Jonathan Clive Lake

Efeito terapêutico da aplicação intra-ocular de ozônio em modelo experimental de endoftalmite por Staphylococcus epidermidis em coelhos

PURPOSE: To evaluate the anti-inflammatory and antimicrobial effect of intraocular ozone diluted in BSS on experimental Staphylococcus epidermidis endophthalmitis. METHODS: We injected 0.1ml of S. epidermidis colonies (105 colonies/ml) to produce experimental endophthalmitis in the right eyes of 17 New Zealand rabbits. Seven rabbits were assigned to a control group and received an intravitreal injection of 0.1ml BSS. Ten rabbits were treated with intravitreal injection of 0.1ml BSS-diluted ozone (2 ppm). Data were distributed according to clinical and histological findings after 24 hours, each rabbit receiving a score. Mean scores and standard deviations were compared using the two-sample t test. RESULTS: Mean clinical score for the control group was 11.14 ± 1.04. Mean clinical score for the treated group was 4.90 ± 1.29, which was significantly lower (p<0.01). Mean histological scores were, respectively, 17.00+ 0.57 and 10.20 ±1.30 for the control group and the treated group. The histological scores were significantly lower for the treated group (p<0.01). All cultures in both control and ozone groups were positive after 24 hours of experiment. CONCLUSION: Treatment with diluted ozone significantly reduced the inflammatory reaction in our model of experimental endophthalmitis. This probably occurred due to a decrease in bacterial content after ozone injection. It is necessary to study other ozone concentrations in different experimental models in order to determine ozone efficacy with a higher precision.

Efeito do mel e do soro autólogo na cicatrização do epitélio corneano em coelhos

PURPOSE: To evaluate the efficacy of pure honey and 20% autologous serum and BSS® in corneal epithelial healing in rabbits after 48 hours. METHODS: All solutions were applied after an epithelial removal of 13-millimeters diameter area. Areas of epithelial healing were studied at 12, 24 and 48 hours. The eyes were treated every four hours during 2 days. All treated eyes were assigned to a control group (contralateral eye) treated with a balanced saline solution. RESULTS: All studied groups were not significantly differents. In group one, the eyes treated with honey and the control were similar (p<0.87). In the second group the eyes treated with autologos serum and the control presented no difference in the mean score (p<0.072). CONCLUSION: Corneal epithelial healing in rabbits did not show improvement after application of either honey or autologous serum. It was possible to stabilish that the autologous serum treated eyes were clinicaly better than the control group but without statistical significance.

Qualidade de vida após transplante penetrante de córnea

Purpose: To determine the quality of life in patients after penetrating keratoplasty using the VF-14 test and correlating it with final visual acuity. Methods: A total of 58 penetrating keratoplasty operated patients (1 year after surgery) were evaluated by the VF-14 test. Ophthalmological examination data were collected from their charts. Students t test and linear regression were applied. Results: The VF-14 ratio was 69.3. Best scores were obtained in activities such as cooking (90.9), card games (88.0), fine handworks (83.9). On the contrary, worst scores were found for car driving (at night, 22.5; and during the day, 40.9). Results were statistically significant (p< 0.01) and linear regression showed weak correlation between scores and final visual acuity (r=0.41). Conclusion: We observed a weak correlation between the quality of life and final visual acuity and suggest changes in this questionnaire including activities that are more adequate for our patients.

Citologia de impressão na ceratoconjuntivite primaveril

OBJETIVO: Estudar as alteracoes conjuntivais provocadas pela inflamacao cronica na ceratoconjuntivite primaveril por meio da citologia de impressao. METODOS: Foram analisadas amostras do epitelio conjuntival de 30 pacientes com ceratoconjuntivite primaveril e 30 individuos normais. O material foi colhido da conjuntiva bulbar superior, utilizando papel de filtro com poros de 0,45 µm. Em seguida, o material foi fixado e, apos 4 dias, corado com PAS, hematoxilina eosina e Papanicolaou modificado. A leitura das lâminas foi realizada por meio de microscopia optica e foram avaliados os seguintes parâmetros: celulas polimorfonucleares, juncoes intercelulares, mucina, celulas caliciformes e relacao nucleo/citoplasma. Apos isso, cada lâmina foi graduada segundo a escala de Nelson. O nivel de significância estatistica foi de 5%. RESULTADOS: Nos casos com ceratoconjuntivite primaveril observaram-se mais celulas polimorfonucleares, maior comprometimento das juncoes intercelulares, menor quantidade de mucina e maior alteracao na relacao nucleo/citoplasma que no grupo controle. Nao houve diferenca na quantidade de celulas caliciformes. A graduacao pela escala de Nelson mostrou acometimento generalizado da conjuntiva na ceratoconjuntivite primaveril. CONCLUSAO: A citologia de impressao e capaz de identificar o grau de acometimento conjuntival dos pacientes com ceratoconjuntivite primaveril.

