Ophthalmic Surgery, Lasers and Imaging Retina, 1999
A retrospective study of 36 cases of infectious keratitis in the graft following 885 consecutive ... more A retrospective study of 36 cases of infectious keratitis in the graft following 885 consecutive penetrating keratoplasties was conducted to evaluate the spectrum of pathogens and the factors affecting graft survival. Gram positive cocci and gram negative rods were equally responsible (47% in both cases) for 94% of the infections. Epithelial defects were responsible for 64% of the ulcers; suture-related infections, for 36%. After the infectious keratitis resolved, only 50% of the patients had a clear graft. Because the visual prognosis is poor once infectious keratitis develops, aggressive treatment is essential as soon as any sign of infiltration appears.
Purpose To describe amniotic membrane transplantation indications and results at the authors'... more Purpose To describe amniotic membrane transplantation indications and results at the authors' institution. Methods In this study, chart review of 108 patients who underwent amniotic membrane transplantation between January 2002 and April 2006 was performed. The survival rate of corneal integrity was compared, using Kaplan-Meier survival analysis, as a measure of success rate. Results The mean age of the patients was 55.2±20.1 (6–87 years, 75 female, 51 male). The patients underwent amniotic membrane transplantation for six different diagnoses: nontraumatic corneal perforation (32 eyes, Group 1), persistent epithelial defect (29 eyes, Group 2), aphakic/pseudophakic bullous keratopathy (18 eyes, Group 3), infectious ulcer resistant to treatment (14 eyes, Group 4), necrotizing keratitis secondary to endophthalmitis (10 eyes, Group 5), and caustic injury (5 eyes, Group 6). The mean survival of corneal integrity was similar in all groups (p=0.156). Conclusions Amniotic membrane trans...
Aims: To investigate the efficacy and safety of postoperative topical cyclosporine A 0.05% (tCsA)... more Aims: To investigate the efficacy and safety of postoperative topical cyclosporine A 0.05% (tCsA) (Restasis®, Allergan Pharmaceutical) eye drops in preventing the recurrence of pterygium. Methods: 31 patients with bilateral pterygium were examined between January 2006 and February 2007. During a 1-year follow-up, the right eyes of the patients assigned as the treatment group were treated by tCsA and the left eyes were considered as the control group. Results: The pterygium recurred in 4 (12.9%) of 31 right eyes in the treatment group and in 14 (45.2%) of 31 left eyes in the control group (p = 0.005). The mean follow-up ± SD was 9.39 ± 4.14 months (range, 1 to 12 months). The control group had a 7.37 times higher risk of recurrence in pterygium compared with the treatment group (OR = 0.1357, p = 0.0051). A statistically significant difference in recurrence-free probabilities was found for the treatment and control groups (log-rank test; p = 0.006). A multivariate Cox regression model...
To evaluate the criteria of diagnosis and management of secondary glaucoma in young nanophthalmic... more To evaluate the criteria of diagnosis and management of secondary glaucoma in young nanophthalmic patients. Considering the anatomic features and clinical characteristics, 22 eyes of 11 patients were identified as bilateral nanophthalmos. Intraocular pressures (IOP) were checked with Goldmann applanation or Keeler pulse-air 2000 tonometer, and Nd-Yag laser was used for iridotomies. Prophylactic V-shaped unsutured sclerectomies over the pars plana were combined with trabeculectomy, and Mitomycin C (MMC) in 0.2 mg/ml concentration was applied. Among 22 eyes of bilateral nanophthalmic patients 8 eyes had secondary angle-closure glaucoma. Laser iridotomies were performed in 6 eyes. Laser iridotomy and supplemental medical therapy were sufficient in 4 out of 6 eyes. Mean IOP dropped from 26.4 to 14.5 mmHg in these patients. Due to continuous increase of IOP in the other patients, they underwent trabeculectomy with V-shaped sclerostomy and intraoperative MMC application. Mean IOP dropped from 39.3 mmHg to 19.3 mmHg. Postoperative uveal effusion on other major complications were not observed. Mean age of these patients was 14.6 years during treatment. Management of glaucoma in nanophthalmus is complicated. Initial treatment is medical. If it is insufficient, laser iridotomies and V-shaped sclerostomies with filtration surgery can be performed at any age.
