Effect of topical steroids on corneal epithelial healing after vitreoretinal surgery

Yülek, Fatma; Özdek, Şengül; Güreli̇k, Gökhan; Hasanreısoğlu, Berati

doi:10.1111/j.1600-0420.2005.00632.x

Cited by 27 publications

(16 citation statements)

References 18 publications

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“…Some previous studies reported a significant decrease in epithelial healing after steroid treatment [7, 8], while other studies reported the absence of such effects on corneal epithelial wound healing in humans and animals [9, 10]. We found that epithelial wound healing was delayed with topical corticosteroid administration, although this delay was not significant.…”

Section: Discussioncontrasting

confidence: 49%

The effects of oral and topical corticosteroid in rabbit corneas

et al. 2016

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BackgroundTo determine the most effective route of administration of corticosteroids in the treatment of ocular surface disease, by characterizing the difference between oral prednisolone and topical dexamethasone administration using an animal model.MethodsPharmacokinetic analyses determined the corticosteroid concentrations in the normal ocular tissues of rabbits after oral or topical administration of corticosteroids using LC-MS/MS. In wound healing analyses, the area of the epithelial defect created by keratectomy using a 6-mm trephine was calculated with an image analyzer using an orally or topically steroid-administrated animal model. The average size of basal epithelial cells, the frequency of mitotic basal epithelial cells, the number of squamous cells, and the number of hypertrophic stromal fibroblasts were determined in the enucleated corneal tissues after wound closure.ResultsBy slit lamp examination, no remarkable differences were observed between orally and topically administered groups. Pharmacokinetic analyses showed that the distribution of dexamethasone after topical administration was superior to that after oral administration in the cornea. In contrast, both concentrations of corticosteroid applied topically and orally were similar with regards to AUCs (area under the concentration-time curve) in the conjunctiva. Although the healing rate was slower in the topical group, all corneas were almost healed within 96 h in the wound healing analysis. According to the histological analyses of epithelial cells, the average basal cell size was larger, the frequency of mitotic basal cells was greater, and the number of squamous epithelial cell layers was lower in the topically administered group although all of these differences were with no statistical significance. However, the number of hypertrophic stromal fibroblasts in the topically administered group was significantly lower than that in the orally administered group.ConclusionsThere are different distributions and effects between orally and topically administered corticosteroids on the ocular surface. The data may provide the useful information in selecting the appropriate route of corticosteroid application for the treatment of ocular surface disease.

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Section: Discussioncontrasting

confidence: 49%

The effects of oral and topical corticosteroid in rabbit corneas

et al. 2016

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“…Yulek et al [54] evaluated the effect of topical steroid treatment on corneal epithelial healing after epithelial debridement in vitreoretinal surgery. Their results showed that topical dexamethasone administered 5 times/day did not significantly retard corneal epithelial healing in subjects undergoing vitreoretinal surgery with postoperative topical steroid treatment, compared with subjects who did not receive steroid treatment.…”

Section: Discussionmentioning

confidence: 99%

Effects of Acetylcysteine and Dexamethasone on Experimental Corneal Wounds in Rabbits

et al. 2007

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Corneal wound healing often leads to the development of scar tissue with loss of transparency. Reconstitution of transparent corneal stroma depends on the regulation of the biosynthetic activities of postlesional keratocytes as well as to a large extent on the limitation of matrix degradation. It has been shown that 3% concentration of N-acetylcysteine (NAC) improves the healing time of corneal wounds but some corneal haze remains. On the other hand, topical corticosteroids may retard the corneal wound healing but decrease the haze. Thus, the aim of the study was to evaluate whether adding dexamethasone to NAC could reduce the side effects of the two drugs. In this study, experimental corneal wounds were created surgically, up to the depth of one half of the stroma in the center of both eyes of all rabbits. The left eyes were treated topically with 0.9% NaCl as controls and the right eyes were treated with a combination of one drop of 3% NAC and one drop of 0.1% dexamethasone, 6 times per day. Corneal wounds were measured by fluorescein staining every day. The results indicated that the combination of acetylcysteine and dexamethasone significantly increased the mean healing time compared to the control group (p < 0.05). Clinical and histopathologic examinations revealed that the corneal haze in the treatment group was greater than in the control group. It is concluded that treatment of the eyes by a combination of 3% acetylcysteine and 0.1% dexamethasone (if used from the first day of ulceration) may retard the corneal wound healing in rabbits.

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“…For most patients, tissue healing is complete in 50–60 h,31 with most of the tissue repair occurring in the first 24 h 32. Laser surgery complication rates are ∼3% less than conventional (mechanical microkeratome) surgery.…”

Section: Eye Surgerymentioning

confidence: 99%

An update on contraindications for lung function testing

Cooper

2010

Thorax

110

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Guidelines on contraindications for lung function tests have been based on expert opinion from >30 years ago. High-risk contraindications to lung function testing are associated with cardiovascular complications such as myocardial infarct, pulmonary embolism or ascending aortic aneurysm. Slightly less risky but still serious contraindications are predominantly centred on recovery from major thoracic, abdominal or head surgery. Less serious surgical procedures will present a possible risk, but the RR depends upon whether the lung function is essential or can wait until the patient's condition improves. In recent decades there have been moves towards less invasive surgical techniques, keyhole surgery and new technology such as laser surgery which minimise the amount of collateral damage to surrounding tissues. In thoracic surgery there is a shift in emphasis to quicker postsurgical mobility. Furthermore there has been little analysis of the scientific facts behind the current recommendations and contraindications. The principle absolute and relative contraindications are in need of revision, and recommended times of abstaining from lung function tests needs to be reviewed. This review aims to outline the key issues and suggests newer recommendations for contraindications for performing lung function using a risk matrix, as well as offering alternative approaches to testing patients who may be at risk of complication from testing. In general, the previous recommendation of waiting for 6 weeks after surgical procedures or medical complications before performing lung function can often now be reduced to <3 weeks with modern less invasive surgical techniques.

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Effect of topical steroids on corneal epithelial healing after vitreoretinal surgery

Cited by 27 publications

References 18 publications

The effects of oral and topical corticosteroid in rabbit corneas

The effects of oral and topical corticosteroid in rabbit corneas

Effects of Acetylcysteine and Dexamethasone on Experimental Corneal Wounds in Rabbits

An update on contraindications for lung function testing

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