Jens Sindberg Eriksen

TIMOLOL TRANSITORY MANIFESTATIONS OF DRY EYES IN LONG TERM TREATMENT

In 64 patients treated with timolol eye drops (0.25% and 0.50%) seven patients developed transitory sensation of dry eyes. Two of these subjects also had xerostomia. Conjunctival and corneal defects were disclosed simultaneously with rose bengal staining. Morphologically, some of these lesions might have the same appearance as of the early stages of kerato‐conjunctivitis sicca. A reduction of Schirmer test and break‐up time was noted. The duration of symptoms ranged from 3 to 13 days. The mean time of treatment at the début of symtoms was 30 weeks (range 23–43 weeks). A pathogenesis of these seemingly harmless findings is at the present obscure.

The concentration of lysozyme and secretory IgA in tears from healthy persons with and without contact lens use

Abstract. A comparison of tear lysozyme and tear secretory IgA, determined by micropipette sampling and immunoassay technique, between 18 long‐term contact lens wearers (median age 35 years, median lysozyme concentration 1.93 g/l, median IgA concentration 0.72 g/l) and 42 non‐contact lens wearers (median age 41 years, median lysozyme concentration 2.21 g/l, median IgA concentration 2.42 g/l) disclosed a significant decrease (P < 0.01) of secretory IgA in the contact lens group. The decrease of secretory IgA was associated (P < 0.01) with the presence of deposits on lens surface. No differences in lysozyme concentration was found between the two groups (P > 0.05). The duration of lens wear was 8.5 years in average ranging from 1 to 23 years. These findings of decreased secretory IgA might partly explain the fact that contact lens wearers are more exposed to infectious corneal and conjunctival complications than non‐contact lens wearers.

CORNEAL THICKNESS AND ENDOTHELIAL DAMAGE AFTER INTRAOCULAR LENS IMPLANTATION

The corneal thickness and the specular appearance of the corneal endothelium are reported in 100 patients with unilateral intraocular lens implantation. Post‐operative time ranged from one to 42 months. An average central endothelial cell loss of uncomplicated cases of 46%, range 1 to 83%, with no correlation with time after the operation was found. A significantly higher cell loss was found in cases with technical complications, shallow anterior chamber or increased intraocular pressure post‐operatively. No correlation was found between the corneal thickness and the endothelial cell loss. In two patients, however, with a cell density below 500 cells/mm2, a slight increase in corneal thickness was noted. Thirty patients presented a guttate endothelium. Irrespective of the occurrence of surgical complications the presence of a guttate endothelium was found to be a major determinant of the corneal thickness increase and could be ascribed as a cause of persistent corneal swelling in six of twelve patients with elevated corneal thickness. The progression of guttate changes occurred independently of the cell loss.

Timolol in maintenance treatment of ocular hypertension and glaucoma.

The hypotensive effect of Timolol eye drops (0.25 and 0.50%) in maintenance treatment of 64 patients with elevated intraocular pressure has been studied. The patients were treated for a period of mean 13 months. In 44 patients, mostly comprising ocular hypertensives, a significant reduction in IOP (32%) could be maintained with Timolol alone (P < 0.001).

Photochemical vs. electrochemical electron-transfer reactions. one-electron reduction of aryl halides by photoexcited anion radicals

Abstract Electrochemical reduction of aryl halides generally leads to expulsion of halide ion. The product aryl radical is unavoidably further reduced. In contrast, reduction of aryl halides by photoexcited anion radicals may be stopped at the aryl radical stage owing to the bimolecular nature of electron-transfer reactions. We have tested this hypothesis by photoinducing electron-transfer from anthraquinone anion radical to several aryl halides. For each halide it was possible to trap the corresponding radical by anthracene forming stituted 9-phenylanthracenes.

Timolol and metoprolol in glaucoma. A comparison of the ocular hypotensive effect, local and systemic tolerance.

