Comparing the effects and safety of dorzolamide hydrochloride + timolol maleate versus brimonidine after neodymium-doped yttrium aluminium garnet laser capsulotomy posterior capsule opacification

Aim Posterior capsular opacification is treated using neodymium-doped yttrium aluminium garnet laser capsulotomy that leads to increased intraocular pressure. Here, we compare the effects of dorzolamide hydrochloride + timolol maleate versus brimonidine on intraocular pressure. We also investigate their side effects after neodymium-doped yttrium aluminium garnet laser capsulotomy. In these patients, there are no prior studies comparing the results of these two drugs. Materials Ninety patients with posterior capsule opacification contributed to the study. They received yttrium aluminium garnet laser capsulotomy. After yttrium aluminium garnet laser capsulotomy, they were randomized into three groups. Group 1 received dorzolamide hydrochloride + timolol maleate; Group 2 took brimonidine; and Group 3, the control group, took no drug. Group 1 took dorzolamide hydrochloride + timolol maleate eye drops 1 h before the procedure and on the third hour of the first day and two times per day between the second and the seventh days. Group 2 took brimonidine eye drops 1 h before the procedure and on the third hour of the first day, two times per day between the second and the seventh days. Results Brimonidine had a similar side effect profile to the fix combination. Intraocular pressure on the first ( p = 0.87) and third days ( p = 0.124) were similar in Group 1 (dorzolamide hydrochloride + timolol maleate), Group 2 (brimonidine) and the control group. The mean intraocular pressure value of the control group was significantly higher than Groups 1 and 2 because the anti-glaucomatous effects of the drugs become prominent on the seventh day ( p = 0.041). In Group 1 and Group 2, intraocular pressure was significantly lower than the control group on the seventh day ( p = 0.041). Stinging, itching, hyperemia and Tyndall rates were similar in Group 1, Group 2 and the control group. Watery eyes were less common in the brimonidine group than in the dorzolamide hydrochloride–timolol maleate and the control groups on the seventh day ( p = 0.02). Brimonidine also significantly lowered the chemosis rate on the third ( p = 0.04) and seventh ( p = 0.03) days. Conclusion We suggest that brimonidine and a combination of dorzolamide + timolol are similarly effective at reducing eye pressure for routine cases. In cases where intraocular pressure attacks might be at higher risk, using the dorzolamide + timolol combination would be more appropriate.

Post-Space Treatment Influences the Bond Strength In Endodontically Treated Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies

SUMMARY Objectives: This systematic review of in vitro studies investigated the influence of the post-space treatment used to remove the smear layer on the bond strength of the post to root canal dentin. Methods and Materials: In vitro studies included in this study were identified from PubMed/MEDLINE, Lilacs, and Scopus databases up until March 2019, without limits on publication year or language. Two reviewers independently selected the studies based on the inclusion and exclusion criteria, extracted the data, and evaluated the risk of bias of all studies. A random effects model was used for pairwise meta-analyses (control vs. post-space preparation groups) at a significance level of p<0.05. Results: Of the 2,832 potentially eligible studies, 453 studies were selected for full-text analysis, and 75 were included in this systematic review. Only one study was considered to have a low risk of bias. Overall, post-space treatment significantly improves the bond strength to root canal dentin (p<0.00001). Conclusion: Post-space treatment has a positive influence on the bond strength of the post to root canal dentin. In this review, the post-space treatments that improve the adhesive resistance of the post were ethanol, sodium hypochlorite, and ethylene diamine tetra-acetic acid (NaOCl + EDTA), NaOCl + EDTA + ultrasound, erbium-doped yttrium aluminium garnet laser (Er:YAG laser), neodymium-doped yttrium aluminium garnet laser (Nd:YAG laser), and diode laser.

Study of Intraocular Pressure following Neodynium Yttrium Aluminium Garnet Laser Capsulotomy with the Use of Brimonidine: A Descriptive Cross-sectional Study

Introduction: Posterior capsular opacification is a common complication after cataract surgery. Neodynium Yttrium Aluminium Garnet laser capsulotomy is still the preferred treatment for posterior capsular opacification. This study was done to determine the use of Brimonidine eye drop in preventing the rise of intraocular pressure post-Neodynium Yttrium Aluminium Garnet laser capsulotomy. Methods: A descriptive cross-sectional study was conducted in Lumbini eye institute and research center, Bhairahawa, Nepal, in 200 eyes with posterior capsular opacification using Brimonidine from Feb 1, 2019, to July 30, 2019. The Institutional Review Committee approved the study with approval number 0237. A convenient sampling method was used. Pre-capsulotomy best-corrected visual acuity, slit-lamp examination of the anterior segment, and dilated fundus examination were done. Intraocular pressure was measured with Goldmann Applanation Tonometer. Post capsulotomy patients were evaluated after one hour, two hours, and two weeks for intraocular pressure and any complications. The statistical analysis was done using Statistical Package of Social Sciences version 20.0 statistical analysis software. The descriptive statistical analysis of the study was done after the collection of the data. Results: Mean age of patients at presentation was 61.61±SD 1.09. The mean intraocular pressure following Neodynium Yttrium aluminum garnet laser capsulotomy using brimonidine at 1 hour was 12.73±3.3 mmHg.and two hours was 11.98±3.2 mmHg. The mean energy per pulse was 2.3±SD 0.3 mJ. The mean duration of posterior capsular opacification from cataract surgery was 22.28 weeks. Conclusions: Neodynium Yttrium Aluminium Garnet laser capsulotomy had lower intraocular pressure after the Brimonidine eye drop procedure. The maximum mean reduction in intraocular pressure was observed after two hours.

A study on efficacy of high fluence Q-switched neodymium doped yttrium aluminium garnet laser in macular amyloidosis

<p class="abstract"><strong>Background: </strong>Macular amyloidosis (MA) typically presents as small, dusky-brown or greyish pigmented macules, treatment of which remains challenging with topical and systemic therapies, however Q-switched neodymium-doped yttrium aluminium garnet (Nd:YAG) laser has proven to be an effective treatment modality to reduce hyperpigmentation. The aim of the study is to study the efficacy of Nd:YAG laser in the management of MA.</p><p class="abstract"><strong>Methods: </strong>30 female patients were treated with Q-switched Nd:YAG laser at 1064 nm with a spot size of 3 mm at a fluence of 6-7 J/cm², frequency of 2 Hz, for 350-500 pulses. Total number of pulses decreased with each treatment session as the intensity of the hyperpigmentation decreased. The procedure was repeated at one-month intervals for a total of 6 treatment sessions.</p><p class="abstract"><strong>Results: </strong>After completion of treatment sessions with Nd-YAG laser 36.66% patients showed &gt;50% improvement in the pigmentation. 66.6% patients were satisfied with the laser treatment. 33.3% patients showed &lt;25% improvement and unsatisfied with the treatment.</p><p class="abstract"><strong>Conclusion: </strong>MA remains an enigma and a source of concern for the suffering patients and physicians. Q-switched Nd-YAG laser 1064 nm has shown positive response in the reduction of pigmentation in MA.</p>