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J Frucht-Pery

Publications and source records attributed to J Frucht-Pery.

At least 37 records · Page 2Linked to original sources
PubMed1998

Deep stromal inflammation--a possible new ocular manifestation of Crohn's disease.

Crohn's disease, an inflammatory bowel disease, is infrequently associated with epithelial and subepithelial corneal inflammation. However, deep stromal inflammation has not been described previously in association with Crohn's disease. We report on a 52-year-old male who suffered from anterior uveitis and deep stromal inflammation. Complete ocular and systemic workup revealed an active asymptomatic Crohn's colitis; no other possible cause for the ocular inflammation was found. We conclude that deep stromal inflammation, in addition to the previously reported corneal epithelial inflammation, may be associated with Crohn's disease.

Colitis↗
PubMed1998

Topical use of zinc desferrioxamine for corneal alkali injury in a rabbit model.

PURPOSE: To evaluate the efficacy of topical zinc desferrioxamine in acute corneal alkali injury in rabbits. METHODS: Twenty rabbits were anesthetized and a standardized alkali burn (1N NaOH) was performed in the center of the cornea (7.5-mm diameter). The animals were randomly divided into two groups and treated (double-masked) with topical zinc desferrioxamine, 220 microM, (group 1) or its vehicle (group 2). Drops were applied 7 times/day for 28 days. Topical gentamicin, 0.3%, was instilled twice a day. Animals were evaluated twice a week. At each examination (using the slit-lamp), the depth of corneal ulcer was graded as follows: 0, no ulcer; 1, tissue loss less than one third of corneal thickness; 2, one third to two thirds tissue loss; 3, more than two thirds tissue loss; 4, descemetocele; or 5, perforation. Ulceration area, vascularization, and epithelial defects also were measured. RESULTS: During the study period, the grading of mean corneal ulcerations in group 1 ranged from 0.2 to 1.00, whereas in group 2, it ranged from 1.4 to 2.7. The mean grade and area of ulceration in group 2 were greater than those in group 1 (p < 0.05). CONCLUSION: Topical zinc desferrioxamine may be an adjunctive treatment in protecting the cornea against induced alkali injury.

Administration, Topical↗
PubMed1998

MIB-1 and PC-10 immunostaining for the assessment of proliferative activity in primary acquired melanosis without and with atypia.

AIMS: To compare the proliferative activity of intraepithelial melanocytes in primary acquired melanosis (PAM) without atypia and PAM with atypia by immunohistochemical staining for the Ki-67 antigen and the proliferating cell nuclear antigen (PCNA). METHODS: Formalin fixed, paraffin embedded sections from 35 archival specimens of PAM without atypia (n = 19) and with atypia (n = 16) were studied by immunostaining with MIB-1 and PC-10 monoclonal antibodies that react with the Ki-67 antigen and PCNA respectively. The results were calculated as the mean number of positive cells per eyepiece grid. All specimens were evaluated by two masked observers, and the interobserver reproducibility was assessed. RESULTS: The means of the positive cell count in PAM with atypia were significantly higher compared with PAM without atypia for both observers, in both the PC-10 and the MIB-1 stained sections. In a linear least square model that estimated the interobserver and between group variation, the difference of MIB-1 and PC-10 positive cell count between PAM without and with atypia remained highly significant. The difference between the observers was not significant. CONCLUSIONS: Immunostaining with MIB-1 and PC-10 demonstrated that PAM with atypia has higher proliferative activity than PAM without atypia. This method was found to be reproducible between different observers.

Antigens, Nuclear↗
PubMed1997

Mitomycin C treatment for conjunctival-corneal intraepithelial neoplasia: a multicenter experience.

