Oxybuprocaine 0.4% eye drops 0.5ml unit dose preservative free

BACKGROUND: The operation sequence of bidirectional endoscopy with topical anesthesia varies among endoscopists, which interferes with clinical procedure. The study aimed to investigate the influence of different operation sequences on the outcomes of quality indicators and improve bidirectional endoscopy performance. METHODS: A randomized trial was conducted at the affiliated hospital of a medical university in China. Outpatients who initially underwent bidirectional endoscopy with topical anesthesia were enrolled. Eligible patients were randomized to either the colonoscopy-first group or the esophagogastroduodenoscopy-first group. Dyclonine hydrochloride mucilage and oxybuprocaine hydrochloride gel were administered for topical anesthesia. After finishing the previous process, the subsequent one was performed immediately. Quality indicators of esophagogastroduodenoscopy and colonoscopy were compared between the groups. RESULTS: Analyzing 395 combined procedures, the cecal intubation rate, discomfort score during esophagogastroduodenoscopy, examination score of esophagogastroduodenoscopy, and colorectal polyp detection rate were similar between the two groups. The colonoscopy-first group had lower colonic spasm incidence (66.0% vs. 30.3%, p < 0.001), shorter median cecal intubation time (254 s vs. 211 s, p < 0.001), and higher colonoscopy comfort rate (72.5% vs. 85.6%, p < 0.001) compared with the esophagogastroduodenoscopy-first group. Operation sequence significantly affected the incidence of colonic spasm (OR 4.739, 95%CI 3.054-7.352, p = 0.000), which correlated with cecal intubation time (r = 0.196, p < 0.001) and patient discomfort score (r = 0.136, p = 0.007). CONCLUSION: In bidirectional endoscopy with topical anesthesia, performing colonoscopy first may improve colonoscopy performance without affecting esophagogastroduodenoscopy examination. The study was registered prior to conducting the research in the Chinese Clinical Trial Registry ( https://www.chictr.org.cn ) on November 7, 2023 with the trial identification number ChiCTR2300077408.

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PURPOSE: To compare changes in human corneal thickness after the instillation of proparacaine with those after oxybuprocaine instillation with time over a period of 10 minutes. METHODS: Eighteen healthy young participants were recruited. Proparacaine was used in the right eye and oxybuprocaine in the left. Right and left baseline corneal thicknesses were measured every 30 seconds for 10 minutes using a noncontact specular microscope by 1 observer. Baseline corneal thickness was defined as the average of all values taken over 10 minutes. Changes in corneal thickness were measured every 20 seconds for 10 minutes after the administration of 1 drop of 0.5% proparacaine onto the right cornea and 1 drop of 0.4% oxybuprocaine onto the left cornea. RESULTS: Mean baseline right cornea thickness was 531 +/- 45 microm, and that of the left cornea was 531 +/- 42 microm. The corneal thickness after proparacaine increased by 8.6 microm ( approximately 4.5-12.6 microm, 95% CI) and then returned to baseline within 80 seconds. Corneal thickness after applying oxybuprocaine increased by 7.7 microm (3.6-11.2 microm, 95% CI) and then returned to baseline within 80 seconds. There was a second transient increase about 5 minutes later after proparacaine instillation but no additional transient increase after oxybuprocaine instillation. CONCLUSION: Oxybuprocaine is similar to proparacaine in terms of the severity of its effect on corneal thickness. Corneal thickness instability may occur for 5 minutes after proparacaine administration. Changes in corneal thickness after topical anesthetic instillation should be considered when performing measurements for refractive surgery or central corneal thickness in glaucoma patients.

Abstract licence: CC BY-NC-ND

Local anesthetics are commonly used in ophthalmic surgery. However, their use can affect the healing process. This study aimed to investigate the potential impact of anesthetic substances at clinically relevant concentrations and incubation times (3 min), specifically oxybuprocaine (OBPC, 0.4%), lidocaine (LIDO, 2%), and bupivacaine (BUPI, 0.5%), either alone or supplemented with hylase (HYLA, 30 I.E.), on corneal epithelium structure, cell viability, and wound healing. To assess the potential cytotoxicity of these anesthetic substances, viability and colony-forming efficiency (CFE) assays were conducted using the human telomerase-immortalized corneal epithelial (hTCEpi) cell line. Additionally, the toxicity of these substances was evaluated using a 3D human tissue-specific corneal epithelial construct as well as a porcine corneal culture model. The results indicate that OBPC (Novesine® 0.4%) exhibited significant cytotoxicity in 2D and 3D corneal epithelial cell culture models and delayed wound healing in the ex vivo porcine corneal organ culture model. In contrast, LIDO, BUPI, and HYLA were less cytotoxic to corneal cells, with no observed impact on wound healing in the porcine corneal organ culture model. In summary, local anesthetics commonly used in eye surgery are generally considered safe. However, the application of OBPC (Novesine® 0.4%) may delay wound healing.

