Levofloxacin Eye Drops Research Articles

Posterior scleritis following a single infusion of zoledronate for osteoporosis: A case report and literature review

Key Clinical MessageThe most frequently reported adverse reaction to zoledronic acid is an acute phase reaction resembling influenza. While rarer adverse events such as osteonecrosis of the jaw and atypical femoral fractures have gained significant recognition, the ocular adverse effects, particularly scleritis, are not yet fully comprehended. Here, we present the case of a 75‐year‐old female patient with osteoporosis who developed bilateral redness and intense eye pain 48 h after receiving a 5 mg intravenous dose of zoledronic acid. Clinical presentation suggested bilateral conjunctivitis, but treatment with levofloxacin eye drops and acyclovir ophthalmic gel exacerbated the symptoms over 2 days, predominantly affecting the left eye. Ocular ultrasonography revealed thickening of the left eyeball wall with a “T” sign, while an orbital CT scan showed increased thickness of the left sclera. Treatment with methylprednisolone 80 mg intravenous infusion twice daily led to gradual symptom improvement and eventual resolution of inflammation. This report, based on a review of relevant literature, investigates the treatment and outcomes of zoledronic acid‐induced scleritis, emphasizing the importance for clinicians to promptly identify and manage this rare and serious ocular adverse reaction.

Comparison of the recovery characteristics for canine corneal ulcer treated with corneoconjunctival transposition or conjunctival autografts

Corneal ulceration induced by Staphylococcus pseudintermedius (S. pseudintermedius) is a common clinical eye disease. Antibiotics combined with corneoconjunctival transposition (CCT) or conjunctival autografts (CA) are often used, but the recovery characteristics are still unknown. In this experiment, canine corneal ulcer models induced by S. pseudintermedius and treated with levofloxacin eye drops (LED) were created. The models were used to compare the recovery characteristics of CCT and CA, combined with LED, by clinical observation, histopathology, and cytokine expression detected by qRT-PCR analysis. The results showed that the ulcerative cornea with only LED treatment perforated after 48 h. The mRNA expression of TLR2, IL-1β, IL-6, IL-8, and TNF-α genes was significantly elevated on 14, 28, and 35 days after the surgery compared to normal (p < 0.01). On day 42, the inflammatory damage had resolved, but the corneal transparency and arrangement of collagen fibrils in the CCT group were higher than those in the CA group. The mRNA expression of EGF, FGF, TGF-β1 and VEGF genes increased significantly (p < 0.01), mostly until day 42, proving that CCT and CA surgery contributed to the corneal recovery, and relieved the inflammatory reaction, with the elimination of corneal cicatrices needing a period of reconstruction. Therefore, this study has provided, for the first time, the method for establishing a canine corneal ulcer model induced by S. pseudintermedius. More importantly, the recovery of canine ulcerative corneas with CCT or CA surgery is reported for the first time.

Amnion Membrane Transplantation: A Therapy for Persistent Epithelial Defect as A Result of Neurotrophic Keratitis

Introduction : A persistent epithelial defect (PED) is a failure of re-epithelialization and complete healing of the cornea. The primary goal of PED treatment is to create a favorable environment for corneal wound healing. Amniotic membrane transplants (AMT) become one of the refractory cases treated for PED. This study aims to report AMT as therapy for a PED.&#x0D; Case Illustration : A fifty-six-year-old male presents with a chief complaint of redness and pain in the left eye in the last2 weeks. The patient complained of blurred vision, tearing, and foreign body sensations. An ophthalmology examination of the left eye revealed that it was close to face finger counting in visual acuity and had a persistent epithelial defect, corneal edema, descemet fold, and a decrease in corneal sensation. The patient was diagnosed with PED and received autologous serum eye drops, levofloxacin eye drops, vitamin A palmitate eye gel, and acyclovir 400mg twice a day, but did not respond adequately. AMT was planned for the patient. The patient's pain level improved one week after surgery.&#x0D; Discussion : The most common symptom of PED is pain. There are various etiological factors for PED. Neurotropic keratitis has emerged as one of the causes of PED. Management for PED is carried out sequentially according to the protocol.&#x0D; Conclusion : Amniotic membrane transplantation has become an alternative therapy for PED. The amniotic membrane provides re-epithelialization of the cornea and anti-inflammatory properties. The prognosis for AMT as a therapy for PED is quite good.

