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Biomedical subjects

F R Hu

Publications and source records attributed to F R Hu.

At least 37 records · Page 2Linked to original sources
PubMed1996

Excimer laser photorefractive keratectomy for myopia.

To evaluate the safety, effectiveness and stability of excimer laser photorefractive keratectomy (PRK) treatment, we studied its posttreatment results in 44 normal-sighted myopic eyes where a 193-nm emission wavelength excimer laser was used to correct myopia. The eyes were divided into three groups according to the preoperative refractive error and attempted correction: group I, preoperative myopia < or = 6.00 diopters (D), full correction; group II, preoperative myopia between 6.00 and 8.00 D, full correction; group III, preoperative myopia > 8.00 D, attempted correction of 8.00 D. Percentages of relative spherical equivalents (ie, observed spherical equivalent -- expected spherical equivalent) within +/- 1.0 D 3 months after treatment were 95% in group I, 64% in group II and 67% in group III. Uncorrected visual acuity of 20/40, or better, was achieved in 100% of eyes in group I, and 92% in group II at 6 months. Initial overcorrection followed by myopic regression was observed in all groups. The refractive outcome in our study was stable 3 months after surgery. Anterior stromal haze was mild and disappeared gradually 3 months postoperatively. The greater the diopter correction needed, the higher the grade of corneal haze (p < 0.01). There were no significant complications. The results of this study demonstrated that excimer laser PRK appears to be a reasonably predictable and stable procedure to correct low to moderate myopia.

Adult↗
PubMed1995

Extensive lamellar keratectomy for treatment of nontuberculous mycobacterial keratitis.

PURPOSE: To determine the efficacy of using extensive lamellar keratectomy for treating patients who have nontuberculous mycobacterial keratitis that is unresponsive to medical treatment. METHODS: Nine patients with bacteriologically proven nontuberculous keratitis, who had poor response to medical treatment and whose corneal infiltrate was not deeper than 80% of corneal thickness, were selected for extensive lamellar keratectomy. This procedure was performed freehand to remove all the corneal infiltration visible by operation-microscopic examination, to have a clean stromal bed. RESULTS: Corneal infection was eradicated in seven patients by a single procedure. In the other two patients, the condition was controlled by a second operation. Epithelialization was rapid and complete in all cases within ten days (mean, 4.8 days). Pain relief was dramatic after surgery. Visual acuity after surgery was improved in seven patients, but remained the same in two. There were no complications as a result of the lamellar keratectomy. CONCLUSIONS: Lamellar keratectomy should be considered as a treatment option for patients with nontuberculous mycobacterial keratitis who are unresponsive to medical therapy.

Adult↗
PubMed1995

Acyclovir treatment for linear endotheliitis on grafted corneas.

Two patients with previous corneal transplants developed unusual rejection-like episodes of the grafted cornea. Both had a migrating line of keratic precipitates and stromal edema involving both the donor and recipient corneas. Intensive steroid treatment attained little effect, but oral acyclovir treatment dramatically suppressed the disease process. The facts suggest that a virus-related immune mechanism against both the donor and recipient endothelia, rather than simple allograft rejection, may have been responsible for the clinical presentations. Oral acyclovir therapy might be considered in patients with steroid-nonresponsive corneal endotheliitis mimicking allograft rejection.

Acyclovir↗
PubMed1995

Clinical evaluation of ciprofloxacin ophthalmic solution in the treatment of refractory bacterial keratitis.

Ciprofloxacin is a fluoroquinolone antimicrobial agent inhibiting bacterial DNA gyrase, with good in vitro and in vivo activity against many Gram-positive and Gram-negative ocular pathogens. It has low toxicity, low resistance rate and low minimum inhibitory concentration. The purpose of this study was to evaluate the efficacy of ciprofloxacin in treating bacterial keratitis refractory to conventional therapy. Thirty patients with smear-proven bacterial ulcers were treated by conventional therapy. Of these, cultures were positive in 28 (93.3%) patients. Pseudomonas aeruginosa was isolated in 13 (46.4%) patients, nontuberculous mycobacteria in nine (32.1%) and other bacteria in six (21.4%). Fifteen patients (50%) were cured with conventional therapy. Four patients (13.3%) underwent surgery due to impending corneal perforation. Eleven patients were shifted to ciprofloxacin therapy because of poor results with conventional treatment. Of these, eight (72.7%) patients were treated successfully. No adverse events were encountered except a white crystalline precipitate in two cases which resolved spontaneously after discontinuation of therapy. In view of its effectiveness and low toxicity, ciprofloxacin should be considered in treating bacterial keratitis which is refractory to conventional therapy.

Adolescent↗
PubMed1994

Clinicopathologic study of Gore-Tex patch graft in corneoscleral surgery.

