Systemic Absorption of Mitomycin-C When Used in Pterygium Surgery.

PURPOSE: To determine whether scleral topical application of mitomycin-C (MMC) results in measurable plasma levels of systemic absorption. METHODS: The study comprised 27 patients who were treated with MMC 0.2 mg/mL (0.02%) for 60 seconds during pterygium surgery. Blood samples were taken 30 minutes after surgery and evaluated by the human plasma liquid chromatography tandem-mass spectrometry method to determine the presence of MMC. RESULTS: The amount of MMC in 27 samples tested was determined as below 0.25 ppb (ng/mL). CONCLUSIONS: In this study of 27 patients treated with topical application of MMC for pterygium surgery, there was no measurable evidence of systemic drug absorption. Although systemic absorption has been found with the use of larger quantities of MMC, there is an extremely low likelihood of systemic absorption or toxicity of MMC after pterygium surgery.

Motor vehicle accident eye injuries in northern Israel.

PURPOSE: To investigate the occurrence and types of motor vehicle accident eye trauma in north Israel. METHODS: The records between the years 2007-2011 of the Ophthalmology Emergency Room of one medical center were searched. Eye injuries due to motor vehicle accidents were classified according to type, severity of injury and demographic data of patients. RESULTS: Nearly five percents of ER presentations were due to motor vehicle accidents. Most motor vehicle accident-related eye injuries were mild. CONCLUSION: Efforts should be taken to prevention and to minimize the severity of motor vehicle accident-related eye injuries.

Presumed Virus-Induced Punctal Occlusion.

Purpose. To investigate viral infection as a cause of punctal stenosis in individuals without any ocular or systemic risk factors. Methods. The study group comprised patients with no known cause for punctal occlusion who underwent surgery at one medical center during a one-year period. Excised tissue was subjected to histological examination, PCR, and nested PCR testing for common viruses (adenovirus, influenza A and B, enterovirus, varicella-zoster, CMV, herpes simplex types 1 and 2, Epstein-Barr virus, and parainfluenza type 1). Results. All nine patients identified were female, 20-38 years of age. The three-snip-procedure resolved tearing in eight of them. All excised samples showed chronic mononuclear inflammation compatible with viral infection or with viral infection immune inflammatory reaction. PCR testing was negative for all the viruses examined; however, nested PCR was positive in three patients. Conclusion. This study supports the proposition that punctal occlusion in young healthy females may be due to viral infection.

Sport-related eye injury in northern Israel.

BACKGROUND: Eye injuries are common in sports. Sports-related eye injuries have the potential for major morbidity OBJECTIVES: To investigate the occurrence and to classify sport-related eye trauma in northern Israel. METHODS: We analyzed the records of the ophthalmology emergency department for the years 2007-2011 and classified the admissions according to type, severity of injury and demographic data. RESULTS: In 2% of the patients the injuries occurred during a sport activity. Most of the injuries occurred during soccer, basketball or school sport activity (74%). The majority of patients were young males. CONCLUSIONS: Most sports-related eye injuries can be prevented with adequate eye protection.

Ascorbate prophylaxis with mitomycin-C for corneal haze after laser-assisted sub-epithelial keratectomy.

BACKGROUND: Corneal haze is a significant complication of photorefractive keratectomy (PRK) and laser-assisted subepithelial keratectomy (LASEK). OBJECTIVES: To evaluate the effect of ascorbic acid supplementation in addition to perioperative topical mitomycin-C for the prevention of haze after LASEK. METHODS: We performed a retrospective, non-randomized case series study of two groups of 48 consecutive patients (96 myopic eyes) who had LASEK surgery. The treatment group was given ascorbic acid (vitamin C) orally, 500 mg, twice daily from 1 week before to 2 weeks after surgery. The control group was not offered any additional treatment. Ascorbate supplementation was the only difference in the postoperative treatment protocol between the treatment and control groups. Haze was assessed on a scale from 0 to 4 at the 1 year visit. RESULTS: Overall, 33.3% and 37.5% of the patients in the treatment and control groups respectively developed corneal haze. The trend of increased haze severity in the control group did not reach statistical significance. CONCLUSIONS: Our results showed that systemic ascorbate supplementation does not have an additional effect on the prevention of haze after LASEK compared to the effect of topical mitomycin-C alone.

Olive-harvesting eye injuries.

