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ABSTRACT Purpose: To compare viscotrabeculotomy with anterior chamber irrigation to Ahmed glaucoma valve implantation for secondary glaucoma following silicone oil removal. Methods: A prospective study was conducted on 43 vitrectomized pseudophakic eyes with persistent glaucoma after silicone oil removal. Patients were randomized to either viscotrabeculotomy with anterior chamber irrigation or Ahmed glaucoma valve implantation. All patients were examined on day 1, week 1, and months 1, 3, 6, 9, 12, 18, and 24 postoperatively. Postoperative complications were noted. Success was defined as an intraocular pressure between 6 and 20 mmHg and with an intraocular pressure reduction of >30% compared with the preoperative intraocular pressure. Results: There were 22 eyes in the viscotrabeculotomy with anterior chamber irrigation and 21 eyes in the Ahmed glaucoma valve implantation group. The mean preoperative and postoperative intraocular pressure in the viscotrabeculotomy with anterior chamber irrigation and Ahmed glaucoma valve implantation groups were 35.5 ± 2.6 mmHg and 35.5 ± 2.4 mmHg and 16.9 ± 0.7 mmHg and 17.9 ± 0.9 mmHg respectively (p˂0.0001). There was a statistically significant intraocular pressure reduction at all follow-up time points compared to preoperative values (p˂0.0001) in both groups. The unqualified success rate in the viscotrabeculotomy with anterior chamber irrigation and Ahmed glaucoma valve implantation groups were 72.73% and 61.9%, respectively. A minimal self-limited hyphema was the most common complication. Conclusions: Both viscotrabeculotomy with anterior chamber irrigation and Ahmed glaucoma valve implantation are effective in lowering the intraocular pressure in glaucoma after silicone oil removal with viscotrabeculotomy with anterior chamber irrigation providing greater reduction, higher success rates, and minimal complications.
RESUMO Objetivo: Comparar a viscotrabeculotomia com irrigação da câmara anterior com o implante de válvula de glaucoma de Ahmed para glaucoma secundário após remoção de óleo de silicone. Métodos: Foi realizado um estudo prospectivo de 43 olhos pseudofácicos vitrectomizados com glaucoma persistente após a remoção de óleo de silicone. Os pacientes foram randomizados para viscotrabeculotomia com irrigação da câmara anterior ou implante de válvula de Ahmed. Todos os pacientes foram examinados no primeiro dia, na primeira semana e 1, 3, 6, 9, 12, 18 e 24 meses após a cirurgia. Observaram-se complicações pós-operatórias. O sucesso foi definido como uma pressão intraocular entre 6 e 20 mmHg e uma redução da pressão intraocular >30% em comparação com a pressão intraocular pré-operatória. Resultados: Foram designados 22 olhos para o grupo da viscotrabeculotomia com irrigação da câmara anterior e 21 olhos para o grupo do implante de válvula de Ahmed. A pressão intraocular média pré-operatória foi de 35,5 ± 2,6 mmHg para o grupo da viscotrabeculotomia com irrigação da câmara anterior e pós- e de 35,5 ± 2,4 mmHg no grupo do implante de válvula de Ahmed. e Os valores pós-operatórios foram de 16,9 ± 0,7 mmHg e 17,9 ± 0,9 mmHg para esses mesmos grupos, respectivamente (p<0,0001). Ambos os grupos tiveram uma redução estatisticamente significativa da pressão intraocular em relação aos valores pré-operatórios (p<0,0001) em todos os momentos do acompanhamento. A taxa de sucesso não qualificado nos grupos da viscotrabeculotomia com irrigação da câmara anterior e do implante de válvula de Ahmed foi de 72,73% e 61,9%, respectivamente. A complicação mais comum foi o hifema, autolimitado e mínimo. Conclusões: Tanto a viscotrabeculotomia com irrigação da câmara anterior quanto o implante de válvula de Ahmed são eficazes na redução da pressão intraocular no glaucoma após injeção de óleo de silicone, mas a viscotrabeculotomia com irrigação em câmara anterior proporcionou maior redução da pressão intraocular e maiores taxas de sucesso, com complicações mínimas.
