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    Aqueous humor penetration of topically applied ciprofloxacin, ofloxacin and tobramycin
    (Ecv-Editio Cantor Verlag Medizin Naturwissenschaften, 1997) Durmaz, B; Marol, S; Durmaz, R; Oram, O; Hepsen, IF; Gunal, S
    The purpose of this study was to determine the aqueous humor concentrations of topically applied ciprofloxacin (GAS 86393-32-0), ofloxacin (GAS 82419-36-1) and tobramycin (GAS 79645-27-5). Thirty patients undergoing cataract extraction or trabeculectomy were randomly divided into three groups and each of the group received either 0.3 % ciprofloxacin, ofloxacin or tobramycin topical drops preoperatively. Eyedrops were instilled for six times at a frequency of one drop every 15 minutes, beginning 90 minutes before initiation of the surgery. At the time of surgery, 0.1 mi aqueous fluid was aspirated from the anterior chamber. Concentrations of the antimicrobial agents were determined using the microbroth dilution procedure outlined by the National Committee for Clinical Laboratory Standards. Escherichia coli (ATCC 25922) was used as a standard strain for determination of minimal inhibitory concentrations (MICs). The mean aqueous levels of ciprofloxacin and ofloxacin were found to be 0.092 +/- 0.077 mu g/ml, 0.964 +/- 0.693 mu g/ml, respectively. Tobramycin did not reach the concentration that could be detected by applied method. Conclusion: The mean aqueous humor levels of ofloxacin and ciprofloxacin were more than the MICs levels for most of the ocular pathogens which may cause postoperative endophthalmitis.
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    Trabeculectomy with brief exposure of mitomycin C
    (Amer Soc Contemporary Ophthalmology, 1996) Hepsen, IF; Bayramlar, H; Oram, O
    In this study, mitomycin-C (MMC) al a concentration of 0.2 mg/mL was applied intraoperatively for 1 minute in 11 consecutive primary trabeculectomies to increase the success of glaucoma-filtration surgery while minimizing the incidence of postoperative complications resulting from MMC use. The success criteria included a postoperative intraocular pressure (IOP) lower than 21 mmHg without treatment, a 20% or more drop from preoperative IOP levels, and a visual loss limited to one or fewer lines of Snellen acuity. The procedure was considered successful in 10 eyes (90.9%), with a mean follow-up period of 25.6 weeks. Blebs were ischemic and microcystic in all successful eyes at the time of the last follow up. Postoperative complications included subconjunctival hemorrhage, hyphema, conjunctival wound leak, and corneal epithelial defects. Complications related to low IOP, such as choroidal detachment and hypotonic maculopathy, were not seen in any of the eyes. Although the longer term of follow-up results of this regimen are not well known, this alternative intraoperative application of MMC at a concentration of 0.2 mg/mL for 1 minute seems to control postoperative IOP effectively in primary trabeculectomies with fewer hypotony-related complications.