Dexamethasone-netilmicin: a new ophthalmic steroid-antibiotic combination. Efficacy and safety after cataract surgery.

Purpose: The purpose of this study was to evaluate both efficacy and safety of a new ophthalmic steroid-antibiotic fixed combination containing dexamethasone and netilmicin in the postsurgical management of cataract surgery.

Methods: In total, 223 patients were randomly treated with dexamethasone 1 mg/ml plus netilmicin 3 mg/ml (n=148), or dexamethasone 1 mg/ml plus tobramycin 3 mg/ml (n=75, TOBRADEX) four times in a day for 7+/-1 days starting immediately after surgery. Efficacy (anterior chamber (AC) inflammation, conjunctival hyperaemia, corneal and lid oedema, ocular infection, pain, photophobia and tearing) and safety (burning, stinging, blurred vision, intraocular pressure, and visual acuity) were analysed in the operated eye after 1 and 7+/-1 days.

[Retinal tumors of the adult--two case reports].

Most frequently, retinal tumors that affect adults are rare, benign lesions that arise from vascular structures (hemangioma), neuroglial structures (astrocytoma, massive gliosis of the retina) or neuroepithelial cells (occasional forms of retinoblastoma that spontaneously stop growing and do not achieve or lose their malignant character). Retinal metastasis might be encountered but the settling of cancer cells at this level is very rare. Retinal tumors have frequently systemic associations and in this case they are included in the phacomatoses syndrome; nevertheless, they can also occur as a nonsyndromic pathological disorder.

[Aspects of optical coherence tomography in diabetic retinopathy].

Optical coherence tomography is a new and very useful technique for diabetic patients. It is used to determine the early changes in diabetic retinopathy and to help the ophthalmologist to choose the appropriate therapy.

[Retinal detachment with giant tears].

Retinal detachments are one of the greatest challenge for the vitreoretinal surgeon. Giant tears have a special place among them because they need a special equipment and experience. We are presenting here our experience concerning this type of tears.

[Modern treatment in venous retinal obstruction].

This article is a general view of modern methods of treatment în venous retinal obstruction. In the last years, medical treatment and LASER therapy have been replaced by early surgical approach. The main advantage of the last one is removal the cause of the disease not its effects.

[Branch retinal arterial occlusions--clinical case].

Branch retinal arterial occlusion is an ophthalmological emergency, presenting with features of sudden and painless loss of vision and visual field defect. Even if the diagnosis is easy to make, the ophthalmologist is, most of the times, unable to improve the prognosis. We present a clinical case of unilateral branch retinal arterial occlusion with unusual evolution.

Photodynamic occlusion of ocular neo-vascularization with B2 vitamin.

Photodynamic therapy (PDT) of cancer has been known for over twenty years and is based on the dye-sensitized photooxidation of different biological targets in the tumoral tissue yielding to a photochemically induced cell's death via apoptotic pathways. Several parameters affect clinical trials in PDT and influence the therapeutic outcome. A potentially major application of PDT in a non-cancer field is its use in treatment of age-related macular degeneration.

[Internal tamponade in proliferative diabetic retinopathy surgery].

Vitreous hemorrhage has been the most common indication of posterior vitrectomy in diabetic retinopathy. Now, the leader is tractional retinal detachement and many others: rhegmatogenous retinal detachement, fibrovascular proliferations membranes, huge premacular hemorrhage. During vitrectomy procedure it may be necessary internal tamponade using air, expanding gases, silicon oil and/or perfluorocarbon liquids.

[Ophthalmic cysticercosis-case report].

This paper presents a particular case regarding ophthalmic cysticercosis with subretinian localization associated with large subretinian hemorrhage, surgically addressed.

[Age related macular degeneration surgery].

Age related macular degeneration (ARMD) is a disease in which the retinal pigment epithelium (RPE) is damaged in the central retinal area. In the exudative form, the vision loss is due to choroidal neovascularization, while in the nonexudative or atrophic form, there is a vision loss because of the retinal pigment epithelium atrophy. Treatment which proved to be efficient in lowering the risk of severe vision loss in the exudative form includes laser photocoagulation, photodynamic therapy, transpupilary thermotherapy and as surgical treatment, the controversial subretinal membrane extraction.

