Total central keratolysis.
Central keratolysis is a rare entity. An interesting case of unilateral central keratolysis in an aphakic patient is reported.
Biomedical subjects
Publications and source records attributed to K S Mehra.
Central keratolysis is a rare entity. An interesting case of unilateral central keratolysis in an aphakic patient is reported.
In this clinical study, the role of enfenamic acid (Tromaril), a new anti-inflammatory and nonsteroidal drug, on various eye diseases such as trauma, on inflammatory diseases such as uveitis, and after cataract surgery was evaluated. The drug was administered to 30 patients (group A) while 29 patients (group B) were given a placebo. Twenty-one patients showed good response, and of these, 15 patients (76%) belonged to group A, to whom Tromaril had been administered. Of the patients who were given Tromaril, none showed any side effects in general. It can be concluded that Tromaril is a strong and effective anti-inflammatory drug for use in various eye diseases.
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In this study, an attempt has been made to evaluate the cortisone like inhibitory activity on healing of wounds of curcuma longa extracts-aqueous extract (2.8%) and alcoholic extract (1.125%) on the healing of superficial and penetrating corneal wounds in albino rabbits. It was observed that curcuma longa aqueous drops (a) definitely delayed healing of superficial corneal wounds (P less than 0.001), (b) delayed healing of penetrating corneal wounds also and markedly reduced the tensile strength of corneal wounds (P less than 0.02), when comparison was made with placebo and preservative drops.
Fibrinolytic activity of aqueous humor was tested by the Astrup fibrin plate lysis technique in 7 patients who had chronic simple glaucoma and was compared with a control group of 7 patients with senile cataract. The plasminogen activator content of aqueous humour in glaucoma patients was remarkably reduced; it was not demonstrable in as many as six out of seven patients. The lysis zones in the control group ranged from 110 to 900 mm2 with an average of 423 mm2. The want of aqueous fibrinolytic activity may have a pathogenetic implication for glaucoma since deposition of fibrin in the angle of the eye to depressed fibrinolytic activity could increase resistance to aqueous flow.
In this experimental work, it was observed that after anterior chamber paracentesis there was more effusion of protein into the anterior chamber. Pretreatment with aspirin/indomethacin and a new drug, enfenamic acid (Tromaril), decreased this trauma-induced increase in aqueous protein content. It was further observed that this inhibition was more marked with Tromaril pretreatment in comparison with other drugs. Prostaglandin-mediated disruption of blood aqueous barrier can also be decreased with Tromaril pretreatment. Tromaril, a prostaglandin synthetase inhibitor, may help us to control the reactions to surgical ocular trauma and other ocular inflammatory diseases.
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The effect of the administration of vitamin A drops on neutralizing the inhibitory role of cortisone in penetrating corneal wound healing was studied on 24 albino rabbits (48 eyes). The rate of healing of the wound was determined by the fluorescein strain technique and the tensile strength of the affected cornea was determined on the 11th day after the wound was made. It was observed that in the group of eyes in which only cortisone in any form was administered, not only was the rate of healing delayed (with statistical significance) but there was also a statistically significant lowering of the tensile strength of the wound. However, in the eyes in which vitamin A was also administered simultaneously with cortisone, the rate of healing of the wound was enhanced and there was also a statistically significant increase in the tensile strength of wound. Therefore in this study it was confirmed that by simultaneous use of vitamin A drops, the inhibitory role of cortisone is neutralized even in penetrating corneal wounds.
Thus, it can be concluded from our observations that the effect of cortisone drops in reducing the concentration of ascorbic acid in the aqueous humor can be neutralized by simultaneous administration of vitamin A drops. This observation has an important clinical bearing, as ophthalmologists have hesitated to use cortisone locally for a long time for fear that it may either precipitate glaucoma or cataract (most probably because of the subsequent lowering of ascorbic acid concentration in the aqueous humor and lens). Our finding that with the administration of vitamin A drops along with cortisone drops there is no significant lowering of the ascorbic acid level in the aqueous humor indicates that one can use cortisone drops without being afraid of precipitating glaucoma or cataract.
Water drinking provocative test was carried out in 28 chronic simple glaucoma and 17 borderline cases of chronic simple glaucoma. These tests were carried out twice on the same patients with an empty stomach and after taking breakfast at an interval of 15 days. It was observed that there was no significant difference in the outcome of the results even when this test was carried out with a full stomach.
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Blood pH, aqueous pH, and intraocular tension were noted in 20 albino rabbits before and after administration of vitamin C in oral dosage of 7.5 gm/kg/day (in 4 equal divided doses for one week). A significant difference was noted in changes of blood pH and fall in intraocular tension but aqueous pH did not show any change. In 20 glaucoma patients there was no significant change in pH of blood of glaucoma after administration of vitamin C in 3.5 gm/kg body weight per day by oral route for one week (in 4 equal divided doses).