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At least 1,027 records · Page 57Linked to original sources
PubMed1988

[Intraocular penetration of ciprofloxacin after infusion and oral administration].

Thirty five patients (mean age: 70 years) undergoing cataract surgery or vitrectomy were perfused with ciprofloxacin (400 mg IV/for 1 hour) or received either a single, 2, 6 or 8 preoperative orale doses (750 mg each). The samples of serum, aqueous humor or vitreous fluid were taken simultaneously at 1, 2, 3, 4, 6, 9 or 12 hours after the last administration of antibiotic. The antibiotic concentrations were determined by microbiological techniques (using Bacillus subtilis ATCC 6633). Aqueous humor levels, after perfusion of 400 mg, were stable during 3 hours (mean: 0.22 mg/l); after a single oral dose of 750 mg were stable during 12 hours (mean: 0.18 mg/l) but were significantly lower than after multiple doses (up to 0.8 mg/l) which suggest accumulation in anterior chamber. In vitreous fluid, levels were elevated from one to six hours after the end of the perfusion (up to 0.4 mg/l). The levels are above the MIC 90 of enterobacteriaceae, and around the MIC 50 of Staphylococcus or Pseudomonas.

Administration, Oral↗
PubMedDate not supplied

Medical devices of the head, neck, and spine.

There are many medical devices used for head, neck, and spinal diseases and injuries, and new devices are constantly being introduced. Many of the newest devices are variations on a previous theme. Knowing the specific name of a device is not important. It is important to recognize the presence of a device and to have an understanding of its function as well as to be able to recognize the complications associated with its use. The article discusses the most common and important devices of the head, neck, and spine, including cerebrospinal fluid shunts and the Codman Hakim programmable valve; subdural drainage catheters, subdural electrodes, intracranial electrodes, deep brain stimulators, and cerebellar electrodes; coils, balloons, adhesives, particles, and aneurysm clips; radiation therapy catheters, intracranial balloons for drug installation, and carmustine wafers; hearing aids, cochlear implants, and ossicular reconstruction prostheses; orbital prostheses, intraocular silicone oil, and lacrimal duct stents; anterior and posterior cervical plates, posterior cervical spine wiring, odontoid fracture fixation devices, cervical collars and halo vests; thoracic and lumbar spine implants, anterior and posterior instrumentation for the thoracic and lumbar spine, vertebroplasty, and artificial disks; spinal column stimulators, bone stimulators, intrathecal drug delivery pumps, and sacral stimulators; dental and facial implant devices; gastric and tracheal tubes; vagus nerve stimulators; lumboperitoneal shunts; and temperature- and oxygen-sensing probes.

Adult↗
PubMed1994

Penetration of topically applied ciprofloxacin, norfloxacin, and ofloxacin into the aqueous humor.

PURPOSE: To determine the intraocular penetration of topically applied fluoroquinolone antibiotics into aqueous humor. METHODS: Thirty-two patients undergoing cataract extraction received either 0.3% ciprofloxacin, 0.3% norfloxacin, or 0.3% ofloxacin topical drops. The patients were given two drops 90 minutes preoperatively and two drops 30 minutes preoperatively. At the time of surgery, 0.1 ml aqueous fluid was aspirated from the anterior chamber and immediately stored at -70 degrees C. RESULTS: Concentrations of ciprofloxacin, norfloxacin, and ofloxacin were determined using a broth dilution bioassay. Morganella morganii with a known minimal inhibitory concentration was used to assay ciprofloxacin and norfloxacin levels. Salmonella enteritidis with a known minimal inhibitory concentration was used to assay ofloxacin levels. Topically applied ciprofloxacin achieved a mean aqueous level of 0.072 microgram/ml (range, 0.02-0.153 microgram/ml). One sample was below the sensitivity of the bioassay. Topical norfloxacin achieved a mean aqueous level of 0.0570 microgram/ml (range, 0.046-0.10 microgram/ml). Seven samples did not reach the sensitivity of the bioassay. Topical ofloxacin achieved a mean level in the aqueous humor of 0.338 microgram/ml (range, 0.078-0.625 microgram/ml). There was no statistically significant difference in intraocular aqueous humor levels of ciprofloxacin versus norfloxacin (P > 0.05). Topical ofloxacin achieved aqueous humor levels significantly higher than either ciprofloxacin or norfloxacin (P < 0.004). CONCLUSION: Of the currently available topical fluoroquinolone antibiotics, ofloxacin achieves the highest aqueous humor concentrations.

Administration, Topical↗
PubMed1977

No-touch technique for intraocular malignant melanomas.