OBJECTIVE: The purpose of the study is to evaluate the efficacy and risks of topical mitomycin C (MMC) for conjunctival-corneal intraepithelial neoplasia (CCIN). DESIGN: The study design was a clinical case series of CCIN. PARTICIPANTS: Seventeen patients, 16 with biopsy-confirmed CCIN and 1 with invasive squamous cell carcinoma (SCC), were included in the study. INTERVENTION: Patients received topical drops of MMC 0.02% to 0.04% four times daily from 7 to 28 days. Retreatment was done in cases of lesion recurrence. MAIN OUTCOME MEASURES: The size of the CCIN before and after the treatment and ocular complications post-MMC application were evaluated. RESULTS: Ten patients remained disease-free after one course of MMC application. In one case, residual CCIN remained very small without regrowth. In the one patient with invasive SCC and in five patients with CCIN, regrowth occurred within 6 months of the first treatment. After retreatment, invasive SCC and CCIN in an additional two patients were eradicated. In two cases, although the size of the lesions decreased after two and three applications of MMC, regrowth occurred, and the CCIN returned to its original size. In the final case, limited recurrence has occurred and no retreatment has been done. The complications of MMC use included mild-to-moderate conjunctival hyperemia and mild allergy, which resolved after discontinuation of the treatment. Severe pain manifested when treatment was longer than 14 days. CONCLUSIONS: Application of topical MMC is an efficient treatment for most but not all cases of CCIN.

Administration, Topical↗
PubMed1997

Microbial findings in suture erosion after penetrating keratoplasty.

PURPOSE: The purpose of the study was to evaluate the presence of microorganisms in eroded (broken or loose) sutures post-penetrating keratoplasty (PKP). METHODS: Fifty-five consecutive episodes of eroded 10-0 nylon sutures post-PKP in 35 eyes were evaluated. Eroded sutures were removed and, along with a swab from the conjunctiva, studied for aerobic and anaerobic bacteria. Preoperative diagnosis, elapsed time since surgery, presence of symptoms, suture location, infiltration, vascularization, and mucous at the suture site were recorded. Student's t test was used for statistical analysis. RESULTS: The average time from PKP to suture removal was 31.6 months. Eyes treated with topical steroids presented earlier suture erosions (P = 0.05). Of the 55 sutures, 34 were sterile, and in 21, both Staphylococcus epidermidis and diphtheroids (mixed flora) were cultured. Of the 55 conjunctivas, 32 were sterile, 22 showed mixed flora, and 1 had Pseudomonas. Sutures eroded for more than 24 hours had more positive cultures than those eroded for 24 hours or less (P = 0.043). Sutures located superiorly had fewer positive cultures than did those in the palpebral fissure area (P = 0.044). Eyes with repeated suture erosions had more culture-positive sutures (P = 0.017) and conjuctivas (P = 0.014) at the first erosion in comparison with the second erosion. Infiltration, vascularization, or muscus at the suture site did not correlate with positive cultures. CONCLUSIONS: Bacteria are encountered at the site of eroded sutures. Patients with PKP should report symptoms immediately, and eroded sutures should be removed as early as possible.

Adolescent↗
PubMed1997

The use of capsaicin in herpes zoster ophthalmicus neuralgia.

The treatment of neuralgia which occurs during and following herpes zoster ophthalmicus is often unsatisfactory. Capsaicin (trans-8-methyl-N-vanillyl-6-nonenamide) is a drug which depletes substance P and may be effective in inhibiting pain. We utilized topical capsaicin to the affected dermatome five times daily for 4 weeks in 6 patients with acute and post herpetic neuralgia. In four cases pain was markedly relieved and narcotic medications were either discontinued or significantly reduced. In two cases, pain was not reduced. Four patients had side effects including burning sensation at the site of the drug administration (4 cases), dermatitis as a result of overuse of the drug (2 cases) and hyperesthesia (1 case). Our results suggest that capsaicin may be a useful therapy for the alleviation of pain in some individuals with herpes zoster ophthalmicus. However, controlled studies are needed to establish these results.

Administration, Topical↗
PubMed1997

Thirty years of penetrating keratoplasty in Israel.

