[MK-507 (L-671 152): local tolerance and effectiveness of a new local carbonic anhydrase inhibitor in healthy probands]. / MK-507 (L-671 152): lokale Verträglichkeit und Wirksamkeit eines neuen lokalen Karboanhydrasehemmers bei gesunden Probanden.

A three-dose, randomized, double-blind parallel, placebo-controlled ocular tolerancy study was undertaken in 24 healthy, normal volunteers with two formulations of 2% MK-507 (L-671 152), a novel water-soluble, topical carbonic anhydrase inhibitor. In this study MK-507 was administered to humans for the first time. Subjects received 3 sequential drops of the test drug in one randomly selected eye (at 13:00, 14:00, and 14:10 o'clock): ten received 2% MK-507 formulated with 0.5% hydroxyethylcellulose (HEC); ten, 2% MK-507 with no HEC; two, vehicle with HEC; and two, vehicle without HEC. Local tolerance of 2% MK-507 was good with predominantly mild and transient local symptoms, somewhat fewer for the formulation without HEC. Significant lowering of intraocular pressure (IOP) by up to 7 mmHg was noted when comparing IOP 4 h and 5 h after the first dose with IOP 20 h and 19 h before the first dose in the treated eyes of subjects receiving MK-507. Slightly greater activity was noted when MK-507 was formulated with HEC.

[A new topical carbonic anhydrase inhibitor (MK-927). Tolerance comparison with betaxolol in healthy probands]. / Ein neuer, lokal anwendbarer Carboanhydrasehemmer (MK-927). Toleranzvergleich mit Betaxolol bei gesunden Probanden.

MK-927 is a new topical carboanhydrase inhibitor with proven ability to lower intraocular pressure in glaucoma patients. Subjective and objective symptoms following topical application of MK-927 were evaluated in a randomized, double-blind, placebo-controlled study in which 24 healthy male volunteers took part. Symptoms were rated according to a visual analog scale by the volunteers and according to a grading scale by the examiner. The study showed good local tolerance of MK-927, comparable to that of Betaxolol.

MK-927: a topically effective carbonic anhydrase inhibitor in patients.

The effects on intraocular pressure of the novel topical carbonic anhydrase inhibitor MK-927 were investigated for the first time in patients. Three drops of 2% MK-927 was administered in a two-center, double-masked, randomized, placebo-controlled, two-period crossover study in 25 patients with bilateral primary open angle glaucoma or ocular hypertension. At 4.5 hours after the dose, MK-927-treated eyes demonstrated a peak mean change of -7.7 mm Hg from a mean intraocular pressure of 27.8 mm Hg immediately before the dose; this compares with a change of -3.9 mm Hg from a mean intraocular pressure of 28.2 mm Hg when the same eyes were treated with placebo. The peak mean percent change in intraocular pressure in eyes treated with MK-927 was -26.7% at 6 hours after the dose compared with a change of -13.7% after treatment with placebo. No contralateral effect on intraocular pressure due to MK-927 was observed.

[Comparison of the effect of 0.75% bupivacaine with 0.75% bupivacaine/2% mepivacaine in retrobulbar anesthesia and the effect of adding hyaluronidase]. / Wirkungsvergleich von Bupivacain 0.75% mit Bupivacain 0.75%/Mepivacain 2% zur Retrobulbäranästhesie und Auswirkungen des Zusatzes von Hyaluronidase.

For about 100 years retrobulbar injection of a local anesthetic has been regarded as being a safe, efficient anesthesia in cataract surgery. Today one of the most difficult steps in cataract surgery is the implantation of the IOL. Vis à tergo can lead to severe problems during this procedure. Therefore, the position of the iris (concave or convex) is an important result that depends on the quality of the block. Motor blockade and analgesia were also examined. The first investigation was done to answer the question of whether or not better results could be obtained by using a mixture of bupivacaine (0.75%) and mepicacaine (2%) or with bupivacaine alone. Injections were done observer-blind in all cases by the same operator. Pure bupivacaine provided the best anesthesia results. A second examination was done in the same way to measure the effects of the addition of hyaluronidase; motor blockade, analgesia und hypotonia of the globe were found to be significantly better with the addition of 75 IU of hyaluronidase.

Local tolerance and activity of MK-927, a novel topical carbonic anhydrase inhibitor.

A three-dose, randomized, double-masked, parallel, placebo-controlled ocular tolerance study was undertaken in 12 healthy, normal volunteers with the water-soluble, topical carbonic anhydrase inhibitor MK-927. To our knowledge, this constitutes the first administration of MK-927 to humans. Ten subjects received three drops of 2% MK-927 ophthalmic solution and two subjects received three drops of placebo (vehicle) in one randomly selected eye. Local tolerance of 2% MK-927 was acceptable and supports further clinical trials in patients. Significant intraocular pressure (IOP)-lowering activity was noted when comparing IOP four hours after first dose with that 20 hours predose in the treated eye of subjects receiving MK-927 (mean percent change in IOP, -29.7%; mean change in IOP, -4.6 mm Hg) as opposed to the same comparison for the contralateral, untreated eye (-7.2% and -1.3 mm Hg, respectively). In the two subjects treated with placebo, IOP-lowering activity was not seen in either the placebo-treated eye (-0.4%) or the contralateral, untreated eye (+3.1%).

[Silicone implant for surgery of therapy-refractory glaucomas]. / Silikonimplantat für die Operation therapierefraktärer Glaukome.