Large variations in intraocular pressure occur during enucleation, scleral depression, 32P testing, and vigorous rubbing of an eye. Data from animal studies show that during a critical phase of an intraocular malignant melanoma, ocular massage significantly decreased longevity due to increased metastastic disease. We report "no-touch" technique to prevent tumor spread from occurring secondary to ocular manipulation during enucleation. This technique avoids IOP elevations above 50 mm Hg before freezing completely around the tumor, thereby preventing flow of fluid and blood to or from the tumor prior to the manipulation necessary for enucleation. Theoretically, the patient with an ocular tumor should be warned against vigorous rubbing of his eyes and hard lid squeezes or diagnostic techniques that elevate IOP. The ophthalmologist should perform enucleation with gentieness and avoid pressure on the globe. Patients who are being followed up with a suspected ocular tumor should be warned not to rub or vigorously squeeze their eyelids.

Animals↗
PubMed2004

Intraocular detection of Bartonella henselae in a patient with HLA-B27 uveitis.

Bartonella henselae uveitis was diagnosed in a 40-year-old woman with underlying HLA-B27 uveitis on the basis of immunodetection and molecular detection of the organism, a Marseilles genogroup and a CAL-1 genotype strain, in the vitreous fluid. This case illustrates that B. henselae should be included in the differential diagnosis of uveitis and the usefulness of immunodetection for rapid and specific diagnosis.

Adult↗
PubMedDate not supplied

Pseudophakic retinal detachment.

PURPOSE: Extracapsular cataract extraction and intraocular lens implantation have become a widespread surgical method in Hungary during the last 10 years. Consecutive pseudophakic retinal detachment cases show an increasing trend. METHOD: 27 patients with pseudophakic retinal detachment were observed during a 3-year period. Careful fundus examination was carried out with indirect ophthalmoscopy, slit-lamp biomicroscopy and ultrasonography. The surgical method of choice was a standard operation (scleral buckling, encircling bend, cryopexy and laser coagulation) as first approach, or, in cases of PVR pars plana vitrectomy with fluid-gas exchange or silicon oil implantation. When reoperation was required, standard methods and/or pars plana vitrectomy with silicon oil implantation was applied. RESULTS: 17 out of 27 retinas reattached. Reoperation was necessary in 10 cases. Standard method failed in 8 out of 17 cases. Vitrectomy was successful in nine out of 17 cases. CONCLUSION: Pseudophakic retinal detachment often produces diagnostic difficulties: smell, undilatable pupils, capsular fibrosis, slightly decentred intraocular lens inhibit detection of tears. In these cases vitrectomy is recommended as first surgical approach. In severe cases removal of the intraocular lenses should be considered.

Aged↗
PubMed1997

Cataract after vitrectomy in young patients.

OBJECTIVE: The purpose of the study was to evaluate the occurrence of cataract in young patients after pars plana vitrectomy. DESIGN: The authors reviewed the medical records for previtrectomy and postvitrectomy lens changes in patients younger than 30 years of age at the Kellogg Eye Center, University of Michigan. PARTICIPANTS: Forty-nine patients (50 eyes) younger than 30 years of age (mean age, 23.5 years; range, 5 months-30 years) underwent phakic vitrectomy over a 12-year period. MAIN OUTCOME MEASURES: Cataracts were categorized as posterior subcapsular, nuclear sclerotic, or cortical. Cataracts also were graded as mild (1+), moderate (2+), or severe (3+). RESULTS: In this series of young patients, vitrectomy was performed for a wide range of ocular conditions, including trauma and complicated retinal detachment. Postvitrectomy cataract developed in 29 patients (60%). Eighteen patients (36%) had visually significant cataract on long-term follow-up (mean follow-up, 29.7 months; range, 6 months-13 years). The most common cataract was posterior subcapsular (57%), followed by nuclear sclerosis (23%), a combination of both (17%), and cortical cataract (3%). Patients with gas-filled eyes had a significantly higher rate of cataract formation than patients with fluid-filled eyes (P < 0.05). CONCLUSIONS: Postvitrectomy cataracts were more common in the authors' series compared with those of previous reports on young patients. Cataracts were most often posterior subcapsular and were significantly associated with the use of intraocular gas. The occurrence of postvitrectomy cataract appears to be higher in patients undergoing vitrectomy for complex ocular conditions, regardless of age.

Adolescent↗
PubMed1999

Vitreous concentrations of TPA and plasminogen activator inhibitor are associated with VEGF in proliferative diabetic vitreoretinopathy.

