Szemészet, 1975 (112. évfolyam, 1-3. szám)
1975 / 3. szám
It was moreover shown that sodium ascorbate, as a 20% solution in watej at blood pH (7.2—7.4), in doses of 0.5 to 1 g/Kg body weight, was one of the most effective osmotic diuretics in reducing both intraocular and intracranial pressure (Virno et ah, 1965, 1966). Our data were successively confirmed by Suzuki et al. (1966, 1967), Hilsdorf (1967), Ikeda et ah (1968), and Reddy et ah (1969). The therapeutic effects of the glycerol-sodium ascorbate solution were recently emphasized by Tams (1971) and by Tsun Мои et ah (1975). No untoward side-effects were noted. However, the preparation of the glycerolsodium ascorbate solution presented considerable difficulties, as sodium ascorbate, at the pH employed and in presence of oxygen, is likely to oxidize with the passing of time. In recent time, the intravenous clinical use of glycerol -has been successfully applied in the treatment of cerebral edema due to acute cerebral infarction (Meyer et ah, 1971; Lebkowski et ah, 1970; Mathew et ah, 1972; Reinglas, 1974). These authors observed an impressive neurological improvement in patients submitted to continuous intravenous infusions of 10% glycerol diluted in 0.9% saline and no toxic side-effects were noted. Moreover, Holtman (1973), and El-Shewi et ah, (1974) reported beneficial effects on the intraocular pressure using intravenous glycerol diluted in saline. Actually, we fully agree with these authors as far as the intraocular and intracranial hypotensive action is concerned, but we warn against the clinical use of intravenous glycerol at the concentration of 10% in normal saline, because of the occurrence of hematuria and hemoglobinuria. Also Hagnevik et ah (1974) stated in man that “the intravenous administration of 20% glycerol in isotonic saline can result in a dangerous degree of hemolysis which can lead to serious renal damage”. This was supported by Welch (1974) too. With the aim of finding an intravenous glycerol solution which could meet the ^requirements both of the ophthalmological and neurosurgical application, we resumed our studies on the possibility of associating glycerol to sodium ascorbate, a drug which has proven able to protect against the hematuria induced by the drug and to enhance its osmotic effect. A series of biochemical investigations were carried out in order to prepare a stable glycerol-sodium ascorbate solution (Virno et ah, 1975). In this study we investigated the effects of a 10% glycerol + 10% sodium ascorbate solution, administered intravenously, as an osmotic agent in the treatment of ocular hypertension and prior to ocular surgery. Besides controling the ocular tension, we studied the behaviour of serum osmolality, natremia, kalemia and blood sugar levels; urine was also analyzed. MATERIALS AND METHODS Preparation of 10% glycerol + 10% sodium ascorbate solution Composition: — glycerol — 1-ascorbic acid — sodium bicarbonate — phenol — thyoglycerol g 10,000 g 10,000 g 4,750 g 0,050 g 0,200 — sodium hydrate 2% solution: the amount necessary to obtain a pH of 7.4 bidistilled water: enough to make 100 ml 166
