Biomedical subjects

Joseph Frucht-Pery

Publications and source records attributed to Joseph Frucht-Pery.

18 recordsLinked to original sources

PubMed2006

Conjunctival autografting combined with low-dose mitomycin C for prevention of primary pterygium recurrence.

PURPOSE: To compare the clinical outcome of pterygium surgery combining intraoperative mitomycin C (MMC) with a free conjunctival autograft, with three other methods of pterygium surgery, including intraoperative MMC alone, conjunctival autograft alone, and bare sclera without adjunctive treatment. DESIGN: Interventional, randomized and in part nonrandomized, prospective, comparative study. METHODS: setting: A university medical center department of ophthalmology. STUDY POPULATION: One hundred and twenty patients underwent pterygium excision surgery. These patients were divided into four treatment groups. INTERVENTION: In group 1 (30 patients), MMC, 0.2 mg/ml, was applied for three minutes. In group 2 (30 patients), conjunctival autografting was performed. Group 3 (30 patients) received sodium chloride 0.9% only, and group 4 (30 patients) underwent conjunctival autografting combined with one minute application of MMC, 0.2 mg/ml. MAIN OUTCOME MEASURE: Recurrence rates and complications. RESULTS: Pterygium recurred in two patients (6.6%) in group 1, in four patients (13.3%) in group 2, in 14 patients (46.6%) in group 3, and in none of the patients in group 4. chi(2) analysis revealed a significantly lower recurrence rate in group 4 compared with group 2 (P = .038) and with group 3 (P < .0001). Epithelialization of the wounds was complete within 14 days of surgery. No complications were demonstrated in any of the study groups except for one case of minor melting of the flap in group 4. CONCLUSIONS: This study indicates that pterygium excision with a free conjunctival autograft combined with intraoperative low-dose MMC is a safe and effective technique in pterygium surgery.

Adult↗

PubMed2006

Iontophoretic treatment of experimental pseudomonas keratitis in rabbit eyes using gentamicin-loaded hydrogels.

PURPOSE: To evaluate the efficacy of iontophoresis using a hydrogel probe containing gentamicin for the treatment of Pseudomonas keratitis in the rabbit cornea. METHODS: Five groups (Groups 1-5) of 8 rabbits each were infected by injecting Pseudomonas aeruginosa into their corneas. Three dosings of corneal iontophoresis were performed, at intervals of 3.5 hours, using soft disposable gentamicin-loaded hydroxyethyl methacrylate hydrogel discs mounted on a portable iontophoretic device. Groups 1 and 2 were treated with corneal iontophoresis for 60 seconds and a current of 0.5 and 0.2 mA. Groups 3 and 4 were treated with hydrogel loaded with 0.9% NaCl solution, using a current of 0.2 mA and mock iontophoresis. Group 5 was treated with eye drops of 1.4% gentamicin every hour for 8 hours. One and a half hours after the last treatment, the animals were killed, and the corneas were excised and cultured for P. aeruginosa count after 24-hour incubation. RESULTS: After iontophoretic treatment of gentamicin with a current of 0.5 mA (Group 1), the logarithmic value of Pseudomonas colony-forming units (CFUs) was 2.96 +/- 0.45. After lower current iontophoretic treatment (Group 2), the logarithmic Pseudomonas count was 5.25 +/- 0.54 CFUs. At the control groups (Groups 3-5), the Pseudomonas counts were found to be much higher, 7.62 +/- 0.28, 7.22 +/- 0.29, and 6.29 +/- 0.45 CFUs, respectively. CONCLUSION: A short iontophoretic treatment using gentamicin-loaded hydrogels has potential clinical value in treating corneal infections.

Animals↗

PubMed2005

Transcorneal and transscleral iontophoresis of dexamethasone phosphate using drug loaded hydrogel.