We studied the indications for keratoplasty and their changes during 30 years in Israel by retrospective evaluation of pathologic records of 1,018 corneal buttons (from 1961 to 1990). The population included 634 (62.3%) male patients and 384 (37.7%) female patients. Keratoconus (n = 222, 21.8%) was the most common indication, followed by corneal graft failure (n = 113, 11.1%), herpetic infections (n = 95, 9.3%), ocular trauma (n = 87, 8.5%), scarring (n = 74, 7.3%), pseudophakic bullous keratopathy (n = 72, 7.1%), nonherpetic infections (n = 71, 7.0%), and other indications. Whereas ocular infections were the most common indications for keratoplasty before 1970, keratoconus has been the most common indication since 1970. Pseudophakic bullous keratopathy became the second most common indication (13.8%) between the years 1981 and 1990. The number of keratoplasties increased in Israel during the past three decades, and the low percentage of pseudophakic bullous keratopathy is related to the types of intraocular lenses that we implanted in the late 1970s and the early 1980s.

Corneal Diseases↗
PubMed1997

Treatment of inflamed pterygium and pinguecula with topical indomethacin 0.1% solution.

PURPOSE: To evaluate the effect of topical indomethacin 0.1% on signs and symptoms in inflamed pterygium and pinguecula. METHODS: Fifty-one consecutive patients who had inflamed pterygium (n = 32) or pinguecula (n = 19) were studied in a randomized, double-masked, controlled way. Objective signs (conjunctival congestion, redness, edema, and staining of cornea) and subjective complaints (photophobia, pain, foreign-body sensation, discomfort, and tearing) were evaluated and scored. In addition, we evaluated total signs, total symptoms, and total score. Group 1 (n = 25) received topical indomethacin 0.1% solution and group 2 (n = 26) received a placebo six times daily for 3 days, then four times daily for 11 days. Patients were examined before and at days 3, 7, and 14 after the treatment began. RESULTS: In group 1 at day 3, the scores of total signs, total symptoms, and total score decreased (p = 0.001), and they further decreased after 14 days (p = 0.02 to p = 0.05). In group 2 at day 3 these parameters also significantly decreased (p = 0.01 to p = 0.02), but no further improvement occurred after 14 days. Comparing groups 1 and 2 revealed a decrease in scores in group 1 for total signs, total symptoms, and total score at days 3, 7, and 14 (p = 0.03 to p = 0.002) except for total signs after 14 days (p = NS). All the patients reported mild stinging for < 1 min after administration of the drops. CONCLUSIONS: This study indicates that topical indomethacin solution 0.1% is a useful treatment for inflamed pterygium and pinguecula.

Administration, Topical↗
PubMed1997

Topical anesthesia with benoxinate 0.4% for pterygium surgery.

BACKGROUND AND OBJECTIVE: Anesthesia during pterygium surgery is usually achieved with injections of anesthetic medications. This study evaluated the efficacy of topical anesthesia with benoxinate hydrochloride 0.4% for pterygium surgery. PATIENTS AND METHODS: One hundred fifty consecutive patients who had primary or recurrent pterygium underwent surgical excision of the lesion. Before the surgical procedure began, each eye that was operated on received 1 drop of benoxinate hydrochloride 0.4% solution every 1 minute for 10 minutes. The pain sensation was tested with 0.12 forceps. The pterygium was dissected, and 1 or 2 conjunctival sutures were placed, leaving bare sclera. Drops of benoxinate hydrochloride 0.4% were added every 5 minutes during the operation. RESULTS: The average pterygium excision time in this study was 25 minutes. Of the 150 patients studied, only 3 required intraoperative injection of lignocaine 1%. In 2 cases, subconjunctival injection was performed, and in 1 case, retrobulbar injection was required to complete the procedure. Of the remaining 147 patients, 115 had discomfort or mild pain and asked for more anesthetics once or twice during the procedure. Postoperatively, the wounds epithelialized within 7 to 14 days in all patients, except for 2 who had postoperative dellen and 2 who received mitomycin-C postoperatively. CONCLUSION: Topical administration of benoxinate hydrochloride 0.4% provides useful anesthesia for pterygium surgery.

Administration, Topical↗
PubMed1996

Use of mitomycin C in the treatment of conjunctival primary acquired melanosis with atypia.

