ABSTRACT
PURPOSE: To evaluate the effect of a fixed combination of brimonidine-timolol on intraocular pressure (IOP) after phacoemulsification cataract surgery. SETTING: Department of Ophthalmology, Patras University Hospital, Patras, Greece. DESIGN: Prospective randomized comparative case series. METHODS: Patients scheduled for phacoemulsification were randomly assigned to 1 of 2 groups. The treatment group received 1 drop of brimonidine-timolol fixed combination immediately after surgery, and the control group received no treatment. The IOP was measured preoperatively and 6, 12, and 24 hours postoperatively. RESULTS: The treatment group comprised 28 eyes and the control group, 30 eyes. The mean IOP increased by 0.14 mm Hg ± 3.88 (SD) (P = .88) in the treatment group and increased by 2.8 ± 5.01 mm Hg (P = .007) in the control group. Twelve hours after surgery, the mean IOP decreased by -0.57 ± 3.82 mm Hg (P = .49) in the treatment group and increased by 2.20 ± 4.56 mm Hg (P = .009) in the control group. Twenty-four hours after surgery, the mean IOP decreased by -1.57 ± 2.30 mm Hg (P=.012) in the treatment group and increased by 0.86 ± 4.21 mm Hg (P = .175) in the control group. The mean IOP change between the 2 study groups 6, 12, and 24 hours postoperatively was statistically significantly different (P = .015, P = .006, and P = .003; respectively). CONCLUSION: The fixed brimonidine-timolol combination effectively reduced IOP 6, 12, and 24 hours after phacoemulsification cataract surgery.
Subject(s)
Antihypertensive Agents/therapeutic use , Cataract Extraction/methods , Intraocular Pressure/drug effects , Ocular Hypertension/drug therapy , Phacoemulsification/adverse effects , Quinoxalines/therapeutic use , Timolol/therapeutic use , Aged , Aged, 80 and over , Brimonidine Tartrate , Cataract Extraction/adverse effects , Double-Blind Method , Drug Combinations , Female , Humans , Lens Implantation, Intraocular , Male , Middle Aged , Ocular Hypertension/etiology , Prospective Studies , Time FactorsABSTRACT
PURPOSE: Periorbital cellulitis is often difficult to distinguish from orbital cellulitis, which is a potentially lethal infection involving the contents of the orbit. A delay in diagnosis and appropriate treatment may result in serious complications. We studied the predisposing factors, microbiologic data, clinical features, complications, and treatment of periorbital and orbital cellulitis in childhood. METHODS: Eighty-three medical records of patients (mean age 3.7 ± 3.1 years) admitted to the Department of Pediatrics with a diagnosis of periorbital or orbital cellulitis during the 10-year period January 1997 to December 2007 were retrospectively studied. RESULTS: In this series, periorbital cellulitis occurred more frequently (83%) than orbital cellulitis (17%). Of the children with periorbital cellulitis, 85% were younger than 5 years of age, while 62% of the children with orbital cellulitis were older than 5 years of age. The most common predisposing factors in periorbital cellulitis were upper respiratory infection (68%) and trauma to the eyelids (20%), while sinusitis was more frequently associated with orbital cellulitis (79%). Blood and skin cultures were usually negative. The most common isolated pathogens were Staphylococcus aureus, Streptococcus pneumoniae, and Staphylococcus epidermidis. Forty-five of the 83 children were treated with intravenous ceftriaxone + clindamycin (mean duration 8.6 ± 5.5 days). Intravenous antibiotics alone was an effective management in most of the patients, but a small proportion (6%) required surgical intervention. CONCLUSIONS: Upper respiratory infection and sinusitis are the most important predisposing factors for periocular infection. Streptococcus species are the predominant causative agents. Both diseases can usually be successfully treated with intravenous antibiotics, but some patients may require surgery to control extensive infection.