Safety of intracameral injection of levofloxacin 0.5% eye drops single dose 0.6 ml preservative free on rabbit eye

Background This was an experimental, parallel, and randomized study to evaluate the safety of single intracameral injection of 0.6 ml 0.5% preservative-free levofloxacin eye drops on rabbit eye. Methods In total, 24 eyes of 12 New Zealand white rabbits were divided into three groups. The first group (LFX) was treated with 0.1 ml intracameral injection of levofloxacin 0.5% eye drops of 0.6 ml preservative-free (n = 6), the second group (CRAV) was treated with 0.1 ml intracameral injection of levofloxacin 0.5% eye drops 5 ml commercially available eye drops preservative-free (n = 6), and the third group (BSS) were treated with 0.1 ml intracameral injection of balanced salt solution (n = 12). All groups received a single dose. The clinical evaluation was performed on the 1st, 3rd, 5th, and 7th day after injection. Each eye was enucleated on the 7th day and underwent a histopathology examination. Results The clinical scores among the three groups did not show any significant difference on days 1st, 2nd, 3rd, and 7th (p&gt;0.05). The only ones noted in clinical scores were mild corneal opacity, mild cells, and flares in the anterior chamber. The histopathology score demonstrated no statistically significant difference between the three groups (p&gt;0.05). Vacuolization of corneal endothelial cells was noted in all groups but was not statistically significant. Conclusions A single intracameral injection of 0.6 ml 0.5% preservative-free levofloxacin eye drops was safe for rabbit eye, according to clinical and histopathology scores, similar to levofloxacin 0.5% eye drops in 5 ml bottle preservative free.

MANAGEMENT OF IRREGULAR ASTIGMATISM AFTER CORNEAL ULCER WITH RGP CONTACT LENS IN PATIENTS WITH HIGH MYOPIA

Introduction: RGP contact lenses are indicated for correcting refractive errors in cases of high myopia and irregular astigmatism due to changes in the corneal curvature. Case Report: A 30-year-old female came with complaints of redness, pain, glare, blurred vision, and yellow discharge and tearing on the left eye for 2 days, history of using Soft Contact Lens (SCL) since 10 years old due to myopia. Visual Acuity of the right eye (VOD) with glasses was 6/12 and VA of the left eye (VOS) was 1/300. The patient was diagnosed with left eye corneal ulcer and was given levofloxacin eye drops, hydroxypropyl methylcellulose eye drops, and vitamin C 1000 mg. The left eye's corneal ulcer healed after three days, but the scarring left the cornea's surface uneven.. Patients were advised to replace the contact lenses with RGP contact lenses. After the RGP fitting, the appropriate size was obtained in both eyes and the patient adapted well with VOD RGP 1.0 and VOS RGP 1.0 False. The patient felt helped by the RGP contact lens. Discussion: RGP was given because it helped reduce the bacterial infection risk. RGP has a higher oxygen transmissibility and maintains the cornea's curvature to become more regular. It can be utilized as an optical device to repair excessive myopia in addition to irregular astigmatism. Conclusion: RGP contact lens can be an option for irregular astigmatism after corneal ulcers due to the SCL use in patients with high myopia to provide good outcomes.

