Systemic medication usage in glaucoma patients.

OBJECTIVE: To study the prevalence of the systemic use of some common classes of medications by glaucoma patients and their relationship to the prevalence and severity of chronic open-angle glaucoma (COAG) and primary-angle closure glaucoma (PACG). DESIGN: Observational prospective single-centre cross-sectional study. METHODS: Glaucoma patients or their pharmacist provided an updated list of all systemic medications that they presently use. The relationship between glaucoma type and severity and medication use for diseases other than glaucoma was assessed by univariate statistics. RESULTS: We studied 514 glaucoma patients. They use a mean of 4.9 oral medications prescribed by a mean of 2.1 doctors. Antihypertensives, medications with anticholinergic properties, steroids, anticoagulants, and thyroid hormones were the most frequently prescribed groups of medications, used by 251 (49%), 178 (35%), 100 (19%), 218 (42%), and 108 (21%) patients, respectively. Steroid usage was associated with advanced visual field loss in COAG patients. Antihypertensives and medications with anticholinergic properties were not associated with severity of COAG and PACG, respectively, and these 3 groups were not associated with an increased prevalence of diagnosis of COAG or PACG. CONCLUSION: Glaucoma patients take many systemic medications in addition to their topical glaucoma treatment.

Antimicrobial effect of cryopreservation on donor ocular tissue.

PURPOSE: The aim of this study was to assess the antimicrobial effect of cryopreservation on donor globes with a previously positive culture. More specifically, our study aims at determining whether microbial organisms can still be cultured after cryopreservation in previously culture positive donor whole globes. METHODS: This is a prospective quality assurance study of microbiological cultures using donor ocular tissues obtained by the Lions Eye Bank of Manitoba and Northwestern Ontario from January 2009 to January 2010. Enucleated globes were soaked in 2.5% povidone iodide for 5 minutes, rinsed with sterile normal saline, and cultured in chocolate and Sabouraud agar and thioglycolate broth. The whole globes were then preserved in Optimyxin Plus and an antibiotic solution before being cryopreserved for 1 month. Culture-positive whole globes were thawed to room temperature and recultured on the same media to determine the effect of the cryopreservation protocol of our eye bank on bacterial counts. RESULTS: Twenty-seven donor whole globes were included in our study. Upon primary culture, all specimens had positive bacterial growth. The most common isolate on primary culture was coagulase-negative Staphylococcus (62.8%). Upon secondary culture of the thawed cryopreserved whole globes, no bacterial growth was detected on any of the culture media. CONCLUSIONS: Our study demonstrates that harvested donor whole globes with positive microbial cultures became culture negative after secondary culture by the Lions Eye Bank of Manitoba and Northwestern Ontario's cryopreservation protocol. This suggests that ocular tissues treated in this manner may be microbiologically safe and therefore able to be used for transplantation in patients.

Canadian ophthalmologists' opinions concerning complementary and alternative medicine (CAM) use in glaucoma.

PURPOSE: Our goal is to investigate the opinion and practice pattern of Canadian ophthalmologists regarding the use of and recommendations for complementary and alternative medicine (CAM) for their glaucoma patients. METHODS: Institutional review board approval for this prospective, cross-sectional survey was obtained from the Research Ethics Board of Sunnybrook Health Sciences Centre. The survey was sent to all ophthalmologists in Canada electronically through the e-mail lists of 4 ophthalmology associations. RESULTS: A total of 241 ophthalmologists representing all provinces in Canada responded to the questionnaire. Twenty-two percent felt that CAM does have a role in glaucoma therapy with specialists being more likely to believe there is a role (P<0.05). Of the total respondents, 26% ask their patients if they use CAM with those in practice for <20 years more likely to encourage use (P<0.05). Of the respondents, 9% recommend CAM and if an ophthalmologist was in practice for <20 years he/she was significantly more likely to recommend CAM (P<0.01). Respondents (62%) in general do not discourage CAM with younger ophthalmologists (younger than 50 y, P<0.02) and ophthalmologists in practice for <20 years (P<0.05) being less likely to discourage CAM use. Respondents (41%) believe that CAM rarely ever affects compliance with ophthalmologists from an urban practice (P<0.01) and academic practice (P<0.05) more likely to deny effect on compliance. Respondents believe that CAM sometimes (46%) results in patient morbidity with ophthalmologists being in practice for <20 years believing that morbidity is less likely (P<0.05). CONCLUSION: A substantial minority of respondents believe that CAM has a role in glaucoma therapy, recommend its use, and ask their patients if they use CAM. Younger doctors are more likely to encourage alternatives; those in practice for <20 years are more likely to ask about alternative medicine use, recommend its use, and believe that morbidity usually does not result from the use of alternative treatments.