[A review of safety and efficacy of levofloxacin 0.5% ophthalmic solution in the treatment of external ocular infections and in prophylaxis of postoperative endophthalmitis]. / Bezpieczenstwo i skutecznosc lewofloksacyny w leczeniu zakazen bakteryjnych powierzchni oka i w profilaktyce pooperacyjnego zapalenia wnetrza galki--przeglad pismiennictwa.

Levofloxacin 0.5% ophthalmic solution is a fluoroquinolone antibacterial agent with a broad spectrum of activity against Gram positive and negative bacteria. For those reasons it is highly effective in treating common external infections of the eye including blepharitis, conjunctivitis, keratitis. In terms of microbial eradication and clinical cure rate it is significantly more effective than ofloxacin 0.3% ophthalmic solution, and non inferior to moxifloxacin ophthalmic solution. After topical administration of levofloxacin 0.5% ophthalmic solution it achieves concentration exceeding MIC90 for most clinically relevant pathogenes in tears, conjunctiva, cornea as well as anterior chamber. Thus it can be used in prophylaxis in patients undergoing ocular surgery. Because of its postantibiotic effect and high concentration in tears three times daily regimen is as effective as most frequent administration in patients with conjunctivitis, which leads to better compliance. Despite the wide use of topical and systemic levofloxacin, most common ocular pathogens remain clinically susceptible. Topical levofloxacin is well tolerated, it rarely causes systemic or ocular adverse events with the majority of treatment-related adverse effects being of mild to moderate severity. It also does not effect the wound healing.

Successive Acanthamoeba Corneal Isolates Identified in Poland Monitored in Terms of In Vitro Dynamics.

BACKGROUND: Amoebae of the genus Acanthamoeba cause a sight-threatening infection called Acanthamoeba keratitis. It is considered a rare disease in humans but poses an increasing threat to public health worldwide, including in Poland. We present successive isolates from serious keratitis preliminary examined in terms of the identification and monitoring of, among others, the in vitro dynamics of the detected strains. METHODS: Clinical and combined laboratory methods were applied; causative agents of the keratitis were identified at the cellular and molecular levels; isolates were cultivated in an axenic liquid medium and regularly monitored. RESULTS: In a phase-contrast microscope, Acanthamoeba sp. cysts and live trophozoites from corneal samples and in vitro cultures were assessed on the cellular level. Some isolates that were tested at the molecular level were found to correspond to A. mauritanensis, A. culbertsoni, A. castellanii, genotype T4. There was variability in the amoebic strain dynamics; high viability was expressed as trofozoites' long duration ability to intense multiply. CONCLUSIONS: Some strains from keratitis under diagnosis verification and dynamics assessment showed enough adaptive capability to grow in an axenic medium, allowing them to exhibit significant thermal tolerance. In vitro monitoring that was suitable for verifying in vivo examinations, in particular, was useful to detect the strong viability and pathogenic potential of successive Acanthamoeba strains with a long duration of high dynamics.

Canaloplasty - Efficacy and Safety in an 18-Month Follow Up Period, and Analysis of Outcomes in Primary Open Angle Glaucoma Pigmentary Glaucoma and Pseudoexfoliative Glaucoma.

PURPOSE: Open-angle glaucoma (OAG), accounting for 90% of all glaucoma cases, is a progressive optic nerve neuropathy. It may lead to irreversible loss of visual field and complete blindness. When conservative treatment becomes insufficient to stop OAG progression, a surgical intervention is considered. Currently, canaloplasty procedure is being introduced instead of conventional trabeculectomy for invasive OAG treatment. The aim of the study is to asses safety and efficacy of canaloplasty. METHODS: This prospective study included 67 eyes that received 360° canaloplasty with placement of a tensioning suture. Primary OAG (n = 35), secondary OAG in pseudoexfoliative syndrome (n = 13), and pigmentary glaucoma (n = 19) patients were included. Control check-ups were conducted pre-operatively and in a 18-month follow-up time. Study endpoints involved reduction in IOP values and in the number of glaucoma medications after the intervention. RESULTS: The intervention led to a significant 38% reduction in IOP value from the preoperative baseline to 18 months after the intervention. The number of medications decreased significantly by 89%. At 18 months postoperative, 79% eyes did not require any glaucoma medications. The incidence of complications after canaloplasty was low, and none of the adverse effects were vision threatening. A surgically-induced astigmatism was the most frequent complication. Pigmentary glaucoma patients were the most beneficial subgroup, with 50% reduction in IOP, the highest success rate, and 98% reduction in the number of medications used. CONCLUSION: This study proved that canaloplasty is an efficient and safe procedure in OAG eyes.

