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Year : 1967  |  Volume : 15  |  Issue : 4  |  Page : 153-156

The management of iridocyclitis with neo-ledercort eye drops

Ophthalmic dept., St. George's Hospital, Bombay, India

Date of Web Publication21-Jan-2008

Correspondence Address:
H K Dordi
Ophthalmic dept., St. George's Hospital, Bombay
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Dordi H K. The management of iridocyclitis with neo-ledercort eye drops. Indian J Ophthalmol 1967;15:153-6

How to cite this URL:
Dordi H K. The management of iridocyclitis with neo-ledercort eye drops. Indian J Ophthalmol [serial online] 1967 [cited 2023 Jun 6];15:153-6. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1967/15/4/153/38798

Table 1

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Table 1

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Irdocyclitis is a condition which is frequently seen in ophthalmic practice. The management of this condition poses a problem in certain cases. Among the numerous agents employed the most commonly used are corticos­teroids. A new formulation, i.e. Neo-­Ledercort eye drops was made avail­able to us for a clinical trial in iridocy­clitis. Neo-Ledercort eye drops con­tains triamcinolone acetonide hemi­succinate 0.1 per cent, neomycin sul­fate 0.35 per cent and phenylmercuric acetate as a preservative. The prepara­tion is reported to be fairly stable in aqueous solution. Rooney (1966).

Amongst the few published reports on the use of these drops in ophthal­mological practice, Ortiz de Fresco (1966) and Rooney (1965) report good results with Neo-Ledercort drops in their series of cases.

  Material and Method Top

This report comprises a study of 105 patients who had iridocyclitis of varied etiology as shown in the accompanying table. These patients were seen as indoor and outdoor patients who at­tended the Ophthalmological Depart­ment of the St. George's Hospital and the K. B. Haji Bachooali Ophthalmic Hospital, Bombay. There were 77 males and 28 females ranging in age from 12 to 72 years.

All patients were asked to instil Neo-Ledercort drops in the affected eye. On an average, usually 1 drop was instilled 4 to 6 times a day for a period of approximately 7 days. In a few cases where the condition was quite severe, the drops were instilled 8 to 10 times daily for about 15 to 20 days. Atropine sulphate, 1 per cent, for its mydriatic effect was used in every case until clinical signs did not warrant its further continuance. In a few cases (as detailed below), anti­biotics either locally or systemically were also given. In this series, eight patients, after a period of observation, did not report for check-up, and the ultimate results of therapy in them could not be assessed.[Table - 1]

  Results Top

In all patients, the response was im­mediate in relieving the symptoms; im­provement in clinical signs occurred later. In a few cases, therapy was irregular probably because the patients felt better; eight patients as mentioned above were lost on follow-up.

Among the 49 cases with non-speci­fic iridocyclitis, marked amelioration and eventual complete relief was ob­tained in 40 cases. In two of these cases improvement was evident after the 3rd and 4th instillation; in another 2 cases, improvement was noticed on the day after instillation of 'Neo-Leder­cort' was started. On an average, in 2 to 3 days, congestion was reduced by about 80 to 90 per cent in this group of patients; the medication was how­ever given on an average for a total duration of about 7 days. However, in 6 cases recurrence of iridocyelitis oc­curred after an initial period of im­provement whilst under observation; persistence of the medication for a longer period of time usually controlled this condition. Finally, no assessment could be made in 3 cases as although improvement was evident after 2 to 4 days, these cases were lost on follow­up.

Twentyfive cases from the post­operative iridocyclitis group were pa­tients in whom iridocyclitis developed after cataract operation which were mainly extracapsular. These patients who developed iridocyclitis usually had pain and irritation of the eye and cor­neal haziness. In these cases, Neo­-Ledercort drops were usually instilled 4 to 5 times daily for a period of two to three weeks. Relief was evident within a week. In one of the 25 pa­tients however, therapy was irregular and he was ultimately lost on follow-­up. Of the remaining two cases, one had iridocyclitis following optical iri­dectomy, whilst the other developed iri­docyclitis following removal of a cor­neal foreign body. This latter patient was initially asked to instil one drop of Neo-Ledercort 4 times daily. He felt better on the 3rd day, but following a recurrence on the 4th day, medication was increased to 2 drops 6 times a day; he was completely relieved by the 15th day.

Among the 17 cases of traumatic iridocyclitis, complete relief was ob­tained from 2 to 10 days in 16 of these cases; results of the remaining case could not be assessed as therapy was irregular and discontinued though the patient reported amelioration of symp­toms after 5 days of therapy with Neo­-Ledercort drops. Depending on the se­verity of the inflammation, the total duration of therapy varied from 5 to 15 days, on an average it was about 8 days. In 13 of these 16 cases no ad­juvant therapy was used; however in the remaining 3 cases, antibiotics were given systemically. It is interesting to record that 3 of these 13 cases were formerly unsuccessfullly treated with other antibiotic and corticosteroid pre­parations.

