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Biomedical subjects

A Ophir

Publications and source records attributed to A Ophir.

18 recordsLinked to original sources
PubMed1992

[Treatment of anterior uveitis with 5-fluorouracil].

Filtering surgery with use of 5-fluorouracil (5FU) was performed in 5 eyes (4 patients) with inflammatory glaucoma to prevent filtering bleb scarring. Postoperative injections of 5FU were given once or twice a day, according to the degree of anterior chamber inflammation. Complete remission of the uveitis was achieved in all 5 eyes after 7-14 days of postoperative injections of 5FU. There were no recurrences of uveitis during a minimum of 8 months of follow-up.

Fluorouracil↗
PubMed1992

A randomized study of trabeculectomy and subconjunctival administration of fluorouracil in primary glaucomas.

Forty-one adult patients with primary open angle glaucoma and nine adult patients with chronic angle closure glaucoma underwent trabeculectomy in one eye each. Twenty-one eyes with primary open angle glaucoma and four with chronic angle closure glaucoma were randomly assigned to receive four to six subconjunctival injections of fluorouracil for 10 days after surgery. Twenty-five control eyes did not receive fluorouracil. Intraocular pressure was 20 mm Hg or lower in 24 eyes (96%) in the treatment group after mean follow-up of 17.8 months and in 19 control eyes (76%) after mean follow-up of 17.5 months (P less than .05). Encapsulated bleb developed in three (12%) of the fluorouracil-treated eyes vs two (8%) of the control eyes. A few injections of fluorouracil adequately inhibited scarring. This might be explained by its toxic effect on existing fibroblasts. Overall, trabeculectomy with injection of fluorouracil was found to be efficacious and relatively safe. Further studies regarding late complications are required.

Aged↗
PubMed1992

Changes in Müller cell plasma membrane specializations during subretinal scar formation in the rabbit.

The aim of this study was to identify changes in Müller cell plasma membrane specializations during experimentally induced subretinal gliosis in rabbits. When rabbits are dosed with sodium iodate, large expanses of retinal pigment epithelium and photoreceptors are destroyed. They are replaced by a subretinal scar consisting mainly of the ascending processes of Müller cells. These processes transform from the slender, highly polarized structures seen in normal animals into irregular processes that form a glia limitans along the basement membrane of the pigment epithelium, left bare following its degeneration. As the scar processes extend through the subretinal space and contract this basement membrane, they undergo dramatic changes in shape that are especially apparent in three-dimensional computer reconstructions of serial thick sections examined by high-voltage electron microscopy. Other changes involve the intercellular junctions and apical microvilli normally associated with the external limiting membrane. These structures become scattered over the surfaces of the ascending processes and are eventually lost. Loss of microvilli is associated with disappearance of immunostaining for a specific glycoconjugate normally associated with the microvillar plasma membrane. The observations document profound changes in Müller cell structural and functional polarity during subretinal scar formation.

Animals↗
PubMed1992

Encapsulated filtering bleb. A selective review--new deductions.

Filtering bleb encapsulation may, in some cases, be a severe complication following filtering surgery. The cause and mechanism of its development are not known. A selective review of data that might shed some light on these dilemmas, is presented. Based on these data, it is suggested that: (a) non-contractile collagen-producing fibroblasts play a major role in the process of bleb encapsulation, while in wound healing following filtering surgery, contractile fibroblasts are the major components; (b) the process of bleb encapsulation is less sensitive to the toxic effect of 5-Fluorouracil than would healing; (c) collagen-producing fibroblasts may be less sensitive to the destructive effect of 5-Fluorouracil than contractile fibroblasts; (d) inflammatory mediators are important triggers of bleb encapsulation.

Animals↗
PubMed1992

Toxic effects of 5-fluorouracil on fibroblasts following trabeculectomy.

The inhibitory effect of 5-fluorouracil (5-FU) on fibroblast proliferation is well established. In addition, toxic effects of 5-FU on existing fibroblasts, in rabbits and in vitro, were demonstrated. We examined human subconjunctival scar tissue which was removed during Molteno tube implantation. Surgery was performed 9 weeks after filtering surgery with 5-FU that resulted in bleb scarring. In the tissue, intracytoplasmic vacuoles were detected in some myofibroblasts, with no visible collagen in their vicinity. This presumed toxic effect of 5-FU may be one explanation for the adequacy of fewer than twice 5-FU injections daily following filtering surgery, and for less than 14 days, as originally recommended for inhibiting bleb scarring.

