Effect of intraoperative Trans-PRK combined with MMC on postoperative haze in the treatment of high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the mitomycin-C(MMC)0.02% efficacy in preventing haze after trans-epithelial photorefractive keratectomy(Trans-PRK)in the treatment of the high myopia. <p>METHODS: Retrospective case series. Trans-PRK were performed on 142 eyes with a preoperative spherical equivalent. They were divided into with 0.02% MMC(MMC group)and without MMC(control)groups. In MMC group there were 94 eyes with MMC 0.02%; in control group there were 48 eyes. Patients were treated with an intraoperative application of MMC 0.02% for 30-45s depending on refractive error in MMC group. After surgery, fluorometholone 0.1% eye drops were used for 4mo in all groups. The mean follow-up time was 6mo. The regression trees were used to analyse the relationship between different related factors and haze. <p>RESULTS:Haze was quantified with Fantes. Incidence of haze was 8.5% eyes in MMC group and 33.3% in without MMC group(<i>P</i>=0.001). In the regression trees, optical zone and ablation depth MAX were related to haze(<i>P</i><0.01). It was possibility induce haze when optical zone is ≤5.6mm. When optical zone is >5.6mm, ablation depth MAX becomes the main factor for haze.<p>CONCLUSION: The design of optical zone and ablation depth MAX in Trans-PRK should be considered for the treatment of the high myopia with thin cornea and abnormal corneal morphology. MMC 0.02% was effective in preventing haze after Trans-PRK in the treatment of the high myopia.

Aplicación transoperatoria de mitomicina-C en la dacriocistorrinostomía externa: acuerdos y desacuerdos / Intraoperative application of Mitomycin-C in external dacryocystorhinostomy: agreements and disagreements

RESUMEN Introducción: la dacriocistorrinostomía externa es la técnica más empleada por la mayoría de los cirujanos oculoplásticos para tratar a los pacientes con obstrucción del canal nasolagrimal. Es posible que los galenos cometan algunos errores en este tipo de cirugía, a pesar de los grandes avances en las tecnologías ópticas, las técnicas quirúrgicas y el uso de modernos materiales de intubación. La principal causa de los errores es el cierre de la osteotomía por tejido cicatrizal o de granulación, con la formación de sinequias en la cavidad nasal. La mitomicina C es el antibiótico alquilante más estudiado en la prevención del exceso de cicatrización en el área de la osteotomía; sin embargo, existen acuerdos y desacuerdos entre estudiosos del tema sobre la eficacia, dosis y tiempo de exposición de este medicamento. El papel de cada una de estas variables en el resultado final de la cirugía es controversial. Objetivo: brindar evidencias sobre el papel de la aplicación transoperatoria de la mitomicina C en la dacriocistorrinostomía externa. Métodos: se realizó una revisión de la bibliografía actualizada disponible en idioma español e inglés. Se consultaron los textos completos y resúmenes en las bases de datos: PubMed, Ebsco, Google Académico y Scielo. También se revisaron novedosos artículos en prestigiosas revistas especializadas. Conclusiones: la mayoría de los autores coinciden en que este medicamento contribuye a elevar la tasa de éxito de la dacriocistorrinostomía externa; aunque su aplicación es segura, todavía se estudian algunas variables que mejorarían su eficacia.

ABSTRACT Introduction: external dacryocystorhinostomy is the most used technique by oculoplastic surgeons to treat patient with nasolacrimal duct obstruction. Physicians may make some mistakes in this type of surgery despite great advances in optical technologies, surgical techniques and the use of modern materials for intubation, The main cause of errors is the closure of the osteotomy due to scar tissue or granulation with synechia formation in the nasal cavity. Mitomycin-C is the most studied alkylating antibiotic in the prevention of excessive scarring in the osteotomy area; however, there are some agreements and disagreements among scholars on the efficacy, dosage and time of exposure of this drug. The role of each of these variables in the final outcome of the surgery is controversial. Objective: to provide some evidences about the transoperative application of Mitomycin-C in external dacryocystorhinostomy. Methods: a review of the updated bibliography available in Spanish and English languages was carried out. Complete texts and abstracts were consulted in the databases: PubMed, Ebsco, Google Scholar and Scielo. Novel articles were also reviewed in prestigious specialized journals. Conclusions: must authors agree that this drug appears to improve the success rate of external dacryocystorhinostomy. Although its application is safe, some variables are still being studied that would improve its efficacy.

