1.Effect of topical ketorolac tromethamine and topical nepafenac on maintaining pupillary dilation during phacoemulsification
Richard Atanis ; Prospero Ma. Tuañ ; o ; Jay Vicencio ; Jose Ma. Martinez ; Lee Verzosa
Philippine Journal of Ophthalmology 2011;36(1):23-27
Objective:
This study compared the effectiveness of prophylactic administration of topical ketorolac tromethamine 0.5% and nepafenac 0.1% on maintaining mydriasis during phacomulsification.
Methods:
This is a prospective, randomized, double-masked comparative study involving adult cataract patients given topical NSAIDs (ketorolac or nepafenac) or balanced salt solution (control) prior to phacoemulsification and capsular bag intraocular-lens (IOL) implantation at a tertiary hospital. Horizontal and vertical diameters of pupil were measured at different stages of cataract surgery and the mean values were compared across the three groups.
Results:
A total of 47 eyes of 44 cataract surgery patients, 13 males and 34 females, with a mean age of 66.04 ± 8.87 years, were included in the study. The mean horizontal and vertical diameters of the three groups were similar at the start of surgery. Significant differences were seen after IOL implantation, with the nepafenac group having the largest mean diameters in both horizontal (p = 0.012) and vertical (p = 0.012) pupil measurements.
Conclusion
Topical nepafenac has been shown to be a more effective inhibitor of miosis during phacoemulsification and provides a more stable mydriatic effect throughout the surgical procedure compared to topical ketorolac and placebo.
Cataract
;
Phacoemulsification
;
Mydriasis
;
Ketorolac
2.Comparison between the Wong Incision and stromal hydration of corneal incisions in phacoemulsification
Raymond Nelson Regalado ; Jay Marianito Vicencio ; Lee Verzosa ; Ruben Lim Bon Siong
Philippine Journal of Ophthalmology 2012;37(2):97-103
Objective:
To determine the efficacy of the Wong incision in providing wound seal compared to stromal wall
hydration in clear cornea phacoemulsification in cadaveric porcine eyes.
Method:
This was an in vitro comparative experimental study using ten porcine eyes. All eyes were randomly
assigned to the stromal wall hydration (control) or the Wong incision group (experimental). A side port was made
and the anterior chamber formed with viscoelastic device. The main incision was made 180 degrees away. In the
experimental group, a Wong incision was made first anterior to the main incision. Phacoemulsification surgery
with IOL insertion was simulated. The main incision was sealed by hydration. The anterior chamber (AC) was
infused with balanced salt solution (BSS) through an AC maintainer and leakage of fluid from the main incision
was assessed. Samples from the AC were taken before and after tryphan blue drip and were sent for analysis
by UV spectrophotometry. Trypan blue was dripped over the main incision and the whole eyeball was sent for
histopathology.
Results:
There was a significant increase in density from the pre-dye to the post-dye AC samples of the control
(0.0052 to 0.0074, p=0.01) and the experimental groups (0.0076 to 0.0094, p=0.02), although the final samples
showed an optical density comparable to pure BSS, indicating that there was no significant amount of trypan blue
detected in both groups. On histology, trypan blue staining was not seen in the incision tracts of both groups.
After infusing the AC with BSS, there was outward wound leakage in all eyes of the control group and none in the
experimental group.
Conclusion
The Wong incision was as effective as the lateral stromal wall hydration in preventing fluid influx.
Furthermore, the Wong incision showed a more stable wound seal against outward wound leakage in an in-vitro
porcine model of clear corneal phacoemulsification.
Phacoemulsification
3.Safety of intracameral moxifloxacin/dexamethasone fixed-dose formulation on the corneal endothelium in a rabbit model.
Reginald Robert Tan ; Joseph Anthony Tumbocon ; Ruben Lim Bon Siong ; Jay Marianito Vicencio
Philippine Journal of Ophthalmology 2015;40(1):24-28
OBJECTIVE: To determine the safety of intracamerally injected preservative-free 0.5% moxifloxacin/0.1% dexamethasone fixed-dose combination on the corneal endothelium in a rabbit model and compare it to intracamerally injected preservative-free 0.5% moxifloxacin.