To investigate the biochemical changes on the oxidant/antioxidant balance in corneal and lens tis... more To investigate the biochemical changes on the oxidant/antioxidant balance in corneal and lens tissues in rabbits, and to determine the relative corneal endothelial toxicities following the injection of intracameral anaesthetic agents: levobupivacaine 0.5% or lidocaine 2%. The experiment was conducted using New Zealand rabbits. The rabbits were randomly divided into three experimental groups. Twenty eyes received injections of 0.2 ml of one of the two anaesthetic preparations and 10 control eyes received injections of 0.2 ml balanced salt solution. Corneal thickness and clarity were measured before and 3 and 6 h after surgery. Anterior chamber reaction was evaluated 1, 3 and 6 h after surgery. In corneal and lens tissues, malondialdehyde and total thiol levels were measured using spectrophotometric methods. Levobupivacaine 0.5% caused corneal thickening, oedema and anterior chamber reaction (p<0.001). There were no biochemical changes in the levobupivacaine group (p>0.05). No change was observed in the corneal thickness, oedema and anterior chamber reactions, whereas the level of malondialdehyde significantly increased in corneal and lens tissues (p<0.001, p=0.015, respectively), and the level of total thiol significantly decreased in the lens tissue in the lidocaine 2% group (p<0.001). The results of this study suggest that levobupivacaine 0.5% has an immediate toxicity on corneal endothelium. Lidocaine 2% causes oxidative damage on corneal and lens tissues. Surgeons should not use repetitive and high doses of intracameral lidocaine in the presence of corneal pathology during cataract surgery.
A clinical double-blind study was performed in patients who had undergone extracapsular cataract ... more A clinical double-blind study was performed in patients who had undergone extracapsular cataract extraction and intraocular lens implantation (ECCE+IOL) to compare the anti-inflammatory effects of diclofenac sodium 0.1% and flurbiprofen 0.03% eye drops. The diclofenac group included 21 eyes of 21 patients and the flurbiprofen group included 22 eyes of 22 patients. The parameters compared were pachymetry of the cornea, corneal surface changes, intraocular pressure (IOP) and the degree of inflammation of the anterior chamber at one, three and six weeks after cataract surgery. There was no statistically significant difference between the two treatment groups in corneal pachymetry, corneal surface changes, IOP and the anterior chamber inflammation (p>0.05). Both drugs were well tolerated and may be safely used to reduce inflammation for cataract surgery.
ÖZET Amaç: On yıl lık sü re de ki pe net ran ke ra top las ti (PK) en di kas yon la rı, greft can... more ÖZET Amaç: On yıl lık sü re de ki pe net ran ke ra top las ti (PK) en di kas yon la rı, greft can lı lı ğı ve gör me kes kin li ği so nuç la rı nı sap ta mak ve li te ra tür ve ri le ri ile kar şı laş tır mak. Ge reç ve Yön tem ler: 19952005 yıl la rı ara sın da PK ya pı lan has ta la rın ka yıt la rı ret ros pek tif ola rak in ce len di. Al tı ay dan az ta kip li has ta lar ça lış ma ya da hil edil me di. Ve ri ler; en di kas yon, al log reft re ak si yo nu, greft say dam lı ğı ve ame li yat son ra sı ni ha i gör me kes kin li ği kri ter le ri ne gö re de ğer len di ril di. Bul gu lar: 665 has ta nın 705 gö zü ne 766 pe net ran ke ra top las ti uy gu lan mış tır. Or ta la ma ta kip sü re si 25.0 ± 25.6 (6-140) ay dı. En sık en di kas yon lar ke ra to ko nüs (234 göz; %33.2), vas kü la ri ze lö kom (105 göz; %14.9), afa kik ve psö do fa kik bül löz ke ra to pa ti (92 göz; %13.0), vi ral ke ra tit (77 göz; %10.9), kor ne a dis tro fi si ve de je ne ras yo nuy du (64 göz; %9.1). 