ABSTRACT
We treated three patients with Aspergillus keratomycosis with collagen shields soaked in amphotericin B (0.50%) for 2 hours at 25 degrees C before application. These shields, replaced daily, were used in conjunction with amphotericin B (0.25%) eye drops, which were applied every 2 hours. Cultures from the eyes of all patients became negative within 15 days of treatment. Subsequently, two patients required keratoplasty. The results suggest that collagen shields prepared this way deliver an adequate concentration of amphotericin B to the cornea, aid its tolerance, and improve the prognosis of Aspergillus keratomycosis. Further studies are needed to define the minimum therapeutic concentrations necessary to inhibit the growth of the fungus and to avoid a toxic effect on the cornea.
Subject(s)
Amphotericin B/administration & dosage , Antifungal Agents/administration & dosage , Aspergillosis/drug therapy , Collagen , Corneal Ulcer/drug therapy , Drug Delivery Systems , Eye Infections, Fungal/drug therapy , Aged , Aged, 80 and over , Aspergillosis/microbiology , Aspergillosis/pathology , Aspergillus fumigatus/isolation & purification , Biological Dressings , Cornea/drug effects , Cornea/microbiology , Cornea/surgery , Corneal Transplantation , Corneal Ulcer/microbiology , Corneal Ulcer/pathology , Eye Infections, Fungal/microbiology , Eye Infections, Fungal/pathology , Female , Humans , Male , Ophthalmic SolutionsABSTRACT
Deficient mydriasis of diverse etiology renders extracapsular cataract extraction and posterior chamber intraocular lens implantation technically difficult. Several techniques are available to improve surgical results when this problem is present. We have used multiple sphincterotomies in 6 patients with narrow pupils undergoing cataract extraction. We discuss the indications, intraoperative complications and postoperatory evolution of these cases.
Subject(s)
Cataract Extraction/methods , Iris/pathology , Adult , Aged , Aged, 80 and over , Humans , Middle AgedABSTRACT
Deficient mydriasis of diverse etiology renders extracapsular cataract extraction and posterior chamber intraocular lens implantation technically difficult. Several techniques are available to improve surgical results when this problem is present. We have used multiple sphincterotomies in 6 patients with narrow pupils undergoing cataract extraction. We discuss the indications, intraoperative complications and postoperatory evolution of these cases