Safety and efficacy of intracameral moxifloxacin injection for prophylaxis of endophthalmitis after phacoemulsification

PURPOSE To evaluate the safety and efficacy of 0.05 mL intracameral injection of moxifloxacin in patients who underwent phacoemulsification and intraocular lens (IOL) implant. METHODS Retrospective study comprising patients who underwent phacoemulsification and IOL implant between January 2009 and December 2013. Patients were divided into two groups. Group A followed standard endophthalmitis prevention protocol and group B followed the same protocol plus intracameral injection of 0.05 mL of moxifloxacin hydrochloride at 5.45 mg/mL, immediately after IOL implant. RESULTS Medical records from 7,195 eyes of 3,751 patients (median age: 67.8 ± 8.96, range: 48-83 years, 53.8% female) were evaluated. Group A included 3,515 eyes of 1,838 patients and group B included 3,680 eyes of 1,913 patients. The incidence of endophthalmitis in group A was 0.22% (8:3,515 eyes) and in group B was 0.03% (1:3,680 eyes, p=0.0198, Fischers exact test). No toxicity or inflammation related to the use of moxifloxacin was observed. CONCLUSIONS There was a 7.3-fold lower ratio of endophthalmitis in the group that received moxifloxacin intracameral injection. This study provides further evidence that moxifloxacin is an effective intracameral prophylactic antibiotic.

Injeção subconjuntival de soro autógeno no tratamento de queimadura ocular por álcali em coelhos

PURPOSE: To determine the activity of subconjunctival injection of autogenous serum in the treatment of ocular alkali burn induced experimentally in rabbits. METHODS: Thirty eyes of 30 New Zeland albino rabbits were divided into two groups of 15 and submitted to ocular alkali burn. One group (treated group) received immediately after the alkali burn a subconjunctival injection of autogenous serum. The results were compared and recorded immediately after the alkali burn and on days 1, 3, 7, 15, and 30 by external ocular examination and manual portable slit lamp. RESULTS: The treated group presented a better reepithelialization of the cornea than the control group, in the beginning of the process, with a statistically significant difference; and a final result with less complications, in the study group. CONCLUSION: The results obtained in this experimental study suggest that the autogenous serum may have a primary effect on the process of scarring of the eyes after ocular alkali burn, decreasing late complications and improving the prognosis related to the stability of the inflammatory scarring process.PURPOSE: To determine the activity of subconjunctival injection of autogenous serum in the treatment of ocular alkali burn induced experimentally in rabbits. METHODS: Thirty eyes of 30 New Zeland albino rabbits were divided into two groups of 15 and submitted to ocular alkali burn. One group (treated group) received immediately after the alkali burn a subconjunctival injection of autogenous serum. The results were compared and recorded immediately after the alkali burn and on days 1, 3, 7, 15, and 30 by external ocular examination and manual portable slit lamp. RESULTS: The treated group presented a better reepithelialization of the cornea than the control group, in the beginning of the process, with a statistically significant difference; and a final result with less complications, in the study group. CONCLUSION: The results obtained in this experimental study suggest that the autogenous serum may have a primary effect on the process of scarring of the eyes after ocular alkali burn, decreasing late complications and improving the prognosis related to the stability of the inflammatory scarring process.

Manifestações oculares em pacientes com esclerose múltipla em São Paulo

Purpose: To study frequency and characteristics of ocular manifestations in patients with multiple sclerosis (MS) in the State of Sao Paulo. Methods: From March, 1996 to November, 1998, 64 patients (48 female, 16 male, age 17 - 59) with MS underwent ophthalmologic examination and computerized visual field perimeter testing. Results: Forty-four (68.75%) of 64 examined patients presented some kind of ocular manifestation. The most frequent manifestation was optic neuritis (28 patients - 43.75%). It was the first manifestation of MS in 18 (28.1%) patients. Alterations of ocular motility were the second most frequent finding. Eight (12.5%) patients suffered from diplopia, of which 6 (9.37%) presented this as their first manifestation of MS. Sixth nerve palsy occurred in 2 patients (3.1%), with esotropia as a first sign of the disease. Other findings can be listed: uveitis (4 patients - 6.25%), changes in iridian topography with anterior lens capsule pigmentation (3 patients - 4.6%). The most frequent visual field defect in the patients who presented optic neuritis was arcuate scotoma with paracentral defects (46.4%). Two patients presented central scotomas and peripheral changes. None of the patients presented nystagmus. Conclusion: Our data shows that ocular findings in MS are frequent and many times are the initial manifestation of this disease. Although optic neuritis was the most frequent finding, we must emphasize the possibility of other ocular manifestations to be either preceding or occuring at the same time as this disease.