In the group of 4 cases of traumatic iridocyclitis with cataract formation, 'Neo-Ledercort' was first used for a period of 10 to 15 days to control the inflammation (two of these patients were also given antibiotics systemical­ly). Three of these four cases were sub­sequently operated for cataract and 'Neo-Ledercort' was re-started a week after the operation although there was no evidence of iridocyclitis, and con­tinued for a period of about 15 days. All these 3 cases made an uneventful recovery. The "protective action" of `Neo-Ledercort' in these cases was striking. The fourth case felt better within 5 days of 'Neo-Ledercort' therapy, but therapy was later inter­rupted and the patient did not return for the operation.

In the two cases of iridocyclitis with hypopyon, in addition to 'Leo-Leder­cort,' penicillin ointment was used in one, and systemic antibiotics in the other. Clearing of the lesions was very rapid, occurring in 2 and 5 days res­pectively. Both cases were completely relieved at the end of 8 and 15 days respectively of 'Neo-Ledercort' therapy.

One of the cases of adherent leucoma with iridocyclitis did not return for check-up and hence the result of 'Neo­-Ledercort' therapy could not be assess­ed. The other case who had an old adherent leucoma with persistent iri­docyclitis had unsuccessfully used another similar preparation for 10 days previously, but felt better after 5 days of `Neo-Ledercort' therapy. Clinically, congestion and irritation was much less and was completely relieved at the end of 10 days.

In the two cases of secondary glau­coma with iridocyclitis, a slightly higher dosage of `Neo-Ledercort' (2 drops 4 to 6 times a day) was used. Unfortunately, therapy was interrupted in both these cases. However, one case felt better after the first day though he had a recurrence of iridocyclitis later; whilst the other case had a 75 per cent improvement after 5 days (he was also given Diamox).

The case of keratoconjunctivitis with iridocyclitis had been unsuccess­fully treated with injections of strepto­pencillin, but relief was complete after 10 days of 'Neo-Ledercort' therapy. Similarly, the case of old corneal ulcer with iridocyclities had been unsuccess­fully treated for a month with another medication, but was completely relieved after 15 days of 'Neo-Ledercort' therapy.

None of the patients complained of any side-effects after instillation of 'Neo-Ledercort' drops.

  Discussion Top

From the results given above, it is evident that Neo-Ledercort drops have proved an effective remedy in the ma­nagement of iridocyclitis. If the eight cases (see Table) who were lost on follow-up and whose results of therapy could not be assessed are eliminated, the relief rate is about 93 per cent. The largest group treated was of non­specific iridocyclitis, followed by post­operative iridocylitis and traumatic iridocyclitis. None of the 40 cases of non-specific iridocyclitis group which are indicated as completely relieved in the Table developed any recurrence during the 12 months of period of the above trial. Recurrences, however, did take place in 6 cases during the period of the trial, but these were controlled when therapy was prolonged. Neo-­Ledercort drops have been extremely beneficial in the post-operative iridocy­clitis group where symptoms like pain and irritation, and signs like congestion and corneal haziness have subsided in a very short interval, after instillation of the drops. It is our impression that regression of the signs and symptoms mentioned above have been quickest with Neo-Ledercort drops than that of any other corticosteroid drops avail­able. A prompt relief in iridocyclitis was observed in the group of 4 cases with traumatic iridocyclitis with cata­ract. In 3 of these cases, Neo-Ledercort drops were used after their cataract was operated though there was no evidence of iridocyclitis. In this instance, Neo­-Ledercort drops were instilled as a protective agent. Among the other groups, a very striking relief was ob­tained in a patient with an old ad­herent leucoma with persistent iridocy­clitis who was previously unsuccessfully treated with other agents.

  Summary Top

1. The results of a trial on 105 cases of iridocyclitis of varied etiology treated with Neo-Ledercort drops, a new ophthalmic preparation con­taining triamcinolone and neomycin, are recorded.

2. Relief from pain was obtained within 4 to 5 instillations and congestion reduced by 80 to 90 per cent in 2 to 3 days. The total duration of treatment varied; on an average it was 7 days.

3. A total of seven recurrences were observed, one in a case of glaucoma and six in the group with non­specific iridocyclitis; these subsided when therapy was persisted for a longer time.

  Acknowledgement Top

Our thanks are due to Lederle Division, Cyanamid India Limited, who supplied us Neo-Ledercort Eye Drops.[2]

  References Top

Ortiz de Fresco, M. V., (1965) Revista Medica De Paraguay, 7: 15-18.  Back to cited text no. 1
Rooney: J. T.: (1966) The Practitioner, 197: 667-670.  Back to cited text no. 2


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