PURPOSE: To evaluate dexamethasone penetration to the eye after a short transcorneal and transscleral iontophoresis using a drug loaded hydrogel assembled on a portable iontophoretic device. METHODS: Iontophoresis of dexamethasone phosphate was studied in healthy rabbits using drug loaded disposable HEMA hydrogel sponges and portable iontophoretic device. Corneal iontophoretic administration was performed with a current intensity of 1 mA for 1 and 4 min. Transconjunctival and transscleral iontophoresis were performed twice for 2 min at two near places in the pars-plana area, on the conjunctival membrane or directly on the sclera. Dexamethasone concentrations were assayed using HPLC. RESULTS: Dexamethasone levels in the rabbit cornea after a single transcorneal iontophoresis for 1 min were up to 30 fold higher compared to those obtained after frequent eye drop instillation. Also, high drug concentrations were obtained in the retina and sclera 4 h after transscleral iontophoresis. CONCLUSIONS: A short low current non-invasive iontophoretic treatment using dexamethasone-loaded hydrogels has potential clinical value in increasing drug penetration to the anterior and posterior segments of the eye.

Animals↗

PubMed2005

The treatment of primary acquired melanosis (PAM) with atypia by topical Mitomycin C.

PURPOSE: To report our results of 12 consecutive patients with conjunctival primary acquired melanosis (PAM) with atypia who were treated by topical Mitomycin C (MMC). DESIGN: Retrospective interventional consecutive case series. METHODS: Twelve patients with PAM with atypia in one of their eyes who were treated by topical chemotherapy with MMC were included in this case study. Eyes with histologically proven PAM with atypia were treated by two to five courses of 0.04% (0.4 mg/ml) MMC four times a day. Each course lasted 2 continuous weeks. Follow-up was conducted on patients for control of local disease, side effects, and visual acuity in the treated eye. RESULTS: In all patients, there was complete or partial response to treatment. In four patients, the pigmentation disappeared, whereas in eight patients, some remnants of the pigmentation remained. In seven of these eight patients, the remnants of the pigmentation were stable during the follow-up period of 4 months to 9 years, whereas one in whom re-growth of the PAM was noticed was successfully treated again by topical MMC. No patients lost visual acuity at the end of the follow-up. All side effects of the local chemotherapy were resolved after cessation of the treatment. CONCLUSIONS: Topical MMC chemotherapy is a good alternative to surgical excision and cryotherapy in treating conjunctival PAM with atypia.

Administration, Topical↗

PubMed2005

Forty years of changing indications in penetrating keratoplasty in Israel.

PURPOSE: To examine the leading indications for keratoplasty and identify the changing trends in the past 40 years in Israel. METHODS: Pathology reports of all penetrating keratoplasties (PKPs) performed at Hadassah-Hebrew University Hospital from 1961 to 2000 were reviewed. We evaluated the indications for keratoplasty in each decade between the years 1961 and 2000. RESULTS: During the 40-year period, a total of 1681 PKPs were performed. Keratoconus (n = 478, 28.4%) was the most common indication, followed by graft failure (n = 226, 13.4%), pseudophakic corneal edema (PCE) (n = 142, 8.4%), herpetic infections (n = 125, 7.4%), nonherpetic infections (n = 114, 6.8%), scarring (n = 113, 6.7%), and trauma (n = 110, 6.5%). The 7 groups account for approximately 77.5% of all keratoplasties performed. Ocular infections were the most common indications before 1970 and have been declining ever since. Keratoconus became the leading indication in the past 30 years. In the past decade, of 663 keratoplasties, keratoconus was the most common indication (56, 38.6%) followed by graft failures/rejections and PCE (the second most common indication between the years 1981 and 1990). CONCLUSIONS: Keratoconus was the leading indication for keratoplasty in our series. There was a decreasing trend in PK for ocular herpetic infections during the decades. The rate of PCE decreased while failed graft became the second most common indication for PKP during the past decade.

Cornea↗

PubMed2005

Increased expression of inflammatory cytokines and matrix metalloproteinases in pseudophakic corneal edema.

