Effect of heparin in the intraocular irrigating solution on postoperative inflammation in the pediatric cataract surgery

Yelda B Özkurt, Arzu Taskiran, Nadire Erdogan, Baran Kandemir, Ömer K Dog?anDepartment of Ophthalmology, Kartal Training and Research Hospital, Istanbul, TurkeyPurpose: To evaluate the influence of irrigation of the anterior chamber with heparin sodium on postoperative inflammation after pediatric cataract surgery. Setting: Kartal Training and Research Hospital, First Eye Clinic, Istanbul, Turkey.Design: Randomized prospective double-blind study.Methods: Fourteen consecutive eyes from 14 patients aged 8.9 ± 5.9 years, (range 3–18 years) (group 1) and 19 eyes from 19 patients aged 9.1 ± 5.2 (range 1.5–18 years) (group 2) underwent pediatric cataract surgery. Five patients in group 1 were between three and five years old. One patient was 1.5 years old and six patients in group 2 were between three and five years old. During the procedure, group 1 received anterior chamber irrigation with heparin sodium (5 IU/cc) and 1 ml of heparin sodium (concentration 10 IU/ml) added to the irrigating balanced salt solution (BSS Plus; Alcon Laboratories, Inc., Fort Worth, TX, USA) while group 2 received BSS without heparin sodium only. Cases aged under three years received anterior vitrectomy in addition to posterior capsulorrhexis. One eye received anterior vitrectomy in group 1 and two eyes received anterior vitrectomy in group 2. Cases with preoperative complications were not included in the study. Early and late postoperative inflammatory complications, including fibrin formation, anterior and posterior synechia, cyclitic and pupillary membrane formation were recorded and compared.Results: Mild anterior chamber reaction was observed in three patients in Group 1, while nine cases in group 2 experienced marked anterior chamber reaction. In four of nine patients from group 2, anterior chamber reaction was severe and resulted in pupillary membrane and synechia despite treatment in the postoperative 7th day, while in all three cases in group 1, reaction disappeared by the 7th day.Conclusion: Anterior chamber irrigation with heparin during pediatric cataract surgery may minimize early inflammatory reaction and decrease the number of postoperative inflammatory related complications.Keywords: pediatric, cataract, surgery, inflammatio

Bilateral Serous Macular Detachment After Attempted Suicide with Pregabalin

A 24-year-old female presented with bilateral vision loss following attempted suicide with pregabalin. Her best-corrected visual acuity (BCVA) was 20/40 in the right eye and 20/50 in the left eye. The bilateral visual disturbance was associated with serous macular detachment. Fundus examination of both eyes showed foveal serous retinal detachment, which was confirmed by optical coherence tomography. Topical nepafenac 0.1% eye drops were started as single drop every 8 hours for 4 weeks. One month later, the serous macular detachment had regressed and BCVA increased to 20/20 in both eyes. To the best of our knowledge, this is the first reported case of bilateral serous macular detachment presumably caused by pregabalin intoxication

Sjogren syndrome and lipid keratopathy

Bu yazının amacı, Sjögren sendromu nedeniyle oluşan korneal neovaskülerizasyon ve se- konder lipid keratopatili bir olguyu sunmaktır. 38 yaşındaki kadın hasta bilateral korneal opasite ve 1 yıldır şiddeti artmış oküler iritasyon ve fotofobi ile kliniğimize sevk edildi. Hasta 10 yıl önce Sjögren sendromu tanısı almıştı ve 8 yıldır da kuru göz nedeniyle suni gözyaşı kul- lanıyordu. Her iki göze 7 yıl önce kalıcı punktum oklüzyonu yapılmıştı. Günde iki kez siklos- porin A %0,05 (Restasis, Allergan) (CSA) kullandığı suni gözyaşına eklendi. 6 ay sonrası tüm semptomları, lipid birikimi ve korneal vaskülerizasyon dışındaki tüm bulguları geriledi. Ciddi komplikasyonlara yol açabilecek kuru göz hastalığı dikkatli tedavi edilmeli ve takipleri düzenli bir şekilde yapılmalıdır.The purpose of this paper is to report a case of bilateral secondary lipid keratopathy and corneal vascularization as a result of Sjogren syndrome. A 38-year old woman was referred to our clinic with bilateral corneal opacity, ocular irritation and photophobia for 1 year. She had a history of Sjogren syndrome for 10 years and dry eye treatment with eye drops for 8 years. Permanent punctal occlusion had been performed 7 years ago in both eyes. For treatment Cyclosporine A, %0.05 (Restasis, Allergan) (CSA) was added to treatment twice a day, along with artificial tears. After 6 months all symptoms and signs other than lipid accumulation and corneal vascularization got better. Dry eye disease that can lead to serious complications should be treated with caution and follow-up should be done in an orderly manner

The effects of levosimendan and dobutamine in experimental bupivacaine-induced cardiotoxicity.