Recurrence and Complication Rates among Current Pterygium Treatment Techniques: Pre-operative Subpterygeal Mitomycin-C Injection, Intraoperative Mitomycin C Application and Pterygium Excision with Conjunctival Autograft

Objective@#This study aims to determine recurrence and complication rates among patients who underwent three current pterygium treatment techniques: preoperative subpterygeal injection of mitomycin C, intraoperative application of mitomycin with pterygium excision and pterygium excision with conjunctival autograft. @*Methods@#This is a randomized controlled clinical trial in a tertiary hospital. We included patients with diagnosed primary pterygium and who underwent either: A = pre-operative injection of 0.02% mitomycin C one month prior to pterygium excision; B = pterygium excision with intraoperative mitomycin C application; or C = pterygium excision with conjunctival autograft. @*Results@#We included 111 patients: a total of 120 eyes randomized to 3 groups (A, B, C) at 40 eyes per group. After 24 months of follow-up, there was no significant difference in the recurrence rates among the groups (6/40 [15%] in groups A and B and 2/40 cases [5%] in group C; P=0.29). No complications were noted in groups B and C, while 1 case of scleral thinning was noted in group A. There was no significant difference in the complication rates among the three procedures (P=1.00).@*Conclusion@#There were no significant differences in the recurrence and complication rates among the three techniques. Careful patient selection and follow-up are recommended to prevent complications such as scleral thinning.

Trabeculectomy with subconjunctival collagen implant in Indian eyes: Long-term results

Purpose: To report long-term safety and efficacy of trabeculectomy with collagen implant in Indian population. Methods: All cases of trabeculectomy with Ologen® Collagen Matrix implant performed over a 7-year period from May 2008 through April 2015 at a tertiary referral institute were reviewed. A total of 30 eyes of 28 patients were included in the study with two patients undergoing bilateral trabeculectomy. Outcomes measured included intraocular pressure (IOP) control, number of antiglaucoma medications used, bleb morphology, and complications/reoperations. Results: Trabeculectomy resulted in reduction in IOP from 36.46 to 11.65 mm Hg in the immediate postoperative period (day 1), a 68% decrease to 15.18 mm Hg at 84 months (58% decrease). The mean IOP reduction decreased over time from 63% in the first year to 55% after 5 years of follow-up. Fourteen eyes attained a follow-up of 5 years and eight eyes a follow-up of ?7 years. No sight-threatening complication such as hypotony, bleb leak, and bleb-related endophthalmitis was observed in our series, and only intervention required was 5-fluorouracil needling in one case. Conclusion: Ologen-augmented trabeculectomy is effective in controlling IOP over a long-term follow up from minimal 3 to maximal 7 years. No untoward events jeopardizing bleb safety were noted at any time. This modality is a viable alternative for patients with contraindications to use of antimetabolites.

THE USAGE OF LOW-DOSE MITOMYCIN-C (MMC) IN THE TREATMENT OF PTERYGIUM / Шинэ санаа Шинэ нээлт

@#BACKGROUND. To observe the efficacy and the safety of low-dose mitomycin-C (MMC) in the treatment of pterygium. MATERIAL AND METHODS. In a prospective, randomized and controlled clinical trial, a total of 550 eyes of 400 patients diagnosed with pterygium were randomly divided into the four groups - group 1:130 eyes of 100 patients without MMC; group 2:140 eyes of 100 patients , with 0.2g\L MMC; group 3:150 eyes of 100 patients, with 0.3g\L MMC; group 4:130 eyes of 100 patients, with 0.4g\L MMC. They underwent the excision of primary pterygium barely the sclera. Visual acuity, intraocular pressure (IOP), extraocular movement, iridocyclitis, scarring, symptoms (tearing, photophobia, foreign body sensation) and signs (conjunctival hyperemia, ulcer of sclera and cornea, perforation of sclera) of subjects, were recorded on the day of enrollment and after the surgery, on 2 weeks, 2 months, 6 months and 1 year. RESULTS. In a group 3 and 4, the recurrence of pterygium after the excision were less than that in group 1 and group 2 (р<0.01) . In a 4 group, after the surgery, there were more probability of raising IOP, iridocyclitis, symptoms and signs than that in group 1,2, and 3. СONCLUSION. Low dose MMC is effective in the treatment of preventing the recurrence of primary pterygium. It’s efficacy rises along with its density. And mean time, the safety of the treatment of low-dose MMC declines.

