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The purpose of this study was to evaluate retinal nerve fiber layer (RNFL) thickness changes in eyes undergoing trypan blue-assisted macular surgery using optical coherence tomography-3. This is a prospective noncomparative, interventional, and observational case series of 35 eyes of 35 consecutive patients (15 eyes with macular hole, 14 eyes with idiopathic macular pucker, and 6 eyes with tractional diabetic macular edema) who underwent pars plana vitrectomy and peeling of the epiretinal membrane and/or internal limiting membrane assisted with 0.1 mL of 0.15% trypan blue.The quantitative analysis of the peripapillary RNFL by optical coherence tomography was performed before surgery and 6 months postoperatively in both eyes of the same patient. The main outcome measures were significant changes in RNFL thickness (overall and by quadrant).Optical coherence tomography assessment of the macular status at 6 months postoperatively showed closure of all macular holes and improvement in foveal contour in all cases of macular pucker or most cases of diabetic macular edema. Dissociated RNFL at the area of internal limiting membrane removal was observed in 9 eyes. No statistical significant changes in the mean RNFL thickness overall or by quadrant were observed after surgery.Trypan blue-assisted peeling of macular epiretinal membranes and/or internal limiting membrane does not induce significant changes in RNFL thickness as measured by optical coherence tomography-3. Internal limiting membrane peeling may induce visible changes of the inner retinal surface possibly because of microdefects on macular nerve fiber layers.

A double-masked study randomly assigned 60 eyes of 60 patients undergoing neodymium: YAG (Nd:YAG) laser iridotomy to pretreatment with either placebo (group 1) or 2% dorzolamide eyedrops in a single dose (group 2). Intraocular pressure (IOP) was measured 30 minutes and 1, 2, 3, 4, 6, and 24 hours after iridotomy. Group 2 pressures were lower and returned to normal levels faster than in group 1. Thus, dorzolamide used preoperatively may safeguard IOP.

* BACKGROUND AND OBJECTIVE: To evaluate the efficacy of topical brimonidine tartrate 0.2% (Allergan, Irvine, CA) in the prophylactic treatment of acute intraocular pressure (IOP) rises following Nd: YAG laser posterior capsulotomy * PATIENTS AND METHODS: This was a doublemasked, randomized, placebo-controlled clinical study in 60 patients who underwent Nd:YAG laser posterior capsulotomy after extracapsular cataract extraction. Two doses of brimonidine or vehicle were administered before and after capsulotomy. Intraocular pressure was measured prior to commencing instillation and for 48 hours postoperatively * RESULTS: Following posterior capsulotomy, the brimonidine group showed a significant mean percent reduction in IOP, while the vehicle group showed a significant mean percent increase in IOP At 48 hours, mean IOP of both groups had returned to pre-laser level. There were no differences between the 2 groups in the incidence of clinical adverse experiences. * CONCLUSION: Two-dose brimonidine tartrate 0.2% effectively prevents acute IOP rises after Nd: YAG laser posterior capsulotomy. [Ophthalmic Surg Lasers 1999;30:647-652.]

The concentrations of hyaluronan and galactosaminoglycans -- i.e., chondroitin sulfate and dermatan sulfate -- were measured in the aqueous humor of the eye from patients with exfoliation syndrome and from healthy persons. The glycosaminoglycans/proteoglycans were almost completely precipitated (97%) with ethanol in the presence of dextran as carrier and, following enzymic digestion, hyaluronan and galactosaminoglycans, were quantitatively converted to delta4,5-disaccharides. Non-degraded heparan sulfate and proteins/glycoproteins were removed by ultrafiltration using a Centricon 3 membrane. Separation and determination of hyaluronan- and galactosaminoglycan-derived delta-disaccharides were performed by ion-suppression HPLC. For an accurate analysis in triplicate, as little as 50 microl of aqueous humor is required. Application of this method to the analysis of samples from six patients with exfoliation syndrome and three healthy persons showed that hyaluronan levels in patients (6.65-16.15 microg ml(-1)) were significantly higher (3-8 times) than in healthy persons (2.0-2.24 microg ml(-1)). There was no significant alteration in the galactosaminoglycan concentration. The obtained data open a new area in the deeper understanding of the exfoliation syndrome pathophysiology and in establishing a highly sensitivity and accurate HPLC method for its diagnosis and patient's follow-up.

Purpose: To determine the efficacy of brimonidine tartrate 0.2% drops given 2 times a day in reducing intraocular pressure (IOP) spikes during the first 24 hours after phacoemulsification cataract surgery. Setting: Department of Ophthalmology, General Hospital of Patras Agios Andreas, Patras, Greece. Methods: In this prospective double-blind placebo-controlled study, 1 eye of 40 consecutive normotensive cataract patients having small-incision cataract surgery was randomized into 1 of 2 treatment arms. Twenty patients received a placebo (artificial tears) and 20 patients received brimonidine tartrate 0.2% drops 2 times a day the day before and the day of surgery. Diurnal IOP variation was the primary efficacy variable; IOP was measured at baseline, before surgery, and 4, 6, 12, and 24 hours postoperatively. Results: The placebo group had higher IOPs at every time point after surgery. Peak elevation of IOP occurred 6 hours after surgery. The mean IOP in the placebo group (27.71 mm Hg ± 3.75 [SD]) was statistically significantly higher than in the brimonidine group (21.45 ± 1.32 mm Hg) (P