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Biomedical subjects

T Wygnanski-Jaffe

Publications and source records attributed to T Wygnanski-Jaffe.

7 recordsLinked to original sources

The reculture technique: individualizing the treatment of Acanthamoeba keratitis.

PURPOSE: To assess the efficacy of three drugs in different concentrations against different strains of Acanthamoeba using the reculture technique. METHODS: Cysts and trophozoites were immersed in five separate solutions. The solutions administered included 0.1% and 0.02% polyhexamethylene biguanide (PHMB), 0.1% and 0.02% chlorhexidine, and propamidine isethionate (Brolene). Readings took place after 1, 5, and 24 hours. The cysts and trophozoites were then recultured for an additional period of 48 hours. An effective drug was defined as a medication that inhibited any growth of trophozoites using the reculture technique. RESULTS: Chlorhexidine at concentrations of 0.1% and 0.02% was the only effective drug against all five strains of Acanthamoeba examined, and no trophozoites were detected on plates immersed with this agent. Only 0.1% chlorhexidine was effective in destroying all cysts in the five strains examined. CONCLUSION: We found that 0.02% chlorhexidine was efficient in irradicating all trophozoites and 0.1% chlorhexidine was effective in eradicating all cysts in the samples we examined. Therefore, it may be possible that 0.02% chlorhexidine is a good initial treatment in amoebic keratitis. Sensitivity testing, then, may be performed using the reculture technique and specification of therapy can be made accordingly.

Acanthamoeba↗

Intraocular pressure increments after cataract extraction in glaucomatous eyes with functioning filtering blebs.

BACKGROUND AND OBJECTIVE: The effects of cataract extraction on intraocular pressure (IOP) were studied in glaucoma patients who had previously undergone trabeculectomy. PATIENTS AND METHODS: The files of 22 patients with 25 glaucomatous eyes with functioning filtering blebs who underwent cataract extraction were retrospectively reviewed. All patients had undergone pretrabeculectomy examination and had at least 18 months of follow-up after cataract surgery. Visual acuity, IOP, status of the filtering bleb, and the number of medications applied were recorded. RESULTS: The mean increase in IOP was 3.63 mm Hg, 3.84 mm Hg, 5.4 mm Hg, and 2.8 mm Hg at 3, 6, 12, and 18 months after cataract extraction, respectively. This elevation was statistically significant 3 months postoperatively (P < .001) and remained relatively constant thereafter. The postoperative IOP was still significantly lower than the pretrabeculectomy IOP (P < .001). CONCLUSIONS: Cataract extraction through corneal incisions in patients with functioning filtering blebs is followed by an increase in IOP. Cataract surgery in these patients does not neutralize the pressure-lowering effect achieved by the trabeculectomy, but it tends to elevate the post-trabeculectomy baseline pressure.

Aged↗

Strabismus surgery using the adjustable suture technique.

BACKGROUND AND OBJECTIVE: To determine the results of adjustable suture technique used in horizontal muscle surgery. MATERIALS AND METHODS: Seventy-eight charts of patients who underwent strabismus surgery between the years 1993 and 1995 were examined retrospectively. The study included 35 cases of esotropia (ET), and 43 cases of exotropia (XT). The results of strabismus surgery were measured and compared 1 day after adjustment; the final results between 6 and 24 months after the surgical procedure. RESULTS: Adjustment was required in 39% of all patients. The highest rate of adjustment was required in patients who underwent monocular surgery for XT (51%), and the lowest rate of adjustment was undertaken in patients who underwent monocular surgery for ET (16%). Mean changes in the angle of deviation between 1 day after surgery to the last follow up was 2.2 prism diopters (delta) (+/-11.2 delta) for cases of esotropia, and 4.6 delta (+/-8.7 delta) for exotropia. The most significant drift was found in patients with XT who underwent binocular surgery 6.8 delta (+/-0.9 delta) and the smallest drift was found in patients with ET who underwent binocular surgery 5.2 delta (+/-5.6 delta). CONCLUSION: Esotropic and exotropic patients have a tendency to drift towards their original deviation postoperatively. It is possible, therefore, that mild overcorrection in the early postoperative period will result in better long-term results.

Adolescent↗

Sclerotomy using needle puncture and subconjunctival injection of mitomycin C.

OBJECTIVE: To explore the possibilty of creating a temporary sclerotomy using a 26-gauge needle and sustaining its patency by injectiong 0.1 mL of 0.1 mg/mL of mitomycin C (MMC). ANIMALS AND METHODS: Twenty-four New Zealand white rabbits were randomized into 3 groups. In the test group, puncture was performed using 26-gauge needle penetrating the anterior chamber at the limbus, and 0.1 mg/mL MMC were injected subconjunctivally. In the control group, a puncture was performed in the same fashion and in the MMC group, MMC only was injected subconjunctivally. Intraocular pressure (IOP) was measured prior to surgery and at days 1, 3, 7, 10, 14, 21, and 28. RESULTS: The mean intraocular pressure in eyes that underwent puncture with application of MMC was significantly lower than the IOP in the eye at all measurements up to and including day 21. In the puncture group, pressure was significantly lower than in the fellow eye only at day 3. No significant pressure reduction was observed at any measurement interval in eyes treated with MMC only. CONCLUSION: This simple technique of subconjunctival puncture of the limbus combined with application of MMC was effective in lowering IOP in rabbits. This may serve to attain a temporary filter in patients who need strict short-term pressure control.

Animals↗