Gürsoy Alagöz

A comparative study of bimatoprost and travoprost: effect on intraocular pressure and ocular circulation in newly diagnosed glaucoma patients.

Background: This study compares intraocular pressure (IOP)-lowering efficacy and retrobulbar hemodynamic effects of bimatoprost and travoprost in patients with newly diagnosed open-angle glaucoma. Methods: Patients were randomly assigned to one of two treatment groups (bimatoprost group, n = 36; travoprost group, n = 46). IOP levels were measured with Goldmann applanation tonometer. Peak systolic velocity, end-diastolic velocity and resistivity index were obtained for each vessel by color Doppler imaging. Results: Both bimatoprost and travoprost significantly lowered IOP on days 30, 90 and 180 (p < 0.001). There was no significance between the 2 drugs on all follow-up visits. End-diastolic velocity of central retinal artery on day 180 was significantly higher than the value obtained at baseline in both groups. Conclusions: Patients were likely to achieve and maintain low target IOP with both drugs. Both drugs also resulted in improvement in the central retinal artery blood flow.

Comparison of ocular surface side effects of topical travoprost and bimatoprost.

Purpose: To compare the subjective symptoms, conjunctival hyperemia, tearing response and conjunctival cytological changes secondary to topical administration of bimatoprost and travoprost for 6 months. Methods: Newly diagnosed primary open-angle glaucoma patients were randomly prescribed bimatoprost (35 cases) or travoprost (42 cases). Two patients in each group were excluded because they did not appear at their appointments regularly. Thus, 33 and 40 patients completed the study in the bimatoprost and travoprost groups, respectively. Redness, itching, foreign-body sensation, pain and discomfort were assessed by a questionnaire, and patients were examined for conjunctival hyperemia. Schirmer’s I and break-up time tests were performed, and impression cytology of conjunctiva was evaluated. Results: Subjective symptoms were similar in both groups. The only subjective symptom that changed significantly was redness. The change in conjunctival hyperemia along the study period correlated with the patient-reported redness in both groups, being highest on day 30. Schirmer’s test I and break-up time did not change with time and were similar in both groups. The impression cytology grade increased with time in both groups with the only significant difference between groups on day 90 (higher in the bimatoprost group). Conclusion: We observed conjunctival hyperemia as the most common side effect of bimatoprost and travoprost. Tear film functions were not affected by these drugs while cytological alterations were.

Treatment of congenital nasolacrimal duct obstruction with high-pressure irrigation under topical anesthesia.

Purpose: To evaluate the effectiveness, safety, and success rate of high-pressure irrigation (HPI) applied under topical anesthesia in outpatient treatment of congenital nasolacrimal duct obstruction. Methods: HPI was applied under topical anesthesia to 39 eyes of 32 consecutive patients with congenital nasolacrimal duct obstruction. If obstructive symptoms persisted after the first attempt, treatment was repeated within 1 month. Patients were divided in two age groups: 7 to 12 months and 12 to 18 months. The two groups were compared in terms of the number of attempts needed to resolve the obstruction. Results: Thirty-nine eyes that had failed conservative treatment underwent high-pressure irrigation. The overall success rate was 31 of 39 (79.48%) at the first attempt; complete success (8/8, 100%) was achieved at the second attempt. The success rate in the younger group was 18 of 22 (81.8%) at the first attempt and 4 of 4 (100%) at the second attempt. The success rate in the older group was 13 of 17 (76.5%) at the first attempt and 4 of 4 (100%) at the second attempt. There was no statistically significant difference between the two groups regarding the number of attempts needed to relieve the symptoms (p > 0.05). There was no statistically significant difference in massage times and age between cases resolved at the first and second attempts (p > 0.05). Conclusions: HPI can be attempted as an alternative second-step treatment or as a transition procedure between conservative and invasive methods. HPI has the advantage of being less invasive than other secondary methods, and its application under topical anesthesia seems to be safe and effective.

Characteristics of Pellet Injuries to the Orbit

Purpose: To investigate the features of orbital injuries by pellets fired from the front. Design: Retrospective, 4 cases of pellet injuries. Methods: Five orbits of 4 patients who sustained pellet injuries received from the front were reviewed retrospectively. The course of injury and results were assessed. Radiological examinations were reviewed. The patients were evaluated between December 1996 and June 2004. Results: Five orbits of 4 patients sustained injuries caused by pellets fired from an anterior direction. The globe in the injured orbit was intact in 2 cases. Severe loss of vi- sion was also present in these 2 globes due to optic nerve involvement. Final visual acuity was down to no light perception in 4 eyes and limited to light perception in 1 eye. Conclusions: The prognosis of orbital pellet injuries is, unfortunately, poor. A pellet passing through the floor of the orbit often causes double perforation of the globe and, once in the orbital aperture, it travels towards the apex as a result of the conical shape of the orbit and lodges in the optic canal or its entrance, severely damaging the optic nerve. Surgery or other treatments are usually unsuccessful. Even if the globe is intact, vision is usually severely impaired.