Three patients with corneal or scleral defects were treated with Gore-Tex grafting, including one case of corneal ulcer, one case of Mooren's ulcer, and one case of necrotizing scleritis. These eyes remained inflamed after Gore-Tex grafting. The interval between grafting and removal ranged from 2 months to 1 year. Pathologically, none of these grafts showed evident epithelial or fibrous tissue ingrowth of the Gore-Tex graft. Fungal inhabitation was noted in one graft, and fungal endophthalmitis developed 5 months after graft removal and penetrating keratoplasty. Although Gore-Tex offers some advantages, it has disadvantages when it is used without adequate conjunctival covering, including poor epithelialization, poor adhesion between graft and surrounding tissue, and potential infectious route.

Adult↗
PubMed1994

The epithelial barrier function in clear corneal grafts.

We conducted a corneal epithelial permeability study using a fluorophotometer on 93 eyes of 79 patients with clear corneal grafts. There were 45 males and 34 females, aged 61.6 +/- 10.2 years. All eyes received penetrating keratoplasty at least 1 year (mean 40.4 +/- 31.3 months) before examination. The normal fellow eyes of 65 subjects were examined as controls. The averaged corneal epithelial permeability of grafted corneas was significantly higher than that of controls (p < 0.001). In the 65 individuals having an otherwise healthy fellow eye, the grafted corneas were significantly more permeable than their control fellow eyes verified by paired t test (n = 65, p = 0.006). Concomitant corneal sensitivity test revealed a significantly hypesthetic cornea. These results show that in spite of a clinically normal clear graft, there is usually a subnormal epithelial barrier function and reinnervation, even years after corneal transplantation.

Adult↗
PubMed1993

Changes in corneal autofluorescence and corneal epithelial barrier function with aging.

Corneal epithelial permeability studies using fluorophotometers were performed on 90 eyes of 51 normal subjects. After recording the autofluorescence of the cornea (AFC) and of the lens (AFL), we applied 20 microliters of 2% sodium fluorescein to the conjunctival sac. The corneal fluorescence 45 min later (F45), which paralleled the corneal epithelial permeability to fluorescein, was measured by fluorophotometer and analyzed. All parameters of the two eyes of each subject correlated well with each other. There was positive correlation between AFL and patient age and between AFC and patient age (r = 0.78, p < 0.001, and r = 0.74, p < 0.001, respectively). The F45 increased exponentially with advancing age (r = 0.67, p < 0.001). The strong correlation between AFC and AFL in each eye (r = 0.79, p < 0.001) indicated corresponding aging processes in both the cornea and the lens. The increase in epithelial permeability with age possibly represents a subclinical breakdown of barrier function, rendering the corneas more vulnerable to insults.

Adult↗
PubMed1992

Pseudomonas aeruginosa isolated from corneal ulcer: susceptibility to antimicrobial agents tested alone or in combination.

Twenty-eight isolates of P. aeruginosa from corneal ulcers were tested for their susceptibility to 19 antimicrobial agents by an agar dilution method. The effect of a combination of an aminoglycoside with a beta-lactam, ciprofloxacin or colistin was checked by the checkerboard titration method. The minimal inhibitory concentrations (MICs) of these antimicrobial agents varied greatly. The MICs of aminoglycosides were near the breakpoint value of the usual susceptibility definition in most tested strains, but some were highly resistant. Ciprofloxacin, imipenem, aztreonam, ceftazidime, cefoperazone, piperacillin and colistin were other effective drugs with low MICs. Piperacillin, ceftazidime or aztreonam in combination with gentamicin or amikacin revealed a synergistic effect, but antagonism was found with ciprofloxacin or colistin combined with gentamicin or amikacin. Considering the difference in drug concentration achievable between systemic administration and topical application, the MIC quantitative determinations and the combination effect of antimicrobial agents against ocular isolates could provide useful information to ophthalmologists in choosing drugs for treatment of P. aeruginosa ocular infections.

Amikacin↗
PubMed1989

Neurological and electroneuromyographic assessment of the adverse effects of acrylamide on occupationally exposed workers.

Seventy-one acrylamide workers and fifty-one unexposed referents were studied. Weak legs and numb hands and feet, preceded by skin peeling from the hands, were the early symptoms of the acrylamide workers; their early signs were impairment of vibration sensation in their toes and loss of ankle reflexes. Three cases had cerebellar involvement followed by polyneuropathy due to heavy exposure. Electroneuromyographic changes, including a decrease in the sensory action potential amplitude, neurogenic abnormalities in electromyography, and prolongation of the ankle tendon reflex latency, are of greater importance in the early detection of acrylamide neurotoxicity since they can precede the neuropathic symptoms and signs. The diagnostic criteria for occupational acrylamide intoxication of this study revealed three severe poisonings, six moderate poisonings, and 43 mild poisonings. The total prevalence of acrylamide poisoning was 73.2%. The prevention of dermal exposure to acrylamide should be emphasized.

Acrylamide↗
PubMed1989

Isolation and in vitro susceptibility of Acanthamoeba from a patient with keratitis.

