Corneal Central Endothelial Cell Loss after Trabeculectomy with Mitomycin C

The effect of mitomycin on the corneal endothelial cell density was evaluated between the mitomycin group of 23 eyes who underwent trabeculectomy with mitomycin and the control group of 20 eyes who underwent trabeculectomy. The mitomycin(0.2 mg/ml) was applied under the scleral flap, Tenon's capsule or conjunctiva during trabeculectomy for 2-5 minutes(average: 4 minutes) and was irrigated with 50ml of balanced salt solution. Average central endothelial cell loss in the mitomycin group was 10.1 +/- 7.1% and 8.4 +/- 8.3% in the control group(P>0.05, t-test). A shallow anterior chamber with iridocorneal touch(Spaeth's grade 1 and 2) was developed in 12(52%) of 23 eyes in the mitomycin group and 9(45%) of 20 eyes in the control group(P>0.05, chi-square). The average central endothelial cell loss was 12.7 +/- 8.3% in 21 eyes with iridocorneal touch and 5.9 +/- 5.4% in 22 eyes that maintained their anterior chamber(P0.05, t-test). In 22 eyes that maintained their anterior chamber, average loss was 7.1 +/- 5.4% in the mitomycin group, and 4.8 +/- 5.4% in the control group(P>0.05, t-test). These findings suggest that intraoperative use of mitomycin(0.2 mg/ml) during trabeculectomy is unlikely to cause profound corneal endothelial cell loss and iridocorneal touch after the filtering surgery is associated with greater loss of endothelial cells.

Chemomyectomy Effect of Doxorubicin and Verapamil on Orbicularis Oculi in Rabbit

Doxorubicin has characteristic chemomyectomy effect of the eyelid without disturbing other eyelid structures, but the major side effect of doxorubicin is the potential for eyelid skin injury as a result of the drug's toxicity in both animal and clinical studies. Verapamil may be used to reduce the dose of doxorubicin and the number of injections that would amplify the toxic effects of doxorubicin. This study was performed to determine whether there is an increase in the toxic effect of the doxorubicin as a result of verapamil pretreatment of the muscle. After 0.5mg, 1.0mg, and 2.0mg doxorubicin was injected in lower eyelids of each group, and equal dose of doxorubicin was injected fo11owing 1.0mg of verapamil injection in lower eyelid of each group, muscle cell loss were measured by light microscopy and side effect was observed. In verapamil and doxorubicin injection group, there was significant differences in the amount of preseptal muscle and even in the pretarsal muscle than the doxorubicin injection group in all doxorubicin doses. Verapamil, injected with a range of doses of doxorubicin, caused suhstantia11y increased muscle loss in the eyelid, compared with injection of doxorubicin alone. Skin ulceration, entropion or ectropion were not visible. Clinically, verapamil cotreatment might be useful to decrease the dose of doxorubicin injected and/or the total number of injections.

Two Cases of Cataract Extraction in Eyes Filled with Silicone Oil by Infusion Cannula

Case Report The silicone oil is widely used as an intraocular tamponade after vitrectomy but its complications were frequently found in postoperative period. The cataract was one of the most common complications in the eyes filled with silicone oil. The cataract in the eyes filled with silicone oil can be removed with either the intracapsular or the extracapsular-extraction technique. But these surgical techniques have two major problems: posterior capsular fibrosis and intraoperative loss of silicone oil. We report two cases of complicated cataract in the eyes filled with silicone oil which those were successfully performed by lens aspiration or extracapsular cataract extraction with large posterior continuous circular capsulorhexis and basal iridectomy without any loss of silicone oil under the continuous positive pressure achieved with an anterior chamber maintainer such as healon and balaneed salt solution.