PURPOSE: To evaluate the expression of inflammatory cytokines and matrix metalloproteinases in the corneal epithelium in pseudophakic corneal edema (PCE). METHODS: Tissue sections were prepared from formalin-fixed, paraffin-embedded blocks of corneal buttons removed from 20 patients with PCE during penetrating keratoplasty (PKP) and from 11 age-matched control eyes enucleated because of uveal melanoma. Expression of interleukin (IL)-1beta, -6, and -8; vascular endothelial growth factor (VEGF); and matrix metalloproteinase (MMP)-1, -3, and -9 proteins in the corneal epithelium was evaluated by immunohistochemistry. Digital image analysis was performed to quantify the expression of the various cytokines and MMPs. A mean intensity stain index (ISI), based on the staining density and the area stained, was calculated from digital images captured from sequential areas of the corneal epithelium. RESULTS: The expression of most of the inflammatory cytokines and MMPs was significantly higher in the corneal epithelium of PCE corneal buttons than in the control specimens. MMP-9 had the highest expression when compared with the control (ISI = 55.08 +/- 23.71 in PCE compared with 0.169 +/- 0.156 in the control; P < 0.0001). Significantly higher ISIs were also recorded for MMP-1 (16.14 +/- 8.49 vs. 1.13 +/- 1.79; P < 0.0001), IL-1beta (62.62 +/- 27.23.97 vs. 1.61 +/- 1.27; P < 0.0001), IL-8 (37.91 +/- 21.18 vs. 4.24 +/- 3.60; P < 0.0001), and VEGF (81.67 +/- 26.22 vs. 19.40 +/- 16.85; P = 0.0001). The expression of MMP-3, IL-6, and TNF-alpha in PCE was not different from control expression. Significant positive correlations were found between the expression of IL-1beta and MMP-9 (r(2) = 0.37; P = 0.015), between VEGF and IL-8 (r(2) = 0.22; P = 0.042), and a significant correlation was found between the expression of MMP-3 and TNF-alpha (r(2) = 0.5197; P = 0.0007). The expression of TNF-alpha correlated significantly with the patient's age (r(2) = 0.28; P = 0.0195). CONCLUSIONS: The corneal epithelium in PCE expresses high levels of cytokines and matrix-degrading enzymes, which are associated with inflammation, wound healing, angiogenesis, and tissue degradation. The expression of these mediators may partially explain the pathologic features associated with this disease, such as bulla formation, recurrent epithelial desquamation, and corneal neovascularization.

Adult↗

PubMed2004

Long-term effects of mitomycin C in pterygium surgery on scleral thickness and the conjunctival epithelium.

PURPOSE: To evaluate the long-term effects of intraoperative application of mitomycin C on the scleral thickness and the conjunctival epithelium at the surgical site of pterygium excision. DESIGN: Prospective observational case series. PARTICIPANTS: Twenty-four patients who underwent excision of primary pterygium with intraoperative mitomycin C in our department during the year 1996. METHODS: Patients were evaluated by slit-lamp biomicroscopy, impression cytology, and high-frequency ultrasonography. Impression cytology was performed by applying a small nitrocellulose filter paper for a few seconds at the excision area and for a few seconds at the opposite perilimbal area, and subjecting the specimens to the periodic acid-Schiff-Gill modified Papanicolaou staining protocol. The morphology of the conjunctival epithelium and goblet cell density (GCD) were recorded. High-frequency ultrasound was performed at the same sites, and the scleral thickness was measured at a distance of 1 mm from the limbus. MAIN OUTCOME MEASURES: Goblet cell density, conjunctival epithelial morphology, and the scleral thickness at the operated and nonoperated sites. RESULTS: All patients had successful pterygium removal with no corneal recurrence after a mean follow-up of 77.2+/-3.9 months (range, 72-84). Impression cytology revealed normal nongoblet conjunctival epithelial cells at the excision area, with a 4-fold decrease in the GCD at the excision area when compared with the contralateral nonoperated site (296+/-120 cells/mm(2) and 1183+/-310 cells/mm(2), respectively; P = 0.0036). No differences were noted between the scleral thicknesses at the operated site (750+/-70 microm) and the opposite site (740+/-80 microm) (P = 0.84). CONCLUSIONS: A single application of mitomycin C after pterygium excision is not associated with reduction in scleral thickness more than 6 years postoperatively. The conjunctival epithelium retains its normal phenotype, with a marked reduction of the GCD.