The acanthamoebae are facultative parasites of man, and may infect the brain, skin, bone, respiratory passages and eyes. Over the past several years, Acanthamoeba keratitis has become a growing problem. This is the first case isolating Acanthamoeba polyphaga from a corneal biopsy of an ophthalmic patient in Taiwan. Direct impression smear by trichrome stain gave positive result. To provide effective clinical treatment, chemotherapeutic agents available for ophthalmic use were tested for its susceptibility with a microtiter plate method. Reading at 24- and 48-hour intervals, only amphotericin B, clotrimazole and neomycin-polymyxin B had an MIC (minimal inhibition concentration) lower than 1,000 micrograms/ml. If reading interval was prolonged to one week, neomycin, 5-flucytosine and gentamicin also showed appreciable activity. Amoebicidal concentrations (AC) and cysticidal concentrations (CC) were much higher than MIC. Only neomycin-polymyxin B, neomycin, and amphotericin B of high concentration were proved to be cysticidal.

Acanthamoeba↗
PubMed1989

[Tear lactoferrin in keratoconjunctivitis sicca].

Keratoconjunctivitis sicca is a commonly encountered disease with decreased lacrimal gland activity. There are several tests to determine the lacrimal gland function, but all have limitations in accuracy, sensitivity or technical difficulty. At present, there is no reliable objective test to render a firm diagnosis of dry eye. Lactoferrin is one of the major proteins secreted by the lacrimal gland. Its concentration was found to correlate well to lacrimal gland activity. In this study we tried to evaluate the diagnostic value of lactoferrin measurement in comparison with other tests for keratoconjunctivitis sicca. Tests including the measurement of tear lactoferrin, Schirmer's-1 test, Schirmer's basal test, tear film break-up time, and rose bengal stain of the cornea were done on 60 healthy eyes and 56 eyes with keratoconjunctivitis sicca. The lactoferrin level was measured by a commercially available "Lactoplate" (Eagle Vision, U.S.A.). It is a plate containing gel loaded with rabbit anti-human-lactoferrin antiserum. Tear-moistened filter paper discs containing lactoferrin were placed on the gel. The lactoferrin concentration could be determined by measuring the concentric ring of precipitate after 72 hours incubation at room temperature. The average concentration of lactoferrin was 1.9 +/- 0.51 mg/ml in the normal group and 1.4 +/- 0.93 mg/ml in the keratoconjunctivitis sicca group. They were significantly different from each other (t-test: p less than 0.05). The results of the other 4 tests also showed a significant difference between the normal and keratoconjunctivitis sicca group, but the lactoferrin measurement had the highest specificity among these 5 tests. Because of the technical simplicity of measurement and its high specificity, lactoferrin measurement could be a valuable tool for the early and accurate diagnosis of keratoconjunctivitis sicca.

Adult↗
PubMed1989

Acanthamoeba keratitis: report of a case.

Acanthamoeba keratitis, rarely seen in Taiwan, has aroused much attention in western countries in recent years because of the increasing number of reported cases and its usually disastrous outcome. Most of the reported cases were closely associated with contact lens wearing. Others were related to a minor trauma or contacting contaminated water. We report a case of recalcitrant corneal ulcer following trauma, which is the first reported case of Acanthamoeba polyphaga keratitis proven by a special culture method and pathological examination in Taiwan. We reviewed the nature and characteristics of Acanthamoeba keratitis, and discussed the laboratory examinations such as staining techniques, culture methods, light and electron microscopic findings, and treatment for such cases.

Acanthamoeba Keratitis↗
PubMedDate not supplied

Clinical and specular microscopic manifestations of iridocorneal endothelial syndrome.

PURPOSE: To investigate the correlation between the clinical pictures and the specular microscopic findings in patients with iridocorneal endothelial (ICE) syndrome. METHODS: The records of 15 patients with ICE syndrome who presented at the National Taiwan University Hospital between 1993 and 1996 were examined. The medical history, clinical pictures of the cornea, iris and anterior chamber angle, intraocular pressure, specular microscopic findings, and the correlation between clinical and specular microscopic findings were assessed. RESULTS: Endothelial changes in specular micrographs were found in all the patients, even in those patients with minimal angle involvement by peripheral anterior synechiae. Corneal decompensation resulting in corneal edema and bullae formation was the main cause of visual impairment. Neither ICE grading nor endothelial cell density correlated with corneal edema or intraocular pressure, but they correlated with the angle involvement in ICE syndrome. The intraocular pressure was difficult to control in 8 of these patients, even after treatment with anti-glaucoma agents and trabeculectomy, especially in the patients with Cogan-Reese syndrome. CONCLUSION: Although specular microscopy provides an invaluable method for the diagnosis of ICE syndrome, it is not a reliable tool for predicting prognosis. Close follow-up of intraocular pressure and early detection of glaucoma are important steps to preserve visual functions in patients with ICE syndrome.

Adult↗