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Biomedical subjects

William Trattler

Publications and source records attributed to William Trattler.

7 recordsLinked to original sources
PubMed2006

Self-reported compliance with topical cyclosporine emulsion 0.05% and onset of the effects of increased tear production as assessed through patient surveys.

BACKGROUND: Keratoconjunctivitis sicca is a common eye condition characterized by itchiness, redness, and dryness due to a lack of tear production or abnormalities in the tear film. Cyclosporine works to increase the production of natural tears, which contain nutrients and proteins not found in artificial tears. OBJECTIVE: The purpose of this report was to assess the association between self-reported compliance with topical cyclosporine 0.05% emulsion and the onset of effects of increased tear production in patients with dry eye. METHODS: Practicing physicians were asked to identify patients for whom treatment with cyclosporine was appropriate and who were willing to participate in the study. Patients who agreed to participate were given medication samples and study materials. The participants were asked to respond to automated survey questions before they used cyclosporine and 30 and 60 days after initiating cyclosporine. Participants were asked how frequently they used the medication, how rapidly their symptoms were relieved, and whether they intended to continue using cyclosporine. RESULTS: Of the 5367 patients initially enrolled in the study, 3145 (59%) patients completed the baseline and 60-day follow-up surveys. The mean age of the participants was 60 years; 2677 (85%) of them were women, and 468 (15%) were men. Compliance with cyclosporine therapy was reported as follows: 2477 (79%) participants said they used cyclosporine twice daily as prescribed by their physicians, 468 (15%) reported missing some doses of cyclosporine, and 189 (6%) reported missing -50% or > or = 50% of the doses. The effects of increased tear production were reported to occur significantly sooner in participants who complied with cyclosporine treatment as prescribed than in those who did not comply with treatment (P < 0.01). Among those who complied with treatment, 1822 (73%) participants reported experiencing the effects of increased tear production in < 5 weeks compared with 468 (70%) participants who did not comply with treatment. Overall, the mean rate of satisfaction with cyclosporine was 7.5 on a scale from 0 (not at all satisfied) to 10 (very satisfied). Participants who reported using cyclosporine twice daily as prescribed gave satisfaction with cyclosporine a mean rating of 7.7 compared with 7.3 given by those who missed some doses and 5.3 from those who missed approximately 50% or > or = 50% of the doses (P < 0.01). An intention to continue using cyclosporine was reported by 2611 (83%) participants. CONCLUSION: The results of this study in participants using cyclosporine for dry eye in an actual-practice setting suggest an association between patient-reported compliance with medication and more rapid onset of the effects of increased tear production.

Adult↗
PubMed2006

Pupil size and corneal laser surgery.

PURPOSE OF REVIEW: The role of scotopic pupil size as a factor in predicting night vision complaints is controversial. This review summarizes reports in the literature, some that have found and some that have failed to find a correlation with scotopic pupil size and night vision complaints. RECENT FINDINGS: Pupil-measuring devices are discussed along with informed consent issues and reports showing that wavefront aberrations increase with increasing pupil size. A new objective measuring device (Larson) showed a correlation with postoperative starbursts and pupil size and a decrease in starbursts with wavefront-guided treatments compared with conventional excimer laser treatments. Cortical adaptation allows many patients to adapt to their new night vision. Treatment options for those who remain symptomatic include drops to reduce pupil size and wavefront-guided retreatments. SUMMARY: Reports in the literature are conflicting, and refractive surgeons would be wise to inform their patients that large scotopic pupil size is a potential risk factor for night vision complaints. By doing this they will follow the recommendations in recent patient information brochures of both VISX (Santa Clara, California) and Alcon (Orlando, Florida) and on the United States Food and Drug Administration web site.

Cornea↗
PubMed2005

Lipid tear deficiency in persistent dry eye after laser in situ keratomileusis and treatment results of new eye-warming device.