PURPOSE: In angiogenesis, matrix degradation is an important step in endothelial cell migration and proliferation. There is evidence that serine proteases, such as tissue plasminogen activator (TPA), urokinase-type plasminogen activator (UPA), and plasminogen activator inhibitor (PAI), are involved in this process. We hypothesized that in eyes in which neovascularization is active, such as in proliferative diabetic vitreoretinopathy (PDVR), vitreous levels of these proteases are increased. Furthermore, correlation was sought between intraocular concentrations of serine proteases and vascular endothelial growth factor (VEGF), a multifunctional cytokine that has been shown to play a major part in mediating active neovascularization in patients with ischemic retinal diseases. METHODS: Undiluted samples of vitreous fluid were obtained from patients who underwent vitreoretinal surgery for PDVR or retinal detachment. Vitreous levels of VEGF, TPA, UPA, and PAI were determined by enzyme-linked immunosorbent assay. RESULTS: We found a statistically significant correlation between levels of VEGF and TPA (P<0.01) and VEGF and PAI (P<0.026) in the vitreous fluid of patients with PDVR. Concentrations of VEGF (P<0.03), TPA (P<0.042), and PAI (P<0.0098) in diabetic eyes were significantly higher than in nondiabetic eyes. Of 14 eyes with PDVR, 6 contained detectable levels of UPA. CONCLUSIONS: A correlation between increased levels of VEGF and TPA or PAI in the vitreous fluid of eyes with PDVR reflects the possible role of plasminogen activators in the progression of this disease. An understanding of the endogenous inhibition of matrix degradation in ocular angiogenesis may be useful in the development of new treatment strategies.

Biomarkers↗
PubMedDate not supplied

[Central and regional hemodynamics of eye in different course of primary open-angle glaucoma with normalized intraocular pressure and their relationship with circulation types, sympathoadrenal activity and hydrocortisone level].

The relationship of systemic and local hemodynamics with neurohumoral factors has been evaluated in 104 patients with primary open-angle glaucoma with normalized intraocular pressure. Changes in the functional activity of the sympathoadrenal activity and hydrocortisone levels were in high correlation with the initial type of systemic hemodynamics: the hormonal activity of the sympathoadrenal system predominated in patients with eukinetic and hyperkinetic circulation with normal levels of hydrocortisone, while in patients with hypokinetic circulation the mediator (norepinephrine) component of the sympathoadrenal system combined with a high plasma level of hydrocortisone predominated. A principal characteristic of unstable primary open-angle glaucoma, discriminating it from the stable condition in all types of circulation, is the presence of deep autonomic disorders in the neurohumoral mechanisms of autoregulation of ocular blood flow, because of excessive accumulation of norepinephrine, epinephrine, and hydrocortisone in the lacrimal fluid at the expense of their decreased utilization by the receptor systems of ocular tissues and blood vessels.

Aged↗
PubMed2005

Noninflammatory flap edema after laser in situ keratomileusis associated with asymmetrical preoperative corneal pachymetry.

PURPOSE: To report persistent unilateral flap edema following laser in situ keratomileusis (LASIK) in patients with asymmetrical central corneal thickness. SETTING: Minnesota Eye Consultants, Minneapolis, Minnesota. METHODS: Retrospective, noncomparative interventional case series. RESULTS: We examined 6 eyes of 3 patients with asymmetrical preoperative pachymetry who developed persistent unilateral flap edema after uneventful myopic LASIK in the eye with thicker preoperative pachymetry. All cases had asymmetrical preoperative pachymetry with flap edema developing in the eye with higher preoperative mean central corneal thickness (CCT) values, preoperative mean CCT subject eye 622 microm (range 556-664 microm) versus fellow eye 583 microm (range 510-621 microm). There was no associated ocular inflammation or rise in intraocular pressure. Significant flap edema resolved on a combination treatment of topical steroid and hypertonic saline. CONCLUSIONS: Laser in situ keratomileusis can cause temporary endothelial cell dysfunction or stress, which manifests as temporary flap edema and subclinical corneal thickening. The edema appears to be limited to the actual flap and there was no loss of epithelial integrity in these eyes and no clinically noticeable interface fluid. This new clinical entity appears to occur in patients with asymmetrical preoperative corneal pachymetry and is associated with postoperative specular microscopy abnormalities. In cases with unexplained asymmetrical corneal thickness, preoperative evaluation should include specular microscopy to evaluate for risk features that may increase the chances of a slower postoperative recovery.

Cornea↗
PubMed2002

Retinal detachment in patients with a preexisting glaucoma drainage device: anatomic, visual acuity, and intraocular pressure outcomes.

