Evaluation of intravitreal kenalog toxicity in humans.

OBJECTIVE: To evaluate possible functional toxicity of intravitreal Kenalog (commercial triamcinolone acetonide) in patients' retinas. DESIGN: Observational case series. PARTICIPANTS: Thirty-two phakic eyes of 16 patients who had nonproliferative diabetic retinopathy and bilateral macular edema refractory to laser therapy, which had no other eye disorder and no previous ophthalmic operation. INTERVENTION: Kenalog (4 mg/0.1 ml) was injected intravitreally to one eye, whereas the second eye served as the control. The experimental eye was chosen as the eye with worse visual acuity (VA). MAIN OUTCOME MEASURES: Deterioration of electroretinogram parameters of the study eye measured at 3 months of follow-up when compared with the electroretinogram responses of the fellow, control eye and when compared with electroretinogram responses obtained before injection. Visual acuity, intraocular pressure (IOP), and eventual complications were assessed. No improvement or deterioration of VA or any increase in IOP was regarded as a secondary outcome. RESULTS: Average maximal response amplitude ratios of the dark-adapted b-wave (treated/control eyes) of the electroretinogram were 0.93 before (P = 0.221) and 0.94 (P = 0.387) 3 months after Kenalog injection. Average ratios of the light-adapted b-wave amplitude (treated/control eyes) of the electroretinogram were 1.04 (P = 0.702) before and 0.86 (P = 0.138) 3 months after Kenalog injection. No significant differences (P>0.05) were found between the electroretinogram parameters obtained from all eyes before and 3 months after Kenalog injection. Average VAs in the treated eyes were 1.08, 0.8, and 1.0 logarithm of the minimum angle of resolution units before and 2 and 4 months after injection, respectively. Temporary elevation of IOP was found in 4 treated eyes of 4 patients (25%). CONCLUSIONS: No electroretinographic evidence of a retinotoxic effect of intravitreal Kenalog was found in our patients.

[Evaluation of efficacy, safety and stability of lasik-zyoptix as compared to lasik-planoscan in myopia patients with or without astigmatism].

AIM: To compare the efficacy, safety and stability of laser in-situ keratomileusis (LASIK) Zyoptix and PlanoScan (PS) systems for the surgical correction of myopia with and without astigmatism. METHODS: In this retrospective study we analyzed the results of 198 eyes of 99 patients (randomly chosen) who underwent LASIK Zyoptix treatment and 198 eyes of 99 patients (randomly chosen) who underwent LASIK PlanoScan standard ablation treatment. Patients were followed for a period of 12 months after treatment. All surgeries were performed with the Bausch & Lomb Technolas 217z. Data on uncorrected (UCVA) and best spectacle-corrected (BSCVA) visual acuity, efficacy, predictability, stability and safety were analyzed. RESULTS: Mean preoperative spherical error in the Zyoptix group was -7.16 D (range= 0 to -16.50, SD = 3.21) and in the PS group -5.31 D (range= 0 to -16.50, SD=3.13). Mean preoperative cylinder was -1.30 D (range= -0.25 to 5.00, SD=0.99) and -1.17 D (range= -1 to -4.00, SD=0.85) respectively. Mean spherical deviation from expected at 1 year in the Zyoptix group was -0.13 D (range= -1.75 to 2, SD=0.73) and in the PS group -0.16 D (range= -4.50 to 2, SD = 0.75). Mean cylinder at 1 year was -0.69 D (range= -0.50 to 0.75, SD= -0.13) and -0.69 D (range = 0 to -2.25, SD = 0.46) respectively. At 1 year, the UCVA in the Zyoptix group was 6/12 or better, 6/7.5 or better and 6/6 or better in 87%, 60% and 27% respectively, and in the PS group 92%, 64% and 39% respectively. CONCLUSIONS: Both treatments can safely and effectively treat myopia and astigmatism with stable results up to one year. Zyoptix was found to show better outcomes in terms of safety and efficacy.

Necrotizing periorbital cellulitis following aesthetic rhinoplasty.

Rhinoplasty is rarely complicated with infection. We present a case of necrotizing periorbital cellulitis that developed in an 18-year-old woman following aesthetic rhinoplasty. The clinical manifestations consisted of swelling of the eyelids and necrosis of the lower eyelid regions, accompanied by high fever. Streptococcus pyogenes was isolated from the wound. The patient responded well to administration of intravenous amoxycillin/clavulanate and conservative local treatment. The infection resolved uneventfully. At 2-year follow-up, the cosmetic result was excellent.