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ABSTRACT Purpose: To analyze the presence of microorganisms in fluorescein eyedrops used in a reference eye center in Recife-PE. Methods: This real-life and masked study evaluated fluorescein eyedrops used at the Altino Ventura Foundation in May 2019. Cultures were performed according to exposure times; I) three eyedrop bottles were analyzed after one day of use, II) three eyedrop bottles after 4 d of use, III) three eyedrop bottles after 8 d of use, and IV) three unopened bottles used as control. Samples were collected from the bottle's tip, instilled drop, and residual fluid. After incubation, all colonies were analyzed and identified through biochemical tests. Results: The contamination rate of the fluorescein eyedrop bottles in this study was 55.5% (5/9 vials). There was no contamination in the control group. The highest contamination was seen in one day exposed eyedrops, in 100% of the bottles. The bottle's tip had a higher rate of contamination compared to the drop and residual fluid. Gram-positive bacteria were isolated in 7/27 (25.9%) samples. Growth of fungi or gram-negative bacteria was not observed. Conclusion: The identification of gram-positive bacteria predominantly on the tip of the fluorescein eyedrop bottles suggests inadequate handling as the main cause of contamination.
RESUMO Objetivo: Analisar a presença de microrganismos nos colírios de fluoresceína utilizados em um centro oftalmológico de referência em Recife-PE. Métodos: Este estudo de vida real e mascarado avaliou colírios de fluoresceína utilizados na Fundação Altino Ventura em maio/2019. As culturas foram realizadas de acordo com os diferentes tempos de exposição: I - três frascos de colírio foram analisados após 1 dia de uso; II - três frascos de colírio após 4 dias de uso; III - três frascos de colírio após 8 dias de uso; IV - três garrafas fechadas foram usadas como grupo controle. As amostras foram coletadas da ponta do frasco, da gota instilada e do líquido residual interior. Após incubação, todas as colônias foram analisadas e identificadas através de testes bioquímicos. Resultados: A taxa de contaminação dos frascos de colírio de fluoresceína neste estudo foi de 55,5% (5/9 frascos). Não houve contaminação no grupo controle. A maior contaminação foi observada os colírios expostos de um dia - 100% dos frascos. A ponta da garrafa teve uma maior taxa de contaminação em comparação com as culturas de gota e de fluido residual inferior. Bactérias gram-positivas foram isoladas em 7/27 amostras (25,9%). Não houve crescimento de fungos ou bactérias Gram-negativas. Conclusão: A identificação de bactérias Gram-positivas predominantemente na ponta dos frascos de colírio de fluoresceína sugere manuseio inadequado como a principal causa de contaminação de colírios multidose.
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Lifitegrast is a novel inhibitor of integrin,which can take effect by blocking the binding of intercellular adhesion molecule 1 and integrin lymphocyte function associated antigen 1.In July 2016,the U.S.Food and Drug Administration (FDA) officially approved the application of lifitegrast ophthalmic solution 5％ (commodity name XiidraTM).Clinical trials of the drug include a 12-week phase II clinical trial and three 12-week phase III clinical trials for dry eye disease patients.The results of clinical trials have demonstrated the efficacy and safety of the drug.Lifitegrast is the first FDA approved drug to improve and treat dry eye symptoms,and other similar drug is only cyclosporine.It is believed that in the near future clinical application of lifitegrast will be more extensive.
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AIM:To observe the efficacy and safety of 1g/L bromfenac sodium hydrate ophthalmic solution in the partial substitution of glucocorticoid after laser subepithelial keratomileusis (LASEK).METHODS: Totally 104 cases (208 eyes) were received LASEK, which were selected and divided into study group and control group.The study group were adopted 1g/L bromfenac sodium hydrate ophthalmic solution combined with tobramycin dexamethasone eye drops and fluorometholone eye drops, the control group were adopted tobramycin dexamethasone eye drops and fluorometholone eye drops.The changes of visual acuity and intraocular pressure of two groups were recorded before and after surgery, and the score of painness and the occurrence of haze were observed after surgery.RESULTS: At postoperative 1, 2, 3d, respectively, the pain score of the study group were 1.70±0.35, 1.25±0.34, 0.82±0.32, the pain score of the control group were 2.30±0.43, 1.68±0.44, 1.12±0.33, the differences were significant (P0.05), and the differences were not significant(P>0.05).At preoperative and postoperative 1, 2wk, 1 and 3mo of surgery, respectively, the intraocular pressure of study group were 17.33±1.58, 7.54±1.28, 7.23±1.58, 7.26±1.47, and 7.30±1.36 mmHg;the intraocular pressure of control group were 17.53±1.43,7.57±1.32,7.73±1.55,7.80±1.38,7.86±1.43 mmHg,the differences were not significant between before and at 2wk after surgery(P>0.05), the differences were significant between the two groups at 2wk, 1mo and 3mo (P0.05).CONCLUSION: It is safe and effective that 1g/L bromfenac sodium hydrate ophthalmic solution in the partial substitution of glucocorticoid after laser subepithelial keratomileusis.The patient has a lower intraocular pressure, has similar therapeutic effect as glucocorticoid in vision and antiinflammatory.
