dorzolamide and Corneal-Edema

To investigate the effect of dorzolamide hydrochloride on central corneal thickness in humans with cornea guttata.. Randomized, placebo-controlled, double-masked, 2-drug crossover study with 10 patients with cornea guttata and 10 healthy controls, who had mean endothelial cell counts of 988 and 2377 cells/mm(2), respectively. Study medications were 2% dorzolamide and placebo drops applied 3 times a day for 4 weeks. Central corneal thickness measurements using ACMaster (Carl Zeiss Meditec AG, Jena, Germany) and Goldmann applanation tonometry were performed at baseline, 1 day, 1 week, and 4 weeks.. The mean increases in central corneal thickness after 4 weeks in eyes with cornea guttata treated with dorzolamide and placebo were 26.3 microm (95% confidence interval, 8.8 to 43.7) and 3.3 microm (95% confidence interval, -0.5 to 7.1), respectively. No statistically significant changes were measured in the healthy control group. Dorzolamide caused a significant decrease in intraocular pressure (P < .01) while placebo did not cause significant changes (P = .50).. Application of dorzolamide for 4 weeks resulted in a statistically significant increase in central corneal thickness in patients with compromised corneal endothelium. These results indicate that patients with corneal endothelial problems receiving dorzolamide therapy should be monitored.

Topics: Aged; Aged, 80 and over; Body Weights and Measures; Carbonic Anhydrase Inhibitors; Cell Count; Cornea; Corneal Diseases; Corneal Edema; Cross-Over Studies; Double-Blind Method; Endothelium, Corneal; Female; Humans; Interferometry; Intraocular Pressure; Light; Male; Middle Aged; Sulfonamides; Thiophenes; Tonometry, Ocular

To investigate whether dorzolamide alters corneal hydration control in patients with glaucoma or ocular hypertension.. Pachymetry, tonometry, and endothelial cell density were measured by a masked observer in 19 subjects with bilateral glaucoma or ocular hypertension. They were treated with 2% dorzolamide in one eye, and with saline in the other, before wearing contact lenses under patched eyes. Corneal thickness, measured each 30 minutes up to 4.5 hours after contact lens removal, enabled estimation of percentage recovery per hour and time for 95% of corneal thickness recovery for both eyes. Seven patients repeated this test after 1 year of dorzolamide use, and their results were compared with those of the preceding year.. After induction of hypoxic corneal edema, there was no significant difference between paired corneas in swelling levels (60.0+/-11.8 and 59.8+/-12.9 microm) (P = .94), time to 95% recovery (440.6+/-255.8 and 445.4+/-186.7 minutes) (P = .93), and percentage recovery per hour (38.1%+/-10.9% and 36.1%+/-9.6%) (P = .40). Subjects followed up after 1 year of dorzolamide use did not differ significantly in values of endothelial cell density, percentage recovery per hour, or time to 95% recovery from those obtained a year before. One subject developed persistent corneal edema after his stress test in the eye treated with dorzolamide.. There is no significant difference in the recovery from induced corneal edema after either a short-term or 1-year use of dorzolamide in patients with glaucoma or ocular hypertension with a normal corneal endothelium. One patient had persistent corneal edema after the stress test was performed on the dorzolamide-treated eye.

Topics: Aged; Aged, 80 and over; Carbonic Anhydrase Inhibitors; Cell Count; Contact Lenses; Cornea; Corneal Edema; Double-Blind Method; Endothelium, Corneal; Female; Glaucoma; Humans; Intraocular Pressure; Male; Middle Aged; Ocular Hypertension; Sulfonamides; Thiophenes; Tonometry, Ocular

To assess the effects of dorzolamide hydrochloride, a topical carbonic anhydrase inhibitor, on corneal endothelial function.. The authors measured the rate of corneal deswelling and the endothelial permeability to fluorescein after 2 hours of hypoxic contact lens wear in 19 normal human subjects. The study was double-masked; one eye of each subject was randomly assigned to receive 2% dorzolamide drops, and the other eye received placebo drops every 8 hours for 24 hours before the study day and twice during the study day.. Dorzolamide-treated eyes were not significantly different from placebo-treated eyes in corneal deswelling rate, expressed as the percent recovery per hour (55.7% +/- 13.6% versus 59.6% +/- 14.5%; P > or = 0.10), open eye steady state thickness, swelling induced by hypoxia, and corneal autofluorescence. Endothelial permeability to fluorescein was increased in the dorzolamide eyes (4.40 +/- 0.84 x 10(-4) cm/minute versus 4.10 +/- 0.80 x 10(-4) cm/minute; P = 0.01). As expected, the intraocular pressure and aqueous humor flow rate were decreased in the dorzolamide eyes.. Dorzolamide hydrochloride, when topically administered to normal human eyes for 24 hours, had no significant effect on the corneal deswelling rate after hypoxic stress. The corneal endothelial permeability to fluorescein, however, was increased by the drug, although this did not result in increased corneal thickness.

Topics: Adult; Aqueous Humor; Carbonic Anhydrase Inhibitors; Corneal Edema; Double-Blind Method; Endothelium, Corneal; Fluorescein; Fluorophotometry; Humans; Hypoxia; Intraocular Pressure; Microscopy; Middle Aged; Ophthalmic Solutions; Permeability; Sulfonamides; Thiophenes

The purpose of this study was to report a case of acute corneal endothelial decompensation caused by a topical dorzolamide/timolol fixed combination (DTFC) after Descemet stripping automated endothelial keratoplasty.. A 75-year-old woman who was referred to our hospital with a chief complaint of visual disturbance in the right eye after cataract surgery. Anterior segment optical coherence tomography identified an extensive defect in Descemet membrane. The patient subsequently underwent uneventful Descemet stripping automated endothelial keratoplasty surgery for persistent corneal edema. Two weeks after surgery, she had been prescribed topical DTFC twice daily to control elevated intraocular pressure. On the day she started using the eye drops, the patient noticed an acute deterioration of visual acuity. Severe corneal edema was detected at follow-up 5 days later.. The topical DTFC was stopped immediately. Thereafter, the corneal edema improved gradually, and there was a reduction in corneal thickness.. Topical DTFC should be used with caution after corneal endothelial transplantation because of the possibility of iatrogenic corneal endothelial dysfunction.