Pterygium combined with corneal perforation: a case report

BackgroundPterygium is a common ocular surface disease. Pterygium combined with corneal perforation is rare.Case presentationA 28-year-old female patient visited our outpatient clinic due to sudden onset of blurred vision and increased tearing in her left eye. The visual acuity was 1.0 OD and intraocular pressure (IOP) of 19.5 mmHg for the right eye with no significant abnormalities found in the anterior and posterior segments. The visual acuity of her left eye was 0.06, and IOP was 6.2 mmHg. A triangular vascular membranous tissue was seen in her left eye below the nose growing into the cornea and the pupil area was not touched. Slit-lamp examination revealed a tiny round corneal perforation in 8 o’clock position of the lesion area. Hospital diagnosis was given as pterygium combined with corneal perforation. The patient was treated with levofloxacin eye drops and autologous serum-based eye drops.ConclusionsWe report a rare case of pterygium combined with corneal perforation. Perforation is a very rare complication of pterygium. This patient received proper treatment and good result was seen. This article aimed to improve clinicians’ understanding of pterygium.

Safety of intracameral injection of levofloxacin 0.5% eye drops single dose 0.6 ml preservative free on rabbit eye.

This was an experimental, parallel, and randomized study to evaluate the safety of single intracameral injection of 0.6 ml 0.5% preservative-free levofloxacin eye drops on rabbit eye. In total, 24 eyes of 12 New Zealand white rabbits were divided into three groups. The first group (LFX) was treated with 0.1 ml intracameral injection of levofloxacin 0.5% eye drops of 0.6 ml preservative-free (n = 6), the second group (CRAV) was treated with 0.1 ml intracameral injection of levofloxacin 0.5% eye drops 5 ml commercially available eye drops preservative-free (n = 6), and the third group (BSS) were treated with 0.1 ml intracameral injection of balanced salt solution (n = 12). All groups received a single dose. The clinical evaluation was performed on the 1 st, 3 rd, 5 th, and 7 th day after injection. Each eye was enucleated on the 7 th day and underwent a histopathology examination. The clinical scores among the three groups did not show any significant difference on days 1 st, 2 nd, 3 rd, and 7 th (p>0.05). The only ones noted in clinical scores were mild corneal opacity, mild cells, and flares in the anterior chamber. The histopathology score demonstrated no statistically significant difference between the three groups (p>0.05). Vacuolization of corneal endothelial cells was noted in all groups but was not statistically significant. A single intracameral injection of 0.6 ml 0.5% preservative-free levofloxacin eye drops was safe for rabbit eye, according to clinical and histopathology scores, similar to levofloxacin 0.5% eye drops in 5 ml bottle preservative free.

Effects of the pharmaceutical formulation of topical medications on corneal epithelial healing after phototherapeutic keratectomy.

To determine the effect of the formulation of topical medications on the healing of corneal epithelial cells after phototherapeutic keratectomy (PTK). Retrospective cohort study. We studied 271 eyes of 189 consecutive patients (aged 67.6 ± 11.8 years) who had undergone PTK for granular corneal dystrophy (n = 140), band keratopathy (n = 47), or lattice corneal dystrophy (n = 2). Postoperatively, generic or brand-named levofloxacin, 0.1% betamethasone, or 0.1% bromfenac sodium hydrate was applied topically. Patients were examined on postoperative days 1, 2, and 5 and weekly thereafter. The time to re-epithelialization was assessed by use of Kaplan-Meier and Cox proportional hazards analyses. The time to re-epithelialization was significantly longer with generic 0.5% levofloxacin, at 8.2 ± 3.5 days, than with 0.5% Cravit (levofloxacin), at 6.7 ± 3.5 days (P = 0.018), or with 1.5% Cravit, at 6.3 ± 2.6 days (P = 0.000). In addition, the time to re-epithelialization was significantly longer with generic 0.1% betamethasone (Sanbetason), at 7.3 ± 3.4 days, than with brand-name 0.1% betamethasone (Rinderon), at 6.1 ± 2.5 days (P = 0.0002). The Cox proportional hazards model indicated that the use of generic formulations for levofloxacin eye drops and 0.1% betamethasone was a significant factor that delayed corneal re-epithelialization (hazard ratio [HR] = 0.72, P = 0.002 and HR = 0.77, P = 0.006, after adjustment for age). Re-epithelialization was significantly shorter in band keratopathy than in corneal dystrophy (HR = 1.56, P = 0.004). No other factors, including age, bandage contact lens, and diabetes mellitus, were significantly associated with time to re-epithelialization. Corneal epithelial healing can be significantly affected by different antibacterial or steroid eye drops. Clinicians need to be aware that a generic formulation may affect corneal epithelial healing.