Adult↗
PubMed1992

A possible role of free radicals in the transplantation of retinal pigment epithelial cells.

Oxygen-derived free radicals have been implicated in tissue injury following ischemia and reperfusion (reoxygenation). It has been hypothesized that the radicals are produced during the early reperfusion stage. Recently, submacular implantation of retinal pigment epithelium cells has been reported. It is probable that during the procedure, the transplant and the 180-degree folded outer retina underwent a period of ischemia, followed by reoxygenation. We, therefore, infer that free radicals were produced during the reoxygenation stage of the procedure, injuring both tissues. We suggest that these hypotheses be investigated with the aim of improving the surgical outcome in eyes with age-related macular degeneration.

Aging↗
PubMed1992

Trabeculectomy with 5-fluorouracil subsequent to circular buckling operation and cataract extraction.

Six patients, each with one eye that had previously undergone circular buckling surgery for the repair of retinal detachment before or followed by cataract extraction with or without intraocular lens implantation, underwent trabeculectomy with 5-fluorouracil (5-FU) for intractable glaucoma. Surgery was done through scarred subconjunctival tissues that were excised partially. The total doses of 5-FU ranged from 65 to 100mg (mean +/- standard deviation, 84.2 +/- 13.2mg) Eight to 47 months later, intraocular pressures were 18mmHg in five eyes, two of which were not receiving hypotensive medications. In the sixth eye, the intraocular pressure was 26mmHg with maximum hypotensive treatment. Intraocular pressures in the six eyes were significantly lower postoperatively than preoperatively (P < .05). This preliminary study suggests that filtering surgery with 5-FU may be beneficial after intraocular operations even in eyes where it is done through postoperative scarred subconjunctival tissues.

Adult↗
PubMed1992

Delayed filtering bleb encapsulation.

Encapsulated filtering blebs concomitant with increased intraocular pressure (IOP) developed 47 and 6 months, respectively, after surgery in two women, 46 and 60 years old, respectively, who had undergone trabeculectomy operations in one eye. Both blebs were associated with mild anterior uveitis. Following treatment with topical steroids, cyclopentolate, hypotensive medications, and digital massage, the uveitis resolved and the IOP fell. The likely cause of these late-appearing encapsulated blebs was anterior uveitis.

Epinephrine↗
PubMed1992

Encapsulated filtering bleb and subconjunctival 5-fluorouracil.

Filtering bleb encapsulation (BE) involves fibroblast proliferation and collagen synthesis. We analyzed the effect of 5-fluorouracil (5-FU) on the inhibition of BE. Forty-one patients with primary open-angle glaucoma underwent trabeculectomy in one eye as an initial surgery. Twenty-one of these eyes, randomly chosen, were treated postoperatively with four to six 5-FU subconjunctival injections over 10 days to inhibit bleb scarring; the remaining 20 eyes did not receive 5-FU. After 12 to 24 months, the surgical success rate was significantly higher in the treated eyes (P less than .05). However, the incidence of BE was similar: two eyes (9.5% and 10%, respectively) in each group. The difference between the effect of 5-FU in the inhibition of BE and bleb scarring suggests that the characteristics of the two fibroblast populations are heterogeneous.

Aged↗
PubMed1991

Effects of 5-fluorouracil on proliferating fibroblasts in vivo.

5-Fluorouracil (5-FU) is a potent inhibitor of the proliferation of fibroblasts, the main cell mediators of scar formation. The mechanism of the toxic effect of 5-FU on cancer cells is well known but unclear in nonmalignant cells. The histopathological effects of 5-FU on proliferating fibroblasts in vivo, 2 and 4 weeks after drug injection, are demonstrated here. An insertion of homologous fibroblasts into rabbits' vitreous followed by one injection of 1 mg 5-FU causes intracytoplasmic accumulation of vacuoles, morphological changes and inhibition of collagen deposition in the matrix.

Animals↗
PubMed1991

Further observations on the prevention of experimental proliferative vitreo-retinopathy by 5-fluorouracil.