Recurrence Rate in Primary Pterygium Managed by Surgical Excision of Pterygium with Application of Mitomycin-C over Bare Sclera and Free Conjunctival Autografting

Background: To study recurrence rate in 50 cases of primary pterygium managed by surgical excision of pterygium along with application of mitomycin-C 0.02% over bare sclera for 2 minutes and ipsilateral free conjunctival autografting. Methods: This prospective observational study was carried out on 50 patients of primary pterygium operated between 25.05.2016—10.08.2016. Pterygium excision was done, 0.02% mitomycin-C was applied over bare sclera for 2 minutes and ipsilateral free conjunctival autografting was done using sutures. Patients were followed up for a mean period of 13.27 months for recurrence.  Results: 55 eyes of 50 patients were operated by above technique by a single surgeon1. Three (3) patients were lost in follow up. In an average follow-up time of 13.27 months, recurrence was found in only 1 case (1.92%). No serious side effects were observed in this study. Conclusions: Primary    Pterygium     managed     by     excision  of  pterygium followed by intraoperative mitomycin-C application and conjunctival autografting is an easy, reproducible and cost effective method which helps in reducing recurrence with minimal complications.

Results of mitomycin-C-augmented viscocanalostomy for open-angle glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the results of mitomycin-C (MMC)-augmented viscocanalostomy in patients with open-angle glaucoma.METHODS:This retrospective study included 104 patients who underwent viscocanalostomy surgery between December 2007 and March 2014.Pre-and postoperative intraocular pressure (IOP), number of glaucoma medications, visual acuity, complications, adjunctive procedure (laser goniopuncture and/or glaucoma medication), and success rate were recorded.Complete success was defined as IOP≤21 mmHg without additional medication, and qualified success was defined as IOP≤21 mmHg with or without glaucoma medication.RESULTS:Mean preoperative IOP was 27.5±9.2 mmHg and mean postoperative IOP was 14.5±6.6 mmHg at the last visit (P<0.001).Mean visual acuity before and after surgery were 0.42±0.4 and 0.32±0.4, respectively (P=0.726).Qualified success was achieved in 106 (86.9%) eyes and complete success was achieved in 62 (50.8%) eyes.Laser goniopuncture was performed in 43 (35.2%) eyes and glaucoma medication usage rate was 49.1%.The mean postoperative followup period was 27.29±16.78 (1-79)mo.CONCLUSION:Although viscocanalostomy is a safer option due to low complication rates and stable visual acuity, without laser goniopuncture(LGP), surgical success rate is still very low.Further comparative studies are necessary to evaluate the contribution of MMC to viscocanalostomy surgery.

Comparative Study of Effect of Mitomycin-C and Merocel Packing on Ostial Patency in Primary Endoscopic Dacryocystorhinostomy.

Background: To compare the post operative ostial patency at the rhinostomy site in the patients undergoing the primary endoscopic dacryocystorhinostomy, using Mitomycin-C application and Merocel packing. Methods: The patients visiting the Otorhinolaryngology out patients department at the tertiary referral hospital were included in this study. The study was prospective in nature and comprised of 50 patients suffering from primary dacryocystitis. Endonasal endoscopic dacryocystorhinostomy was done in the patients suffering from the chronic dacryocystitis with postsaccular obstruction of lacrimal system. The patients were divided in two equal groups containing 25 patients in each group. In first group (Group- A) Mitomycin-C (0.5 mg/ml for 15 min) was locally applied at the rhinostomy site and nasal cavity was packed with bactigras after the surgery, whereas in the second group, nasal cavity was packed with Merocel after reposition of the flap without application of any drug. Follow up was done every week in the first month, then monthly till the six months after the surgery. The post operative results were compared in terms of ostial patency at the rhinostomy site at one month, three months and six months of follow up. The surgical technique used remained same throughout the period of study. Results: The post operative ostial patency of rhinostomy stoma was better in the group of the patients undergoing application of Mytomycin-C at the rhinostomy site as compared to the packing of the nasal cavity with Merocel. The difference between both the groups was statistically significant. The rhinostomy created was free from synachiae and granulation tissue formation on follow up examination in the group of the patients having application of Mitomycin-C at the time of surgery. Ultimately the ostial patency was better in the patients having application of Mitomycin-C. Conclusion: Mitomycin-C has statistically significant beneficial effect in the maintenance of ostial patency after primary endonasal endoscopic dacryocystorhinostomy as compared to the merocel packing alone after the surgery.

