Long-term outcomes of antiproliferative agents in primary trabeculectomy

Purpose: To evaluate and compare long-term outcomes of trabeculectomies with subconjunctival injections of 5-fluorouracil (5-FU) after sugery or use of mitomycin C (MMC) during surgery. Methods: Retrospective study of 133 eyes who underwent primary trabeculectomy. Results: Intraocular pressure levels were not statistically significant at any of the postoperative visits when comparing the 5-fluorouracil and mitomycin C groups. In each group, analyzed separately, the intra-ocular pressure levels showed no statistically significant difference before or after surgery. The incidence of postoperative complications was not statistically significant as well, except for a greater incidence of the corneal epithelial defects, more frequent in the 5-fluorouracil group. In both groups, a greater incidence of development/progression of cataract was noted. Conclusion: Both mitomycin C and 5-fluorouracil promoted an important and stable decrease in intraocular pressure with similar complication rates.Objetivo: Avaliar comparativamente a longo prazo os resultados cirúrgicos de trabeculectomias nas quais foram utilizadas injeções subconjuntivais de 5-fluorouracil (5-FU) no pós-operatório ou aplicações de mitomicina C (MMC) peroperatória. Métodos: Estudo retrospectivo de 133 olhos submetidos a trabeculectomia primária. Resultados: A pressão ocular não apresentou valores estatisticamente significantes em nenhuma das visitas de pós-operatório quando comparados os grupos em que se utilizou a mitomicina C ou 5-fluorouracil. Em cada um dos grupos analisados separadamente, os níveis da pressão ocular não apresentaram diferenças estatisticamente significantes nos períodos pré e pós-operatório. A incidência de complicações pós-operatórias também não apresentou diferença estatisticamente significante à exceção de alterações epiteliais na córnea, mais freqüentes no grupo tratado com 5-fluorouracil. Nos dois grupos, destacou-se a elevada incidência de desenvolvimento/progressão de catarata. Conclusão: O uso de mitomicina C ou 5-fluorouracil promoveu redução importante e estável da pressão ocular, com índices de complicações semelhantes.Universidade Federal de São Paulo (UNIFESP) Departamento de OftalmologiaUniversidade de Miami Bascom Palmer Eye InstituteUNIFESP, Depto. de OftalmologiaSciEL

Variable Curvature Slab Molecular Dynamics as a Method to Determine Surface Stress

A thin plate or slab, prepared so that opposite faces have different surface stresses, will bend as a result of the stress difference. We have developed a classical molecular dynamics (MD) formulation where (similar in spirit to constant-pressure MD) the curvature of the slab enters as an additional dynamical degree of freedom. The equations of motion of the atoms have been modified according to a variable metric, and an additional equation of motion for the curvature is introduced. We demonstrate the method to Au surfaces, both clean and covered with Pb adsorbates, using many-body glue potentials. Applications to stepped surfaces, deconstruction and other surface phenomena are under study.Comment: 16 pages, 8 figures, REVTeX, submitted to Physical Review

Combined pars plana vitrectomy and Baerveldt glaucoma implant placement for refractory glaucoma

To evaluate outcomes of combined pars plana vitrectomy and Baerveldt glaucoma implant (PPV-BGI) placement for refractory glaucoma

A Topical Carbonic Anhydrase Inhibitor Finally Arrives

In this issue of the Archives, Strahlman and associates1 report a 1-year study of the safety profile and efficacy of a topical carbonic anhydrase inhibitor (CAI), dorzolamide hydrochloride (Trusopt), as either primary or supplemental therapy for primary open-angle glaucoma and ocular hypertension. This is the first topical CAI to show sufficient efficacy for clinical use and that appears to nearly match the pressure-lowering of oral CAIs without having their systemic side effects. Having advanced to Food and Drug Administration phase 3 trials, it was approved early this year2 and marketed in June.The quest to develop a topically active CAI has taken a long time, generating apt comparisons to the biblical 40-year journey in the wilderness needed to reach the promised land. This journey also was circuitous and skeptics wondered if it would be completed.The rationale for the development of a topically active CAI was to eliminat