Therapeutic Effect of Topical Autologous Serum in Recurrent Punctate Corneal Erosion

PURPOSE: To study the effect of topical autologous serum in the treatment of recurrent punctate corneal erosions. METHODS: A total of 10 eyes from recurrent corneal erosion patients, who had suffered from recurrence after initial treatment with conventional therapy were treated using topical autologous serum from October 2001 to April 2003. We investigated the efficacy of this method over conventional therapy by retrospective review of their medical records. RESULTS: The recurrence rate of erosions before treatment with autologous serum eyedrops ranged from once every 2months to twice a month. Mean follow-up time was 11.0 +/- 4.6 months (range, 6~19 months). There was one case of recurrence 3 months after first treatment with autologous serum eyedrops which was effectively cured with autologous serum eyedrops. No side effects were noted in any of the treated patients. CONCLUSIONS: Topical autologous serum application may be considered as an effective and safe treatment modality in recurrent corneal erosions.

The Fungal Infection of Nasal Cavity After Endonasal Dacryocystorhinostomy

PURPOSE: To achieve the higher success rate of Dacryocystorhinostomy, Adjunctively, Mitomycin C has been widely used. There have been many complications with the administration of mitomycin C, such as delayed wound healing, wound infection and recurrent nasal bleeding. We are reporting a case of fungal infection in the nasal cavity after the administration of mitomycin C in the endoscopic dacryocystorhinostomy. METHODS: Under the general anesthesia, 63 year old female patient underwent endoscopic Dacryocystorhinostomy. At the end of this operation, a piece of neurosurgical cottonoid soaked with 0.04% mitomycin C was applied at the osteotomy site for 30 mins. During the postoperative follow-up, we executed incisional biopsy for some mass-like lesion in nasal cavity. RESULTS: Pathologic finding of inflammatory fibrinoid exudate due to Candida albicans was found. The evacuation of the mass was carried out without postoperative recurrence.

The Change of the Tobramycin Concentration in Aqueous Humor According to the Administration Routes

PURPOSE: To determine the best routes of administration of Tobramycin, the intracameral concentrations was assessed as time progressed after administering identical amounts and concentrations of tobramycin through various methods. METHODS: 40 eyes from 20 house rabbits were administered the same amount (200 micro liter) of 0.3% tobramycin. The first group was administered topically, and the second group was administered by subconjunctival injection. Contact lenses were soaked in tobramycin for 30 minutes and were covered over the corneas of the third group. While amniotic membranes were transplanted onto the corneas and tobramycin was topically administered in the fourth group. 100 micro liter of aqueous fluid was extracted 30 min, 1 hr, 2 hr and 3 hr after the administration and intracameral concentrations of tobramycin were measured using FPIA (fluorescence polarization immunoassay). RESULTS: After topical administration and subconjunctival injection, statistically significant decreases of average concentrations were observed after 2~3 hours. The group that was covered with flexible hydrophilic contact lenses showed high concentrations after 30 minutes, and a statistically significant increases of concentration was observed after 2 hours. The group that was topically administered with 0.3% tobramycin after amniotic transplantation on the cornea, showed a gradual increase of concentration as time progressed, and statistically significant increase of concentration was observed after 1~2 hours. CONCLUSIONS: Topical administrations with more frequent instillations increased intracameral concentrations, exceeding the MIC90 concentration of Staphylococcus aureus. while low concentration (0.3%) of subconjunctival injections did not significantly increases intracameral concentrations. Using flexible contact lenses, high concentrations were observed in the early stages, exceeding the MIC90 concentrations of Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa. Concentrations exceeded MIC90 concentration of Staphylococcus epidermidis 30 minutes after amniotic membranes transplantation, and continued to increases after 3 hours, Therefore, we can conclude that amniotic membrane can be used as a reservoir for transferring drugs.