Management and Treatment of Ocular Surface Neoplasia.

Conjunctival squamous cell carcinoma (CSCC) is an invasive ocular surface neoplasia ranging from dysplasia to carcinoma in situ to invasive squamous cell carcinoma, which is identifi ed as premalignant and malignant epithelial lesions. Often, it is seen in males in tropical countries lying close to the equator where there is excessive exposure to sunlight. Clinical diagnosis requires close examination with a degree of high suspicion. Appropriate and defi nitive diagnosis of conjunctival squamous neoplasia by ocular pathologists and the need for future detailed clinicopathologic studies is recommended. Appropriate and defi nitive diagnosis requires histopathology. We describe a case of CSCC underlying dysplasia with intraepithelial squamous cell neoplasia, where the case was confi rmed by histopathological examination. Th e treatment modality involving surgery and medication and follow-up is described. Th ere was no evidence of recurrence, complication, or metastasis.

Limbal Squamous Cell Carcinoma in a Young Non‑Human Immunodeficiency Virus Patient and its Surgical Outcome: A Rare Case Report.

Ocular surface squamous neoplasia presents as a spectrum from simple dysplasia to carcinoma in situ to invasive squamous cell carcinoma (SCC) involving the conjunctiva as well as the cornea. SCCs are commonly seen in eye at the transitional zone of epithelium-the limbus and eyelid margin and usually seen in elderly patients or in young human immunodeficiency virus (HIV) positive patients. Limbal lesion spreads over the ocular surface and enters the fornices but rarely penetrates the globe. Wide total excision serves both therapeutic and diagnostic purpose. We report a rare case of 32 years old, non-HIV male patient who presented with complaints of painless, progressive mass in the right eye with mild visual blurring since 2 months. Slit lamp examination suggested the clinical diagnosis of limbal carcinoma for which a total excisional biopsy with fibrin glued conjunctival autograft was performed. Postoperatively with the confirmed diagnosis of SCC from histopathology, mitomycin - C 0.02% eye drops were prescribed for 4 weeks along with steroid- antibiotic combination in a tapering dose. Postoperatively no recurrence was seen, and good cosmetic improvement was noted.

Corneal melanosis successfully treated using topical mitomycin-C and alcohol corneal epitheliectomy: a 3-year follow-up case report / Tratamento com êxito da melanose de córnea utilizando mitomicina-C tópica e epiteliectomia auxiliada por álcool: relato de caso com três anos de seguimento

ABSTRACTWe report a case of primary acquired corneal melanosis without atypia associated with corneal haze in a patient with a history of limbal malignant melanoma and the effect of mitomycin-C. A 75-year-old woman with a history of limbal malignant melanoma presented with loss of vision in right eye. Corneal examination showed a patchy melanotic pigmentation with a central haze. Topical mitomycin-C improved visual acuity and corneal haze. However, the pigmented lesions persisted, and they were removed with alcohol corneal epitheliectomy. Histopathological examination demonstrated primary acquired melanosis without atypia. The lesions were successfully removed, and there were no recurrences during the follow-up period of 36 months. The association of conjunctival and corneal melanosis without atypia is a rare condition. In addition, co-existence of central corneal haze and melanosis may decrease visual acuity. Topical mitomycin-C and alcohol corneal epitheliectomy can be useful treatments in this condition.

RESUMORelatar um caso de melanose adquirida primária de córnea sem atipia, associado a haze corneano em um paciente com história de melanoma maligno de limbo e o efeito da mitomicina-C. Uma mulher de 75 anos de idade, com história de melanoma maligno do limbo apresentado com diminuição de visão no olho direito. O exame de córnea mostrou uma pigmentação melânica irregular com um haze central. O uso de mitomicina-C tópica levou à melhora da acuidade visual e da opacidade corneana. No entanto, as lesões pigmentadas persistiram e foram removidas com epiteliectomia associada ao álcool. O exame histopatológico demonstrou melanose adquirida primária sem atipia. As lesões foram removidas com êxito, e não houve recidiva durante o período de acompanhamento de 36 meses. A associação melanose sem atipia da conjuntiva e da córnea é uma condição rara. Além disso, a coexistência de haze corneano central e melanose pode diminuir a acuidade visual. O uso de mitomicina-C tópica e epiteliectomia corneana auxiliada pelo álcool podem ser tratamentos úteis nessa situação.

