Ocular Applications of Dipyridamole: A Review of Indications and Routes of Administration.

Dipyridamole was introduced decades ago as a treatment for angina, subsequently found to inhibit platelet aggregation. It is most commonly used, and approved for use in thromboembolism prevention, following surgery. Some of its recognized effects such as adenosine uptake inhibition, elevation of cAMP and cGMP levels, vasodilation, and tissue perfusion are important in various ocular disorders. For this reason, dipyridamole represents an interesting candidate as a therapeutic target for the treatment of eye disorders affecting different ocular structures. The aim of this article is to review the evidence and current understanding of the mechanisms by which dipyridamole exerts its effects on different ocular tissues, discuss the role of dipyridamole in clinical practice, and highlight areas of use and routes of administration.

Minimal astigmatism after sutureless planned extracapsular cataract extraction.

PURPOSE: To evaluate astigmatism after mini-nuc extracapsular cataract extraction (ECCE) in which a chevron incision is enlarged to 6.0 to 7.0 mm for easier nucleus removal and to compare the results with those using a 5.0 mm incision. SETTING: Department of Ophthalmology, The Edith Wolfson Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Holon, Israel. METHODS: Thirty eyes of 29 patients were enrolled in this study. Keratometry was performed preoperatively and 3 to 9 months postoperatively. The incision length was 6.0 mm in 6 eyes, 6.5 mm in 10 eyes, and 7.0 mm in 14 eyes that had mature cataract. RESULTS: The mean induced astigmatism calculated by simple subtraction was 0.12 diopter (D) +/- 0.51 (SD), 0.16 +/- 0.98 D, and 0.67 +/- 0.91 D for the 6.0 mm, 6.5 mm, and 7.0 mm incision, respectively. By vector analysis, the mean induced astigmatism was 0.60 +/- 0.30 D, 0.75 +/- 0.67 D, and 1.36 +/- 0.77 D, respectively. Results by both methods showed no significant difference between the previously reported 5.0 mm incision and the 6.0 mm and 6.5 mm incisions. The 7.0 mm group had statistically significantly greater induced astigmatism than the 5.0 mm group (P =.01, simple subtraction; P =.002, vector analysis). CONCLUSIONS: Enlarging the size of the chevron incision up to 7.0 mm resulted in a small increase in induced astigmatism. The enlarged incision simplified the operative technique.