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Biomedical subjects

H M Leibowitz

Publications and source records attributed to H M Leibowitz.

At least 91 records · Page 5Linked to original sources

Therapeutic effectiveness of fluorometholone in inflammatory keratitis.

During an experimentally-induced inflammatory keratitis, we measured the ability of 0.1% fluorometholone ophthalmic suspension to reduce the numbers of polymorphonuclear leukocytes that invaded the cornea. The data demonstrate that topically administered fluorometholone is an effective therapeutic agent and that it compares favorably in anti-inflammatory activity with dexamethasone and prednisolone preparations. Comparison of our results with comparable studies of dexamethasone and prednisolone formulations indicates that 1.0% prednisolone acetate ophthalmic suspension is still the most effective corneal anti-inflammatory agent that we have investigated to date. However, the decreased potential of fluorometholone to produce secondary elevation of the intraocular pressure would appear to make it the drug of choice in situations in which maximum pharmacologic suppression of inflammation is not required and in chronic inflammatory conditions that require prolonged treatment.

Administration, Topical↗

Bacteriology of normal and infected conjunctiva.

The conjunctivas of 273 inflamed eyes were cultured by both aerobic and anaerobic techniques. Isolations were obtained from 267 (97.8%) of the eyes. Aerobic organisms were isolated from 237 (86.8%) of the conjunctivas. Staphylococcus aureus from 63 (23.1%) of the diseased eyes was the aerobic pathogen most often isolated. Anaerobic bacteria were isolated from 172 (63.0%) of the conjunctivas. Propionibacterium acnes was isolated from 126 (46.2%) of the conjunctivas, and Peptostreptococcus species were isolated from 80 (29.3%) of the conjunctivas. Comparison with the bacteriology of 96 normal eyes showed that anaerobes play a much greater role as etiological agents of conjunctivitis than formerly believed. When anaerobic bacteria were isolated, they appeared on the average in 7 days, indicating that they may be missed by ordinary bacteriological culturing.

Aerobiosis↗

Anti-inflammatory effectiveness of topically administered corticosteroids in the cornea without epithelium.

The present studies demonstrate that modification of the derivative of a given steriod base alters its anti-inflammatory potential as measured by suppression of leukocyte invasion of the cornea. A comparison of each drug's corneal bioavailability with its anti-inflammatory effectiveness shows the acetate derivative of prednisolone to be a more potent anti-inflammatory agent than the phosphate derivative. Similarly, the free alcohol derivative of dexamethasone proved to be more potent than the phosphate derivative. Increasing the concentration of prednisolone acetate from 0.125 per cent to 1.0 per cent results in a significant increase in its anti-inflammatory effectiveness in the cornea following topical administration. The same increase in prednisolone phosphate concentration does not produce a significant increase in its ability to suppress polymorphonuclear leukocyte infiltration of the cornea. When the epithelium of the inflamed cornea is intact, prednisolone acetate, 1.0 per cent ophthalmic suspension, is the most effective of the corticosteroid preparations studied. In the absence of an intact epithelium, prednisolone acetate, 1.0 per cent ophthalmic suspension, again produces the greatest mean reduction in polymorphonuclear leukocytic infiltration of the cornea although here one cannot demonstrate a statistically significant difference from the anti-inflammatory effect produced by prednisolone phosphate, 1.0 per cent ophthalmic solution, or dexamethasone alcohol, 0.1 per cent ophthalmic suspension. Overall, therefore, prednisolone acetate 1.0 per cent is the most effective of the topical agents studied for suppression of corneal inflammation.

Administration, Topical↗

Initial treatment of descemetocele with hydrophilic contact lenses.

A hydrophilic contact lens was used as the initial mode of therapy in 5 cases of descemetocele. The lens was left in place over the descemetocele continuously for periods ranging from 2 to 15 months. Corneal perforation did not occur, and the anterior chamber remained formed in all cases. The device seemingly provides sufficient structural reinforcement to Descemet's membrane to prevent its distension by the intraocular pressure. It also maintains Descemet's membrane in a moist state and protects the descemetocele from the trauma of the lid margins during blinking. This series of cases indicates that a hydrophilic contact lens can be a very effective temporizing measure for the treatment of descemetocele, enabling the surgeon initially to cope with an ocular emergency in a very simple manner, and to convert the ultimate surgical repair to a scheduled, carefully planned procedure with a much greater potential for success.

Adult↗