Zwitterionic silver nanoparticle based antibacterial eye drops for efficient therapy of bacterial keratitis.

Inefficient biofilm clearance and the risk of drug resistance pose significant challenges for antibiotic eye drops in the treatment of bacterial keratitis (BK). Recently, silver nanoparticles (AgNPs) have emerged as promising alternatives to antibiotics due to their potent antibacterial activity and minimal drug resistance. However, concerns regarding the potential biotoxicity of aggregated AgNPs in tissues have limited their practical application. In this study, polyzwitterion-functionalized AgNPs with excellent dispersion stability in the ocular physiological environment were chosen to prepare antibacterial eye drops. Zwitterionic AgNPs were synthesized using a copolymer, poly(sulfobetaine methacrylate-co-dopamine methacrylamide) (PSBDA), as a stabilizer and a reducing agent. The resulting antibacterial eye drops, named ZP@Ag-drops, demonstrated outstanding biocompatibility in in vitro cytotoxicity tests and in vivo rabbit eye instillation experiments, attributed to the zwitterionic PSBDA surface. Furthermore, the ZP@Ag-drops exhibited strong antibacterial activity against multiple pathogenic bacteria, particularly in penetrating and eradicating biofilms, due to the synergistic bactericidal effect of the released Ag+ and reactive oxygen species (ROS). Importantly, in vivo BK rabbit models showed that the ZP@Ag-drops effectively inhibited corneal infection and prevented ocular tissue damage, surpassing the therapeutic effect of commercial levofloxacin eye drops (LEV-drops). Overall, this study presents a promising alternative option for the effective treatment of BK using antibacterial eye drops.

Bilateral Herpes Simplex Keratoconjungtivitis: A Case Report

Introduction: Herpes Simplex Virus (HSV) is one of the DNA viruses known to infect the human eye. Herpes simplex keratitis is, in general, a unilateral disease. Simultaneous bilateral involvement is a rare occurrence that has been observed in patients with compromised immune systems. Purpose: To report a case of bilateral herpes simplex keratoconjunctivitis Case Report: A 22-year-old man arrives with the primary complaint of redness in both eyes in the last four days. The patient complained of blurred vision, tearing, and foreign body sensations. Ophthalmology examination of both eyes revealed visual acuity of 1.0 in the right eye and 0.8 in the left eye, a dendritic lesion, and a decrease in corneal sensation. Patient was diagnosed with bilateral keratoconjunctivitis HSV and was treated with acyclovir ointment, levofloxacin eye drops, acyclovir 400 mg five times a day, and vitamin C 500 mg. Discussion: Bilateral herpes simplex keratitis can occur in both immunocompromised and immunocompetent individuals. Recurrence of HSV infectious keratitis is common. Factors such as emotional stress, fever, postoperative tear dysfunction, ultraviolet (UV-A) radiation exposure, and ocular (accidental or surgical) trauma have also been related to the reactivation of the herpes simplex virus. History, physical, and laboratory examinations support the patient?s diagnosis in order to get the appropriate treatment. Conclusion: Simultaneously occurring bilateral herpetic keratitis has a high proportion of complications, either because of the greater virulence of the virus or because of altered host susceptibility. Therefore, prompt administration of medication upon diagnosis is essential to reduce the severity and frequency of viral attacks and delay the progression of corneal damage.

