Anterior chamber fluid contamination after uncomplicated phacoemulsification.

This study determined the rate of anterior chamber aerobic bacterial contamination in 103 eyes that had uncomplicated posterior chamber phacoemulsification. Anterior chamber fluid was aspirated on completion of surgery. Cultures of sterile balanced salt solution served as a control. Of 103 anterior chamber cultures, 4 (3.9%) showed contamination; however, 3 of 103 control cultures (2.9%) also grew micro-organisms. These findings suggest a very low rate of aerobic bacterial contamination after uncomplicated phacoemulsification and underscore the importance of control cultures when determining contamination rates.

Inhibition by rapamycin of PDGF- and bFGF-induced human tenon fibroblast proliferation in vitro.

PURPOSE: Fibrosis of subconjunctival tissues is a major cause of bleb failure following glaucoma filtration surgery. The aim of the present investigation was to demonstrate the effect of Rapamycin, a clinically relevant macrolide antibiotic with potent immunosuppressive properties, on human Tenon fibroblast proliferation induced by platelet-derived growth factor and basic fibroblast growth factor. METHODS: Primary Tenon fibroblast cultures were derived from patients undergoing trabeculectomies or routine cataract extractions. Rapamycin was added in concentrations of 0.1-100 ng/ml with or without 3-30 ng/ml of porcine platelet-derived growth factor or of human recombinant basic fibroblast growth factor. Two days after treatment, the cells were examined and counted. The results were expressed as the percent of cell growth in treated culture relative to its untreated control. RESULTS: Rapamycin was not cytotoxic at any of the concentrations tested. Inhibition of platelet-derived growth factor-induced Tenon fibroblast proliferation occurred with all doses of Rapamycin, the most marked effect being observed with 30 ng/ml (60% inhibition, p < 0.001). In contrast, optimal inhibition of basic fibroblast growth factor-induced proliferation was only 37% (p < 0.01), achieved with 10 ng/ml of the peptide. CONCLUSION: Rapamycin potently inhibits platelet-derived growth factor-induced fibroblast proliferation in vitro without any apparent cytotoxicity. It may eventually prove to be a useful adjunct to glaucoma filtration surgery.

Effect of timolol vs. acetazolamide on sodium hyaluronate-induced rise in intraocular pressure after cataract surgery.

This prospective study was done to compare the efficacy of timolol and acetazolamide in lowering the intraocular pressure (IOP) secondary to the use of sodium hyaluronate (Healon) in cataract surgery. Fifty patients undergoing extracapsular cataract extraction and implantation of a posterior chamber lens were randomly assigned to one of four treatment groups: no viscoelastic (10 patients), Healon with 0.5% timolol drops postoperatively (12 patients), Healon with acetazolamide postoperatively (16 patients), or Healon only (12 patients). The IOP was measured during the first 24 hours after surgery. Sodium hyaluronate caused a marked increase in IOP in the early (6 to 12 hours) postoperative period. Timolol proved to be more effective than acetazolamide in controlling this pressure increase.

Apraclonidine 0.5% versus brimonidine 0.2% for the control of intraocular pressure elevation following anterior segment laser procedures.

BACKGROUND AND OBJECTIVE: Both apraclonidine hydrochloride 0.5% and brimonidine tartrate 0.5% are potent alpha-2 agonists, effective in controlling the intraocular pressure (IOP) rise following argon laser trabeculoplasty (ALT). Brimonidine has recently become available commercially as a 0.2% solution. Our goal in this study was to compare the efficacy and side effect profile of 0.2% brimonidine to that of 0.5% apraclonidine in the prevention of IOP spikes following anterior segment laser procedures. PATIENTS AND METHODS: Patients undergoing argon laser trabeculoplasty, Nd:Yag peripheral iridectomy or posterior capsulotomy were prospectively randomized to receive either apraclonidine 0.5% or brimonidine 0.2%, approximately 10 minutes prior to laser surgery. Intraocular pressure was measured by a masked observer, using Goldmann applanation tonometry, before and 1 hour after the treatment. RESULTS: 51 ALTs, 21 peripheral iridectomies, and 13 posterior capsulotomies were performed. The incidence of an IOP rise greater than 5 mmHg was 3/43 (7.0%) in the brimonidine group and 0/42 (0%) in the apraclonidine group (P = 0.08, chi-squared). There were no IOP elevations greater than 8 mmHg. All IOP rises of greater than 5 mmHg occurred in the ALT sub-group, and within this sub-group, the mean change in IOP from pre- to post-op was -4.00 +/- 5.87 in the brimonidine group versus -4.29 +/- 3.86 in the apraclonidine group (P = 0.84). There was a statistically significant decrease in IOP from baseline in both drug groups (P < .0001). CONCLUSIONS: Both drugs are highly effective in controlling IOP spikes following anterior segment laser procedures. There is a tendency toward higher risk of IOP rise following argon laser trabeculoplasty with 0.2% brimonidine as compared to 0.5% apraclonidine, however, this was not statistically significant.

[A new beta-blocking agent in the treatment of chronic open-angle glaucoma: timolol maleate. Effect of instillation of 1 drop on the intraocular pressure]. / Un nouveau béta-bloquant dans le traitement du glaucome chronique à angle ouvert: le maléate de timolol. Effet tensionnel de l'instillation d'une goutte.

A total of 45 patients with chronic open-angle glaucoma were divided randomly into three groups of fifteen. Each patient in each group was given one drop into one eye (the other eye serving as a control), of either placebo, timolol 0,5%, or timolol 1,5%. The patients were observed for a period of seven hours, and results showed that timolol was effective in reducing ocular tension when compared to placebo. It was also rapid in action (one to two hours after instillation), and no side-effects were noted. Timolol 0,5% appears to be as equally effective as the 1,5% strength.