766 PK’nın 710 (%92.7)’un da op tik ne den ler le, 56 (%7.3)’sın da te ra pö tik ne den ler le greft uy gu lan mış tı. Al log reft re ak si yo nu 113 (%16.0) göz de ge liş miş ti ve ge ri ye dö nü şüm ora nı %31.9 idi. Ça lış ma sü re si so nun da, san tral gör me ak sın da gref tin tü müy le say dam ol ma sı şek lin de ta nım la nan, greft say dam lık ora nı %74 idi. Greft ba şa rı sız lı ğı için ana ne den ler; ge ri ye dö nü şüm süz al log reft red di (%42.1), en do tel yet mez li ği (%24) ve greft en fek si yo nuy du (%13.1). 388 (%55) göz de 0.2 ve üze rin de dü zel til miş en iyi gör me kes kin li ği el de edil miş tir. So nuç: Ol gu la rın bü yük bir kıs mın da greft, gör me kes kin li ği ni ar tır mak için uy gu lan mış tır. Kli ni ği miz de 10 yıl lık sü re de ön de ge len en di kas yon ke ra to ko nüs tür. Pe net ran ke ra top las ti se çil miş kor ne a has ta lık la rın da et ki li ve em ni yet li bir te da vi yön te mi dir.
In this study, we evaluated ocular-surface changes and tear-film functions in patients with plaqu... more In this study, we evaluated ocular-surface changes and tear-film functions in patients with plaque-type psoriasis. This study was performed on two groups. Group I included 100 eyes of 50 subjects with chronic plaque-type psoriasis whose diagnoses were confirmed with skin biopsy. Group II included 100 eyes of 50 healthy volunteers who were in the same age and sex distribution. Ocular-surface changes were evaluated on the cell content of the surface conjunctival epithelium by conjunctival impression cytology and tear-film functions by the Schirmer I test and break-up time (BUT). Of the patients with psoriasis, 50% had a grade 0, 30% had a grade I, and 20% had a grade II conjunctival impression cytology differentiation compared with 95, 3, and 2%, respectively in the control group (p < 0.001). Snake-like appearance of nuclear chromatin in conjunctival epithelial cells was demonstrated in 12% of eyes in group I but in 2% of eyes in group II. The Schirmer's test results showed that average values were 10.1 +/- 5.8 mm in group I and 12.6 +/- 5.5 mm in group II (p > 0.001). The mean break-up time was 7.8 +/- 3.7 s in group I and 12.5 +/- 4.6 s in group II (p < 0.001). We showed the early conjunctival changes in patients with psoriasis. According to these results, primary etiologic factors may contribute to ocular lesions in psoriasis.
Congenital ptosis is often associated with visual impairment. The aim of the study is to find out... more Congenital ptosis is often associated with visual impairment. The aim of the study is to find out the pattern of refractive error, strabismus and amblyopia in patients with congenital ptosis in a hospital setting. This is a hospital based prospective and descriptive study conducted at Tribhuvan University, B P Koirala Lion's Centre for Ophthalmic studies in Nepal from February 2003 to July 2004. All the consecutive cases with congenital ptosis were included and cases with pseudoptosis were excluded from the study. Among the 78 cases (95 eyes) of congenital ptosis, refractive error was present in 13 cases (16.7%) with astigmatism as the commonest refractive error (8.9%). Strabismus was found in 23 cases (26.9%) of congenital ptosis. Among the strabismus, combined exotropia with hypotropia was found in the majority of cases (16.7%). Visual impairment due to amblyopia was found in 15 cases (19.2%) of congenital ptosis with mixed strabismic and refractive etiology as the commonest one (46.7%) followed by pure strabismic (26.7%), pure refractive (20%) and stimulus deprivation amblyopia (6.7%). Patients with congenital ptosis have higher rate of amblyopia due to greater prevalence of strabismus and refractive errors although stimulus deprivation amblyopia is less common. Early ophthalmic evaluation and timely treatment of these conditions may help prevent the irreversible visual impairment in case of congenital ptosis.