PURPOSE: To report anatomic, visual acuity, and intraocular pressure (IOP) outcomes after retinal detachment (RD) repair in patients with a preexisting glaucoma drainage device. METHODS: Consecutive case series including patients with a preexisting glaucoma drainage device who underwent RD repair at Bascom Palmer Eye Institute between 1989 and 1999. RESULTS: Ten patients were identified with a mean follow-up of 18 months. Initial RD repair included pars plana vitrectomy (PPV) and fluid-gas exchange in four patients, scleral buckling procedure (SBP) in two, PPV and SBP in three, and pneumatic retinopexy in one. Three patients initially treated with SBP or pneumatic retinopexy developed recurrent RD secondary to proliferative vitreoretinopathy. All patients eventually underwent PPV. At 6 months, the retina was attached in eight patients, and nine patients had an IOP no greater than 21 mmHg. Although postoperative vision was stable or improved compared to preoperative levels in seven patients, visual acuity at 6 months was worse than 2/200 in only four patients, largely because of preexisting advanced glaucoma. CONCLUSIONS: In eyes with RD and a preexisting glaucoma drainage device, PPV with fluid-gas exchange was the most successful approach in achieving retinal reattachment. Although anatomic success is usually achieved and IOP is usually controlled, visual acuity outcomes are often poor, largely because of preexisting advanced glaucoma.

Adolescent↗
PubMed1975

Effect of retinal detachment surgery on the course of preexisting open-angle glaucoma.

In 11 of 12 eyes with chronic simple glaucoma after surgery for retinal detachment, intraocular pressures were decreased for one to 5 1/2 years without any antiglaucomatous treatment. No further deterioration in the state of the optic disks or the visual fields occurred in any of these eyes. In all 12 fellow eyes antiglaucomatous treatment is still being administered. The operation employed in nine of the 11 cases consisted of an encircling silicone rubber band shortened by 15 to 20% of its length when placed around the eyeball before tapping subretinal fluid. An episcleral silicone implant was placed under the encircling ban in seven of these eyes. Kinking and possibly narrowing of the long posterior ciliary arteries by the encircling silicone band probably caused the ciliary hyposecretion and the resultant hypotony.

Aged↗
PubMed2005

[New etiological concepts in uveitis].

Uveitis remains an important cause of visual impairment, particularly in young patients. Idiopathic forms of intraocular inflammation should no longer be regarded as a presumed clinical entity, and the ophthalmologist must reconsider the specific etiology of primary uveitis when the clinical examination does not yield a definitive diagnosis or when the course of the disease on corticosteroids remains atypical. Laboratory tests based on serum analysis have limited value and should not be considered as diagnostic proof in different clinical presentations. The diagnostic management of infectious uveitis has been greatly improved by the use of molecular techniques applied to ocular fluids and tissues. Polymerase chain reaction (PCR) technology is a powerful tool that should be proposed in atypical cases of uveitis or retinitis of unclear but potentially infectious origin. This strategy is a major step before using unconventional and new immunomodulatory agents such as anti-TNF-alpha molecules. Under strict experimental conditions including adequate testing to rule out a possible contamination, PCR and its variants have changed our practical approach to intraocular inflammatory disorders and have provided new details for the understanding of infectious uveitis. The concept of pathogen-induced intraocular inflammation can be revisited in the light of molecular data obtained after anterior chamber paracentesis or diagnostic vitrectomy.

Humans↗
PubMed2006

[Intermittent ciliary block as a result of haemodialysis].

We report the case of a patient who experienced recurrent elevations of intraocular pressure during haemodialysis. We measured a rise in intraocular pressure of 10-12 mmHg after dialysis. The lens showed intumescence, and a ciliary block was detected by means of Orbscan II. Within 6 h findings had normalized. Changes in serum osmolarity due to haemodialysis may result in fluid shifts between different compartments. Decrease of serum osmolarity during dialysis may lead to lens swelling and thus cause a ciliary block. This may end with regression of the lens swelling.

Aged↗
PubMed2000

[Additive effect of pilocarpine and Timoptol on pupillary diameter and intraocular pressure in healthy rabbits].

In the submitted paper experimental results are interpreted comparing the administration of two fundamental anti-glaucomatous drugs into the conjunctival sac of healthy rabbits of the Chinchilla strain. The authors administered 2% pilocarpine and 0.25% Timoptol (Timololi maleas, Léciva) alone, as combined consecutive administration and concurrent administration. The greatest effect on the width of the pupil and on IOP was exerted before 60 minutes by administration of pilocarpine, then Timoptol resp. And after 60 minutes the mixture of the two substances was most effective. This effect is explained by the additive action via substances produced by interaction (metabolites). Pilocarpine being a cholinergic substance promotes formation of the vitreous fluid and thus also an increased supply of free amino acids into ciliary body processes and the vitreous fluid. Timoptol then interacts with the increased amount of free amino acids and thus a greater and longer reduction of VOT occurs than after the action of newly formed cholinergic or newly formed adrenergic substances alone.

Adrenergic beta-Antagonists↗
PubMed1975

[Intraocular and cerebral reticular sarcoma].

An anatomo-clinical study is presented of a reticulum cell sarcoma (or lymphosarcoma), limited to the eye-ball and the brain. The eye disease developed as a chronic, diffused hypertensive uveitis. The diagnosis of the nature of the brain tumour was made by cytological study of the cerebro-spinal fluid.

Aged↗