Adult↗

PubMed2004

Iontophoresis-gentamicin delivery into the rabbit cornea, using a hydrogel delivery probe.

PURPOSE: To evaluate the efficacy of penetration of gentamicin into the cornea of rabbits using iontophoresis with a hydrogel-gentamicin containing probe. METHODS: Eight of 10 groups (groups 3-10) of 6 rabbits (one eye per rabbit), underwent corneal iontophoresis using soft stable hydroxyethyl methacrylate hydrogel discs (80% water content) loaded with gentamicin sulphate which were mounted on an iontophoresis probe. The studied current intensities were 0, 0.1, 0.3 and 0.6 mAmp, and the durations of iontophoresis were 10 and 60 sec. Two control groups received 1.4% topical drops of gentamicin every 5 min for 1 hr (group 1) or sub-conjunctival injection of 10 mg gentamicin (group 2). Following sacrifice, aqueous humour was taken, corneas were excised, and gentamicin concentration was determined in aqueous humour and cornea samples. RESULTS: Post-iontophoresis, the concentration of gentamicin in the corneas ranged from high (88.60 +/- 38.64 microg ml(-1)) to very low (0.10 +/- 0.89 microg ml(-1)). Both the control groups and those rabbits treated with current intensity of 0.1 mAmp or greater obtained therapeutic gentamicin levels in the corneas. Use of iontophoresis for 60 sec or current intensity greater than 0.1 mAmp obtained corneal gentamicin levels not different from sub-conjunctival injection. Application of current intensity of 0.1 mAmp or greater gave corneal gentamicin concentrations comparable to topical application of the drug, except when 0.6 mAmp were used for 60 sec (p = 0.05). Increasing current intensity or duration of iontophoresis significantly increased (p = 0.001 for both) gentamicin penetration into the cornea. Current intensity had more influence (Beta2 = 0.40) than duration (Beta2 = 0.13) on drug penetration. A significant interaction was found between the duration of iontophoresis and the current intensity. Very small or no concentrations of the drug were discovered in the anterior chambers of rabbits. CONCLUSIONS: Iontophoresis using hydrogel-gentamicin probe may deliver therapeutic concentrations of gentamicin into the cornea.

Animals↗

PubMed2004

Surgical management of corneal plaques in vernal keratoconjunctivitis: a clinicopathologic study.

PURPOSE: To describe the surgical management and histopathologic and immunohistochemical findings in corneal plaques of shield ulcers in vernal keratoconjunctivitis. PATIENTS AND METHODS: Three children (ages 4, 7.5, and 9) presented with corneal plaques unresponsive to conservative systemic and topical medical treatment. Plaques were scraped under general anesthesia, and soft bandage contact lenses were placed. The excised tissue was evaluated by histopathology and immunohistochemistry. RESULTS: During surgery, plaques were found to extend beyond the ulcer margins. Histopathology revealed granular, deeply-eosinophilic, laminar material, firmly attached to the Bowman layer in all cases. Immunohistochemistry confirmed this to be eosinophil-derived major basic protein (MBP). After surgical removal, complete epithelization was evident within 1-4 weeks in all cases. CONCLUSIONS: Corneal plaque is a rare complication of vernal keratoconjunctivitis. These plaques usually do not resolve with standard conservative measures. Failure to epithelialize may be a result of the plaque material extending below the edges of adjacent epithelium. We suggest that MBP plaques precipitate on the denuded stromal bed, thereby playing a pathogenic role in nonhealing shield ulcers.

Blood Proteins↗

PubMed2004

Hydrogel probe for iontophoresis drug delivery to the eye.

