D Yorston, PT Khaw (Institute of Ophthalmology, Bath Street, London).
A randomised trial of the effect of intraoperative 5-FU on the outcome of trabeculectomy in east Africa.
BJO, 2001; 85: 1028-1030.
Sixty-eight eyes with chronic open angle glaucoma were included in a randomized trial of intraoperative 5Fluorouracil (5-FU) versus placebo.
Six months after surgery the mean intraocular pressure (IOP) was 17.4mmHg in the placebo group and 16.9 mmHg in the 5-FU group.
Two years after trabeculectomy, the probability of successful IOP control was 70.6% in the placebo group and 88.8% in the 5-FU group.
Placebo group patients were more likely (2.18 times) to require additional IOP lowering procedures than the 5-FU group.
The authors conclude that the success rate of trabeculectomy in Africa may be enhanced by the use of intraoperative 5-FU.
A.C. Sobottka Ventura, M Bohnke ((Universitat Bern, Switzerland)
Pentoxifylline influences the autocrine function of organ cultured donor corneas and enhances endothelial cell survival.
BJO, 2001; 85: 1110-1114
Pentoxifylline has recognised effects on immune functions, particularly on cytokine production.
The authors have previously demonstrated that spiking of organ culture media with endotoxin elicited enhancement in the release of IL-6 and IL-8 from corneal tissue and these events coincided with degenerative changes in endothelial cells and actual cell loss.
Traces of donor derived endotoxin are found in up to 50% of corneal organ cultures and may trigger inflammatory responses in the host.
Twelve fellow pairs of donor corneas were cultured for 20 days, with change of medium on day 10. One of each pair was incubated in the absence, while the other in the presence of pentoxifylline (25 mg/ml).
Media samples were withdrawn at regular intervals during the course of incubation and screened for cytokines IL-6,IL-8 and prostaglandin E2.
Endothelial cell morphology and numerical density were assessed on days zero, ten and twenty.
It was found that adding pentoxifylline to culture media definitely led to improvement in endothelial cell survival and after day 10 to suppression of IL-6 and IL-8 secretion by corneal tissue.
D. J. Keegan, G. Geerling, et al (Moorfields Eye Hosp, City Rd, London)
Botulinum Toxin Treatment for Hyperlacrimation Secondary to Aberrant Regenerated Seventh Nerve Palsy or Salivary Gland Transplantation
BJO, January 2002; 86(1); 43-46
Four patients received botulinum toxin A (Dysport) for treating hyperlacrimation. Three had unilateral symptoms of hyperlacrimation, while one patient had a submandibular salivary gland transplant (SMGT).
Tear production was quantified in the resting and stimulated (chewing) state, using Schirmer’s test and tear clearance. Outflow was assessed by lacrimal scintigraphy.
Intraglandular injections (for patients with crocodile tears) or periglandular injections (for the SMGT patient) of Dysport were administered in divided doses.
The authors conclude that in confirmed hyperlacrimation, botulinum toxin treatment is effective but side effects may occur (two patients who received intraglandular injections developed ptosis, which resolved spontaneously).