Evaluation of topical 0.03% flurbiprofen drops in the treatment of herpetic stromal keratitis

Purpose: The management protocol for herpetic stromal keratitis (HSK) is still controversial. We have attempted to compare the relative efficacy of topical dexamethasone 0.01 % and flurbiprofen 0.03% in combination with topical acyclovir 3% in HSK.
Methods: In this institutional, prospective, randomized, controlled, double-blind study, 45 clinically diagnosed cases of HSK were randomly distributed into three coded treatment groups — topical placebo, dexamethasone 0.01 %, and flurbiprofen 0.03% each in tapering frequency and in combination with acyclovir 3% ointment five times per day for four weeks. Therapeutic response was assessed every third day for four weeks. Decoding of the treatment groups was done at the conclusion of the study and data analysed.
Results: Four-week success rate was 93.3% (14 of 15) in the dexamethasone-acyclovir treatment group, 66.7% (10 of 15) in the flurbiprofen-acyclovir treatment group and 20% (3 of 15) in the placeboacyclovir treatment group.
Conclusion: While dexamethasone in combination with acyclovir gives the best results in HSK with minimal side-effects, the role of topical flurbiprofen seems promising.     

Retreatment of LASIK

PURPOSE: To review the indications, techniques, and results of retreatment LASIK. METHODS: Review of the literature and the authors' experience. RESULTS: Patient selection is the key to successful LASIK enhancement. The enhancement procedure should generally be undertaken 3 months after the initial LASIK procedure. Relifting of the flap may be done easily within 1 year of previous LASIK surgery. A new LASIK flap is required in cases with previously complicated LASIK. LASIK retreatment by lifting the flap is an effective and safe procedure. Overall improvement is seen in uncorrected visual acuity (> or = 20/20 and > or = 20/40) and postoperative spherical equivalent refraction within +/- 0.5 D and +/- 1.0 D. CONCLUSIONS: LASIK retreatment is an effective modality to treat regressions and residual refractive errors.     

Automated lamellar therapeutic keratoplasty (ALTK) in the treatment of anterior to mid-stromal corneal pathologies

PURPOSE: To evaluate the efficacy of automated lamellar therapeutic keratoplasty (ALTK) in the treatment of anterior to mid-stromal corneal pathologies. METHODS: A prospective clinical study was undertaken in 15 eyes of 15 patients who underwent ALTK using the ALTK System (Moria/Microtek Inc., Doylestown, Pennsylvania, USA). The parameters evaluated were uncorrected and best corrected visual acuity (BCVA), keratometry, pachymetry, contrast sensitivity, glare acuity, intraoperative surgical time and complications, postoperative time to epithelialization, graft clarity and postoperative complications. RESULTS: The mean surgical time was 46 +/- 9 mins. The BCVA, contrast sensitivity and glare acuity significantly improved at 6 months postoperatively. The mean decimal BCVA was 0.08 +/- 0.03 preoperatively, which improved to 0.33 +/- 0.30 at 6 months, when 11 eyes had BCVA > or = 6/18. The median epithelialization time was 3 days (range 1-10 days). CONCLUSIONS: Automated lamellar therapeutic keratoplasty appears to be safe and effective for diseases affecting the anterior to mid-stroma of the cornea.     

Development of a candidate DNA/MVA HIV-1 subtype C vaccine for India

Development of a vaccine against human immunodeficiency virus type-1 (HIV-1) is the mainstay for controlling the AIDS pandemic. An ideal HIV vaccine should induce neutralizing antibodies, CD4+ helper T cells, and CD8+ cytotoxic T cells. While the induction of broadly neutralizing antibodies remains a highly challenging goal, there are a number of technologies capable of inducing potent cell-mediated responses in animal models, which are now starting to be tested in humans. Naked DNA immunization is one of them. The present study focuses on the stimulation cell-mediated and humoral immune responses by recombinant DNA-MVA vaccines, the areas where this technology might assist either alone or as a part of more complex vaccine formulations in the HIV vaccine development. Candidate recombinant DNA-MVA vaccine formulations expressing the human immunodeficiency virus-1 env and gagprotease genes from HIV-1 Indian subtype C were constructed and characterized. A high level of expression of the respective recombinant MVA (rMVA) constructs was demonstrated in BHK-21 cells followed by the robust humoral as well as cell mediated immune (CMI) responses in terms of magnitude and breadth. The response to a single inoculation of the rDNA vaccine was boosted efficiently by rMVA in BALB/c mice. This is the first reported candidate HIV-1 DNA/MVA vaccine employing the Indian subtype C sequences and constitutes a part of a vaccine scheduled to enter a preclinical non-human primate evaluation in India.