The aim of this study was to evaluate the use of a solid hydrogel loaded with a drug solution as a probe for ejecting drugs to the eye upon application of low current iontophoresis. Hydroxyethyl methacrylate (HEMA), cross-linked with ethylene glycol dimethacrylate (EGDMA), and cross-linked arabinogalactan or dextran were prepared to form solid hydrogels. The hydrogels were examined for their mechanical suitability, absorption of drug solution and in vitro release properties when applying an iontophoretic current through the drug-loaded hydrogel into a solid-agar surface. Transconjunctival and transscleral iontophoresis of gentamicin sulfate was studied in healthy rabbits using drug-loaded disposable HEMA hydrogel disc probes. Gentamicin concentrations in different eye segments were assayed using a fluorescence polarization immunoassay. Preliminary corneal toxicity was examined in rabbits using a current intensity of 2.5 and 5.1 mA/cm2 for 60 and 120 s. The most appropriate hydrogel is composed of HEMA, 2% EGDMA and 75% water. lontophoresis onto agar gel was found indicative for the evaluation of iontophoretic activity of a hydrogel. Transscleral iontophoretic treatment resulted in high concentrations of drugs in the posterior segments of the eye. Application of iontophoresis onto the rabbit eye caused a reversible swelling of the cornea which lasted a few hours after application. Low current iontophoresis using drug-loaded hydrogel has a potential clinical value in obtaining high drug concentration at posterior segments of the eye.

Animals↗

PubMed2004

Delivery of gentamicin to the rabbit eye by drug-loaded hydrogel iontophoresis.

PURPOSE: To assess the corneal iontophoretic delivery of gentamicin by drug-loaded hydrogel probe, and to determine the resultant ocular disposition and elimination of the drug from the cornea and anterior chamber. METHODS: Corneal iontophoresis of gentamicin sulfate was studied in healthy white rabbits by using drug-loaded disposable hydroxyethyl methacrylate (HEMA) hydrogel disk probes and a portable mini-ion device designed in the authors' laboratory. The iontophoretic treatment was performed with a current intensity of 1 mA for 60 seconds only. Three control groups were used: mock iontophoresis (no current) for 60 seconds, topical eye drops of fortified gentamicin (1.4%) every 5 minutes for 1 hour, and subconjunctival injection of 0.25 mL of 40 mg/mL gentamicin solution. The animals in the iontophoretic experimental groups were killed at predetermined time points. The gentamicin concentrations in the cornea and aqueous humor were assayed with a fluorescence polarization immunoassay. Analysis of the gentamicin eye pharmacokinetics was performed with a modeling approach. RESULTS: Peak gentamicin concentrations in the cornea (363.1 +/- 127.3 microg/g) and in the aqueous humor (29.4 +/- 17.4 microg/mL) were reached at 0 and 2 hours after the iontophoretic treatment, respectively. The peak gentamicin concentrations after a single iontophoresis treatment were 12 to 15 times higher than those obtained after gentamicin injection or after topical eye drop instillation, and much higher than in mock iontophoresis. The concentration versus time profile of gentamicin in the cornea and the anterior chamber after iontophoresis was appropriately described by applying a two-compartment pharmacokinetic model. CONCLUSIONS: A short iontophoretic treatment using gentamicin-loaded hydrogels has potential clinical value in increasing drug penetration to the anterior segments of the eye and maintaining therapeutic drug levels in the cornea for more than 8 hours.

Animals↗

PubMed2003

To lift or recut: changing trends in LASIK enhancement.

PURPOSE: To report serious complications caused by recutting laser in situ keratomileusis (LASIK) flaps for enhancement and reconsider the current preferred method of LASIK enhancement. SETTING: Multiple surgeon practices. METHODS: This retrospective noncomparative nonconsecutive case series comprised LASIK patients in the private practices of 9 experienced refractive surgeons and those reported in a survey of refractive surgeons. Case histories, refractions, corneal topographies, slitlamp photographs, and measurements of uncorrected and best corrected (BCVA) visual acuity after recutting LASIK flaps were collected. Surveys of refractive surgeons and an analysis of changing practice trends among the authors and these surgeons were assessed. RESULTS: In 12 cases, significant loss of BCVA and subjective visual difficulties resulted from recutting LASIK flaps. Most surveyed surgeons had changed their practice from recutting to lifting flaps even 9 to 10 years postoperatively with good results. CONCLUSION: Recutting flaps for enhancement should be avoided unless other alternatives are unavailable.

