 mmHg just after the injection of anesthetics and 11.31 mmHg after digital massage. The mean increase of IOP after the injection of anesthetics was 6.40 mmHg in retrobulbar group and 7.03 mmHg in peribulbar group. There was no statistical difference in the change of IOP between the two groups.(Student t-test, p>0.10).

The Effect of 0cclusion in Intermittent Exotropia

Occlusion therapy has been reported to improve the motor phase and sensory phase of exodeviations. We performed occlusion on the preferred eye in intermittent exotropia for three hours a day. Average follow-up time was 15.8 weeks. The frequency of tropic status of exodeviation was decreased in 21 cases(70%). In two cases intermitent pattern was changed to exophoria, and in one case, to exotopia. The size of the deviation angle was changed from 28.93 +/- 7.6 prism diopter(PD) to 24.03 +/- 7.9 PD(p<0.01). In 13 cases(43.3%) the size of the deviation angle decreased more than 6 PD, increased more than 6 PD in one case(3.3%), and in 16 cases(53.3%) the size of deviation angle showed no change. The preference pattern changed from monocular to alternating type in 5 cases. Stereopsis improved in 24% of the cases and did not deteriorate in Others.