Enhancing best practices in ophthalmology for prevention of nosocomial epidemic keratoconjunctivitis infections

Epidemic keratoconjunctivitis (EKC) outbreaks were reported as early as the 1940s in the United States. Nearly 80 years later, EKC remains a major eye health concern in the US and worldwide. Of particular concern is that a significant number of EKC cluster outbreaks in the US are healthcare acquired infections (HAIs) at ophthalmology offices. Therefore, immediate attention to enhancing best practices of standardization and universal precautions in ophthalmology is paramount.     

Application of umbilical cord serum eyedrops after laser epithelial keratomileusis

Purpose: To investigate the efficacy of umbilical cord serum eyedrops after laser epithelial keratomileusis (LASEK). Methods: Sixty patients (120 eyes) with myopia who underwent LASEK were studied. Thirty‐two patients (64 eyes) were treated with 20% umbilical cord serum eyedrops in combination with conventional treatment (group A), and 28 patients (56 eyes) received conventional treatment only (group B). Epithelial healing time was analysed. Visual acuity, refraction, haze score (0–4) and tear film and ocular surface parameters were evaluated at 1, 2, 4 and 12 weeks after LASEK. The concentration of transforming growth factor (TGF)‐β1 in tears was measured with ELISA at 1 week after LASEK. Results: No significant differences in visual acuity and refraction were found between groups. The mean time to epithelial healing was 3.53 ± 1.19 days in group A and 3.91 ± 1.41 days in group B (p = 0.18). The mean haze scores at 2 and 4 weeks were 0.59 ± 0.80 and 0.31 ± 0.54 in group A and 1.06 ± 0.91 (p = 0.02) and 0.69 ± 0.78 (p = 0.03) in group B. Four and 12 weeks after LASEK, tear film break‐up time was longer and keratoepitheliopathy score was lower in group A compared with group B. The mean concentration of TGF‐β1 was lower in group A compared with group B (p = 0.01). Conclusion: Application of 20% umbilical cord serum eyedrops in addition to conventional treatment after LASEK can reduce early postoperative corneal haze and improve tear film and ocular surface parameters.     

苏为坦滴眼液的替代降眼压作用

目的:在其他降眼压药物眼压控制不佳、或无法耐受其他降眼压药物的原发性开角型青光眼或高眼压症患者中评价苏为坦TM0.04g/L的治疗效果。方法:使用单种或多种降眼压药物后眼压控制不佳,或无法耐受其他降眼压药物的原发性开角型青光眼或高眼压症患者40例61眼,给予苏为坦滴眼液替代治疗。每晚点药1次,每次1滴。将连续点药后1,4,12wk的眼压与基线眼压进行比较研究,同时观察血压、心率等全身及局部副作用及其患者的依从性。结果:使用苏为坦滴眼液后眼压明显下降。连续点药1,4,12wk眼压下降分别为6.78±3.45mmHg,5.92±4.29mmHg,5.88±4.12mmHg,P<0.05;降压有效率分别为97%,93%,92%。用药后1,4,12wk降压效果比较,无统计学差异。用药前后,视力、视野、视乳头杯盘比、血压均无明显改变。不良反应发生率为22%,均为轻度,最主要的不良反应为结膜充血,但不妨碍继续用药。患者依从性好。结论:苏为坦TM0.04g/L滴眼液对治疗其他降眼压药物眼压控制不佳、或无法耐受其他降眼压药物的原发性开角型青光眼或高眼压症患者是有效和安全的。     

左旋氧氟沙星滴眼剂的研制

目的 :以苯扎溴铵为抑菌剂 ,氯化钠为渗透压调节剂 ,聚乙烯吡咯烷酮 (PVP)为增粘剂 ,制备左旋氧氟沙星缓释滴眼剂。方法 :含量测定采用高效液相色谱法 ;稳定性实验以60℃～90℃之间每5℃为1个梯度进行考察。结果 :加样回收率高 ,日内、日间相对标准偏差均<3 %。预测有效期为1 5年。家兔眼刺激性实验表明 ,本制剂对家兔眼睛无刺激性 ,符合《中国药典》对滴眼剂的质量要求。结论 :本制剂性质比较稳定     

Allergenicity and tolerogenicity of amlexanox in the guinea pig

Amlexanox (AMLX), an anti-allergic agent, is available in Japan as Elics® opthalmic solution, Solfa® nasal douche and Solfa® tablets. Cases of allergic contact dermatitis induced by Elics® ophthalmic solution, which contains 0.25% AMLX, were reported within a year of its introduction. We therefore examined the contact sensitizing potency of AMLX. Guinea pigs sensitized to 0.25% AMLX exhibited a strong positive patch test reaction. Further, AMLX-sensitized animals developed rashes following oral and systemic challenge with AMLX. This animal model reflected the clinical experience of systemic contact dermatitis due to AMLX. The non-responsiveness induced by oral administration of AMLX to AMLX-induced animals was transient, and clinical prophylaxis by desensitization with oral AMLX may only increase the risk of systemic contact dermatitis. On the other hand, there have been few reports of drug eruption from oral Solfa® tablets in spite of their wide use. Therefore, we also examined the induction of tolerance by oral administration of AMLX. Oral administration of AMLX before sensitization resulted in complete non-responsiveness. It seems likely that a substantial reduction in the risk of AMLX sensitization by Elics® may be achieved by prior oral administration of Solfa® tablets containing AMLX.     

Cysteamin eyedrops in three patients with nephropathic cystinosis

Cysteamin-P04 eyedrops 5 mMol/l, given to three patients with nephropathic cystinosis brought a great relief from their photophobia and in two of the three patients a measurable decrease in the glare was shown.