Comparison of the biometric measurements obtained using noncontact optical biometers LenStar LS 900 and IOL Master V.5.

PURPOSE: Evaluation of the measurement accuracy using a new optical biometer LenStar LS 900 (Haag Strait) and comparison according to the IOL Master V.5 (Zeiss) device. METHODS: In a prospective clinical study biometric measurements along with artificial lens power calculation using the LenStar LS 900 device were performed. A total number of 106 patients qualified for a cataract extraction procedure were included in the study. Measurements along with lens power calculation were repeated using the IOL Master V.5. device. Results were elaborated using Pearson's correlation and Bland-Altman plot. RESULTS: Measurements were performed in 204 eyes of 106 patients. Mean values and ranges of biometry results were as follows: 23.46 +/- 2.81 mm [20.79-29.80] for IOL Master, and 23.47 +/- 2.83 mm [20.79-29.86] for LenStar LS 900. In keratometry for flat meridian (K1) the following data was obtained: mean 43.24 +/- 3.22 D [range 38.27-47.94] for IOL Master and 42.44 +/- 3.15 D [38.27-47.94] for LenStar LS 900. For steep meridian (K2) the data obtained were 44.14 +/- 3.40 D; [39.29-49.13] and 43.27 +/- 3.34 D [38.61-48.4] respectively. The obtained calculation results for each eye were as follows: mean 21.23 +/- 8.07, [range 3.25-28.99] for Hagis formula, 21.14 +/- 6.90; [4.83-27.6] for SRK II, 21.04 +/- 7.78; [3.05-28.05] for SRK/T, 21.09 +/- 8.13; [2.43-28.61] for Holladay using IOL Master and 21.41 +/- 8.23; [2.99-29.15] for Haigis; 21.24 +/- 7.00; [4.6-27.71] for SRK II, 21.13 +/- 7.90; [2.76-28.18] for SRK/T; 21.09 +/- 8.13; [2.16-28.76] for Holladay using LenStar LS 900. CONCLUSIONS: The LenStar LS 900 device enables to perform accurate and repetitive biometric measurements and implant power calculations. Implant calculation results obtained using the LenStar LS 900 device are comparable to those achieved using the IOL Master V.5 device, which has been commonly accepted as standard for over a decade. The use of both devices is limited by significant lens opacification and posterior capsule calcification. In such cases, additional ultrasound biometry should be performed. Keratometry results obtained using both devices should not be used alternatively because of the different measurement methods and different refraction indexes. The LenStar LS 900 device comparing to the IOL Master additionally enables pachymetry, macular retinal thickness, lens thickens and pupil diameter measurement. Accuracy of those measurements should be studied in the future.

The first investigation on differences in the effectiveness of mycophenolate mofetil and azathioprine antimetabolites determined in Polish patients treated for non-infectious uveitis.

INTRODUCTION: The non-infectious uveitis, a serious vision-threatening disease is the fourth most common cause of blindness in working population of the developed world. Various antimetabolites are applied in corticosteroid-sparing therapy also in Poland but their efficacy was not compared in our country. The aim of our study was to compare mycophenolate mofetil and azathioprine in terms of therapeutic effect of the antimetabolites in Polish patients with this disease. MATERIAL AND METHODS: The comparative, retrospective study included data of 61 patients admitted to Independent Public University Eye Hospital between January 2009 and January 2017, treated with antimetabolites for non-infectious uveitis. 31 patients received mycophenolate mofetil, 30 patients - azathioprine. In the assessment of corticosteroid-sparing efficacy, among others changes in visual acuity, the duration of the disease and therapy, incidence of ophthalmologic complications, adverse systemic side effects were determined. RESULTS: The corticosteroid-sparing therapy was more often effective, and an improvement of visual acuity more frequent in patients treated with mycophenolate mofetil than in these receiving azathioprine (84% patients vs. 60%, and 27% patients vs. 13%, respectively); these differences were statistically significant (p<0.05). CONCLUSIONS: Results of our study showing better therapeutic efficacy when applied mycophenolate mofetil seems promising approach for treatment of non-infectious posterior uveitis and panuveitis. In the first study, there was different duration of the disease before drug administration (10.5 years vs. 7.14 years in the azathioprine and mycophenolate mofetil therapy, respectively, p<0.05) and limited number of patients assessed, thus it is desirable to examine more Polish patients treated with the antimetabolites.