Mitomycin-C in dacryocystorhinostomy: From experimentation to implementation and the road ahead: A review.

Dacryocystorhinostomy (DCR) is the procedure of choice in patients with epiphora due to primary acquired nasolacrimal duct obstruction. The evolution of surgical tools, fiber‑optic endoscopes, effective anesthesia techniques, and the adjunct use of antimetabolites intraoperatively; namely mitomycin‑C (MMC) have significantly contributed to the advancement of DCR surgery. MMC is a systemic chemotherapeutic agent derived from Streptomyces caespitosus that inhibits the synthesis of DNA, cellular RNA, and protein by inhibiting the synthesis of collagen by fibroblasts. Even the cellular changes in the human nasal mucosal fibroblasts induced by MMC at an ultrastructural level have been documented. There, however, seems to be a lack of consensus regarding MMC: The dosage, the route of delivery/application, the time of exposure and subsequently what role each of these variables plays in the final outcome of the surgery. In this review, an attempt is made to objectively examine all the evidence regarding the role of MMC in DCR. MMC appears to improve the success rate of DCR.

Atresia de coanas, revisión y una mirada desde la evidencia / Choanal atresia, review and a look from the evidence

La atresia de coanas es la anomalía congénita nasal más común. Cuando es bilateral, se presenta con dificultad respiratoria desde el nacimiento. La atresia unilateral se manifiesta con insuficiencia ventilatoria y rinorrea unilateral, pudiendo pasar inadvertida. El diagnóstico se sospecha ante la ausencia de paso de aire en las fosas nasales y la imposibilidad de hacer progresar una sonda nasogástrica. Se confirma mediante examen endoscópico y tomografía computarizada. El tratamiento definitivo es quirúrgico, existiendo diferentes técnicas y vías de abordaje. Se presenta una revisión de la literatura, con especial énfasis en el tratamiento pos-quirúrgico con stents y mitomicina-C a través de una mirada desde la evidencia.

Choanal atresia is the most common congenital nasal anomaly. When bilateral, it presents with respiratory distress at birth. Unilateral atresia is manifested by respiratory failure and unilateral rhinorrhea, and may go along unnoticed. Diagnosis is suspected in the absence of airflow in the nasal cavity and for the inability to advance a nasogastric tube. Diagnosis is confirmed by endoscopic examination and computed tomography. The definitive treatment is surgical, and there are different techniques and surgical approaches. A review of the literatureis presented, with special emphasis onthepost-surgical treatmentwithstents and Mitomycin-Cview from the evidence.

Treatment of Nasopharyngeal Stenosis after Revisional Palatopharyngoplasty with Balloon Dilatation and Topical Mitomycin-C Application / 대한이비인후과학회지

Nasopharyngeal stenosis (NPS) is a rare condition and classified as primary NPS (due to a disease process as syphilis) or secondary NPS (due to a surgery or radiotherapy) according to the etiology. Patients with NPS suffer significant morbidities, including nasal obstruction, phonatory changes, sleep disordered breathing, dysphagia, and otologic disturbances. Treatment modalities include wide range of strategies, such as local rotation flaps, free flaps, Z-plasty, prolonged stenting, insertion of obturators, and laser excision. However, treatment is difficult, often resulting in only short-term symptom relief and restenosis. The authors experienced a case of NPS following revisional palatopharyngoplasty in a 50-year-old man, which was treated successfully with balloon dilatation and topical mitomycin-C application. We present the etiology, symptoms, and treatment of this rare disease entity with a review of the literature.

Revisión con agujas y uso de mitomicina C en bulas de filtración encapsuladas / Needle revision and use of Mitomycin-C to manage encapsulated filtering blebs

La trabeculectomía es uno de los tratamientos de elección en los pacientes con glaucoma. La causa más común de fallo de esta cirugía en su primer trimestre es la bula de filtración encapsulada. Usualmente es resultado de la proliferación fibrótica subconjuntival que lleva a fallo de la bula, como por ejemplo en los glaucomas traumáticos. La revisión con agujas y la mitomicina C constituyen una opción efectiva y relativamente segura para restaurar la función de la cirugía de filtración. Se presenta un paciente donde se restableció el flujo de humor acuso con este proceder

