Topical medications have a very important role in chronic glaucoma treatment. Long-term use of these medications can cause significant changes on ocular surfaces. In this study, the ocular surfaces of 20 control subjects (group I), 20 primary open-angle glaucoma patients (group II) treated (mean 21.20 +/- 1.32 months) with 0.50% timolol maleate, and 20 primary open-angle glaucoma patients (group III) treated (mean 21.70 +/- 1.34 months) with 0.50% timolol maleate + 1% dipivefrin hydrochloride were evaluated. Studied parameters included Schirmer's test, tear break-up time, conjunctiva impression cytology and goblet cell density. These results suggest that long-term applications of topical anti glaucoma medications damage the ocular surface.

A 47-y-old female underwent revision of a left total hip replacement because of loose prosthesis. Routine intraoperative culture of the hip site grew Brucella sp. The patient was treated with a combination of vibramycin and rifampicin for 5 months. At 4-y follow-up, her condition is good. Though prosthetic infection with Brucella spp. is an extremly rare condition (only 1 case each of femur and hip, and 3 cases of knee had been previously reported in the English literature), brucella infection of prosthetic joints should be considered in brucella endemic areas.

No abstract

Purpose To determine the beneficial effect of topically administered Cyclosporine A (CsA) for the dry eye findings of thyroid orbitopathy patients. Patients and methods This prospective pilot study included 73 eyes of 42 patients with thyroid orbitopathy who had documented dry eye findings. Patients were randomly assigned into two groups: in group 1 (48 eyes), patients received topical artificial tear-drop treatment. In group 2 (25 eyes), patients received topical CsA and artificial tear-drop treatment. During a mean follow-up of 6 months, change in Schirmer's test with aneasthesia, tear break-up-time (BUT) and impression cytology results were analyzed and were compared between groups. Results The two groups were age (P ¼ 0.449) and gender (P ¼ 0.942) matched. The Schirmer's test (P ¼ 0.441), tear BUT (P ¼ 0.718) and impression score (P ¼ 0.103) were also similar before the treatment in both groups. In group 1, all three parameters improved significantly with treatment (Po0.001 for all). In group 2, Schirmer's test (P ¼ 0.001) and tear BUT (Po0.001) improved, but the impression score (P ¼ 0.175) did not change significantly after treatment. The percentage of patients with improved tear BUT (P ¼ 0.04) and improved impression score (Po0.001) were higher in group 1. At the end of follow-up, group 1 patients had better Schirmer's test (P ¼ 0.004), tear BUT (P ¼ 0.021) and impression scores (Po0.001), than group 2 patients. Conclusions The combined CsA use with artificial tear drops is not more advantageous than the use of artificial tear drops alone, for the dry eye findings of thyroid orbitopathy patients.

The results of primary trabeculectomy with and without mitomycin C (MMC) were evaluated in young glaucoma patients. The patients, 15–40 years of age, were divided into two main groups and two subgroups. In group IA, primary Cairns type trabeculectomy was performed in 24 eyes of 24 patients with juvenile glaucoma; in group IB, trabeculectomy + MMC 0.4 mg/ml in 3 min was done in 20 eyes of 20 patients with juvenile glaucoma; in group IIA, primary trabeculectomy was performed in 20 eyes of 20 patients with developmental glaucoma, and in group IIB, trabeculectomy + MMC 0.4 mg/ml in 3 min was performed in 16 eyes of 16 patients with developmental glaucoma. The success rate of the surgery was 75% in group IA, 90% in group IB, 50% in group IIA, and 75% in group IIB. There was no statistically significant difference among the groups in terms of success rates of trabeculectomies (p > 0.05).