Suchergebnisse

Abdulmoghni Al-Barrag1, Mutahar Al-Shaer1, Nabil Al-Matary2, Mohammed Al-Hamdani21Ophthalmic Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Republic of Yemen; 2Ophthalmic Department, Military Hospital, Sana'a, Republic of YemenObjective: To evaluate the efficacy and risks of complications of pulse dosing of topical 5-fluorouracil (5-FU) in the treatment of corneal intraepithelial neoplasia (CIN), and conjunctival squamous cell carcinoma (SCC). Design: Prospective, noncomparative case series. Participants: Fifteen patients with histological evidence CIN or SCC of the conjunctiva and cornea were identified by tumor biopsy. Methods: All patients clinically evident of CIN, or SCC were evaluated, with maximum 30 months of follow-up were treated with pulsed dosing of 1% 5-FU. Treatment cycles were defined as four times per day for 4 days using the medication followed by 30 days without medication. The number of initial treatment was six cycles. Results: The mean age of the 15 patients was 50.8 years (range 25–78 years). Excision biopsy proved seven cases as CIN, and eight cases as locally invasive SCC. All patients remained disease free with a mean follow-up of 14.53 months (range 6-30 months). Additional chemotherapy was given after the initial treatment cycles, only for one case. 5-FU caused mild temporary local irritation, but no long-term intraocular or extra ocular complications. Conclusions: Adjuvant 1% topical 5-FU appears to be effective in the prevention of recurrence of conjunctival or corneal CIN and SCC after excision biopsy. Our results indicate that at least six cycles of topical 1% 5-FU is required to prevent local recurrence in the long term. It is well-tolerated and an effective method of treatment. No complications that would preclude use of our dose regimen were noted.Keywords: chemotherapy, fluorouracil, neoplasia, treatment cycles

Abdulmoghni Al-Barrag1, Motaher Al-Shaer1, Nabil Al-Matary2, Mahfoud Bamashmous11Ophthalmic Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Republic of Yemen; 2Ophthalmic Department, Military Hospital, Sana'a, Republic of YemenPurpose: To compare the effect of oral acetazolamide and topical 2% dorzolamide in prevention of ocular hypertension after scleral tunnel cataract surgery.Setting: Ophthalmic department, Sana'a University, Yemen Sana'a from March 2007 to October 2007.Methods: This prospective double-blind, randomized study included 150 eyes undergoing scleral tunnel cataract surgery with hard posterior chamber intraocular implantation. Methylcellulose was used as the viscoelastic in all surgery cases. Patients were assigned to one of three groups: group 1: topical gentamicin eye drops (control; n = 52); group 2: systemic acetazolamide 250 mg (n = 45); and group 3: topical 2% dorzolamide (n = 53). Acetazolamide patients received one 250 mg tablet, one hour before surgery, then half a tablet every eight hours. A topical dorzolamide 2% or gentamicin was applied in one drop one hour before surgery then every eight hours, for three days postoperatively. Intraocular pressures (IOP) were measured by Goldman applanation tonometry one hour preoperatively and 16, 24, and 48 hours postoperatively. Results: At 16 hours, IOP between the three groups increased significantly with a statistically significant p-value of 0.008, but the mean IOP of acetazolamide patients was less than other groups. IOP nearly returned to the normal level 24 and 48 hours postoperatively, but this was not statistically significant (p = 0.452 and 0.138, respectively).Conclusion: Acetazolamide offers better IOP control than topical dorzolamide 2% in preventing ocular hypertension after scleral tunnel cataract surgery. Keywords: cataract surgery, ocular hypertension, viscoelastic, dorzolamide, intraocular pressure