A Rare Case of Orbital Cellulitis with Tolosa-Hunt Syndrome Caused by Methicillin-Resistant Staphylococcus aureus (MRSA): a Case Report

Background: Orbital cellulitis is an active infection of the orbital soft tissue posterior to the orbital septum, which can cause Tolosa-Hunt Syndrome (THS) complication. Purpose: We reported a child with orbital cellulitis with THS complication caused by methicillin-resistant Staphylococcus aureus (MRSA). Case: A two-year-old girl complained of swelling and pain in the left eye accompanied by fever. In nasal region and left eye showed multiple erythema patches with geographic shape, size 1x2cm - 4x5cm, unclear border, erosion with sizes 0.5x1cm - 1x1.5 cm size covered with blackish crusts. After several days of hospitalization, she complained of proptosis and pain in moving her eye. We did the magnetic resonance imaging (MRI) scan examination, which showed a mass size of 2.2 x1.1 x 0.9 cm in a left intraconal orbital and dilation of the left-sided cavernous sinus. The blood culture showed MRSA bacteria. She was diagnosed with orbital cellulitis with THS complication and showed a good response with Meropenem, Methylprednisolone, cendo lyteers eye drops, levofloxacin eye drops, and gentamicin eye ointment. Discussion: Orbital cellulitis presents as ill-defined erythema, edema, warmth, and pain around the nasal and the orbital region and is more often found in children. The THS complication is characterized by ophthalmoplegia, unilateral orbital or periorbital pain, unilateral headache, and leukocytosis. Orbital cellulitis management includes antibiotic intravenous, corticosteroid, and eye care. Conclusion: THS is a rare complication of orbital cellulitis. Early diagnosis and management of orbital cellulitis are essential to prevent THS complication.

Conjunctival sac bacterial culture of patients using levofloxacin eye drops before cataract surgery: a real-world, retrospective study

BackgroundThe use of antibiotics preoperatively is effective to decrease the incidence of ocular bacterial infections but may lead to high resistance rate, especially on patients with multi-risk clinical factors. This study systematically analyzed real-world data (RWD) of patients to reveal the association between clinical factors and conjunctival sac bacterial load and offer prophylaxis suggestions.MethodsWe retrieved RWD of patients using levofloxacin eye drops (5 mL: 24.4 mg, 4 times a day for 3 days) preoperatively. Retrieved data included information on the conjunctival sac bacterial culture, sex, presence of hypertension and diabetes mellitus (DM), and history of hospital-based surgeries. Data was analyzed using SPSS 24.0.ResultsRWD of 15,415 cases (patients) were retrieved. Among these patients, 5,866 (38.1%) were males and 9,549 (61.9%) females. 5,960 (38.7%) patients had a history of hypertension, and 3,493 (22.7%) patients had a history of DM. 7,555 (49.0%) patients had a history of hospital-based operations. There were 274 (1.8%) positive bacterial cultures. Male patients with hypertension and DM may be at increased risk of having positive bacterial cultures (P < 0.05). Staphylococcus epidermidis (n = 56, 20.4%), Kocuria rosea (n = 37, 13.5%), and Micrococcus luteus (n = 32, 11.7%) were the top 3 isolated strains. Most bacterial strains were resistant to various antibiotics except rifampin, and 82.5% (33 of 40 isolates) of Staphylococcus epidermidis isolates had multidrug antibiotic resistance. Numbers of culture-positive Staphylococcus epidermidis isolates in the male group and non-DM group were greater than those in the female and DM groups, respectively. Micrococcus luteus (n = 11, 8.8%) was found less frequently in non-hypertension group than in hypertension group.ConclusionSex (Male) and the presence of hypertension and DM are risk factors for greater conjunctival sac bacterial loads. We offer a prophylactic suggestion based on the combined use of levofloxacin and rifampin. However, this approach may aggravate risk of multidrug resistance.

Clinical observation of ranibizumab combined with surgery in the treatment of neovascular glaucoma with vitreous hemorrhage.