PURPOSE: To document the types of ocular trauma that occurs during the olive-harvesting season in a region of the Middle East. MATERIALS AND METHODS: Ophthalmic assessments of all patients were performed by one ophthalmologist. Examinations included visual acuity, slit-lamp evaluation of the anterior segment, intraocular pressure measurement and posterior segment assessment after pupil dilatation. RESULTS: The study cohort comprised 119 patients who presented for ocular injury due to olive harvesting. Seven patients (5.9%) had severe ocular trauma. Two of these patients presented with corneal perforation, and five with retinal edema. Six patients with severe ocular injury were male. CONCLUSIONS: Ocular injuries are common when olives were harvested manually or with sticks. A preventive program to reduce injury should consider environmental and cultural factors.

Human aqueous humor phosphatase activity in cataract and glaucoma.

PURPOSE: To investigate the presence and activity of protein phosphatase-2A (PPase2A), protein phosphatase-2C (PPase2C), and protein tyrosine phosphatases (PTPs) in the human aqueous humor (AH) of patients with primary open-angle glaucoma (POAG) and cataract and to study the correlation between these phosphatases and the redox state of the AH. METHODS: Eighty-six cataract patients and 29 POAG patients who were scheduled for cataract surgery with or without glaucoma surgery were enrolled in the study. PPase2A, PPase2C, and PTPs levels in AH were measured by enzyme-linked immunosorbent assays, Western blot analyses, and spectral METHODS: The redox state was measured by spectral and fluorescent methods. RESULTS: Phosphatase activity-positive results were significantly higher in AH samples from the POAG group (PP2A χ(2)(1) = 11.754, P < 0.01; PP2C χ(2)(1) = 8.754, P < 0.01; PTP χ(2)(1) = 11.073, P < 0.01). Western blot analysis revealed higher PP2C levels in the AH of glaucoma patients compared with PP2C levels in the AH of cataract patients (P = 0.012). Both oxidized/reduced glutathione ratios and superoxide dismutase levels in the AH were significantly higher in the glaucoma group than in the cataract group. Finally significant correlations were found between PP2A and PP2C, PP2A and PTP, and total antioxidant activity and PTP levels. CONCLUSIONS: There is a statistically significant difference between phosphatase levels in the AH of POAG patients and cataract patients. The phosphatase content of the AH represents tissue pathology, but their presence in the AH may be attributed to cell debris or to active signaling to other molecular events.

Evaluation of polybutylate-coated braided polyester (ethibond) sutures for levator-advancement blepharoptosis repair.

Purpose. To evaluate the efficacy and safety of polybutylate-coated braided polyester (Ethibond* 5-0) suture for levator aponeurosis suturing to the anterior tarsal surface in involutional blepharoptosis repair surgery. Methods. Ten consecutive patients (16 eyes) with acquired blepharoptosis which resulted from levator aponeurosis dehiscence with good levator function had gone through surgery and were followed up for, at least, one year. Results. There was no significant change between postoperative MRD1 measurements. No serious complications, such as infection of the sutures, inflammation, granuloma formation or ptosis recurrence, were registered. Conclusion. Polybutylate-coated braided polyester (Ethibond* 5-0) suture is a safe and effective material for involutional blepharoptosis repair surgery.

Haptoglobin genotype is a regulator of reverse cholesterol transport in diabetes in vitro and in vivo.

Two common alleles exist at the haptoglobin (Hp) locus, and the Hp2 allele is associated with an increased incidence of cardiovascular disease, specifically in diabetes mellitus (DM). Oxidative stress is increased in Hp2 mice and humans with DM. Oxidative modification of the apolipoprotein A-I inhibits reverse cholesterol transport. We sought to test the hypothesis that reverse cholesterol transport is impaired in Hp2 DM mice and humans. In vitro, using serum from non-DM and DM individuals, we measured cholesterol efflux from (3)H-cholesterol-labeled macrophages. In vivo, we injected (3)H-cholesterol-loaded macrophages intraperitoneally into non-DM and DM mice with the Hp1-1 or Hp2-2 genotype and monitored (3)H-tracer levels in plasma, liver, and feces. In vitro, in DM individuals only, we observed significantly decreased cholesterol efflux from macrophages incubated with serum from Hp2-1 or Hp2-2 as compared with Hp1-1 individuals (P<0.01). The interaction between Hp type and DM was recapitulated using purified Hp and glycated Hb. In vivo, DM mice loaded with (3)H-cholesterol-labeled macrophages had a 40% reduction in (3)H-cholesterol in plasma, liver, and feces as compared with non-DM mice (P<0.01). The reduction in reverse cholesterol transport associated with DM was significantly greater in Hp2-2 mice as compared with Hp1-1 mice (54% versus 25% in plasma; 52% versus 27% in liver; 57% versus 32% in feces; P<0.03). reverse cholesterol transport is decreased in Hp2-2 DM. This may explain in part the increased atherosclerotic burden found in Hp2-2 DM individuals.