Trabeculectomy is the surgical treatment of choice for many patients with glaucoma. The most common cause of failure during the first trimester after trabeculectomy is encapsulated bleb. Generally, that results from scarring in the subconjunctival space with a resultant intrableb fibrosis and the development of a failed bleb, for example in traumatic glaucoma. Needling bleb revision with mitomycin-C appears to be an effective and relatively safe way to revive the function of the filtration surgery. This was the case report of a patient whose aqueous humor flow was reestablished with this treatment

The Effect of Mitomycin C Instillation after Silicone Intubation in Adult Partial Nasolacrimal Duct Obstruction

PURPOSE: To compare the result of mitomycin C (MMC) instillation after silicone intubation in partial nasolacrimal duct obstruction in adults according to duration of instillation. METHODS: An instillation of 0.04% MMC eyedrops was performed on 61 eyes of 38 patients diagnosed with partial nasolacrimal duct obstruction. The clinical result of patient groups, classified according to duration of MMC eyedrops instillation, was analyzed prospectively. The patients groups was as follows: no MMC eyedrop instillation (group A), 1 week of MMC instillation (group B), 2 weeks of MMC instillation (group C), and 3 weeks of MMC instillation (group D). RESULTS: Among all patients, 50 eyes (81.9%) showed improved symptoms. Fifteen eyes (71.4%) in group A, 8 eyes (72.7%) in group B, 13 eyes (86.7%) in group C and 14 eyes (100.0%) in group D had a successful outcome. The success rate was observed in groups D, C, B, and A, in descending order, which was statistically significant (p = 0.025). CONCLUSIONS: Silicone intubation is an effective treatment option for partial nasolacrimal duct obstruction in adults and MMC eyedrop instillation may improve silicone intubation results.

Effects of Mitomycin C on Trabeculectomy Outcomes in Patients Who Preoperatively Used Prostaglandin Ophthalmic Solution

PURPOSE: To investigate whether mitomycin C (MMC) results in an improved trabeculectomy outcome in primary open-angle glaucoma patients who preoperatively used prostaglandin (PG) ophthalmic solution. METHODS: The subjects consisted of three groups of primary open-angle glaucoma patients who underwent trabeculectomy. Group A consisted of 17 patients who did not use PG ophthalmic solution preoperatively, while Group B consisted of ten patients who used PG ophthalmic solution for at least three months but were not treated with MMC during the operation, and Group C consisted of 14 patients who used PG ophthalmic solution for at least three months and were treated with MMC during the operation. The operation was considered successful when the intraocular pressure ranged from 6 to 18 mmHg, regardless of application of ocular hypotensive agents. RESULTS: Four years after the operation, differences of the cumulative success rate between Group A and B (p = 0.008) and between Group B and Group C (p = 0.036) were statistically significant, but differences between Group A and C were not (p = 0.813) (Log rank test results). CONCLUSIONS: The cumulative success rate of trabeculectomy in primary open-angle glaucoma patients who used PG ophthalmic solution for at least three months was lower than that of patients who did not use PG ophthalmic solution. However, the intraoperative administration of MMC increased the cumulative success rate of trabeculectomy in patients who did use PG ophthalmic solution for at least three months to a level similar to patients who did not use PG ophthalmic solution.

Uso de la mitomicina C en la prevención del haze corneal / Use of mitomycin-C in prevention of corneal haze

OBJETIVOS: Evaluar resultados visuales y aparición de haze en pacientes sometidos a LASEK con Mitomicina C intraoperatoria. MÉTODOS: Se realizó un estudio longitudinal prospectivo, tipo serie de casos, en el servicio de cirugía refractiva del Instituto Cubano de Oftalmología Ramón Pando Ferrer, con pacientes operados entre septiembre y diciembre de 2008, y seguimiento por 12 meses. La muestra fue de 92 ojos con miopía o astigmatismo miópico. Se analizó la agudeza visual mejor corregida y sin corrección, así como la refracción manifiesta pre y posoperatoria. Se cuantificó el haze corneal y se determinaron los índices de efectividad, seguridad, predictibilidad y estabilidad. Se utilizaron técnicas de estadísticas descriptivas para el análisis de los resultados. RESULTADOS: La edad promedio fue 30,11 ± 7,00 años. El sexo femenino representó el 58,82 por ciento. La mejor agudeza visual sin corrección media preoperatoria fue 0,12 ± 0,07 y la mejor agudeza visual corregida media fue 0,89 ± 0,15. Al año de operados, la mejor agudeza visual sin corrección y la mejor corregida fueron 0,9 ± 0,01 (R: 0,5 a 1,0). El haze corneal grado 1 apareció en dos ojos (2,17 por ciento). El índice de efectividad fue 1,01; el índice de seguridad: 1,02; el índice de predictibilidad: 90,22 por ciento de los ojos en±0,50 dioptrías. Hubo estabilidad de la refracción después del tercer mes posoperatorio. CONCLUSIONES: Hubo mejoría de agudeza visual sin corrección en posoperatorio con mantenimiento de agudeza visual mejor corregida preoperatoria. La aparición del haze corneal fue mínima. Los índices de efectividad, seguridad, predictibilidad y estabilidad mostraron valores similares a estándares internacionales