The rate of retinal detachment in fellow control eyes of rabbits following fibroblast administration is progressively lower with increased dose of 5-Fluorouracil in the test eyes. Thus, it seems mandatory to choose control eyes in other animals rather than the fellow eyes of the treated ones. Retinal detachment appeared in the second week or earlier after intravitreal fibroblast administration. However, in eyes treated intravitreally with 5-Fluorouracil, retinal detachment or pucker appeared later, even in the second month suggesting routine follow-up of at least 2 months in future studies.

Animals↗
PubMed1991

Regulating the dose of 5-fluorouracil to prevent filtering bleb scarring.

Repeated doses of 5mg of 5-fluorouracil (5-FU) were injected subconjunctivally in 25 poor-prognosis glaucomatous eyes after filtering surgery to prevent filtering bleb scarring. The frequency (1-2 times a day) and duration (minimum, 7 days) of injections were determined by the degree of the anterior chamber reaction and/or conjunctival hyperemia at the filtering bleb site. Punctate corneal erosions or filaments were not considered a contraindication to continuation of 5-FU treatment. After 12 months, intraocular pressure (IOP) of 16 mmHg or less without medical treatment was found in 19 (76%) eyes. In 16 of these (64%), the IOP was 12 mmHg or less. In two (8%) other eyes, it was 20 mmHg or less with medication. We believe that the comparatively low IOP levels achieved without medical treatment in 76% of the eyes in our study can be attributed in part to our therapeutic approach with 5-FU.

Adolescent↗
PubMed1991

Subconjunctival 5-fluorouracil and herpes simplex keratitis.

We present a case of herpes simplex keratitis that appeared during a period following filtering surgery in which subconjunctival 5-FU was being administered. Although the 5-FU treatment was not halted, 4 days later the keratitis healed. The typical practice of discontinuing 5-FU treatment when these kinds of inflammation occur following filtering surgery may be unwarranted.

Eye Diseases↗
PubMed1990

[Prevention of scarring of filtering bleb by 5-fluorouracil].

Scarring of the filtering bleb is the most common cause of failure of surgery for glaucoma. It is much more common when the surgery is for certain types of glaucoma, such as aphakic glaucoma, cases of previously failed filtering surgery and neovascular and uveitic glaucoma. In 31 such high-risk cases we injected 5-fluorouracil subconjunctivally for 7-16 days after operation to prevent scarring of the filtering bleb. The success rate was 83%. After a follow-up of 3-12 months, there was statistically significant improvement in each group as compared to cases in which the drug was not administered. Further indications should be considered for the use of 5-fluorouracil in glaucoma.

Conjunctiva↗
PubMed1990

Filtering surgery with 5-fluorouracil: a second course.

In five glaucoma patients, a previous filtering surgery that was followed by sub-conjunctival injections of 5-Fluorouracil (5-FU) failed, due to filtering bleb scarring. A repetition of the filtering surgery with subsequent sub-conjunctival injections of 5 mg of 5-FU, administered once daily for 8-14 days, was undertaken. At the end of 6-19 months of follow-up, IOP levels in all five eyes were 20 mmHg or less with medication. A repeated course of filtering surgery plus 5-FU treatment seems to be a favourable surgical option in refractory glaucoma.

Adult↗
PubMed1977

Cervical incompetence: diagnostic and therapeutic aspects.

During a seven-year period, 311 women with cervical incompetence were treated by cerclage. Fifty-three of the women were treated twice during the study period, 12, three times, and one, four times, so that a total of 391 pregnancies was studied. There were only 45 emergency procedures. Candidates for elective cerclage were selected on the basis of hysterographic findings and the Hegar test. Cerclage was performed by the simple McDonald procedure, usually during the 11th to 12th week of gestation, after the presence of fetal life had been established by ultrasonic detection of the fetal heartbeats. Apart from antibiotics no medical treatment was given. Hospitalization following cerclage was reduced to less than 24 h. The fetal salvage rate was 89%, with minor differences among four etiologic subgroups. The minimum benefit rate of the operations was 64.6%. The degree of cervical patency, as established by the Hegar test, was found to be of prognostic value in cerclage-treated pregnancies. Ultrasonic detection of fetal heartbeat before cerclage significantly improved fetal salvage by almost complete elimination of early fetal loss. Simplification of the surgical procedure is recommended.

Abortion, Spontaneous↗