A double‐masked cross‐over comparison of the ocular hypotensive effect in 19 glaucoma patients between timolol 0.5% ‐ a non‐selective beta‐blocking agent ‐ and metoprolol 3% ‐ a betar‐selective blocking agent ‐ disclosed a greater pressure lowering effect (mean 9%, median 7% more) with timolol in a treatment period of 1 month. In patients on timolol treatment 47%‐60% of the eyes could be controlled on an IOP level < 20 mmHg compared to 34%‐47% of the eyes treated with metoprolol. Metoprolol induced a transitory burning sensation in the eyes of 58% patients compared to 26% treated with timolol. Possible signs of dry eyes manifestations as measured by break‐up time, rose bengal and fluorescein 1% staining, tear osmolality and Schirmer test I developed in both the timolol (4 patients) and metoprolol (3 patients) treated group. No significant influence on blood pressure and heart rate was observed. In none had the visual field or visual acuity deteriorated at the end of the study.

LYSOZYME, ALFA‐1‐ANTITRYPSIN AND SERUM ALBUMIN IN TEAR FLUID OF TIMOLOL TREATED GLAUCOMA PATIENTS WITH AND WITHOUT SYMPTOMS OF DRY EYES

Determination of tear lysozyme, alfa‐1‐antitrypsin and serum albumin was performed in the tear fluid of 24 glaucoma patients on maintenance treatment with timolol. In 7 patients with symptoms of dry eye decreased levels of tear lysozyme and increased levels of alfa‐1‐antitrypsin and serum albumin were disclosed in contrast to 17 timolol treated patients without dry eyes and to healthy controls. The timolol treated patients with ocular dryness also showed hyperosmolality of tear fluid, abnormal corneal staining with rose bengal and decreased break‐up time and Schirmer‐I‐test. It is concluded that decreased concentration of tear lysozyme in glaucoma patients on topical treatment with timolol may indicate some impairment of the teargland function provoked by the treatment.

Unusual ocular manifestation in temporal arteritis. A case report.

Transitory oedema of the left orbit and maxillary sinus was revealed radiographically in an active phase of temporal arteritis. This is possibly caused by inflammatory changes of the soft tissues in these regions. Early signs of compromised retinal flow and anterior ischemic optic neuropathy were demonstrated with fluorescein angiography. This finding promoted early, immediate therapy.

Photochemistry of 1,3-dimethyluracil: a novel photochemical ring-opening leading to an enamine

Abstract Besides known reduction and solvent addition products, the photolysis of 1,3-dimethyluracil in methanol resulted in formation of the enamine 2-methoxycarbonyl-N-methyl-3-methylaminopropenamide (5) via a novel ring-opening reaction. A mechanism for the formation of 5 is suggested and its structure was confirmed by an independent synthesis.

VISUAL OUTCOME AND COMPLICATIONS IN 287 INTRAOCULAR LENS IMPLANTS (FEDEROW) COMPARED WITH 290 INTRACAPSULAR CATARACT EXTRACTIONS

In 287 consecutively intracapsular cataract extracted eyes with a Federow intraocular lens implant (IOL) and 290 eyes with consecutively performed intracapsular cataract extractions (ICCE) the final visual outcome and complications were examined in a retrospective study. The average observation time was 31 months in the IOL group and 37 months in the ICCE group. Seventy‐five per cent in the IOL group and 77% in the ICCE group achieved a visual acuity ≥ 0.5. The main cause of a visual acuity <0.5 was maculopathy pre‐operatively recognized. A visual acuity <0.5 due to post‐operative complications occurred more frequently in the IOL group (28 eyes) compared with the ICCE group (13 eyes) ‐ P <0.01. Twelve intraocular implants (4.3%) had to be removed. The most important cause was dislocation of the IOL (9 eyes). During our first 12 months of IOL implantation 8 dislocations occurred out of 56 implanted eyes (14.3%). The remaining 6 dislocations occurred among the last 231 IOL eyes (2.6%). It is concluded that complications are few, but often serious in intraocular lens implant surgery. Careful pre‐operative examination and surgical experience are mandatory.