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Objectives: We aimed to probe the safety and effectiveness of flexible ureteroscopic lithotripsy (FURL) with a suctioning ureteral access sheath (S-UAS) for removing upper urinary calculi under local anesthesia (LA). Materials and methods: The clinical data of 56 patients with upper urinary calculi treated by FURL with an S-UAS under LA during the period between September 2019 and November 2022 were analyzed retrospectively. For LA, intramuscular pethidine (1.0-2.0 mg/kg) and phenergan (25 mg) were administered 30 min prior to surgery, and oxybuprocaine hydrochloride gel was administered through the urethra at the start of the surgery. The S-UAS and flexible ureteroscope were used for FURL. Demographic characteristics, stone-related parameters, and clinical outcomes were analyzed. Result: A total of 66 procedures were performed successfully on 46 patients (Group A), who underwent unilateral surgeries, and on 10 patients (Group B) who underwent same-session bilateral surgeries. All 56 patients were operated upon without altering the anesthesia strategy, and none required additional analgesia. The mean stone sizes of the Group A and Group B patients were 20.24 ± 5.45 mm and 29.40 ± 3.89 mm, respectively. The mean operative times of the two groups were 53.04 ± 13.35 min and 90.00 ± 15.81 min, respectively. In Group A, the stone-free rates (SFRs) were 76.1% (35/46) and 85.1% (40/46) at postoperative day 1 and day 30, respectively. In Group B, the SFRs were 80.0% (16/20) and 85.0% (17/20), respectively. Four (8.7%) patients in Group A suffered complications such as fever, stent pain, urosepsis, and steinstrasse. In Group B, one (10%) patient suffered from fever. Conclusion: FURL, combined with an S-UAS under LA, is a feasible option and provides satisfactory clinical outcomes for appropriately selected patients.

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Objective: To evaluate the efficacy of preservative-free 0.4% oxybuprocaine hydrochloride eye drops in pain management during small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK), and to investigate its anesthetic effect and safety profile. Methods: A total of 1 560 patients (3 120 eyes) who underwent corneal refractive surgery in the Refractive Surgery Department from December 2023 to March 2024 were selected,including 780 cases (1 560 eyes) of SMILE and 780 cases (1 560 eyes) of FS-LASIK.All patients were given preservative-free 0.4% oxybuprocaine hydrochloride eye drops 1 minute before surgery. Pain was assessed using the Numerical Rating Scale (NRS) during surgery and at 5 minutes postoperatively. Intraoperative corneal complications and patient cooperation were also recorded. Results: Preservative-free 0.4% oxybuprocaine hydrochloride eye drops effectively alleviated intraoperative and postoperative pain. The median NRS scores during and after surgery were 0 (0, 0) in both the SMILE and FS-LASIK groups. The incidence of intraoperative corneal complications was low, with corneal epithelial injury rates of 0.2% in the SMILE group and 0.3% in the FS-LASIK group. Patient cooperation during surgery was excellent, with rates of 98% in the SMILE group and 96% in the FS-LASIK group. No adverse reactions related to the study drug were observed. Conclusions: Preservative-free 0.4% oxybuprocaine hydrochloride eye drops demonstrate a good anesthetic effect and high safety profile in laser corneal refractive surgery, providing patients with a better treatment experience and representing an effective option for perioperative management.

Abstract licence: CC BY-SA

A clinical case of viral conjunctivitis COVID-19, which was complicated by partial symblepharon and severe dry eye syndrome, is presented. The latter was treated for several days with eye drops containing solutions of glucocorticosteroid, a cytostatic and an antiseptic combined with tear replacement therapy, which however led to an extensive detachment of the corneal epithelium of the right eye, a superficial ulcer and an area of keratomalacia in the lower part of the cornea. In view of this, a further hospital treatment was required: the patient received anti-inflammatory and keratoprotective drugs. A subsequent medical consultation found out that the patient had periodically instilled oxybuprocaine hydrochloride 0.4% into the right eye for pain relief for a long time (4 months) without informing the attending physician. As a result of hospital treatment, the condition of the patient’s right eye improved: the corneal ulcer, was epithelialized, followed by the formation of a vascularized corneal leukoma. In our opinion, a deterioration of the tear film stability of the patient, who had had COVID-19 accompanied by ocular manifestations in the form of initially developed conjunctivitis, was due to the anesthetic effect of long-term instillations of oxybuprocaine hydrochloride. This led to a significant decrease in tear secretion, a decrease in the density of goblet cells of the conjunctiva and a violation of the sensory innervation of the cornea, which gradually brought about a severe dry eye syndrome. The above case clearly demonstrates the importance of increasing the patients’ awareness of the harm that could be caused by long-term use of local anesthetics without a doctor’s approval.

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Neurocognitive impairment refers to a spectrum of disorders characterized by a decline in cognitive functions such as memory, attention, and problem-solving, which are often linked to structural or functional abnormalities in the brain. While its exact etiology remains elusive, genetic factors play a pivotal role in disease onset and progression. This study aimed to identify highly correlated gene clusters (modules) and key hub genes shared across neurocognition-impairing diseases, including Alzheimer's disease (AD), Parkinson's disease with dementia (PDD), HIV-associated neurocognitive disorders (HAND), and glioma. Herein, the microarray datasets AD (GSE5281), HAND (GSE35864), glioma (GSE15824), and PD (GSE7621) were used to perform Weighted Gene Co-expression Network Analysis (WGCNA) to identify highly preserved modules across the studied brain diseases. Through gene set enrichment analysis, the shared modules were found to point towards processes including neuronal transcriptional dysregulation, neuroinflammation, protein aggregation, and mitochondrial dysfunction, hallmarks of many neurocognitive disorders. These modules were used in constructing protein-protein interaction networks to identify hub genes shared across the diseases of interest. These hub genes were found to play pivotal roles in processes including protein homeostasis, cell cycle regulation, energy metabolism, and signaling, all associated with brain and CNS diseases, and were explored for their drug repurposing experiments. Drug repurposing based on gene signatures highlighted drugs including Dorzolamide and Oxybuprocaine, which were found to modulate the expression of the hub genes in play and may have therapeutic implications in neurocognitive disorders. While both drugs have traditionally been used for other medical purposes, our study underscores the potential of a combined WGCNA and drug repurposing strategy for searching for new avenues in the simultaneous treatment of different diseases that have similarities in gene co-expression networks.

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