[Difficulties in cataract surgery of patient with old glaucoma].

Cataract surgery of glaucoma patients treated with Pilocarpine several years, with a small and miotic pupil, with synechiae is an important problem of management. The self-retaining flexible iris retractor is a microsurgical innovation that allows adequate enlargement of the pupil without iris incision. Each retractor is inserted through a separate self-sealing beveled incision made as far posteriorly in the cornea as possible.

[Optical coherence tomography in surgical management of macular diseases].

Optical coherence tomography is a new imagistic technique recently introduced in ophthalmology. It is useful for diagnosis of macular diseases and it is extremely important in the management of those surgical ones. The most suitable diseases for postoperative evaluation by optical coherence tomography are: macular holes, epi and subretinal membranes, macular edema of diverse etiology and severe proliferative diabetic retinopathy.

[High-altitude retinopathy].

High-altitude retinopathy is a very rare ocular disease in our country, which can occur isolately or as a part of high-altitude illness. This paper presents the case of a patient with high-altitude illness and the diagnosis and treatment problems of this case.

[Surgical principles and techniques in severe proliferative diabetic retinopathy].

The development and new achievements of the last 30 years in vitreo-retinal surgery, since Machemer developed pars plana vitrectomy as surgical treatment of diabetic retinopathy, have led to a marked change of indications as well as surgical techniques which are applied in this disease. Surgical indications in severe proliferative diabetic retinopathy are: severe vitreous hemorrhage, tractional retinal detachment recently involving the macula, combined tractional and regmatogenous retinal detachment, severe fibrovascular proliferation, premacular dense hemorrhage, chronic macular edema, hemolytic glaucoma and anterior segment neovascularization with media opacity.

[Ophthalmologic involvement of intracranial tumors--report of a case].

Bilateral papillary edema is considered to be the expression of a tumoral process that reduces the intracranial space resulting in elevation of the intracranial cerebrospinal fluid pressure. The authors present the case of a 21-year-old man consulting for mild visual loss of the left eye. The ophthalmologic examination showed bilateral papilledema and visual field defects in the left eye (enlargement of the blind spot), with no clinic or imagistic signs of increased intracranial pressure.

[Prostaglandin esters--new directions in the treatment of glaucoma].

The therapeutically approach of glaucoma still represent a problem of the ophthalmology. Latanoprost, a new prostaglandin derivative, fall the intraocular pressure as good in the night as during the day by its special way of action. Since January 1998, in the Eye Clinic of the Central Military Hospital, we studying the ocular hypotensive effects of the latanoprost.

[An inclusion cyst of the anterior chamber].

Our paper present a clinical case of inclusion cyst of the anterior chamber. We discuss the clinical course, the specific investigations, the surgical management and the histopathologic diagnosis.

[Optical coherence tomography].

Optical coherence tomography is a novel, noninvasive, noncontact and repetitive imaging technique which produces high depth resolution cross-sectional tomographs of ocular tissue. It's value is given by the possibility of achieving pseudo-histological images of the target tissue. It is optically based, analogue to ultrasound B-scan examination and similar to laser reflectometry.

[Specular microscopy--its clinical implications].

Specular microscopy has multiple advantages in the clinical practice, allowing the study of the corneal endothelium in-vivo. We can observe corneal disorders, as well as the corneal status after intraocular surgery, of the posterior pole as well as of the anterior pole of the eye.

[Emergency keratoplasty].

In some ocular diseases may occur the corneal perforation. This condition requires an emergency penetrating keratoplasty. We show in this paper the conditions, surgical techniques and the complications in this kind of surgical intervention, with examples from our clinical cases.

[Retinopathy of prematurity].

The paper presents theoretical aspects about the pathogenesis, diagnosis and treatment of the retinopathy of prematurity.