Live virus survives excimer laser ablation.

OBJECTIVES: To determine whether live virus can withstand excimer laser ablation and pose a possible health hazard to medical personnel. DESIGN: Experimental study. METHODS: Fibroblasts infected with oral polio vaccine virus were ablated with an excimer laser. The plume was collected using a smoke evacuator and bubbled through viral culture media. MAIN OUTCOME MEASURES: The inlet tube from the smoke evacuator was swabbed and cultured for virus. Liquid from the bubble trap was also cultured. RESULTS: Live virus was shown in the material trapped from the laser plume. CONCLUSIONS: Oral polio vaccine virus can survive excimer laser ablation. Whether other more clinically relevant viruses, such as human immunodeficiency virus, can withstand ablation and remain infectious remains to be determined.

Collagen shield delivery of ofloxacin to the human eye.

PURPOSE: To determine the ocular penetration of ofloxacin into the anterior chamber of the human eye when delivered by a presoaked collagen shield. SETTING: University of Colorado School of Medicine, Denver, Colorado. METHODS: This prospective randomized clinical study comprised 31 patients having cataract surgery. Patients were divided into 2 groups: the first received 3 preoperative drops of commercially available topical ofloxacin 0.3% given 10 minutes apart; the second had a collagen shield soaked in the same medication applied to the eye before surgery. Aqueous humor was extracted immediately before surgery for analysis. RESULTS: Mean aqueous concentration was 287 ng/mL +/- 69 (SEM) (range 40 to 1141 ng/mL) in the drops group and 957 +/- 189 ng/mL (range 214 to 2437 ng/mL) in the shield group. The difference was statistically significant (P < .005). The minimum inhibitory concentration (MIC) for selected ocular pathogens is between 500 and 4000 ng/mL. CONCLUSIONS: A collagen shield presoaked in commercially available topical ofloxacin and applied before surgery appears safe. The MICs for many common ocular pathogens were reached or exceeded. Further study is recommended to determine whether this method of infection prophylaxis is an acceptable substitute for subconjunctival injections of antibiotics.

Collagen shield delivery of tobramycin to the human eye.

PURPOSE: The purpose of this study was to determine the ocular penetration of tobramycin into the anterior chamber of the human eye when delivered by a pre-soaked collagen shield. METHODS: We conducted a prospective, randomized study of 32 patients undergoing cataract surgery. The subjects were divided into two groups. The first group received three preoperative drops of commercially available combination tobramycin-dexamethasone drops at 15 minute intervals. In the second group, a collagen shield soaked in the same medication was applied to the eye prior to surgery. At the beginning of surgery, the aqueous humor was extracted for analysis. RESULTS: The samples from 11 patients could not be analyzed due to an insufficient aqueous sample. Of the remaining 21 patients, the mean aqueous concentration was 0.026 microgram/mL (range: 0.0-0.09) in the drops group and 0.024 microgram/mL (range: 0.04-0.8 microgram/mL) in the shield group. This difference was not statistically significant. The aqueous concentration in both groups did not approach the minimum inhibitory concentration (4 micrograms/mL) for common ocular pathogens. No adverse effects related to the use of collagen shields occurred. CONCLUSIONS: Perioperative use of a pre-soaked collagen shield utilizing a commercially available preparation of tobramycin-dexamethasone combination drops appears safe. However, the use of this system to prevent endophthalmitis is not warranted based on the concentrations obtained from the aqueous humor.

Delivery of trifluridine to human cornea and aqueous using collagen shields.

PURPOSE: We investigated the ability of collagen shields to deliver trifluridine (trifluorothymidine [TFT]) to human cornea and aqueous humor. METHODS: 24-hour porcine collagen shields were soaked in commercially prepared TFT (Viroptic). Patients undergoing penetrating keratoplasty wore a pre-soaked collagen shield for at least 30 minutes preoperatively. Control patients received drops of TFT only. Cornea and aqueous samples were obtained. TFT levels were measured using high performance liquid chromatography. RESULTS: Among the four patients with intact corneal epithelium, TFT was detected in only one patient (0.13 microgram/g in the aqueous). In seven patients with poor epithelium, corneal levels ranged from 0 to 635.34 micrograms/g, and aqueous levels ranged from 0.06 to 11.17 micrograms/g. CONCLUSIONS: Collagen shields do not enhance delivery of TFT to corneas with intact epithelium. In corneas with poor epithelium, drug penetration was higher but variable. The role of collagen shields as a drug delivery system for the treatment of herpes simplex keratitis remains to be determined.

Reducing the amount of cytoplasm available for early embryonic development decreases the quality but not quantity of embryos produced by in vitro fertilization and nuclear transplantation.

The effect of reducing the amount of cytoplasm available for early embryonic development was investigated in embryos produced by in vitro fertilization (IVF) and nuclear transplantation. In Experiment 1, approximately 1/2 or 1/20 of the cytoplasm was removed from bovine embryos at the pronuclear-stage of development. The percentage of embryos developing to the compact morula or blastocyst stage was significantly higher in non-manipulated controls (26%) than in embryos with 1/20 of the cytoplasm removed (16%), and those with 1/2 of the cytoplasm removed (10%; P < 0.05). There was also a significant difference in the average number of cells between blastocysts in which 1/20 of their cytoplasm was removed (67), those with 1/2 of their cytoplasm removed (55), and nonmanipulated controls (77; P < 0.05). In Experiment 2, nuclear transfer embryos were produced in which approximately 1/2 or 1/20 of the cytoplasm was removed during oocyte enucleation. The percentage of embryos developing to the blastocyst stage was 17% for both groups of nuclear transfer embryos compared to 44% for control embryos (P < 0.05). The mean number of cells in blastocysts produced by nuclear transfer in which 1/20 of the cytoplasm was removed during oocyte enucleation (61) was no different than that in control embryos (66), but significantly higher than the mean number of cells in blastocysts produced by nuclear transfer in which 1/2 of the cytoplasm was removed (42; P < 0.05). There was no indication that altering the amount of cytoplasm available for early embryonic development of IVF embryos affected the timing of differentiation events, including those of embryo compaction and blastocyst formation.