Assessment of efficacy of topical azithromycin 1.5 per cent ophthalmic solution for the treatment of meibomian gland dysfunction

WOS: 000417934000004PubMed ID: 28677153BackgroundThe aim was to evaluate the clinical efficacy of topical azithromycin 1.5 per cent ophthalmic solution in treatment of the clinical signs and symptoms associated with meibomian gland dysfunction (MGD). MethodsIn this retrospective study, 35 patients with MGD were treated with topical azithromycin 1.5 per cent ophthalmic solution for 30 days. Topical azithromycin 1.5 per cent ophthalmic solution was prescribed twice daily for two days and then once daily for a total of 30 days. Daily lid hygiene with dilute baby shampoo was instructed for all patients. Patient total symptom score, meibomian gland grading score, Schirmer score with anaesthetic, tear film break-up time (TFBUT) and corneal fluorescein staining score were evaluated at baseline and after one and three months. ResultsPatient total symptom score, meibomian gland grading score, Schirmer score with anaesthetic, TFBUT and corneal staining score reduced significantly from the baseline to the first month (p 0.05, for each). ConclusionThese results demonstrate that topical azithromycin 1.5 per cent ophthalmic solution appears effective in the short-term treatment of the clinical signs and symptoms associated with MGD

Intraoperative and early postoperative flap-related complications of laser in situ keratomileusis using two types of Moria microkeratomes

WOS: 000341838700012PubMed ID: 24531872The purpose of this study is to describe the incidence, management, and visual outcomes of intraoperative and early postoperative flap-related complications of laser in situ keratomileusis (LASIK) surgery using two types of Moria M2 microkeratomes. This retrospective analysis was performed on 806 primary LASIK cases. The intraoperative and early postoperative flap-related complications were identified and categorized according to type of Moria microkeratome. There were 52 intraoperative and early postoperative complications-one case of partial flap (0.124 %), one case of free flap (0.124 %), one case of small flap (0.124 %), 13 cases of epithelial defect (1.61 %), 12 cases of flap striae (1.49 %), 10 cases of diffuse lamellar keratitis (1.24 %), 10 cases of interface debris (1.24 %), three cases of epithelial ingrowth (0.37 %), and one case of microbial infection (0.124 %). The overall incidence of flap complications was 6.45 %. There were 27 right eye (6.73 %) and 25 left eye (6.17 %) complications. The incidence of complications with the Moria automated metallic head 130 microkeratome was 4.22 % and with the Moria single-use head 90 microkeratome was 2.23 %. We observed one culture-negative interface abscess which was cured with surgical cleaning and intensive medical treatment. The most common complication encountered was epithelial defects, followed by flap striae. Our study showed that LASIK with a microkeratome has a relatively low incidence of intraoperative and early postoperative flap complications. The authors have no financial interest in any of the issues contained in this article and have no proprietary interest in the development of marketing of or materials used in this study

Comparison of the efficacy and tolerability of tobramycin and dexamethasone combination for prophylaxis in a laser-assisted in situ keratomileusis (LASIK) population