To investigate the biochemical changes on the oxidant/antioxidant balance in corneal and lens tis... more To investigate the biochemical changes on the oxidant/antioxidant balance in corneal and lens tissues in rabbits, and to determine the relative corneal endothelial toxicities following the injection of intracameral anaesthetic agents: levobupivacaine 0.5% or lidocaine 2%. The experiment was conducted using New Zealand rabbits. The rabbits were randomly divided into three experimental groups. Twenty eyes received injections of 0.2 ml of one of the two anaesthetic preparations and 10 control eyes received injections of 0.2 ml balanced salt solution. Corneal thickness and clarity were measured before and 3 and 6 h after surgery. Anterior chamber reaction was evaluated 1, 3 and 6 h after surgery. In corneal and lens tissues, malondialdehyde and total thiol levels were measured using spectrophotometric methods. Levobupivacaine 0.5% caused corneal thickening, oedema and anterior chamber reaction (p<0.001). There were no biochemical changes in the levobupivacaine group (p>0.05). No change was observed in the corneal thickness, oedema and anterior chamber reactions, whereas the level of malondialdehyde significantly increased in corneal and lens tissues (p<0.001, p=0.015, respectively), and the level of total thiol significantly decreased in the lens tissue in the lidocaine 2% group (p<0.001). The results of this study suggest that levobupivacaine 0.5% has an immediate toxicity on corneal endothelium. Lidocaine 2% causes oxidative damage on corneal and lens tissues. Surgeons should not use repetitive and high doses of intracameral lidocaine in the presence of corneal pathology during cataract surgery.
Ophthalmic Surgery, Lasers and Imaging Retina, 1999
A retrospective study of 36 cases of infectious keratitis in the graft following 885 consecutive ... more A retrospective study of 36 cases of infectious keratitis in the graft following 885 consecutive penetrating keratoplasties was conducted to evaluate the spectrum of pathogens and the factors affecting graft survival. Gram positive cocci and gram negative rods were equally responsible (47% in both cases) for 94% of the infections. Epithelial defects were responsible for 64% of the ulcers; suture-related infections, for 36%. After the infectious keratitis resolved, only 50% of the patients had a clear graft. Because the visual prognosis is poor once infectious keratitis develops, aggressive treatment is essential as soon as any sign of infiltration appears.
Purpose To describe amniotic membrane transplantation indications and results at the authors'... more Purpose To describe amniotic membrane transplantation indications and results at the authors' institution. Methods In this study, chart review of 108 patients who underwent amniotic membrane transplantation between January 2002 and April 2006 was performed. The survival rate of corneal integrity was compared, using Kaplan-Meier survival analysis, as a measure of success rate. Results The mean age of the patients was 55.2±20.1 (6–87 years, 75 female, 51 male). The patients underwent amniotic membrane transplantation for six different diagnoses: nontraumatic corneal perforation (32 eyes, Group 1), persistent epithelial defect (29 eyes, Group 2), aphakic/pseudophakic bullous keratopathy (18 eyes, Group 3), infectious ulcer resistant to treatment (14 eyes, Group 4), necrotizing keratitis secondary to endophthalmitis (10 eyes, Group 5), and caustic injury (5 eyes, Group 6). The mean survival of corneal integrity was similar in all groups (p=0.156). Conclusions Amniotic membrane trans...
