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Biomedical subjects

N Morlet

Publications and source records attributed to N Morlet.

46 records · Page 3Linked to original sources

Prevention of intraocular pressure rise following intravitreal injection.

The intraocular pressure change produced by an intravitreal injection of ganciclovir, 2 mg in 0.1 ml, was studied in patients with cytomegalovirus retinitis. Using a Tono-pen XL to measure the intraocular pressure (IOP) of four patients (six eyes) we found the mean pressure immediately following injection was 44.5 mm Hg. Measurements taken on separate occasions after a 30 mm Hg decompression of the eye for 15 minutes before the injection showed a mean IOP of only 20.6 mm Hg after the injection. Mercury bag decompression of the eye significantly reduced the rise in IOP following intravitreal injection (difference in the mean IOP rise = 26.4 mm Hg, df = 54, t = 7.67, p < 0.001). Without ocular decompression before injection, all patients complained of temporary loss of vision, and reflux of the injection solution was frequently observed. Use of ocular decompression also reduced the discomfort of the injection. Throughout the full course of treatment by this means there were no adverse effects on the visual acuity. This technique is recommended to those performing intravitreal injections.

Cytomegalovirus Infections↗

High dose intravitreal ganciclovir in the treatment of cytomegalovirus retinitis.

OBJECTIVE: To assess the role of intravitreal administration of high doses of ganciclovir as a supplement and alternative to intravenous administration in the treatment of cytomegalovirus (CMV) retinitis in patients with acquired immunodeficiency syndrome (AIDS). DESIGN: A retrospective study of visual outcome, relapse and complications of intravenous and high dose intravitreal administration of ganciclovir alone and in combination. METHOD: Twenty-three patients with AIDS and CMV retinitis (37 eyes) were examined by the authors and notes, fundal drawings and photographs reviewed. Initially patients were treated with intravenous ganciclovir alone and given supplementary intravitreal therapy for relapse or vision-threatening retinitis; however, later patients were managed with combination maintenance ganciclovir or maintenance intravitreal treatment alone. RESULTS: Relapse and loss of vision occurred frequently in patients treated with intravenous ganciclovir alone or in combination with intermittent intravitreal therapy. Eyes managed with maintenance high dose intravitreal ganciclovir alone or in combination with intravenous treatment did not relapse or lose vision. The most important complication of intravenous administration of ganciclovir was neutropenia (73% of patients), whereas that of intravitreal therapy was endophthalmitis (three eyes). CONCLUSION: High dose ganciclovir given intravitreally effectively suppressed CMV retinitis and preserved vision without adverse systemic effects or deterioration of quality of life.

AIDS-Related Opportunistic Infections↗

A quantitative scale for the Barrett keratoscope.

By allowing the surgeon to measure and modify corneal curvature during wound closure, intraoperative keratometry can reduce postoperative astigmatic errors. A number of keratometric devices have been developed over the last 10 years, each offering a compromise between cost, accuracy and ease of use. The Barrett keratoscope is a simple, inexpensive hand-held device which gives a qualitative indication of the degree of astigmatism. Addition of a transparent overlay, as described in this paper, sets the distance at which the keratoscope is held and allows the magnitude of the astigmatism to be determined, thereby enabling refined adjustment of the suture tension during wound closure. We describe the error in estimation of astigmatism due to the effect of the distance at which the keratoscope is held from the cornea.

Anthropometry↗

Effect of topical interferon-alpha 2b on corneal haze after excimer laser photorefractive keratectomy in rabbits.

BACKGROUND: Anterior corneal stromal keratocytes are activated by excimer laser photorefractive keratectomy resulting in haze with healing of the ablated area. In some eyes, this causes a visible haze or scar on the cornea, and an unpredictable regression of the myopic correction following refractive ablations. METHODS: Following a 6.00-diopter excimer laser photorefractive keratectomy to both eyes, 16 rabbits were treated for 5 weeks with interferon-alpha 2b drops four times a day to one eye only. Eight of these rabbits were treated with dexamethasone drops four times a day to both eyes. Using a standard grading scale for haze, the corneas were examined and the haze graded weekly. RESULTS: The observed corneal haze was significantly reduced in the treated eyes by the application of topical interferon-alpha 2b drops (p = .004), and topical dexamethasone drops (p < .001). Topical dexamethasone also produced less haze in combination with interferon-alpha 2b than when used alone (p = .035). There was continuing resolution of the corneal haze in those rabbits observed for 7 weeks after the cessation of the drops. Topical interferon-alpha therapy was not toxic to the rabbit eye and was not associated with delayed reepithelialization after the laser procedure. CONCLUSION: Topical interferon-alpha 2b appears to reduce the corneal haze produced by excimer laser photorefractive keratectomy in rabbits.

Administration, Topical↗

Improving drop administration by patients.

1. Patients that have difficulties with drop application may have poor compliance with therapy. We studied the effectiveness of teaching a technique of drop administration that allows the patient to steady the hand and observe the dropper tip during application. 2. Comparing the group taught the technique of application with another group who had their drops applied by a home caregiver, we found that those taught the technique were as reliable as the others in the delivery of their drops. 3. Although some patients will be physically incapable of applying drops, we found that the technique we describe in the present study enables effective and safe delivery of drops.

Aged↗