Corneal wound healing after superficial foreign body injury: vitamin A and dexpanthenol versus a calf blood extract. A randomized double-blind study.

A prospective randomized double-blind clinical study was performed to investigate corneal wound healing after treatment either with an eye gel containing calf blood extract or an eye ointment containing vitamin A and dexpanthenol. A total of 54 outpatients were included in this study, all treated for corneal foreign body injury. The size of the corneal lesions was measured by planimetry on days 0, 1, and on the following days until complete epithelial healing occurred. Results showed the calf blood extract eye gel to be statistically more effective in promoting corneal wound healing, especially in patients with wound areas larger than 6 mm(2).

Bacterial growth in human vitreous humor.

The aim of this study was to investigate the capacity of human vitreous to support bacterial growth and to show differences in the growth kinetics of gram-positive and gram-negative bacteria. Vitreous gel of 70 keratoplasty donor eyes was sampled under sterile conditions, screened microscopically for cellular components and tested for sterility and levels of antibiotic drugs by bio-assay. The samples were inoculated with clinical isolates of Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus viridans and Streptococcus pyogenes. As control each strain was added both to 0.9% sodium chloride solution and to Mueller-Hinton broth. In order to determine bacterial growth the number of colony forming units was determined 4, 6, 24, 48 and 72 hr after inoculation by viable count. Vitreous gel did not support bacterial growth; the tested strains could not be recovered after 48 hr. Similar results could be obtained with sodium chloride; whereas in Mueller Hinton broth the strains showed normal pattern of growth. It seems that vitreous humor has inherent antibacterial capacity in vitro, although the responsible factors remain unknown.

Ocular side effects associated with 13-cis-retinoic acid therapy for acne vulgaris: clinical features, alterations of tearfilm and conjunctival flora.

Isotretinoin (13-cis-retinoic acid) is commonly used for the treatment of acne vulgaris. We included 55 patients in this prospective study, and inspected them before, while and after therapy with isotretinoin regarding ocular side effects. Careful slit-lamp inspection, measurement of break-up-time and Schirmer-test and microbiological investigations of the conjunctival flora were performed. While staphylococcus aureus was cultured from the conjunctival sac before application of isotretinoin in 7.3%, this percentage increased to 61.8% during therapy. A pathological decrease of break-up-time was realized in 69.1% of the cases, the development of blepharitis in 40%. But in spite of the alteration of conjunctival flora, bacterial conjunctivitis developed in just 7.3% of the cases. However, only 34.5% of the patients showed symptoms of a conjunctivitis sicca, in spite of the impressive diminution of break-up-time in so many cases. All ocular side effects of isotretinoin were treatable and disappeared completely within 1 month after stopping therapy.

Canaliculitis: difficulties in diagnosis, differential diagnosis and comparison between conservative and surgical treatment.

The most important clinical features of canaliculitis include a red, swollen eyelid in the area of the affected canaliculus, a unilateral conjunctivitis, a mucopurulent discharge and in some cases dacryoliths visible in the lacrimal punctum. Conservative therapy was found to be little effective: only 10% of the patients could be cured, 40% showed a recurrence after conservative treatment. 20 patients (50%) were treated by canaliculotomy: 16 of these were cured by this surgical treatment, 4 patients complained of epiphora, although diagnostic syringing showed free lacrimal pathways. The surgical treatment of canaliculitis in combination with conservative therapy yields far better results than conservative therapy alone.