RESUMEN
We report a case of bacterial keratitis 3 days after corneal crosslinking for keratoconus. The patient complained of increasing pain and redness combined with blurred vision in the treated eye starting on the first postoperative day. Clinical examination showed multiple stromal infiltrations and moderate anterior chamber inflammation. Corneal scraping revealed an Escherichia coli infection, which was successfully treated with fortified tobramycin and cephazolin eyedrops for several weeks. This is the first report of a case of rare postoperative complication resulted in an avascularized corneal scar and permanent reduction of the visual acuity.
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Sustancia Propia/metabolismo , Úlcera de la Córnea/microbiología , Infecciones por Escherichia coli/microbiología , Infecciones Bacterianas del Ojo/microbiología , Queratocono/tratamiento farmacológico , Complicaciones Posoperatorias , Riboflavina/uso terapéutico , Adulto , Antibacterianos/uso terapéutico , Cefazolina/uso terapéutico , Colágeno/metabolismo , Úlcera de la Córnea/diagnóstico , Úlcera de la Córnea/tratamiento farmacológico , Quimioterapia Combinada , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/diagnóstico , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Humanos , Queratocono/metabolismo , Masculino , Fotoquimioterapia , Fármacos Fotosensibilizantes/uso terapéutico , Tobramicina/uso terapéutico , Rayos Ultravioleta , Agudeza VisualRESUMEN
PURPOSE: To evaluate the efficacy of the laser photolysis system (LPS) (A.R.C. Laser GmbH) in removing lens epithelial cells (LECs) to prevent posterior capsule opacification (PCO) in an in situ model. SETTING: Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany. METHODS: Twelve enucleated porcine eyes fixed in a specially developed eye holder were randomly assigned to the control or treatment group. The cornea and iris were removed from all eyes, and a small paracentral capsulorhexis was performed. The lens nucleus and cortex were extracted by hydroexpression. The tip of the LPS was inserted into the capsular bag of eyes in the treatment group, and 50 pulses (10 mJ) were applied to the anterior capsule. All capsules were evaluated for remaining LECs by confocal laser scanning microscopy (HRT II with the Rostock Cornea Module, Heidelberg Engineering) and standard histology (hematoxylin-eosin and periodic acid-Schiff stains). RESULTS: In the control group, a homogenous layer of LECs attached to the anterior capsule was seen with both evaluation methods. In the treatment group, no LECs adherent to the anterior capsule were detected, suggesting complete ablation of LECs from the capsule. Small islands of equatorial LECs were found in places in which the remaining cortical fibers protected cells from the laser shockwave. The results of the confocal laser scanning microscopy were confirmed by standard histology. CONCLUSIONS: The LPS completely ablated LECs in an in situ model of cataract extraction. This system might prevent formation of PCO in vivo.
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Terapia por Láser/métodos , Cápsula del Cristalino/cirugía , Fotólisis , Animales , Catarata/prevención & control , Eosina Amarillenta-(YS) , Células Epiteliales/patología , Hematoxilina , Cápsula del Cristalino/patología , Microscopía Confocal , Reacción del Ácido Peryódico de Schiff , Facoemulsificación , Complicaciones Posoperatorias/prevención & control , Coloración y Etiquetado/métodos , PorcinosRESUMEN
INTRODUCTION: Although the chemical mechanism of the triphenyltetrazolium (TTC) reaction, for macroscopic detection of myocardial infarction, has been described previously, literature reports on correct tissue preparation and the use of this technique in intact large animals are lacking. METHODS: We investigated the special requirements for TTC staining in blood-perfused porcine hearts, validated the various handling steps and provided detailed information for precise and easy use of this histochemical method. The left anterior descending coronary artery was occluded for 45 min followed by 6 h of reperfusion in an open chest preparation using anesthetised domestic pigs. The hearts were excised and the organ-handling steps and TTC-staining procedure validated. RESULTS: The protocol includes (i) intracoronary saline perfusion, (ii) pressure-controlled determination of the non-ischemic region by Evans blue dye, (iii) a freeze-thaw cycle, (iv) a triphenyltetrazolium incubation period, and (v) a bleach cycle with 4% paraformaldehyde. The TTC-staining results were confirmed by histology of transitional regions of the infarct area, area-at-risk and non-risk-region. DISCUSSION: If some special features associated with blood-perfused porcine hearts are considered carefully, reliable results for subsequent infarct size calculations can be obtained and large potential errors excluded.
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Infarto del Miocardio/patología , Sales de Tetrazolio , Animales , Apoptosis , Colorantes , Azul de Evans , Histocitoquímica , Técnicas In Vitro , Infarto del Miocardio/metabolismo , Reperfusión Miocárdica , Miocardio/química , Miocardio/patología , Coloración y Etiquetado/métodos , PorcinosRESUMEN
Calpains, a family of Ca2+-dependent cysteine proteases, are activated during myocardial ischemia and reperfusion. This study investigates the cardioprotective effects of calpain inhibition on infarct size and global hemodynamics in an ischemia/reperfusion model in pigs, using the calpain inhibitor A-705253. The left anterior descending coronary artery was occluded for 45 min and reperfused for 6 h. A bolus of 1.0 mg/kg A-705253 or distilled water was given intravenously 15 min prior to induction of ischemia and a constant plasma level of A-705253 was maintained by continuous infusion of 1.0 mg/kg A-705253 during reperfusion. Infarct size was assessed histochemically using triphenyltetrazolium chloride staining. Macromorphometric findings were verified by light microscopy on hematoxylin-eosin- and Tunel-stained serial sections. Global hemodynamics, including the first derivate of the left ventricular pressure (dP / dtmax), were measured continuously throughout the experiment. A-705253 reduced the infarct size by 35% compared to controls (P < 0.05). Hemodynamic alterations, including heart rate, aortic blood pressure, central venous pressure and left atrial pressure, were attenuated mainly during ischemia and the first 2 h during reperfusion by A-705253. Cardiac function improved, as determined by dP / dtmax, after 6 h of reperfusion (P < 0.003). Our results demonstrate that myocardial protection can be achieved by calpain inhibition, which decreases infarct size and improves left ventricular contractility and global hemodynamic function. Hence, the calpain-calpastatin system might play an important pathophysiological role in porcine myocardial ischemia and reperfusion damage and A-705253 could be a promising cardioprotective agent.