Adult↗

PubMed2003

Inadvertent conjunctival trauma related to contact with drug container tips: a masquerade syndrome.

PURPOSE: To report the diagnosis, clinical course, and management of acute painful red eye syndrome associated with unintentional tube- or bottle-tip-induced conjunctival trauma. DESIGN: A small, noncomparative, interventional case series. PARTICIPANTS: Twelve eyes of 12 patients (8 female and 4 male, aged 21-84 years) who were urgently reported or referred with a variety of diagnoses resulting from acute onset of red, painful eye. Four eyes had corneal transplants, two were recovering from herpetic keratitis, two had undergone cataract surgery or a laser in situ keratomileusis procedure, one had a corneal neurotrophic ulcer, and one used a contact lens. All the patients had received new medications (ophthalmic ointments in nine patients, topical drops in three patients) within 1 week before onset of symptoms. INTERVENTION: Assessment of method of self-administration of topical medication, evaluation of the ocular surface lesion, and patient education. MAIN OUTCOME MEASURES: Association of patient behavior with ocular surface lesions. RESULTS: All 12 patients presented red, painful eyes, congested lower palpebral conjunctiva, epithelial conjunctival erosions, and episcleritis. In all patients, direct contact of the tube or bottle-tip with the affected area of the conjunctiva was ascertained by inspection. Instructions on proper method of drug administration and eye patching with lubrication were followed, within 2 weeks, by healing of conjunctival lesions. CONCLUSIONS: Drug containers may cause nonintentional conjunctival trauma and simulate severe ocular disorders. Physicians should be aware of this diagnosis in any case of prolonged and unexplained ocular irritation and should instruct patients as to the proper instillation of topical ophthalmic medications.

Acute Disease↗

PubMed2003

Long-term evaluation of hyperopic laser in situ keratomileusis.

PURPOSE: To evaluate the efficacy, safety, and predictability of hyperopic laser in situ keratomileusis (H-LASIK). SETTING: Departments of Ophthalmology, Hadassah University Hospital, Jerusalem, and Assaf Harofeh Medical Center, Zerifin, Israel. METHODS: This prospective noncomparative case series studied the results of H-LASIK in the first 92 consecutive eyes of 50 patients with up to +10.25 diopters (D) of hyperopia. For analysis, the patients were divided into 3 groups based on preoperative hyperopia: low hyperopia (< +3.00 D), moderate hyperopia (> or = +3.00 to 6.00 D), and high hyperopia (> or = +6.00 D). RESULTS: Forty-two patients, 77 eyes (83.7%), were followed for at least 12 months. At 12 months, the mean manifest spherical equivalent was +0.33 +/- 0.65 D (93.1% of eyes within +/-1.0 D of the intended correction) in the low myopia group, +0.21 +/- 0.60 D (92.3% within +/-1.0 D of the intended correction) in the moderate hyperopia group, and +1.62 +/- 1.50 D (36.4% within +/-1.0 D of the intended correction) in the high hyperopia group. The uncorrected visual acuity (UCVA) was 20/40 or better in all eyes (100%), 24 eyes (92.3%), and 13 eyes (59.1%) in the low, moderate, and high hyperopia groups, respectively. Comparing the UCVA at the last examination with the best corrected visual acuity (BCVA) before surgery in all patients showed that 59 eyes (76.6%) were within +/-1 line and 18 eyes (23.4%) were within +/-2 or more lines of the preoperative BCVA. Three eyes (3.9%) in the high hyperopia group lost 2 or more lines of BCVA. Three eyes (3.9%) had flap- related complications. Eight patients (15 eyes) with a follow-up less than 12 months did not have intraoperative or postoperative complications. CONCLUSION: Laser in situ keratomileusis was a safe, effective, and predictable procedure for hyperopia up to +6.0 D and less predictable for higher hyperopia.