Amaç:Lasik cerrahisi sonrası proflaksi için reçete edilen Tobramisin ve Dekzametazonun ayrı ayrı kullanımları ile tek bir kombine preparatta kullanımlarının etkinlik ve uyum açısından karşılaştırılması. Metod: Prospektif, randomize, tek kör ve paralel grup olarak yapılan çalışmada her iki gözünden LASİK cerrahisi geçirmiş 58 hasta oküler enflamasyon ve infeksiyon açısından izlenirken Grup A (28 hastanın 56 gözü) %0.3 Tobramisin (3mg/ml) + %0.1 Deksametazon (1mg/ml) (TobraDex® Alcon) kombine formunu, Grup B (30 hastanın 60 gözü) ise %0.1 Deksametazon (Maxidex® Alcon ) ve %0.3 Tobramisin (3mg/ml) (Tobrex® Alcon) etken maddelerini içeren preparatları tekli formlarda göze topikal olarak uygulamışlardır. Ameliyat öncesinde ve ameliyat sonrası dönemde 1,3 ve 10 günlerde görme keskinliği,göz içi basıncı,kornea, konjonktiva ve kapaklarda ki inflamasyon ile oküler yakınmalar ve belirtile ri(yanma,batma,sulanma,yabancı cisim hissi ve ağrı) değerlendirildi. Sonuçlar: İki grup arasında yapılan karşılaştırmalarda postoperatif dönemde oküler enfeksiyon yada uzun süren enflamasyon belirtilerine rastlanılmaz iken elde edilen objektif ve subjektif şikayetler arasında da istatistiksel olarak anlamlı fark bulunmamıştır. Bunun yanında ilaçları kombine olarak kullanan grup da batma ve yanma açısından 3. günde farklılık olmakla beraber istatistiksel olarak anlamlı fark bulunamadı. Tartışma: Lasik ameliyatı sonrasında proflaksi için kullanılan tobramisin ve dekzametazonun kombine edilmiş hali ile etken maddeyi içeren tekli formlarının kullanımı arasında etkinlik ve tolaribilite açısından fark bulunamadı. Kombine formun kullanımı da bu iki ilacın ayrı ayrı kullanımı kadar etkili olmaktadır.Purpose: To compare the efficacy and tolerability of a fixed-dose combination of 0.3% Tobramycin and 1% Dexamethasone formulation versus the same agents administered separately for prophylaxis in a laser-assisted in situ keratomileusis (LASIK) population. Methods: In a prospective, randomized, onemasked, parallel-group study, 97 patients were evaluated for signs and symptoms of ocular infection or inflammation after bilateral LASIK. Group A (28 patients, 56 eyes) received a combined formulation of 0.3% tobramicin + 1% dexamethasone (Tobradex). Group B (30 patients, 60 eyes) received conventional treatment with the same agents from separate vials. Baseline and postoperative assessments were made on surgery days -2, 1, 3, and 15 and consisted of visual acuity; intraocular pressure; severity of inflammation of eyelids, conjunctiva, and cornea;tearing; ocular discomfort (foreignbody sensation, itching, or photophobia); and ocular pain. Results: No ocular infection or persistent inflammation was detected in either group at any time. All objective and subjective criteria of efficacy were similar regardless of treatment, with no significant differences between the groups. More patients who were dosed with the combined agent complained of mild ocular discomfort on day 3, but this different has no signifigant statistical difference between two groups. Conclusion: Post-LASIK topical prophylaxis with combined tobramicin + dexametazon eye drops (Tobradex) was well tolerated. This formulation appears to be therapeutically equivalent to conventional dosing with tobramicin and dexametazon from individual bottles for topical prophylaxis after laser refractive surgery

Anterior segment optical coherence tomography evaluation of corneal epithelium healing time after 2 different surface ablation methods

WOS: 000349405000011PubMed ID: 25630007Objectives: To compare epithelial healing time following laser epithelial keratomileusis (LASEK) and photorefractive keratectomy (PRK) with anterior segment optic coherence tomography (AS-OCT). Methods: This prospective interventional case series study comprised 56 eyes of 28 patients that underwent laser refractive surgery in the Department of Ophthalmology, Medipol University Medical Faculty, Istanbul, Turkey, between March 2014 and May 2014. Each patient was randomized to have one eye operated on with PRK, and the other with LASEK. Patients were examined daily for 5 days, and epithelial healing time was assessed by using AS-OCT without removing therapeutic contact lens (TCL). Average discomfort scores were calculated from ratings obtained from questions regarding pain, photophobia, and lacrimation according to a scale of 0 (none) to 5. Results: The mean re-epithelialization time assessed with AS-OCT was 3.07 +/- 0.64 days in the PRK group, 3.55 +/- 0.54 days in the LASEK group, and the difference was statistically significant (p=0.03). Mean subjective discomfort score was 4.42 +/- 0.50 in the PRK eyes, and 2.85 +/- 0.44 in the LASEK eyes on the first exam day (p=0.001). The score obtained on the second (p=0.024), and third day (p=0.03) were also statistically significant. The fourth (p=0.069), and fifth days scores (p=0.1) showed no statistically significant difference between groups. Conclusion: The PRK showed a statistically significant shorter epithelial healing time, but had a statistically significant higher discomfort score until the postoperative fourth day compared with LASEK.الطريقة: هذه الدراسة التداخلية املرتقبة للحاالت املسلسلة تتضمن 56 ً عينا من 28 ً مريضا الذين تلقوا جراحة الليزر االنكسارية في قسم أمراض العيون في مستشفى كلية الطب جامعة ميدي بول، اسطنبول، تركيا، في الفترة ما بني مارس 2014م مايو 2014م. كل مريض خضع للعملية ألحدى عينيه بطريقة )الالزيك( والعني االخرى بطريقة )بي آر كي(. مت االختيار بني العينني بطريقة عشوائية. مت فحص كل مريض بعد العملية بشكل دوري وملدة خمسة أيام، ومت حساب الزمن املستغرق لشفاء الغشاء الظهاري للقرنية باستخدام الـ ) أي اس- أو سي تي( بدون ازالة العدسات الالصقة املداوية. مت حساب معدل درجات االنزعاج عن طريق سؤال املريض عن األلم، رهاب الضوء و تدمع العني بنقاط من الصفر )مبعنى ال يوجد( الى 5. النتائج: املتوسط الزمني لعودة التظهرن املقاس بطريقة الـ ) أي اس- أو سي تي( كانت: 64.0±07.3 يوم في مجموعة الـ)بي آر كي( و 54.0±55.3 في مجموعة الـ )الالزيك( والفرق بني املجموعتني كان ً واضحا ً إحصائيا )بي= 03.0 .)املتوسط االنزعاجي الغير املوضوعي كان 50.0±42.4 في العيون التي خضعت للـ )بي آر كي( و 44.0±85.2 في العيون التي خضعت للـ )الالزيك( في اليوم األول للفحص. املعدالت التي مت احلصول عليها لدرجة االنزعاج في اليومني الثاني والثالث كانت ً أيضا ً واضحة احصائيا، )بي= 024.0 و بي=03.0 على التوالي(. ً اليومني الرابع واخلامس لم يظهر درجات واضحة احصائيا بني املجموعتني )بي=069.0 و بي=1.0 )على التوالي. اخلامتة: أظهرت طريقة الـ )بي آر كي( زمنا أقصر اللتئام الغشاء الظهاري ً الذي كان واضحا ً إحصائيا ولكنه في الوقت نفسه أظهرت درجة انزعاج أكثر حتى اليوم الثالث بعد العملية