OBJECTIVES: To assess the visual results and the appearance of haze in patients underwent LASEK with intraoperative mitomycin-c. METHODS: A prospective and longitudinal and cases series type was conducted in the service of refractive surgery of the Ramón Pando Ferrer Cuban Institute of Ophthalmology in patients operated on between September and December, 2008 and with a 12 months follow-up. Sample included 92 eyes with myopia or myopic astigmatism. The visual acuity with and without correction, as well as the pre- and postoperative manifest refraction were analyzed. The corneal haze was quantified and the effectiveness, safety, prediction rates and stability were determined. Authors used the descriptive statistic techniques for the result analysis. RESULTS: The mean age was of 30.11 ± 7.00 years. The female sex accounted for the 58.82 percent. The mean preoperative visual acuity without correction was of 0.12 ± 0.07 and the better corrected visual acuity was of 0.89 ± 0.15. A year after operated on the better visual acuity without correction and the corrected one were of 0.9 ± 0,01 (R: 0.5 to 1,0). The corneal haze grade 1 appears in two eyes (2.17 percent). The effectiveness rate was of 1,01; the safety rate was of 1.02; the prediction was of 90.22 percent of eyes in ± 0.50 dioptres. There was stability of refraction after the third postoperative month. CONCLUSIONS: There was improvement of visual acuity without correction in the postoperative period with maintenance of the preoperative corrected better visual acuity. The appearance of corneal haze was minimal. The effectiveness, safety, prediction and stability rates showed values similar to international standards

Cytoprotective effect of honey against chromosomal breakage in fanconi anemia patients in vitro.

BACKGROUND: Natural honey is widely used all over the world as a complementary and alternative medicine in various disorders including Fanconi anemia (FA). FA is a rare genetic chromosomal instability syndrome caused by impairment of DNA repair and reactive oxygen species (ROS) imbalance. This disease is also related to bone marrow failure and cancer. The aim of this study was to evaluate the cytoprotective effect of honey on mitomycin C (MMC-) induced chromosomal damage in peripheral lymphocytes from FA patients. MATERIALS AND METHODS: Treatment of these complications with alkylation agents MMC may enhance chromosomal breakage. We have evaluated the effect of honey on MMC- induced chromosomal breakage in FA blood cells using chromosomal breakage assay. The basal chromosomal breakage count was higher among FA patients than healthy subjects. RESULTS: The addition of MMC alone gave a significantly higher of chromosomal breakage in FA patients than control group (P < 0.0001). Pre- treatment with honey significantly inhibited breakage induced by MMC in FA patients by its antioxidant effect. CONCLUSION: Honey can prevent MMC- induced chromosomal breakage by its antioxidant effect.

Autophagy of Human Tenon's Capsule Fibroblasts Induced by Mitomycin-C

PURPOSE: The present study investigated whether an autophagic process is involved in the apoptotic death of human tenon's capsule fibroblasts (HTCFs) caused by mitomycin-C. METHODS: An autophagic phenotype was tested using fluorescence microscopy and flow cytometry with specific biological staining dyes including monodansylcadaverine and acridine orange and microtubule-associated protein 1 light chain 3 (LC3). RESULTS: Treatment with mitomycin-C (0.4 mg/ml) increased the acidic vesicular organelles of tenon's capsule fibroblasts in a time dependent manner. Mitomycin-C induced both LC3-II cleavage and beclin-1 expression. 3-MA, a pharmacological inhibitor of autophagy, inhibited the mitomycin-C induced increase of acidic vesicular organelleS. CONCLUSIONS: Autophagy was induced with 0.4 mg/ml mitomycin-C in tenon's capsule fibroblasts. And, autophagic mechanisms may be involved in the early stage of apoptosis of fibroblasts.