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Background Laser in-situ keratomileusis (LASIK) has been widely used to correct myopia,and the glucocorticoid-induced complication is increased.Bromfenac sodium 0.1％ is a non-steroidal anti-inflammatory drug used post-LASIK,but if it is better in clinical effects,safety and tolerance than glucocorticoid is unclear.Objective This study was to evaluate the safety,effectiveness,compliance of bromfenac sodium ophthalmic solution compared with glucocortieoid following LASIK.Methods A prospective randomized controlled trail were performed.Two hundred thirty-eight myopic eyes of 119 patients for LASIK were included in Peking Union Medical College Hospital from January 2011 to May 2012.The myopic eyes were firstly assigned to moderate and low spherical equivalent (SE) group (≤-6.0 D) or high SE group(＞-6.0 D) and then were further randomized into a NSAIDs subgroup and a glucocorticoid subgroup.Bromfenac sodium ophthalmic solution 0.1％ was topically administered 4 times per day for 10 days in the NSAIDs subgroup,and 0.1％ dexamethasone eye drops was used in the same way in the glucocorticoid subgroup after the LASIK.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),intraocular pressure (IOP),corneal topography,clinical symptom were examined and compared between the groups 1 day,10 days,1 month,3 months and 6 months after LASIK.Results There was no statistically significant postoperative difference in visual acuity and corneal topography (K1,K2,surface asymmetry index [SAI],surface regular index [SRI] and cylinder) between the NSAIDs and control group (P＞0.05).Postoperative IOP was significantly lower than that in preoperation,and lower IOP was found in the NSAIDs group than that of the glucocorticoid group.The IOP values in the moderate and low SE subjects of the NSAIDs group and glucocorticoid group were (13.31±2.44) mmHg and (16.62±4.74) mmHg on postoperative 10 days,(12.93±2.25) mmHg and (12.82± 1.72) mmHg in 1 month,(13.83±3.08) mmHg and (13.33 ±2.10) mmHg in 3 months,(11.67 ±2.48) mmHg and (13.64± 1.37)mmHg in 6 months after operation,respectively,showing significant differences among the groups and various timepoints (Fgroup =4.067,P =0.045 ; Ftime =10.689,P =0.000 ; Finteraction =2.897,P =0.023).In the high SE subjects of the NSAIDs and glucocorticoid group,the IOP values were (12.36± 1.30) mmHg and (17.32±4.74) mmHg in postoperative 10 days,(12.10t2.12)mmHg and (14.81 ±2.26)mmHg in postoperative I month,with a significant difference among the groups and timepoints (Fgroup =2.188,P =0.121 ;Ftime =14.025,P =0.000 ;Fi tion =15.805,P=0.000).No haze or diffuse lamellar keratitis (DLK) appeared in both groups,and the epithelial flaps were wellpositioned with satisfying healing process except for one eye in the moderate and low SE eyes of the NSAIDs group.Bromfenac sodium ophthalmic solution 0.1％ was well tolerated by all patients in the NSAIDs group,but discontinuation sensation occurred in 8 eyes of 6 patients and the antiglaucoma drugs were administered due to elevated IOP in the glucocorticoid group.The refractive status remained stable for patients of the moderate and low SE group.Conclusions Bromfenac sodium ophthalmic solution 0.1％ is safe,effective and well tolerated after topically administered following LASIK,and its outcomes in recovery of visual acuity,anti-inflammation and stabilizing refractive status and IOP are satisfying.But long-term attention should be payed to the high-myopic eyes.