A silicone implant for surgery of refractory glaucomas has been developed. It consists of a tube 0.64 mm in diameter glued to the upper surface of a plate resembling a contact lens. The surgical procedure, which is similar to a trabeculectomy, is described.

[Injuries of the corneal endothelium]. / Verletzungen des Hornhautendothels.

Examples of "endogenous" or direct and "endogenous" or indirect endothelial trauma are presented. Corneal contusion, McCannel suture, YAG laser iridectomy, congenital luxation of the lens, and chronic over wearing of contact lenses all cause traumatic changes. The etiology and effects of these changes are discussed. Specular microscopy of the corneal endothelium permits good clinical control of both the trauma and wound healing.

[Aqueous humor outflow capacity after argon laser trabeculoplasty. Preliminary report]. / Kammerwasserabfluss-vermögen nach Argonlaser-Trabekuloplastik. Vorläufige Mitteilung.

In a prospective study of 44 eyes with open angle-glaucoma and 27 with pseudocapsular glaucoma, the aqueous humor outflow facility was controlled for up to 12 months following argon laser trabeculoplasty (ALT). The average increase in the facility of outflow, which was 70% in open-angle glaucoma, was 25% higher in pseudocapsular glaucoma. In successful ALT, this increase in outflow facility was established within the first 20 hours after coagulation and did not decrease during the following year. There were no major complications such as transitory elevations of intraocular pressure, hyphema, or severe uveitis; this fact is interpreted as a result of the authors' technique, in which only the light-pigmented trabecular meshwork is coagulated.

Lacrimal dacryoscintigraphy.

Lacrimal dacryoscintigraphy facilitates definite diagnosis of obstructions and stenosis of the lacrimal drainage system with little stress to the patient. Together with x-ray dacryocystography it is an important diagnostic tool especially for pre- and postoperative evaluation of the drainage apparatus. Dacryoscintigraphy is the best method for measuring the dynamics of tear drainage especially in the canaliculi. Although it is not a substitute for other methods in general use, it complements them and expands their diagnostic accuracy.

[Calcareous cataract]. / Cataracta calcarea.

In this report on a case of lens calcification the typical X-ray findings, the clinical sings and the unusual concentrations of calcium, phosphates, sodium, potassium and chloride are discussed.

[Nephropathic and benign cystinosis (author's transl)]. / Beitrag zur nephropathischen und benignen Zystinose.

Cystinosis is a rare, autosomally and recessively inherited disorder of amino-acid metabolism with ocular involvement. Four patients with this disease are reported on. The clinical signs of the first patient, who had nephropathic cystinosis, are compared with the signs and symptoms of the benign phenotype (benign cystinosis). In both nephropathic and benign cystinosis, multiple crystals were found in the cornea and conjunctiva. In the second case a large number of crystals were demonstrated in bone-marrow smears and conjunctival sections; a chromatogram of the conjunctiva indicated the presence of cystine. Although the results of an analysis of cultured fibroblasts from this case were contradictory, an elevated cystine level appeared likely. Crystals were also found in conjunctival sections from the third case. In the fourth case it proved impossible to demonstrate crystals clearly in either the bone marrow or in conjunctival sections. There was no evidence of any other cause of the corneal or conjunctival crystals.

Fluorescein angiography and changes in aqueous humor protein after argon laser photomydriasis in rabbits.

In brown-eyed and blue-eyed rabbits, irises treated with argon laser photomydriasis (ALP) were studied by using fluorescein angiography and by evaluating the aqueous humor protein concentration. The following results were obtained. Immediately after ALP, a breakdown of the blood-aqueous barrier is demonstrated by a marked influx of fluorescein into the ciliary processes and into the anterior and posterior chambers. The dye flow into the aqueous humor decreases to normal values within 3 days. There is no fluorescein leakage from laser impacts themselves. Peripupillary capillary loops are permanently occluded, but in a few cases, recanalization occurs. Neovascularization did not occur during 56 days of observation. ALP initially leads to a six- to eightfold increase in normal aqueous humor protein concentration, which decays to normal values within 3 days.

[Healing of argon laser lesions of the rabbit iris (author's transl)]. / Zur Abheilung von Argon-Laserläsionen der Kanincheniris.

Healing of perforating and low dose argon laser lesions of pigmented rabbit irides was studied by light microscopy. Low dose coagulation produced brown stained areas with fibrinous exudation of the surrounding tissue. Healing proceeded with little infiltration of leucocytes leading to an atrophic iris scar with numerous pigment macrophages. Laser iridotomies were closed within 28 days by a scar, shaped by proliferating cells and newly formed collagen fibrils. Lesions of the epithelium of the lens were demonstrated by hemalum staining of the nuclei, even in cases, when no lens opacities could be detected by biomicroscopy.

[The significance of fluorescein angiogarphy in ocular toxocara granuloma (author's transl)]. / Fluoreszenzangiographie beim okulären Toxocara-Solitärgranulom.

Four serologically-proved cases of intraocular toxocara infections are demonstrated. Three different manifestations in the following way were found: 1. Solitary granuloma on the posterior pole (2 patients). 2. Anterior and posterior uveitis of both eyes with granuloma near the ora (1 patient). 3. Iridocyclitis of both eyes (1 patient). The fluorescein angiography examination in two cases with solitary granuloma have been repeated over a period of time and the relation of the satisfactory results to the further development of the disease is shown.