Aims: To investigate the efficacy and safety of postoperative topical cyclosporine A 0.05% (tCsA)... more Aims: To investigate the efficacy and safety of postoperative topical cyclosporine A 0.05% (tCsA) (Restasis®, Allergan Pharmaceutical) eye drops in preventing the recurrence of pterygium. Methods: 31 patients with bilateral pterygium were examined between January 2006 and February 2007. During a 1-year follow-up, the right eyes of the patients assigned as the treatment group were treated by tCsA and the left eyes were considered as the control group. Results: The pterygium recurred in 4 (12.9%) of 31 right eyes in the treatment group and in 14 (45.2%) of 31 left eyes in the control group (p = 0.005). The mean follow-up ± SD was 9.39 ± 4.14 months (range, 1 to 12 months). The control group had a 7.37 times higher risk of recurrence in pterygium compared with the treatment group (OR = 0.1357, p = 0.0051). A statistically significant difference in recurrence-free probabilities was found for the treatment and control groups (log-rank test; p = 0.006). A multivariate Cox regression model...
To evaluate the criteria of diagnosis and management of secondary glaucoma in young nanophthalmic... more To evaluate the criteria of diagnosis and management of secondary glaucoma in young nanophthalmic patients. Considering the anatomic features and clinical characteristics, 22 eyes of 11 patients were identified as bilateral nanophthalmos. Intraocular pressures (IOP) were checked with Goldmann applanation or Keeler pulse-air 2000 tonometer, and Nd-Yag laser was used for iridotomies. Prophylactic V-shaped unsutured sclerectomies over the pars plana were combined with trabeculectomy, and Mitomycin C (MMC) in 0.2 mg/ml concentration was applied. Among 22 eyes of bilateral nanophthalmic patients 8 eyes had secondary angle-closure glaucoma. Laser iridotomies were performed in 6 eyes. Laser iridotomy and supplemental medical therapy were sufficient in 4 out of 6 eyes. Mean IOP dropped from 26.4 to 14.5 mmHg in these patients. Due to continuous increase of IOP in the other patients, they underwent trabeculectomy with V-shaped sclerostomy and intraoperative MMC application. Mean IOP dropped from 39.3 mmHg to 19.3 mmHg. Postoperative uveal effusion on other major complications were not observed. Mean age of these patients was 14.6 years during treatment. Management of glaucoma in nanophthalmus is complicated. Initial treatment is medical. If it is insufficient, laser iridotomies and V-shaped sclerostomies with filtration surgery can be performed at any age.
To investigate the biochemical changes on the oxidant/antioxidant balance in corneal and lens tis... more To investigate the biochemical changes on the oxidant/antioxidant balance in corneal and lens tissues in rabbits, and to determine the relative corneal endothelial toxicities following the injection of intracameral anaesthetic agents: levobupivacaine 0.5% or lidocaine 2%. The experiment was conducted using New Zealand rabbits. The rabbits were randomly divided into three experimental groups. Twenty eyes received injections of 0.2 ml of one of the two anaesthetic preparations and 10 control eyes received injections of 0.2 ml balanced salt solution. Corneal thickness and clarity were measured before and 3 and 6 h after surgery. Anterior chamber reaction was evaluated 1, 3 and 6 h after surgery. In corneal and lens tissues, malondialdehyde and total thiol levels were measured using spectrophotometric methods. Levobupivacaine 0.5% caused corneal thickening, oedema and anterior chamber reaction (p<0.001). There were no biochemical changes in the levobupivacaine group (p>0.05). No change was observed in the corneal thickness, oedema and anterior chamber reactions, whereas the level of malondialdehyde significantly increased in corneal and lens tissues (p<0.001, p=0.015, respectively), and the level of total thiol significantly decreased in the lens tissue in the lidocaine 2% group (p<0.001). The results of this study suggest that levobupivacaine 0.5% has an immediate toxicity on corneal endothelium. Lidocaine 2% causes oxidative damage on corneal and lens tissues. Surgeons should not use repetitive and high doses of intracameral lidocaine in the presence of corneal pathology during cataract surgery.