The aim was to explore the clinical efficacy of ranibizumab combined with surgical treatment of neovascular glaucoma with vitreous hemorrhage. A total of 15 patients (17 affected eyes) who had neovascular glaucoma (NVG) with vitreous hemorrhage in our hospital were enrolled. After admission, the patient was given levofloxacin eye drops, 4 times a day. Three days later, the patients received intravitreal injection of ranibizumab. Then, trabeculectomy and vitrectomy were performed. The detailed clinical data, such as type of diseases, intraocular pressure (IOP), and best corrected visual acuity (BCVA), were collected before and after surgery. Visual acuity remained stable or improved in thirteen effected eyes and decreased in effected three eyes. Within 30days after discharge, one effected eye recurred iris neovascularization with slightly higher IOP; then, the patient received intravitreal injection of ranibizumab again and neodymium-doped yttrium aluminum garnet (YAG) therapy. One patient (one effected eye) was given intravitreal ranibizumab injection again because of uncontrollable IOP and recurrence of neovascularization on iris surface and angle after operation; then, the patient received cyclophotocoagulation. Vitreous cavity hemorrhage occurred again in 3 patients after operation; then, these patients received the vitreous cavity lavage again. After trabeculectomy, inflammatory exudation or a small amount of bleeding could be seen in the anterior chamber of 6 young patients. Intravitreal injection of ranibizumab can effectively promote the rapid regression of intraocular neovascularization and help to control the IOP and improve postoperative visual acuity.

Inhibitory Effect of Short-Term Palpebral Margin Cleaning with Antibiotic Eye Drops on Ocular Surface Flora before Cataract Extraction: A New Preoperative Antibacterial Method

ObjectiveTo explore the clinical significance of the combined application of palpebral margin cleaning and antibiotic eye drops in inhibiting bacterial growth in the palpebral margin and conjunctival sacs before cataract extraction. MethodsIn this study, 61 patients (97 eyes) with age-related cataract who underwent phacoemulsification and intraocular lens implantation were selected, and randomly grouped. In the experimental group, the combined application of palpebral margin cleaning with cotton pads and levofloxacin eye drops was given for three days before the surgery. In the control group, levofloxacin eye drops alone were applied for three consecutive days. Bacteria samples from the conjunctival sac and eyelid margins were cultivated and identified before and three days after taking antimicrobial measures, respectively. ResultsIn the experimental group, the positive rates of the two bacteria samples were 100% (50/50) and 40% (20/50) before and 10% (5/50) and 0% (0/50) after the treatment. In the control group, the positive rates of the two bacteria samples were 97.9% (46/47) and 29.8% (14/47) before and 40.4% (19/47) and 10.6% (5/47) after the treatment. The positive rates between the two groups were not significantly different before taking antimicrobial measures (P = 0.485 and 0.395), while they were significantly different after taking antimicrobial measures (P = 0.001 and 0.024). ConclusionCombined application of eyelid and palpebral margin cleaning with cotton pads and antibiotic eye drops before cataract extraction imparted excellent antibacterial effects.

A One-Week Course of Levofloxacin/Dexamethasone Eye Drops: A Review on a New Approach in Managing Patients After Cataract Surgery.

A new fixed-dose combination of dexamethasone and levofloxacin eye drops has recently been approved for the prevention and treatment of inflammation, and the prevention of infection associated with cataract surgery in adults. This combination has been developed to respond to a series of unmet needs in the practical management of patients undergoing cataract surgery. Namely, despite updated guidelines, many ophthalmologists employ protocols mainly based on their personal experience. As a result, the choice of drugs, treatment duration, and drug association is not evidence-based medicine (EBM)-oriented. In addition, antibiotic resistance may occur since antibiotics are used for an extended length of time, even with tapering. Corticosteroids are also prescribed for prolonged periods, frequently without follow-up. Therefore, patient adherence to postsurgical self-care is low, and mainly affects older patients who are the majority undergoing cataract surgery. In both rabbit and human trials, it has been demonstrated that both active ingredients penetrate the ocular system without pharmacokinetic interaction between the two. The concentrations of both ingredients in aqueous humor after their ocular instillation are high enough at the site of action to carry out their expected potent anti-inflammatory and antibiotic activity. Tested in a pivotal study aimed at investigating efficacy and safety of the intended indication, the mixture/compound was non-inferior to a 2-week treatment with dexamethasone/tobramycin in preventing or reducing inflammation and in preventing infection when administered for 1 week, followed by the administration of dexamethasone alone for another week. The outcomes obtained by this study suggest that a 1-week course of levofloxacin/dexamethasone eye drops is sufficient to resolve inflammation and prevent infection in patients undergoing cataract surgery. In addition, this study underlines that a follow-up visit after 1 week allows for a decision about whether to stop or continue a treatment in patients still experiencing symptoms or inflammation. In conclusion, this new dose combination could represent a turning point in managing patients after cataract surgery, while mostly avoiding antibiotic resistance and improving treatment adherence.