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Allergic conjunctivitis is a very common pathology and its incidence has increased in developing countries with the development of industrialization.At present,the therapy of allergic conjunctivitis is mainly the use of topical eyedrops to eliminate causative factors,relieve symptoms and prevent complications.The drugs used in allergic conjunctivitis have 6 groups,including antihistamine,mastocyte stabilizer,drugs with dual effects (antihistamine and mastocyte stabilizer),non-steroidal anti-inflammatory drugs (NSAIDs),glucocorticoids and immunosuppressors.The goals of topical use of antihistamine,mastocyte stabilizer and drugs of dual effects are to remove the itching and hyperaemia of eye or to treat the patients with acute allergic conjunctivitis; while NSAIDs,glucocorticoids and immunosuppressors are used for the patients with severe or chronic allergic conjunctivitis.The glucocorticoid drugs are more effective because of their arresting effects in several links of the allergic response.Nevertheless,the long-term use of glucocorticoids probably results in ocular hypertension or posterior subcapsular cataract,furthermore,glucocorticoid drugs should be more cautionary in the application of the patients with corneal ulcer.Immunosuppressors inhibit abnormal immune responses,but these drugs should not be used for a long term because of higher cost and adverse effects.NSAIDs have a good anti-inflammatory effect and less irritant,so the topical use of NSAIDs for allergic conjunctivitis appears to be a better choice nowadays.
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BACKGROUND: Olopatadine hydrochloride ophthalmic solutions are treated for allergic conjunctival diseases that are a selective histamine H1 receptor antagonist and an inhibitor of the release of mediators including histamine from the human mast cells. Substance P (SP) levels are increased in tears of patients with allergic conjunctivitis. However, little is known about the regulation of SP release by anti-allergic ophthalmic solutions. OBJECTIVE: We investigated that the effect of olopatadine hydrochloride ophthalmic solutions (olopatadine 0.1% and olopatadine 0.2%) on rat conjunctivitis models compared with other anti-allergic ophthalmic solutions. METHODS: Conjunctivitis was induced by subconjunctival injection of histamine or intravenous injection of ovalbumin in rats passively sensitized with anti-ovalbumin anti-serum. The releases of SP were determined in the conjunctiva and tears using rat antigen-induced conjunctivitis models. RESULTS: Olopatadine 0.1% and 0.2% significantly inhibited the increased conjunctival dye leaked in the histamine- or antigen-induced hyperpermeability. The inhibitory effects by olopatadine were more potent than by other tested anti-allergic ophthalmic solutions. Moreover, olopatadine significantly inhibited the release of SP from the conjunctiva. CONCLUSION: These results indicate that olopatadine ophthalmic solutions appear to exert additional SP release inhibition besides dual-action such as selective histamine H1 receptor antagonistic action and mast cell stabilization action.
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Animals , Humans , Rats , Conjunctiva , Conjunctival Diseases , Conjunctivitis , Conjunctivitis, Allergic , Histamine , Injections, Intravenous , Mast Cells , Olopatadine Hydrochloride , Ophthalmic Solutions , Ovalbumin , Receptors, Histamine H1 , Substance P , TearsABSTRACT
· AIM: To evaluate the combined effect of rapamycin ophthalmic solution and cyclosporin A ophthalmic solution on allogeneic transplantation in a rat model.rats were used as donors. The animals were randomly assigned to 4 groups. Group A: control (ophthalmic solution solvent 100μ L); group B: 2g/L rapamycin ophthalmic solution 100μ L; group C: 10g/L cyclosporin A ophthalmic solution 100μ L; group D: 2g/L rapamycin ophthalmic solution 50μ L and 10g/L cyclosporin A ophthalmic solution 50μ L, 4 times every day. The treatment was started on 2d after operation, and the animals were administered until rejection. The grafts were inspected by slit-lamp microscope and the corneal survival time was recorded. The pathologic changes were measured by light microscope.significantly prolonged compared with the control group (P ＜ 0.01). However, the combined therapy (group D) was significantly superior compared with group B and C (P＜0.05, P＜ 0.01). The histopathological findings showed that the inflammation cells, neovascularity in each treated group were significantly fewer than that in control group at 14d after operation.a double drug regimen with rapamycin ophthalmic solution and cyclosporin A ophthalmic solution for the control of acute corneal allograft rejection. It indicats that the combined therapy produced synergistic effect.
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Chloramphenicol ophthalmic solut,ion is a commonly used eye drui in the treatment of superficial eye infection because of its wide antibacterial spectrum and easy peitation in the ocular tissue and aqueous humor. The true contact dermat it is to chloramphenicol is rarely reported. A case of contact. dermatii,is due to chloramphenicol in a 6-year-old girl was confirmed by the patch test. Marked improvement of the skin lesion and symptoms were rated after the withdrawal of topieal application of the chloramphericol ophthalmic solution.