A clinical double-blind study was performed in patients who had undergone extracapsular cataract ... more A clinical double-blind study was performed in patients who had undergone extracapsular cataract extraction and intraocular lens implantation (ECCE+IOL) to compare the anti-inflammatory effects of diclofenac sodium 0.1% and flurbiprofen 0.03% eye drops. The diclofenac group included 21 eyes of 21 patients and the flurbiprofen group included 22 eyes of 22 patients. The parameters compared were pachymetry of the cornea, corneal surface changes, intraocular pressure (IOP) and the degree of inflammation of the anterior chamber at one, three and six weeks after cataract surgery. There was no statistically significant difference between the two treatment groups in corneal pachymetry, corneal surface changes, IOP and the anterior chamber inflammation (p>0.05). Both drugs were well tolerated and may be safely used to reduce inflammation for cataract surgery.
ÖZET Amaç: On yıl lık sü re de ki pe net ran ke ra top las ti (PK) en di kas yon la rı, greft can... more ÖZET Amaç: On yıl lık sü re de ki pe net ran ke ra top las ti (PK) en di kas yon la rı, greft can lı lı ğı ve gör me kes kin li ği so nuç la rı nı sap ta mak ve li te ra tür ve ri le ri ile kar şı laş tır mak. Ge reç ve Yön tem ler: 19952005 yıl la rı ara sın da PK ya pı lan has ta la rın ka yıt la rı ret ros pek tif ola rak in ce len di. Al tı ay dan az ta kip li has ta lar ça lış ma ya da hil edil me di. Ve ri ler; en di kas yon, al log reft re ak si yo nu, greft say dam lı ğı ve ame li yat son ra sı ni ha i gör me kes kin li ği kri ter le ri ne gö re de ğer len di ril di. Bul gu lar: 665 has ta nın 705 gö zü ne 766 pe net ran ke ra top las ti uy gu lan mış tır. Or ta la ma ta kip sü re si 25.0 ± 25.6 (6-140) ay dı. En sık en di kas yon lar ke ra to ko nüs (234 göz; %33.2), vas kü la ri ze lö kom (105 göz; %14.9), afa kik ve psö do fa kik bül löz ke ra to pa ti (92 göz; %13.0), vi ral ke ra tit (77 göz; %10.9), kor ne a dis tro fi si ve de je ne ras yo nuy du (64 göz; %9.1). 766 PK’nın 710 (%92.7)’un da op tik ne den ler le, 56 (%7.3)’sın da te ra pö tik ne den ler le greft uy gu lan mış tı. Al log reft re ak si yo nu 113 (%16.0) göz de ge liş miş ti ve ge ri ye dö nü şüm ora nı %31.9 idi. Ça lış ma sü re si so nun da, san tral gör me ak sın da gref tin tü müy le say dam ol ma sı şek lin de ta nım la nan, greft say dam lık ora nı %74 idi. Greft ba şa rı sız lı ğı için ana ne den ler; ge ri ye dö nü şüm süz al log reft red di (%42.1), en do tel yet mez li ği (%24) ve greft en fek si yo nuy du (%13.1). 388 (%55) göz de 0.2 ve üze rin de dü zel til miş en iyi gör me kes kin li ği el de edil miş tir. So nuç: Ol gu la rın bü yük bir kıs mın da greft, gör me kes kin li ği ni ar tır mak için uy gu lan mış tır. Kli ni ği miz de 10 yıl lık sü re de ön de ge len en di kas yon ke ra to ko nüs tür. Pe net ran ke ra top las ti se çil miş kor ne a has ta lık la rın da et ki li ve em ni yet li bir te da vi yön te mi dir.