The Effects of Green Betel Leaf (Piper betle) Extract Eye Drops on the Number of Staphylococcus aureus Colonies in Conjunctivitis Wistar Rats Model (Rattus novergicus)

Irrational use of antibiotics can cause resistance to some diseases such as bacterial conjunctivitis caused by Staphylococcus aureus. Previous research said that green betel leaf (Piper betle) contains antimicrobial compounds such as eugenol, cavalry, tannins, saponins, and flavonoids which also have antiseptic power as well as antibiotics. This study aims to prove the decrease in the number of Staphylococcus aureus colonies after giving green betel leaf eye drops (Piper betle) to conjunctivitis Wistar rats (Rattus norvegicus). This research was true experimental with a pretest-posttest control group design. 25 male white Wistar rats as objects were selected by simple random sampling and grouped into 5 groups randomly. The rats were given Staphylococcus aureus, control group K+ was given 0.5% levofloxacin eye drops, and K- was given aquadest as a comparison. Treatment groups P1, P2, and P3 were given different concentrations of betel leaf eye drops. Swab pretest was done 3 days after the rats were inoculated with Staphylococcus aureus and swab post-test was done 5 days after the rats were given green betel leaf eye drops, the calculation of Staphylococcus aureus bacteria colonies used the Total Plate Count (TPC) method. There was a significant decrease (p&lt;0.05) in the number of bacterial colonies for K-, K+, P1, P2, and P3 groups. In addition, there was a significant difference (p&lt;0.05) between K+ with P1 and K+ with P3. There was a decrease in the number of Staphylococcus aureus for all groups of conjunctivitis Wistar rats (Rattus norvegicus)

Improved Treatment on Ocular Inflammation with Rationally Designed Thermoresponsive Nanocomposite Formulation

AbstractCataract is the principal cause of preventable blindness in older people globally. Intraocular surgeries stimulate multiple postoperative inflammatory responses. The current clinical treatment by dropping prednisolone acetate (PA) and levofloxacin (LF) suffers from drawbacks, such as low bioavailability and poor patient compliance. This study aims to develop a rationally designed thermoresponsive formulation combining PA and LF using nancomposites of mesoporous silica nanoparticle (MSN) and thermo‐nanogel (thermogel) (PA@MSN‐LF@Thermogel). The in vitro release profiles of PA and LF from PA@MSN‐LF@Thermogel are tailor‐made to adapt to wound healing by a sustained release of 28 days. PA@MSN‐LF@Thermogel exhibits little cytotoxicity to human Tenon's fibroblasts and human corneal epithelial cells, while presents excellent in vitro antibacterial effectiveness to Staphylococcus bacteria. After implanted into the rabbit eye by a subconjunctival injection, PA@MSN‐LF@Thermogel displays overwhelming anti‐inflammatory and antibacterial effectiveness up to 21 days using only one‐eighth of the total dose, compared with PA and LF eye drops. The formulation does not cause any ocular hypertension and noticeable histopathological abnormality which indicate good biosafety. This thermoresponsive nanocomposite formulation is thus a promising drug delivery alternative for treatment of postoperative inflammation after intraocular surgeries.

The ocular surface bacterial contamination and its management in the prophylaxis of post cataract surgery endophthalmitis.

