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.

The complications of repeated surgery may reduce final graft clarity and visual acuity; the disease process necessitating regrafting may carry a poorer prognosis for sight.

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This study revealed that there is a decrease in tear production in patients with vitiligo, particularly in those with the acrofacial type of vitiligo.

Therapeutic PK is effective in the management of the eye with active uncontrolled infection or perforation from corneal disease. Approximately half of our patients maintained a clear graft at the last visit. Without therapeutic surgery, these eyes would have been lost.

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).

* PURPOSE: To investigate the prevalence of microbial keratitis, predisposing risk factors and treatment modalities in patients who developed keratitis following penetrating keratoplasty (PK). * PATIENTS AND METHODS: The records of 285 patients who had undergone PK between January 1991 and December 1995 in a tertiary care center were reviewed. Patients who developed postoperative microbial keratitis were evaluated for predisposing risk factors, microbiological etiology, response to broad spectrum antibiotic therapy and subsequent PK. Patients were mainly treated with fortified topical antibiotics with or without repeat PK. * RESULTS: Of the 285 patient records reviewed, microbial keratitis developed in 21 eyes of 21 patients (7.4%). Seventy-one percent of infections occurred within 6 months after grafting. Keratitis initially began from the donor-recipient border in 16 cases (76.2%) and were central or paracentral in 5 patients. Predisposing risk factors included loose or exposed suture (9), suture removal (1), persistent epithelial defect (3), graft failure (3), contact lens wear (1), Stevens-Johnson syndrome (1). Fifteen (71.4%) patients were culture-positive consisting of Streptococcus pneumoniae (7), Staphylococcus aureus (5), Pseudomonas aureginosa (2), and Hemophilus influenzae (1). Forty-three percent of patients were successfully treated with medical therapy only. Seven patients underwent second PK for visual rehabilitation and 4 for tectonic purposes. After medical and surgical therapy, graft clarity was achieved in 17 (81%) of patients. * CONCLUSIONS: The microbial keratitis following PK is a major postoperative problem affecting the long term prognosis. Careful selection of patients, and preoperative and postoperative control of risk factors, may decrease the frequency of this complication. Several factors, including loose or exposed sutures, epithelial defects, ocular surface disorders, and graft failure, may predispose patients to develop microbial keratitis following PK. [Ophthalmic Surg Lasers 1999;30:449-455.]

Aims: To investigate the efficacy and safety of postoperative topical cyclosporine A 0.05% (tCsA) (Restasis®, Allergan Pharmaceutical) eye drops in preventing the recurrence of pterygium. Methods: 31 patients with bilateral pterygium were examined between January 2006 and February 2007. During a 1-year follow-up, the right eyes of the patients assigned as the treatment group were treated by tCsA and the left eyes were considered as the control group. Results: The pterygium recurred in 4 (12.9%) of 31 right eyes in the treatment group and in 14 (45.2%) of 31 left eyes in the control group (p = 0.005). The mean follow-up ± SD was 9.39 ± 4.14 months (range, 1 to 12 months). The control group had a 7.37 times higher risk of recurrence in pterygium compared with the treatment group (OR = 0.1357, p = 0.0051). A statistically significant difference in recurrence-free probabilities was found for the treatment and control groups (log-rank test; p = 0.006). A multivariate Cox regression model showed that age (p = 0.0093) and tCsA (p = 0.0103) were independent statistically significant impacts on recurrence-free time for pterygium. Conclusion: This study suggests that primary excision of pterygium with postoperative instillation of 0.05% cyclosporine is both safe and efficient.