Background: Accidental intravenous exposure to bupivacaine is highly cardiotoxic and may lead to death. Positive inotropic agents are usually utilized in resuscitative efforts. We have compared the efficacy of levosimendan, a novel inotropic agent, with dobutamine and their combination in a rat model of bupivacaine intoxication

Economic fast synthesis of olive leaf extract and silver nanoparticles and biomedical applications

In this study, silver nanoparticles (AgNPs) were synthesized economically and simply using an environmentally friendly method with the extract obtained from agricultural waste olive leaves. AgNPs synthesized according to the analysis data were determined to have maximum absorbance at 433.5 nm wavelength, spherical appearance, 7.2 nm crystal nano size and -19.9 mV zeta potential. It was determined by the microdilution method with Minimum Inhibition Concentration (MIC) that AgNPs exert a suppressive effect on the growth of pathogen gram-negative, positive bacteria and yeast at very low concentrations. The cytotoxic effects of the particles were investigated on healthy cell lines (HDF) and cancerous cell lines (U118, CaCo-2, Skov-3). AgNPs showed up to 70% suppression in cancer cell lines

Ecofriendly/Rapid Synthesis of Silver Nanoparticles Using Extract of Waste Parts of Artichoke (Cynara scolymus L.) and Evaluation of their Cytotoxic and Antibacterial Activities

Recycling wastes and providing their use in useful fields attract attention every day. In our study, with the extract prepared from the parts of the Cynara scolymus L. (artichoke) plant that is not suitable for human consumption, silver nanoparticles were easily synthesized in an ec-friendly, energy-free way. Characterization of the obtained nanoparticles was done with a UV-visible spectrophotometer (UV-Vis.), fourier transform infrared spectroscopy (FTIR), X-ray diffraction diffractometer (XRD), scanning electron microscope (SEM), transmission electron microscopy (TEM), and zeta potential analysis data. In these data, it was determined that AgNPs have a maximum absorbance at 458.8 nm wavelength, a crystal nanosize of 28.78 nm, and a spherical appearance. The zeta potential of (-) 16.9 mV indicates that silver nanoparticles exhibit a stable structure. Particles show antimicrobial effects on pathogenic species at concentrations of 0.03-0.25 μg/ml, and it was determined by using the minimum inhibition concentration (MIC) microdilution method. By examining their cytotoxic effects on U118, CaCo-2, and Skov-3 cancer cell lines and healthy HDF cell lines by the MTT method, concentrations of inhibitive effects on survival were determined

Comparison of contrast sensitivity and visual acuity between deep anterior lamellar keratoplasty and penetrating keratoplasty in patients with keratoconus

AIM: To evaluate postoperative visual acuity and contrast sensitivity results following deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty (PK) in patients with keratoconus (KC). METHODS: All the patients’ records with KC who had PK or DALK surgery between May 2010 and May 2011 were retrospectively reviewed. Sixty patients who underwent successful corneal transplantation for KC: 30 eyes underwent DALK and 30 eyes underwent PK were included in this study. Preoperative and postoperative mean logarithm of the minimum angle of resolution (logMAR) uncorrected visual acuity (UCVA), logMAR best spectacle-corrected visual acuity (BSCVA) and intraocular pressure (IOP) were evaluated. Contrast sensitivity tests (CS) were done preoperative and 2 months after all sutures had removed. All surgeries were performed under regional anesthesia (retrobulbar anesthesia) by 1 surgeon (B.K.) who was experienced in penetrating and lamellar keratoplasty techniques.RESULTS: The mean age of the DALK group was 29.67±4.95 (range 18-40) years and the PK group was 28.7±3.53 (range 18-39) years. Preoperatively there was no significant difference in the logMAR UCVA, logMAR BSCVA and IOP between the DALK (1.281±0.56; 0.97±0.85; 12.07±2.12mmHg) and PK (1.34±0.21; 0.98±0.21; 13±2.12mmHg) groups. One-year after surgery there was no significant difference in the mean logMAR UCVA and IOP between the DALK (0.46±0.37; 11.73±2.1mmHg) and PK (0.38±0.21; 12±2.12mmHg) groups. The mean contrast sensitivity was evaluated by CC-100 Topcon LCD at 1.5, 2.52, 4.23, 7.10 and 11.91 cycles per degree (cs/deg) spatial frequencies before and 2 months after the all sutures had removed. CONCLUSION: All patients with keratoconus in both DALK and PK groups performed good visual function postoperatively. The mean contrast sensitivity increased considerably at all spatial frequencies compared with preoperative levels in the DALK and PK groups. The mean post-operative evaluation of contrast sensitivity measurements was not significantly different between the two groups