In this study, we evaluated ocular-surface changes and tear-film functions in patients with plaqu... more In this study, we evaluated ocular-surface changes and tear-film functions in patients with plaque-type psoriasis. This study was performed on two groups. Group I included 100 eyes of 50 subjects with chronic plaque-type psoriasis whose diagnoses were confirmed with skin biopsy. Group II included 100 eyes of 50 healthy volunteers who were in the same age and sex distribution. Ocular-surface changes were evaluated on the cell content of the surface conjunctival epithelium by conjunctival impression cytology and tear-film functions by the Schirmer I test and break-up time (BUT). Of the patients with psoriasis, 50% had a grade 0, 30% had a grade I, and 20% had a grade II conjunctival impression cytology differentiation compared with 95, 3, and 2%, respectively in the control group (p < 0.001). Snake-like appearance of nuclear chromatin in conjunctival epithelial cells was demonstrated in 12% of eyes in group I but in 2% of eyes in group II. The Schirmer's test results showed that average values were 10.1 +/- 5.8 mm in group I and 12.6 +/- 5.5 mm in group II (p > 0.001). The mean break-up time was 7.8 +/- 3.7 s in group I and 12.5 +/- 4.6 s in group II (p < 0.001). We showed the early conjunctival changes in patients with psoriasis. According to these results, primary etiologic factors may contribute to ocular lesions in psoriasis.
Congenital ptosis is often associated with visual impairment. The aim of the study is to find out... more Congenital ptosis is often associated with visual impairment. The aim of the study is to find out the pattern of refractive error, strabismus and amblyopia in patients with congenital ptosis in a hospital setting. This is a hospital based prospective and descriptive study conducted at Tribhuvan University, B P Koirala Lion's Centre for Ophthalmic studies in Nepal from February 2003 to July 2004. All the consecutive cases with congenital ptosis were included and cases with pseudoptosis were excluded from the study. Among the 78 cases (95 eyes) of congenital ptosis, refractive error was present in 13 cases (16.7%) with astigmatism as the commonest refractive error (8.9%). Strabismus was found in 23 cases (26.9%) of congenital ptosis. Among the strabismus, combined exotropia with hypotropia was found in the majority of cases (16.7%). Visual impairment due to amblyopia was found in 15 cases (19.2%) of congenital ptosis with mixed strabismic and refractive etiology as the commonest one (46.7%) followed by pure strabismic (26.7%), pure refractive (20%) and stimulus deprivation amblyopia (6.7%). Patients with congenital ptosis have higher rate of amblyopia due to greater prevalence of strabismus and refractive errors although stimulus deprivation amblyopia is less common. Early ophthalmic evaluation and timely treatment of these conditions may help prevent the irreversible visual impairment in case of congenital ptosis.
To investigate the biochemical changes on the oxidant/antioxidant balance in corneal and lens tis... more To investigate the biochemical changes on the oxidant/antioxidant balance in corneal and lens tissues in rabbits, and to determine the relative corneal endothelial toxicities following the injection of intracameral anaesthetic agents: levobupivacaine 0.5% or lidocaine 2%. The experiment was conducted using New Zealand rabbits. The rabbits were randomly divided into three experimental groups. Twenty eyes received injections of 0.2 ml of one of the two anaesthetic preparations and 10 control eyes received injections of 0.2 ml balanced salt solution. Corneal thickness and clarity were measured before and 3 and 6 h after surgery. Anterior chamber reaction was evaluated 1, 3 and 6 h after surgery. In corneal and lens tissues, malondialdehyde and total thiol levels were measured using spectrophotometric methods. Levobupivacaine 0.5% caused corneal thickening, oedema and anterior chamber reaction (p<0.001). There were no biochemical changes in the levobupivacaine group (p>0.05). No change was observed in the corneal thickness, oedema and anterior chamber reactions, whereas the level of malondialdehyde significantly increased in corneal and lens tissues (p<0.001, p=0.015, respectively), and the level of total thiol significantly decreased in the lens tissue in the lidocaine 2% group (p<0.001). The results of this study suggest that levobupivacaine 0.5% has an immediate toxicity on corneal endothelium. Lidocaine 2% causes oxidative damage on corneal and lens tissues. Surgeons should not use repetitive and high doses of intracameral lidocaine in the presence of corneal pathology during cataract surgery.
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