A patient who had primary acquired melanosis with marked atypia shown on histological studies received topical 0.02% mitomycin C for 2 weeks and 0.04% mitomycin C for an additional 2 weeks. Conjunctival biopsy specimens were obtained to evaluate the efficacy of the treatment. After the first course of mitomycin C administration, some decrease of conjunctival pigmentation was seen, and histological studies disclosed a lower degree of atypia. After the second application of mitomycin C, the pigmentation disappeared except for one small spot that contained only a few typical melanocytes on histological study. The clinical findings did not change during 7 months of follow-up. No adverse reactions to topical mitomycin C occurred except for mild conjunctival hyperemia at the end of the courses of treatment. Administration of topical mitomycin C may be an effective medical treatment for primary acquired melanosis with atypia.

Administration, Topical↗
PubMed1996

Efficacy of iontophoresis in the rat cornea.

BACKGROUND: Iontophoresis can enhance penetration of drugs into tissues. We examined the extent of penetration of gentamicin into the cornea of rats during iontophoresis and the effect of varying the concentrations of gentamicin, the duration of iontophoresis and the current densities during iontophoresis. METHODS: Eight groups of rats underwent corneal iontophoresis using gentamicin dissolved in agar. Low and high concentrations of gentamicin were used, as well as low and high current densities and long and short durations of iontophoresis. Control groups received topical or subconjunctival gentamicin, topical saline solution and mock iontophoresis with the agar-gentamicin mixture. The Mann-Whitney test was used for statistical evaluation. RESULTS: Highly bactericidal concentrations of gentamicin were obtained in all the iontophoresis-treated corneas. The high concentration compared to the low concentration of gentamicin in agar significantly increased the concentration of gentamicin in the corneas, as did the longer duration of iontophoresis. However, higher current intensity did not significantly enhance the drug concentration in the cornea. CONCLUSION: Iontophoresis with a concentrated gentamicin-agar mixture may provide a rapid increase of gentamicin levels in the cornea.

Absorption↗
PubMed1996

Bilateral simultaneous corneal graft rejection after influenza vaccination.

PURPOSE: To treat a patient with bilateral simultaneous corneal graft rejection after influenza vaccination. METHODS: The patient received topical, subconjunctival, and systemic corticosteroids. RESULTS: The corneal grafts cleared after administration of corticosteroids. CONCLUSION: Ophthalmologists should be aware of the possibility of corneal graft rejection after influenza vaccination.

Administration, Topical↗
PubMed1996

Intraoperative application of topical mitomycin C for pterygium surgery.

BACKGROUND: Postoperative recurrence of pterygium occurs in many patients. The authors studied the recurrence rate of pterygium after administration of a single intraoperative dosage of topcial mitomycin C at the completion of pterygium excision. METHODS AND PATIENTS: Eighty-one patients underwent excision of the pterygium, leaving the sclera bare. The first 60 patients were randomized into two treatment groups of 30 patients each. Their remaining 21 patients were offered mitomycin C. Group 1 included 49 patients (30 randomized and 19 of the remaining 21 patients) who received an intraoperative application of 0.02% (0.2 mg/ml) mitomycin C for 5 minutes, and group 2 included 32 patients (30 randomized and 2 of the remaining 21 patients) who received NaCl 0.9% instead of mitomycin C. Patients were followed from 12 to 28 months in a masked manner. RESULTS: The pterygium recurred in 2 (4%) of 49 patients in group 1 and in 15 (46.7%) of the 32 patients in group 2 (P = 0.0001). A delay of epithelialization for 5 and 10 weeks occurred in two patients in group 2 and granuloma manifested in one patient in group 1. CONCLUSION: This study indicates that intraoperative administration of a single dosage of 0.02% mitomycin C is an effective treatment for prevention of recurrence of pterygium.

Administration, Topical↗
PubMed1996

Vinblastine toxicity to the ocular surface.

Local ocular exposure to antineoplastic drugs occurs either during regular use of some of these drugs in ophthalmology or accidentally during the general use of these drugs. Many ocular side effects have been described after such intentional or accidental exposures. We describe a case of accidental ocular trauma by vinblastine. As in one of the only two previously published cases of ocular trauma by vinblastine, our patient showed acute keratopathy with a drop in visual acuity followed by the development of dry eyes and a subepithelial corneal scar. In addition, in an attempt to further evaluate the clinical course and the benefits of steroid treatment, nine rabbits were studied after ocular instillation of vinblastine. After the trauma, local steroid treatment was given in one eye of each rabbit; the second eye served as a control. The animal studies showed acute conjunctivitis and keratopathy with increasing severity in the first days and improvement thereafter. That course was similar to the one manifested in our patient. Local steroid treatment in the rabbit eye had no effect as compared with the control group. A possible mechanism for the induction of dry eyes is discussed.