A new technique for encapsulated blebs filtration: Vitrector assisted cystectomy

WOS: 000425546600010PubMed ID: 29269183We introduce a new technique for the management of encapsulated non filtering blebs which are unresponsive to needling procedure. A 21 year-old man with a visual acuity of 20/30 presented with encapsulated bleb in the left eye 4 weeks after a successful trabeculectomy operation with adjunctive mitomycin C for medically uncontrolled glaucoma. The internal ostium was patent on gonioscopic examination. Intraocular pressure was 35 mmHg despite multiple therapies with bimatoprost, brimonidine, and dorzalomide-timolol fixed combination. He underwent two consecutive bleb needling procedures with adjunctive subconjunctival 5-fluorouracil (5-FU) injections which were successful initially but encapsulated bleb recurred. The 5-FU augmented bleb needling was performed at the slit lamp after cleaning the patient’s eyelid and periorbital skin with 10% providone iodine followed by instillation of a drop of 5% providone iodine. Needling of the bleb was performed using a 27-gauge needle. The aim was to remove episcleral scarring which was obstructing the intrascleral pathway. This was followed by an injection of 0.1 mL of 5-FU solution (50 mg/mL) along the far posterior margins of the bleb area

A case of cone dystrophy associated with choroidal neovascularization

PURPOSE: To report a case of choroidal neovascularization (CNV) in a patient with cone dystrophy (CD). METHODS: Case report.RESULTS: A 20-year-old woman presented with diminished vision in her right eye. Fundus examination showed perifoveal retinal pigment epithelial changes and retinal hemorrhage consistent with subretinal CNV in the right eye, and mild retinal pigment epithelial changes with a dull foveal reflex in the left eye. Optical coherence tomography analysis and fundus fluorescein angiography also confirmed the subfoveal CNV in the right eye. Electroretinography showed decreased amplitudes in photopic and 30-Hz. flicker tests in both eyes, which confirmed cone dystrophy. A single intravitreal ranibizumab injection resolved the edema and stabilized the CNV during the follow-up of 6 months.CONCLUSION: Cone dystrophy is an inherited ocular disorder characterized by loss of cone photoreceptors. Association of CNV has been reported in patients with fundus flavimaculatus, best dystrophy, gyrate atrophy, choroideremia, retinitis pigmentosa, adult-onset foveomacular vitelliform dystrophy, Sorsby macular dystrophy, Bietti crystalline dystrophy, and myotonic dystrophy-related macular dystrophy. We report a case of a patient with CD in whom CNV developed in one eye and responded to a single ranibizumab injection

Ocular surface and tear parameters in patients with chronic hepatitis c at initial stages of hepatic fibrosis

WOS: 000350136600012PubMed ID: 25503914Purpose: The aim of this study was to evaluate changes in ocular surface and tear function parameters in chronic hepatitis C at initial stages of hepatic fibrosis. Methods: Thirty-one patients with biopsy-proven chronic hepatitis C and 31 age-and sex-matched healthy control subjects without systemic hepatitis C infection were examined with the Ocular Surface Disease Index (OSDI) questionnaire, Schirmer I, tear film break-up time, and scoring of ocular surface fluorescein and Rose Bengal staining using modified Oxford and van Bijsterveld scoring systems, respectively. Results: All ocular surface parameters, except OSDI and corneal staining scores, were significantly worse in hepatitis C group. The control group had greater OSDI scores than the hepatitis C group, but there was no statistically important difference. In subgroup analysis, progression of hepatic fibrosis was found to be correlated strongly with decreased Schirmer test I, increased OSDI, lid parallel conjunctival folds, conjunctival, and corneal staining scores. Conclusion: Patients with chronic hepatitis C were more likely to exhibit severe ocular surface damage and signs of dry eye