ESCRS Homepage

November 2002
IN THIS ISSUE

Wavefront seeks a higher order of vision correction
New laser system for intraoperative measurement of LASIK flap thickness
Visual prostheses use neurotransmitter retinal chips to stimulate retinal function
Wavefront emerges as powerful tool for night vision
Allegretto promising for hyperopia and hyperopic astigmatism
Topography's role in wavefront systems
IOP measurement after LASIK may be unreliable
LASEK may only play support on refractive stage
Solid-state laser PRK yields favourable results for myopia
GTS-assisted DLK useful alternative to PK for keratoconus
Glaucoma common after PK bodes poorly for visual outcome
Classic drawbacks of PRK succumb to new strategies
New insight into LASIK dry eye pathogenesis
Use of anti-inflammatories after capsulotomy questioned
Good quality training leads to good quality cataract surgery
One line of regained visual acuity is a snip at just €120
Mitomycin-C provides effective haze prophylaxis
Long-term concerns linger on safety of Mitomycin-C
German politicos promise health reforms
Honey forms biblical basis for corneal oedema
Routine two-step LASIK after PK unnecessary
Plasma knife provides clean and accurate cut for capsulorhexis
Glaucoma therapy targets apoptosis and trabecular meshwork
Viscocanalostomy viable choice for cataract-glaucoma
Device allows needle-free injections into smallest vessels
New river blindness therapy may provide panacea for 18m people
Daytime running lights may soon be compulsory in all EU states
Intracorneal lamellar implants still a questionable option
Aqualase system viable for small incision cataract removal
Unilateral von-Hippel disease with optic nerve head
FEATURES
From The Editor
Reflections on Refractive Surgery
In Your Good Books
An Eye On Travel
Bio-ophthalmology
Outlook on Industry
Regulatory Matters



Honey forms biblical basis for corneal oedema

By Ana Hidalgo-Simón MD, PhD

NICE - As medications go, honey is easily affordable and readily available. But it also has antimicrobial and hyperosmotic properties that could effectively be used to clear corneal oedema, according to a report at the XX ESCRS Congress Breaking News session.

"Honey has therapeutic potential, particularly in relation to the eye. According to the Bible, 'honey lightens the eye of man'," Ahmad Mansour MD said.
The product has a long history as a medical remedy. It was a common component in many therapies among the ancient Egyptians. Indeed, it is mentioned 500 times in 900 remedies - including eye remedies - in the literature of the time, Dr Mansour said.

Traditional medicine in many parts of the world takes advantage of honey's antibiotic and wound healing properties. In eye therapy, honey has been used as a viscoelastic agent and to treat infections, mainly of the conjunctiva and eyelids.

"Because of its antibacterial activity and because it is an hyperosmotic milieu, we thought of using it as an hyperosmotic agent in the treatment of epithelial corneal oedema," he explained.

In a prospective study, Dr Mansour treated 32 consecutive patients with epithelial corneal oedema who were not candidates for penetrating keratoplasty (PK) or other surgical interventions.

After informed consent, a drop of honey was applied topically to the eye with a sterile cotton applicator.
The effect was quick. The cornea cleared of oedema almost immediately and visual acuity improved considerably in all patients treated.
But it was short lasting. The clearing effect lasted only about an hour. Dr Mansour then showed the patients how to apply the honey and told them to do it four or five times daily.

All patients experienced initial stinging in the treated eye but with repeated use the discomfort became minimal.
The patients in which this therapy was most useful were those unfit for surgery. Those with severe heart disease or disabling corneal oedema are examples of unfit candidates.
In these cases the visual acuity improvement could be from counting fingers to near normal vision.

An added advantage of rapid clearing of the cornea was that the posterior segment of the eye could then be explored, allowing further therapy in necessary cases.
The quality and the characteristics of honey vary substantially with regional production. Colour and consistency can also be important factors when selecting honey for eye treatment. According to Dr Mansour, honey is actually more hyperosmotic than it is necessary to clear corneal oedema.

"Apart from its hyperosmotic properties, honey contains inhibin, an enzyme with antimicrobial activity and hygroscopic properties. It has antiviral, antiamoebal and antibacterial activity," he said.

He added that honey improved visual acuity as much as other similar treatments. It is cheap, widely available, contains no preservatives and does not produce allergies.
One concern is a potential link to botulism. Honey does not support bacterial life but it may contain spores of some pathogens. Although the link has not been proven, Dr Mansour did advise against honey eye treatment in children.

"In future, we are planning to use transparent honey which is less hyperosmotic for corneal hydrops and painful epithelial bullae. It could also be used for epithelial corneal oedema during extended surgery where corneal oedema is likely to occur," he said.

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