Accidents, Occupational↗
PubMed1995

Efficacy of topical gentamicin treatment after 193-nm photorefractive keratectomy in an experimental Pseudomonas keratitis model.

BACKGROUND: The treatment of Pseudomonas keratitis has many limitations, and further investigation to identify more effective approaches is required. We therefore studied the possible contribution of the debridement effect of 193-nm excimer laser on Pseudomonas keratitis in rabbit eyes. METHODS: Pseudomonas keratitis was induced in 30 rabbit eyes by inflicting controlled central corneal scratches and applying a drop of Pseudomonas aeruginosa suspension. After 24 h, one cornea of each animal was photo-ablated (excimer laser: fluency 90 mJ/cm2, 10 Hz, 213 pulses), yielding 50 microns of tissue ablation, while the follow cornea served as control. Five groups of six animals each were formed and received: a subconjunctival injection of gentamicin 20 mg (group 1), topical 14 mg/ml gentamicin hourly (group 2) or every 2.5 h (group 3), or NaCl 0.9% hourly (group 4) for 8 h. In group 5, animals were sacrificed without additional treatment. After 9 h corneas were excised, homogenized, serially diluted, and plated on agar blood plates. The numbers of colony-forming units (CFU) per cornea were statistically evaluated (Mann-Whitney test). RESULTS: In control eyes, a greater decrease of CFU was observed in group 2 than in group 3 (P = 0.03). In laser-ablated eyes, there was no difference in CFU between groups 2 and 3. Comparison of the excimer-treated and control eyes revealed a greater number of bacteria (CFU) in controls only in group 3 (P = 0.02). CONCLUSION: Our study suggests that controlled debridement of cornea with excimer laser may improve the effect of topical antibiotics.

Administration, Topical↗
PubMed1995

Visual outcome following traumatic wound dehiscence after cataract surgery.

We reviewed the charts of 21 patients who had cataract surgery and subsequent ocular trauma with wound dehiscence. Eighteen patients were re-examined for this study; the other three were lost to follow-up. A complete examination of both eyes was performed 3 to 84 months after the trauma occurred. Patients were assigned to one of two groups: Group A, minor trauma (n = 14), or Group B, major trauma (n = 7). In Group A, visual acuity was 20/40 or better in four patients, 20/50 to 20/80 in five patients, and 20/300 or worse in three patients. In Group B, visual acuity was 20/60 or better in three patients and 20/300 or worse in three patients. Poor visual acuity was associated with endophthalmitis and bullous keratopathy in Group A and globe rupture or recurrent retinal detachment in Group B. In 14 of the 18 patients, final visual acuity in the traumatized eye was similar to that in the fellow eye, which had the same ocular pathology. This study suggests that pre-existing ocular disease is an important factor in final visual outcome in patients with traumatic wound dehiscence after cataract surgery.

Adolescent↗
PubMed1994

Mitomycin C therapy for corneal intraepithelial neoplasia.

We treated three patients who had intraepithelial neoplasia involving the visual axis and a subsequent decrease of visual acuity with topical mitomycin C 0.02% four times daily for ten to 22 days. In two of the three cases, the intraepithelial neoplasia was histologically confirmed. The intraepithelial neoplastic lesion was replaced by biomicroscopically normal epithelium within nine weeks of the beginning of drug administration and did not recur during the four to 12 months of follow-up. Adverse reactions to topical mitomycin in two patients ranged from minimal conjunctival hyperemia after 14 days to marked hyperemia, ocular pain, and blepharospasm after 22 days. These signs and the symptoms, however, disappeared after the drug was discontinued. Administration of topical mitomycin C 0.02% for two weeks may be an effective treatment for corneal intraepithelial neoplasia that affects the visual axis.

Administration, Topical↗