METHODS: This experimental study included twenty eyes from ten albino rabbits. The eyes were assessed for baseline corneal clarity and anterior chamber (AC) inflammation using slit-lamp biomicroscopy. A specular microscope measured the corneal endothelial cell density (ECC) and corneal thickness (CT). Intracameral injections of 0.1 mL 0.5% moxifloxacin ophthalmic solution were administered to the 10 right eyes (IPFM group) and 0.1 mL of 0.5% moxifloxacin/0.1% dexamethasone fixed-dose preparation were administered to the 10 left eyes (IPFMDex group). In both groups, ECC, CT, corneal clarity, and AC inflammation at Day 1 (one day post-injection) and Day 7 (seven days post-injection) were compared with Day 0 (baseline). The IPFMDex group was also compared with the IPFM group at Days 0, 1, and 7. The endothelial cells of harvested corneas from both groups at Day 1 and 7 were stained with trypan blue and alizarin red, and compared for endothelial cell damage (ECD). Data were analyzed using paired and independent sample t-tests.
RESULTS: In both the IPFM and IPFMDex groups, ECC and CT at Day 1 (IPFM: ECC p=0.07, CT p=0.76; IPFMDex: ECC p=0.41, CT p=0.94) and Day 7 (IPFM: ECC p=0.95, CT p=0.28; IPFMDex: ECC p=0.29, CT p=0.34) were not different from Day 0 (baseline). No significant difference in ECC, CT, and ECD were found between the IPFM and IPFMDex groups at Day 1 (ECC p=0.82, CT p=0.36, ECD p=0.96) and Day 7 (ECC p=0.95, CT p=0.22, ECD p=0.61). Throughout the study, the cornea in both groups were clear and showed no signs of AC inflammation.
CONCLUSION: Intracameral injection of preservative-free moxifloxacin/dexamethasone fixed-dose formulation was safe on the rabbit corneal endothelium and was no different from preservative-free moxifloxacin.
Animal ; Endothelium, Corneal ; Moxifloxacin ; Alizarin ; Dexamethasone ; Slit Lamp ; Aza Compounds ; Anterior Chamber ; Cornea ; Anthraquinones ; Endothelial Cells ; Inflammation ; Ophthalmic Solutions
4.Safety of Intracameral Moxifloxacin/Dexamethasone fixed-dose formulation on the Corneal Endothelium in a rabbit model
Reginald Robert Tan ; Joseph Anthony Tumbocon ; Ruben Lim Bon Siong ; Jay Marianito Vicencio
Philippine Journal of Ophthalmology 2015;40(2):24-28
Objective:
To determine the safety of intracamerally injected preservative-free 0.5% moxifloxacin/0.1%
dexamethasone fixed-dose combination on the corneal endothelium in a rabbit model and compare it to
intracamerally injected preservative-free 0.5% moxifloxacin.
Methods:
This experimental study included twenty eyes from ten albino rabbits. The eyes were assessed for baseline
corneal clarity and anterior chamber (AC) inflammation using slit-lamp biomicroscopy. A specular microscope
measured the corneal endothelial cell density (ECC) and corneal thickness (CT). Intracameral injections of 0.1
mL 0.5% moxifloxacin ophthalmic solution were administered to the 10 right eyes (IPFM group) and 0.1 mL of
0.5% moxifloxacin/0.1% dexamethasone fixed-dose preparation were administered to the 10 left eyes (IPFMDex
group). In both groups, ECC, CT, corneal clarity, and AC inflammation at Day 1 (one day post-injection) and Day 7
(seven days post-injection) were compared with Day 0 (baseline). The IPFMDex group was also compared with the
IPFM group at Days 0, 1, and 7. The endothelial cells of harvested corneas from both groups at Day 1 and 7 were
stained with trypan blue and alizarin red, and compared for endothelial cell damage (ECD). Data were analyzed
using paired and independent sample t-tests.
Results:
In both the IPFM and IPFMDex groups, ECC and CT at Day 1 (IPFM: ECC p=0.07, CT p=0.76;
IPFMDex: ECC p=0.41, CT p=0.94) and Day 7 (IPFM: ECC p=0.95, CT p=0.28; IPFMDex: ECC p=0.29, CT
p=0.34) were not different from Day 0 (baseline). No significant difference in ECC, CT, and ECD were found
between the IPFM and IPFMDex groups at Day 1 (ECC p=0.82, CT p=0.36, ECD p=0.96) and Day 7 (ECC
p=0.95, CT p=0.22, ECD p=0.61). Throughout the study, the cornea in both groups were clear and showed no
signs of AC inflammation.
Conclusion
Intracameral injection of preservative-free moxifloxacin/dexamethasone fixed-dose formulation was
safe on the rabbit corneal endothelium and was no different from preservative-free moxifloxacin.
Moxifloxacin
;
Dexamethasone
;
Endothelium, Corneal