cortodoxone and Postoperative-Complications

To develop a new technique to visualize vitreous body prolapsed in the anterior chamber using 11-deoxycortisol.. Experimental study.. An animal model of posterior capsule rupture was developed to investigate the usefulness of 11-deoxycortisol, a precursor of cortisol without steroid activity. After the intentional creation of posterior capsule rupture, the suspension of 11-deoxycortisol was injected into the anterior chamber of rabbit eyes. After gentle irrigation and aspiration, the vitreous body that had prolapsed into the anterior chamber was removed using an anterior vitrectomy cutter. To investigate the safety of 11-deoxycortisol, the biomicroscopic appearance, intraocular pressure (IOP), corneal endothelial count, and microstructure of the corneal endothelium were examined in the rabbits that received injections of 11-deoxycortisol in the anterior chamber.. In our posterior capsule rupture model, the vitreous in the anterior chamber became clearly visible, with 11-deoxycortisol showing white particles entrapped on its surface. The injection of 11-deoxycortisol facilitated the complete removal of the vitreous body from the anterior chamber. In intact rabbit eyes, most of the injected 11-deoxycortisol had disappeared from the anterior chamber by 12 hours after injection. The injection of 11-deoxycortisol had no effect on IOP, corneal endothelial density, or the microstructure of the corneal endothelium.. The injection of 11-deoxycortisol in the anterior chamber is useful in visualizing the vitreous body and has no significant side effects. This technique might reduce the intraoperative and postoperative complications of anterior vitrectomy after posterior capsule rupture.

Topics: Animals; Anterior Chamber; Cell Count; Cortodoxone; Disease Models, Animal; Endothelium, Corneal; Eye Diseases; Intraocular Pressure; Intraoperative Complications; Lens Capsule, Crystalline; Postoperative Complications; Prolapse; Rabbits; Rupture; Safety; Vitreous Body

Ten patients were given dexamethasone therapy for prevention of postoperative complications after oral surgical procedures. The hypothalamic-pituitary-adrenal response of the patients was measured by their response to a single-dose metyrapone test. A significant difference was found between preoperative values of 11-deoxycortisol and values three days postoperatively. No difference was found when comparing preoperative values of 11-deoxycortisol with values seven days postoperatively. There appears to be an initial suppression of the normal feedback mechanism of the hypothalamic-pituitary-adrenal axis followed by a complete return of normal functioning by the seventh postoperative day. The amount of surgical stress involved in these routine oral surgical procedures is of an insufficient magnitude to overcome this hypothalamic-pituitary-adrenal suppression of the negative feedback mechanism caused by dexamethasone therapy. The presence of adequate amounts of synthetic steroids at a cellular level appears to prevent manifestations of adrenal insufficiency despite suppression of endogenous production of steroids.

Topics: Adult; Cortodoxone; Dexamethasone; Female; Humans; Hypothalamo-Hypophyseal System; Male; Metyrapone; Mouth; Pituitary-Adrenal System; Postoperative Complications