Objective: To investigate the recent pieces of evidence regarding the bacterial ocular surface contamination and its treatment in the prophylaxis of post-cataract surgery endophthalmitis.Methods: We conducted a literature research on the topic of interest and selected the most relevant data.Results: The studies reported a relatively high rate of positive conjunctival culture and the most frequently isolated organism was Coagulase negative Staphylococcus, which is also the most common etiological agent of the postoperative endophthalmitis. The bacterial ocular surface load is influenced by age, climate, associated diseases, topical and systemic medication. The use of povidone-iodine alone or in association with levofloxacin eyedrops as prophylactic method is effective in reducing the conjunctival bacterial contamination and consequently decreases the incidence of postoperative endophthalmitis.Conclusions: Based on the current pieces of evidence, adequate treatment of the bacterial ocular surface contamination prior to cataract surgery seems to be effective in preventing endophthalmitis after cataract surgery.Abbreviations: EU = European Union, Spp. = Species, HIV = Human Immunodeficiency Virus

Post-surgical management of cataract: Light and dark in the 2020s

Cataract surgery is the most frequently performed elective surgery worldwide. Although considered a safe procedure, potentially sight-threatening adverse events are possible. Among these, post-surgical inflammation and infections are the most relevant. Anti-inflammatory drugs, such as corticosteroids, and topical antibiotics are the pillars for the treatment of inflammation and for the prevention of infections. However, uncertainties remain regarding the duration of both topical antibiotic prophylaxis and corticosteroid treatment. LEADER7, a recent international clinical study conducted with the new fixed combination of levofloxacin and dexamethasone eye drops in patients undergoing uncomplicated cataract surgery, found that 1-week topical antibiotic prophylaxis is just as effective as the 2-week course commonly used in clinical practice. The study also showed that treatment for 1 week with dexamethasone results in complete resolution of inflammatory signs and symptoms in over 85% of patients, for whom further prolongation of corticosteroid treatment is, therefore, not necessary. This new treatment strategy can represent a significant step forward to reduce the unjustified use of prophylactic antibiotics after cataract surgery, limiting the emergence of bacterial resistance, as well as representing an opportunity to optimize the use and safety of the corticosteroid treatment.

Effect of bloodletting at tip of ear with different amounts on pain in patients with early-stage stye: a randomized controlled trial

To compare the curative effect between bloodletting at tip of ear with different amounts combined with western medication and western medication alone for early-stage stye. A total of 108 patients with early-stage stye were randomly divided into a 50 μL group (36 cases, 4 cases dropped off), a 100 μL group (36 cases, 2 cases dropped off) and a western medication group (36 cases, 5 cases dropped off). The patients in the western medication group were treated with levofloxacin eye drops and levofloxacin hydrochloride eye gel. Based on the treatment of the western medication group, the patients in the 50 μL group were treated with 50 μL bloodletting (about 3 drops) at tip of ear while the patients in the 100 μL group were treated with 100 μL bloodletting (about 6 drops) at tip of ear; the bloodletting was given once a day for 3 days. After treatment, the changes of visual analogue scale (VAS) and clinical effect were observed, and the patients were followed up by telephone on the 8th day. After treatment, the VAS score in each group was reduced (P<0.01), and the score in the 50 μL group and 100 μL group was lower than that in the western medication group (P<0.05, P<0.01), and the score in the 100 μL group was lower than that in the 50 μL group (P<0.05). After treatment, the cured rate was 76.5% (26/34) in the 100 μL group, 71.9% (23/32) in the 50 μL group and 51.6% (16/31) in the western medication group, and there were no significant differences among three groups (P>0.05). One week after the onset of the disease, all the patients in the 50 μL group and 100 μL group were cured, and one patient in the western medication group was not cured, and treated with routine surgery. Based on the conventional western medication treatment, bloodletting at tip of ear can significantly reduce the pain of stye, and the effect of 100 μL bleeding is better than 50 μL.