Contents Vol. 223, 2009

W. Behrens-Baumann, Magdeburg S. Binder, Wien R. Brancato, Milan A.J. Bron, Oxford J. Cunha Vaz, Coimbra R. Dana, Boston, Mass. S.S. Hayreh, Iowa City, Iowa P.C.P. Ho, Hong Kong Y.-N. Hui, Xian J.B. Jonas, Mannheim A. Kanpolat, Ankara I. Kim, Boston, Mass. T. Kohnen, Frankfurt B. Lorenz, Giessen A. Negi, Kobe U. Pleyer, Berlin T. Reinhard, Freiburg G. Renard, Paris D. Spalton, London K. Tsubota, Tokyo P. Wiedemann, Leipzig X. Xu, Shanghai L. Zografos, Lausanne International Journal of Ophthalmology

Acknowledgement to the Reviewers

Iester Michele M., Genoa (Italy) Jandeck Claudia, Dillenburg (Germany) Jonas Jost B., Mannheim (Germany) Jordan Jens, Freiburg (Germany) Kashii Satoshi, Osaka (Japan) Katori Nobutada, Hamamatsu (Japan) Kazim Michael, New York, N.Y. (USA) Kishi Shoiji, Gunma (Japan) Kita Mihori, Shiga (Japan) Kitaoka Takashi, Nagasaki (Japan) Klauss Volker, München (Germany) Kniestedt Christoph, Zürich (Switzerland) Koh Adrian, Singapore (Singapore) Kohnen Thomas, Frankfurt (Germany) Konstas Anastasios G.P., Thessaloniki (Greece) Kotecha Aachal, London (United Kingdom) Kroll Peter, Marburg (Germany) Küchle Michael, Erlangen (Germany) Kurz Schmitz Sabine, Mainz (Germany) Kusaka Shunji, Osaka (Japan) Lagrèze Wolf A., Freiburg (Germany) Langmann Andrea, Graz (Austria) Lee Shu-Yen, Singapore (Singapore) Lorenz Birgit, Giessen (Germany) Lüchtenberg Marc, Frankfurt (Germany) Mackey David A., East Melbourne, Vic. (Australia) Menapace Rupert, Vienna (Austria) Mennel Stefan, Marburg (Germany) Mermoud André, Lausanne (Switzerland) Mester Ulrich, Sulzbach/Saar (Germany) Meyer Carsten H., Bonn (Germany) Meyer Peter, Basel (Switzerland) Meyer-Rüsenberg H.-W., Hagen (Germany) Michels Stephan, Zürich (Switzerland) Mimura Osamu, Hyogo (Japan) Mizota Atsushi, Urayasu (Japan) Mochizuki Manabu, Tokyo (Japan) Mohamed Moin, Leeds (United Kingdom) Mojon Daniel S., St. Gallen (Switzerland) Morse Lawrence S., Sacramento, Calif. (USA) Moshirfar Majid, Salt Lake City, Utah (USA) Murdoch Ian, London (United Kingdom) Nao-i Nobuhisa, Miyazaki (Japan) Ness Thomas, Freiburg (Germany) Olson Randall J., Salt Lake City, Utah (USA) Otani A., Kyoto (Japan) Pauleikhoff Daniel, Münster (Germany) Abe Haruki, Niigata (Japan) Alió Jorge L., Alicante (Spain) Araie Makoto, Tokyo (Japan) Augustin Albert J., Karlsruhe (Germany) Baatz Holger, Recklinghausen (Germany) Behrens-Baumann Wolfgang, Magdeburg (Germany) Birnbaum Florian, Freiburg (Germany) Blumberg Dana, Baltimore, Md. (USA) Brookes John, London (United Kingdom) Brusini P., Udine (Italy) Callizo Planas Josep, Marburg (Germany) Catoira-Boyle Yara, Indianapolis, Ind. (USA) Chee Soon-Phaik, Singapore (Singapore) Cheng Bobby, Singapore (Singapore) Chihara Etsuo, Kyoto (Japan) Clemens Stefan, Greifswald (Germany) Crandall Alan, Salt Lake City, Utah (USA) Cunha-Vaz José G., Coimbra (Portugal) Degenring Robert, Mannheim (Germany) Deuter Christoph, Tübingen (Germany) Dick H. Burkard, Bochum (Germany) Duncker Gernot I.W., Halle (Germany) Emmerich K.-H., Darmstadt (Germany) Esser Joachim, Essen (Germany) Forlini Cesare, Ravenna (Italy) Friedburg Dieter, Krefeld (Germany) Fries Ulrich, Bonn (Germany) Frisen Lars, Göteborg (Sweden) Geerling Gerd, Würzburg (Germany) Gelisken Faik, Tübingen (Germany) Goldblum David, Basel (Switzerland) Grunz Christiane, Marburg (Germany) Güell Joseph L., Barcelona (Spain) Gümbel Hermann O. C., Ulm (Germany) Guthoff Rudolf, Rostock (Germany) Hammer Beat, Aarau (Switzerland) Hansen Lutz Lothar, Freiburg (Germany) Haritoglou Christos, München (Germany) Hattenbach Lars-Olof, Ludwigshafen (Germany) Heiligenhaus Arnd, Münster (Germany) Helbig Horst, Regensburg (Germany) Hesse Lutz, Heilbronn (Germany) Holló Gábor, Budapest (Hungary) Holmes Jonathan, Rochester, N.Y. (USA) Holz Frank G., Bonn (Germany) Honda Shigeru, Kobe (Japan) Hörle Steffen, Marburg (Germany)