ABSTRACT
PURPOSE: Carbomer gel is a water-soluble polymeric resin that has been reported to maintain the tear film in contact with the eye for an extended period. The efficacy and safety of this new artificial tear were assessed. METHODS: A multicenter, single-masked, randomized, placebo-controlled study was carried out on 123 patients with moderate-to-severe dry eyes. The placebo was a mannitol solution with benzalkonium chloride 0.008% as preservative. Patients were observed over an 8-week period, and subjective and objective changes analyzed, compared to a baseline of no therapy, after 1 to 7 days washout period from previous medication. RESULTS: All primary subjective symptoms decreased significantly in the carbomer gel-treated group compared to the placebo group (i.e., dryness, discomfort, and foreign body sensation). The carbomer gel also significantly improved the rose bengal staining score relative to placebo. When data for the primary subjective efficacy variables were stratified for disease severity, there was a statistically significant improvement from baseline by day 10 for severely affected patients and from day 42 for patients with moderate disease. Secondary subjective symptoms that improved significantly in the tear gel group compared to placebo were photophobia, erythema, tear breakup time, blurry-filmy, dry-sandy sensation, and physician impression. However, no significant improvements in the secondary subjective symptoms of tearing, itching, scaling, conjuctival discharge, palpebral conjunctival redness, bulbar conjuctival redness, conjunctival luster, relief of discomfort, ease of use, and overall acceptability were found in either group over the baseline score. In addition, neither carbomer gel nor placebo improved the baseline fluorescein staining score or the Schirmer test score. Two patients suffered local allergic reactions to the carbomer gel or its preservative, which settled on withdrawal of the medication. CONCLUSIONS: Carbomer gel was more efficacious than was placebo in improving a number of subjective and objective symptoms of moderate-to-severe dry eye syndrome. The results of this study indicate that carbomer gel was a safe as was the placebo.
Subject(s)
Acrylic Resins/therapeutic use , Dry Eye Syndromes/drug therapy , Ophthalmic Solutions/therapeutic use , Acrylic Resins/adverse effects , Adult , Aged , Aged, 80 and over , Drug Evaluation , Dry Eye Syndromes/physiopathology , Female , Fluorescent Dyes , Gels , Humans , Male , Middle Aged , Ophthalmic Solutions/adverse effects , Placebos , Rose Bengal , Safety , Single-Blind Method , Tears/physiology , Treatment OutcomeABSTRACT
PURPOSE: To investigate the role of human papillomavirus (HPV) types, 6, 11, 16 and 18 in corneal and conjunctival carcinoma, we examined 88 dysplastic corneal and conjunctival specimens and 66 controls that had been formalin-fixed and paraffin-embedded. METHODS: Sections were graded for histological abnormality by light microscopy and the presence of HPV DNA was determined by polymerase chain reaction using LI consensus primers. RESULTS: Human papillomavirus DNA was detected in 34 (39%) dysplasias and in five (7.5%) controls. Of dysplasias that were HPV-positive, 20 (59%) contained either types 16 or 18, 13 (38%) contained only types 6/11, while combinations of HPV types were present in 11 (32%). A histological correlation was found with HPV positivity (all genotypes) and unusually large ('epithelioid') dysplastic cells. CONCLUSION: The present study demonstrates a lower incidence of HPV in corneal and conjunctival carcinoma than previously reported, but shows an unexpectedly high incidence of HPV 6/11 in conjunctival carcinomas.
Subject(s)
Carcinoma, Squamous Cell/virology , Conjunctival Neoplasms/virology , Corneal Diseases/virology , Eye Infections, Viral/etiology , Eye Neoplasms/virology , Papillomaviridae , Papillomavirus Infections/etiology , Tumor Virus Infections/etiology , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/pathology , Conjunctival Neoplasms/pathology , Corneal Diseases/pathology , DNA, Viral/analysis , Eye Infections, Viral/pathology , Eye Neoplasms/pathology , Female , Humans , Male , Middle Aged , Papillomaviridae/genetics , Papillomaviridae/isolation & purification , Papillomavirus Infections/pathology , Polymerase Chain Reaction , Retrospective Studies , Tumor Virus Infections/pathologySubject(s)
Eye Foreign Bodies/etiology , Eye Injuries, Penetrating/etiology , Orbit/injuries , Orbital Fractures/etiology , Accidents, Traffic , Adolescent , Eye Foreign Bodies/diagnostic imaging , Eye Injuries, Penetrating/diagnostic imaging , Humans , Male , Orbital Fractures/diagnostic imaging , Radiography , Skull/diagnostic imagingABSTRACT
A patient presented with a history of chronic corneal ulceration and corneal hypoaesthesia. This proved to be an unusual presentation of breast carcinoma metastatic to the sphenoidal wing. This was an unexpected diagnosis in view of the long duration of ocular signs without other evidence of metastatic disease.
Subject(s)
Adenocarcinoma/secondary , Breast Neoplasms/pathology , Corneal Ulcer/diagnosis , Adenocarcinoma/diagnostic imaging , Aged , Chronic Disease , Female , Humans , Orbital Neoplasms/diagnostic imaging , Orbital Neoplasms/secondary , Skull Neoplasms/diagnostic imaging , Skull Neoplasms/secondary , Tomography, X-Ray ComputedABSTRACT
Severe epistaxis after combined nasolacrimal duct probing and cardiac catheterisation in a one-year-old child is reported. The epistaxis followed streptokinase infusion given as treatment for femoral artery thrombosis secondary to cardiac catheterisation and necessitated nasal packing and blood transfusion. The authors recommend that probing not be undertaken in conjunction with another procedure if anticoagulant and/or thrombolytic agents are likely to be required.