Emilia Mulet’s research while affiliated with Miguel Hernández University of Elche and other places

To evaluate the clinical efficacy and the clinical and histopathologic tolerance of a new acrylic tissue adhesive (ADAL-2) versus 8/0 polyglactin sutures (Vicryl) for its use in conjunctival surgery. Experimental study performed on New Zealand albino rabbits. The animals were divided into two groups. Surgery consisted of a conjunctival peritomy of 8 mm in the superior limbus followed by extensive subconjunctival dissection and creation of a flap by two radial cuts. The conjunctiva was then attached to the limbus again by the proposed acrylic tissue adhesive (ADAL-2) or 8/0 polyglactin suture depending on the group. Clinical efficacy of the closure of the conjunctival wound, either with adhesives or sutures, and the clinical and histopathologic tolerance were also evaluated 1, 7, 28 and 42 days after surgery. Both conjunctival surgical closure methods were found to be equal in efficacy concerning their ability to fix the conjunctiva to the limbus. There were no significant clinical and histopathologic tolerance differences between the new tissue adhesive investigated (ADAL-2) and 8/0 polyglactin sutures (Vicryl). Histopathology showed no presence of the adhesive 28 days postoperatively. ADAL-2 tissue adhesive is an efficient conjunctival closure method, very well tolerated by the ocular surface. Its sealing efficiency and its tolerance are similar to 8/0 polyglactin sutures. This new acrylic adhesive has a potential as an alternative for surgical conjunctival sealing in ophthalmic surgery.

The goal of this study was to determine whether sequence analysis of internal transcribed spacer/5.8S ribosomal DNA (rDNA) can be used to detect fungal pathogens in patients with ocular infections (endophthalmitis and keratitis). Internal transcribed spacer 1 (ITS1) and ITS2 and 5.8S rDNA were amplified by PCR and seminested PCR to detect fungal DNA. Fifty strains of 12 fungal species (yeasts and molds) were used to test the selected primers and conditions of the PCR. PCR and seminested PCR of this region were carried out to evaluate the sensitivity and specificity of the method. It proved possible to amplify the ITS2/5.8S region of all the fungal strains by this PCR method. All negative controls (human and bacterial DNA) were PCR negative. The sensitivity of the seminested PCR amplification reaction by DNA dilutions was 1 organism per PCR, and the sensitivity by cell dilutions was fewer than 10 organisms per PCR. Intraocular sampling or corneal scraping was undertaken for all patients with suspected infectious endophthalmitis or keratitis (nonherpetic), respectively, between November 1999 and February 2001. PCRs were subsequently performed with 11 ocular samples. The amplified DNA was sequenced, and aligned against sequences in GenBank at the National Institutes of Health. The results were PCR positive for fungal primers for three corneal scrapings, one aqueous sample, and one vitreous sample; one of them was negative by culture. Molecular fungal identification was successful in all cases. Bacterial detection by PCR was positive for three aqueous samples and one vitreous sample; one of these was negative by culture. Amplification of ITS2/5.8S rDNA and molecular typing shows potential as a rapid technique for identifying fungi in ocular samples.

To study the efficacy of a synthetic (cyanoacrylate) and a biological (fibrinogen) bioadhesive in sealing scleral tunnel incisions in cataract surgery. Private institution with academic orientation. This controlled clinical study comprised 126 eyes with high myopia (axial length > 28.0 mm) divided into three groups based on method of incision closure 10-1 nylon anchor suture; cyanoacrylate (Histoacryl); fibrinogen (Tissucol). Phacoemulsification was done through a double-valved scleral tunnel incision with an 8.0 mm arc. In all eyes, a hyperconcave, 7.0 mm optic, posterior chamber intraocular lens was implanted. Mean induced astigmatism at 12 weeks was 0.18 diopter (D) in the suture group, 0.50 D in the cyanoacrylate group, and 0.43 D in the fibrinogen group. The difference between the bioadhesive groups and the suture group was not significant. A mild inflammatory reaction occurred in the cyanoacrylate group. In the fibrinogen group, 3 eyes developed postoperative hypotony requiring reclosing of the incision with sutures and 5 eyes developed intraoperative hypotony requiring suture closure. These eyes were not included in the refractive analysis. These complications led to the suspension of the fibrinogen portion of the study after uneventful use of the bioadhesive in 26 eyes. The results of this study indicate that bioadhesives, especially synthetic ones such as cyanoacrylate, are an effective alternative to sutures in scleral tunnel cataract surgery. Future improvements in bioadhesives could extend their application to other ocular incision types.

The authors studied the effect of topical 2% 6-aminonicotinamide and 0.1% adenosine on an experimental model of acute corneal inflammation. Luminol-enhanced chemiluminescence (LAC), as an indirect measurement of free-radical release, and computer-assisted planimetry of the corneal ulcer and its infiltrate were performed both ex vivo and in vivo on the fifth day following the induction of experimental alkali burn keratitis. The authors proved that both drugs significantly inhibited LAC both ex vivo and in vivo and that such treatments had also a significant beneficial effect on the evolution of the corneal ulcer and its infiltrate. To the best of the authors' knowledge, this finding had not been previously reported in experimental corneal inflammation and may indicate that treatment with inhibitors of the oxidative metabolism could offer a new approach in the pharmacological modulation of acute corneal inflammation.