BackgroundTo evaluate the treatment with topical 0.05% cyclosporine A (CsA) in patients with subepithelial corneal infiltrates (SEI).MethodsWe reviewed 16 patients (22 eyes) before and after the treatment with 0.05% CsA eye drops. All patients had been treated previously with topical corticosteroids without any improvement and also they had to stop the medication secondary to intraocular pressure elevation. The objective data recorded included best-corrected visual acuity (BCVA), evaluation of corneal subepithelial infiltrate scores (CSIS), intraocular pressure (IOP) prior to treatment and the last follow-up visit.ResultsSix males (37.5%) and 10 females (62.5%), mean age of 35.2 ± 16.6 years, were included. The patients’ average topical CsA use duration was 5.1 ± 3.5 months (1 – 13 months). The average follow up time of the patients was 9.2 ± 4.7 months (4 – 22 months). One patient, although he didn’t have a 0 scale of SCIS, did not show up for follow up examinations after six months. The mean BCVA (logarithm of the minimum angle of resolution) before and after the treatment were 0.15 ± 0.15 and 0.07 ± 0.07 respectively, CSIS 1.68 ± 0.89 and 0.23 ± 0.53 respectively, IOP 18.50 ± 3.82 and 16.86 ± 2.76 mmHg respectively. There were statistically significant improvements in BCVA (p = 0.002), reduction of CSIS (p = 0.002) and reduction of IOP (p < 0.001) prior to treatment and the last follow-up visit. 18 eyes (81.9%) showed clinical improvement and 4 (18.1%) had decreased SEI which did not fully disappear during the treatment period. The eyes which reached CSIS score 0 (18 eyes) were treated with CsA for 1 – 13 months; while the eyes which had clinical improvement but had not CSIS score 0 (4 eyes) were decided to discontinue of CsA treatment in last follow-up visit. There were recurrences in 2 eyes 3 months after the treatment. Patients reported reduction in the severity of symptoms after the treatment. Most of the patients reported no foreign body sensation, glare, or other side effects with topical CsA treatment. Overall, patients noted an improvement in vision and satisfaction with topical 0.05% CsA treatment.ConclusionsTopical 0.05% CsA is a safe and effective alternative treatment in patients with SEI who do not respond to other treatment modalities or have undesired side effects from topical steroids.
Flow injection cold vapor atomic absorption spectrometry (FI-CVAAS) was used for determination of cadmium in high salt matrices such as dialysis concentrates and textile leach solutions. The parameters such as acidity, concentration of reducing agent, reaction coil length, and carrier gas flow rate were investigated to obtain the best sensitivity. No significant background signal was observed even at high salt concentrations. Under the optimized conditions the limit of detection value (3s b m −1 , where sb is the standard deviation of the blank signals and m is the slope of the calibration graph) was found to be 0.05 ng mL −1 for an injection volume of 250 μ L and the precision in terms of relative standard deviation was 3.2% using 11 consecutive measurements of 0.5 ng mL −1 standard. The standard addition method was used for quantitation. The accuracy of the method was tested using ETAAS as a comparison method and a certified reference material (Waste Water EU-L-1). In both cases, the results were in good agreement at 95% confidence level. The concentrations of cadmium in textile product leach solutions were found to be below the limit value assigned by Oeko-Tex standards.
PurposeThe aim of this study was to show the efficiency of preoperative botulinum toxin A (Botox A) in patients with benign essential blepharospasm who were to undergo ocular surgery with local anesthesia.Materials and methodsTwenty-eight benign essential blepharospasm patients who were administered unilateral Botox A prior to ocular surgery between January 2004 and May 2011 were included in this study. Eleven cases had pterygiums, ten had cataracts, and four had glaucomas, while the remaining three had aphakia. All cases’ severity of spasm (stage 0–4) and eyelid closing forces (stage 1–4) were evaluated according to the Jankovic scale prior to the injection, at 3 days, 14 days, 1 month, and 3 months after Botox A injection.ResultsOf the patients enrolled in the study, 16 were female and 12 were male, with an average age of 55.52 ± 1.53 years (52–65). Average onset of the Botox injection’s effect was 2.8 ± 0.9 (2–5) days. Its effect lingered for about 11.5 ± 3.6 (8–22) weeks. The severity of spasm and eyelid closing forces of all the patients enrolled were compared prior to the injection at 3 and 14 days and the first and third months after the injection. There were statistically significant differences between prior to the injection and 3 days (P = 0.001), 14 days (P < 0.001) and 1 month after the injection (P < 0.001). There was no statistically significant difference between prior to the injection and 3 months after the injection (P = 0.513). Fourteen days following the injection, the surgeries were successfully performed.ConclusionBotox A administered prior to ocular surgery will control both blepharospasm and lower the risks that can be encountered before and during surgery, thus increasing the comfort of the patient and the surgeon.
Objective: To evaluate the results of corneal cross-linking with UV-A/riboflavin in patients with progressive keratoconus.Methods: Forty-seven eyes of 30 patients with progressive keratoconus (16 female, 14 male) were included in the study. Uncorrected and the best corrected distance visual acuities, biomicroscopic findings, intraocular pressure measurements, fundoscopic findings, pachymetric measurements and corneal topography parameters were recorded for each patient. Results:The mean age of the patients was 18.3±5.34 (range: 8-31) years and the mean follow-up duration was 7±2.4 (range: 3-12) months. Following the procedure, the mean decrease in K1, K2, Kav, spherical and cylindrical values were 0.77 D, 0.85 D, 0.80 D, 0.50 D and 0.74 D, respectively (p<0.05). There were no cases with decrease in visual acuity and significant complication during or after the treatment. Conclusion:Cross-linking with riboflavin/UV-A in patients with progressive keratoconus is an effective procedure. In addition, the preservation of visual acuity and not seen a significant complication indicate that a safe metod. However, large prospective randomized controlled studies are needed to evaluate the long-term effects of this treatment.
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