Topics: Aged; Corneal Diseases; Corneal Edema; Descemet Stripping Endothelial Keratoplasty; Endothelium, Corneal; Female; Humans; Sulfonamides; Thiophenes; Timolol

Topics: Acetazolamide; Acute Disease; Anesthesia, General; Atropine; Combined Modality Therapy; Corneal Edema; Dexamethasone; Drug Therapy, Combination; Female; Glaucoma, Angle-Closure; Humans; Laser Therapy; Mannitol; Middle Aged; Mydriasis; Pilocarpine; Postoperative Complications; Sulfonamides; Thiophenes; Timolol; Vomiting

To describe irreversible corneal decompensation after topical dorzolamide hydrochloride (Trusopt; Merck and Co, Inc, West Point, Pennsylvania) therapy in nine patients who had histories consistent with corneal endothelial compromise.. Multicenter review of patients' charts.. Nine eyes of nine patients developed overt corneal decompensation after starting topical dorzolamide, a condition that did not resolve with drug cessation. This occurred after 3 to 20 weeks (mean, 7.8) of therapy. All nine patients had undergone intraocular surgery. Eight patients had undergone cataract surgery; three were aphakic and three had posterior chamber intraocular lenses. Two patients had anterior chamber intraocular lenses and also had undergone trabeculectomies. Four patients had undergone penetrating keratoplasties, each case complicated by episodes of corneal allograft rejection that were successfully treated. Two patients had asymptomatic Fuchs endothelial dystrophy. Seven patients have since undergone successful penetrating keratoplasties.. The reports suggest that dorzolamide can cause irreversible corneal edema in a subset of glaucoma patients with endothelial compromise. The findings suggest a rationale for research into the long-term effects of dorzolamide on the corneal endothelium.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Carbonic Anhydrase Inhibitors; Corneal Edema; Endothelium, Corneal; Female; Glaucoma; Humans; Intraocular Pressure; Keratoplasty, Penetrating; Male; Middle Aged; Ophthalmic Solutions; Refractive Errors; Retrospective Studies; Sulfonamides; Thiophenes; Visual Acuity

Topics: Administration, Topical; Carbonic Anhydrase Inhibitors; Corneal Edema; Glaucoma; Humans; Sulfonamides; Thiophenes

To report a case of glaucomatocyclitic crisis (Posner-Schlossman syndrome) in a child.. Case report. A 13-year-old boy presented with decreased vision, photophobia, halos, and pain in the right eye.. Findings in this child were consistent with a diagnosis of Posner-Schlossman syndrome.. Glaucomatocyclitic crisis can occur in a child and must be included in the differential diagnosis of uveitis and glaucoma in pediatric patients.

Topics: Adolescent; Clonidine; Corneal Edema; Diagnosis, Differential; Drug Therapy, Combination; Glaucoma; Humans; Intraocular Pressure; Male; Pain; Prednisolone; Sulfonamides; Syndrome; Thiophenes; Timolol; Uveitis, Intermediate; Vision Disorders; Visual Acuity

To develop a technique to estimate the corneal endothelial pump rate in human subjects.. Corneal hydration control is thought to be maintained by a pump-leak mechanism whereby the leak of solutes and fluid across the endothelial barrier into the stroma is, in the steady state, exactly balanced by the pumping of solutes and passive fluid transfer across the endothelium to the aqueous humor. Overall corneal hydration control can be measured from the rate at which the swollen cornea thins (deswells), and a measure of the leak can be obtained simultaneously from the endothelial permeability to fluorescein. From the pump-leak hypothesis, the deswelling rate is directly proportional to the pump rate and inversely proportional to the leak rate. The relative endothelial pump rate can be estimated as the product of the normalized deswelling rate and the normalized endothelial permeability. This procedure was used to obtain the relative endothelial pump rate in 41 patients with diabetes mellitus, 12 patients with long-term corneal transplants, 20 long-term wearers of contact lenses, and 19 normal volunteer subjects after the short-term administration of topical dorzolamide.. The relative endothelial pump rate did not differ significantly from that of control subjects in diabetics, in contact lens wearers, and after dorzolamide administration, but was markedly decreased in the patients with corneal transplants, despite a reduction in permeability (reduced leak).. This method allows the estimation of both the barrier and pump arms of corneal endothelial function and should be useful in the investigation of causes and mechanisms of functional endothelial insufficiency.

Topics: Administration, Topical; Adolescent; Adult; Body Water; Contact Lenses; Corneal Edema; Corneal Transplantation; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Endothelium, Corneal; Humans; Permeability; Reference Values; Sulfonamides; Thiophenes

Seven patients with open angle glaucoma were treated using Dorsolamida twice daily together Betablocant treat. Five patients with secondary glaucoma were treated with Dorsolamida three time daily as well three patients with edematous postimplant keratopathy. Intraocular pressure decreased with an average of 3-4 mm Hg and at the patients with corneal edema that decreased.

Topics: Administration, Topical; Adrenergic beta-Antagonists; Carbonic Anhydrase Inhibitors; Chronic Disease; Combined Modality Therapy; Corneal Edema; Drug Evaluation; Drug Therapy, Combination; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Sulfonamides; Thiophenes; Time Factors