PURPOSE: To determine whether lipid tear deficiency is a significant pathogenic factor in persistent dry eyes after laser in situ keratomileusis (LASIK). SETTING: Ocular Surface Center, Miami, Florida, USA. METHODS: Thirty-four eyes of 17 patients (mean 46.35 years +/- 11 [SD]) complaining of persistent dryness more than 12 months after LASIK were prospectively studied by symptom scoring and kinetic analysis of tear interference image, tear breakup time, and fluorescein clearance test. Once patients had been clear of inflammation and treated for aqueous tear deficiency, lipid tear deficiency was further confirmed and treated with Eyefeel (Kao, Inc.), an eye-warming device, 4 times daily for 4 weeks. RESULTS: Sixteen patients were asymptomatic before LASIK but dryness persisted for 41 +/- 19.3 months. Delayed tear clearance was observed in 15 patients (88.2%) and floppy lids in 12 patients (70.5%). Aqueous tear deficiency was reconfirmed in 16 eyes (53.3%). After Eyefeel treatment, there was a subjective improvement of ocular surface diseases index from 60.6 +/- 10.6 to 25.8 +/- 18.5 (P = .0007). Tear breakup time was improved from 2.4 +/- 3.9 seconds to 7.9 +/- 3.6 seconds (P = .004). There was a tear interference pattern change from a vertical lipid tear deficiency to a horizontal normal in 7 eyes. There was a mean lipid spread time improvement from 1.3 +/- 0.4 sec to 0.8 +/- 0.4 sec (P = .001), and there was a mean lipid thickness improvement from 63.5 +/- 23 nm to 79.5 +/- 27 nm (P = .04). CONCLUSION: Persistent nature of dry eye after LASIK is attributed to in part to delayed tear clearance, undercorrected aqueous tear deficiency, and nonrecognized lipid tear deficiency.

Adult↗
PubMed2005

A comparison of therapeutic regimens containing moxifloxacin 0.5% ophthalmic solution and gatifloxacin 0.3% ophthalmic solution for surgical prophylaxis in patients undergoing LASIK or LASEK.

The purpose of these two studies was to compare the safety and tolerability of moxifloxacin 0.5% ophthalmic solution and gatifloxacin 0.3% ophthalmic solution for use with laser-assisted in situ keratomileusis (LASIK) and laser-assisted subepithelial keratomileusis (LASEK) patients. Treatment with the two antibiotic regimens was randomly assigned to fellow eyes of each patient. The LASIK study showed no difference between the two therapies in terms of visual acuity, pupil size, SPK, edema, haze, day- and nighttime glare, halos, clarity of day or night vision, and dry eye symptoms up to 1 week after surgery. Patients reported no preference between the two antibiotics on the basis of ease of use, irritation, redness, itching, gritty, sandy or scratchy feeling, speed of recovery, overall vision, or overall comfort up to 7 days after LASIK surgery. Corneal healing after LASEK surgery was equivalent for the antibiotic regimens containing moxifloxacin 0.5% ophthalmic solution and gatifloxacin 0.3% ophthalmic solution. When comparing safety and tolerability, these findings suggest an equivalent role for these fluoroquinolone antibiotics in surgical prophylaxis.

Adult↗
PubMed2003

Effects of minocycline on the ocular flora of patients with acne rosacea or seborrheic blepharitis.

PURPOSE: To assess the effect of minocycline on the ocular flora in patients with acne rosacea or blepharitis. METHODS: A total of ten patients were enrolled in this prospective study, with six patients diagnosed with acne rosacea with concomitant meibomianitis, two patients with acne rosacea without concomitant ocular involvement, and two patients with seborrheic blepharitis. The eyelids and conjunctiva of both eyes were cultured before the initiation of systemic minocycline therapy, after 3 months of active therapy, and 3 months after the discontinuation of therapy. Isolated bacteria were identified and quantified, and antibiotic susceptibility was determined. RESULTS: The colony-forming units (CFU) isolated from the eyelids significantly decreased after a 3-month treatment with minocycline (P = 0.0013). The CFU significantly increased to approach that of the baseline with the discontinuation of minocycline (P = 0.0275). The most common isolated bacteria, including coagulase-negative Staphylococcus (CNS), Staphylococcus aureus (S. aureus), and Propionibacterium acne (P. acne), except for corynebacterium, had a significant decrease in bacterial count with minocycline therapy compared with baseline (P < 0.05). There was a trend in the decrease of bacterial CFU isolated from the conjunctiva with minocycline therapy, although this was not statistically significant (P = 0.1955). Four of the ten patients carried tetracycline-resistant CNS strains, but none of the S. aureus or P. acne isolated at baseline was resistant to tetracycline. All six patients with acne rosacea and concomitant meibomianitis had marked clinical improvement. CONCLUSION: Minocycline effectively decreased eyelid bacterial flora in patients with acne rosacea or blepharitis. One of the mechanisms of newer generation tetracycline analogues may be a decrease or elimination of bacterial flora from the eyelids.

Anti-Bacterial Agents↗