Adult↗

PubMed2002

Anterior ischemic optic neuropathy after a trans-Atlantic airplane journey.

PURPOSE: To report a case of anterior ischemic optic neuropathy after a trans-Atlantic airplane journey. DESIGN: An observational case report. METHODS: A 48-year-old healthy man presented with severe visual loss in his left eye within 12 hours after a 15-hour-long trans-Atlantic airplane flight. The patient underwent slit-lamp examination, funduscopy, fluorescein angiography, automated perimetry, and various blood examinations. RESULTS: Visual acuity was LE: 20/30, and a mild left eye relative afferent pupillary defect was noted. Funduscopic evaluation revealed an edematous optic disk in the left eye with a para-diskal retinal hemorrhage. Fluorescein angiography revealed a leaking optic disk, and perimetry showed an inferior hemi-field scotoma. Anterior ischemic optic neuropathy was diagnosed. CONCLUSION: Prolonged airplane travel may compromise vision either by a thromboembolic mechanism caused by prolonged immobilization or by a vasospasm mechanism induced by the low oxygen pressure during the flight.

Aerospace Medicine↗

PubMed2002

Topical mitomycin-C for partially excised conjunctival squamous cell carcinoma.

PURPOSE: To evaluate the efficacy of topical mitomycin-C (MMC) for treatment of postoperative residual conjunctival squamous cell carcinoma (SCC). DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Five patients, two males and three females, with conjunctival and histologically proven incompletely excised conjunctival SCC. METHODS: Patients were treated with topical MMC. Two to three courses of topical MMC, 0.02% or 0.04%, were applied four times daily for 14 days per course. One month after the final treatment, the scar area with surrounding normal conjunctiva was excised, and histologic evaluation was done. MAIN OUTCOME MEASURES: No evidence of malignant cells in excised tissues. RESULTS: Histologic evaluation of the five specimens showed no malignant cells. Conjunctival scarring with inflammatory response was observed. No regrowth was reported during the follow-up period of 18 to 37 months. The complications of MMC use included mild to moderate conjunctival hyperemia in three patients. All signs and symptoms were resolved after discontinuation of the treatment. CONCLUSIONS: Application of topical MMC is an efficient treatment for residual conjunctival SCC. Longer follow-up is required to confirm these findings.

Administration, Topical↗

PubMed2002

Intraocular pressure after LASIK for hyperopia.

PURPOSE: To determine whether hyperopic laser in situ keratomileusis (H-LASIK) affects Goldmann applanation tonometry measurements. DESIGN: Retrospective, comparative, self-controlled case series. PARTICIPANTS: One hundred eight eyes of 58 patients were enrolled in the study. METHODS: Baseline intraocular pressure (IOP) was measured by Goldmann applanation tonometry. These readings were compared with readings obtained at least 6 months after surgery. RESULTS: After H-LASIK, a decrease was observed in the measured IOP of treated eyes that could not be related to the degree of hyperopia treated or to the treatment zone diameter. A significant difference was observed between the IOP before and after surgery (P < 0.00001). CONCLUSIONS: The applanation tonometer underestimates the true IOP after LASIK for hyperopia.

Adult↗

PubMedDate not supplied

Two cases of pneumococcal keratitis following myopic LASIK.

PURPOSE: To report two cases of pneumococcal keratitis after LASIK. METHODS: Retrospective interventional small case series of two patients who underwent bilateral LASIK for myopia and developed pneumococcal keratitis after surgery. This complication was encountered 2 days after surgery in one eye in both cases. The corneal flap was lifted, and irrigation and cultures from the stromal bed performed. Topical and subconjunctival antibiotics were started. RESULTS: Culture revealed Streptococcus pneumoniae in both cases. The infiltrates responded well to treatment. One year after the procedure, uncorrected visual acuity is > 20/40 in both cases. CONCLUSIONS: Pneumococcal keratitis can complicate LASIK. Patients should be informed of this potential complication, as prompt treatment is crucial.

Adult↗